Expression of SMARCD1 interacts with age in association with asthma control on inhaled corticosteroid therapy.

BackgroundGlobal gene expression levels are known to be highly dependent upon gross demographic features including age, yet identification of age-related genomic indicators has yet to be comprehensively undertaken in a disease and treatment-specific context.MethodsWe used gene expression data from CD4+ lymphocytes in the Asthma BioRepository for Integrative Genomic Exploration (Asthma BRIDGE), an open-access collection of subjects participating in genetic studies of asthma with available gene expression data. Replication population participants were Puerto Rico islanders recruited as part of the ongoing Genes environments & Admixture in Latino Americans (GALA II), who provided nasal brushings for transcript sequencing. The main outcome measure was chronic asthma control as derived by questionnaires. Genomic associations were performed using regression of chronic asthma control score on gene expression with age in years as a covariate, including a multiplicative interaction term for gene expression times age.ResultsThe SMARCD1 gene (SWI/SNF-related matrix-associated actin-dependent regulator of chromatin subfamily D member 1) interacted with age to influence chronic asthma control on inhaled corticosteroids, with a doubling of expression leading to an increase of 1.3 units of chronic asthma control per year (95% CI [0.86, 1.74], p = 6 × 10- 9), suggesting worsening asthma control with increasing age. This result replicated in GALA II (p = 3.8 × 10- 8). Cellular assays confirmed the role of SMARCD1 in glucocorticoid response in airway epithelial cells.ConclusionFocusing on age-dependent factors may help identify novel indicators of asthma medication response. Age appears to modulate the effect of SMARCD1 on asthma control with inhaled corticosteroids

Objective cough frequency, airway inflammation, and disease control in asthma

Background Cough is recognized as an important troublesome symptom in the diagnosis and monitoring of asthma. Asthma control is thought to be determined by the degree of airway inflammation and hyperresponsiveness but how these factors relate to cough frequency is unclear. The goal of this study was to investigate the relationships between objective cough frequency, disease control, airflow obstruction, and airway inflammation in asthma. Methods Participants with asthma underwent 24-h ambulatory cough monitoring and assessment of exhaled nitric oxide, spirometry, methacholine challenge, and sputum induction (cell counts and inflammatory mediator levels). Asthma control was assessed by using the Global Initiative for Asthma (GINA) classification and the Asthma Control Questionnaire (ACQ). The number of cough sounds was manually counted and expressed as coughs per hour (c/h). Results Eighty-nine subjects with asthma (mean ± SD age, 57 ± 12 years; 57% female) were recruited. According to GINA criteria, 18 (20.2%) patients were classified as controlled, 39 (43.8%) partly controlled, and 32 (36%) uncontrolled; the median ACQ score was 1 (range, 0.0-4.4). The 6-item ACQ correlated with 24-h cough frequency (r = 0.40; P < .001), and patients with uncontrolled asthma (per GINA criteria) had higher median 24-h cough frequency (4.2 c/h; range, 0.3-27.6) compared with partially controlled asthma (1.8 c/h; range, 0.2-25.3; P = .01) and controlled asthma (1.7 c/h; range, 0.3-6.7; P = .002). Measures of airway inflammation were not significantly different between GINA categories and were not correlated with ACQ. In multivariate analyses, increasing cough frequency and worsening FEV1 independently predicted measures of asthma control. Conclusions Ambulatory cough frequency monitoring provides an objective assessment of asthma symptoms that correlates with standard measures of asthma control but not airflow obstruction or airway inflammation. Moreover, cough frequency and airflow obstruction represent independent dimensions of asthma control

Routine Asthma Control, Other Factors and Trend of Perception on Controlled Asthma Among Asthma Patient in a Hospital in Jakarta

Background: Asthma remains an important health problem across the globe. This study aimed toinvestigate the dominant risk factors that related to perception on controlled asthma.Methods: Methods: Subjects in this cross-sectional study consisted of patients with asthma who seektreatment at the clinic of Persahabatan Hospital Jakarta in 2011. Interviews were conducted by usinga questionnaire containing questions about demographic data (age, gender, occupation), routine asthmacontrol, the use of dose asthma medication, how to use inhaled drugs, and financing sources. QuestionnaireAsthma Control Test (ACT) was also used to obtain data on activity limitation due to asthma, frequency ofexperiencing shortness of breath, frequency of experiencing asthma symptoms at night, frequency of useof inhaled medications, and self-assessment against asthma control. Linear regression analysis was usedto analyze factors associated with self-assessment against asthma control.Results: We had 132 subjects in this study. Mean of perception on controlled asthma was 3.11±1.30.Risk factors related to rating of self control asthma were activity limitation, rescue inhaler use and routinecontrol asthma. Less activity limitation, less rescue inhaler use, and subject who had more frequent routineasthma control were dominant factors to perception on controlled asthma.Conclusion: Less of the time of activity limitation, less frequent rescue inhaler use, and more frequent routineasthma control tended to be better controlled asthma. (Health Science Journal of Indonesia 2015;6:52-6

