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  • 1.
    Boyle, R J
    et al.
    Imperial College London.
    Pedroletti, C
    Karolinska Institutet, Stockholm.
    Wickman, M
    Karolinska Institutet, Stockholm.
    Bjermer, L
    Lund University Hospital.
    Valovirta, E
    Terveystalo Allergy Clinic, Turku, Finland.
    Dahl, R
    Aarhus University Hospital, Denmark .
    Von Berg, A
    Marien-Hospital, Wesel, Germany .
    Zetterström, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US.
    Warner, J O
    Imperial College London.
    Nocturnal temperature controller laminar airflow for treating atopic asthma: a randomised controlled trial2012Ingår i: Thorax, ISSN 0040-6376, E-ISSN 1468-3296, Vol. 67, nr 3, s. 215-221Artikel i tidskrift (Refereegranskat)
    Abstract [en]

       Objective To determine whether environmental control using nocturnal temperature controlled laminar airflow (TLA) treatment could improve the quality of life of patients with persistent atopic asthma. <br> <br>Design Randomised, double-blind, placebo-controlled, parallel-group trial. <br> <br>Setting Nineteen European asthma clinics. <br> <br>Participants 312 patients aged 7-70 with inadequately controlled persistent atopic asthma. <br> <br>Main outcome measure Proportion of patients with an increase of &gt;= 0.5 points in asthma quality of life score after 1 year of treatment. <br> <br>Results TLA devices were successfully installed in the bedrooms of 282 (90%) patients included in the primary efficacy analysis. There was a difference in treatment response rate between active (143 of 189, 76%) and placebo (56 of 92, 61%) groups, difference 14.8% (95% CI 3.1 to 26.5, p=0.02).(3) In patients aged &gt;= 12, on whom the study was powered, the difference in response rate was similar-active 106 of 143 (74%), placebo 42 of 70 (60%), difference 14.1% (0.6 to 27.7, p=0.059). There was a difference between groups in fractional exhaled nitric oxide change of -7.1 ppb (-13.6 to -0.7, p=0.03). Active treatment was associated with less increase in cat-specific IgE than placebo. There was no difference in adverse event rates between treatment groups. <br> <br>Conclusion Inhalant exposure reduction with TLA improves quality of life, airway inflammation and systemic allergy in patients with persistent atopic asthma. TLA may be a treatment option for patients with inadequately controlled persistent atopic asthma.

  • 2.
    Brodtkorb, Thor-Henrik
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US.
    Zetterström, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US.
    Tinghög, Gustav
    Linköpings universitet, Institutionen för medicin och hälsa, Utvärdering och hälsoekonomi. Linköpings universitet, Hälsouniversitetet.
    Cost-effectiveness of clean air administered to the breathing zone in allergic asthma2010Ingår i: CLINICAL RESPIRATORY JOURNAL, ISSN 1752-6981, Vol. 4, nr 2, s. 104-110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Airsonett Airshower (AA) is a novel non-pharmaceutical treatment for patients with perennial allergic asthma that uses a laminar airflow directed to the breathing zone of patients during sleep. It has been shown that AA treatment in addition to optimized standard therapy significantly increases asthma-related quality of life among adolescent asthmatics. However, the cost-effectiveness of AA treatment has not yet been assessed. As reimbursement decisions are increasingly guided by results from the cost-effectiveness analysis, such information is valuable for health-care policy-makers. Objective: The objective of this study was to estimate the cost-effectiveness of adding AA treatment with allergen-free air during night sleep to optimized standard therapy for adolescents with perennial allergic asthma compared with placebo. Materials and Methods: A probabilistic Markov model was developed to estimate costs and health outcomes over a 5-year period. Costs and effects are presented from a Swedish health-care perspective (QALYs). The main outcome of interest was cost per QALY gained. Results: The Airshower strategy resulted in a mean gain of 0.25 QALYs per patient, thus yielding a cost per QALY gained of under 35 000 as long as the cost of Airshower is below 8200. Conclusions: Adding AA treatment to optimized standard therapy for adolescents with perennial allergic asthma compared with placebo is generating additional QALYs at a reasonable cost. However, further studies taking more detailed resource use and events such as exacerbations into account would be needed to fully evaluate the cost-effectiveness of AA treatment. Please cite this paper as: Brodtkorb T-H, Zetterstrom O and Tinghog G. Cost-effectiveness of clean air administered to the breathing zone in allergic asthma.

  • 3.
    Casas, Rosaura
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik.
    Lindau, C
    Division of Paediatrics Linköping University.
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Duchén, Karel
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Downregulation of CXCR6 and CXCR3 in lymphocytes from birch-allergic patients2008Ingår i: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 68, nr 3, s. 351-361Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Preferential expression of chemokine receptors on Th1 or Th2 T-helper cells has mostly been studied in cell lines generated in vitro or in animal models, however, results are less well characterized in humans. We determined T-cell responses through chemokine receptor expression on lymphocytes, and cytokine secretion in plasma from birch-allergic and healthy subjects. The expression of CCR2, CCR3, CCR4, CCR5, CCR7, CXCR3, CXCR4, CXCR6, IL-12 and IL-18R receptors was studied on CD4+ and CD8+ cells from birch-allergic (n = 14) and healthy (n = 14) subjects by flow cytometry. The concentration of IL-4, IL-5, IL-10, IL-12, IFN-γ and TNF-α cytokines was measured in plasma from the same individuals using a cytometric bead array human cytokines kit. The similar expression of CCR4 in T cells from atopic and healthy individuals argues against the use of the receptor as an in vivo marker of Th2 immune responses. Reduced percentages of CD4+ cells expressing IL-18R, CXCR6 and CXCR3 were found in the same group of samples. TNF-α, IFN-γ, IL-10, IL-5, IL-4 and IL-12 cytokines were elevated in samples from allergic individuals. Reduced expression of Th1-associated chemokine receptors together with higher levels of Th1, Th2 and anti-inflammatory cytokines in samples from allergic patients indicate that immune responses in peripheral blood in atopic diseases are complex and cannot be simplified to the Th1/Th2 paradigm. Not only the clinical picture of atopic diseases but also the clinical state at different time points of the disease might influence the results of studies including immunological markers associated with Th1- or Th2-type immune responses. © 2008 The Authors.

  • 4.
    Casas, Rosaura
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Skarsvik, Susanne
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Lundberg, Anna
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Zetterström, Olle
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US. Linköpings universitet, Hälsouniversitetet.
    Duchén, Karel
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Impaired maturation of monocyte-derived dendritic cells from birch allergic individuals in association with birch-specific immune responses2007Ingår i: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 66, nr 5, s. 591-598Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Optimal activation of T lymphocytes requires a costimulatory signal provided by the interaction of molecules on the surface of T cells with their ligands expressed on dendritic cells (DC). We investigated whether DC differentiated from monocytes from healthy and birch allergic asthmatic individuals and further maturated by stimulation with cat and birch allergens and LPS differ in their phenotypic receptor expression. Similar expression of DC surface markers, including HLA-DR, CD80, CD86, CD83, CD1a and CD11c, was detected in monocyte-derived DC from allergic and healthy individuals. Cells from healthy donors stimulated either antigen showed a similar activation of the CD80 and double CD80/CD86 costimulatory molecules when compared with non-stimulated cells. In the case of cells from allergic individuals, birch allergen was unable to produce the same increased expression of CD80 alone or in combination with CD80/CD86, in comparison with cells stimulated with cat and LPS. Levels of IL-6, IL-8, IL-10, MCP-1/MCAF and MIP-1β were similar in the supernatant of non-stimulated DC from both groups of subjects. By contrast, the spontaneous secretion of IL-12p70 and TNF-α was higher in the supernatant of DC from healthy subjects when compared with that from allergic individuals. Stimulation with birch and LPS resulted in an increased secretion of IL-12p70 in samples from healthy when compared with that in allergic individuals. The results suggest an impaired specific maturation of DC from birch allergic individuals in association with birch-specific immune responses. Lower secretion of IL-12p70 from birch-stimulated DC from allergic individuals suggests that not only maturation, but also the specific Th1 function of these cells seems to be affected in those individuals.

