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Children
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Persistent Childhood Asthma
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Persistent Childhood Asthma

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Pulmonary and Sleep Medicine".

Deadline for manuscript submissions: closed (15 November 2021) | Viewed by 15039

Special Issue Editors

Dr. Ann-Marie Malby Schoos

E-Mail Website
Guest Editor
COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Ledreborg Alle 34, 2820 Gentofte, Denmark
Interests: allergy; allergy diagnostics; asthma; allergic rhinitis; eczema; immunology
Special Issues, Collections and Topics in MDPI journals
Dr. Cilla Söderhäll

E-Mail Website
Guest Editor
Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden
Interests: Asthma; allergy; eczema; genetics; epigenetics; biomarkers

Special Issue Information

Dear Colleagues,

Asthma is the most common chronic disease in children and the cause of great distress for both the children and their families. Various overlapping phenotypes exist, complicating aligned research in the field and meaningful, personalized treatment of the disease. Young children are particularly diverse with numerous and variable phenotypic presentations in early life that correspond to different outcomes. Despite the high reported rates of remission of asthma, the disease is usually considered as treatable but not curable once present. Understanding of the determinants that affect the course of diagnosed asthma, e.g., the avoidance of environmental or occupational exposures, is therefore important for tertiary prevention, since asthma persistence is associated with frequent and severe symptoms and with the development of impaired lung function. Asthma treatment guidelines have proven useful in standard care and the reduction of adverse outcomes in patients with asthma; however, the phenotypic heterogeneity within the disorder indicates the need for personalized medicine as opposed to a one-size-fits-all treatment approach.

The goal of this Special Issue is to provide an improved understanding of the phenotypes of persistent asthma (prevalence, comorbidities, lung function, response to treatment, etc.) and also to investigate the impact of genetic and environmental exposures in order to elucidate the possibility of tertiary prevention.

Dr. Ann-Marie Malby Schoos
Dr. Cilla Söderhäll
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • asthma
  • children
  • phenotypes
  • persistence
  • remission
  • severity
  • lung function
  • treatment
  • tertiary prevention
  • comorbidities
  • exposures
  • genetics
  • epigenetics

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Published Papers (5 papers)

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Editorial

Jump to: Research

2 pages, 163 KiB  
Editorial
Persistent Asthma in Childhood
by Cilla Söderhäll and Ann-Marie Malby Schoos
Children 2022, 9(6), 820; https://doi.org/10.3390/children9060820 - 1 Jun 2022
Cited by 2 | Viewed by 1399
Abstract
Asthma is the most common chronic disease in children and a cause of great distress for both the children and their families [...] Full article
(This article belongs to the Special Issue Persistent Childhood Asthma)