Determinants and impact of suboptimal asthma control in Europe : The INTERNATIONAL CROSS-SECTIONAL AND LONGITUDINAL ASSESSMENT ON ASTHMA CONTROL (LIAISON) study

Acknowledgements We are grateful to THERAmetrics for the study management, data collection and analysis. The authors would like to thank the following investigators for their contribution (>30 patients enrolled): F. Fohler, A.G. Haider, J. Hesse-Tonsa, J. Messner, W. Pohl (Austria); G. Joos, J.L. Halloy, R. Peche, H. Simonis, P. Van den Brande (Belgium); B. Bugnas, J.M. Chavaillon, P. Debove, S. Dury, L. Mathieu, O. Lagrange, A. Prudhomme, S. Verdier (France); A. Benedix, O. Kestermann, A. Deimling, G. Eckhardt, M. Gernhold, V. Grimm-Sachs, M. Hoefer, G. Hoheisel, C. Stolpe, C. Schilder, M. John, J. Uerscheln, K.H. Zeisler (Germany); A. Chaniotou, P. Demertzis, V. Filaditaki-Loverdou, A. Gaga, E. Georgatou-Papageorgiou, S. Michailidis, G. Pavkalou, M. Toumpis (Greece); K. Csicsari, K. Hajdu, M. Póczi, M. Kukuly, T. Kecskes, C. Hangonyi, J. Schlezak, E. Takács, M. Szabo,G. Szabó, C. Szabo (Hungary); G.W. Canonica, W. Castellani, A. Cirillo, M.P. Foschino Barbaro, M. Gjomarkaj, G. Guerra, G. Idotta, D. Legnani, M. Lo Schiavo, R. Maselli, F. Mazza, S. Nutini, P. Paggiaro, A. Pietra, O. Resta, S. Salis, N.A. Scichilone, M.C. Zappa, A. Zedda (Italy); M. Goosens, R. Heller, K. Mansour, C. Meek, J. van den Berg (The Netherlands); A. Antczak, M. Faber, D. Madra-Rogacka, G. Mincewicz, M. Michnar, D. Olejniczak, G. Pulka, Z. Sankowski, K. Kowal, I. Krupa-Borek, B. Kubicka Kozik, K. Kuczynska, P. Kuna, A. Kwasniewski, M. Wozniak (Poland); F. Casas Maldonado, C. Cisneros, J. de Miguel Díez, L.M. Entrenas Costa, B. Garcìa-Cosio, M.V. Gonzales, L. Lores, M. Luengo, C. Martinez, C. Melero, I. Mir, X. Munoz, A. Pacheco, V. Plaza, J. Serra, J. Serrano, J.G. Soto Campos (Spain); T. Bekci, R. Demir, N. Dursunoglu, D. Ediger, A. Ekici, O. Goksel, H. Gunen, I.K. Oguzulgen, Z.F. Ozseker, (Turkey); L. Barnes, T. Hall, S. Montgomerie, J. Purohit, J. Ryan (United Kingdom). The authors would also like to thank P. Galletti (THERAMetrics S.p.A., Sesto San Giovanni, Italy) and K. Stockmeyer (THERAMetrics GmbH, Essen, Germany) for providing editorial assistance in the preparation of this manuscript.Peer reviewedPublisher PD

Assessment of asthma control using the asthma control test at a tertiary care centre in Karachi, Pakistan

The aim of our study was to assess asthma control among asthmatics at a tertiary care setting in Karachi using ACT questionnaire. The ACT questionnaire was filled by known asthmatics in January 2007. A total of 150 questionnaires were filled of which, 61 (40%) were males and 89 (60%) females. Mean ACT score was 17.71 +/- 4.41. Association between sex and asthma control was not statistically significant. Significant association was seen with asthma control and Ipratropium bromide inhaler. Asthma control among patients at a tertiary care centre is moderate. ACT can be used to follow patients in the hospital

Asthma control and academic performance of school-aged children with asthma

Background: A number of factors are thought to influence the academic performance of children with asthma (Subjects) and asthma control is one. Reports on the influence/impact of asthma control on the academic performance of children with asthma are limited and the independent contribution of asthma status, if any, to academic performance of children with asthma has been poorly explored. Aims: To determine the influence of asthma control on the academic performance of children with asthma in Enugu, Nigeria. Methods: Children with Asthma (Subjects) aged 5–11 years were recruited consecutively at the weekly asthma clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Level of asthma control was ascertained using the Childhood Asthma Control Test (C-ACT) tool. The IQ of the subjects was calculated using the validated Zi ler criteria and the table of Draw –A-person Quotient (DAPQ) by Ebigbo and Izuora. The total number of days of school absence for the academic session was obtained from the class attendance register. Academic performance was assessed using the average of the overall scores in the three term examinations of the academic session. Result: The prevalence of high school absence among subjects with poor asthma control was higher compared to those with good asthma control and this difference was statistically significant (χ2 = 14.67; d.f = 1; p < 0.001). The difference between the median (range) overall academic score of children with poor asthma control (79.96% (36.00% - 93.57%)) and that of those with good control (78.11% (37% - 99.57%)) was not statistically significant (U= 1235, p = 0.486). However on multivariate analysis, good asthma control had a significant positive effect on academic performance (β = 1.080, p = 0.003). Conclusion: Asthma control had a significant positive effect on academic performance of school children with asthma

