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Antibacterial antibody responses associated with the development of asthma in house dust mite-sensitised and non-sensitised children.

Infants who develop house dust mite (HDM) allergy and HDM-sensitised children with severe persistent asthma have low antibody responses to the P6 antigen of Haemophilus influenzae.

Objective : To measure the development of antibody to two ubiquitous bacteria of the respiratory mucosa in a prospective birth cohort at high risk of allergic disease and to assess which responses are associated with asthma and atopy.

Methods : IgG1 and IgG4 antibody to H influenzae (P4 and P6) and Streptoccocus pneumoniae (PspA and PspC) surface antigens was measured in yearly blood samples of children aged 1-5 years. IgE to the P6 antigen was examined for the 5-year group. The children were stratified based on HDM sensitisation and asthma at 5 years of age.

Results : HDM-sensitised children had lower IgG1 antibody titres to the bacterial antigens, and early responses (<3 years and before the development of HDM sensitisation and asthma) corrected for multiple antigens were significantly reduced for P4, P6 and PspC (p=0.008, p=0.004 and p=0.028, respectively). Similar associations with asthma were also found (p=0.008, p=0.004 and p=0.032 for P4, P6 and PspC, respectively). The IgG4 antibody titre and prevalence were similar in both HDM-sensitised and non-sensitised groups, but sensitised children had a slower downregulation of the IgG4 response. Children with asthma (27/145 at 5 years) had lower anti-P6 IgE responses (p<0.05).

Conclusions : HDM-sensitised children have early defective antibody responses to bacteria that are associated with asthma. Surprisingly, antibacterial IgE was associated with a reduced risk for asthma.

Asthma, chronic obstructive pulmonary disease, or both? Diagnostic labeling and spirometry in primary care patients aged 40 years or more (Free Fulltext)

Aims: To describe symptoms and lung function in patients registered with asthma or chronic obstructive pulmonary disease (COPD) in primary care and to examine how spirometry findings fit with general practitioners’ (GPs) diagnoses.

Methods: Patients aged ≥40 years with a diagnosis of asthma or COPD registered in the electronic medical record during the previous 5 years were recruited at seven GP offices in Norway in 2009–2010. Registered diagnosis, spirometry results, comorbidity, and reported symptoms were compared.

Results: Among 376 patients, 62% were women. Based on Global Initiative for Chronic Obstructive Lung Diseases criteria, a spirometry diagnosis of COPD could be made in 68.1% of the patients with a previous COPD diagnosis and in 17.1% of those diagnosed with asthma only (P < 0.001). The κ agreement between last clinical diagnosis of COPD and COPD based on spirometry was 0.50. A restrictive spirometry pattern was found in 19.4% and more frequently in patients diagnosed with both asthma and COPD (23.9%) than in patients diagnosed with COPD only (6.8%, P = 0.003).

Conclusion: The ability of GPs to differentiate between asthma and COPD seems to have considerably improved during the last decade, probably due to the dissemination of spirometry and guidelines for COPD diagnosis. A diagnosis of COPD that cannot be confirmed by spirometry represents a challenge in clinical practice, in particular when a restrictive pattern on spirometry is found.

 

Lung Cancer Diagnosis Through Early COPD Detection

Early screening of patients with chronic obstructive pulmonary disease (COPD) may help to detect lung cancer at an earlier stage, according to a new study. The research, published online in the European Respiratory Journal, suggests that if COPD can be detected at an earlier stage, this will also aid the early detection of lung cancer. The news came on World COPD Day, which aims to improve awareness of the condition and care of people with COPD around the world. COPD and lung cancer are major worldwide health problems that are on the increase... (Source: Health News from Medical News Today)

MedWorm Sponsor Message: Please support the DoctorsInChains.org campaign for the health workers in Bahrain. #FreeDoctors

VTE common in hospitalized COPD patients

Approximately one in 100 patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease develops venous thromboembolism during their hospital stay, Spanish study data show. (Source: MedWire News - Respiratory)

The pulmonary radiologic findings of rheumatoid arthritis

In conclusion, the pulmonary changes may be accompanied as a systemic component of the RA. If these changes are well recognized, they can help in the diagnosis of the RA. (Source: Respiratory Medicine CME)

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