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The role of inflammation markers, risk factors and measures of severity in different phenotypes of childhood asthma. Alla Nakonechna (Liverpool UK) , Tanya Umanetz (Kiev Ukraine), Vladimir Lapshin (Kiev Ukraine). Asthma in children.
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The role of inflammation markers, risk factors and measures of severity in different phenotypes of childhood asthma Alla Nakonechna (Liverpool UK), Tanya Umanetz (Kiev Ukraine), Vladimir Lapshin (Kiev Ukraine)
Asthma in children phenotypically heterogeneous disorder; important to determine for correct treatment and prognostic assessment Diagrammatical classification of clinical asthma phenotypes includes: • onset age • inflammatory profile • severity pattern Main childhood asthma phenotypes • transient infant wheezing • non atopic wheezing of the toddler and early school years • persistent IgE-mediated wheezing/asthma • late-onset childhood asthma Summer Allergy School, Norwich
Objective investigate whether there are differences between children with different asthma phenotypes in: • inflammation markers • risk factors • measures of severity Summer Allergy School, Norwich
Materials and methods 245 children - aged 6-12 years with BA Control group: 57 age matched children Diagnosis, assessment of asthma status and criteria for asthma phenotypes based on: • clinical questionnaire • physical examination • allergy skin prick tests (SPTs) • Total and antigen specific IgE • Lung functions • Bronchial hyperreactivity (BHR) tests • Methacholine provocation test – MPT- PC20, FEV1 • exercised challenge - by 6 minutes running, at 85-90% of maximum heart rate, measured by heart rate monitor. • Induced sputum analysis – method PizzichiniT Summer Allergy School, Norwich
Results Summer Allergy School, Norwich
Results Summer Allergy School, Norwich
Results Summer Allergy School, Norwich
Sensitization to allergen Summer Allergy School, Norwich
IgE levels Summer Allergy School, Norwich
Lung function Summer Allergy School, Norwich
Results Summer Allergy School, Norwich
Total and differential cell counts in induced sputum Summer Allergy School, Norwich
Conclusions • Asthma risk factors and measures of severity vary between children with different asthma phenotypes (atopic and non-atopic). • Inflammation markers suggest a role for monitoring inflammation and therapy in childhood asthma management. Summer Allergy School, Norwich