Medicine and Health Sciences Commons^™

Effect Of Intrauterine Smoke Exposure On Microrna-15a Expression In Human Lung Development And Subsequent Asthma Risk., Sunita Sharma, Alvin T. Kho, Divya Chhabra, Kathleen Haley, Carrie A. Vyhlidal, R Gaedigk, J Steven Leeder, Kelan G. Tantisira, Benjamin Raby, Scott T. Weiss

Manuscripts, Articles, Book Chapters and Other Papers

Background: In utero smoke (IUS) exposure is associated with asthma susceptibility.

Objective: We sought to test the hypothesis that changes in miRNA expression by IUS exposure during human lung development is associated with asthma susceptibility.

Methods: Gene expression was profiled from 53 IUS unexposed and 51 IUS exposed human fetal lung tissues. We tested for the differential expression of miRNAs across post-conception age and by IUS using linear models with covariate adjustment. We tested the IUS-associated miRNAs for association with their gene expression targets using pair-wise inverse correlation. Using our mouse model, we investigated the persistence of the IUS-associated miRNA …

Pediatric Asthma And Psychological Resilience: Examining Whether Family Functioning And Social Support Relate To Asthma Symptoms And Lung Function, Dalia Jaafar, Natasha H. Hikita, Pornchai Tirakitsoontorn, Azucena Talamantes, Anchalee Yuengsrigul, Eric Sternlicht, Brooke N. Jenkins

Student Scholar Symposium Abstracts and Posters

Upwards of 6 million children in the United States are afflicted with pediatric asthma. While previous research has linked asthma to multiple contributing biological and environmental factors, recent research suggests that psychological and social factors may have an impact on physiological outcomes of asthma like lung function and lung inflammation. Therefore, we suggest the need to study the impact of positive psychological factors such as a well-functioning family environment and beneficial social support on symptoms and lung function of children diagnosed with asthma. In the present pilot study, we recruited a total of 15 children with a confirmed asthma diagnosis …

Inducible Epithelial Resistance Against Acute Viral Pneumonia And Chronic Asthma, Shradha Wali

Dissertations & Theses (Open Access)

Viral pneumonia remains a global health threat despite worldwide vaccination and therapeutic programs. The influenza pandemic of 1918 and SARS-CoV2 pandemic of 2019-2020 are cautionary reminders demanding the need for novel treatment strategies. Moreover, in addition to causing acute disease, respiratory virus infections are often complicated by chronic lung pathologies, such as asthma induction, progression, and exacerbation. We have reported that mice treated with a combination of inhaled Toll-like receptor (TLR) 2/6 and TLR 9 agonists (Pam2-ODN) to stimulate innate immunity are broadly protected against respiratory pathogens, but the mechanisms underlying this protection remain incompletely elucidated. Here, we show in …

5th & 6th Grade School-Based Asthma Self-Management Program: Toolkit For Facilitators, Sarah Laroe, Jasmine Terrell, Tracy L. Brewer

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

This toolkit will aid school nurses in facilitating an asthma self-management program in their school. School-based asthma self-management programs have been shown to significantly improve school absences and improve health care outcomes in children living with asthma. Although there are many programs out there, this toolkit will utilize the Iggy and the Inhalers© program by Booster Shot Media. The program has several resources available online for free at their website, as well as resources that may be purchased. The program will be enlightening for the students and a fun way to learn about managing their asthma before they attend middle …

A Patient-Centered Asthma Management Communication Intervention For Rural Latino Children: Protocol For A Waiting-List Randomized Controlled Trial, Robin Dawson, Sue P. Heiney, De Anne Hilfinger Messias, Dennis Ownby

Faculty Publications

Background: Rural Latino children with asthma suffer high rates of uncontrolled asthma symptoms, emergency department visits, and repeat hospitalizations. This vulnerable population must negotiate micro- and macrolevel challenges that impact asthma management, including language barriers, primary care access, parental time off from work, insurance coverage, distance from specialty sites, and documentation status. There are few proven interventions that address asthma management embedded within this unique context. Objective: Using a bio-ecological approach, we will determine the feasibility of a patient-centered collaborative program between rural Latino children with asthma and their families, school-based nursing programs, and primary care providers, facilitated by the …

A Randomized, Placebo-Controlled Trial Evaluating Effects Of Lebrikizumab On Airway Eosinophilic Inflammation And Remodelling In Uncontrolled Asthma (Clavier), Cary D Austin, Kaharu Sumino, Et Al.