  • 5. Dahlén, Barbro
    et al.
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Dahlén, Sven-Erik
    Specific problems: Asthma induced by aspirin and other non-steroidal anti-inflammatory drugs.2001Ingår i: Manual of Asthma management / [ed] Paul M O'Byrne; Neil C Thomson, London: Harcourt Publishers Limited , 2001, 2, s. 453-462Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    This unique manual provides comprehensive, practical, and easily accessible guidelines on the key points of asthma management in both adults and children. The updated 2nd edition incorporates the most recent national and international guidelines for the care of asthmatic patients, with vital information on how to address clinical issues while emphasizing essential basic science in diagnosing, managing, and treating asthma.

  • 6. Dahlén, Sven-Erik
    et al.
    Millinger, Eva
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Internmedicin. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Lungmedicinska kliniken US.
    Skedinger, Maria
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Dahlén, Barbro
    TNF-blockade--new strategy in difficult-to-treat asthma2008Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, nr 26-27, s. 1946-1948Artikel i tidskrift (Refereegranskat)
    Abstract [en]

      

  • 7.
    Ferdousi, Hosne Ara
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Munir, Abdul Kashem Mohamma
    Linköpings universitet, Institutionen för medicin och vård, Lungmedicin. Linköpings universitet, Hälsouniversitetet.
    Zetterström, Olle
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Dreborg, Sten
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Seasonal differences of peak expiratory flow rate variability and mediators of allergic inflammation in non-atopic adolescents2001Ingår i: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 12, nr 5, s. 238-246Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Variations in peak expiratory flow (PEF) and serum eosinophil mediators were studied in healthy adolescents. Twenty-five boys and 31 girls, 11–16 years of age (mean age 14.3 years), were selected and investigated during the birch pollen season of 1995; 45 were also investigated during the autumn of the same year. The PEF was measured twice daily and eosino-phil mediators in serum and in urine were measured by radioimmunoassay (RIA) once during the birch pollen season and once in autumn. The type values of the daily PEF variation, expressed in amplitude percentage mean, were 6.4 and 3.9%, mean values were 7.35 and 6.74%, and the 95th percentiles were 18 and 14%, during the birch pollen season and autumn, respectively. The 95th percentiles were 41 and 38 µg/l for serum eosinophil cationic protein (s-ECP), 74 and 62 µg/l for serum eosinophil protein X (s-EPX), 987 and 569 µg/l for serum myeloperoxidase (s-MPO), and 165 and 104 µg/mmol for urinary eosinophil protein X/urinary creatinine (u-EPX/u-creatinine), during the birch pollen season and autumn, respectively. The levels of the eosinophil mediators decreased significantly from May (n = 56) to November (n = 45), for s-ECP from a median value of 14 µg/l to 7 µg/l (p= 0.001), for s-EPX from a median value of 28 µg/l to 20 µg/l (p= 0.001), and for the neutrophil mediator, s-MPO, from a median value of 440 g/l to 292 g/l (p< 0.001). The PEF variability decreased significantly (p= 0.037), from spring (n = 55; median 8%, 95% confidence interval [CI] 7.8–10.19) to autumn (n = 44; median 6%, 95% CI 6.1–8.9). A significant correlation was found between the levels of s-ECP and s-EPX (rs = 0.7, p< 0.001), between s-ECP and s-MPO (rs = 0.6, p< 0.001), between s-EPX and s-MPO (rs = 0.4, p< 0.005), and between s-EPX and u-EPX/u-creatinine (rs = 0.6, p< 0.0001), in the birch pollen season (n = 56) and in the autumn (n = 45). There was a positive correlation found in PEF variability between the two seasons (n = 43; rs = 0.5, p= 0.0006). No other correlation was found between PEF variability and any other parameters. The difference in the levels of eosinophil mediators between seasons in non-atopic, healthy children is unexplained. Normal limits for mediators were higher and PEF variability was almost the same as has been reported in adults. When using normal values, seasonal influences should be considered.

  • 8.
    Ferdousi, Hosne Ara
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Zetterström, Olle
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet.
    Dreborg, Sten
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Asthma and allergy in pollinosis children: an 11-year follow-up of specific immunotherapyManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Background: Pollen immunotherapy is effective in hay fever and asthma in children, although there are few studies on the long-term benefit.

    Methods: We conducted a longitudinal follow up for 11 years of specific immunotherapy (SIT) for birch and or grass pollen allergy in children (n=28) who took part in the preventive allergic treatment (PAT) study. Bronchial hyperresponsiveness (BHR.) to methacholine, conjunctival provocation tests (CPT), and the skin sensitivity to common allergens-(SPT) were done. A matched group of patients who had not received immunotherapy served as controls.

    Results: Eight years after of discontinuation of IT, 11 children with and 11 children without IT could be investigated. In the SIT group 2 had asthma compared to 7 in the control group. The skin and conjunctival sensitivity in the SIT group decreased more (n.s.). Birch pollen counts were measured dming the pollen seasons in every year from 1992 to 1995 and in the year 1997. The years 1993 and 1995 had high levels of birch pollen counts compared to the other years.

    When all the children were considered, scores for asthma symptoms and BHR was higher in these years.

    PEF variation decreased with age in both groups.

    Conclusions: SIT for hay fever for three years induced a clinical remission 8 years after discontinuation of immunotherapy accompanied by a reduction in the degree of BHR, conjunctival sensitivity, number of allergen sensitizatlons, and occurrence of asthma symptoms.

  • 9.
    Ferdousi, Hosne Ara
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Zetterström, Olle
    Linköpings universitet, Institutionen för medicin och vård, Lungmedicin. Linköpings universitet, Hälsouniversitetet.
    Dreborg, Sten
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Bronchial hyper-responsiveness predicts the development of mild clinical asthma within 2 yr in school children with hay-fever2005Ingår i: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 16, nr 6, s. 478-486Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In children with mild asthma, symptoms are not always apparent. Therefore, results of tests play an important role for the diagnosis. First, to investigate whether children with bronchial hyper-responsiveness (BHR) but no symptoms of asthma in 1992 had developed clinical asthma at follow up in 1994. The second aim was to find out the diagnostic properties of tests for asthma/allergic inflammation, using either doctor diagnosed asthma (DDA), self-assessed symptoms of asthma or iso-capnic hyperventilation of cold air (IHCA), as the standard, to diagnose asthma in a group of children with hay fever. Twenty-eight children with pollinosis, 12 of them with a history of asthma for the first time during the season 1992, were studied during the birch pollen season and in the autumn of 1994. During both periods, the bronchial hyper-reactivity was estimated by methacholine bronchial provocation tests (MBPT), bronchial variability by peak expiratory flow rate variability, subjective symptoms of asthma by visual analogue scale (VAS) and bronchial inflammation by serum and urine levels of inflammatory mediators. In 1994 IHCA was added during both seasons. Eight of 16 children with BHR but without clinical asthma in 1992 had developed asthma in 1994, 14 of 16 reacted to IHCA and 13 to MBPT. All 12 children with DDA in 1992 had still asthma in 1994 and 14 children with BHR in 1992 had persistent BHR in 1994. Of 23 children with BHR in 1992, 17 had DDA in 1994 and all maintained their BHR. Furthermore, 20 of them reacted to IHCA in 1994. In 1994, 24 of 28 hay-fever children had a positive IHCA tests and 24 had positive MBPT. In relation to VAS, the sensitivity of IHCA and MBPT to predict present asthma was high, but the specificity low, whereas the specificity of most other tests was high, but based on few individuals. In relation to DDA both the IHCA test (65–80%) and the MBPT test (79–85%) had a high sensitivity and it was three to six times more likely to find a positive test among asthmatics than in non-asthmatics. Children with hay fever without clinical asthma have a high risk of developing asthma within 2 yr. In relation to DDA, inhalation of cold air and the MBPT showed a high sensitivity.

