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- Almqvist, Linnea, 1987-
(author)
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Asthma epidemiology : prognosis of asthma with onset in childhood and in adulthood
- 2024
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Doctoral thesis (other academic/artistic)abstract
- Aim: to update the knowledge on the epidemiology of asthma with onset in childhood and adulthood as well as examine the importance of risk factors in early childhood and clinical characteristics on the incidence and prognosis of asthma.Methods: The thesis is based on the epidemiological research program Obstructive Lung Disease in Northern Sweden (OLIN) studies. Pediatric cohort: recruited in 1996 (age 8y, n=3430, 97% of invited) and followed annually by questionnaire about asthma, allergy and risk factors until 19y and a postal questionnaire at 28y. Clinical examinations included skin prick tests (SPT at 8, 12 and 19y) and spirometry (19y). Adult cohort: 309 adults (age 20–60y) with asthma onset in the last 12 months were recruited 1995-99 and re-examined in 2012-14 (n=205). Structured interviews, spirometry and SPT were performed at recruitment and follow-up and bronchial hyperreactivity (BHR) at recruitment.Results: The asthma incidence rate was 10-13/1000/year in childhood and adolescence and 6/1000/year in young adulthood. Several risk factors in early life were associated with asthma onset in childhood, adolescence and young adulthood, e.g. family history of asthma, <3 months breastfeeding, rhinoconjunctivitis and positive SPT at 8y, while low birthweight, maternal smoking during pregnancy, severe respiratory infections and eczema were associated with onset in childhood and adolescence. Among those with asthma at 8y, 62% still had asthma at 28y and this was associated with positive SPT, rhinoconjunctivitis, severe respiratory infection in childhood, and bronchial hyperreactivity (BHR) in adolescence. Coexistence of asthma, rhinitis and eczema increased by age, especially among those with a positive SPT. However, having all three conditions was uncommon. In the 15y follow-up adult onset asthma, 89% had persistent asthma. Better lung function at recruitment and less severe BHR was associated with remission. Remission rate of adult onset asthma was <1% per year.Conclusion: The incidence of asthma was high during childhood and adolescence and then decreased in young adulthood. Factors in early life that were associated with incident asthma during childhood were still associated with the incidence in adult age. Among those with asthma onset by 8 years, 62%, still had asthma as young adults. The coexistence of asthma, rhinitis and eczema varied from 8 to 28y without following a specific pattern, only a small proportion reported having all three conditions. Remission of adult onset asthma was rare.
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- Almqvist, Linnea, et al.
(author)
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No remission in 60% of those with childhood-onset asthma : a population-based cohort followed from 8 to 28 years of age
- 2024
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In: Respiratory Medicine. - : Saunders Elsevier. - 0954-6111 .- 1532-3064. ; 224
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Journal article (peer-reviewed)abstract
- Background: Although remission occur, childhood-onset asthma may persist until adulthood. Since few longitudinal population-based studies have followed a cohort from childhood until adulthood, the knowledge on predictors of persistence of asthma is sparse.Aim: To estimate persistence of asthma from 8 to 28 years and its associated factors. Methods: Within the OLIN (Obstructive Lung Disease in Northern Sweden) studies, a cohort was recruited in 1996 (age 8y, n = 3430) and followed annually with questionnaires about asthma and risk factors until 19y. Clinical examinations included skin prick tests (at 8, 12 and 19y) and lung function tests (17 and 19y) whereof a subsample performed bronchial hyperreactivity test. We identified n = 248 with asthma at 8y whereof 170 (69%) participated in a follow-up at 28y (73% of possible to invite).Results: Of the 170 participants at 28y, 105 (61.8%) had persistent asthma (women: 49/76, 64.5%; men: 56/94, 59.6%, p = 0.513). Factors collected at recruitment: allergic sensitization (OR7.8, 95%CI 3.0–20.2), severe respiratory infection (OR2.6, 95%CI 1.1–6.3) and higher asthma severity score (OR1.6, 95%CI 1.1–2.4) were associated with asthma at 28y after adjustment for sex, family history of asthma, breastfeeding <3 months and eczema. Replacing allergic sensitization with rhinoconjunctivitis in the model yielded OR3.4 (95%CI 1.5–8.0). Bronchial hyperreactivity at age 17y associated with asthma at 28y (OR9.0, 95%CI 1.7–47.0).Conclusions: Among children with asthma onset by 8y, 62% still had asthma at age 28 years. Persistent asthma was associated with allergic sensitization, rhinoconjunctivitis, severe respiratory infection, a more severe asthma and bronchial hyperreactivity.
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- Hedman, Linnea, 1979-, et al.
(author)
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Early-life risk factors for development of asthma from 8 to 28 years of age : a prospective cohort study
- 2022
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In: ERJ Open Research. - : European Respiratory Society. - 2312-0541. ; 8:4
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Journal article (peer-reviewed)abstract
- Background: The objective was to estimate the incidence rate of asthma from age 8 to 28 years and evaluate early-life risk factors for asthma onset at different ages.Methods: In 1996, within the Obstructive Lung Disease in Northern Sweden (OLIN) studies, a cohort of 3430 schoolchildren (97% of invited) was recruited at age 8 years to a prospective study about asthma. The cohort was followed annually from age 8 to 19 years and at 28 years by questionnaire surveys (67% of the original cohort participated). Asthma was categorised as never-asthma, onset age ⩽8 years, onset age 9–13 years, onset age 14–19 years or onset age >19 years.Results: Of the 3430 individuals in the cohort, 690 (20.1%) reported asthma in any survey. The average incidence rate was 10.0/1000 per year at ⩽8 years, 11.9/1000 per year at 9–13 years, 13.3/1000 per year at 14–19 years and 6.1/1000 per year at >19 years. The incidence was higher among boys until age 10 years, but from age 15 years, it became higher among girls. Family history of asthma, allergic sensitisation and breastfeeding <3 months were associated with asthma onset throughout the study. Low birthweight, maternal smoking during pregnancy, severe respiratory infection, rhinoconjunctivitis and eczema were associated with asthma onset ⩽8 and 9–13 years.Conclusions: The incidence of asthma was high during childhood and the teenage period, and decreased substantially during young adulthood. Early-life factors were associated with asthma onset throughout childhood but had also a lasting effect on asthma incidence until adulthood.
