Day 1 :
Michigan State University, USA
Keynote: Two year follow-up with asthmatic vulnerable population on seasonal variations of asthma attack at Dearborn, Michigan, USA
Time : 10:00-10:35
Professor Jamil received his medical degree from Baghdad University. He holds several postgraduate degrees from England. In 1979 joined Baghdad University, then in 1998 joined Wayne State University and in 2015 joined Michigan State University. He has published 20 books and 191 field research articles. He is one of the founders of "The International Society of Iraqi Scientists" in 2000 and “The AlNahrain International Society of Iraqi Scientists in 2017. Elected in 2002 as President of International Society of Iraqi Scientists until 2015. Professor Jamil received the Teacher Award from Wayne State University in 2006, 2010 and in 2013.
Background: In US asthma prevalence increase from 3.1% in 1980 to 10.9% in 2014, in which Michigan have over one million asthma people. Asthma causes people to miss school, work days, 1.8 million people visit emergency room and 439,000 people admit to hospital. Its total cost is $60 billion. Although, we do not know the exact etiology for asthma, it is still able to be managed with proper prevention and treatment. Asthma prevalence among Arab in the Detroit region range from 12-15% which is higher than the general population. However, asthma prevalence varies between countries and between people living in different places within the same country.
Objective: The study aims (1) Do the self-reported risk factors of asthma among the same asthmatic people change in two consequence years? (2) Do the risk factors of asthma change between Summer and Winter (3) Do the Lung Function Tests (LFT) of the same asthmatic people change in two consequence years?
Methods: Sixty-eight asthmatic participants were involved in two years of study. Participants criteria were: physician diagnosed asthma, live within two-mile from “air particles monitoring station”, age 55+ years, both sexes, accept to participate volunteer. A structured check-list was used by research assistant to assess the house environment at each site visits. Different Tests of significant were used to tests the objective questions.
Results: 68 asthmatic participants (36.8% male) were interview and its LFT were done four times in two years (Y1 & Y2). A significant change (Y1 to Y2) toward employment status and health insurance. There was no significant difference in the home evaluation, between the two-years. There was significant difference in the environmental chemical agents that participants exposed by seasons in two-year while for total air pollution was only for the first year. The study identifies different predictor risk factors (E.g. 12 triggers, indoor air quality, years living at home, outdoor pollution) through using linear regression on different dependent variables s by season for two years. Testing FEV1, FEV/FVC and FEF25-75 showed no different between the two summer or winter but significant different exist between summer and winter in two-year but not for FVC. Several linear regression tests were applied on different LFT to predict risk factors, some were similar in summer and winter (age, total triggers, years living at home) and some different (E.g. in summer: gender, smoke tobacco, indoor air quality; while in winter: live close to exposure places, asthma chest symptoms). There were significant differences in reporting self-rated health (SRH) and self-rated respiratory health (SRRH) between two summer and two winter.
Conclusion: There were no real changes in the risk factors between the two years, but there was a significant difference between Summer and Winter that caused attach of asthma. Also, there was no significant difference in the LFT between the two-years, but the difference persists between Summer and Winter. SRRH may be an early indicator of worsening SRH – an indicator of future morbidity risks.
University Hospital Basel, Switzerland
Time : 10:35-11:10
Michael Roth is currently working as the Head of Pulmonary Cell Research and Pneumology, University Hospital of Basel, Switzerland. He has completed his PhD from University of Basel. He has worked as a Visiting Professor and Associate Professor at University of Sydney for two years. He has published 148 articles in reputed journals.
Asthma is the most frequent chronic lung disease and affects over 250 million people worldwide with no curative therapy available. Moreover, the incidence of asthma is continually inclining and it is estimated to double every ten years by the WHO. Existing asthma drugs allow symptom control by only reducing inflammation and relaxing constricted airway smooth muscles, but they have no documented effect on airway wall remodeling. Thus, the hypothesis that airway wall remodeling results from chronic inflammation was questioned. Clinical studies indicated that airway wall remodeling occurs within days after airway provocation and is irreversible. Therefore, airway wall remodeling is today regarded as an independent pathology. Airway wall remodeling consists of at least four independent events: Derangement of epithelium; sub-epithelial fibroblasts hyperplasia and hypertrophy; extracellular matrix deposition by these fibroblasts and; hyperplasia of airway smooth muscle cells. New studies provided evidence that the healthy epithelium actively suppresses activity and proliferation of sub-epithelial cells, and this function is significantly reduced in asthmatic airways. In turn, sub-epithelial cells become active, proliferate and secrete pro-inflammatory immune cell recruiting cytokines which increase the local inflammation. In addition, the sub-epithelial cells attempt to counteract inflammation by secreting more extracellular matrix, which leads to local tissue hypoxia and subsequently to vascularization of the thickened airway wall. Interestingly, most of these remodeling pathologies have recently been linked to the activation of epigenetic mechanisms including histone acetylation, protein methylation and mitochondria activity. Genetic studies failed to identify strong asthma susceptibility factors, but clearly indicated that the precondition to asthma is set early in life through epigenetic events, which can be handed down over three generations mainly through the maternal line. However, the nature of the mechanism(s) by which these epigenetic modifications become permanent in asthma have to be investigated and will present novel curative targets for therapy. Thus, understanding of the cause of airway wall remodeling in asthma is regarded today as the key to cure the diseases by many investigators.