  • 10.
    Ferdousi, Hosne Ara
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Zetterström, Olle
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet.
    Munir, Abdul Kashem Mohamma
    Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Lungmedicinska kliniken. Linköpings universitet, Hälsouniversitetet.
    Cat allergen exposure in Swedish schools is high enough to maintain continuous bronchial hyperreactivity and to cause symptoms in children with asthma who are sensitized to catManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Background: Exposure to indoor allergens play a major role for development of sensitization and induction of allergic inflammation, bronchial hyperreactivity and symptoms in sensitized individual.

    Objective: fu this study, we investigated the individual exposure levels of cat allergen, Fel d1, among asthmatic schoolchildren sensitized to cats. We studied the exposure relationship with symptoms, medication, lung functions, bronchial hyperreactivity (BHR) and mediators of allergic inflallrmation.

    Methods: Ten school children with known allergy to cats were selected from 5 schools in Linköping, Sweden. All children had positive skin test to cats. We collected dust samples from homes and schools. All children carried a portable air-sampler in the schools during the period of 4-6 weeks. Air was also sampled fi·om the bedroom. The children performed lung function (PEF) twice daily using a digital Peak flow meter. They maintain symptom and medication chart once in a week. We performed methacholine bronchial provocation test (PD20) and analyzed mediators of allergic inflammation (s-ECP, EPX and MPO) iu blood and urine at the beginning and at the end of the study period. Dust and air samples were analyzed for major cat allergen (Fel d1) using ELISA.

    Results: Exposure levels of cat allergen varied from 0,5 µg/g to 751 µg/g dust in homes (median, 36 µg/g) and from 17 µg/g to 378 µg/g in schools (median, 137 µg/g). Airborne allergen levels varied from 13 to 2184 pg/m3 (median, 43 pg/m3) in the homes and 68 to 7718 pg/m3 (median 352 pg/m3) in the schools. The mediators of allergic inflammation ranged from 4 to 57 µg/L for ECP, from 12 to 73 µg/L for EPX and from 148 to 581 µg/L for MPO. All children had bronchial hyperreactivity and all but one child used asthma/allergy medicine during the entire study period. A significant relationship (p<0.05) was found between the peak allergen exposure and symptoms, airborne allergens and BHR of the children.

    Conclusions: Our study suggests, that school is an important source of cat allergen exposure, that cat sensitized asthmatic children inhale a substantial amount of cat allergen in the schools, that despite treatment of asthma including regular use of inhaled corticosteroids, 8 pg to 2336 pg of cat allergen inhaled per minute is sufficient enough to maintain a continuous airway hyper-responsiveness among this group of children.

  • 11. Fernvik, E
    et al.
    Gronneberg, R
    Lundahl, J
    Raud, J
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    van Hage-Hamsten, M, study group
    Hallden, G
    Characterization of eosinophils and detection of eotaxin in skin chamber fluid after challenge with relevant allergen in patients with mild asthma.1999Ingår i: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 29, s. 1516-1525Artikel i tidskrift (Refereegranskat)
  • 12. Haahtela, T
    et al.
    Tamminen, K
    Malmberg, LP
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Karjalainen, J
    Ylä-Outinen, H
    Svahn, T
    Ekström, T
    Selroos, O
    Formoterol as needed with or without budesonide in patients with intermittent asthma and raised NO levels in exhaled air: A SOMA study2006Ingår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 28, nr 4, s. 748-755Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Patients with mild intermittent asthma sometimes show signs of inflammation, and guidelines suggesting bronchodilator therapy alone as needed may be questioned. The current study compared as-needed use of a rapid-acting β2-agonist with as-needed use of a β2-agonist and corticosterold combination as the only medication in asthma patients with intermittent symptoms. A total of 92 nonsmoking asthma patients (of 187 screened) using only an inhaled β2-agonist as needed (28 males, 64 females, mean age 37 yrs, mean forced expiratory volume in one second (FEV1) 101% predicted, mean reversibility 6.5% pred and fractional exhaled nitric oxide (FeNO) ≥20 parts per billion (ppb)) were randomised to treatment with formoterol (Oxis® Turbuhaler®) 4.5 μg as needed (n=47) or budesonide/formoterol (Symbicort® Turbuhaler®) 160/4.5 pg as needed (n=45) in a double-blind, parallel-group 24-week study. The primary variable of efficacy was change in FeNO. Baseline FeNO was 60 ppb and 59 ppb in the budesonide/formoterol and formoterol groups, respectively. Mean reductions in FeNO in the budesonide/formoterol and formoterol groups were 18.2 ppb and 2.8 ppb, respectively (95% confidence interval (CI) 7.5-23.5 ppb). The reduction in the budesonide/formoterol group occurred during the first 4 weeks of treatment and remained at this low level. Mean FEV1 increased by 1.8% pred normal value in the budesonide/formoterol group and decreased by 0.9% pred normal value in the formoterol group (95% Cl -4.7 - -0.7). In the budesonide/formoterol group, use of ≥4 inhalations-day-1 of study medication was seen on 21 treatment days compared with 74 in the formoterol group. In conclusion, as-needed use of an inhaled corticosteroid together with a rapid-acting bronchodilator may be more beneficial than a β2-agonist alone in patients with intermittent asthma and signs of airway inflammation. The long-term benefits are unknown. Copyright © ERS Journals Ltd 2006.

  • 13. Ihre, E
    et al.
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum.
    Ihre, E
    Hammarberg, B
    Voice problems as side effects of inhaled corticosteroids in asthma patients - A prevalence study2004Ingår i: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, Vol. 18, nr 3, s. 403-414Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Voice disturbances in asthma patients may be caused by inhaled corticosteroids. In order to study the prevalence of such voice disturbances, a questionnaire was delivered to asthma patients at three asthma and allergy departments in Stockholm. The questionnaire consisted of 25 questions concerning the asthma disease symptoms, medication, voice function, and voice disturbances. A total of 350 questionnaires were delivered. Response frequency was 80%. There was a significant positive correlation between inhalation of cortison and voice disturbances. Most of the patients complained about hoarseness, followed by throat clearing, a lump in the throat, loss of voice, and less frequently, throat pain. There were no significantly differences between men and women. Elderly had more voice problems than young persons. Patients with voice-demanding professions had more problems than patients who used their voice to a lesser extent during the working day. There was a significant positive correlation between high cortison doses and voice problems as well as between voice problems and acid regurgitation.

