Effects of traffic-related air pollution on susceptibility to infantile bronchiolitis and childhood asthma: A cohort study in Korea

Objective: This study examined the role of exposure to traffic-related air pollution (TRAP) on susceptibility to asthma in children with past episodes of bronchiolitis. Methods: The baseline data included 2,627 school children aged 6–14 years who had participated in the longitudinal follow-up survey of the Children's Health and Environmental Research of Korea. Lifetime wheezing, past episodes of bronchiolitis, and doctor-diagnosed asthma were evaluated using an International Study of Asthma and Allergies in Childhood questionnaire. We used generalized linear regression with binomial distribution to calculate the relative risk (RR) between TRAP, assessed by proximity to a main road and the total length of roads, and asthma. Results: Compared with the subjects who had less than 100 m of road length within 200-m radius from their home, those with more than 500 m of road length had significantly increased odds for infantile bronchiolitis (adjusted OR [aOR]: 1.57, 95% confidence interval [CI]: 1.01–2.42). Positive exposure-response relationships were found between residential proximity to the main road and asthma (aOR: 1.79, 95% CI: 1.05–3.06; <75 m vs. >700 m from a main road, P for the trend = 0.02). Closer residential proximity to the main road (<75 m) and bronchiolitis combined increased the risks of newly diagnosed asthma (adjusted RR: 3.62, 95% CI: 1.07–12.26) compared with those without bronchiolitis and living ≥ 75 m away from the main road. Conclusions: TRAP appeared to be associated with an increased asthma among children with bronchiolitis, indicating the importance of modifying effects of bronchiolitis in asthma pathogenesis.     

肠道菌群和心血管疾病的免疫调节

心血管疾病是人类健康的第一杀手,发病率和死亡率逐年增加。数万亿微生物寄居于人类肠道,在心血管疾病及其相关的代谢、免疫反应中发挥着至关重要的作用。先天性和适应性免疫机制都参与了心血管疾病的发生发展,菌群组分和代谢产物可调节巨噬细胞、淋巴细胞等免疫细胞的分化及功能,并通过循环系统影响机体免疫稳态。本文将通过肠道菌群及其代谢产物与免疫系统的相互作用,讨论肠道菌群与心血管疾病发展之间潜在的免疫机制,为预防和治疗心血管疾病提供新思路。     

Gut microbiota changes in patients with hypertension: A systematic review and meta-analysis

Hypertension is a major public health issue worldwide. The imbalance of gut microbiota is thought to play an important role in the pathogenesis of hypertension. The authors conducted the systematic review and meta-analysis to clarify the relationship between gut microbiota and hypertension through conducting an electronic search in six databases. Our meta-analysis included 19 studies and the results showed that compared with healthy controls, Shannon significantly decreased in hypertension [SMD = −0.13, 95%CI (−0.22, −0.04), p = .007]; however, Simpson [SMD = −0.01, 95%CI (−0.14, 0.12), p = .87], ACE [SMD = 0.18, 95%CI (−0.06, 0.43), p = .14], and Chao1 [SMD = 0.11, 95%CI (−0.01, 0.23), p = .08] did not differ significantly between hypertension and healthy controls. The F/B ratio significantly increased in hypertension [SMD = 0.84, 95%CI (0.10, 1.58), p = .03]. In addition, Shannon index was negatively correlated with hypertension [r = −0.12, 95%CI (−0.19, −0.05)], but had no significant correlation with SBP [r = 0.10, 95%CI (−0.19, 0.37)] and DBP [r = −0.39, 95%CI (−0.73, 0.12)]. At the phylum level, the relative abundance of Firmicutes [SMD = −0.01, 95%CI (−0.37, 0.34), p = .94], Bacteroidetes [SMD = −0.15, 95%CI (−0.44, 0.14), p = .30], Proteobacteria [SMD = 0.25, 95%CI (−0.01, 0.51), p = .06], and Actinobacteria [SMD = 0.21, 95%CI (−0.11, 0.53), p = .21] did not differ significantly between hypertension and healthy controls. At the genus level, compared with healthy controls, the relative abundance of Faecalibacterium decreased significantly [SMD = −0.16, 95%CI (−0.28, −0.04), p = .01], while the Streptococcus [SMD = 0.20, 95%CI (0.08, 0.32), p = .001] and Enterococcus [SMD = 0.20, 95%CI (0.08, 0.33), p = .002] significantly increased in hypertension. Available evidence suggests that hypertensive patients may have an imbalance of gut microbiota. However, it still needs further validation by large sample size studies of high quality.     

Effects of omalizumab in children with asthma: A protocol for systematic review and meta-analysis

Background:It is still controversial in the current literature whether omalizumab is beneficial for children with asthma. Given that there is no high-quality meta-analysis to incorporate existing evidence, the purpose of this protocol is to design a systematic review and meta-analysis of the level I evidence to ascertain whether omalizumab is beneficial and safe for children with asthma.Methods:The systematic literature review is structured to adhere to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The following search terms will be used in PUBMED, Scopus, EMBASE, and Cochrane Library databases on June, 2021, as the search algorithm: (omalizumab) AND (asthma) AND (children). The primary outcome is the long-term safety and tolerability of omalizumab. The other outcomes include asthma control, quality of life, use of asthma controller medications, and spirometry measurements and emergency room visits due to asthma, and serum trough concentrations of omalizumab, free and total immunoglobulin E measured. Review Manager software (v 5.3; Cochrane Collaboration) will be used for the meta-analysis.Results:The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.Registration number:10.17605/OSF.IO/G6N3P.     

