Severe asthma in children
Abstract
Most children with asthma have their disease easily controlled if low-dose inhaled corticosteroids (ICSs) are regularly and correctly administered. If a child presents with asthma which is apparently resistant to therapy with high-dose ICS and other controllers, then they have problematic severe asthma. However, in light of the UK National Review of Asthma Deaths, definitions of severe asthma based solely on the levels of prescribed treatment are too narrow. A detailed assessment of all such children should be performed. First, the diagnosis of asthma should be confirmed, then co-morbidities assessed. Next, a nurse-led assessment further characterizes the problem, conventionally categorizing the child as either having difficult asthma or severe therapy-resistant asthma. Here, we reassess in particular the interactions between, and management of, these two categories, highlighting that this dichotomous classification may need reconsideration. We use bronchoscopy and an intramuscular steroid injection to determine if the child has steroid-resistant asthma, using a novel, multidomain approach because the adult definition does not apply to around half the children we see. Finally, we highlight some mechanistic data which have emerged from this protocol such as the absence of T-helper 2 (TH2) cytokines even in eosinophilic severe asthma and the potential role of the innate epithelial cytokine IL-33, novel data on lineage negative innate lymphoid cells, which we can measure in induced sputum, and demonstrating that intraepithelial neutrophils are associated with better, not worse asthma outcomes. Severe paediatric asthma is very different from severe asthma in adults, and approaches must not be uncritically extrapolated from adult disease to children.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Despite interventions and treatments aimed at addressing modifiable factors and comorbidities, some children with difficult asthma and Asthma plus may not improve because of continued poor adherence with medications or ongoing high exposure to allergens, in which case they should be considered as having refractory difficult asthma or refractory Asthma plus.
“However, despite interventions and treatments aimed at addressing modifiable factors and comorbidities, some children with DA and Asthma plus may not improve [e.g., because of the continued poor adherence with medications (50, 68), or ongoing high exposure to allergens (69–71)], in which case they should be considered as having refractory DA or refractory Asthma plus (46, 72).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [72]
Cites
Cluster analysis and clinical asthma phenotypes
Haldar, P., Pavord, I. D., Shaw, D. E., Berry, M. A., Thomas, M., Brightling, C. E., Wardlaw, A. J., & Green, R. H. (2008) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200711-1754oc · Cited by 1,987 · see citing works
Mepolizumab and Exacerbations of Refractory Eosinophilic Asthma
Haldar, P., Brightling, C. E., Hargadon, B., Gupta, S., Monteiro, W. R., Sousa, A. R., Marshall, R. P., Bradding, P. H., Green, R. H., Wardlaw, A. J., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0808991 · Cited by 1,862 · see citing works
Disordered Microbial Communities in Asthmatic Airways
Hilty, M., Burke, C. M., Pedro, H., Cárdenas, P., Bush, A., Bossley, C. J., Davies, J. C., Ervine, A., Poulter, L. W., Pachter, L. S., et al. (2010) · PLoS ONE · doi:10.1371/journal.pone.0008578 · Cited by 1,825 · see citing works
Self-citationMepolizumab for Prednisone-Dependent Asthma with Sputum Eosinophilia
Nair, P. K., Pizzichini, M. M. M., Kjarsgaard, M., Inman, M. D., Efthimiadis, A., Pizzichini, E., Hargreave, F. E., & O’Byrne, P. M. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0805435 · Cited by 1,346 · see citing works
Kumar, S., & Kelly, A. S. (2017) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2016.09.017 · Cited by 1,310 · see citing works
