Publications by authors named "Graham Roberts"

Background: Early identification of children at risk of asthma attacks is important for optimizing treatment strategies. We aimed to integrate salivary microbiome and serum inflammatory mediator profiles with asthma attacks history to develop a comprehensive predictive model for future attacks.

Methods: This study contained a discovery (SysPharmPediA) and a replication phase (U-BIOPRED).

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The European Academy of Allergy and Clinical Immunology (EAACI) is currently developing guidelines on immunomodulation and nutrition. To inform these recommendations, a scoping review will be conducted to synthesize and map the available empirical evidence on how complementary feeding affects immune health in infants and toddlers to explore the association between complementary feeding during the first year of life and immune health outcomes in children up to 3 years of age. The scoping review will be conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Scoping Review Extension for scoping reviews (PRISMA-ScR) guidelines.

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Background: Intranasal medications are considered a first-line treatment of allergic rhinitis (AR).

Objective: We performed a systematic review and network meta-analysis (NMA) comparing the efficacy and safety of intranasal antihistamines (INAH), intranasal corticosteroids (INCS), and their fixed combination (INAH+INCS) for the treatment of AR in children.

Methods: We searched four electronic bibliographic and three clinical trial databases for randomized controlled trials assessing the use of INAH, INCS, and INAH+INCS in children (aged <18 years) with seasonal or perennial AR.

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Background: Component-resolved diagnostics allow detailed assessment of IgE sensitization to multiple allergenic molecules (component-specific IgEs, or c-sIgEs) and may be useful for asthma diagnosis. However, to effectively use component-resolved diagnostics across diverse settings, it is crucial to account for geographic differences.

Objective: We investigated spatial determinants of c-sIgE networks to facilitate development of diagnostic algorithms applicable globally.

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GALEN and EFA propose minimum specifications for all industrialised countries/regions to work towards to support students with food allergies in educational settings. We reviewed research and legislation and gained feedback from over 100 patient and professional groups. We built shared expectations around: 1.

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Background: Lung function during childhood is an important predictor of subsequent health and disease. Understanding patterns of lung function and development of airflow limitation through childhood is necessary to inform lung function trajectories in relation to health and chronic airway disease. We aimed to derive trajectories of airflow limitation from childhood (age 5-8 years) into early adulthood (age 20-26 years) using repeated spirometry data from birth cohorts.

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Background: The 2006 National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network anaphylaxis criteria are widely used in clinical care and research. In 2020, the World Allergy Organization published modified criteria that have not been uniformly adopted. Different criteria contribute to inconsistent care and research outcomes.

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Background: Adverse food reactions include food allergy (FA; immune-mediated) and food intolerances (non-immune-mediated). FA are classified into IgE- and non-IgE-mediated FA. There is limited information available about changes in FA prevalence over time.

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Rationale: Knowledge about the clinical importance of patient-reported outcome measures (PROMs) in severe asthma is limited.

Objectives: To assess whether and to what extent asthma exacerbations affect changes in PROMS over time and asthma-specific PROMs can predict exacerbations in adult patients with severe asthma in usual care.

Methods: Data of 421 patients with severe asthma (62% female; mean age 51.

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This Anaphylaxis Manifesto calls on communities to prioritise 10 practical actions to improve the lives of people at risk of serious allergic reactions. The Global Allergy and Asthma European Network and the European Federation of Allergy and Airways Diseases Patients' Associations (EFA) compiled patient-centric priorities. We used qualitative consensus methods, research evidence and feedback from over 200 patient groups, stakeholder organisations and healthcare professionals.

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Background: Elevated blood or tissue eosinophils are considered to characterize type 2 inflammation in children with asthma and are associated with increased exacerbation rates and worse asthma control. Dupilumab, a human mAb that blocks type 2 inflammatory drivers IL-4 and IL-13, reduced severe exacerbation rates and improved lung function versus placebo in children aged 6 to 11 years with uncontrolled moderate to severe asthma in the phase 3 LIBERTY ASTHMA VOYAGE study (NCT02948959).

Objective: To assess dupilumab efficacy and safety in children from VOYAGE with moderate to severe asthma and greater than or equal to 500 and less than 1500 blood eosinophils/μL at baseline.