Different of Asthma Control Level in Suburban and Urban Areas

Background: Asthma is a reversible and temporary respiratory disorder. The level of asthma control can be influenced by many factors, such as the environmental factor. This research aims to depict the differences asthma control level in suurban and urban communities. This research conducted in Kendalsari and Kedungkandang, Malang, East Java. Method: This research use observational analytic with crossectional approach. Sample were taken by simple random technique as many as 50 respondents. Patient asthma 18-60 years with 20 women and 5 men in each areas The Asthma control levels were measured using Asthma Control Test (ACT), Data were analyzed using the Mann Whitney Test. Result: Asthma control level data, In suburban areas uncontrolled patients 60% and 40% partially controlled. In urban areas there are 28% of patients uncontrolled and 72% partially controlled. Distribution age of asthma patients predominantly 26-45 years (66%). Distribution education level predominantly in senior high school 18 patients (36%). The result of analysis showed a difference of asthma control level in suburban and urban areas (p 0,024). Conclusion: There are different asthma control level in suburban and urban areas in Malang, East Java (α0,05)

Validation of a guideline-based composite outcome assessment tool for asthma control.

Background: A global definition of asthma control does not currently exist. The purpose of this study was to validate two new guideline-based composite measures of asthma control, defined as totally controlled (TC) asthma and well controlled (WC) asthma. Methods: We used data from 3416 patients randomised and treated in the multi-centre Gaining Optimal Asthma controL (GOAL) study. The criteria comprising the asthma control measures were based on Global Initiative for Asthma/National Institutes of Health guidelines. This validation study examined the measurement properties of the asthma control measures using data from runin, baseline, 12 and 52 weeks. Forced expiratory volume in 1 second (FEV1) and the Asthma Quality of Life Questionnaire (AQLQ) were used as the reference criteria in the validation analysis. Results: Both measures had good discriminative ability showing significant differences in FEV1 and AQLQ scores between control classification both cross-sectionally and longitudinally (p < 0.001). Overall both of the composite measures accounted for more of the variance in FEV1 after 52 weeks than the individual components of each asthma control measure. Both of the reference criteria were independently related to each asthma control measure (p < 0.0001). The measures also had good predictive validity showing significant differences in FEV1 and AQLQ scores at 52 weeks by control classification at 12 weeks (p < 0.0001). Conclusion: The guideline-based composite asthma control measures of WC asthma and TC asthma have good psychometric properties and are both valid functional indices of disease control in asthma

Assessment of asthma control and lung function in asthmatic children in Sokoto, North Western Nigeria

Objectives: This study aimed at assessing asthma control using Global Initiative for Asthma (GINA) asthma assessment, and determining its relationship with lung function parameters among asthmatic children in Usmanu Danfodiyo University Teaching hospital, Sokoto.Materials and Methods: This was a cross-sectional study among 60 children with asthma diagnosed based on GINA guidelines. It was conducted over a period of 4 months. The GINA asthma control assessment was administered to assess asthma control. Lung function was done using a portable spirometer.Results: Males accounted for 58.3% of the study population with M: F of 1.4:1 and median age of 9.47 years, with majority from urban domicile (91.7%). Well-controlled asthma accounted for 50.0% while 35.0% had partly controlled asthma and 15.0% had poorly controlled asthma. The median FEV1/FVC among the study participants was 0.856 (IQR: 0.170). There was no relationship between asthma control and LF parameters (FEV1: r = 0.044, P = 0.736, FVC: r = 0.010, P = 0.941, FEV1/FVC: r = 0.122, P = 0.352, and PEFR: r = 0.015, P = 0.911).Conclusion:Majority of the study participants had well-controlled asthma and no relationship was found between asthma control and lung function. Thus, serial monitoring of LF in addition to uniformly agreed standardized assessment of asthma control is required to objectively evaluate asthma control in children

Is asthma control more than just an absence of symptoms? An expert consensus statement

Purpose: Definitions and measures of asthma control used in clinical trials and in clinical practice vary considerably. There is also misalignment between patients and healthcare professionals (HCPs) in terms of understanding and managing asthma control. This study aimed to progress towards a consensus definition of asthma control, and evaluate disparities between HCP and patient perspectives. Basic procedures: A two-stage Delphi questionnaire involving asthma specialists sought to identify areas of consensus on aspects of asthma control in clinical practice. Results were compared with those of a structured literature review to assess if existing guidance and measures of asthma control used in studies correlated with practice. Eighty-two panelists took part in the Delphi questionnaire. The structured literature review included 185 manuscripts and 31 abstracts. Main findings: Panelists agreed that there was no standard definition of asthma control, confirmed by a total of 19 different composite consensus/guideline definitions and/or validated measures of control being identified across the Delphi study and literature review. Panelists agreed on the positive associations of well-controlled asthma with patient outcomes, but not on the components or thresholds of a working definition of control. Principal conclusions: A universally accepted definition and measure of asthma control that is utilized and understood by patients, HCPs, and researchers is required