The First 1000 Days: Impact of Prenatal Tobacco Smoke Exposure on Hospitalization Due to Preschool Wheezing

Collet, Cyrielle; Fayon, Michaël; Francis, F; Galode, François; Bui, Stéphanie; Debelleix, Stéphane

doi:10.3390/healthcare9081089

Cited by 6 publications

(5 citation statements)

References 36 publications

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“…For most drugs, within a certain dose range, the dose of drugs is directly proportional to the effect ( Qian et al, 2021 ; Zhang et al, 2021 ). However, due to the influence of multiple factors (including constitution, age, and gender) in the population, there are individual differences in the patient’s response to drugs, which makes the existing dose-response relationship research deviate in clinical practice ( Collet et al, 2021 ; Vakilian et al, 2021 ). It is necessary to establish a new study model of the dose-effect relationship for TCM.…”

Section: Introductionmentioning

confidence: 99%

Dosage Modification of Traditional Chinese Medicine Prescriptions: An Analysis of Two Randomized Controlled Trials

Zhou

Zheng

et al. 2021

Front. Pharmacol.

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Traditional Chinese medicine (TCM) prescriptions lack standardization due to the complex composition of the prescribed herbs, the unclear mechanism of the formulas, and a lack of scientific data to support the dose-response relationship. Here, we proposed a new clinical strategy of dosage modification for TCM prescriptions to evaluate the clinical efficacy and guide the clinical medication. This study used two TCM prescriptions for the treatment of newly diagnosed type 2 diabetes mellitus (T2DM) to explore the key indications and the most appropriate critical values of dosage modification by analyzing two randomized controlled trials (RCTs). In this study, the indications refer to a change in the indicators from baseline at a certain time point (week 4, week 8, week 12), which could predict the change in outcome indicators, and the critical values refer to the change ranges closely related to the decrease in HbA1c at week 12. In Study 1, the correlation analysis between the change range of indicators at three time points (weeks 4, 8, and 12) from baseline and the decrease in HbA1c at week 12 from baseline (HbA1c 012) was carried out to screen the related indications. Next, we evaluate the related indications and the respective critical values to determine the key indicators, indications, and the most appropriate critical value. We conducted a correlation between the change range of key indicators (obtained from the result of Study 1) at three time points from baseline and HbA1c 012 to screen the key indications in the drug group, high-dose group, and low-dose group in Study 2. Key indications with critical values were determined to investigate the most appropriate critical value in the three groups separately. In Study 1, the key indicator was FBG, the key indication was FBG 04, and the most appropriate critical value was 0.5 mmol/L. In Study 2, the key indication was FBG 04 and the most appropriate critical value was 0.6 mmol/L in the drug group. In the high-dose group, the key indication was FBG 04, and the most appropriate critical value was 0.3 mmol/L. In the low-dose group, the key indication was FBG08, and the most appropriate critical value was 0.1 mmol/L. In addition, we summarized a verification strategy for dosage modification.

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Section: Introductionmentioning

confidence: 99%

Dosage Modification of Traditional Chinese Medicine Prescriptions: An Analysis of Two Randomized Controlled Trials

Zhou

Zheng

et al. 2021

Front. Pharmacol.

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“…The risk was highest in children exposed to both passive smoking and mothers smoking actively during pregnancy [ 171 , 172 ]. In a recent French study, 129 infants under two years admitted to the hospital for acute wheezing were assessed for prenatal smoke exposure [ 173 ]. Children exposed (36.4%) had a longer length of hospital stay, and the authors estimated that smoking one cigarette/day during pregnancy was associated with an increase in hospitalization duration of 0.055 days/month (r = 0.238, p = 0.006) [ 173 ].…”

Section: Resultsmentioning

confidence: 99%

“…In a recent French study, 129 infants under two years admitted to the hospital for acute wheezing were assessed for prenatal smoke exposure [ 173 ]. Children exposed (36.4%) had a longer length of hospital stay, and the authors estimated that smoking one cigarette/day during pregnancy was associated with an increase in hospitalization duration of 0.055 days/month (r = 0.238, p = 0.006) [ 173 ]. Consequences of prenatal and postnatal smoke exposure on wheezing in childhood have also been confirmed in two recent case-control studies [ 174 , 175 ].…”

Section: Resultsmentioning

confidence: 99%

Risk Factors Affecting Development and Persistence of Preschool Wheezing: Consensus Document of the Emilia-Romagna Asthma (ERA) Study Group