Research

Jump to: Editorial

11 pages, 456 KiB  
Article
Screening Accuracy of FeNO Measurement for Childhood Asthma in a Community Setting
by Kamil Barański and Jan Eugeniusz Zejda
Children 2022, 9(6), 858; https://doi.org/10.3390/children9060858 - 8 Jun 2022
Cited by 1 | Viewed by 1965
Abstract
(1) Background: The exhaled fractional nitric oxide is a well-recognized biomarker used in clinical settings for controlling and managing asthma. Less is known about the value of Fractional Exhaled Nitric Oxide (FeNO) measurement in epidemiological studies on childhood asthma, although available evidence suggests [...] Read more.
(1) Background: The exhaled fractional nitric oxide is a well-recognized biomarker used in clinical settings for controlling and managing asthma. Less is known about the value of Fractional Exhaled Nitric Oxide (FeNO) measurement in epidemiological studies on childhood asthma, although available evidence suggests that an increased FeNO is associated with an increased risk of asthma. (2) Aim: The aim of the study was to assess FeNO accuracy in the identification of children with asthma, participants in a population-based respiratory survey. (3) Material and methods: The cross-sectional study included 449 children, 224 (49.9%) boys and 225 (50.1%) girls aged 6–10 years. The FeNO was measured in 449 children; Spirometry tests were completed with 441 children, but technically acceptable spirometry was done in 350. All participants fulfilled the questionnaire (ISAAC) for assessment of the status of their respiratory system on which diagnosis was based on. FeNO and Spirometry were performed according to ERS/ATS recommendations. (4) Results: The FeNO was significantly higher in asthmatic children (n = 22): 27.3 ± 21.3 ppb; with allergic rhinitis (n = 106): 9.9 ± 21.6 ppb, with atopic dermatitis (n = 67) 20.8 ± 25.0 ppb, with an asthmatic tendency (n = 27): 19.8 ± 16.0 ppb in comparison to children without any respiratory/atopy symptoms. The highest diagnostic odds ratio and area under the curve were found in any treated asthma or asthma without any atopic symptoms in relation to FeNO cutoff > 35 ppb; DOR 4.85 and 8.37; AUC 0.615 and 0.795, respectively. The adjustment for spirometry parameters did not improve the diagnostic accuracy of FeNO. In each FeNO cutoff, there were more false positive than true positive subjects. (5) Conclusions. The best diagnostic accuracy of FeNO was for isolated asthma without any atopy against children without any coexisting respiratory or allergic disease. The sensitivity and specificity did not reach the required values for a good screening tool; therefore, it should not be used in epidemiological settings. Full article
(This article belongs to the Special Issue Persistent Childhood Asthma)
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11 pages, 478 KiB  
Article
Clinical Experience with Anti-IgE Monoclonal Antibody (Omalizumab) in Pediatric Severe Allergic Asthma—A Romanian Perspective
by Elena Camelia Berghea, Mihaela Balgradean, Carmen Pavelescu, Catalin Gabriel Cirstoveanu, Claudia Lucia Toma, Marcela Daniela Ionescu and Roxana Silvia Bumbacea
Children 2021, 8(12), 1141; https://doi.org/10.3390/children8121141 - 6 Dec 2021
Cited by 4 | Viewed by 3184
Abstract
Background: Asthma is the most common chronic disease affecting children, with a negative impact on their quality of life. Asthma is often associated with comorbid allergic diseases, and its severity may be modulated by immunoglobulin E (IgE)-mediated allergen sensitization. Omalizumab is a humanized [...] Read more.
Background: Asthma is the most common chronic disease affecting children, with a negative impact on their quality of life. Asthma is often associated with comorbid allergic diseases, and its severity may be modulated by immunoglobulin E (IgE)-mediated allergen sensitization. Omalizumab is a humanized monoclonal anti-IgE antibody, the first biological therapy approved to treat patients aged ≥6 years with severe allergic asthma. The primary objective of our study was to investigate the efficacy and safety of Omalizumab in Romanian children with severe allergic asthma. Methods: In this observational real-life study, 12 children and adolescents aged 6 to 18 years (mean 12.4 years) with severe allergic asthma received Omalizumab as an add-on treatment. Asthma control, exacerbations, lung function, and adverse events were evaluated at baseline and after the first year of treatment. Results: We observed general improvement in total asthma symptom scores and reduction in the rate of exacerbation of severe asthma. Omalizumab treatment was associated with improvement in the measures of lung function, and no serious adverse reactions were reported. FEV1 improved significantly after one year of treatment with Omalizumab [ΔFEV1 (% pred.) = 18.3], and [similarly, ΔMEF50 (%) = 25.8]. The mean severe exacerbation rate of asthma decreased from 4.1 ± 2.8 to 1.15 ± 0.78 (p < 0.0001) during the year of treatment with Omalizumab. Conclusions: This study showed that Omalizumab can be an effective and safe therapeutic option for Romanian children and adolescents with severe allergic asthma, providing clinically relevant information on asthma control and exacerbation rate in children and adolescents. The results demonstrated the positive effect of Omalizumab in young patients with asthma, starting from the first year of treatment. Full article
