Abstracts from the 3rd International Severe Asthma Forum (ISAF)
Pulmonology
DOI:
10.1186/s13601-017-0149-8
Publication Date:
2017-05-24T07:24:37Z
AUTHORS (211)
ABSTRACT
ORAL ABSTRACT SESSION 1—Asthma: from mechanisms to managementO01 Serum IL-1RL1-A levels predict an eosinophilic subtype of asthma in preschool wheezing childrenM. E. Ketelaar1, K. Van De Kant2, F. N. Dijk1, M. Klaassen3, Grotenboer4, C. Nawijn4, Dompeling2, G. H. Koppelman1 1University Medical Center Groningen, Beatrix Children's Hospital, Groningen Research Institute for Asthma and COPD (GRIAC), The Netherlands; 2Department Pediatric Pulmonology, School Public Health Primary Care (CAPHRI), Maastricht University (MUMC+), Maastricht, 3Department General Practice, 4University Department Pathology Biology, Laboratory Experimental Pulmonology Inflammation (EXPIRE), Netherlands Correspondence: Maria Elizabeth Ketelaar - m.e.ketelaar@student.rug.nl Clinical Translational Allergy 2017, 7(Suppl 2):O01 Introduction: Respiratory symptoms are common children. However, which these wheezers will develop at school age, what phenotype they remains difficult predict. Current models such as the prediction index (API) based on clinical parameters have only modest predictive accuracy. Expression well replicated genes could potentially form novel biomarkers prediction. IL1RL1 is susceptibility gene, has also been linked eosinophilia. Therefore, we hypothesized that expression soluble IL-1RL1-a measured serum children contribute age. Moreover, since was previously associated with blood eosinophilia, our second aim determine whether asthma. Method: We used logistic modeling a prospective Dutch birth cohort (n = 202 wheezers), calculated area under curve (AUC) sensitivity/1-specificity curves potential models. Results: Neither age 2–3 years alone nor its combination API had value doctors' diagnosed 6y (IL-1RL1-a alone: AUC 0.50 [95 CI 0.41–0.59, P 0.98], + IL-1RL1-a: 0.57 0.49–0.66, 0.12]).However, correlated severity airway eosinophilia (determined by exhaled fraction NO, [FeNO]) who developed (Pearson's R −0.24, 0.046, N 59). Logistic (asthma FeNO ≥ 20 ppb) showed itself this subphenotype 0.65 0.52–0.79, 0.04], 0.70 0.56–0.84, 0.01]). Interestingly, negative direction effect. Conclusion: Our study shows IL-1RL1–a do not general 6 years, but negatively asthma.This suggests IL-1RL1 might play protective role development experience implies targeted therapy rather be further explored asthmatic predominant inflammation. Keywords: Childhood Asthma, Eosinophilic Prediction, IL-1RL1, SerumFigure 1 Prediction childhood using IL-1 RL1-a O03 Diagnosing symptomatic lung function: evidence studyClare Murray1, Philip Foden1, Lesley Lowe1, Hannah Durrington1, Adnan Custovic2, Angela Simpson1 Manchester, United Kingdom; 2Imperial College, London, Kingdom Simpson angela.simpson@manchester.ac.uk 2):O03 In UK, new national draft guidance diagnosis proposes algorithms four tests function, each dichotomous variable (FEV1/FVC ratio less than lower limit normal [LLN], bronchodilator reversibility [BDR] ≥12%, 35 ppb PEFR variability). accuracy diagnosing unknown, largely derived studies adults. Within setting population-based (Manchester Study—MAAS), investigated FEV1/FVC, BDR Using validated questionnaires assessed participants 16 years. defined all three of: (1) doctor-diagnosed ever, (2) previous 12 months (3) current use treatment. assigned features non-asthmatic controls. ATS/ERS guidelines, spirometry (NIOX chemiluminescence analyser; Sweden). considered positive if FEV1 increased ≥12% following administration 400 mg salbutamol. variability measured. To test diagnostic simulating clinic situation, selected reporting recent wheeze, cough or breathlessness were regular inhaled corticosteroids (ICS). Of 630 MAAS full data available, 163 reported symptoms, ICS; 34 met definition asthma, 55 multivariable regression analysis, increasing risk (OR 1.02, 95% 1.01–1.04, p 0.006), trend FEV1/FVC 0.95, 0.87–1.02, 0.17), no association (p 0.94). proportion those show Venn diagram (Figure 1). 58 tests, 29.3% accounting 50% Only 5.9% tests. Applying 3 function failed detect cases. Proposed need tested prospectively. Diagnosis, FeNO, Lung Function, ChildrenFigure 2 showing number (n163) O04 Treatable traits European U-BIOPRED adult severe cohortAndrew J. Simpson1, Dominick Shaw2, Ana R. Sousa3, Louise Fleming4, Graham Roberts5, Ioannis Pandis6, Aruna T. Bansal7, Julie Corfield8, Scott Wagers9, Ratko Djukanovic5, Kian Fan Chung4, Peter Sterk10, Jorgen Vestbo1, Stephen Fowler1 1Division Infection, Immunity Medicine, Biological Sciences, Manchester Hospital South NHS Foundation Trust, 2Respiratory Unit, Nottingham, 3Respiratory Therapeutic GSK, Stockley Park, 4National Heart Institute, Imperial 5NIHR Southampton RespiratoryBiomedical Sciences Human Development Health, Southampton, 6Data Science Kensington Campus, College 7Acclarogen Ltd, St John's Innovation Centre, Cambridge, 8AstraZeneca R&D, Mölndal, Sweden; 9BioSci Consulting, Maasmechelen, Belgium; 10Dept Academic Amsterdam, Andrew Andrew.Simpson-2@Manchester.ac.uk 2):O04 Individuals may remain uncontrolled exacerbation-prone despite intensive guideline-directed treatment, management options limited. concept treatable traits, identification disease-associated characteristics, thus particularly useful framework context. Unbiased Biomarkers Disease Outcomes (U-BIOPRED) project recruited individuals (SA) specialist care, controls mild moderate (MMA). Aim: identify quantify within cohorts. criteria Agusti (Eur Respir J, 2016) identified prevalence rates database. Chi Square examine differences frequency between SA MMA Data 509 included analysis; 421 88 MMA. Twenty-nine identified, including 13 pulmonary, extra-pulmonary behavioral traits. Pulmonary airflow limitation (SA vs. 6%, < 0.001), 58% 39%, 0.002), 54% 43%, 0.067), exercise-induced 77% 54%, allergic rhinitis 47% 44%, 0.641), 63% 19%, 0.001) bronchitis 51% Vs. 16%, 0.000) highly prevalent cohorts, typically more versus most were; atopy 74% 92%, obesity 30% 38%, 0.178), reflux 36% 11%, hypertension 25% 9%, obstructive sleep apnea 26% 0.003). Behavioral low medication adherence 39% 52%, 0.031) smoking 8%, smokers eligible cohort). Participants mean (SD) 8 ± (2), 5 applied approach characterisation found commonly non-severe asthma; very high many there targets treatment even patients, supports management. Phenotypes, Traits
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