  • 14. Lindskog, S
    et al.
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Kamkar, A
    Bergman, E
    Forsgardh, A
    Blomlöf, L
    Skin-prick test for severe marginal periodontitis.1999Ingår i: The international journal of periodontics & restorative dentistry, ISSN 0198-7569, E-ISSN 1945-3388, Vol. 19, s. 373-377Artikel i tidskrift (Refereegranskat)
  • 15.
    Lindskog, Sven
    et al.
    DentoSyst Scandinavia AB.
    Blomlof, Johan
    DentoSyst Scandinavia AB.
    Persson, Inger
    DentoSyst Scandinavia AB.
    Niklason, Anders
    Med Competence Resources.
    Hedin, Anders
    Perioscience, Eskilstuna.
    Ericsson, Leif
    Vastervik Hospital.
    Ericsson, Mats
    Roslagstandlakarna.
    Jarncrantz, Bo
    FTV Kringlan.
    Palo, Ulf
    FTV Sodertalje Centre.
    Tellefsen, Georg
    Danakliniken.
    Zetterström, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US.
    Blomlof, Leif
    DentoSyst Scandinavia AB.
    Validation of an Algorithm for Chronic Periodontitis Risk Assessment and Prognostication: Risk Predictors, Explanatory Values, Measures of Quality, and Clinical Use2010Ingår i: JOURNAL OF PERIODONTOLOGY, ISSN 0022-3492, Vol. 81, nr 4, s. 584-593Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The American Academy of Periodontology has recently stated that, "[risk assessment will become] increasingly important in periodontal treatment planning and should be part of every comprehensive dental and periodontal evaluation." (J Periodontol 2006;77:1608). Unaided risk assessment and prognostication show significant variability because chronic periodontitis is a multifactorial disease. This report summarizes the clinical validation of an algorithm for chronic periodontitis risk assessment and prognostication. The algorithm is a Web-based analytic tool that integrates some 20 risk predictors and calculates scores indicating levels of risk for chronic periodontitis for the dentition (Level I) and, if an elevated risk is found, prognosticates disease progression tooth by tooth (Level II). Methods: An independent clinical validation sample was generated in an open, prospective clinical trial and analyzed in a predetermined validation plan. Results: The analyses identified two threshold scores above which significant progression of periodontitis was found. Based on these scores, sufficiently high explanatory values with significant and increasing parameter estimates for increasing risk were established in Level I, justifying detailed analysis tooth by tooth in Level II. Subsequent prognostication of chronic periodontitis in Level II was found to be accompanied by clinically relevant measures of quality in relation to rates of disease progression. Three score intervals representing increasing levels of periodontitis progression were identified corresponding to increasing levels of significant annual marginal bone loss. Conclusions: The predictors included in the algorithm reflect a relevant selection for periodontitis risk assessment. Risk assessment and prognostication with the algorithm provides the clinician with a validated, reliable, consistent, and objective tool supporting treatment planning.

  • 16.
    Lindskog, Sven
    et al.
    DentoSyst Scandinavia AB, Stockholm.
    Blomlof, Johan
    DentoSyst Scandinavia AB, Stockholm.
    Persson, Inger
    DentoSyst Scandinavia AB, Stockholm.
    Niklason, Anders
    Medical Competence Resources, Bandhagen.
    Hedin, Anders
    Private practice, Perioscience, Eskilstuna.
    Ericsson, Leif
    Västervik Hospital.
    Ericsson, Mats
    Private practice, Roslagstandläkarna, Norrtälje.
    Järncrantz, Bo
    Folktandvården Kringlan, Södertälje.
    Palo, Ulf
    Folktandvården Södertälje Centrum.
    Tellefsen, Georg
    Danakliniken, Danderyd.
    Zetterström, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US.
    Blomlof, Leif
    DentoSyst Scandinavia AB, Stockholm.
    Validation of an Algorithm for Chronic Periodontitis Risk Assessment and Prognostication: Analysis of an Inflammatory Reactivity Test and Selected Risk Predictors2010Ingår i: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 81, nr 6, s. 837-847Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Patients with severe forms of chronic periodontitis present with varying degrees of decreased inflammatory reactivity. A previously reported algorithm for chronic periodontitis risk assessment and prognostication is based on the analysis of some 20 risk predictors. One of these predictors is a skin provocation test that assesses the individual patient's reactivity to a lipid A challenge. The aim of this report was to analyze results from validation data for the algorithm with respect to the contribution of results of the skin provocation test as a risk predictor for the progression of chronic periodontitis and to compare these results with the contribution from other predictors, namely smoking, angular bony destruction, furcation involvement, abutment teeth, and endodontic pathology.

    Methods: Data from a previously reported clinical validation sample were used for the analysis, including the calculation of quality measures and explanatory values using different types of regression analysis and non-parametric testing.

    Results: Smoking, endodontic pathology, abutment teeth, angular bony destruction, and furcation involvement presented with individual explanatory values for periodontitis progression between 4% and 13% and highly significant parameter estimates. Explanatory values for the results of the skin provocation test ranged between 2.6% and 5.1% depending on the disease severity group, with a positive predictive value of 82% for the identification of high-risk patients.

    Conclusion: The skin provocation test provided a clinically significant contribution to the quality of analysis with the periodontitis risk and prognostication algorithm, in particular in the selection of high-risk patients for in-depth individual tooth analysis.

  • 17.
    Mai, Xiaomei
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik.
    Fagerås Böttcher, Malin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik.
    Bruhammar, M
    Allergicentrum US, Linköping.
    Nilsson, Lennart
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Urinary inflammatory mediators and inhalation of hypertonic saline in children2005Ingår i: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 60, nr 1, s. 60-64Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The inflammatory mechanisms of hypertonic saline-induced bronchoconstriction are not well understood. Methods: Seventeen asthmatics with (n = 11) and without bronchial hyperresponsiveness (BHR) (n = 6) and 18 randomly selected nonatopic nonasthmatic controls without BHR were evaluated by urine samples collected before and 1 h after hypertonic saline provocation test. Histamine, 11β-PGF2α, and LTE4 were analysed by enzyme immunoassay (EIA) and eosinophil protein X (EPX) by radioimmunoassay (RIA). Results: The levels of leukotriene E4 (LTE4) increased significantly after the challenge tests, both in the asthmatics (median: 354 pg/mg pre-challenge vs. 628 pg/mg post-challenge, P = 0.05) and in the controls (median: 294 pg/mg pre-challenge vs. 460 pg/mg post-challenge, P < 0.01). The levels of histamine also increased significantly in the latter (median: 299 μmol/mg pre-challenge vs. 569 μmol/mg post-challenge, P = 0.03). However, the levels of 11β-PGF2α and EPX did not change significantly after the challenge tests either in the asthmatics or in the controls. Conclusions: The inhalation of hypertonic saline increased urinary excretion of LTE4 both in the asthmatics and in the controls. The slight increase of leukotrienes was enough to induce airway obstruction in some of the asthmatics, because of the hyperresponsiveness in their airways.

