The predictive role of biomarkers and genetics in childhood asthma exacerbations

Asthma exacerbations are associated with significant childhood morbidity and mortality. Recurrent asthma attacks contribute to progressive loss of lung function and can sometimes be fatal or near‐fatal, even in mild asthma. Exacerbation prevention becomes a primary target in the management of all asthmatic patients. Our work reviews current advances on exacerbation predictive factors, focusing on the role of non‐invasive biomarkers and genetics in order to identify subjects at higher risk of asthma attacks. Easy‐to‐perform tests are necessary in children; therefore, interest has increased on samples like exhaled breath condensate, urine and saliva. The variability of biomarker levels suggests the use of seriate measurements and composite markers. Genetic predisposition to childhood asthma onset has been largely investigated. Recent studies highlighted the influence of single nucleotide polymorphisms even on exacerbation susceptibility, through involvement of both intrinsic mechanisms and gene‐environment interaction. The role of molecular and genetic aspects in exacerbation prediction supports an individual‐shaped approach, in which follow‐up planning and therapy optimization take into account not only the severity degree, but also the risk of recurrent exacerbations. Further efforts should be made to improve and validate the application of biomarkers and genomics in clinical settings

Asthma and food allergy: Which risks?

Over the past few decades, an increase in the prevalence of asthma and food allergy has been observed in the pediatric population. In infants, food sensitization, particularly to egg, has increased the risk of developing allergic asthma. This is even more likely if sensitization to food allergens occurs early within the first few years of life. It is indeed known that both diseases may be present simultaneously in the pediatric population, but coexistence may negatively influence the severity of both conditions by increasing the risk of life-threatening asthmatic episodes as well as food-related anaphylaxis. Therefore, an accurate clinical and phenotype characterization of this high-risk group of children with both asthma and food allergy and a more aggressive management might lead to reducing related morbidity and mortality. The aim of this review is to provide an updated overview on the close link between food allergy and asthma and their negative mutual influence

Childhood obesity and respiratory diseases: Which link?

Prevalence of childhood obesity is progressively increasing, reaching worldwide levels of 5.6% in girls and of 7.8% in boys. Several evidences showed that obesity is a major preventable risk factor and disease modifier of some respiratory conditions such as asthma and Obstructive Sleep Apnea Syndrome (OSAS). Co-occurrence of asthma and obesity may be due to common pathogenetic factors including exposure to air pollutants and tobacco smoking, Western diet, and low Vitamin D levels. Lung growth and dysanapsis phenomenon in asthmatic obese children play a role in impaired respiratory function which appears to be different than in adults. Genes involved in both asthma and obesity have been identified, though a gene-by-environment interaction has not been properly investigated yet. The identification of modifiable environmental factors influencing gene expression through epigenetic mechanisms may change the natural history of both diseases. Another important pediatric respiratory condition associated with obesity is Sleep-Disordered Breathing (SDB), especially Obstructive Sleep Apnea Syndrome (OSAS). OSAS and obesity are linked by a bidirectional causality, where the effects of one affect the other. The factors most involved in the association between OSAS and obesity are oxidative stress, systemic inflammation, and gut microbiota. In OSAS pathogenesis, obesity’s role appears to be mainly due to mechanical factors leading to an increase of respiratory work at night-time. However, a causal link between obesity-related inflammatory state and OSAS pathogenesis still needs to be properly confirmed. To prevent obesity and its complications, family education and precocious lifestyle changes are critical. A healthy diet may lead to an improved quality of life in obese children suffering from respiratory diseases. The present review aimed to investigate the links between obesity, asthma and OSAS, focusing on the available evidence and looking for future research fields

Yield of forage, grain and biomass in eight hybrids of maize with different sowing dates and environmental conditions

The aim was to evaluate yield of forage, grain and biomass and fibre content of eight hybrids of maize (Rio-Grande, Arrayan, Genex 778, Narro 2010, Advance 2203, DAS 2358, P4082W and HT9150W) during two sowing seasons (spring/summer) for two consecutive years at La Laguna in Torreon, Mexico. Once the grain progression of the kernel milk line was ⅓, green forage yield (GFY), dry matter (DM), neutral detergent fiber (NDF) and acid detergent fiber (ADF) were determined. When the corncobs were fully mature, grain yield (GY) and biomass production (TBP) were determined. Weather conditions were recorded during the experiment. The results indicated that maximum temperature was higher and rainfall lower in the summer sowing and second year. Spring sowing had significantly higher yields of GFY, DM, GY and TBP compared to summer sowing. The first year of study showed significantly higher yields regarding GFY, GY and TBP, but FDN, FDA, DM content compared to the second year. The best hybrid for GFY and DM was Rio-Grande; for FDN and FDA was Advance 2203; for GY was HT9150W and finally for TBP was Arrayan. Regardless of the hybrid used and the sowing season, production of maize depended on external factors such as maximum temperature and rainfall; therefore, producers need to consider sowing in spring to avoid the negative effect of high temperatures on plant development.The aim was to evaluate yield of forage, grain and biomass and fibre content of eight hybrids of maize (Rio-Grande, Arrayan, Genex 778, Narro 2010, Advance 2203, DAS 2358, P4082W and HT9150W) during two sowing seasons (spring/summer) for two consecutive years at La Laguna in Torreon, Mexico. Once the grain progression of the kernel milk line was ⅓, green forage yield (GFY), dry matter (DM), neutral detergent fiber (NDF) and acid detergent fiber (ADF) were determined. When the corncobs were fully mature, grain yield (GY) and biomass production (TBP) were determined. Weather conditions were recorded during the experiment. The results indicated that maximum temperature was higher and rainfall lower in the summer sowing and second year. Spring sowing had significantly higher yields of GFY, DM, GY and TBP compared to summer sowing. The first year of study showed significantly higher yields regarding GFY, GY and TBP, but FDN, FDA, DM content compared to the second year. The best hybrid for GFY and DM was Rio-Grande; for FDN and FDA was Advance 2203; for GY was HT9150W and finally for TBP was Arrayan. Regardless of the hybrid used and the sowing season, production of maize depended on external factors such as maximum temperature and rainfall; therefore, producers need to consider sowing in spring to avoid the negative effect of high temperatures on plant development

