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Asthma Treatment Outcome Measures

  • Manisha WitmansEmail author
Chapter

Abstract

Asthma is a common, systemic chronic inflammatory disease characterized by reversible lower airflow obstruction affecting over 334 million people worldwide and is the most common chronic disease in children. Asthma is influenced by genetic and environmental factors in its presentation in affected individuals. Whether allergies play a role or not, the inflammation in the airway is the pathophysiological mechanism and target of treatment to not only control the symptoms but also the inflammatory cascade that results from the trigger that initiated the response. In the last decade, it has become apparent that asthma is also a risk factor for obstructive sleep disordered breathing (pediatric OSA) and vice versa. Additional burden from inflammation associated with obesity further contributes to the problem and may be an accelerant of systemic inflammation. The role of inflammation within the airway systemically has widespread systemic effects for childhood development, growth, and functioning. As much as allergies affect sleep quality and can be a risk factor for the presence of pediatric OSA, the role of fragmented sleep may equally affect the presence of inflammatory cytokines both in the airway and systemically. The aim of this chapter is to discuss the role of treatment outcome measures in asthma and how that may determine future management of asthma, allergies, and sleep problems in affected individuals.

Keywords

Asthma outcome measures Pediatric obstructive sleep disordered breathing (pediatric OSA) Atopic disease Anti-inflammatory therapy in asthma Medications for asthma 

