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OR045 Evaluations of inflammatory cell markers in aspirin-exacerbated respiratory disease patients during aspirin challenge test
S6
Abstracts: Oral Concurrent Sessions / Ann Allergy Asthma Immunol 119 (2017) S1eS15
Method: A retrospective study was conducted to assess temporal patterns for children with asthma in the asthma program of national health insurance. A total of 481 children with asthma was enrolled. The air pollution information was collected by air monitoring stations in Taipei. The severity of asthma was graded as GINA guideline. Generalized estimating equation and cox proportional hazard model were applied to evaluate the risk factors of asthma exacerbations. Time series analyses were used to evaluate the monthly aggregations of asthma admissions. Results: A mean number of doctor visits with asthma was 27.00 per month. The severity of most asthma cases were in the third grade of GINA guideline(n¼267,55.5%). Number of doctor visits was highly correlated to high air pollutant levels. The peak of the asthma admissions every year occurred in January. Temperature, carbon monoxide (CO), nitric oxide (NO), NOx, were associated with the asthma admissions in children by time series analysis of autoregressive integrated moving average (0, 0, 3) (0,0,0) model. Conclusion: Temperature and air pollutants CO, NO, and NOx exposure were significantly related to asthma admissions and showed a day lag effect on the asthma severity. Asthma admission in children is highest in winter and is correlated with air pollution and temperature. Air quality control programs and early public warning systems for air pollution are important for susceptible children.
OR043 OBESITY DISRUPTS TISSUE-PROTECTIVE MACROPHAGE POPULATIONS IN THE ADIPOSE AND LUNG D. Hill*, H. Lim, Y. Foong, V. Nelson, K. Won, M. Lazar, Philadelphia, PA. Introduction: Obesity causes significant morbidity and mortality by predisposing to diabetes, cancer, and atopy. Adipose tissue macrophages (ATMs) are critical for maintaining a lean state, but can contribute to adiposity and metabolic syndrome in some settings, raising questions as to the number of functionally distinct ATMs. Additionally, it is unknown the extent to which obesity influences tissue macrophages outside of adipose, a line of investigation that is important for understanding comorbid conditions. Methods: We used flow cytometry and single cell RNA-seq to interrogate the number of distinct ATM subsets in adipose and lung tissue of obese C57Bl/6 (B6) mice. Adoptive transfer of ATMs allowed interrogation of cell-specific functions, and analysis of human adipose samples revealed conserved features of ATM biology. Results: We establish the existence of three, functionally distinct ATM populations in adipose of obese B6 mice. These populations display unique surface markers, have different transcriptional profiles, exhibit distinct functions upon adoptive transfer including regulating lipogenic pathways in adipocytes and maintaining tissue homeostasis. Examination of lung macrophages revealed similar, tissue-protective populations that were disrupted with obesity. Conclusion: We establish the existence of functionally distinct ATM populations in obese adipose of mice and humans. Similar populations of obesity-related macrophages exist in the lung. These findings establish the importance of considering functional heterogeneity among innate immune cells, identify new functions for ATMs in obesity, and suggest that obesity-induced changes in macrophages may influence disease processes outside of adipose.
OR044 THE IMPACT OF TRADITIONAL LITERACY AND EDUCATION ON HEALTH LITERACY IN ADOLESCENTS WITH ASTHMA D. Jordan*1, J. Bush2, D. Ownby1, J. Waller1, M. Tingen1, 1. Augusta, GA; 2. Macon, GA.
Introduction: Patients with low health literacy have poorer understanding and self-management of chronic diseases such as asthma. We hypothesized that traditional literacy is a major contributing factor to health literacy in adolescents. Methods: Health literacy was assessed at the final data collection of a randomized controlled trial of an asthma education intervention in four rural Georgia high schools. Baseline sociodemographic data was obtained. Three instruments were used: REALM (Rapid Estimate of Adolescent/Adult Literacy in Medicine), SILS (Single Item Literacy Screener) and NVS (Newest Vital Sign). To examine agreement between scores, weighted kappa statistics were calculated and Bowkers test of symmetry performed. Results: 243 adolescents and 203 caregivers completed health literacy assessments yielding 198 paired observations. The 9-12 grade adolescents were 60.6% female, 72.7% African American (AA), and mean age 15.3 ( 0.9) years. Caregiver education ranged from < high school (19.1%) to college graduate (24.0%). Agreement between adolescent and caregiver scores were poor: REALM (kw¼0.26), SILS (kw¼0.12) and NVS (kw¼0.29) and disagreement did not significantly differ by race. Positive correlations of moderate strength (overall and between racial groups) were found between the CRCT reading scores and both REALM scores and NVS scores, and between REALM and NVS scores. Due to the inverse relationship of SILS scores with health literacy level, SILS scores (overall and between racial groups) were weakly and negatively correlated with CRCT reading scores, REALM and NVS. Conclusion: Education level and traditional literacy are major contributing factors to health literacy for adolescents with asthma due to the correlation seen in this study.