An Italian investigation on nutritional risk at hospital admission : the PIMAI (Project: Iatrogenic malnutrition in Italy) study

Background & aims: Nutritional risk on admission to hospital, which turns out to be high in most countries, was investigated. However, when consulting the "malnutrition-mapping" in Europe, the lack of Italian data raises attention. Accordingly, we designed a multidisciplinary, cross-sectional survey: the PIMAI study (Project: Iatrogenic MAlnutrition in Italy). Methods: Patients were enrolled from 13 large (>400 beds) multidisciplinary hospitals. Randomly selected adult (>18-year-old) patients were included according to a 4-strata model by gender and age (<65 and 6565 years). Nutritional risk was assessed by the Nutritional Risk Screening 2002 tool. Results: A total of 1284 patients were evaluated. Overall prevalence of nutritional risk was 28.6% with similar distribution between sexes and higher rates in medical rather than in surgical departments (33.6% vs 22.8%; p < 0.0001). Risk prevalence was markedly heterogeneous among specialties, ranging between 4.8% (ophthalmology) and 62.5% (oncology units). Moreover, in adults aged 18-65 years the prevalence of "risk of malnutrition" was significantly lower than in those 6565 years (18.3% vs 41.9%; p < 0.0001). Conclusions: The prevalence of nutritional risk on admission to hospital is high also in Italy. However, in patients aged 18-65 years nutritional risk appears a less prevalent comorbidity, thus supporting the role of age as an important determinant

A nationally representative survey of hospital malnutrition : the Italian PIMAI (Project: Iatrogenic MAlnutrition in Italy) study

Hospital malnutrition is high in every country it was investigated, but no nationally representative prevalence study, considering potential geographical interfering factors, has yet been performed. We designed a multidisciplinary, cross-sectional, nation-wide survey: the PIMAI study (Project: Iatrogenic MAlnutrition in Italy). Adult (>18 years old) patient inclusion was managed on a four-strata randomisation model according to sex and age (<65 and 6565 years). Malnutrition was defined by analytical criteria related to recent food intake and both physical (body mass index, weight loss, midupper arm anthropometry) and biochemical (albumin, prealbumin and lymphocyte count) malnutrition correlates. Thirteen hospitals (n = 1583) completed the study. The survey is likely to represent the country of Italy. Overall prevalence of malnutrition was 30.7%, with higher rates in the northern macroarea (36.7%) than in central (28.0%), southern (26.9%) and island (16.7%) ones (p < 0.0001). This discrepancy appeared to be mainly related to the prevalence of overweight/obesity. By a multivariate model, malnutrition was significantly lower in males (p < 0.05) and surgical wards (p < 0.002), associated with geography (p < 0.05) and consistently higher in patients aged 6565 years (p < 0.01), presenting with malignancies (p < 0.005) and having multidrug therapy (p < 0.05). The prevalence of hospital malnutrition is high also in Italy. It presents with different geographical distribution also according to overweight prevalence. This evidence should be considered when designing national nutritional policies

Peptide Conformer Acidity Analysis of Protein Flexibility Monitored by Hydrogen Exchange†

ABSTRACT: The amide hydrogens that are exposed to solvent in the high-resolution X-ray structures of ubiquitin, FK506-binding protein, chymotrypsin inhibitor 2, and rubredoxin span a billion-fold range in hydroxide-catalyzed exchange rates which are predictable by continuum dielectric methods. To facilitate analysis of transiently accessible amides, the hydroxide-catalyzed rate constants for every backbone amide of ubiquitin were determined under near physiological conditions. With the previously reported NMR-restrained molecular dynamics ensembles of ubiquitin (PDB codes 2NR2 and 2K39) used as representations of the Boltzmann-weighted conformational distribution, nearly all of the exchange rates for the highly exposed amides were more accurately predicted than by use of the high-resolution X-ray structure. More strikingly, predictions for the amide hydrogens of the NMR relaxation-restrained ensemble that become exposed to solvent in more than one but less than half of the 144 protein conformations in this ensemble were almost as accurate. In marked contrast, the exchange rates for many of the analogous amides in the residual dipolar coupling-restrained ubiquitin ensemble are substantially overestimated, as was particularly evident for the Ile 44 to Lys 48 segment which constitutes the primary interaction site for the proteasome targeting enzymes involved in polyubiquitylation. For both ensembles, “excited state ” conformers in this active site region having markedly elevated peptide acidities are represented at a population level that is 102 to 103 abov