Fractional exhaled nitric oxide in Chinese children with asthma and allergies–A two-city study

SummaryFractional exhaled nitric oxide (FeNO) is a non-invasive biomarker of eosinophilic airway inflammation. Our aim was to study associations between FeNO in Chinese children in two cities and asthma, asthmatic symptoms, rhinitis, eczema, and selected childhood and home environmental factors.A random sample of children in Shanghai (n = 187) and Taiyuan (n = 127), and additional randomly selected children reporting current wheeze (n = 115) were invited for FeNO measurements by NIOX MINO. A questionnaire survey was performed among all subjects (12–14 y) in 59 classes in Shanghai and 44 in Taiyuan. Associations were studied using multiple linear regression using 10log transformed FeNO data and mutual adjustment.The geometric mean FeNO in the random sample (GM ± GSD) was higher in Shanghai (16.2 ± 1.9 ppb) as compared to Taiyuan (12.8 ± 1.6 ppb) (P < 0.001). In the total material (n = 429), Shanghai residency (P = 0.001), male gender (P = 0.02), parental asthma/allergy (P = 0.04), doctors' diagnosed asthma (DDA) (P < 0.001) and current wheeze (P < 0.001) were associated with higher FeNO levels. In non-wheezers (n = 291), Shanghai residency (P = 0.007), male gender (P = 0.002), DDA (P = 0.04), current rhinitis (P = 0.004) and reported pollen/furry pet allergy (P = 0.04) were positively associated with FeNO. In wheezers (n = 138), DDA was the only significant factor (P = 0.009). In conclusion, male gender, current wheeze, DDA, parental asthma/allergy, current rhinitis, pollen/furry pet allergy can be independent determinants of increased FeNO. The lower level of FeNO in Taiyuan is in agreement with previous studies showing lower prevalence of asthma and allergy in Taiyuan as compared to Shanghai

Acute Effects of a Fungal Volatile Compound

Objective: 3-Methylfuran (3-MF) is a common fungal volatile product with active biologic properties, and previous studies have indicated a contribution to airway disease. The aim of the present study was to assess the acute health effects of this compound in humans. Design: Acute effects were assessed via chamber exposure to (1 mg/m(3)) 3-MF. Participants and measurements: Twenty-nine volunteers provided symptom reports, ocular electromyograms, measurement of eye tear film break-up time, vital staining of the eye, nasal lavage, acoustic rhinometry, transfer tests, and dynamic spirometry. Results: No subjective ratings were significantly increased during exposure. Blinking frequency and the lavage biomarkers myeloperoxidase and lysozyme were significantly increased, and forced vital capacity was significantly decreased during exposure to 3-MF compared with air control. Conclusions and relevance to clinical practice: Acute effects in the eyes, nose, and airways were detected and might be the result of the biologically active properties of 3-MF. Thus, 3-MF may contribute to building-related illness

Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia f Environmental Health, Allied Health Science College Sg Buloh, Ministry of Health Malaysia

• Elevated FeNO, a marker of lower airway inflammation, was found in many students. • Signs of dampness in the classroom were related to airway infections among students. • Students in classrooms with signs of dampness had 31% higher FeNO values. • Higher quantities of DNA from Aspergillus versicolor were related to higher FeNO. • DNA from Aspergillus versicolor were related to asthma and respiratory symptoms. Few health studies exist on dampness and mould in schools in the tropics. We studied associations between fraction of exhaled nitric oxide (FeNO), respiratory symptoms and airway infections among students and dampness and fungal DNA in schools in Malaysia. A total of 368 randomly selected students from 32 classrooms in 8 secondary schools in Penang, Malaysia, participated (58% participation rate). Information on current respiratory symptoms and the home environment was collected by a standardised questionnaire. FeNO was measured by NIOX MINO (50 ml/min). The classrooms were inspected and dust was collected by vacuuming on special filters and was analysed for five fungal DNA sequences by quantitative PCR. Linear mixed models and 3-level multiple logistic regression (school, classroom, student) were applied adjusting for demographic data and the home environment. Totally 10.3% reported doctor&apos;s diagnosed asthma, 15.1% current wheeze, 12.4% current asthma, 37.3% daytime breathlessness, 10.2% nocturnal breathlessness, 38.9% airway infections and 15.5% had pollen or furry G R A P H I C A L A B S T R A C T a b s t r a c t a r t i c l e i n f o Contents lists available at ScienceDirect Science of the Total Environment j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / s c i t o t e n v pet allergy. The geometric mean of FeNO was 19.9 ppb and 45% had elevated FeNO (N20 ppb). Boys had higher levels of FeNO. Chinese had less daytime breathlessness than Malay (OR = 0.30: p b 0.001). Indoor carbon dioxide levels were low (380-720 ppm). Dampness was observed in 18% of the classrooms and was associated with respiratory infections (OR = 3.70; 95% CI 1.14-12.1) and FeNO (p = 0.04). Aspergillus versicolor DNA was detected in 67% of the classrooms. Higher numbers of Aspergillus versicolor DNA in classroom dust were associated with wheeze (p = 0.006), current asthma (p = 0.002), respiratory infections (p = 0.005) and elevated FeNO levels (p = 0.02). In conclusion, respiratory symptoms were common among the students and the high FeNO levels indicate ongoing airway inflammation. Building dampness and the mould Aspergillus versicolor in schools in Malaysia can be risk factors for impaired respiratory health among the students