Wenzel, S. E., Schwartz, L. B., Langmack, E. L., HALLIDAY, J. L., Trudeau, J. B., Gibbs, R. L., & Chu, H. W. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.160.3.9812110 · Cited by 1,232 · see citing works
Treatable traits: toward precision medicine of chronic airway diseases
Agustí, A. G. N., Bel, E. H., Thomas, M. D., Vogelmeier, C. F., Brusselle, G., Holgate, S. T., Humbert, M. J. C., Jones, P., Gibson, P. G., Vestbo, J., et al. (2016) · European Respiratory Journal · doi:10.1183/13993003.01359-2015 · Cited by 1,102 · see citing works
Bisgaard, H., Li, N., Bonnelykke, K., Chawes, B. L. K., Skov, T., Paludan-Müller, G., Stokholm, J., Smith, B., & Krogfelt, K. A. (2011) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2011.04.060 · Cited by 786 · see citing works
Murray, C. S. (2006) · Thorax · doi:10.1136/thx.2005.042523 · Cited by 497 · see citing works
The role of acute and chronic stress in asthma attacks in children
Sandberg, S., Paton, J. Y., Ahola, S., McCann, D. C., McGuinness, D., Hillary, C. R., & Oja, H. (2000) · The Lancet · doi:10.1016/s0140-6736(00)02715-x · Cited by 464 · see citing works
Dysregulation of Allergic Airway Inflammation in the Absence of Microbial Colonization
Herbst, T., Sichelstiel, A., Schär, C., Yadava, K., Bürki, K., Cahenzli, J., McCoy, K., Marsland, B. J., & Harris, N. L. (2011) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201010-1574oc · Cited by 440 · see citing works
Reevaluation of Diagnosis in Adults With Physician-Diagnosed Asthma
Aaron, S. D., Vandemheen, K. L., FitzGerald, J. M., Ainslie, M., Gupta, S., Lemière, C., Field, S. K., McIvor, A., Hernandez, P., Mayers, I., et al. (2017) · JAMA · doi:10.1001/jama.2016.19627 · Cited by 439 · see citing works
Walker, S., Khan-Wasti, S., Fletcher, M., Cullinan, P., Harris, J., & Sheikh, A. (2007) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2007.03.034 · Cited by 431 · see citing works
Gibson, P. G., McDonald, V. M., & Marks, G. B. (2010) · The Lancet · doi:10.1016/s0140-6736(10)61087-2 · Cited by 395 · see citing works
Smoking and asthma: dangerous liaisons
Polosa, R., & Thomson, N. C. (2012) · European Respiratory Journal · doi:10.1183/09031936.00073312 · Cited by 371 · see citing works
der Voort, A. M. M. S., Arends, L. R., de Jongste, J. C., Annesi‐Maesano, I., Arshad, S. H., Barros, H., Basterrechea, M., Bisgaard, H. F., Chatzi, L., Corpeleijn, E., et al. (2014) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2013.12.1082 · Cited by 364 · see citing works
Decreased response to inhaled steroids in overweight and obese asthmatic children
Forno, E., Lescher, R., Strunk, R. C., Weiss, S. T., Fuhlbrigge, A. L., & Celedon, J. C. (2011) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2010.12.010 · Cited by 342 · see citing works
Randomized Controlled Trial of Oral Antifungal Treatment for Severe Asthma with Fungal Sensitization
Denning, D. W., O’Driscoll, B. R., Powell, G., Chew, F., Atherton, G. T., Vyas, A., Miles, J., Morris, J., & Niven, R. M. (2008) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200805-737oc · Cited by 342 · see citing works
Pediatric severe asthma is characterized by eosinophilia and remodeling without TH2 cytokines
Bossley, C. J., Fleming, L., Gupta, A. K., Regamey, N., Frith, J., Oates, T., Tsartsali, L., Lloyd, C. M., Bush, A., & Saglani, S. (2012) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2012.01.059 · Cited by 316 · see citing works
Self-citationWhat do parents of wheezy children understand by "wheeze"?
Cane, R. (2000) · Archives of Disease in Childhood · doi:10.1136/adc.82.4.327 · Cited by 310 · see citing works
Obesity and Airway Dysanapsis in Children with and without Asthma
Forno, E., Weiner, D. J., Mullen, J. R., Sawicki, G. S., Kurland, G., Han, Y. Y., Cloutier, M. M., CANINO, G. J., Weiss, S. T., Litonjua, A. A., et al. (2016) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201605-1039oc · Cited by 290 · see citing works
Is the Gut Microbiota a New Factor Contributing to Obesity and Its Metabolic Disorders?