2020-Current year OA Pubs

BACKGROUND: The anti-interleukin 13 (IL-13) monoclonal antibody lebrikizumab improves lung function in patients with moderate-to-severe uncontrolled asthma, but its effects on airway inflammation and remodelling are unknown. CLAVIER was designed to assess lebrikizumab's effect on eosinophilic inflammation and remodelling.

OBJECTIVE: To report safety and efficacy results from enrolled participants with available data from CLAVIER.

METHODS: We performed bronchoscopy on patients with uncontrolled asthma before and after 12 weeks of randomized double-blinded treatment with lebrikizumab (n = 31) or placebo (n = 33). The pre-specified primary end-point was relative change in airway subepithelial eosinophils per mm

RESULTS: There was a baseline …

Eosinophil Micrornas Play A Regulatory Role In Allergic Diseases Included In The Atopic March., Émile Bélanger, Anne-Marie Madore, Anne-Marie Boucher-Lafleur, Marie-Michelle Simon, Tony Kwan, Tomi Pastinen, Catherine Laprise

Manuscripts, Articles, Book Chapters and Other Papers

(1) Background: The atopic march is defined by the increased prevalence of allergic diseases after atopic dermatitis onset. In fact, atopic dermatitis is believed to play an important role in allergen sensitization via the damaged skin barrier, leading to allergic diseases such as allergic asthma and allergic rhinitis. The eosinophil, a pro-inflammatory cell that contributes to epithelial damage, is one of the various cells recruited in the inflammatory reactions characterizing these diseases. Few studies were conducted on the transcriptome of this cell type and even less on their specific microRNA (miRNA) profile, which could modulate pathogenesis of allergic diseases and …

The Odorant Receptor Or2w3 On Airway Smooth Muscle Evokes Bronchodilation Via A Cooperative Chemosensory Tradeoff Between Tmem16a And Cftr., Jessie Huang, Hong Lam, Cynthia Koziol-White, Nathachit Limjunyawong, Donghwa Kim, Nicholas Kim, Nikhil Karmacharya, Premraj Rajkumar, Danielle Firer, Nicholas M Dalesio, Joseph Jude, Richard C Kurten, Jennifer L Pluznick, Deepak A. Deshpande, Raymond B Penn, Stephen B Liggett, Reynold A Panettieri, Xinzhong Dong, Steven S An

Center for Translational Medicine Faculty Papers

The recent discovery of sensory (tastant and odorant) G protein-coupled receptors on the smooth muscle of human bronchi suggests unappreciated therapeutic targets in the management of obstructive lung diseases. Here we have characterized the effects of a wide range of volatile odorants on the contractile state of airway smooth muscle (ASM) and uncovered a complex mechanism of odorant-evoked signaling properties that regulate excitation-contraction (E-C) coupling in human ASM cells. Initial studies established multiple odorous molecules capable of increasing intracellular calcium ([Ca2+]i) in ASM cells, some of which were (paradoxically) associated with ASM relaxation. Subsequent studies showed a terpenoid molecule (nerol)-stimulated …

Human Respiratory And Gut Microbiomes - Do They Really Contribute To Respiratory Health?, Juliana Durack, Claus T. Christophersen

Research outputs 2014 to 2021

© Copyright © 2020 Durack and Christophersen. Human gastrointestinal and respiratory tracts are colonized by diverse polymicrobial communities shortly after birth, which are continuously molded by environmental exposure. The development of the resident microbiota in early life is a critical factor in the maturation of a healthy immune system. Disturbances to the intricate relationship between environmental exposure and maturation of the infant microbiome have been increasingly identified as a potential contributor to a range of childhood diseases. This review details recent evidence that implicates the contribution of gut and airway microbiome to pediatric respiratory health.

Asthma, Rachel Webber

Nursing Student Class Projects (Formerly MSN)

This poster will investigate the pathophysiology of Asthma, and the importance of understanding how asthma is developed. The pathophysiologic relationship between the immune system, inflammation and asthma occurrence is explored in this poster. Asthma is caused by many environmental and genetic factors that lead to inflammatory mechanisms in the airway. There are many different risk factors that can cause an increased likelihood of developing asthma, such as childhood illness, pollutants, obesity, poor nutrition, and having allergies. There are many risk factors for the development of asthma, and cases across the world continue to grow. Although there is not an exact …

Prematurity, Socioeconomic Status, And Childhood Asthma: A Canadian Cohort Study, Crystal P. Mcleod

Electronic Thesis and Dissertation Repository

Introduction: Preterm birth (PTB) and socioeconomic status (SES) have both been associated previously with the onset of childhood asthma in high income countries. Yet, these factors have been studied minimally outside of an exposure or confounded relationship, and amongst the Canadian population.