OR045 EVALUATIONS OF INFLAMMATORY CELL MARKERS IN ASPIRIN-EXACERBATED RESPIRATORY DISEASE PATIENTS DURING ASPIRIN CHALLENGE TEST C. Mitsui*, Sagamihara, Japan. Introduction: Aspirin-exacerbated respiratory disease (AERD) is characterized by the induction of upper and lower respiratory symptoms after intake of COX-1 inhibitors. Cysteinyl leukotriene (cysLT) overproduction occurs even under stable disease condition, and urinary leukotriene E4 (uLTE4) levels further increase after an aspirin challenge test. We reported recently that platelets were significantly activated in AERD patients under stable disease condition (Mitsui et al. JACI 2016). Although cysLT overproduction after aspirin-induced reactions is the most important characteristic in AERD, the entire mechanism of cysLT overproduction in AERD has not been clarified in detail. Methods: Urine and blood samples were collected before and after aspirin-induced reactions both in AERD patients and aspirintolerant asthma (ATA) patients. We evaluated the changes in uLTE4 level, urinary prostaglandin D2 metabolite (PGD2M) level, and expression levels of surface markers on peripheral platelets and basophils. Results: The levels of uLTE4 and urinary PGD2M increased significantly only in AERD patients after aspirin-induced reactions. Additionally, the levels of uLTE4 and urinary PGD2M positively correlated with each other. In contrast, the expression levels of surface markers on peripheral platelets and basophils did not change during the aspirin challenge test either in AERD patients or ATA patients. However, the peripheral basophil count decreased after aspirin-induced reactions only in AERD patients. Conclusion: We found that the levels of uLTE4 and PGD2M increased significantly after aspirin-induced reactions in AERD patients. The expression levels of surface markers on platelets and basophils have not changed after aspirin-induced reactions. Mast cells may be the main source of cysLT after aspirin-induced reactions.
Abstracts: Oral Concurrent Sessions / Ann Allergy Asthma Immunol 119 (2017) S1eS15
Method: A retrospective study was conducted to assess temporal patterns for children with asthma in the asthma program of national health insurance. A total of 481 children with asthma was enrolled. The air pollution information was collected by air monitoring stations in Taipei. The severity of asthma was graded as GINA guideline. Generalized estimating equation and cox proportional hazard model were applied to evaluate the risk factors of asthma exacerbations. Time series analyses were used to evaluate the monthly aggregations of asthma admissions. Results: A mean number of doctor visits with asthma was 27.00 per month. The severity of most asthma cases were in the third grade of GINA guideline(n¼267,55.5%). Number of doctor visits was highly correlated to high air pollutant levels. The peak of the asthma admissions every year occurred in January. Temperature, carbon monoxide (CO), nitric oxide (NO), NOx, were associated with the asthma admissions in children by time series analysis of autoregressive integrated moving average (0, 0, 3) (0,0,0) model. Conclusion: Temperature and air pollutants CO, NO, and NOx exposure were significantly related to asthma admissions and showed a day lag effect on the asthma severity. Asthma admission in children is highest in winter and is correlated with air pollution and temperature. Air quality control programs and early public warning systems for air pollution are important for susceptible children.
OR043 OBESITY DISRUPTS TISSUE-PROTECTIVE MACROPHAGE POPULATIONS IN THE ADIPOSE AND LUNG D. Hill*, H. Lim, Y. Foong, V. Nelson, K. Won, M. Lazar, Philadelphia, PA. Introduction: Obesity causes significant morbidity and mortality by predisposing to diabetes, cancer, and atopy. Adipose tissue macrophages (ATMs) are critical for maintaining a lean state, but can contribute to adiposity and metabolic syndrome in some settings, raising questions as to the number of functionally distinct ATMs. Additionally, it is unknown the extent to which obesity influences tissue macrophages outside of adipose, a line of investigation that is important for understanding comorbid conditions. Methods: We used flow cytometry and single cell RNA-seq to interrogate the number of distinct ATM subsets in adipose and lung tissue of obese C57Bl/6 (B6) mice. Adoptive transfer of ATMs allowed interrogation of cell-specific functions, and analysis of human adipose samples revealed conserved features of ATM biology. Results: We establish the existence of three, functionally distinct ATM populations in adipose of obese B6 mice. These populations display unique surface markers, have different transcriptional profiles, exhibit distinct functions upon adoptive transfer including regulating lipogenic pathways in adipocytes and maintaining tissue homeostasis. Examination of lung macrophages revealed similar, tissue-protective populations that were disrupted with obesity. Conclusion: We establish the existence of functionally distinct ATM populations in obese adipose of mice and humans. Similar populations of obesity-related macrophages exist in the lung. These findings establish the importance of considering functional heterogeneity among innate immune cells, identify new functions for ATMs in obesity, and suggest that obesity-induced changes in macrophages may influence disease processes outside of adipose.
