Setting definitions of childhood asthma in epidemiologic studies

Silva, Diana; Severo, Milton; Paciência, Inês; Rufo, João Cavaleiro; Martins, Carla; Moreira, Pedro; Padrão, Patrícia; Delgado, Luís; Moreira, André

doi:10.1111/pai.13111

Cited by 21 publications

(21 citation statements)

References 22 publications

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“…Asthma was defined using a gold standard definition based on a positive bronchodilation (BD) defined as at least 12% and over 200mL increase in FEV1 after inhaling 400 μg of salbutamol; or had self-reported medical diagnosis of asthma with symptoms (wheezing, dyspnea or dry cough) in the previous year [12]. Additionally, different asthma phenotypes were created based on classical definitions that involved several asthma features and traits [13]: i) allergic asthma, defined by positive skin prick tests (SPT); ii) eosinophilic asthma, defined by exhaled nitric oxide above 35 ppb; iii) obese asthma, defined by overweight or obesity; iv) persistent asthma, defined by current use of anti-asthma medication; v) symptomatic asthma, defined by current symptoms; vi) positive bronchodilation with asthma symptoms (BD+S+); vii) positive bronchodilation without asthma symptoms (BD+S-); and viii) negative bronchodilation with asthma symptoms (BD-S+).…”

Section: Methodsmentioning

confidence: 99%

Development and validation of exhaled breath condensate microRNAs to identify and endotype asthma in children

et al. 2019

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Detection and quantification of microRNAs (miRNAs) in exhaled breath condensate (EBC) has been poorly explored. Therefore we aimed to assess miRNAs in EBC as potential biomarkers to diagnose and endotype asthma in school aged children. In a cross sectional, nested case control study, all the asthmatic children (n = 71) and a random sample of controls (n = 115), aged 7 to 12 years, attending 71 classrooms from 20 local schools were selected and arbitrarily allocated to the development or validation set. Participants underwent skin-prick testing, spirometry with bronchodilation, had exhaled level of nitric oxide determined and EBC collected. Based on previous studies eleven miRNAs were chosen and analyzed in EBC by reverse transcription-quantitative real-time PCR. Principal component analysis was applied to identify miRNAs profiles and associations were estimated using regression models. In the development set (n = 89) two clusters of miRNAs were identified. After adjustments, cluster 1 and three of its clustered miRNAs, miR-126-3p, miR-133a-3p and miR-145-5p were positively associated with asthma. Moreover miR-21-5p was negatively associated with symptomatic asthma and positively associated with positive bronchodilation without symptoms. An association was also found between miR-126-3p, cluster 2 and one of its clustered miRNA, miR-146-5p, with higher FEF25-75 reversibility. These findings were confirmed in the validation set (n = 97) where two identical clusters of miRNAs were identified. Additional significant associations were observed between miR-155-5p with symptomatic asthma, negative bronchodilation with symptoms and positive bronchodilation without symptoms. We showed that microRNAs can be measured in EBC of children and may be used as potential biomarkers of asthma, assisting asthma endotype establishment.

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Section: Methodsmentioning

confidence: 99%

Development and validation of exhaled breath condensate microRNAs to identify and endotype asthma in children

et al. 2019

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“…In fact, in the present study, among children with higher eNO ( n = 75), only 18 have asthma defined by self-reported medical diagnosis with reported symptoms (wheezing, dyspnea, or dry cough) occurring in the past 12 months or positive bronchodilation (data not shown). Moreover, our group previously showed that eNO had very low diagnostic accuracy for asthma [ 53 ]. Nonetheless, the mechanisms that led its production, either to be a mediator of cell damage or a mechanism of defense under pro-oxidant environments, are not completely understood [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

The Influence of Eating at Home on Dietary Diversity and Airway Inflammation in Portuguese School-Aged Children

Castro-Mendes

Cunha

Paciência

et al. 2021

IJERPH

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Considering the negative impact of a lack of dietary diversity on children’s nutritional status, we aimed to describe dietary variety according to eating at home frequency and assessed its association with respiratory outcomes in school-aged children. This cross-sectional study included 590 children (49% girls) aged 7 to 12 years from 20 public schools located in city of Porto, Portugal. Daily frequency of eating at home groups were calculated and dietary diversity was calculated using a 10-food group score from a 24 h recall questionnaire. Spirometry and exhaled nitric oxide levels (eNO; <35 and ≥35 ppb) were assessed. The comparison of diet diversity according to the groups was performed by ANOVA and ANCOVA. The association between dietary diversity and respiratory outcomes was examined using regression models. In multivariate analysis, children in the highest group of eating at home episodes (≥4 occasions) obtained the lowest dietary diversity mean score, while the lowest group (<2) had the highest mean score (p-value 0.026). After adjustment for confounders, higher diet diversity (≥5 food groups) significantly decreased the odds of having an eNO ≥35. Diet diversity might decrease the chance of airway inflammation among children. However, having more eating episodes at home could be a barrier to a more diverse diet.

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“…However, compared to direct measures, self-reported methods may be able to represent the type of activity that is undertaken [47]. Although current asthma was not diagnosed by a physician, the used criteria in this study included a standardized operational definition of asthma supported by objective lung function measurements [48]. Another limitation of our study is the fact that food intake was evaluated using questionnaires, which can lead to bias.…”

Section: Discussionmentioning

confidence: 99%

Dietary Acid Load: A Novel Nutritional Target in Overweight/Obese Children with Asthma?

et al. 2019

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Obesity has been repeatedly linked to asthma, and several potential mechanisms have been proposed in the etiologies of the obese-asthma phenotype. Considering that lungs play an important role in systemic pH and acid–base regulation, are a key organ in asthma development, and that nutritional inadequacy of several nutrients and high dietary acid load can affect airway inflammation and reactivity, we aimed to test the hypothesis that dietary acid load may be associated with asthma in children. Data on 699 children (52% females), aged 7–12 years, were analyzed. Anthropometric measurements were performed to assess body mass index. Dietary acid load was calculated using potential renal acid load (PRAL) equations from a 24 h dietary recall administrated to children. Adjusted PRAL for total energy intake was applied with the use of the residual method. Lung function and airway reversibility were assessed with spirometry. Asthma was defined by a positive bronchodilation or self-reported medical diagnosis with reported symptoms (wheezing, dyspnea, or dry cough) in the past 12 months. After adjustment for energy intake, sex, age, parent’s education level, and physical activity, positive and significant associations were found between asthma and PRAL [odds ratio (OR) = 1.953, 95% CI = 1.024, 3.730) in overweight/obese children. Our findings suggest that dietary acid load might be a possible mechanism in overweight/obese-asthma phenotype development.

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Setting definitions of childhood asthma in epidemiologic studies

Cited by 21 publications

References 22 publications

Development and validation of exhaled breath condensate microRNAs to identify and endotype asthma in children

Development and validation of exhaled breath condensate microRNAs to identify and endotype asthma in children

The Influence of Eating at Home on Dietary Diversity and Airway Inflammation in Portuguese School-Aged Children

Dietary Acid Load: A Novel Nutritional Target in Overweight/Obese Children with Asthma?

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