Harris, K. A., Kassis, A. N., Major, G. C., & Chou, C. J. (2012) · Journal of Obesity · doi:10.1155/2012/879151 · Cited by 274 · see citing works
Food allergy as a risk factor for life-threatening asthma in childhood: A case-controlled study
Roberts, G. C., Patel, N., Levi‐Schaffer, F., Habibi, P., & Lack, G. (2003) · Journal of Allergy and Clinical Immunology · doi:10.1067/mai.2003.1569 · Cited by 266 · see citing works
IL-33 promotes airway remodeling in pediatric patients with severe steroid-resistant asthma
Saglani, S., Lui, S., Ullmann, N., Campbell, G. A., Sherburn, R. T., Mathie, S. A., Denney, L., Bossley, C. J., Oates, T., Walker, S. A., et al. (2013) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2013.04.012 · Cited by 258 · see citing works
Self-citationLansoprazole for Children With Poorly Controlled Asthma: A Randomized Controlled Trial
Holbrook, J. T., Wise, R. A., Gold, B. D., Blake, K., Brown, E. D., Castro, M., Dozor, A. J., Lima, J. J., Mastronarde, J. G., Sockrider, M. M., et al. (2012) · JAMA · doi:10.1001/jama.2011.2035 · Cited by 242 · see citing works
Johansson, H., Norlander, K., Berglund, L., Janson, C., Malinovschi, A., Nordvall, L., Nordang, L., & Emtner, M. (2014) · Thorax · doi:10.1136/thoraxjnl-2014-205738 · Cited by 233 · see citing works
Elevated Sputum Interleukin-5 and Submucosal Eosinophilia in Obese Individuals with Severe Asthma
Desai, D., Newby, C., Symon, F. A., Haldar, P., Shah, S., Gupta, S., Bafadhel, M., Singapuri, A., Siddiqui, S., Woods, J., et al. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201208-1470oc · Cited by 225 · see citing works
Diagnostic Criteria for the Classification of Vocal Cord Dysfunction
Morris, M. J., & Christopher, K. L. (2010) · CHEST Journal · doi:10.1378/chest.09-2944 · Cited by 222 · see citing works
Management of severe asthma in children
Bush, A., & Saglani, S. (2010) · The Lancet · doi:10.1016/s0140-6736(10)61054-9 · Cited by 220 · see citing works
Self-citationAllergic rhinitis is associated with poor asthma control in children with asthma
de Groot, E. P., Nijkamp, A., Duiverman, E. J., & Brand, P. L. P. (2012) · Thorax · doi:10.1136/thoraxjnl-2011-201168 · Cited by 210 · see citing works
Pediatric severe asthma with fungal sensitization is mediated by steroid-resistant IL-33
Castanhinha, S., Sherburn, R. T., Walker, S. A., Gupta, A. K., Bossley, C. J., Buckley, J., Ullmann, N., Grychtol, R. M., Campbell, G. A., Maglione, M., et al. (2015) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2015.01.016 · Cited by 208 · see citing works
Self-citationThe importance of nurse-led home visits in the assessment of children with problematic asthma
Bracken, M. B., Fleming, L., Hall, P., Stiphout, N. V., Bossley, C. J., Biggart, E. A., Wilson, N. M., & Bush, A. (2009) · Archives of Disease in Childhood · doi:10.1136/adc.2008.152140 · Cited by 202 · see citing works
Self-citationvan Huisstede, A., Rudolphus, A., Cabezas, M. C., Biter, L. U., van de Geijn, G. J., Taube, C., Hiemstra, P. S., Braunstahl, G., & van Schadewijk, A. M. (2015) · Thorax · doi:10.1136/thoraxjnl-2014-206712 · Cited by 192 · see citing works
Sputum inflammatory phenotypes are not stable in children with asthma
Fleming, L., Tsartsali, L., Wilson, N., Regamey, N., & Bush, A. (2012) · Thorax · doi:10.1136/thoraxjnl-2011-201064 · Cited by 187 · see citing works
