Browsing by Subject "RESPIRATORY SYMPTOMS"

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  • Honkamäki, Jasmin; Hisinger-Mölkänen, Hanna; Ilmarinen, Pinja; Piirilä, Päivi; Tuomisto, Leena E.; Andersen, Heidi; Huhtala, Heini; Sovijärvi, Anssi; Backman, Helena; Lundbäck, Bo; Rönmark, Eva; Lehtimäki, Lauri; Kankaanranta, Hannu (2019)
    Background: Asthma is currently divided into different phenotypes, with age at onset as a relevant differentiating factor. In addition, asthma with onset in adulthood seems to have a poorer prognosis, but studies investigating age-specific incidence of asthma with a wide age span are scarce. Objective: To evaluate incidence of asthma diagnosis at different ages and differences between child- and adult-diagnosed asthma in a large population-based study, with gender-specific analyzes included. Methods: In 2016, a respiratory questionnaire was sent to 8000 randomly selected subjects aged 20-69 years in western Finland. After two reminders, 4173 (52.3%) subjects responded. Incidence rate of asthma was retrospectively estimated based on the reported age of asthma onset. Adult-diagnosed asthma was defined as a physician-diagnosis of asthma made at >= 18 years of age. Results: Among those with physician-diagnosed asthma, altogether, 63.7% of subjects, 58.4% of men and 67.8% of women, reported adult-diagnosed asthma. Incidence of asthma diagnosis was calculated in 10-year age groups and it peaked in young boys (0-9 years) and middle-aged women (40-49 years) and the average incidence rate during the examined period between 1946 and 2015 was 2.2/1000/year. Adult-diagnosed asthma became the dominant phenotype among those with physician-diagnosed asthma by age of 50 years and 38 years in men and women, respectively. Conclusions: Asthma is mainly diagnosed during adulthood and the incidence of asthma diagnosis peaks in middle-aged women. Asthma diagnosed in adulthood should be considered more in clinical practice and management guidelines.
  • Kainu, Annette; Rouhos, Annamari; Sovijärvi, Anssi; Lindqvist, Ari; Sarna, Seppo; Lundback, Bo (2013)
  • Salonen, Heidi; Duchaine, Caroline; Letourneau, Valerie; Mazaheri, Mandana; Laitinen, Sirpa; Clifford, Sam; Mikkola, Raimo; Lappalainen, Sanna; Reijula, Kari; Morawska, Lidia (2016)
    As endotoxin exposure has known effects on human health, it is important to know the generally existing levels of endotoxins as well as their contributing factors. This work reviews current knowledge on the endotoxin loads in settled floor dust, concentrations of endotoxins in indoor air, and different environmental factors potentially affecting endotoxin levels. The literature review consists of peer-reviewed manuscripts located using Google and PubMed, with search terms based on individual words and combinations. References from relevant articles have also been searched. Analysis of the data showed that in residential, school, and office environments, the mean endotoxin loads in settled floor dust varied between 660 and 107,000 EU/m(2), 2180 and 48,000 EU/m(2), and 2700 and 12,890 EU/m(2), respectively. Correspondingly, the mean endotoxin concentrations in indoor air varied between 0.04 and 1610 EU/m(3) in residences, and 0.07 and 9.30 EU/m(3) in schools and offices. There is strong scientific evidence indicating that age of houses (or housing unit year category), cleaning, farm or rural living, flooring materials (the presence of carpets), number of occupants, the presence of dogs or cats indoors, and relative humidity affect endotoxin loads in settled floor dust. The presence of pets (especially dogs) was extremely strongly associated with endotoxin concentrations in indoor air. However, as reviewed articles show inconsistency, additional studies on these and other possible predicting factors are needed. (C) 2016 Elsevier Ltd. All rights reserved.