  • 18.
    Mai, Xiaomei
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Fagerås Böttcher, Malin
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Holmberg, Mikaela
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet.
    Nilsson, Lennart
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet.
    Zetterström, Olle
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet.
    Inflammatory mediators monitored in urine in asthmatic children with hypertonic saline-induced bronchoconstriction and in healthy controlsManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Hypertonic saline provocation tests have been validated to be useful in the International Study of Asthma and Allergies in Childhood, but the inflammatory mechanisms of hypertonic saline-induced bronchial hyperresponsiveness (BHR) have not been well understood in asthmatic children. Of the 127 children who participated in hypertonic saline provocation tests, all asthmatics with (n = 13) and without BHR (n = 7) as well as all healthy controls without BHR (n = 37) were evaluated with urine samples collected before and one hour after the provocation test. Paired samples were analyzed in 11 asthmatics with and 6 asthmatics without BHR and 18 healthy controls. Urinary histamine, 11ß-PGF and LTE4 were analyzed by EIA and urinary EPX by RIA. The levels of LTE4 increased after the challenge tests, both in the asthmatics (median value: 354.2 pg/mg pre-challenge vs. 628.3 pg/mg post-challenge, p = 0.05) and in the healthy controls (median value: 294.4 pg/mg pre-challenge vs. 460.0 pg/mg post-challenge, p = 0.008). The levels of histamine also increased in the latter (median value: 299.3 µmol/rug pro-challenge vs. 568.8 µmol/mg post-challenge, p = 0.03). However, the levels of 11ß-PGF and EPX were similar before and after the challenge tests both in the asthmatics and in the healthy controls. The inhalation of hypertonic saline induced the secretion of LTE4 and histamine even in healthy children, but the bronchoconstriction did not seem to be induced by the analyzed inflammatory mediators, such as LTE4, 11ß-PGF, histamine and EPX.

  • 19.
    Nayeri, Fariba
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Millinger, Eva
    Linköpings universitet, Institutionen för medicin och vård, Lungmedicin. Linköpings universitet, Hälsouniversitetet.
    Nilsson, Ingela
    Departments of Clinical Chemistry, County Hospital, Kalmar, Sweden.
    Zetterström, Olle
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet.
    Brudin, Lars
    Departments of Clinical Physiology, County Hospital, Kalmar, Sweden.
    Forsberg, Pia
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Exhaled breath condensate and serum levels of hepatocyte growth factor in pneumonia2002Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 96, nr 2, s. 115-119Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Hepatocyte growth factor (HGF) is a protein produced by mesenchymal cells in many organs, which can stimulate epithelial growth. An enhanced production and concentration of HGF is observed after injuries. The lung is one of the major sources of HGF. By cooling exhaled air, a condensate is formed containing molecules from bronchi and alveoli. In order to investigate HGF concentration and time course in pneumonia, paired serum and exhaled breath condensate was collected from 10 patients with pneumonia, 10 patients with non-respiratory infections and 11 healthy controls. The concentration of HGF was measured by an immunoassay kit. In the acute phase HGF-levels in breath condensate and serum were significantly higher in the patients with pneumonia compared to the control groups. Similar concentrations in breath condensate were seen in healthy controls and in patients with non-respiratory infections. In the patients with pneumonia a decrease in serum HGF was seen already after 4–7 days while HGF values in breath condensate remained elevated even after 4–6 weeks. These results might imply local production of HGF in the lungs and a long repair and healing process after pneumonia.

  • 20.
    Nyström Kronander, Ulla
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Falkenberg, Melcher
    Linköpings universitet, Institutionen för hälsa och samhälle. Linköpings universitet, Hälsouniversitetet.
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Prevalence and incidence of asthma related to waist circumference and BMI in a Swedish community sample2004Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 98, nr 11, s. 1108-1116Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Both asthma and obesity have become more common in affluent societies during the recent decades and several studies have shown a correlation between the presence of asthma and obesity. In order to further study this association we have investigated a population from a community in southern Sweden, where almost all inhabitants had their body indices measured as part of a study on diabetes at a primary care centre. An asthma unit working with a structured care programme for asthma was available. This organisation enabled us to study whether body mass index and waist circumference was associated with having or developing asthma. There was a significant association between both overweight, increased waist circumference and asthma, P

  • 21.
    Pedroletti, C
    et al.
    Karolinska University Hospital.
    Millinger, Eva
    Linköpings universitet, Institutionen för medicin och hälsa, Internmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US.
    Dahlen, B
    Karolinska University Hospital.
    Soderman, P
    Karolinska University Hospital.
    Zetterström, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Clinical effects of purified air administered to the breathing zone in allergic asthma: A double-blind randomized cross-over trial2009Ingår i: RESPIRATORY MEDICINE, ISSN 0954-6111, Vol. 103, nr 9, s. 1313-1319Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Exposure to inhaled allergens is a pathogenetic factor in allergic asthma. However, most studies that previously looked at air cleaning devices have shown little or no effect on patients with perennial allergic asthma. Aims and objectives: We examined a novel treatment using temperature regulated laminar airflow with a very low particle concentration directed to the breathing zone of teenagers and young adults with mild to moderate allergic asthma during night steep. We hypothesised that the decreased allergen exposure during the night would have an effect on bronchial inflammation and quality of life. Method: Twenty-two patients (mean 18.8 years) were randomized to start with active or placebo treatment for 10 weeks. At( patients received both active and placebo treatment with unfiltered air, with a 2-week wash-out period in between treatments. Maintenance treatment with inhaled corticosteroids was unaltered during the trial period. Health related quality of life (miniAQLQ) was the primary effectiveness measure. Exhaled nitric oxide (FeNO) and spirometry were also investigated. Results: Active treatment resulted in an improved miniAQLQ compared to placebo (mean score 0.54, p andlt; 0.05, n = 20). An effect on bronchial, inflammation was also detected with significantly tower FeNO values during the active treatment period (mean -6.95 ppb, p andlt; 0.05, n = 22). Both effects were evident after 5 weeks. The change in lung function was not statistically significant. Conclusion: Clean air, administered directly to the breathing zone during steep, can have a positive effect on bronchial. inflammation and quality of life in patients with perennial allergic asthma.

  • 22. Reichel, W
    et al.
    Dahl, R
    Ringdal, N
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö.
    van den Elshout, FJ
    Laitinen, LA
    Extrafine beclomethasone dipropionate breath-actuated inhaler (400 micrograms/day) versus budesonide dry powder inhaler (800 micrograms/day) in asthma.2001Ingår i: International journal of clinical practice (Esher), ISSN 1368-5031, E-ISSN 1742-1241, Vol. 55, s. 100-106Artikel i tidskrift (Refereegranskat)
  • 23.
    Roel, Eduardo
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Faresjö, Åshild
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Trell, Erik
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Faresjö, Tomas
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Clinically diagnosed childhood asthma and follow-up of symptoms in a Swedish case control study2005Ingår i: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Childhood asthma has risen dramatically not only in the western societies and now forms a major and still increasing public health problem. The aims of this study were to follow up at the age of ten the patterns of asthma symptoms and associations among children with a clinically diagnosed asthma in a sizeable urban-rural community and to in compare them with demographic controls using a standardised questionnaire. Methods: In a defined region in Sweden with a population of about 150 000 inhabitants, all children (n = 2 104) born in 1990 were recorded. At the age of seven all primary care and hospital records of the 1 752 children still living in the community were examined, and a group of children (n = 191) was defined with a well-documented and medically confirmed asthma diagnosis. At the age of ten, 86 % of these cases (n = 158) and controls (n = 171) completed an ISAAC questionnaire concerning asthma history, symptoms and related conditions. Results: Different types of asthma symptoms were highly and significantly over-represented in the cases. Reported asthma heredity was significantly higher among the cases. No significant difference in reported allergic rhinitis or eczema as a child was found between cases and controls. No significant difference concerning social factors or environmental exposure was found between case and controls. Among the control group 4.7 % of the parents reported that their child actually had asthma. These are likely to be new asthma cases between the age of seven and ten and give an estimated asthma prevalence rate at the age of ten of 15.1 % in the studied cohort. Conclusion: A combination of medical verified asthma diagnosis through medical records and the use of self-reported symptom through the ISAAC questionnaire seem to be valid and reliable measures to follow-up childhood asthma in the local community. The asthma prevalence at the age of ten in the studied birth cohort is considerably higher than previous reports for Sweden. Both the high prevalence figure and allowing the three-year lag phase for further settling of events in the community point at the complementary roles of both hospital and primary care in the comprehensive coverage and control of childhood asthma in the community. © 2005 Roel et al, licensee BioMed Central Ltd.