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Article Synopsis
  • Chronic obstructive pulmonary disease (COPD) can be influenced by genetic factors and may stem from reduced lung growth during childhood, leading to lower lung function throughout life.
  • A polygenic risk score (PRS) was calculated using data from a large genome-wide association study and tested for its correlation with lung function in individuals aged 4-50 from multiple research cohorts.
  • Results indicated that higher PRS scores were associated with significantly lower lung function, measured by key indicators, starting from childhood and continuing into adulthood, regardless of smoking, sex, or asthma diagnosis.
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  • - The development of the CompOsite iNdexes For Response in asthMa (CONFiRM) aimed to create patient-centered tools that measure responses to biologics for severe asthma in both adults and children, integrating clinical data and quality of life (QoL) indicators.
  • - Experts and patients collaborated to identify significant outcome changes and devised CONFiRM scores, which demonstrated high levels of agreement on key factors, with patients emphasizing the importance of quality of life more than healthcare professionals did.
  • - The CONFiRM scores effectively measure treatment response, with strong validity metrics indicating their reliability, and they facilitate a comprehensive assessment of biologics’ effectiveness; further studies are required for prospective validation.
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  • IgE-mediated food allergies are the most common type, causing quick and serious reactions that affect patients' and caregivers' lives.
  • Omalizumab is a humanized monoclonal antibody that binds to IgE, reducing allergic reactions, and has been approved by the FDA for treating these food allergies.
  • The GALEN ANACARE Consensus Statement supports omalizumab's use based on a systematic review and expert agreement, noting it is currently the only drug that can significantly reduce IgE-mediated food allergic reactions, although more evidence is needed for stronger guideline recommendations.
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  • - The study explores how atmospheric pressure changes during flights can influence insulin delivery from pumps in people with type 1 diabetes, potentially leading to issues like hypoglycaemia.
  • - An in vitro flight simulation mimicking airline conditions revealed that insulin pumps can over-deliver and under-deliver insulin at different stages of flight, particularly significant during emergency decompression scenarios.
  • - Real-world data from pilots using continuous subcutaneous insulin infusion (CSII) showed that insulin levels remained stable with only a small percentage of blood glucose readings falling outside the safe range, indicating effective management while flying.
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This European Academy of Allergy and Clinical Immunology (EAACI) guideline provides recommendations for the management of IgE-mediated food allergy and was developed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Following the confirmation of IgE-mediated food allergy diagnosis, allergen avoidance and dietary advice (with support of a specialised dietitian, if possible) together with the provision of a written treatment plan, education on the recognition of allergic symptoms and prescription of medication including adrenaline using an auto-injector are essential. Patients with significant anxiety and requirement for coping strategies may benefit from support from a clinical psychologist.

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  • Precautionary Allergen Labelling (PAL) is used to warn people about possible allergens in food that could affect those with allergies.
  • The World Allergy Organization found that PAL is not consistently regulated, which makes it confusing for people with food allergies.
  • There are discussions among global organizations to create better rules for PAL so that it is clear and helpful for everyone, but there are still some challenges to making these rules work everywhere.
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  • - The study explored the feasibility of using high-flow humidified oxygen (HiFlo) as a treatment for children aged 2-11 with acute severe asthma (ASA) who did not respond to standard inhaled bronchodilator treatment.
  • - In a randomized controlled trial involving 56 children, those receiving HiFlo experienced a lower treatment failure rate (64%) compared to the standard care group (86%), and they also had a faster time to meet hospital discharge criteria (29.3 hours vs. 36.8 hours).
  • - The findings suggest that HiFlo could be a promising intervention for childhood ASA, warranting a larger definitive trial to evaluate its effectiveness despite the initial lack of evidence.
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  • Respiratory allergies often start in childhood and mainly show up as allergic rhinitis and/or asthma, which can significantly affect a child's quality of life.
  • These allergies frequently coexist with other issues like asthma and gastrointestinal or mental health problems, highlighting the importance of early diagnosis.
  • Allergen immunotherapy (AIT) is suggested as a potential early treatment option to help alter the course of respiratory allergies and improve long-term outcomes for affected children.
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Background: Wheezing in childhood is prevalent, with over one-half of all children experiencing at least 1 episode by age 6. The pathophysiology of wheeze, especially why some children develop asthma while others do not, remains unclear.

Objectives: This study addresses the knowledge gap by investigating the transition from preschool wheeze to asthma using multiomic profiling.

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Introduction: A minority of school-aged children with asthma have persistent poor control and experience frequent asthma attacks despite maximal prescribed maintenance therapy. These children have higher morbidity and risk of death. The first add-on biologic therapy, omalizumab, a monoclonal antibody that blocks immunoglobulin (Ig)E, was licensed for children with severe asthma in 2005.

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Asthma is a common chronic disease in children. It is a dynamic condition-symptoms change over time, and the outcome of diagnostic tests can vary. Consequently, evaluating the onset of asthma at a single point in time, perhaps when patients are asymptomatic with limited impairment of the lung function, may result in false diagnostic conclusions.

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Article Synopsis
  • - The traditional healthcare approach often overlooks patients' personal experiences and strengths, focusing mainly on disease treatment. Person-centered care aims to align medical decisions with individual values and preferences, particularly for those with chronic conditions.
  • - This paper seeks to enhance care for rhinitis and asthma by developing digital care pathways and incorporating real-world evidence to create a more patient-centered approach.
  • - Key components of the review include advancements in mHealth, the integration of artificial intelligence, a novel classification system for airway diseases, and proposals for the ARIA 2024 guidelines, all targeting a sustainable and applicable healthcare model.
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