Special Issue "Persistent Childhood Asthma"

A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: 15 November 2021.

Special Issue Editors

Dr. Ann-Marie Malby Schoos
E-Mail Website
Guest Editor
COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Ledreborg Alle 34, 2820 Gentofte, Denmark
Interests: Allergy; allergy diagnostics; asthma; allergic rhinitis; eczema; immunology
Special Issues and Collections in MDPI journals
Dr. Cilla Söderhäll
E-Mail Website
Guest Editor
Department of Women’s and Children’s Health, Karolinska Institutet, 171 77 Stockholm, Sweden
Interests: Asthma; allergy; eczema; genetics; epigenetics; biomarkers

Special Issue Information

Dear Colleagues,

Asthma is the most common chronic disease in children and the cause of great distress for both the children and their families. Various overlapping phenotypes exist, complicating aligned research in the field and meaningful, personalized treatment of the disease. Young children are particularly diverse with numerous and variable phenotypic presentations in early life that correspond to different outcomes. Despite the high reported rates of remission of asthma, the disease is usually considered as treatable but not curable once present. Understanding of the determinants that affect the course of diagnosed asthma, e.g., the avoidance of environmental or occupational exposures, is therefore important for tertiary prevention, since asthma persistence is associated with frequent and severe symptoms and with the development of impaired lung function. Asthma treatment guidelines have proven useful in standard care and the reduction of adverse outcomes in patients with asthma; however, the phenotypic heterogeneity within the disorder indicates the need for personalized medicine as opposed to a one-size-fits-all treatment approach.

The goal of this Special Issue is to provide an improved understanding of the phenotypes of persistent asthma (prevalence, comorbidities, lung function, response to treatment, etc.) and also to investigate the impact of genetic and environmental exposures in order to elucidate the possibility of tertiary prevention.

Dr. Ann-Marie Malby Schoos
Dr. Cilla Söderhäll
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • asthma
  • children
  • phenotypes
  • persistence
  • remission
  • severity
  • lung function
  • treatment
  • tertiary prevention
  • comorbidities
  • exposures
  • genetics
  • epigenetics

Published Papers (2 papers)

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Research

Article
Early Life Wheeze and Risk Factors for Asthma—A Revisit at Age 7 in the GEWAC-Cohort
Children 2021, 8(6), 488; https://doi.org/10.3390/children8060488 - 08 Jun 2021
Viewed by 469
Abstract
One third of all toddlers are in need of medical care because of acute wheeze and many of these children have persistent asthma at school age. Our aims were to assess risk factors for and the prevalence of asthma at age 7 in [...] Read more.
One third of all toddlers are in need of medical care because of acute wheeze and many of these children have persistent asthma at school age. Our aims were to assess risk factors for and the prevalence of asthma at age 7 in a cohort of children suffering from an acute wheezing episode as toddlers. A total of 113 children, included during an acute wheezing episode (cases), and 54 healthy controls were followed prospectively from early pre-school age to 7 years. The protocol included questionnaires, ACT, FeNO, nasopharyngeal virus samples, blood sampling for cell count, vitamin D levels, and IgE to food and airborne allergens. The prevalence of asthma at age 7 was 70.8% among cases and 1.9% among controls (p < 0.001). Acute wheeze caused by rhinovirus (RV) infection at inclusion was more common among cases with asthma at age 7 compared to cases without asthma (p = 0.011) and this association remained significant following adjustment for infection with other viruses (OR 3.8, 95% CI 1.4–10.5). Cases with asthma at age 7 had been admitted to hospital more often (p = 0.024) and spent more days admitted (p = 0.01) during the year following inclusion compared to cases without asthma. RV infection stands out as the main associated factor for wheeze evolving to persistent asthma. Cases who developed asthma also had an increased need of hospital time and care for wheeze during the year after inclusion. Full article
(This article belongs to the Special Issue Persistent Childhood Asthma)
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Article
Predicting Treatment Outcomes Using Explainable Machine Learning in Children with Asthma
Children 2021, 8(5), 376; https://doi.org/10.3390/children8050376 - 10 May 2021
Cited by 2 | Viewed by 612
Abstract
Asthma in children is a heterogeneous disease manifested by various phenotypes and endotypes. The level of disease control, as well as the effectiveness of anti-inflammatory treatment, is variable and inadequate in a significant portion of patients. By applying machine learning algorithms, we aimed [...] Read more.
Asthma in children is a heterogeneous disease manifested by various phenotypes and endotypes. The level of disease control, as well as the effectiveness of anti-inflammatory treatment, is variable and inadequate in a significant portion of patients. By applying machine learning algorithms, we aimed to predict the treatment success in a pediatric asthma cohort and to identify the key variables for understanding the underlying mechanisms. We predicted the treatment outcomes in children with mild to severe asthma (N = 365), according to changes in asthma control, lung function (FEV1 and MEF50) and FENO values after 6 months of controller medication use, using Random Forest and AdaBoost classifiers. The highest prediction power is achieved for control- and, to a lower extent, for FENO-related treatment outcomes, especially in younger children. The most predictive variables for asthma control are related to asthma severity and the total IgE, which were also predictive for FENO-based outcomes. MEF50-related treatment outcomes were better predicted than the FEV1-based response, and one of the best predictive variables for this response was hsCRP, emphasizing the involvement of the distal airways in childhood asthma. Our results suggest that asthma control- and FENO-based outcomes can be more accurately predicted using machine learning than the outcomes according to FEV1 and MEF50. This supports the symptom control-based asthma management approach and its complementary FENO-guided tool in children. T2-high asthma seemed to respond best to the anti-inflammatory treatment. The results of this study in predicting the treatment success will help to enable treatment optimization and to implement the concept of precision medicine in pediatric asthma treatment. Full article
(This article belongs to the Special Issue Persistent Childhood Asthma)
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