Clinical, Airway Inflammatory, and HRA Phenotypes, in Preschool Children With Acute Asthmatic Attack Presenting to the ED.
Condition: Asthma
MeSH terms: Asthma
Study type: Observational

Summary: 
      Clinical, Airway Inflammatory, and HRA Phenotypes, in preschool children with acute asthmatic
      attack presenting to the ED.

      Background:

      Children under the age of 5 years have the highest hospitalization rate of asthma. The most
      common causes of acute exacerbations of asthma requiring urgent medical care are viral
      respiratory infections. Most of these children < 6 y old are not atopic.

      The inflammatory response to these mostly viral-induced asthmatic attacks is not well
      characterized in the literature. Moreover it is not known whether different kind of
      inflammatory responses exist in this population and how this correlate to clinical outcomes
      and clinical phenotypes in preschool children presenting ti the ED with acute asthmatic
      attack.

      Therefore, the purpose of the present study is to:

      Investigate the characterization of induced sputum cytology in preschool children with acute
      asthmatic attack and whether there is correlation between specific sputum cytology and
      response to therapy and to investigate airways hyper-responsiveness to adenosine
      5'-monophosphate and to metacholine in pre school children 2-6 y old at 2 weeks and at 3
      month following acute asthmatic exacerbation and look for correlation with response to
      treatment and sputum cytology. Clinical phenotypes of this patient population will also be
      investigated.
    

Detailed description: 
      Clinical, Airway Inflammatory, and HRA Phenotypes, in preschool children with acute asthmatic
      attack presenting to the ED.

      Background:

      Children under the age of 5 years have the highest hospitalization rate of asthma. The most
      common causes of acute exacerbations of asthma requiring urgent medical care are viral
      respiratory infections. Most of these children < 6 y old are not atopic.

      The inflammatory response to these mostly viral-induced asthmatic attacks is not well
      characterized in the literature. Moreover it is not known whether different kind of
      inflammatory responses exist in this population and how this correlate to clinical outcomes
      and clinical phenotypes.

      Therefore, the purpose of the present study is to:

      Investigate the characterization of induced sputum cytology, bronchial hyper-responsiveness
      (BHR, and clinical phenotypes in preschool children with acute asthmatic attack presenting to
      the ED and whether there is correlation between specific sputum cytology and response to
      therapy.

      and to investigate airways hyper-responsiveness (BHR)to adenosine 5'-monophosphate and to
      metacholine in pre school children 2-6 y old at 2 weeks and at 3 month following acute
      asthmatic exacerbation and look for correlation with response to treatment and sputum
      cytology.

      Clinical phenotypes of this patient population will also be investigated.Clinical
      characteristics of the preschool children presenting to the ED with asthmatic attack will be
      compared to normal controls recruited from ambulatory clinics at the same area.
    

Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Children, age: 1-6 years old presenting to the emergency room (ER) with acute wheezing
        episode.
      
Keywords: asthma; preschool children; adenosine provocation test; metacholine provocation test; pediatric emergency department