  • Nieminen, Pentti; Panychev, Dmitry; Lyalyushkin, Sergei; Komarov, German; Nikanov, Alexander; Borisenko, Mark; Kinnula, Vuokko L.; Toljamo, Tuula (2013)
  • Hose, Alexander J.; Depner, Martin; Illi, Sabina; Lau, Susanne; Keil, Thomas; Wahn, Ulrich; Fuchs, Oliver; Pfefferle, Petra Ina; Schmausser-Hechfellner, Elisabeth; Genuneit, Jon; Lauener, Roger; Karvonen, Anne M.; Roduit, Caroline; Dalphin, Jean-Charles; Riedler, Josef; Pekkanen, Juha; von Mutius, Erika; Ege, Markus J.; Bauer, Carl Peter; Forster, Johannes; Zepp, Fred; Wahn, Volker; Schuster, Antje; Bergmann, Renate L.; Bergmann, Karl E.; Reich, Andreas; Grabenhenrich, Linus; Schaub, Bianca; Loss, Georg J.; Renz, Harald; Kabesch, Michael; Roponen, Marjut; Hyvarinen, Anne; Tiittanen, Pekka; Remes, Sami; Braun-Fahrlander, Charlotte; Frei, Remo; Kaulek, Vincent; Dalphin, Marie-Laure; Doekes, Gert; Blumer, Nicole; Frey, Urs; MAS Study Grp; PASTURE Study Grp (2017)
    Background: Phenotypes of childhood-onset asthma are characterized by distinct trajectories and functional features. For atopy, definition of phenotypes during childhood is less clear. Objective: We sought to define phenotypes of atopic sensitization over the first 6 years of life using a latent class analysis (LCA) integrating 3 dimensions of atopy: allergen specificity, time course, and levels of specific IgE (sIgE). Methods: Phenotypes were defined by means of LCA in 680 children of the Multizentrische Allergiestudie (MAS) and 766 children of the Protection against allergy: Study in Rural Environments (PASTURE) birth cohorts and compared with classical nondisjunctive definitions of seasonal, perennial, and food sensitization with respect to atopic diseases and lung function. Cytokine levels were measured in the PASTURE cohort. Results: The LCA classified predominantly by type and multiplicity of sensitization (food vs inhalant), allergen combinations, and sIgE levels. Latent classes were related to atopic disease manifestations with higher sensitivity and specificity than the classical definitions. LCA detected consistently in both cohorts a distinct group of children with severe atopy characterized by high seasonal sIgE levels and a strong propensity for asthma; hay fever; eczema; and impaired lung function, also in children without an established asthma diagnosis. Severe atopy was associated with an increased IL-5/IFN-gamma ratio. A path analysis among sensitized children revealed that among all features of severe atopy, only excessive sIgE production early in life affected asthma risk. Conclusions: LCA revealed a set of benign, symptomatic, and severe atopy phenotypes. The severe phenotype emerged as a latent condition with signs of a dysbalanced immune response. It determined high asthma risk through excessive sIgE production and directly affected impaired lung function.
  • Nissilä, Juho-Jooel; Savelieva, Kateryna; Lampi, Jussi; Ung-Lanki, Sari; Elovainio, Marko; Pekkanen, Juha (2019)
    Poor indoor air quality (IAQ) in schools is related to increased symptom reporting in students. We investigated whether parental worry about school IAQ influences this association. Data came from survey collected from five Finnish primary schools with observed IAQ problems and five control schools. Parents (n = 1868) of primary school students reported worry about IAQ in schools and symptoms of their children. Associations between observed IAQ problems, worry, and five symptom scores (ie, respiratory, lower respiratory, eye, skin, and general symptoms) were analyzed using multivariate logistic regression and mediation analysis. Parents were on average more worried in schools with observed IAQ problems. Observed IAQ problems were strongly associated with increased worry and all symptoms under study (unadjusted ORs ranged between 1.48 [95% CI 1.48-2.16] and 2.70 [95% CI 1.52-5.17]). Parental worry was associated with all symptoms (unadjusted ORs ranged between 2.49 [95% CI 1.75-3.60] and 4.92 [95% CI 2.77-9.40]). Mediation analyses suggested that parental worry might partially explain the association between observed IAQ problems and symptom reporting (proportion mediated ranged between 67% and 84% for the different symptoms). However, prospective studies are needed to assess causal relationships between observed IAQ problems, worry, and symptom reporting in schools.