References

  1. 1.
    National Institutes of Health. International consensus report on diagnosis and treatment of asthma. Bethesda: National Heart, Lung, and Blood Institute, National Institutes of Health; 1992.Google Scholar
  2. 2.
    GINA (Global Initiative for Asthma) – global strategy for asthma management and prevention: 2017. www.ginasthma.org. pp. 1–92.
  3. 3.
    Ellwood P, Asher MI, Beasley R, Clayton TO, Stewart AW, ISAAC Steering Committee. The international study of asthma and allergies in childhood (ISAAC): phase three rationale and methods. Int J Tuberc Lung Dis. 2005;9:10–6.PubMedGoogle Scholar
  4. 4.
    Asher MI, Anderson HR, Stewart AW, et al. Worldwide variations in the prevalence of asthma symptoms: the international study of asthma and allergies in childhood (ISAAC). Eur Respir J. 1998;12:315–35.CrossRefGoogle Scholar
  5. 5.
    Lai CKW, Beasley R, Crane J, et al. Global variation in the prevalence and severity of asthma symptoms: phase three of the international study of asthma and allergies in childhood (ISAAC). Thorax. 2009;64:476–83.CrossRefGoogle Scholar
  6. 6.
    Peters SP, Ferguson G, Deniz Y, Reisner C. Uncontrolled asthma: a review of the prevalence, disease burden and options for treatment. Respir Med. 2006;100:1139–51.CrossRefGoogle Scholar
  7. 7.
    Demoly P, Paggiaro P, Plaza V, et al. Prevalence of asthma control among adults in France, Germany, Italy, Spain and the UK. Eur Respir Rev. 2009;18:105–12.CrossRefGoogle Scholar
  8. 8.
    Tai A, Tran H, Roberts M, et al. Outcomes of childhood asthma to the age of 50 years. J Allergy Clin Immunol. 2014;133:1572–8.CrossRefGoogle Scholar
  9. 9.
    Bahadori K, Doyle-Waters MM, Marra C, et al. Economic burden of asthma: a systematic review. BMC Pulm Med. 2009;9:24.CrossRefGoogle Scholar
  10. 10.
    Nurmagambetov T, Kuwhara R, Garbe P. The economic burden of asthma in the United States, 2008-2013. Ann Am Thorac Soc. 2018;15:348–56.CrossRefGoogle Scholar
  11. 11.
    Moorman JE, Rudd RA, Johnson CA, King M, Minor P, Bailey C, et al. National surveillance for asthma—United States, 1980–2004. Atlanta: Department of Health and Human Services, Centers for Disease Control and Prevention; 2007.Google Scholar
  12. 12.
    Wainwright C, Isles AF, Francis PW. Asthma in children. Med J Aust. 1997;167:218–23.CrossRefGoogle Scholar
  13. 13.
    Serebrovskaya TV, Xi L. Intermittent hypoxia in childhood: the harmful consequences versus potential benefits of therapeutic uses. Front Pediatr. 2015;3:44.  https://doi.org/10.3389/fped.2015.00044.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Gozal E, Gozal D. Respiratory plasticity following intermittent hypoxia: developmental interactions. J Appl Physiol. 2001;90:1995–9.CrossRefGoogle Scholar
  15. 15.
    Brockmann PE, Koren D, Kheirandish-Gozal L, Gozal D. Gender dimorphism in pediatric OSA: is it for real? Respir Physiol Neurobiol. 2017;245:83–8.CrossRefGoogle Scholar
  16. 16.
    DelRosso LM. Epidemiology and diagnosis of pediatric obstructive sleep apnea. Curr Probl Pediatr Adolesc Health Care. 2016;46:2–6.CrossRefGoogle Scholar
  17. 17.
    Cote V, Ruiz AG, Perkins J, Sillau S, Friedman NR. Characteristics of children under 2 years of age undergoing tonsillectomy for upper airway obstruction. Int J Pediatr Otorhinolaryngol. 2015;79(6):903–8.CrossRefGoogle Scholar
  18. 18.
    Meaney MJ. Epigenetics and the biological definition of gene x environment interactions. Child Dev. 2010;81:41.CrossRefGoogle Scholar
  19. 19.
    Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14:245–58.CrossRefGoogle Scholar
  20. 20.
    Brown DW, Anda RF, Felitti VJ, et al. Adverse childhood experiences are associated with the risk of lung cancer: a prospective cohort study. BMC Public Health. 2010;10:20.CrossRefGoogle Scholar
  21. 21.
    Oh D, Jerman P, Marques S, et al. Systematic review of pediatric health outcomes associated with childhood adversity. BMC Pediatr. 2018;18:83.CrossRefGoogle Scholar
  22. 22.
    Yen NH, Thuy NTD, Sy DQ. Study of the clinical and functional characteristics of asthmatic children with obstructive sleep apnea. J Asthma Allergy. 2017;10:285–92.CrossRefGoogle Scholar
  23. 23.
    Moffatt MF, Kabesch M, Liang L, et al. Genetic variants regulating ORMDL3 expression contribute to the risk of childhood asthma. Nature. 2007;448:470–3.CrossRefGoogle Scholar
  24. 24.
    Portelli MA, Hodge E, Sayers I. Genetic risk factors for the development of allergic disease identified by genome-wide association. Clin Exp Allergy. 2015;45:21–31.CrossRefGoogle Scholar
  25. 25.
    Gaines J, Vgontzas AN, Fernandez-Mendoza J, et al. Inflammation mediates the association between visceral adiposity and obstructive sleep apnea in adolescents. Am J Physiol Endoccrinol Metab. 2016;311(5):E851–8.CrossRefGoogle Scholar