Grandinetti

Fainardi

Caffarelli

et al. 2022

JCM

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Wheezing at preschool age (i.e., before the age of six) is common, occurring in about 30% of children before the age of three. In terms of health care burden, preschool children with wheeze show double the rate of access to the emergency department and five times the rate of hospital admissions compared with school-age asthmatics. The consensus document aims to analyse the underlying mechanisms involved in the pathogenesis of preschool wheezing and define the risk factors (i.e., allergy, atopy, infection, bronchiolitis, genetics, indoor and outdoor pollution, tobacco smoke exposure, obesity, prematurity) and the protective factors (i.e., probiotics, breastfeeding, vitamin D, influenza vaccination, non-specific immunomodulators) associated with the development of the disease in the young child. A multidisciplinary panel of experts from the Emilia-Romagna Region, Italy, addressed twelve key questions regarding managing preschool wheezing. Clinical questions have been formulated by the expert panel using the PICO format (Patients, Intervention, Comparison, Outcomes). Systematic reviews have been conducted on PubMed to answer these specific questions and formulate recommendations. The GRADE approach has been used for each selected paper to assess the quality of the evidence and the degree of recommendations. Based on a panel of experts and extensive updated literature, this consensus document provides insight into the pathogenesis, risk and protective factors associated with the development and persistence of preschool wheezing. Undoubtedly, more research is needed to improve our understanding of the disease and confirm the associations between certain factors and the risk of wheezing in early life. In addition, preventive strategies must be promoted to avoid children’s exposure to risk factors that may permanently affect respiratory health.

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“…In the multi-variable analysis, this association was confirmed (β = 0.04, p = 0.04; standardized β = 0.27, p = 0.03). There is thus a dose-effect relationship, without a threshold effect, between prenatal CSE and duration of hospitalization for wheezing in nonpremature infants during the first 2 years of life 18 . Maternal smoking while in utero is associated with poor asthma control in black and Latino subjects assessed at 8-17 years of age 19 .…”

Section: Dose-effect Of Csementioning

confidence: 99%

Iv. Topic Sessions

Forno

2022

Pediatric Pulmonology

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Childhood asthma and obesity are major public health problems, and their prevalence has markedly increased over the past several decades. There is extensive epidemiological, observational, and experimental evidence of an association between obesity and asthma. While in some children both diseases may simply coexist, there is growing awareness of a specific "obesity-related asthma" or "obese asthma" sub-phenotype, in which obesity increases asthma risk and morbidity-including worse asthma severity and control, more frequent exacerbations, reduced response to asthma medications, and poorer quality of life (1) .Much like obesity and asthma, "obese asthma" is a complex phenotype, underpinned by several contributing mechanisms. Obesity may lead to alterations in airway mechanics and lung function. Initial studies in adults described a restrictive deficit with symmetrically reduced FEV1 and FVC and lower lung volumes. However, some studies in children have described an obstructive pattern or airway dysanapsis (2) . Yet, others have described reductions in lung volumes like those seen in adults, suggesting that the consequences of obesity on airway mechanics may differ by age, severity, and duration. A recent study reported accumulation of adipose tissue within the airway walls of obese adults with asthma (3) , which would further explain some of the airflow obstruction seen in this phenotype.Obesity can lead to low-grade systemic inflammation that differs from the classic T2-high airway inflammation most frequently seen in pediatric asthma. Thus, inflammation in obese asthma may differ not just in quality (T2-low vs. T2-high) but also location (systemic vs. centered in the airway) (4) . Obesity has been associated with asthma in children without eosinophilic airway inflammation, but at the same time the coexistence of obesity and high FeNO is linked to worse asthma severity (5) . Systemic inflammation in obese asthma is mediated by adipokines such as leptin, and altered immune profiles including Th1 polarization, activation of monocytes, macrophages, and innate lymphoid cells (ILCs).Both obesity and asthma have high heritability. Mendelian randomization studies have reported that SNPs associated with obesity are associated with incident asthma (6) , and not vice versa.Recent genome-wide association studies (GWAS) have identified SNPs associated with late-onset asthma, non-atopic asthma, BMI, and waist-to-hip ratio (7) . Unlike the genetic code, epigenetic regulation and gene expression respond to the environment, and thus transcriptomic and epigenetic studies will allow us to evaluate the interaction between genetic susceptibility and socio-environmental factors that play an important role in obesity and asthma.Insulin resistance and metabolic dysregulation have also been implicated in obese asthma and resulting changes in lung function.Moreover, dietary changes in obesity may contribute to microbiome alterations, which could increase inflammation and contribute to asthma severity. Alternatively, it could be tha...

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The First 1000 Days: Impact of Prenatal Tobacco Smoke Exposure on Hospitalization Due to Preschool Wheezing

Cited by 6 publications

References 36 publications

Dosage Modification of Traditional Chinese Medicine Prescriptions: An Analysis of Two Randomized Controlled Trials

Dosage Modification of Traditional Chinese Medicine Prescriptions: An Analysis of Two Randomized Controlled Trials

Risk Factors Affecting Development and Persistence of Preschool Wheezing: Consensus Document of the Emilia-Romagna Asthma (ERA) Study Group

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