Materials and Methods: Merging household interview data from Cycles 2 to 5 of the Canadian Health Measures Survey, this study analyzed data from weighted respondents in early (3-5 years, n = 1,096,609) and middle (6-11 years, n = 2,112,059) childhood. Bivariate, stepwise logistic regression, and logit decomposition were performed using STATA software. Intersectionality guided the study’s methodology.

Results: …

Asthma Pathophysiology, Chad Webster

Nursing Student Class Projects (Formerly MSN)

Asthma is a chronic underlying condition that affects millions of people worldwide. It has a variety of issues that it may cause including shortness of breath, difficulty breathing, airway inflammation and swelling among many others. These issues usually arise from a potential trigger (environmental or genetic) and can cause an hyper-responsive airway issue. The Doctor of Nursing Practice practitioner should be extremely knowledgeable and trained on the different types of interventions and implications when dealing with asthma. The intention of this poster is to educate students on the importance of understanding the pathophysiology of asthma and its effect on the …

Stress And Negative Affect As Mediators In The Association Between Parental Social Support And Lung Function In Adolescents With Asthma, Amber Osorno, Eric Sternlicht, Pornchai Tirakitsoontorn, Azucena Talamantes, Anchalee Yuengsrigul, Zeev N. Kain, Brooke Jenkins

SURF Posters and Papers

Asthma is the leading chronic condition amongst children in the United States as 7.5% of children are diagnosed with asthma. Studies have shown that positive social support is associated with positive asthma management. A strong social support system predicts good management of asthma symptoms; however, current literature has not yet examined how social support impacts lung function as opposed to merely symptom management. Stress and negative affect have been revealed to be associated with worse asthma control, as well as exacerbation of symptoms. Stressful situations, such as the death of a family member, unemployment, and familial tensions lead to worsening …

Area-Level Landfill Density And Asthma Prevalence In Urban Texas Areas, Jessica Meighan Herrin

Dissertations & Theses (Open Access)

Environmental exposures, especially air pollutants, pose a threat for an increase in asthma prevalence. In particular, hydrogen sulfide (H2S) gas can cause severe health effects closely resembling asthmatic symptoms. Ambient concentrations of H2S gas correlates with the amount of solid waste found in landfills. The potential for adverse health risks associated with H2S emitted from landfills is of concern for those populations living in close proximity to landfills. Asthma is one of the adverse health effects that can occur due to H2S exposure. However, there is a lack of detailed studies characterizing possible associations between the density of landfills and …

Automatic Recognition, Segmentation, And Sex Assignment Of Nocturnal Asthmatic Coughs And Cough Epochs In Smartphone Audio Recordings: Observational Field Study, Filipe Barata, Peter Tinschert, Frank Rassouli, Claudia Steurer-Stey, Elgar Fleisch, Milo Puhan, Martin Brutsche, David Kotz, Tobias Kowatsch

Dartmouth Scholarship

Background: Asthma is one of the most prevalent chronic respiratory diseases. Despite increased investment in treatment, little progress has been made in the early recognition and treatment of asthma exacerbations over the last decade. Nocturnal cough monitoring may provide an opportunity to identify patients at risk for imminent exacerbations. Recently developed approaches enable smartphone-based cough monitoring. These approaches, however, have not undergone longitudinal overnight testing nor have they been specifically evaluated in the context of asthma. Also, the problem of distinguishing partner coughs from patient coughs when two or more people are sleeping in the same room using contact-free audio …

Multidisciplinary Team Approach Effect On Pediatric Severe Asthma, Lila Kertz

Dissertations

Problem. Children with severe asthma are more likely to be non-adherent with their prescribed medications, often related to barriers. A holistic assessment of these patients has been suggested, but is not typically performed in most pediatric asthma clinics. The purpose of this project was to evaluate the effects of severe pediatric asthma clinic services designed to perform holistic assessments and provide comprehensive care.

Methods. An observational, descriptive design was used to evaluate the Severe Asthma Clinic for Kids (SACK) created in 2013 using a retrospective database review. A convenience sample of data collected on all children treated in the clinic …

Pediatric Asthma, Monica Stricklin

Nursing Student Class Projects (Formerly MSN)

Effective management of asthma will improve pediatric patient quality of life. This may be achieved through the prevention of asthma exacerbations by continuous pediatric and guardian/parent education to proper inhaler technique, appropriate medication management and the avoidance of environmental triggers. These modalities may prevent trips to the emergency department, hospital admissions and the pediatric patient can avoid missing days from school.

