Pediatric Inflammatory Diseases of the Respiratory Tract: Asthma

哮喘的发病通常发生在儿童时期；当儿童出现特应性时，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果。 这项研究考察了因过敏或免疫功能障碍而患有呼吸道疾病的儿童的炎症检测技术。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，从而对管理有用。 初步数据支持无症状哮喘儿童持续呼吸道炎症的概念。它还支持现有使用一氧化氮作为呼吸道炎症的标志物，该炎症可能与支气管收缩有关，也可能不与肺部收缩相关，如肺活量测定所示。此外，与呼吸道炎症相关的过期一氧化氮升高可能与以前在哮喘加重期间记录的呼吸道pH值下降有关。在健康的配对对照组中没有表现出类似的模式。 有趣的是，呼气冷凝液的一小部分代表性样本被分析了几种炎性细胞因子，结果还在等待中。 我们正在完成这项非侵入性测量哮喘儿童和健康对照儿童呼吸道炎症的纵向研究中的数据收集。

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.