| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
- Hisinger-Molkanen, Hanna, et al.
(författare)
-
Asthma in adults : association of asthma symptoms and age at asthma diagnosis
- 2020
-
Ingår i: European Respiratory Journal. - : ERS Publications. - 0903-1936 .- 1399-3003. ; 56:Suppl 64
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Asthma may begin at any age. However, knowledge about the relationship between age at asthma diagnosis and asthma symptoms is still scarce.Objectives: To test the hypothesis that among adults, asthma diagnosed in adulthood is associated with more symptoms than asthma diagnosed in childhood.Methods: A FinEsS postal survey was conducted in a random sample of 16000 20-69-year-old adults in Finland in 2016. Age 18 years was chosen to delineate child and adult-diagnosed asthma. Current asthma was defined as physician-diagnosed asthma and asthma medication use, attacks of breathlessness or wheezing in the past year.Results: Of responders (8199, 51,5%), 692 reported current asthma and age at diagnosis. Adult-diagnosed asthma was reported by 445 (64.3%) and child-diagnosed by 247 (35.7%) responders. Those with adult-diagnosed asthma had more attacks of breathlessness in the past year (82.9% vs. 74.1%, p=0.006), dyspnea (mMRC grade ≥2) (34.4% vs. 18.8%, p<0.001) and sputum production in the past three consecutive months (40.0% vs. 27.5%, p=0.001). Of responders with adult and child-diagnosed asthma, 22.5% and 28.3% were current smokers, and 91.7% and 84.2% used asthma medication, respectively. In a logistic regression model, risk factors for attacks of breathlessness were adult-diagnosis (OR=1.8, 95% CI 1.1-3.0) and exercising <2 times a week (OR=2.0, 1.2-3.2).Conclusion: Asthmatics with adult-diagnosed asthma had significantly more symptoms even though they smoked less and used asthma medication more often compared to those with child-diagnosed asthma. Recognizing adult onset asthma in clinical practise is important to direct precise clinical care and achieve better asthma control.
|
|
| 7. |
- James, Hayley R, et al.
(författare)
-
IgE Antibodies to Mammalian Allergens Are a Major Risk Factor for Prevalence, Severity, and Persistence of Asthma in Northern Sweden
- 2015
-
Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier. - 0091-6749 .- 1097-6825. ; 135:2, s. AB22-AB22
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- IgE to mammalian allergens can contribute significantly to asthma risk. Studying the details of the relationship between animal sensitization and asthma is simpler in an environment where mite, fungal, and cockroach allergens make little or no contribution to asthma risk. Methods: Quantitative assays for IgE to eight allergens were carried out on 963 sera from 19-year-olds in a population-based cohort in northern Sweden, and associations with questionnaire data from ages 7, 12, and 19 on asthma symptoms, diagnosis, and treatment were tested. Results: Overall, 79 (53%) of the students with a physician diagnosis of asthma were positive to one or more of the mammalian allergens (cat, dog, or horse danders) tested. Of the allergens assessed, only mammalian allergens, birch, and timothy grass pollen showed a significant relationship with asthma diagnosis. Multivariate analysis showed that high titer (>17.5 IU/ml) IgE to any mammalian allergen had the strongest relationship with asthma at age 19 (odds ratio 5.1 [3.0-8.6]). Furthermore, IgE to mammalian allergens gave an odds ratio of 8.5 [4.9-15] for asthma that started before age 12 and was still present at age 19. Sensitization to Fel d 1 and Fel d 4 was strongly associated with asthma and significantly reduced in cat owners. Conclusions: Sensitization to cat and dog related allergens, and specifically to the components Fel d 1 and Fel d 4, is a major risk factor for the persistence and severity of asthma in an area where these are the only significant perennial allergens.
|
|
| 8. |
- Lawrence, Monica G, et al.
(författare)
-
Undetectable Serum IgE Is a Sensitive and Specific Marker of Common Variable Immunodeficiency (CVID)
- 2015
-
Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier. - 0091-6749 .- 1097-6825. ; 135:2, s. AB275-AB275
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Common variable immunodeficiency (CVID) is characterized by antibody deficiency and recurrent infections as well as autoimmunity, lymphoproliferation, and hematologic malignancy. The current diagnostic criteria for CVID include reduction in serum immunoglobulin (Ig)G and either IgA or IgM and failure of antibody production. Serum IgE level is not currently considered in establishing the diagnosis of CVID. Methods: A cohort of 123 subjects from the University of Virginia Health Systems, Medical College of Wisconsin and Mount Sinai School of Medicine were diagnosed with CVID by an experienced immunologist on the basis of currently accepted diagnostic criteria, including clinical history, serum IgG, IgA and IgM, and antibody response to vaccinations. Serum IgE was measured in all of these subjects using the Phadia ImmunoCap system. Serum IgE was also measured in an unbiased control cohort of 963 healthy 17-18 year olds from northern Sweden. Results: The prevalence of undetectable (<2 IU/ml) total serum IgE in our cohort of 123 subjects with CVID was 84.6% and the prevalence of IgE <10 IU/ml was 97.6%. In comparison, IgE <2 IU/ml was found in only 3.8% of controls, in agreement with other published population estimates. Conclusions: The finding of an undetectable (<2 IU/ml) serum IgE has both a high sensitivity of 84.6% and a high specificity of 96.2% for the diagnosis of CVID. Based on this observation, measurement of serum IgE should be included as a part of the routine laboratory work-up for CVID, and an undetectable serum IgE included as a component of the diagnostic criteria.
|
|
| 9. |
- Pakkasela, Johanna, et al.
(författare)
-
Age at asthma diagnosis in subjects with and without allergic rhinitis
- 2018
-
Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Onset of allergic asthma has a strong association with childhood. Much less is known about adult onset asthma and its association with allergy.Objectives: To assess the proportion of allergic and non-allergic asthma in adulthood in relation to the age at asthma diagnosis.Methods: Postal questionnaires were sent to 8000 randomly selected recipients aged 20-69 years in Finland in 2016. The participation rate was 52% (n=4173). Asthma was classified allergic when a physician-diagnosed asthma and a physician-diagnosed allergic rhinitis were both reported.Results: The prevalence of physician-diagnosed asthma and allergic rhinitis were 11% (n=445) and 18%, respectively. Mean ages at diagnosis of allergic asthma and non-allergic asthma were 19 and 35 years, respectively. Among subjects with asthma diagnosis at ages 0-19, 20-39 and 50-69 years, 67%, 55% and 23%, respectively, were allergic. For non-allergic asthma, the incidence rate of asthma was lowest in children and young adults (0.7/1000/year). It increased after middle age and was highest in older age groups (2.4/1000/year in 50-59 years old).Conclusions: The study results support the well-recognized fact that childhood asthma is mostly allergic. To our knowledge, this is the first study to show that the proportion of allergic asthma steadily declines with advancing age at asthma diagnosis and non-allergic asthma becomes the dominant phenotype with asthma diagnosed in middle age.
|
|
| 10. |
|
|