Enhanced ROCK1 dependent contractility in fibroblast from chronic obstructive pulmonary disease patients

Background: During wound healing processes fibroblasts account for wound closure by adopting a contractile phenotype. One disease manifestation of COPD is emphysema which is characterized by destruction of alveolar walls and our hypothesis is that fibroblasts in the COPD lungs differentiate into a more contractile phenotype as a response to the deteriorating environment. Methods: Bronchial (central) and parenchymal (distal) fibroblasts were isolated from lung explants from COPD patients (n = 9) (GOLD stage IV) and from biopsies from control subjects and from donor lungs (n = 12). Tissue-derived fibroblasts were assessed for expression of proteins involved in fibroblast contraction by western blotting whereas contraction capacity was measured in three-dimensional collagen gels. Results: The basal expression of rho-associated coiled-coil protein kinase 1 (ROCK1) was increased in both centrally and distally derived fibroblasts from COPD patients compared to fibroblasts from control subjects (p < 0.001) and (p < 0.01), respectively. Distally derived fibroblasts from COPD patients had increased contractile capacity compared to control fibroblasts (p < 0.01). The contraction was dependent on ROCK1 activity as the ROCK inhibitor Y27632 dose-dependently blocked contraction in fibroblasts from COPD patients. ROCK1-positive fibroblasts were also identified by immunohistochemistry in the alveolar parenchyma in lung tissue sections from COPD patients. Conclusions: Distally derived fibroblasts from COPD patients have an enhanced contractile phenotype that is dependent on ROCK1 activity. This feature may be of importance for the elastic dynamics of small airways and the parenchyma in late stages of COPD

Respiratory Health among Korean Pupils in Relation to Home, School and Outdoor Environment

There are few studies about school-environment in relation to pupils' respiratory health, and Korean school-environment has not been characterized. All pupils in 4th grade in 12 selected schools in three urban cities in Korea received a questionnaire (n = 2,453), 96% participated. Gaseous pollutants and ultrafine particles (UFPs) were measured indoors (n = 34) and outdoors (n = 12) during winter, 2004. Indoor dampness at home was investigated by the questionnaire. To evaluate associations between respiratory health and environment, multiple logistic- and multi-level regression models were applied adjusting for potential confounders. The mean age of pupils was 10 yr and 49% were boys. No school had mechanical ventilation and CO2-levels exceeded 1,000 ppm in all except one of the classrooms. The indoor mean concentrations of SO2, NO2, O3 and formaldehyde were 0.6 µg/m3, 19 µg/m3, 8 µg/m3 and 28 µg/m3, respectively. The average level of UFPs was 18,230 pt/cm3 in the classrooms and 16,480 pt/cm3 outdoors. There were positive associations between wheeze and outdoor NO2, and between current asthma and outdoor UFPs. With dampness at home, pupils had more wheeze. In conclusion, outdoor UFPs and even low levels of NO2 may adversely contribute to respiratory health in children. High CO2-levels in classrooms and indoor dampness/mold at home should be reduced

A Review on Epidemiological and Clinical Studies on Buckwheat Allergy

Background: Cultivated buckwheat include two species originating from China: common buckwheat (Fagopyrum esculentum) and tartary buckwheat (Fagopyrum tartaricum). Buckwheat can cause IgE-mediated allergy, including severe allergic reactions and anaphylaxis. Exposure can occure when eating buckwheat food (food allergen), when producing or handling buckwheat food (occupational exposure) or when sleeping on buckwheat husk pillows (houeshold environmental exposure). Methods: A search on buckwheat allergy in the medical database PubMed from 1970-2020. Result: A number of allergenic proteins have been identified in common buckwheat (e.g., Fag e 1, Fag e 2 and Fag e 3) and in tartary buckwheat (e.g., Fag t 1, Fag t 2, Fag t 3). Clinically relevant cross-reactivity has been described between buckwheat and peanut, latex, coconut, quinoa, and poppy seed. The prevalence of buckwheat allergy in the population can be estimated as 0.1-0.4% in Japan, Korea and buckwheat consuming areas of China. Among patients in allergy clinics in different countries, 2-7% has confirmed buckwheat allergy. School studies from Japan and Korea found 4-60 cases of buckwheat-related anaphylaxis per 100,000 school children. The incidence of severe allergic reactions to buckwheat, including anaphylaxis, can be estimated as 0.1-0.01 cases per 100,000 person-years. Conclusions: Buckwheat allergy is a neglected allegy deserving further attention but severe allergic reactions are rare