Viral infection and allergy status impact severity of asthma symptoms in children with asthma exacerbations.
Viral infection and allergy status impact severity of asthma symptoms in children with asthma exacerbations.
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DOI：
10.1016/j.anai.2022.06.017
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发表时间：
2022-09
影响因子：
5.9
通讯作者：
Kennedy, Joshua L.
中科院分区：
文献类型：
--
作者：
Dinwiddie, Darrell L.;Kaukis, Nicholas;Pham, Sarah;Hardin, Olga;Stoner, Ashley N.;Kincaid, John C.;Caid, Katherine;Kirkpatrick, Catherine;Pomeroy, Kelsi;Putt, Claire;Schwalm, Kurt C.;Thompson, Tonya M.;Storm, Elizabeth;Perry, Tamara T.;Kennedy, Joshua L.
虽然已知病毒感染与哮喘加重有关，但先前的研究尚未确定病毒相关性哮喘加重(VRAE)急性症状严重程度的可靠预测因素。目的：确定哮喘控制和病毒感染对当前疾病严重程度的影响，并评估与哮喘急性发作症状相关的生物标志物。我们前瞻性地招募了120名患有哮喘和当前喘息的儿童，他们到阿肯色州儿童医院急诊科就诊。哮喘控制试验(ACT)对哮喘进行分层控制(ACT>；19)和未控制(ACT≤；19)，而儿科呼吸道症状评分评估症状。取鼻咽拭子进行病毒分析，用鼻滤纸片和Luminex试剂盒检测炎症介质。哮喘控制组33例，未控制组87例。在未得到控制的哮喘患者中，77%的患者在VRAE期间感染了病毒，而控制哮喘的患者中这一比例为58%。与患有VRAE的对照组或未感染病毒的对照组相比，VRAE非控制组的症状更为严重。有VRAE和变态反应的非控制组急性症状评分最高(3.363分，P=0.04)。症状积分越高的哮喘儿童Periostin越多(P=0.02)。呼吸道病毒的检测在那些未得到控制的哮喘患者中很常见。携带病毒的未受控制的受试者在病情恶化期间会有更严重的症状，特别是那些有过敏反应的人。Periostin在症状最严重的受试者中最高，与对照状态无关。综上所述，这些数据表明，当考虑到哮喘急性发作期间的急性哮喘症状和鼻部炎症时，未控制哮喘的受试者的病毒感染和过敏之间存在协同作用。
Although viral infection is known to be associated with asthma exacerbations, prior research has not identified reliable predictors of acute symptom severity in virus-related asthma exacerbations (VRAEs). To determine the effect of asthma control and viral infection on the severity of current illness and evaluate biomarkers related to acute symptoms during asthma exacerbations. We prospectively enrolled 120 children with physician-diagnosed asthma and current wheezing who presented to Arkansas Children’s Hospital emergency department. The asthma control test (ACT) stratified controlled (ACT > 19) and uncontrolled (ACT ≤ 19) asthma, whereas pediatric respiratory symptom scores evaluated symptoms. Nasopharyngeal swabs were obtained for viral analysis, and inflammatory mediators were evaluated by nasal filter paper and Luminex assays. There were 33 children with controlled asthma and 87 children with uncontrolled asthma. In those with uncontrolled asthma, 77% were infected with viruses during VRAE compared with 58% of those with controlled asthma. Uncontrolled subjects with VRAE had more acute symptoms compared with the controlled subjects with VRAE or uncontrolled subjects without a virus. The uncontrolled subjects with VRAE and allergy had the highest acute symptom scores (3.363 point pediatric respiratory symptom; P = .04). Children with asthma with higher symptom scores had more periostin (P = .02). Detection of respiratory viruses is frequent in those with uncontrolled asthma. Uncontrolled subjects with viruses have more acute symptoms during exacerbations, especially in those with allergy. Periostin was highest in subjects with the most acute symptoms, regardless of control status. Taken together, these data imply synergy between viral infection and allergy in subjects with uncontrolled asthma when considering acute asthma symptoms and nasal inflammation during an exacerbation of asthma.
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影响因子：
4.6
作者：
Ninomiya T;Noguchi E;Haruna T;Hasegawa M;Yoshida T;Yamashita Y;Okano M;Yoshida N;Haruna S;Sakuma Y;Ohta S;Ono J;Izuhara K;Okada M;Kidoguchi M;Tokunaga T;Okamoto M;Kanno M;Sakashita M;Takabayashi T;Narita N;Fujieda S
通讯作者：
Fujieda S
DOI：
10.1165/rcmb.2019-0004oc
发表时间：
2020-03-01
影响因子：
6.4
作者：
Parikh, Vishal;Scala, Jacqueline;Koziol-White, Cynthia J.
通讯作者：
Koziol-White, Cynthia J.
DOI：
10.1164/ajrccm.159.3.9801052
发表时间：
1999-03-01
影响因子：
24.7
作者：
Rakes, CP;Arruda, E;Heymann, PW
通讯作者：
Heymann, PW
影响因子：
5.8
作者：
Conroy DM;Williams TJ
通讯作者：
Williams TJ
DOI：
10.1016/j.jaci.2006.08.041
发表时间：
2007-03
期刊：
The Journal of allergy and clinical immunology
影响因子：
--
作者：
Khetsuriani N;Kazerouni NN;Erdman DD;Lu X;Redd SC;Anderson LJ;Teague WG
通讯作者：
Teague WG