Phosphodiesterase Isoforms And Camp Compartments In The Development Of New Therapies For Obstructive Pulmonary Diseases, Martina Schmidt, Isabella Cattani-Cavalieri, Francisco J. Nuñez, Rennolds S. Ostrom

Pharmacy Faculty Articles and Research

The second messenger molecule 3′5′-cyclic adenosine monophosphate (cAMP) imparts several beneficial effects in lung diseases such as asthma, chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF). While cAMP is bronchodilatory in asthma and COPD, it also displays anti-fibrotic properties that limit fibrosis. Phosphodiesterases (PDEs) metabolize cAMP and thus regulate cAMP signaling. While some existing therapies inhibit PDEs, there are only broad family specific inhibitors. The understanding of cAMP signaling compartments, some centered around lipid rafts/caveolae, has led to interest in defining how specific PDE isoforms maintain these signaling microdomains. The possible altered expression of PDEs, and thus abnormal …

An Evaluation Of Respiratory Exacerbation In New York City Given Current Trends In Climate Variability And Predictive Sociodemographic Factors, Sarah L.R. Kuril

Dissertations and Theses

Background: Within the last century, the massive increase in emissions due to economic growth has made climate variability a major problem for many of the industrialized countries and an emerging problem for the rest of the world. With an increasing number of extreme weather events, such as heat waves, cold fronts, floods, heavy rain, and storms, individuals with Chronic Obstructive Pulmonary Disease (COPD) and asthma remain a vulnerable population, placing them at highest risk of respiratory exacerbation. This dissertation aims to contribute to our understanding of how climate variability, which can influence patterns of rainfall, temperature and other variables on …

Exploring The Effectiveness Of Asthma Action Plans In Long-Term Asthma Management, Pankhuri Jha, Jessica Most, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Aims for Improvement

• Determine the efficacy of AAP in helping patients feel more confident in their self-management
• Improve asthma control by at least 10% after receiving an Asthma Action Plan

An Evaluation Of The Treatment Of Asthma In The State Of Mississippi Using Hedis Quality Control Measures, Kyle Kantor

Honors Theses

Introduction: Asthma is an inflammatory condition of the lungs that can have significant impacts on a patient’s quality of life. Asthma attacks can be very uncomfortable and even deadly in some cases. The objective of this study is to evaluate the treatment of asthma in the state of Mississippi and to describe the disparities between demographics to help healthcare providers identify patients who might be at risk for poor treatment and help those patients receive quality healthcare. Methods: The data was retrospectively collected from January to December 2014 Mississippi Centers for Medicare and Medicaid Services claims data. This study is …

Structure And Function Of Asthma Evaluated Using Pulmonary Imaging, Rachel L. Eddy

Electronic Thesis and Dissertation Repository

Asthma has been understood to affect the airways in a spatially heterogeneous manner for over six decades. Computational models of the asthmatic lung have suggested that airway abnormalities are diffusely and randomly distributed throughout the lung, however these mechanisms have been challenging to measure in vivo using current clinical tools. Pulmonary structure and function are still clinically characterized by the forced expiratory volume in one-second (FEV₁) – a global measurement of airflow obstruction that is unable to capture the underlying regional heterogeneity that may be responsible for symptoms and disease worsening. In contrast, pulmonary magnetic resonance imaging (MRI) …

Fev1 And Mri Ventilation Defect Reversibility In Asthma And Copd, Hana Serajeddini, Rachel L Eddy, Christopher Licskai, David G Mccormack, Grace Parraga

Medical Biophysics Publications

The underlying pathophysiological determinants of asthma and chronic obstructive pulmonary disease (COPD) are related in complex ways. Importantly however, post-bronchodilator FEV1- reversibility may occur in approximately 50% of COPD patients whilst epidemiological and magnetic-resonance-imaging (MRI) studies suggest that in asthmatics, FEV1-reversibility may diminish over time. As compared to patients with asthma or COPD alone, patients with coexisting asthma and COPD report worse clinical outcomes and increased healthcare costs and burden.

Galcanezumab-Induced Anaphylaxis: A Case Report, Erick Perez Sifontes, Sonja Knittel-Hliddal, Zhao Han, Rahimullah Asad, Aya Marachi, Uma Iyer

Pulmonary Disease

Introduction: Case Report: Galcanezumab is a monoclonal antibody recently approved by the FDA for migraine prevention. Common side effects include injection site reactions, nasopharyngitis, and nausea. However, there have been no reported cases of anaphylaxis.