Self-citationParents' interpretations of children's respiratory symptoms on video
Cane, R. (2001) · Archives of Disease in Childhood · doi:10.1136/adc.84.1.31 · Cited by 179 · see citing works
Gwilt, C., Donnelly, L., & Rogers, D. F. (2007) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2007.05.007 · Cited by 172 · see citing works
Overdiagnosis of asthma in children in primary care: a retrospective analysis
den Akker, I. L., van Luijn, K., & Verheij, T. J. (2016) · British Journal of General Practice · doi:10.3399/bjgp16x683965 · Cited by 163 · see citing works
Problematic severe asthma in children, not one problem but many: a GA 2 LEN initiative
Hedlin, G., Bush, A., Carlsen, K. C. L., Wennergren, G., Benedictis, F. M. D., Melén, E., Paton, J. Y., Wilson, N. M., & Carlsen, K. H. (2010) · European Respiratory Journal · doi:10.1183/09031936.00104809 · Cited by 162 · see citing works
Self-citationThe molecular phenotype of severe asthma in children
Fitzpatrick, A. M., Higgins, M. K., Holguín, F., Brown, L. A. S., & Teague, W. G. (2010) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2010.01.048 · Cited by 158 · see citing works
Type 2 innate lymphoid cells in induced sputum from children with severe asthma
Nagakumar, P., Denney, L., Fleming, L., Bush, A., Lloyd, C. M., & Saglani, S. (2015) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2015.06.038 · Cited by 149 · see citing works
Self-citationUpper airway and systemic inflammation in obstructive sleep apnoea
Vicente, E., Marín, J. M., Carrizo, S. J., Osuna, C. S., González, R., Marín‐Oto, M., Forner, M., Vicente, P., Cubero, P., Gil, A. V., et al. (2016) · European Respiratory Journal · doi:10.1183/13993003.00234-2016 · Cited by 127 · see citing works
Weinmayr, G., Forastiere, F., Büchele, G., Jaensch, A., Strachan, D. P., Nagel, G., & the ISAAC Phase Two Study Group (2014) · PLoS ONE · doi:10.1371/journal.pone.0113996 · Cited by 125 · see citing works
Passive Smoking Impairs Histone Deacetylase-2 in Children With Severe Asthma
Kobayashi, Y., Bossley, C. J., Gupta, A. K., Akashi, K., Tsartsali, L., Mercado, N., Barnes, P. J., Bush, A., & Ito, K. (2013) · CHEST Journal · doi:10.1378/chest.13-0835 · Cited by 109 · see citing works
Self-citationRosenkranz, M. A., Busse, W. W., Sheridan, J. F., Crisafi, G. M., & Davidson, R. J. (2012) · PLoS ONE · doi:10.1371/journal.pone.0040921 · Cited by 109 · see citing works
ADCYAP1R1 and Asthma in Puerto Rican Children
Chen, W., Boutaoui, N., Brehm, J. M., Han, Y., Schmitz, C., Cressley, A., Acosta‐Pérez, E., Alvarez, M., Colón‐Semidey, A., Baccarelli, A., et al. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201210-1789oc · Cited by 107 · see citing works
Vocal cord dysfunction: a review
Dunn, N. M., Katial, R. K., & Hoyte, F. C. L. (2015) · Asthma Research and Practice · doi:10.1186/s40733-015-0009-z · Cited by 104 · see citing works
Childhood Overweight Increases Hospital Admission Rates for Asthma
Carroll, C. L., Stoltz, P., Raykov, N., Smith, S. R., & Zucker, A. R. (2007) · PEDIATRICS · doi:10.1542/peds.2007-0409 · Cited by 103 · see citing works
Phenotypic Differences between Pediatric and Adult Asthma
Bush, A., & Menzies-Gow, A. N. (2009) · Proceedings of the American Thoracic Society · doi:10.1513/pats.200906-046dp · Cited by 98 · see citing works
Self-citationClinical significance of cough and wheeze in the diagnosis of asthma.
