Asthma and lower airway diseaseAsthma morbidity among inner-city adolescents receiving guidelines-based therapy: Role of predictors in the setting of high adherence
Section snippets
Study population and design
In brief, 546 participants, ages 12 to 20 years, with physician-diagnosed asthma were enrolled at 10 urban locations across the United States. Eligibility was limited to residents of census tracts in which at least 20% of households had incomes below the federal poverty threshold. In addition, individuals had to have evidence of moderate to severe persistent disease. Those receiving long-term control therapy were required to have symptoms of persistent disease or uncontrolled asthma, whereas
Participant characteristics at randomization
Of the 546 participants enrolled, 53% were male, and 64% were black. Table I describes additional demographic characteristics of the population as well as asthma-related symptoms, lung function, atopic status, and degree of allergic inflammation at randomization. The mean number of maximum symptom days over a 2-week period decreased significantly from 5.6 ± 4.6 at enrollment to 2.3 ± 2.9 after the 3-week run-in period at randomization (mean within-participant reduction, 3.4 days/2 weeks; P <
Discussion
Our study reveals that factors often used to predict future asthma risk in poorly controlled populations are of no clinical benefit in predicting future risk in a well treated, highly adherent population of inner-city adolescents and young adults with persistent asthma. We did find that future maximum symptom days and exacerbations could be predicted, but only to a minor extent, by using a combination of asthma-related symptoms and lung function measurements that included FEV1% predicted, FEV1
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2016, Annals of Allergy, Asthma and ImmunologyCitation Excerpt :A third study, in subjects with asthma in the Severe Asthma Research Program study, found that those with severe asthma were more likely to not have atopy.26 Two studies conducted in the same study population as the present study did not directly contrast asthma severity or other measurements of morbidity between participants with and those without atopy; however, Gruchalla et al27 did not find tIgE to be a significant predictor of asthma symptoms or exacerbations, whereas Matsui et al28 found increased IgE levels to be associated with decreased lung function and increased FeNO, but not with asthma exacerbations. Asthma control and severity are 2 measurements increasingly used in the clinical management of asthma.
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2016, Journal of Allergy and Clinical Immunology: In PracticeBiomarker surrogates do not accurately predict sputum eosinophil and neutrophil percentages in asthmatic subjects
2013, Journal of Allergy and Clinical ImmunologyCitation Excerpt :However, before using surrogate biomarkers, whether individually or combined, sensitivity, specificity, and accuracy of prediction compared with actual sputum counts must be demonstrated across the full range of asthma severity or shown to be applicable to specific asthma subphenotypes only. Readily accessible biomarkers, including blood eosinophil counts, Feno levels, and total serum IgE levels, are associated with sputum eosinophil percentages,13-20 whereas age and FEV1 percent predicted are associated with sputum neutrophil percentages.26,32 Despite these reported associations, the accuracy of a biomarker to predict sputum cell percentages requires specific demonstration in individual asthmatic subjects.
Peripheral airway impairment measured by oscillometry predicts loss of asthma control in children
2013, Journal of Allergy and Clinical Immunology
Supported in whole or in part with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, under contracts NO1-AI-25496 and NO1-AI-25482 and from the National Center for Research Resources, National Institutes of Health, under grants RR00052, M01 RR00533, M01RR0071, 5UL1RR024992-02, and 5M01RR020359-04.
Disclosure of potential conflict of interest: R. S. Gruchalla receives consulting fees from GlaxoSmithKline, research support from the National Institute of Allergy and Infectious Diseases/National Institutes of Health, Novartis, and ExxonMobil, and is a board member of the American Board of Allergy and Immunology. H. A. Sampson is a consultant for and 4% shareholder in Allertein Pharmaceuticals, LLC; is on the advisory board for Schering-Plough; receives grants from the Food Allergy Initiative and the National Institute of Allergy and Infectious Diseases/National Institutes of Health; is a consultant and scientific advisor for the Food Allergy Initiative; is 45% owner of Herbal Springs, LLC; and is a board member of the American Academy of Allergy, Asthma, and Immunology. E. Matsui receives research support from the National Institutes of Health. M. Brown is a speaker for GlaxoSmithKline and AstraZeneca and a consultant for Novartis. A. H. Liu is a speaker/consultant for GlaxoSmithKline, Merck, and AstraZeneca and receives research support from GlaxoSmithKline. G. R. Bloomberg receives research support from the National Institute of Allergy and Infectious Diseases/National Institutes of Health. J. F. Chmiel is a consultant for MyCysticFibrosis.com, receives honoraria from the France Foundation, and receives grant support from Cystic Fibrosis Foundation Therapeutics, Inc, and the National Institutes of Health. R. Kumar receives grant support from the National Heart, Lung, and Blood Institute/National Institutes of Health, is a member of the American Thoracic Society, and is vice president of the Illinois Society of Allergy and Immunology. C. A. Sorkness receives consulting fees and speaker honoraria from GlaxoSmithKline and receives research support from Pharmaxis and Schering-Plough. S. F. Steinbach receives research support from the National Institute of Allergy and Infectious Diseases/National Institutes of Health and is on the speakers bureau for Merck and GlaxoSmithKline. K. D. Stone receives research support from the National Institute of Allergy and Infectious Diseases/National Institutes of Health. S. J. Szefler is a consultant for GlaxoSmithKline, Genentech, and Merck and receives research support from the National Heart, Lung, and Blood Institute/National Institutes of Health, the National Institute of Allergy and Infectious Diseases/National Institutes of Health, Ross Pharmaceuticals, and GlaxoSmithKline. W. W. Busse is a consultant for Altair, GlaxoSmithKline, Merck, Wyeth, Pfizer, Centocor, Amgen, UCB, Johnson & Johnson, Novartis, AstraZeneca, Eisai, TEVA, CompleWare, KaloBios, and Boehringer Ingelheim Sandoz and receives research support from the National Heart, Lung, and Blood Institute/National Institutes of Health, the National Institute of Allergy and Infectious Diseases/National Institutes of Health, Novartis, Centocor, GlaxoSmithKline, MedImmune, and Ception. The rest of the authors have declared that they have no conflict of interest.