  • 24.
    Roel, Eduardo
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa.
    Olsen Faresjö, Åshild
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Socialmedicin och folkhälsovetenskap.
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum.
    Faresjö, Tomas
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin.
    Perinatal, social, and environmental factors and the risk for childhood asthma in a 10-year follow-up2004Ingår i: Pediatric Asthma Allergy & Immunology, ISSN 0883-1874, E-ISSN 1557-7767, Vol. 17, nr 2, s. 136-145Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to investigate the relative importance of perinatal, social, and environmental factors in a birth cohort for the risk of developing asthma in a 10-year follow-up. A group of children (n = 144) with medically diagnosed asthma was matched to a control group of demographic twins (n = 144) from the same birth cohort and region. In a defined region in Sweden, children with a well-documented and medically confirmed asthma diagnosis were retrospectively identified and followed from birth up to the age of 10. Asthma diagnosis, perinatal and obstetric factors, and social data for both the case and control groups were collected through medical records at all health centers in primary care, privately practicing pediatricians, and the public pediatric clinic in the region. The parents of these children answered the standardized ISAAC postal questionnaire, with an overall response rate of 87%. Family history of asthma and allergic rhinitis and low birth weight indicated an increased asthma risk. The social class of the mother and life-style factors concerning mothers smoking habits and indication of passive smoking were also related to increased asthma risk. Also residential factors like mist or mold damage, unusual odors, and dry air were found to indicate increased asthma risk. Maternal asthma, low birth weight, and exposure to passive smoking in the family were all found to be independent predictors for childhood asthma.

  • 25.
    Roel, Eduardo
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Olsen-Faresjö, Åshild
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Faresjö, Tomas
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin.
    Perinatal, Socila, and Environmental Factors and the Risk for Childhood Asthma in a 10-Year Follow-Up2004Ingår i: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 17, nr 2, s. 146-150Artikel i tidskrift (Refereegranskat)
  • 26.
    Roel, Eduardo
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Zetterström, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US.
    Trell, Erik
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Faresjö, Tomas
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Why are some children with early onset of asthma getting better over the years? - Diagnostic failure or salutogenetic factors2009Ingår i: International Journal of Medical Sciences, ISSN 1449-1907, E-ISSN 1449-1907, Vol. 6, nr 6, s. 348-357Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Among children earlier having been identified with a hospital or primary care diagnosis of asthma at least once between 0-7 years of age, almost 40 % of their parents reported in the ISAAC-questionnaire as never having had asthma (NA). These are further analysed and compared with the persisting asthma cases (A) in this study. All these childrens medical records were scrutinized concerning their asthma diagnose retrospectively. The aim of this study was to analyse possible factors related to the outcome in an Asthma diagnosis reassessment by parental questionnaire at the age of ten of the children earlier having been identified with a hospital or primary health care diagnosis of asthma at least once between 0-7 years of age in a total birth-year cohort in a defined Swedish geographical area. A multiple logistic analysis revealed four significant and independent factors associated to the improvement/non-report of asthma at the age of ten. These factors were; not having any past experiences of allergic symptoms (pless than0.0001), only having one or two visits at the hospital for asthma diagnosis in the 0-7 interval (p=0.001), not living in a flat but a villa at the age of ten (p=0.029) and no previous perception of mist or mould damage in the house (p=0.052). In the early postnatal stage, obstructive and bronchospastic symptoms typical of asthma may be unspecific, and those cases not continuing to persisting disease tend to have identifiable salutogenetic factors of constitutional rather than environmental nature, namely, an overall reduced allergic predisposition.

  • 27.
    Stratelis, Georgios
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Primärvården i västra länsdelen.
    Jakobsson, Per
    Linköpings universitet, Institutionen för medicin och hälsa, Lungmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Lungmedicinska kliniken US.
    Mölstad, Sigvard
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Zetterström, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Allergicentrum.
    Early detection of COPD in primary care: screening by invitation of smokers aged 40 to 55 years2004Ingår i: British Journal of General Practice, ISSN 0960-1643, E-ISSN 1478-5242, Vol. 54, nr 500, s. 201-206Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The incidence of chronic obstructive pulmonary disease (COPD) is increasing in developed countries, as is the mortality rate. The main cause of COPD is smoking, and COPD is usually diagnosed at a late stage. AIM: To evaluate a method to detect COPD at an early stage in smokers in a young age group (40-55 years).

    DESIGN OF STUDY: Prospective descriptive study.

    SETTING: The city of Motala (45,000 inhabitants) and its surrounding rural areas (43,000 inhabitants) in south-east Sweden. Nineteen thousand, seven hundred and fifty subjects were between 40 and 55 years of age. According to Swedish statistics, approximately 27% of this population are smokers.

    METHOD: Smokers aged between 40 and 55 years were invited to have free spirometry testing in primary healthcare centres. Placards were placed in pharmacies and health centres and advertising was carried out locally twice a year.

    RESULTS: A total of 512 smokers responded. The prevalence of COPD was 27% (n = 141). The COPD was classified as mild obstruction in 85% (n = 120), moderate in 13% (n = 18) and severe in 2% (n = 3) according to the European Respiratory Society classification. Knowledge of the disease COPD was acknowledged by 39% of the responders to the questionnaire. Logistic regression analysis showed that age, male sex, number of pack years, dyspnoea and symptoms of chronic bronchitis significantly increased the odds of having COPD. The adjusted odds ratio was significant for having > 30 pack years.

    CONCLUSIONS: This method of inviting relatively young smokers selected a population of smokers with a high incidence of COPD, and may be one way of identifying smokers with COPD in the early stages.

  • 28.
    Stratelis, Georgios
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och samhälle, Allmänmedicin. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland.
    Mölstad, S
    Jakobsson, P
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    ABS88: Diagnosis of COPD combined with brief smoking cessation advice increases smoking cessation rate in comparison with those with normal lung function.2006Ingår i: Primary Care Respiratory Journal, ISSN 1471-4418, E-ISSN 1475-1534, Vol. 20, s. 210-210Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

       

  • 29.
    Stratelis, Georgios
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Primärvården i västra länsdelen.
    Mölstad, Sigvard
    Linköpings universitet, Institutionen för medicin och hälsa, Allmänmedicin. Linköpings universitet, Hälsouniversitetet.
    Jakobsson, Per
    Linköpings universitet, Institutionen för medicin och hälsa, Lungmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Lungmedicinska kliniken US.
    Zetterström, Olle
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Allergicentrum.
    The impact of repeated spirometry and smoking cessation advice on smokers with mild COPD2006Ingår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 24, nr 3, s. 133-139Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Smoking cessation is the most important therapeutic intervention in patients with chronic obstructive pulmonary diseases (COPD) and the health benefits are immediate and substantial. Major efforts have been made to develop methods with high smoking cessation rates.

    OBJECTIVES: To study whether a combination of spirometry and brief smoking cessation advice to smokers with COPD, annually for three years, increased their smoking cessation rate in comparison with groups of smokers with normal lung function.

    METHOD: Prospective, randomized study in primary care. Smoking cessation rates were compared between smokers with COPD followed-up yearly over a period of three years and smokers with normal lung function followed-up yearly for three years or followed-up only once after three years.