Kelly, Y. J., Brabin, B. J., Milligan, P. J., et al. (1996) · Archives of Disease in Childhood · doi:10.1136/adc.75.6.489 · Cited by 96 · see citing works
Cárdenas, P., Cooper, P. J., Cox, M. J., Chico, M. E., Arias, C., Moffatt, M. F., & Cookson, W. (2012) · PLoS ONE · doi:10.1371/journal.pone.0046803 · Cited by 95 · see citing works
Severe childhood asthma: a common international approach?
Bush, A., Hedlin, G., Carlsen, K. C. L., et al. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61422-1 · Cited by 94 · see citing works
Self-citationMeta-analysis of asthma-related hospitalization in mepolizumab studies of severe eosinophilic asthma
Yancey, S. W., Ortega, H. G., Keene, O. N., et al. (2016) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2016.08.008 · Cited by 94 · see citing works
Inflammatory pathways in children with insufficient or disordered sleep
Kim, J., Hakim, F., Gozal, D., & Gozal, D. (2011) · Respiratory Physiology & Neurobiology · doi:10.1016/j.resp.2011.04.024 · Cited by 88 · see citing works
Agbetile, J., Bourne, M., Fairs, A., Hargadon, B., Desai, D., Broad, C., Morley, J. P., Bradding, P. H., Brightling, C. E., Green, R. H., et al. (2013) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2013.09.050 · Cited by 87 · see citing works
Pediatric Obesity-Related Asthma: The Role of Metabolic Dysregulation
Vijayakanthi, N., Greally, J. M., & Rastogi, D. (2016) · PEDIATRICS · doi:10.1542/peds.2015-0812 · Cited by 84 · see citing works
Assessment of problematic severe asthma in children: Figure 1–
Carlsen, K. C. L., Hedlin, G., Bush, A., Wennergren, G., de Benedictis, F. M., de Jongste, J. C., Baraldi, E., Pedroletti, C., Barbato, A., Malmström, K., et al. (2010) · European Respiratory Journal · doi:10.1183/09031936.00091410 · Cited by 83 · see citing works
Self-citationKendig and Chernick’s Disorders of the Respiratory Tract in Children
Kendig, E. L., Chernick, V., & Wilmott, R. W. (2012) · Cited by 83 · see citing works
Stressful life events and the onset of asthma
Lietzén, R., Virtanen, P., Mika Kivimaki, B., Sillanmäki, L. H., Vahtera, J., & Koskenvuo, M. (2010) · European Respiratory Journal · doi:10.1183/09031936.00164609 · Cited by 81 · see citing works
Neuroeffector mechanisms: The interface between inflammation and neuronal responses
Barnes, P. J. (1996) · Journal of Allergy and Clinical Immunology · doi:10.1016/s0091-6749(96)70020-9 · Cited by 80 · see citing works
Mechanisms by which obesity impacts upon asthma
Umetsu, D. T. (2016) · Thorax · doi:10.1136/thoraxjnl-2016-209130 · Cited by 77 · see citing works
Wheeze Detection: Recordings vs. Assessment of Physician and Parent
Levy, M. L., Godfrey, S., Irving, C. S., et al. (2004) · Journal of Asthma · doi:10.1081/jas-200038451 · Cited by 71 · see citing works
Steroid resistance in asthma: a major problem requiring novel solutions or a non-issue?