  26. 26.
    Li Z, Celestin J, Lockey RF. Pediatric sleep apnea syndrome: an update. J Allergy Clin Immunol Pract. 2016;4:852–61.CrossRefGoogle Scholar
  27. 27.
    Tan HL, Gozal D, Kheirandish-Gozal L. Obstructive sleep apnea in children: a critical update. Nat Sci Sleep. 2013;5:109–23.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Strachan D, Pearce N. Factors affecting asthma. In: The International Union Against Tuberculosis and Lung Disease, The International Study of Asthma and Allergies in Childhood, eds. The global asthma report, 2011. Paris, France, 2011.Google Scholar
  29. 29.
    Genuneit J, Cantelmo JL, Weinmayr G, et al. A multi-centre study of candidate genes for wheeze and allergy: the international study of asthma and allergies in childhood phase 2. Clin Exp Allergy. 2009;39:1875–88.CrossRefGoogle Scholar
  30. 30.
    Cabieses B, Uphoff E, Pinart M, Antó JM, Wright J. A systematic review on the development of asthma and allergic diseases in relation to international immigration: the leading role of the environment confirmed. PLoS One. 2014;9:e105347.CrossRefGoogle Scholar
  31. 31.
    Gur M, Hakim F, Bentur L. Better understanding of childhood asthma, towards primary prevention – are we there yet? Consideration of pertinent literature. F1000 Res. 2017;6:2152.CrossRefGoogle Scholar
  32. 32.
    Greenberg H, Cohen RI. Nocturnal asthma. Curr Opin Pulm Med. 2012;18:57–62.CrossRefGoogle Scholar
  33. 33.
    Erichsen D, Godoy C, Granse F, Axelsson J, Rubin D, Gozal D. Screening for sleep disorders in pediatric primary care: are we there yet? Clin Pediatr. 2012;51:1125–9.CrossRefGoogle Scholar
  34. 34.
    National Heart, Lung, and Blood Institute. Expert panel report 3: guidelines for the diagnosis and management of asthma. National Institutes of Public Health Publication No. 97-4051. Bethesda: National Heart, Lung, and Blood Institute; 2007.Google Scholar
  35. 35.
    Papi A, Brightling C, Pedersen SE, et al. Asthma. Lancet. 2018;391:783–800.CrossRefGoogle Scholar
  36. 36.
    Global Initiative for Asthma. 2017 GINA report, global strategy for asthma management and prevention. 2017. http://ginasthma.org/2017-gina-report-global-strategy-for-asthma-management-andprevention/. Accessed 6 June 2017.
  37. 37.
    Prasad B, Nyenhuis SM, Weaver TE. Obstructive sleep apnea and asthma: associations and treatment implications. Sleep Med Rev. 2014;18:165–71.CrossRefGoogle Scholar
  38. 38.
    Shay LA, Lafata JE. Where is the evidence? A systematic review of shared decision making and patient outcomes. Med Decis Mak. 2015;35:114–31.CrossRefGoogle Scholar
  39. 39.
    Braman SS. The global burden of asthma. Chest. 2006;130(1 Suppl):4S–12S.CrossRefGoogle Scholar
  40. 40.
    Lavoie KL, Bouthillier D, Bacon SL, et al. Psychologic distress and maladaptive coping styles in patients with severe vs moderate asthma. Chest. 2010;137:1324–31.CrossRefGoogle Scholar
  41. 41.
    Heaney LG, Conway E, Kelly C, Gamble J. Prevalence of psychiatric morbidity in a difficult asthma population: relationship to asthma outcome. Respir Med. 2005;99:1152–9.CrossRefGoogle Scholar
  42. 42.
    Yorke J, Fleming S, Rao H, et al. Non-pharmacological interventions aimed at modifying health and behavioral outcomes for adults with asthma: a critical review. Clin Exp Allergy. 2015;45:1750–64.CrossRefGoogle Scholar
  43. 43.
    Parry GD, Cooper CL, Moore JM, et al. Cognitive behavioural intervention for adults with anxiety complications of asthma: prospective randomised trial. Respir Med. 2012;106:802–10.CrossRefGoogle Scholar
  44. 44.
    Ross CJ, Davis TM, MacDonald GF. Cognitive-behavioral treatment combined with asthma education for adults with asthma and coexisting panic disorder. Clin Nurs Res. 2005;14:131–57.CrossRefGoogle Scholar
  45. 45.
    Skoner D. Outcome measures in childhood asthma. Pediatrics. 2002;109:393–8.PubMedGoogle Scholar
  46. 46.
    Worth A, Hammersley V, Knibb R, et al. Patient-reported outcome measures for asthma: a systematic review. NPJ Prim Care Respir Med. 2014;24:14020.CrossRefGoogle Scholar
  47. 47.
    Yeatts KB, Stucky B, Thissen D, et al. Construction of the pediatric asthma impact scale (PAIS) for the patient-reported outcomes measurement information system (PROMIS). J Asthma. 2010;47:295–302.CrossRefGoogle Scholar
  48. 48.
    Licari A, Brambilla I, Marseglia A, et al. Difficult vs. severe asthma: definition and limits of asthma control in the pediatric population. Front Pediatr. 2018;6:170.  https://doi.org/10.3389/fped.2018.00170.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Pediatric Pulmonology, Department of PediatricsThe Stollery Children’s Hospital & University of Alberta HospitalsEdmontonCanada

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