    RESULTS: The point-prevalence abstinence rate and prolonged abstinence rate at 6 and 12 months increased yearly and in smokers with COPD at year 3 was 29%, 28%, and 25%, respectively. The abstinence rates were significantly higher in smokers with COPD than in smokers with normal lung function. Smoking cessation rates among smokers with normal lung function did not increase with increasing number of follow-ups.

    CONCLUSION: Smokers diagnosed with COPD stopped smoking significantly more often than those with normal lung function.

  • 30. van Hage-Hamsten, M
    et al.
    Kronqvist, M
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Johansson, E
    Niederberger, V
    Vertala, S
    Gronlund, H
    Gronneberg, R
    Valenta, R
    Skin test evaluation of genetically engineered hypoallergenic derivatives pollen allergen, Bet v 1: trimer in a Swedish population before the birch pollen season.1999Ingår i: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 104, s. 969-977Artikel i tidskrift (Refereegranskat)
  • 31.
    Vogt, Hartmut
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Bråbäck, Lennart
    Occupational & Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Zetterström, Olof
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US.
    Zara, Katalin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet.
    Fälth-Magnusson, Karin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Pediatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Nilsson, Lennart
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet.
    Asthma heredity, cord blood IgE and asthma-related symptoms and medication in adulthood: a long-term follow-up in a Swedish birth cohort2013Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, nr 6, s. e66777.-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cord blood IgE has previously been studied as a possible predictor of asthma and allergic diseases. Results from different studies have been contradictory, and most have focused on high-risk infants and early infancy. Few studies have followed their study population into adulthood. This study assessed whether cord blood IgE levels and a family history of asthma were associated with, and could predict, asthma medication and allergy-related respiratory symptoms in adults.

    A follow-up was carried out in a Swedish birth cohort comprising 1701 consecutively born children. In all, 1661 individuals could be linked to the Swedish Prescribed Drug Register and the Medical Birth Register, and 1227 responded to a postal questionnaire. Cord blood IgE and family history of asthma were correlated with reported respiratory symptoms and dispensed asthma medication at 32–34 years.

    Elevated cord blood IgE was associated with a two- to threefold increased risk of pollen-induced respiratory symptoms and dispensed anti-inflammatory asthma medication. Similarly, a family history of asthma was associated with an increased risk of pollen-induced respiratory symptoms and anti-inflammatory medication. However, only 8% of the individuals with elevated cord blood IgE or a family history of asthma in infancy could be linked to current dispensation of anti-inflammatory asthma medication at follow-up.

    Elevated cord blood IgE and a positive family history of asthma were associated with reported respiratory symptoms and dispensed asthma medication in adulthood, but their predictive power was poor in this long-time follow-up.

  • 32. Xu, Junyang
    et al.
    Jiang, Fengxia
    Nayeri, Fariba
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Zetterström, Olle
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Apoptotic eosinophils in sputum from asthmatic patients correlate negatively with levels of IL-5 and eotaxin2007Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 101, nr 7, s. 1447-1454Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Eosinophilic inflammation of the airways is a key characteristic of asthma. A defect in eosinophil apoptosis might contribute to the chronic tissue eosinophilia associated with asthma. Objective: Our purpose was to examine whether the occurrence of apoptotic eosinophils in induced sputum from asthmatic patients correlate with interleukin (IL)-5 and eotaxin. Methods: Thirty stable and 30 exacerbated asthmatic patients were recruited. Twenty healthy subjects were enrolled as a control group. Induced sputum was obtained from asthmatic patients and from control subjects. The number of apoptotic eosinophils in sputum was assessed by flow cytometry. In sputum supernatant, eosinophil cationic protein (ECP) was measured by sensitive radioimmunoassay, and IL-5 and eotaxin by sandwich enzyme linked immunosorbant assay. Results: Levels of eosinophils, apoptotic eosinophils, IL-5, ECP and eotaxin from asthmatic patients were higher than those from healthy subjects. Thirty exacerbated asthmatics showed higher proportions of eosinophils (median 29.3%, range 13.4%-40.9%), more detectable levels of IL-5 (50.44, 32.99-67.01 pg/ml) and eotaxin (644.6, 197.4-937.7 pg/ml) in their sputum than the patients with stable asthma (P < 0.05). There were significant inverse correlations between the levels of sputum IL-5 and the proportion of sputum eosinophil apoptosis in patients with exacerbated and stable asthma (r = - 0.85 and -0.79, P < 0.01 and P < 0.05, respectively). Also inverse correlations were found between the levels of eotaxin and the proportion of sputum eosinophil apoptosis in exacerbated (r = - 0.85, P < 0.01), or stable asthma (r = - 0.69, P < 0.05). Additional positive corrlations between the levels of sputum IL-5 and eotaxin in either exacerbatated (r = 0.93, P < 0.01) or stable asthma (r = 0.82, P < 0.05) were observed. Conclusions: Apoptosis of eosinophils might be suppressed by proinflammatory cytokines and chemokines such as IL-5 and eotaxin leading to their accumulation in the lung. Stimulation of eosinophils in airway with IL-5 and eotaxin may play a crucial role in allergic inflammation. © 2007 Elsevier Ltd. All rights reserved.

  • 33.
    Zara, Katalin
    et al.
    Allergicentrum Linköpings University.
    Hellman, Britt-Marie
    Allergicentrum Linköpings University.
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Pain estimation caused by adrenaline injectors for the treatment of anaphylaxis. The recommendation to practice the use prior to acute allergic reaction is supported by a cross-sectional study2008Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, nr 19, s. 1388-1390Artikel i tidskrift (Refereegranskat)
  • 34.
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Compliance och astmabehandling.2000Ingår i: Incitament, ISSN 1103-503X, Vol. 7, s. 664-667Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 35.
    Zetterström, Olle
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum.
    Buhl, R.
    Mainz University Hospital, Mainz, Germany.
    Mellem, H.
    Ullevål Hospital, Oslo, Norway.
    Andersson, F.
    Clinical Science, AstraZeneca R and D, Lund, Sweden.
    The whole story: Treatment outcomes with Symbicort®2002Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 96, nr SUPPL. 1Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Asthma is a chronic inflammatory disorder of the airways that has a considerable socioeconomic impact. Asthma management guidelines have been introduced to help provide better long-term control of asthma. Although recommended guidelines may increase the direct medication costs, the overall direct costs of asthma may be reduced due to fewer exacerbations. In addition, indirect costs due to lost productivity and mortality are reduced and patients have an improved quality of life. Inhaled corticosteroids are first-line therapy in the treatment of persistent asthma. Against this background, we have assessed the cost-effectiveness of Symbicort® (budesonide and formoterol in a single inhaler), a treatment that provides better control of asthma compared with budesonide alone. While the prescribing costs of Symbicort® were found to be higher than for budesonide alone, these were partially offset by reduced costs due to fewer asthma exacerbations and a reduced need for other medications. Combined long-term therapy with budesonide and formoterol also improves patient quality of life compared with budesonide alone. Two other factors associated with asthma treatment success and cost-effectiveness are patient/physician education and good patient adherence to prescribed therapy. The introduction of a single inhaler that is easy to use in simple treatment regimens may improve patient adherence to prescribed medication, thus resulting in improved asthma control and fewer exacerbations. Treatment with Symbicort® is more cost-effective than treatment with budesonide alone. © 2002 Elsevier Science Ltd.