  • Lajunen, Katariina Tytti; Malmberg, Leo Pekka; Kalliola, Satu; Kotaniemi-Syrjänen, Anne; Pelkonen, L. Anna Susanna; Mäkelä, Mika Juhani (2020)
    Abstract Background Airway hyperresponsiveness (AHR) is a common feature in asthma. The use of AHR in predicting active asthma or the persistence of AHR in childhood is poorly understood. By analyzing longitudinal connections including different measures of AHR, lung function, and inflammation markers, we sought to identify the best available method for predicting persistence of AHR and identification of later active asthma. Methods We tested 105 asthmatic children aged 3-7 years with fractional exhaled nitric oxide (FeNO), impulse oscillometry (IOS), and AHR evaluated by indirect methods (hypertonic saline and exercise challenge). Ten years later, 64 children participated in the follow-up visit and were tested with FeNO, IOS, spirometry, and methacholine challenge. At both study visits, blood samples were collected, and a questionnaire was completed. Results Asthma was in remission in 66% of patients at adolescence. AHR measured by hypertonic saline challenge at preschool age was associated with asthma symptoms (OR 10.2; 95%CI 2.8, 37.3) but not with AHR estimated with methacholine challenge 10 years later. AHR measured by exercise challenge was not associated with AHR or recent asthma symptoms in adolescence. Preschool eosinophilia continued until adolescence in 87% of patients but was not associated with AHR or subjective signs of asthma 10 years later. Wheezy preschoolers with atopy had a higher risk for AHR in adolescence (OR 4.1; 95%CI 1.0, 16.2). Conclusion Results from hypertonic saline challenge are associated with persistent asthma symptoms even after a decade. AHR measured by indirect methods at preschool age did not predict AHR in adolescence.
  • Backman, Helena; Eriksson, Berne; Hedman, Linnea; Stridsman, Caroline; Jansson, Sven-Arne; Sovijarvi, Anssi; Lindberg, Anne; Ronmark, Eva; Lundback, Bo (2016)
    Background: Attempts have been made to use dynamic spirometry to define restrictive lung function, but the definition of a restrictive spirometric pattern (RSP) varies between studies such as BOLD and NHANES. The aim of this study was to estimate the prevalence and risk factors of RSP among adults in northern Sweden based on different definitions. Methods: In 2008-2009 a general population sample aged 21-86y within the obstructive lung disease in northern Sweden (OLIN) studies was examined by structured interview and spirometry, and 726 subjects participated (71% of invited). The prevalence of RSP was calculated according to three different definitions based on pre-as well as post-bronchodilator spirometry: 1) FVC <80% & FEV1/FVC > 0.7 2) FVC <80% & FEV1/FVC > LLN 3) FVC <LLN & FEV1/FVC > LLN Results: The three definitions yielded RSP prevalence estimates of 10.5%, 11.2% and 9.4% respectively, when based on pre-bronchodilator values. The prevalence was lower when based on post-bronchodilator values, i.e. 7.3%, 7.9% and 6.6%. According to definition 1 and 2, the RSP prevalence increased by age, but not according to definition 3. The overlap between the definitions was substantial. When corrected for confounding factors, manual work in industry and diabetes with obesity were independently associated with an increased risk for RSP regardless of definition. Conclusions: The prevalence of RSP was 7-11%. The prevalence estimates differed more depending on the choice of pre-compared to post-bronchodilator values than on the choice of RSP definition. RSP was, regardless of definition, independently associated with manual work in industry and diabetes with obesity. (C) 2016 The Authors. Published by Elsevier Ltd.
  • Hisinger-Mölkänen, Hanna; Piirilä, Päivi; Haahtela, Tari; Sovijärvi, Anssi; Pallasaho, Paula (2018)
    Background: Allergic and non-allergic rhinitis cause a lot of symptoms in everyday life. To decrease the burden more information of the preventable risk factors is needed. We assessed prevalence and risk factors for chronic nasal symptoms, exploring the effects of smoking, environmental tobacco smoke, exposure to occupational irritants, and their combinations. Methods: In 2016, a postal survey was conducted among a random population sample of 8000 adults in Helsinki, Finland with a 50.5% response rate. Results: Smoking was associated with a significant increase in occurrence of chronic rhinitis (longstanding nasal congestion or runny nose), but not with self-reported or physician diagnosed allergic rhinitis. The highest prevalence estimates of nasal symptoms, 55.1% for chronic rhinitis, 49.1% for nasal congestion, and 40.7% for runny nose, were found among smokers with occupational exposure to gases, fumes or dusts. Besides active smoking, also exposure to environmental tobacco smoke combined with occupational exposure increased the risk of nasal symptoms. Conclusions: Smoking, environmental tobacco smoke, and occupational irritants are significant risk factors for nasal symptoms with an additive pattern. The findings suggest that these factors should be systematically inquired in patients with nasal symptoms for appropriate preventive measures. (192 words).