OR044 THE IMPACT OF TRADITIONAL LITERACY AND EDUCATION ON HEALTH LITERACY IN ADOLESCENTS WITH ASTHMA D. Jordan*1, J. Bush2, D. Ownby1, J. Waller1, M. Tingen1, 1. Augusta, GA; 2. Macon, GA.
Introduction: Patients with low health literacy have poorer understanding and self-management of chronic diseases such as asthma. We hypothesized that traditional literacy is a major contributing factor to health literacy in adolescents. Methods: Health literacy was assessed at the final data collection of a randomized controlled trial of an asthma education intervention in four rural Georgia high schools. Baseline sociodemographic data was obtained. Three instruments were used: REALM (Rapid Estimate of Adolescent/Adult Literacy in Medicine), SILS (Single Item Literacy Screener) and NVS (Newest Vital Sign). To examine agreement between scores, weighted kappa statistics were calculated and Bowkers test of symmetry performed. Results: 243 adolescents and 203 caregivers completed health literacy assessments yielding 198 paired observations. The 9-12 grade adolescents were 60.6% female, 72.7% African American (AA), and mean age 15.3 ( 0.9) years. Caregiver education ranged from < high school (19.1%) to college graduate (24.0%). Agreement between adolescent and caregiver scores were poor: REALM (kw¼0.26), SILS (kw¼0.12) and NVS (kw¼0.29) and disagreement did not significantly differ by race. Positive correlations of moderate strength (overall and between racial groups) were found between the CRCT reading scores and both REALM scores and NVS scores, and between REALM and NVS scores. Due to the inverse relationship of SILS scores with health literacy level, SILS scores (overall and between racial groups) were weakly and negatively correlated with CRCT reading scores, REALM and NVS. Conclusion: Education level and traditional literacy are major contributing factors to health literacy for adolescents with asthma due to the correlation seen in this study.
OR045 EVALUATIONS OF INFLAMMATORY CELL MARKERS IN ASPIRIN-EXACERBATED RESPIRATORY DISEASE PATIENTS DURING ASPIRIN CHALLENGE TEST C. Mitsui*, Sagamihara, Japan. Introduction: Aspirin-exacerbated respiratory disease (AERD) is characterized by the induction of upper and lower respiratory symptoms after intake of COX-1 inhibitors. Cysteinyl leukotriene (cysLT) overproduction occurs even under stable disease condition, and urinary leukotriene E4 (uLTE4) levels further increase after an aspirin challenge test. We reported recently that platelets were significantly activated in AERD patients under stable disease condition (Mitsui et al. JACI 2016). Although cysLT overproduction after aspirin-induced reactions is the most important characteristic in AERD, the entire mechanism of cysLT overproduction in AERD has not been clarified in detail. Methods: Urine and blood samples were collected before and after aspirin-induced reactions both in AERD patients and aspirintolerant asthma (ATA) patients. We evaluated the changes in uLTE4 level, urinary prostaglandin D2 metabolite (PGD2M) level, and expression levels of surface markers on peripheral platelets and basophils. Results: The levels of uLTE4 and urinary PGD2M increased significantly only in AERD patients after aspirin-induced reactions. Additionally, the levels of uLTE4 and urinary PGD2M positively correlated with each other. In contrast, the expression levels of surface markers on peripheral platelets and basophils did not change during the aspirin challenge test either in AERD patients or ATA patients. However, the peripheral basophil count decreased after aspirin-induced reactions only in AERD patients. Conclusion: We found that the levels of uLTE4 and PGD2M increased significantly after aspirin-induced reactions in AERD patients. The expression levels of surface markers on platelets and basophils have not changed after aspirin-induced reactions. Mast cells may be the main source of cysLT after aspirin-induced reactions.