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Determinants of Quality of life (QOL) Among Children Undergoing Oral Food Challenge (OFC) in Canada
180
Determinants of Quality of life (QOL) Among Children Undergoing Oral Food Challenge (OFC) in Canada
Lianne Soller, PhD1, Christopher Mill, MSc2, Tiffany Wong, MD1, Ingrid Baerg1, Tracy Gonzalez1, Timothy Teoh1, Kyla Hildebrand, MD2, and Edmond S. Chan, MD, FAAAAI3; 1BC Children’s Hospital, Vancouver, BC, Canada, 2Division of Allergy & Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, BC Children’s Hospital, Vancouver, BC, Canada, 3Division of Allergy & Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, BC Children’s Hospital, Vancouver, British Columbia, Vancouver, BC, Canada. RATIONALE: To describe QOL of children undergoing OFC in Canada and explore association between QOL, demographic/clinical characteristics, and parental confidence in recognizing anaphylaxis and using an autoinjector. METHODS: The FAQLQ-PF (higher score5poorer QoL; range50-6) was used to calculate QOL among children (n5166) undergoing OFC at the BC Children’s Hospital Allergy clinic between Jan’14 and Oct’15. Linear regression was used to assess the relationship between QOL, demographic/clinical characteristics, and several confidence domains. RESULTS: Mean QOL score was 1.95 (95%CI: 1.71, 2.17) overall, 1.05 (0.47, 1.63) for tree nut, 1.70 (1.30, 2.11) for peanut, and 2.16 (1.74, 2.58) for egg. QOL was worse for older children (p50.001), having a health professional (HCP) parent (p50.02), experiencing more severe reactions (p50.04), and having ever administered an autoinjector (p<0.001). QOL was better for children undergoing OFC to tree nut compared with egg (p50.009). CONCLUSIONS: Health professionals are likely more aware of risks of food allergy, negatively affecting their child’s QOL. Similarly, older children, those who’ve experienced severe reactions, and those who’ve used an autoinjector may be more worried about risks. Tree nut allergy resulted in better QOL than egg allergy, likely due to egg being harder to avoid. We found no association between QOL and several confidence domains, suggesting confidence with recognizing anaphylaxis and using an autoinjector is insufficient for improving QOL.
181
Impact of Asthma Control on Health Related Quality Of Life of Affected Children and their Caregivers
Shajitha Melethil, MD, Karen E. Smith, PhD, Vibha S. Acharya, BS, Heidi Spratt, PhD, Sandra Ho, MD, and Randall M. Goldblum, MD; University of Texas Medical Branch, Galveston, TX. RATIONALE: Asthma is a chronic disease that can negatively affect the health-related quality of life (HRQoL) of children and their primary caregivers. Caregiver mental health and perception of HRQoL burden directly influences asthma control in children. Current studies have not compared the impairment of HRQoL of children and caregivers whose asthma is well-controlled (WC) versus not well-controlled (NWC) to healthy children (HC). METHODS: Children between 5-17 years of age were stratified into three groups: WC (n525), NWC (n56), and HC (n510). Caregivers completed Child Health Questionnaire Parent Form (CHQPF-28) constituting 14 concepts, combined to derive physical (PhS) and psychosocial (PsS) summary measures of HRQoL in children. They also completed the Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) which evaluates activity limitations and emotional functioning of caregivers. RESULTS: Non-parametric tests were used for analysis of non-normally distributed data. Kruskal-Wallis test showed significant differences among the groups for PhS (p50.002) and PsS (p50.02). Pairwise comparisons showed no significant difference between HC and WC children, but higher psychosocial functioning and fewer physical limitations when compared to NWC. Wilcox rank test on PACQLQ indicated that caregivers of children
with WC asthma reported superior emotional functioning and fewer activity limitations versus NWC (p 50.015). CONCLUSIONS: HRQoL is significantly higher in children with WC asthma when compared to NWC, supporting the parental perception that caring for children with WC asthma is similar to caring for HC. This finding adds further impetus for attaining optimal control of asthma in order to improve the well-being of these children and their families.