  • Päivinen, Marja; Keskinen, Kari; Tikkanen, Heikki (2021)
    Background A special improvement in pulmonary function is found in swimmers. In clinical testing the airway reactivity is observed at certain exercise intensity and target ventilation. However, in highly trained swimmers exercising in water the reactions may not function the same way. The aim was to study the combined effects of the water environment and swimming on pulmonary function and the associations with perceived symptoms. Methods First, 412 competitive swimmers completed questionnaires concerning respiratory symptoms at different swimming intensities. Then, pulmonary function testing was performed in 14 healthy elite swimmers. Spirometry and maximal voluntary ventilation (MVV) were measured on land and in water before and after swimming. While swimming, minute ventilation (VE) tidal volume (VT) and breathing frequency (fb) were measured during competition speed swimming. Results Swimmers reported the most symptoms at competition speed intensity swimming. In the transition from the land into the water swimming body position, the ratio of forced expiratory volume in one second (FEV1) and forced expiratory capacity (FVC) (FEV1/FVC) decreased by a mean (SD) 5.3 % (3) in females and by 2.2 % (5) in males. During competition speed intensity swimming, the minute ventilation (VE) had a mean of 72 and 75 % of calculated maximal voluntary ventilation (cMVV) in females and in males, respectively. Conclusions Spirometry showed sex differences in water compared to land measurements. These differences should be considered when the effects of swimming are observed. During the intensity that triggered the symptoms the most, the VE was approximately 20 % higher than the target ventilations for clinical testing. These findings encourages specific modifications of clinical testing protocols for elite swimmers.
  • Matsson, Hans; Soderhall, Cilla; Einarsdottir, Elisabet; Lamontagne, Maxime; Gudmundsson, Sanna; Backman, Helena; Lindberg, Anne; Ronmark, Eva; Kere, Juha; Sin, Don; Postma, Dirkje S.; Bosse, Yohan; Lundback, Bo; Klar, Joakim (2016)
    Background: Reduced lung function in patients with chronic obstructive pulmonary disease (COPD) is likely due to both environmental and genetic factors. We report here a targeted high-throughput DNA sequencing approach to identify new and previously known genetic variants in a set of candidate genes for COPD. Methods: Exons in 22 genes implicated in lung development as well as 61 genes and 10 genomic regions previously associated with COPD were sequenced using individual DNA samples from 68 cases with moderate or severe COPD and 66 controls matched for age, gender and smoking. Cases and controls were selected from the Obstructive Lung Disease in Northern Sweden (OLIN) studies. Results: In total, 37 genetic variants showed association with COPD (p <0.05, uncorrected). Several variants previously discovered to be associated with COPD from genetic genome-wide analysis studies were replicated using our sample. Two high-risk variants were followed-up for functional characterization in a large eQTL mapping study of 1,111 human lung specimens. The C allele of a synonymous variant, rs8040868, predicting a p.(S45=) in the gene for cholinergic receptor nicotinic alpha 3 (CHRNA3) was associated with COPD (p = 8.8 x 10(-3)). This association remained (p = 0.003 and OR = 1.4, 95 % CI 1.1-1.7) when analysing all available cases and controls in OLIN (n = 1,534). The rs8040868 variant is in linkage disequilibrium with rs16969968 previously associated with COPD and altered expression of the CHRNA5 gene. A follow-up analysis for detection of expression quantitative trait loci revealed that rs8040868-C was found to be significantly associated with a decreased expression of the nearby gene cholinergic receptor, nicotinic, alpha 5 (CHRNA5) in lung tissue. Conclusion: Our data replicate previous result suggesting CHRNA5 as a candidate gene for COPD and rs8040868 as a risk variant for the development of COPD in the Swedish population.