A Single Measure of FEV 1 Is Associated With Risk of Asthma Attacks in Long-term Follow-up

Kitch, Barrett T.; Paltiel, A. David; Kuntz, Karen M.; Dockery, Douglas W.; Schouten, Jan P.; Weiss, Scott T.; Fuhlbrigge, Anne L.

doi:10.1378/chest.126.6.1875

Cited by 144 publications

(97 citation statements)

References 32 publications

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“…It is of utmost importance to reveal a biomarker of future risk due to insufficiency of traditional tools in assessment of the likelihood of asthma exacerbation. Namely, the limitations of lung function measurements have been seen in Childhood Asthma Management Program study where at baseline mean FEV1 % predicted was more than 93% among this pediatric population, and yet approximately one third of the children had asthma exacerbation 6 months after enrollment [26]. In accordance with that result, in our study, 53.3% of patients with asthma exacerbation in future had FEV1 % predicted >90%.…”

Section: Discussionsupporting

confidence: 87%

Association of Asthma Symptoms and Exacerbation with Inflammatory Biomarkers

Navratil¹,

Jureković²,

Topalušić³

et al. 2017

Clin Pediatr OA

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Objective: To investigate a relationship of asthma symptoms and exacerbations with systemic (high-sensitivity Creactive protein (hs-CRP), eosinophilic cationic protein (ECP), leukocytes) and local (exhaled NO (FENO), pH and urates in exhaled breath condensate (EBC) and exhaled breath temperature (EBT)) inflammatory biomarkers (BMs) in asthmatic children. Methods:This cross-sectional study comprised 93 consecutive asthmatic patients (age 6-18 years, 22 girls) with mild intermittent asthma ([IA], N=44) and mild to moderate persistent asthma ([PA], N=49). Medical history (asthma symptoms and exacerbation), pulmonary function, FENO, EBT, samples of exhaled breath and peripheral blood were collected.Results: Local BMs (EBC urates and EBT) showed stronger correlation with asthma symptoms then systemic BMs (hs-CRP, blood count with differencials) (r=0.26-0.68, r=0.06-0.32, p<0.05; respectively). Single measurements of inflammatory BMs are not good predictors for future asthma exacerbation (binary logistic regression; χ²=13.9; df=11; p=0.238). Conclusion:Study of combination of various exhaled breath and exhaled breath condensate BMs should continue, especially in longitudinal studies with repeated measurements of BMs.

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Section: Discussionsupporting

confidence: 87%

Association of Asthma Symptoms and Exacerbation with Inflammatory Biomarkers

Navratil¹,

Jureković²,

Topalušić³

et al. 2017

Clin Pediatr OA

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“…A previous study in Latino Americans showed that asthma severity might be influenced by ancestry in Mexican Americans . Recognizing that there is no single measure that accurately captures all facets of asthma severity, pre-FEV 1 percent predicted has several advantages as a marker of asthma severity, including its objectivity and reproducibility (Enright et al 1991;Enright et al 1994;Kitch et al 2004). …”

Section: Discussionmentioning

confidence: 99%

Admixture-matched case-control study: a practical approach for genetic association studies in admixed populations

et al. 2005

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Case-control genetic association studies in admixed populations are known to be susceptible to genetic confounding due to population stratification. The transmission/disequilibrium test (TDT) approach can avoid this problem. However, the TDT is expensive and impractical for late-onset diseases. Case-control study designs, in which cases and controls are matched by admixture, can be an appealing and suitable alternative for genetic association studies in admixed populations. In this study, we applied this matching strategy when recruiting our African American participants in the Study of African American, Asthma, Genes and Environments (SAGE). Group admixture in this cohort consists of 83% African ancestry and 17% European ancestry, which was consistent with reports from other studies. By carrying out several complementary analyses, our results show that there is substructure in the cohort, but that the admixture distributions are almost identical in cases and controls, and also in cases only. We performed association tests for asthma-related traits with ancestry, and only found that FEV 1 , a measure for baseline pulmonary function, was associated with ancestry after adjusting for socio-economic and environmental risk factors (P = 0.01). We did not observe an excess of type I error rate in our association tests for ancestry informative markers (AIMs) and asthma-related phenotypes when ancestry was not adjusted in the analyses. Furthermore, using the association tests between genetic variants in a known asthma candidate gene, β 2 adrenergic receptor (β 2 AR) and ΔFEF 25-75 , an asthma-related phenotype, as an † Correspondence and reprint requests should be addressed to:

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“…For example, the use of LABA alone may offer false reassurance by improving symptoms, morning PEF [29,30] and even composite control scores [30] but, because they do not treat the underlying disease process, they expose the patient to a greater risk of exacerbations [29]. In addition, several pathological and physiological markers have been shown to predict future risk of exacerbations [31][32][33][34][35][36][37] or loss of lung function [38,39] independently of features of clinical control. Furthermore, treatment algorithms based on AHR [40], sputum eosinophils [41,42] or exhaled nitric oxide [43,44] have shown benefit in terms of reduced exacerbations and/or reduced medication requirements, when compared with, or added to, algorithms based on the assessment of current clinical control.…”

Section: Is the Assessment Of Clinical Asthma Control Sufficient?mentioning

confidence: 99%

A new perspective on concepts of asthma severity and control

Taylor¹,

Bateman²,

Boulet³

et al. 2008

European Respiratory Journal

409

321

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Concepts of asthma severity and control are important in the evaluation of patients and their response to treatment but the terminology is not standardised and the terms are often used interchangeably. This review, arising from the work of an American Thoracic Society/European Respiratory Society Task Force, identifies the need for separate concepts of control and severity, describes their evolution in asthma guidelines and provides a framework for understanding the relationship between current concepts of asthma phenotype, severity and control.''Asthma control'' refers to the extent to which the manifestations of asthma have been reduced or removed by treatment. Its assessment should incorporate the dual components of current clinical control (e.g. symptoms, reliever use and lung function) and future risk (e.g. exacerbations and lung function decline).The most clinically useful concept of asthma severity is based on the intensity of treatment required to achieve good asthma control, i.e. severity is assessed during treatment. Severe asthma is defined as the requirement for (not necessarily just prescription or use of) highintensity treatment. Asthma severity may be influenced by the underlying disease activity and by the patient's phenotype, both of which may be further described using pathological and physiological markers. These markers can also act as surrogate measures for future risk.

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A Single Measure of FEV 1 Is Associated With Risk of Asthma Attacks in Long-term Follow-up

Cited by 144 publications

References 32 publications

Association of Asthma Symptoms and Exacerbation with Inflammatory Biomarkers

Association of Asthma Symptoms and Exacerbation with Inflammatory Biomarkers

Admixture-matched case-control study: a practical approach for genetic association studies in admixed populations

A new perspective on concepts of asthma severity and control

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