182
Genome-wide gene-environment interaction study to identify potential genes for respiratory syncytial virus infection in asthmatic children
Ching-Hui Tsai, and Yungling Lee; National Taiwan University, Taipei, Taiwan. RATIONALE: Respiratory syncytial virus (RSV) is the most common cause of hospitalization and mortality in children, and RSV induced lower respiratory infections increased risks of childhood asthma. In our previous study, children with current RSV infection were found to have increased risks of severe asthma. However, not all children exposed to RSV developed asthmatic symptoms. Host genetic background may contribute parts of causes of severe asthma exacerbations. Therefore, the purpose of this study is to perform gene-RSV interactions to identify genes related to severe asthma exacerbations in children. METHODS: Taiwanese Consortium of Childhood Asthma Study (TCCAS) is a consortium-based study coordinated by several pediatric study groups in Taiwan. Asthmatic children, diagnosed by pediatric asthma specialists under Global Initiative for Asthma guidelines, were recruited from hospitals and clinics. We examined the whole genome genotyping and expression from peripheral blood mononuclear cells. Current RSV infection status was confirmed by ELISA kits to assess the units of IgM antibodies to RSV. RESULTS: We used in silico analysis to investigate differentially expressed genes (DEGs) of RSV infection from GEO datasets. In addition, genome-wide SNP-based association study for RSV infection were also examined in TCCAS. Expression quantitative trait loci (eQTL) analysis was applied to investigate the targeted genetic polymorphisms and DEGs. Finally, we performed gene-RSV interaction study to investigate the association between all targeted SNPs and RSV infection on severe asthma exacerbations. We will further validate our genetic targets by genome-wide SNP-based gene-RSV interaction. CONCLUSIONS: Host genetic polymorphisms would modify the level of RSV-induced asthma exacerbations in children.
SATURDAY
Abstracts AB57
J ALLERGY CLIN IMMUNOL VOLUME 139, NUMBER 2
Determinants of Quality of life (QOL) Among Children Undergoing Oral Food Challenge (OFC) in Canada
Lianne Soller, PhD1, Christopher Mill, MSc2, Tiffany Wong, MD1, Ingrid Baerg1, Tracy Gonzalez1, Timothy Teoh1, Kyla Hildebrand, MD2, and Edmond S. Chan, MD, FAAAAI3; 1BC Children’s Hospital, Vancouver, BC, Canada, 2Division of Allergy & Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, BC Children’s Hospital, Vancouver, BC, Canada, 3Division of Allergy & Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, BC Children’s Hospital, Vancouver, British Columbia, Vancouver, BC, Canada. RATIONALE: To describe QOL of children undergoing OFC in Canada and explore association between QOL, demographic/clinical characteristics, and parental confidence in recognizing anaphylaxis and using an autoinjector. METHODS: The FAQLQ-PF (higher score5poorer QoL; range50-6) was used to calculate QOL among children (n5166) undergoing OFC at the BC Children’s Hospital Allergy clinic between Jan’14 and Oct’15. Linear regression was used to assess the relationship between QOL, demographic/clinical characteristics, and several confidence domains. RESULTS: Mean QOL score was 1.95 (95%CI: 1.71, 2.17) overall, 1.05 (0.47, 1.63) for tree nut, 1.70 (1.30, 2.11) for peanut, and 2.16 (1.74, 2.58) for egg. QOL was worse for older children (p50.001), having a health professional (HCP) parent (p50.02), experiencing more severe reactions (p50.04), and having ever administered an autoinjector (p<0.001). QOL was better for children undergoing OFC to tree nut compared with egg (p50.009). CONCLUSIONS: Health professionals are likely more aware of risks of food allergy, negatively affecting their child’s QOL. Similarly, older children, those who’ve experienced severe reactions, and those who’ve used an autoinjector may be more worried about risks. Tree nut allergy resulted in better QOL than egg allergy, likely due to egg being harder to avoid. We found no association between QOL and several confidence domains, suggesting confidence with recognizing anaphylaxis and using an autoinjector is insufficient for improving QOL.