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- af Klinteberg, Maja, 1980-, et al.
(author)
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Decreasing prevalence of atopic dermatitis in Swedish schoolchildren : three repeated population-based surveys
- 2024
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In: British Journal of Dermatology. - : Oxford University Press. - 0007-0963 .- 1365-2133. ; 190:2, s. 191-198
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Journal article (peer-reviewed)abstract
- Background: The prevalence of atopic dermatitis (AD) has increased over several decades and now affects about one-fifth of all children in high-income countries (HICs). While the increase continues in lower-income countries, the prevalence of AD might have reached a plateau in HICs.Objectives: To investigate trends in the prevalence of AD and atopic comorbidity in schoolchildren in Sweden.Methods: The study population consisted of three cohorts of children (median age 8 years) in Norrbotten, Sweden, for 1996 (n = 3430), 2006 (n = 2585) and 2017 (n = 2785). An identical questionnaire that included questions from the International Study of Asthma and Allergies in Childhood (ISAAC) protocol was used in all three cohorts. Trends in AD prevalence were estimated, as well as trends in atopic comorbidity. AD prevalence was estimated both according to the ISAAC definition of AD and by adding the reported diagnosis by a physician (D-AD).Results: The prevalence of AD decreased in the last decade, from 22.8% (1996) and 21.3% (2006) to 16.3% (2017; P < 0.001). The prevalence of D-AD was lower, but the same pattern of decrease was seen, from 9.3% (1996) and 9.4% (2006) to 5.7% (2017; P < 0.001). In all three cohorts, AD was more common among girls than boys (18.9% vs. 13.8% in 2017; P < 0.001). Children from the mountain inlands had a higher prevalence of AD than children from coastal cities (22.0% vs. 15.1% in 2017; P < 0.001). In comparing D-AD, there were no significant differences between the sexes or between inland or coastal living. Concomitant asthma increased over the years from 12.2% (1996) to 15.8% (2006) to 23.0% (2017; P < 0.001). Concomitant allergic rhinitis and allergic sensitization increased from 1996 (15.0% and 27.5%) to 2006 (24.7% and 49.5%) but then levelled off until 2017 (21.0% and 46.7%).Conclusions: The prevalence of AD among schoolchildren in Sweden decreased over the study period, whereas atopic comorbidity among children with AD increased. Although a decrease was seen, AD is still common and the increase in atopic comorbidity among children with AD, especially the increase in asthma, is concerning.
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- Andersson, Alma, et al.
(author)
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Spatial deconvolution of HER2-positive breast cancer delineates tumor-associated cell type interactions
- 2021
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In: Nature Communications. - : Springer Nature. - 2041-1723. ; 12:1
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Journal article (peer-reviewed)abstract
- In the past decades, transcriptomic studies have revolutionized cancer treatment and diagnosis. However, tumor sequencing strategies typically result in loss of spatial information, critical to understand cell interactions and their functional relevance. To address this, we investigate spatial gene expression in HER2-positive breast tumors using Spatial Transcriptomics technology. We show that expression-based clustering enables data-driven tumor annotation and assessment of intra- and interpatient heterogeneity; from which we discover shared gene signatures for immune and tumor processes. By integration with single cell data, we spatially map tumor-associated cell types to find tertiary lymphoid-like structures, and a type I interferon response overlapping with regions of T-cell and macrophage subset colocalization. We construct a predictive model to infer presence of tertiary lymphoid-like structures, applicable across tissue types and technical platforms. Taken together, we combine different data modalities to define a high resolution map of cellular interactions in tumors and provide tools generalizing across tissues and diseases. While transcriptomics have enhanced our understanding for cancer, spatial transcriptomics enable the characterisation of cellular interactions. Here, the authors integrate single cell data with spatial information for HER2 + tumours and develop tools for the prediction of interactions between tumour-infiltrating cells.
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| 9. |
- Andersson, Alma, et al.
(author)
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Spatial Deconvolution of HER2-positive Breast Tumors Reveals Novel Intercellular Relationships
- 2020
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Other publication (other academic/artistic)abstract
- In the past decades, transcriptomic studies have revolutionized cancer treatment and diagnosis. However, tumor sequencing strategies typically result in loss of spatial information, critical to understand cell interactions and their functional relevance. To address this, we investigate spatial gene expression in HER2-positive breast tumors using Spatial Transcriptomics technology. We show that expression-based clustering enables data-driven tumor annotation and assessment of intra-and interpatient heterogeneity; from which we discover shared gene signatures for immune and tumor processes. We integrate and spatially map tumor-associated types from single cell data to find: segregated epithelial cells, interactions between B and T-cells and myeloid cells, co-localization of macrophage and T-cell subsets. A model is constructed to infer presence of tertiary lymphoid structures, applicable across tissue types and technical platforms. Taken together, we combine different data modalities to define novel interactions between tumor-infiltrating cells in breast cancer and provide tools generalizing across tissues and diseases.
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