Pediatric Inflammatory Diseases of the Respiratory Tract: Asthma

哮喘的发作通常发生在儿童时期;当儿童患有特应性时，儿童更有可能在成年后继续患有哮喘。 哮喘等疾病在儿童中的患病率较高;改变儿童过敏性疾病发病率的管理可能会影响未来几年的疾病结局。 本研究探讨了过敏或免疫功能障碍引起的呼吸道疾病患儿的炎症检测技术。重点是非侵入性方法。我们将使用收集的信息来确定是否有炎症标志物可以诊断或代表疾病的严重程度，从而在管理中有用。 初步数据支持无症状哮喘儿童持续气道炎症的概念。它也支持现有的使用一氧化氮作为气道炎症的标志物，可能与或可能不相关的支气管收缩，如肺量测定法所证明的。此外，与气道炎症相关的呼出一氧化氮升高可能与气道pH值降低有关，这在哮喘急性发作期间已有记录。在健康匹配的对照组中未显示类似的模式。 值得注意的是，对呼出气冷凝液的一小部分代表性样品进行了几种炎性细胞因子的分析，结果尚未确定。 我们正在完成这项纵向研究的数据收集，该研究对哮喘儿童和健康对照组的气道炎症进行了无创测量。

The onset of asthma is often during childhood; and when the child is atopic, the child is more likely to continue to have asthma as an adult. Diseases such as asthma have a higher prevalence in childhood; and management that alters the morbidity of allergic diseases in children may impact disease outcomes in future years. This study examines techniques for the detection of inflammation in children with respiratory diseases due to allergy or immunologic dysfunction. Emphasis is on non-invasive methods. We will use information gathered to determine if there are inflammatory markers that may be diagnostic or representative of disease severity, and thus useful in management. Preliminary data supports the concept of ongoing airway inflammation in asymptomatic children with asthma. It also supports the existing use of nitric oxide as a marker of airway inflammation that may or may not correlate with bronchoconstriction as demonstrated by spiromertry. Furthermore, an elevated expired nitric oxide seen in association with airway inflammation may be associated with a decrease in airway pH, previously documented during an asthma exacerbation. A similar pattern was not demonstrated in healthy matched controls. Of interest, a small representative sample of exhaled breath condensate was analyzed for several inflammatory cytokines and the results are pending. We are completing the data collection in this longitudinal study of non-invasive measurements of airway inflammation in children with asthma and healthy-matched controls.