181
Impact of Asthma Control on Health Related Quality Of Life of Affected Children and their Caregivers
Shajitha Melethil, MD, Karen E. Smith, PhD, Vibha S. Acharya, BS, Heidi Spratt, PhD, Sandra Ho, MD, and Randall M. Goldblum, MD; University of Texas Medical Branch, Galveston, TX. RATIONALE: Asthma is a chronic disease that can negatively affect the health-related quality of life (HRQoL) of children and their primary caregivers. Caregiver mental health and perception of HRQoL burden directly influences asthma control in children. Current studies have not compared the impairment of HRQoL of children and caregivers whose asthma is well-controlled (WC) versus not well-controlled (NWC) to healthy children (HC). METHODS: Children between 5-17 years of age were stratified into three groups: WC (n525), NWC (n56), and HC (n510). Caregivers completed Child Health Questionnaire Parent Form (CHQPF-28) constituting 14 concepts, combined to derive physical (PhS) and psychosocial (PsS) summary measures of HRQoL in children. They also completed the Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) which evaluates activity limitations and emotional functioning of caregivers. RESULTS: Non-parametric tests were used for analysis of non-normally distributed data. Kruskal-Wallis test showed significant differences among the groups for PhS (p50.002) and PsS (p50.02). Pairwise comparisons showed no significant difference between HC and WC children, but higher psychosocial functioning and fewer physical limitations when compared to NWC. Wilcox rank test on PACQLQ indicated that caregivers of children
with WC asthma reported superior emotional functioning and fewer activity limitations versus NWC (p 50.015). CONCLUSIONS: HRQoL is significantly higher in children with WC asthma when compared to NWC, supporting the parental perception that caring for children with WC asthma is similar to caring for HC. This finding adds further impetus for attaining optimal control of asthma in order to improve the well-being of these children and their families.
182
Genome-wide gene-environment interaction study to identify potential genes for respiratory syncytial virus infection in asthmatic children
Ching-Hui Tsai, and Yungling Lee; National Taiwan University, Taipei, Taiwan. RATIONALE: Respiratory syncytial virus (RSV) is the most common cause of hospitalization and mortality in children, and RSV induced lower respiratory infections increased risks of childhood asthma. In our previous study, children with current RSV infection were found to have increased risks of severe asthma. However, not all children exposed to RSV developed asthmatic symptoms. Host genetic background may contribute parts of causes of severe asthma exacerbations. Therefore, the purpose of this study is to perform gene-RSV interactions to identify genes related to severe asthma exacerbations in children. METHODS: Taiwanese Consortium of Childhood Asthma Study (TCCAS) is a consortium-based study coordinated by several pediatric study groups in Taiwan. Asthmatic children, diagnosed by pediatric asthma specialists under Global Initiative for Asthma guidelines, were recruited from hospitals and clinics. We examined the whole genome genotyping and expression from peripheral blood mononuclear cells. Current RSV infection status was confirmed by ELISA kits to assess the units of IgM antibodies to RSV. RESULTS: We used in silico analysis to investigate differentially expressed genes (DEGs) of RSV infection from GEO datasets. In addition, genome-wide SNP-based association study for RSV infection were also examined in TCCAS. Expression quantitative trait loci (eQTL) analysis was applied to investigate the targeted genetic polymorphisms and DEGs. Finally, we performed gene-RSV interaction study to investigate the association between all targeted SNPs and RSV infection on severe asthma exacerbations. We will further validate our genetic targets by genome-wide SNP-based gene-RSV interaction. CONCLUSIONS: Host genetic polymorphisms would modify the level of RSV-induced asthma exacerbations in children.
SATURDAY
Abstracts AB57
J ALLERGY CLIN IMMUNOL VOLUME 139, NUMBER 2