  • 36.
    Zetterström, Olle
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Buhl, R
    Mellem, H
    Andersson, F
    The whole story: treatment outcomes with Symbicort?2002Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 96, nr Supplement A, s. 29-35Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Asthma is a chronic inflammatory disorder of the airways that has a considerable socioeconomic impact. Asthma management guidelines have been introduced to help provide better long-term control of asthma. Although recommended guidelines may increase the direct medication costs, the overall direct costs of asthma may be reduced due to fewer exacerbations. In addition, indirect costs due to lost productivity and mortality are reduced and patients have an improved quality of life. Inhaled corticosteroids are first-line therapy in the treatment of persistent asthma. Against this background, we have assessed the cost-effectiveness of Symbicort(R) (budesonide and formoterol in a single inhaler), a treatment that provides better control of asthma compared with budesonide alone. While the prescribing costs of Symbicort(R) were found to be higher than for budesonide alone, these were partially offset by reduced costs due to fewer asthma exacerbations and a reduced need for other medications. Combined long-term therapy with budesonide and formoterol also improves patient quality of life compared with budesonide alone. Two other factors associated with asthma treatment success and cost-effectiveness are patient/physician education and good patient adherence to prescribed therapy. The introduction of a single inhaler that is easy to use in simple treatment regimens may improve patient adherence to prescribed medication, thus resulting in improved asthma control and fewer exacerbations. Treatment with Symbicort(R) is more cost-effective than treatment with budesonide alone.

  • 37.
    Zetterström, Olle
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Buhl, R
    Mellem, H
    Perpina, M
    Hedman, J
    O'Neill, S
    Ekström, T
    Improved asthma control with budesonide/formeterol in a single inhaler, compared with budesonide alone2001Ingår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 18, nr 2, s. 262-268Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Budesonide/formoterol in a single inhaler was compared with budesonide alone, and with concurrent administration of budesonide and formoterol from separate inhalers, in patients with asthma, not controlled with inhaled glucocorticosteroids alone. In this 12-week, double-blind, randomized, double-dummy study, 362 adult asthmatics (forced expiratory volume in one second 73.8% of predicted, inhaled glucocorticosteroid dose 960 ╡g╖day-1) received single inhaler budesonide/formoterol (Symbicort « Turbuhaler «) 160/4.5 ╡g, two inhalations b.i.d., or corresponding treatment with budesonide, or budesonide plus formoterol via separate inhalers. There was a greater increase in morning peak expiratory flow (PEF) with single-inhaler (35.7 L╖min-1) and separate-inhaler (32.0 L╖min-1) budesonide and formoterol, compared with budesonide alone (0.2 L╖min-1, p<0.001, both comparisons), the effect was apparent after 1 day (p<0.001 versus budesonide, both comparisons). Similarly, evening PEF, use of rescue medication, total asthma symptom scores and percentage of symptom-free days improved more with both single inhaler and separate inhaler therapy than with budesonide alone, as did asthma control days (~15% more, p<0.001 versus budesonide, both comparisons, with a marked increase in the first week). All treatments were well tolerated and the adverse event profile was similar in all three treatment groups. It is concluded that single inhaler therapy with budesonide and formoterol is a clinically effective and well-tolerated treatment for patients with asthma that is not fully controlled by inhaled glucocorticosteroids alone.

  • 38.
    Zetterström, Olle
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Allergicentrum. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Dahl, R.
    Department of Respiratory Medicine Aarhus University Hospital, Denmark.
    Lindqvist, A.
    Department of Medicine Helsinki University Central Hospital, Helsinki, Finland.
    Olsson, P.
    Centre for Allergy Research Karolinska Institutet, Stockholm, Sweden.
    Comparable morning versus evening administration of once-daily mometasone furoate dry powder inhaler2008Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 102, nr 10, s. 1406-1411Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The control of daytime and nighttime symptoms is an important measure of effectiveness of asthma therapy, especially, when administered once-daily. Objective: To evaluate the efficacy of evening and morning administrations of mometasone furoate administered via a dry powder inhaler (MF-DPI) 400 μg once-daily (QD) to show equivalence. Methods: Open-label, randomized, parallel-group study in adult patients with mild to moderate asthma with a ≥3-month history of ICS use. Patients received MF-DPI 400 μg QD either in the morning (AM) or evening (PM) for 12 weeks. The primary measure was the change in asthma symptoms from baseline to week 12. Secondary outcomes included response to treatment, adherence, inhaler device evaluation, use of rescue medication, urinary cortisol levels, and differential white blood cell count. Results: A total of 1537 patients were randomized, the efficacy population comprised 543 and 479 patients in the MF-DPI QD morning and evening groups, respectively. Mean improvements from baseline in daytime symptom scores at week 12 with morning and evening administration of MF-DPI 400 μg were -0.11 ± 0.59 and -0.12 ± 0.68, respectively (95% CI, -0.095 to 0.061) and the corresponding improvements in nighttime symptom scores were -0.08 ± 0.59 and -0.07 ± 0.50, respectively (95% CI, -0.067 to 0.068). Use of rescue medication was the same in both groups (1 puff/day). MF-DPI QD was well tolerated regardless of time of administration. Conclusions: This open-label study did not identify differences between morning and evening dosing of MF-DPI 400 μg QD. A better effect of evening dosing compared to morning dosing found in previous double-blind placebo-controlled studies could not be confirmed. © 2008 Elsevier Ltd. All rights reserved.

  • 39.
    Zetterström, Olle
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Lähelmä, S
    Keski-Karhu, J
    Silvasti, M
    Östling-Kulling, E
    Ahonen, A
    Salbutamol via EasyhalerR is at least a effective as salbutamol via TurbuhalerR in the treatment of histamine-induced bronchoconstriction.2000Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 94, s. 1097-1102Artikel i tidskrift (Refereegranskat)
  • 40. Ädelroth, E
    et al.
    Rak, S
    Haahtela, T
    Aasand, G
    Rosenhall, L
    Zetterström, Olle
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för hälsa och miljö. Östergötlands Läns Landsting, Medicincentrum, Allergicentrum US.
    Byrne, A
    Champain, K
    Thirlwell, J
    Cioppa, GD
    Sandström, T
    Recombinant humanized mAb-E25, an anti-IgE mAb, in birch pollen-induced seasonal allergic rhinitis2000Ingår i: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 106, nr 2, s. 253-259Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Allergic rhinitis is a common condition often requiring treatment. Objective: We evaluated whether recombinant humanized (rhu)mAb-E25, a recombinant humanized construct of a murine antibody that binds to circulating IgE, could control symptoms and reduce intake of concomitant medication in seasonal allergic rhinitis (SAR) induced by birch pollen if given subcutaneously in a dose schedule predicted to reduce serum free IgE levels below 25 ng/mL. Methods: We randomly assigned 251 adult subjects with a history of SAR and a positive skin test response to birch pollen to receive 300 mg of rhumAb-E25 or placebo given 2 or 3 times during the season, depending on baseline IgE levels. The primary efficacy variable was the subject's average daily nasal symptom severity score (sneezing, itching, runny, and stuffy nose) from diary data collected over the double-blind treatment period. Secondary efficacy variables included the average number of rescue antihistamine tablets per day, the proportion of days with any SAR medication use, and rhinoconjunctivitis-specific quality of life (QOL). Results: Significant between-treatment differences in favor of rhumAb-E25 were observed in average daily nasal symptom severity scores, the average number of tablets of rescue antihistamines per day, the proportion of days with any SAR medication use, and all domains of QOL. Serum-free IgE levels were markedly lower in rhumAb-E25-treated subjects and were associated with clinical effectiveness. Recombinant humanized mAb-E25 was well tolerated. No anti-rhumAb-E25 antibodies were detected. Conclusion: Compared with placebo, rhumAb-E25 was safe and effective in controlling birch pollen-induced SAR symptoms, with less concomitant medication use and improved QOL. This study shows the therapeutic potential of anti-IgE antibody in SAR.

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