Predicting the course of asthma from childhood until early adulthood

PURPOSE OF REVIEW: To communicate recent insights about the natural history of childhood asthma, with a focus on prediction of persistence and remission of childhood asthma, up to early adulthood.RECENT FINDINGS: Lung function around the age of 8-9 years is the strongest predictor: obstructive lung function predicts asthma persistence up to early adulthood, whereas normal lung function predicts remission. The ability to predict asthma remission improves when lung function is combined with blood eosinophil levels and degree of bronchial hyperresponsiveness. Interventions, such as inhaled corticosteroids and immunotherapy do not appear to alter the course of asthma. Epigenetic studies have revealed potential novel biomarkers of asthma remission, such as micro-RNA patterns in blood. Specifically, lower serum levels of mi-R221-5p, which is associated with lower IL-6 release and eosinophilic inflammation, predict remission. Higher levels of blood DNA-methylation of a CpG site in Peroxisomal Biogenesis Factor 11 Beta were associated with asthma remission.SUMMARY: Lung function, allergic comorbidity and polysensitization in childhood predict the course of asthma. Recent epigenetic studies have provided a better understanding of underlying pathological processes in asthma remission, which may be used to improve prediction or develop novel treatments aimed at altering the course of asthma.</p

Asthma, bronchial hyperresponsiveness, allergy and lung function development until early adulthood:A systematic literature review

BACKGROUND: It is unclear in which periods of life lung function deficits develop, and whether these are affected by risk factors such as asthma, bronchial hyper‐responsiveness (BHR) and allergic comorbidity. The goal of this systematic review was to identify temporal associations of asthma, BHR and allergic comorbidity with large and small lung function development from birth until peak function in early adulthood. METHODS: We searched MEDLINE, EMBASE, Web of Science and CINAHL for papers published before 01.01.2020 on risk factors and lung function measurements of large and small airways. Studies were required to report lung function at any time point or interval from birth until peak lung function (age 21‐26) and include at least one candidate risk factor. RESULTS: Of the 45 papers identified, 44 investigated cohorts and one was a clinical trial with follow‐up. Asthma, wheezing, BHR and allergic sensitization early in life and to multiple allergens were associated with a lower lung function growth of large and small airways during early childhood compared with the control populations. Lung function development after childhood in subjects with asthma or persistent wheeze, although continuing to grow at a lower level, largely tracked parallel to non‐affected individuals until peak function was attained. CLINICAL IMPLICATIONS AND FUTURE RESEARCH: Deficits in lung function growth develop in early childhood, and children with asthma, BHR and early‐life IgE (poly)sensitization are at risk. This period is possibly a critical window of opportunity to identify at‐risk subjects and provide treatment aimed at preventing long‐term sequelae of lung function

Mobile encounters:bus 5A as a cross-cultural meeting place

The paper explores modes of encounters in the everyday practice of bus travel. Particularly, it addresses cross-cultural encounters located in the tension between familiarity and difference, between inclusion and exclusion. The paper is located in contemporary thoughts, approaching public transport not only as a moving device but also as a social arena. Furthermore, the bus is simultaneously perceived as a public space, at once composite, contradictory and heterogeneous, and as a meeting place involving ‘Throwntogetherness’. The encounters analysed are bodily, emotional charged and outspoken meetings between passengers, with the socio-materiality of the bus and drivers as co-riders and gatekeepers

Sucrose Counteracts the Anti-Inflammatory Effect of Fish Oil in Adipose Tissue and Increases Obesity Development in Mice

BACKGROUND: Polyunsaturated n-3 fatty acids (n-3 PUFAs) are reported to protect against high fat diet-induced obesity and inflammation in adipose tissue. Here we aimed to investigate if the amount of sucrose in the background diet influences the ability of n-3 PUFAs to protect against diet-induced obesity, adipose tissue inflammation and glucose intolerance. METHODOLOGY/PRINCIPAL FINDINGS: We fed C57BL/6J mice a protein- (casein) or sucrose-based high fat diet supplemented with fish oil or corn oil for 9 weeks. Irrespective of the fatty acid source, mice fed diets rich in sucrose became obese whereas mice fed high protein diets remained lean. Inclusion of sucrose in the diet also counteracted the well-known anti-inflammatory effect of fish oil in adipose tissue, but did not impair the ability of fish oil to prevent accumulation of fat in the liver. Calculation of HOMA-IR indicated that mice fed high levels of proteins remained insulin sensitive, whereas insulin sensitivity was reduced in the obese mice fed sucrose irrespectively of the fat source. We show that a high fat diet decreased glucose tolerance in the mice independently of both obesity and dietary levels of n-3 PUFAs and sucrose. Of note, increasing the protein∶sucrose ratio in high fat diets decreased energy efficiency irrespective of fat source. This was accompanied by increased expression of Ppargc1a (peroxisome proliferator-activated receptor, gamma, coactivator 1 alpha) and increased gluconeogenesis in the fed state. CONCLUSIONS/SIGNIFICANCE: The background diet influence the ability of n-3 PUFAs to protect against development of obesity, glucose intolerance and adipose tissue inflammation. High levels of dietary sucrose counteract the anti-inflammatory effect of fish oil in adipose tissue and increases obesity development in mice

From Big Society to Shared Society? Geographies of social cohesion and encounter in the UK’s National Citizen Service

This article explores and expands debates on the geographies of social cohesion and encounter, specifically in relation to young people and informal citizenship training. Three questions drive our agenda in this paper. First, how do certain youth spaces get enrolled into wider political discourses, functioning as geographical expressions of government visions to create a political legacy? Second, how are these spaces engineered and operate on-the-ground? Finally, how do young people understand their experiences of such spaces? To address these questions, we use the example of ‘National Citizen Service’ – a youth programme operating in England and Northern Ireland – to raise critical questions about the wider politics of spaces of informal education and attempts by the state to ‘make’ citizens and future neighbours. The article examines the rationale for this growing scheme, targeted at 15–17 year olds and designed to foster a ‘more cohesive, responsible and engaged society’. Drawing on original fieldwork with key architects, stakeholders and young people, we analyse the narratives that underlie NCS and its expansion – specifically around social cohesion and citizenship education. We explore the idea of ‘social mix’ as one of NCS’ guiding principles and its place as part of state narratives about the ‘Big Society’ and ‘Shared Society’