Description: We describe the first case of galcanezumab-induced anaphylaxis in a 47-year-old female with history of asthma and a prior episode of topiramate-induced anaphylaxis requiring intubation. The patient presented to the emergency department (ED) complaining of sudden onset shortness of breath, generalized pruritus, flushing, throat and mouth swelling 20 minutes after self- administration of two 120 mg doses of galcanezumab IM. Prior to ED presentation, …

To Study Drug Utilization And Qol In Patients With Bronchial Asthma, Kanav Khera Dr

Manipal College of Pharmaceutical Sciences, Manipal Theses and Dissertations

Background: Bronchial Asthma (BA) is a chronic inflammatory of the airways.[1] It is generally known that asthma can cause an impact on a patient’s Quality of Life (QoL), mostly in a negative manner. To perceive the impact it has on the population, ‘Questionnaires on Quality of Life’ in asthmatic patients were made. Improving the QoL of patients with asthma mainly aims at reducing the risk of exacerbation and preventing morbidity related to asthma. Drug Utilization studies are important in order to assess the current prescription patterns against standard guidelines and can help in rationalizing the management. The economic burden of …

Improving The Inhaler, Bradley Freid, Jesse Evensky, Kabir Malkani, Alex Reibstein, Gregory C. Kane, Md

Phase 1

Background: Inhaled drugs play a critical role in caring for patients with respiratory disease such as COPD and asthma. It is understood that many of the patients that use inhalers to deliver these drugs to their lungs use them entirely improperly or in a sub-optimal manner. Improving the inhaler design for increased effectiveness and ease of use was the focus of this project.

Methods: A pulmonary critical care attending was interviewed regarding patient inhaler use. The attending provided information about proper inhaler use and also described patient errors in using the inhaler that were observed. Inhalers that are currently in …

Improvements On The Inhaler, Jesse Evensky, Bradley Freid, Kabir Malkani, Alex Reibstein, Gregory C. Kane, Md

Phase 1

Background: Inhalers are a commonplace in American health care and deliver crucial drugs to patients with COPD and asthma. Inhaler use has been shown to be unsatisfactory among patients resulting in ineffective medication delivery. The goal of this project was to improve the inhaler design for increased effectiveness and ease of use.

Methods: Our team first interviewed a Pulmonologist regarding patient inhaler use. Dr. Harry Kane demonstrated the proper use of an inhaler as well and described errors in inhaler use are due to patient technique. A variety of inhalers currently available were examined and were compared for ease of …

Improving The Inhaler, Kabir Malkani, Jesse Evensky, Bradley Freid, Alex Reibstein, Gregory C. Kane, Md

Phase 1

Background: It is estimated that about 1 in 10 Americans use inhalers to deliver inhaled drugs for respiratory disease such as COPD and asthma. Some studies have shown that up to 84% of people use their inhaler incorrectly, which can cause long term problems and acute flareups. Therefore, improving the inhaler design to allow for ease of use was the main focus of our project.

Methods: We had a discussion with a pulmonary critical care attending who provided information on proper patient inhaler use and common user errors. He also gave us a sample of different inhalers on the market …

Does Aerobic Training On A Treadmill Improve Symptomatic Control And Quality Of Life In Patients With Asthma?, Brianna Bracy

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Does aerobic training on a treadmill improve symptomatic control and quality of life in patients with asthma?”

STUDY DESIGN: This is a systematic review of three randomized control trials (RCTs) published between 2013 and 2016 in peer-reviewed journals.

DATA SOURCES: Three randomized control trials (RCTs) were found using PubMed. All articles were published in peer reviewed journals and selected based on their relevance to the topic and evaluation of outcomes that mattered to patients.

OUTCOMES MEASURED: Symptomatic control was measured by recording occurrence of symptoms in …

Implementing Feno Testing Protocol In A Pulmonary Clinic: A Dnp Project, Herbert "Allen" Nolan

Doctor of Nursing Practice Projects

Airway inflammation is a common condition seen in the pulmonary clinic and can be present in patients with chronic obstructive pulmonary disease, asthma, chronic cough and asthma chronic obstructive overlap syndrome. Utilization of fractional exhaled nitric oxide testing is a quick means of identifying airway inflammation in patients who visit the pulmonary clinic with the diagnoses listed above. Fractional Exhaled Nitric Oxide testing along with Asthma Control Testing were used in the pulmonary clinic to aid in the identification of airway inflammation along with traditional spirometry testing. The results reflected an increase in the identification of patients with airway inflammation …