Gut microbiome and amyotrophic lateral sclerosis: A systematic review of current evidence

Amyotrophic lateral sclerosis (ALS), characterized by a loss of motor neurons in the brain and spinal cord, is a relatively rare but currently incurable neurodegenerative disease. The global incidence of ALS is estimated as 1.75 per 100,000 person-years and the global prevalence is estimated as 4.1–8.4 per 100,000 individuals. Contributions from outside the central nervous system to the etiology of ALS have been increasingly recognized. Gut microbiome is one of the most quickly growing fields of research for ALS. In this article, we performed a comprehensive review of the results from existing animal and human studies, to provide an up-to-date summary of the current research on gut microbiome and ALS. In brief, we found relatively consistent results from animal studies, suggesting an altered gut microbiome composition in experimental ALS. Publication bias might however be a concern. Findings from human studies are largely inconclusive. A few animal and human studies demonstrated the usefulness of intervention with microbial-derived metabolites in modulating the disease progression of ALS. We discussed potential methodological concerns in these studies, including study design, statistical power, handling process of biospecimens and sequencing data, as well as statistical methods and interpretation of results. Finally, we made a few proposals for continued microbiome research in ALS, with the aim to provide valid, reproducible, and translatable findings.     

Gut microbial communities modulating brain development and function

Mammalian brain development is initiated in utero and internal and external environmental signals can affect this process all the way until adulthood. Recent observations suggest that one such external cue is the indigenous microbiota which has been shown to affect developmental programming of the brain. This may have consequences for brain maturation and function that impact on cognitive functions later in life. This review discusses these recent findings from a developmental perspective.     

Gut microbial communities modulating brain development and function

Mammalian brain development is initiated in utero and internal and external environmental signals can affect this process all the way until adulthood. Recent observations suggest that one such external cue is the indigenous microbiota which has been shown to affect developmental programming of the brain. This may have consequences for brain maturation and function that impact on cognitive functions later in life. This review discusses these recent findings from a developmental perspective.     

Lung function and symptom perception in children with asthma and their parents

A large proportion of children with asthma are managed without recourse to specialized care, and treatment decisions are based solely on symptoms as reported by the children and their parents. We investigated 90 school-age children with the diagnosis of asthma and their accompanying parent to evaluate whether we can obtain better information by using three different means of asking for asthma symptoms: a questionnaire for children (QSR(children)), "smilies," and a visual analogue scale for children (VAS(children)). Furthermore, we analyzed the relationship between these symptom reports and lung function results. Finally, we attempted to determine whether performing a lung function test contributes relevant information toward improving asthma management. Multiple linear regression adjusted for age and gender showed a significant relationship between VAS for children and forced expiratory volume in 1 sec (FEV(1)) (P = 0.047) and maximal expiratory flow at 50% of forced vital capacity (MEF(50)) (P = 0.037). Neither age, gender, QSR for children, "smilies for children" nor all the parents' scores showed a significant association with lung function measurement in the regression model. Subgroup analysis with Spearman's rank correlation coefficients by age group revealed significant correlation in children <10 years between VAS for children, QSR for parents, smilies for parents, and the lung function parameters FEV(1), and MEF(50). Above age 10 years there was no correlation at all, with the accuracy correlation ranging from -0.04 to +0.21. Our data demonstrate that reported symptoms do not reliably correlate with lung function results in asthmatic children and the childrens' parents, and correlation is dependent on the instrument used for symptom evaluation. In children, the VAS, and in parents, the QSR were the most valuable means of obtaining best information on asthma symptoms. This underlines the importance of supplementing information on asthma symptoms with lung function measurements to more reliably assess the severity of asthma.     

氨溴索用于小儿毛细支气管炎疗效研究

目的观察氨溴索用于小儿毛细支气管炎的治疗效果。方法选取我院收治的毛细支气管炎患儿48例,本次研究的毛细支气管炎治疗采用氨溴索超声雾化吸入,将患儿分为雾化吸入组和常规治疗组各24例,将两组患儿治疗效果对比。结果笔者通过对两组患儿治疗后数据分析后发现,雾化吸入组患儿的治愈率和有效率均高于常规治疗组(P<0.05);雾化吸入组患儿的咳嗽症状、肺部湿啰音和哮鸣音缓解时间明显优于常规治疗组(P<0.05);但是雾化吸入组患儿的气促症状的缓解和心率改善方面与常规治疗组无明显差别(P>0.05)。结论采用氨溴索雾化吸入治疗婴幼儿的急性期毛细支气管炎,患儿的临床症状、体征可以明显得到改善,且能大幅缩短病程,毒副作用轻微,疗效显著,理应推广。     

糖皮质激素吸入治疗对哮喘儿童肺功能的影响

目的探讨不同的糖皮质激素吸入治疗的疗程对哮喘儿童肺功能的影响。方法110例初诊时处于发作期的哮喘儿童年龄（6-14岁）,按糖皮质激素吸入治疗的疗程分成3组,A组（半年期组）50例,B组（1年期组）30例和C组（2年期组）30例,分别在用药前及用药后半年、1年、2年测定肺功能。结果三组患儿用药后肺功能均较用药前明显改善（P〈0.001）,其中大气道功能改善最为迅速,半年即达预计值的80%以上,小气道功能障碍持续存在,随疗程的延长,二年期与半年期相比大小气道功能均有显著性改善（P〈0.05）。结论在儿童哮喘防治中,应坚持小剂量糖皮质激素吸入治疗二年以上。