(This article belongs to the Special Issue Persistent Childhood Asthma)
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10 pages, 897 KiB  
Article
Early Life Wheeze and Risk Factors for Asthma—A Revisit at Age 7 in the GEWAC-Cohort
by Idun Holmdahl, Anastasia Filiou, Katarina Stenberg Hammar, Anna Asarnoj, Magnus P. Borres, Marianne van Hage, Gunilla Hedlin, Cilla Söderhäll and Jon R. Konradsen
Children 2021, 8(6), 488; https://doi.org/10.3390/children8060488 - 8 Jun 2021
Cited by 7 | Viewed by 2435
Abstract
One third of all toddlers are in need of medical care because of acute wheeze and many of these children have persistent asthma at school age. Our aims were to assess risk factors for and the prevalence of asthma at age 7 in [...] Read more.
One third of all toddlers are in need of medical care because of acute wheeze and many of these children have persistent asthma at school age. Our aims were to assess risk factors for and the prevalence of asthma at age 7 in a cohort of children suffering from an acute wheezing episode as toddlers. A total of 113 children, included during an acute wheezing episode (cases), and 54 healthy controls were followed prospectively from early pre-school age to 7 years. The protocol included questionnaires, ACT, FeNO, nasopharyngeal virus samples, blood sampling for cell count, vitamin D levels, and IgE to food and airborne allergens. The prevalence of asthma at age 7 was 70.8% among cases and 1.9% among controls (p < 0.001). Acute wheeze caused by rhinovirus (RV) infection at inclusion was more common among cases with asthma at age 7 compared to cases without asthma (p = 0.011) and this association remained significant following adjustment for infection with other viruses (OR 3.8, 95% CI 1.4–10.5). Cases with asthma at age 7 had been admitted to hospital more often (p = 0.024) and spent more days admitted (p = 0.01) during the year following inclusion compared to cases without asthma. RV infection stands out as the main associated factor for wheeze evolving to persistent asthma. Cases who developed asthma also had an increased need of hospital time and care for wheeze during the year after inclusion. Full article
(This article belongs to the Special Issue Persistent Childhood Asthma)
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16 pages, 1040 KiB  
Article
Predicting Treatment Outcomes Using Explainable Machine Learning in Children with Asthma
by Mario Lovrić, Ivana Banić, Emanuel Lacić, Kristina Pavlović, Roman Kern and Mirjana Turkalj
Children 2021, 8(5), 376; https://doi.org/10.3390/children8050376 - 10 May 2021
Cited by 13 | Viewed by 4606
Abstract
Asthma in children is a heterogeneous disease manifested by various phenotypes and endotypes. The level of disease control, as well as the effectiveness of anti-inflammatory treatment, is variable and inadequate in a significant portion of patients. By applying machine learning algorithms, we aimed [...] Read more.
Asthma in children is a heterogeneous disease manifested by various phenotypes and endotypes. The level of disease control, as well as the effectiveness of anti-inflammatory treatment, is variable and inadequate in a significant portion of patients. By applying machine learning algorithms, we aimed to predict the treatment success in a pediatric asthma cohort and to identify the key variables for understanding the underlying mechanisms. We predicted the treatment outcomes in children with mild to severe asthma (N = 365), according to changes in asthma control, lung function (FEV1 and MEF50) and FENO values after 6 months of controller medication use, using Random Forest and AdaBoost classifiers. The highest prediction power is achieved for control- and, to a lower extent, for FENO-related treatment outcomes, especially in younger children. The most predictive variables for asthma control are related to asthma severity and the total IgE, which were also predictive for FENO-based outcomes. MEF50-related treatment outcomes were better predicted than the FEV1-based response, and one of the best predictive variables for this response was hsCRP, emphasizing the involvement of the distal airways in childhood asthma. Our results suggest that asthma control- and FENO-based outcomes can be more accurately predicted using machine learning than the outcomes according to FEV1 and MEF50. This supports the symptom control-based asthma management approach and its complementary FENO-guided tool in children. T2-high asthma seemed to respond best to the anti-inflammatory treatment. The results of this study in predicting the treatment success will help to enable treatment optimization and to implement the concept of precision medicine in pediatric asthma treatment. Full article
(This article belongs to the Special Issue Persistent Childhood Asthma)
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