Adcock, I. M. (2004) · Current Opinion in Pharmacology · doi:10.1016/j.coph.2004.02.001 · Cited by 71 · see citing works
Exacerbations of severe asthma
McDonald, V. M., & Gibson, P. G. (2012) · Clinical & Experimental Allergy · doi:10.1111/j.1365-2222.2012.03981.x · Cited by 70 · see citing works
Bossley, C. J., Fleming, L., Ullmann, N., Gupta, A. K., Adams, A., Nagakumar, P., Bush, A., & Saglani, S. (2016) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2015.12.1347 · Cited by 70 · see citing works
Self-citationSaglani, S. (2005) · Archives of Disease in Childhood · doi:10.1136/adc.2004.071134 · Cited by 68 · see citing works
Self-citationLang, J. E., Hossain, J., & Lima, J. J. (2014) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2014.08.029 · Cited by 68 · see citing works
Managing the pediatric patient with refractory asthma: a multidisciplinary approach
Cook, J., Beresford, F., Fainardi, V., Hall, P., Housley, G., Jamalzadeh, A., Nightingale, M., Winch, D., Bush, A., Fleming, L., et al. (2017) · Journal of Asthma and Allergy · doi:10.2147/jaa.s129159 · Cited by 63 · see citing works
Self-citationLeft Vocal Cord Paralysis After Extreme Preterm Birth, a New Clinical Scenario in Adults
Røksund, O. D., Clemm, H. H., Heimdal, J. H., et al. (2010) · PEDIATRICS · doi:10.1542/peds.2010-1129 · Cited by 61 · see citing works
Long-term effectiveness of a staged assessment for paediatric problematic severe asthma
Sharples, J., Gupta, A. K., Fleming, L., Bossley, C. J., Bracken-King, M., Hall, P., Hayward, A., Puckey, M., Balfour-Lynn, I. M., Rosenthal, M., et al. (2012) · European Respiratory Journal · doi:10.1183/09031936.00209511 · Cited by 60 · see citing works
Self-citationSulaiman, I., Seheult, J. N., MacHale, E., Boland, F., O'Dwyer, S., Rapčan, V., D’Arcy, S., Cushen, B., Mokoka, M., Killane, I., et al. (2016) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201603-222oc · Cited by 50 · see citing works
Guglani, L., Atkinson, S., Hosanagar, A., & Guglani, L. (2014) · Frontiers in Pediatrics · doi:10.3389/fped.2014.00082 · Cited by 48 · see citing works
Congenital laryngomalacia is related to exercise-induced laryngeal obstruction in adolescence
Hilland, M., Røksund, O. D., Sandvik, L., et al. (2016) · Archives of Disease in Childhood · doi:10.1136/archdischild-2015-308450 · Cited by 48 · see citing works
Macrophage activation, age and sex effects of immunometabolism in obese asthma
Periyalil, H., Wood, L. G., Scott, H. A., Jensen, M. E., & Gibson, P. G. (2014) · European Respiratory Journal · doi:10.1183/09031936.00080514 · Cited by 47 · see citing works
The yin and the yang of immunosuppression with inhaled corticosteroids
Sabroe, I., Postma, D. S., Heijink, I. H., et al. (2013) · Thorax · doi:10.1136/thoraxjnl-2013-203773 · Cited by 47 · see citing works
Bush, A., Pedersen, S., Hedlin, G., Baraldi, E., Barbato, A., de Benedictis, F., Carlsen, K., de Jongste, J. C., & PIACENTINI, G. L. (2011) · European Respiratory Journal · doi:10.1183/09031936.00030711 · Cited by 47 · see citing works
Self-citationThe complexities of defining atopy in severe childhood asthma
Frith, J., Fleming, L., Bossley, C., Ullmann, N., & Bush, A. (2011) · Clinical & Experimental Allergy · doi:10.1111/j.1365-2222.2011.03729.x · Cited by 46 · see citing works
Self-citationBush, A., & Fleming, L. (2016) · Archives of Disease in Childhood · doi:10.1136/archdischild-2015-309053 · Cited by 46 · see citing works
Self-citationVocal cord dysfunction in bronchial asthma. A review article
Idrees, M. M., & FitzGerald, J. M. (2014) · Journal of Asthma · doi:10.3109/02770903.2014.982288 · Cited by 39 · see citing works
Bronchial and Systemic Inflammation in Morbidly Obese Subjects with Asthma: A Biopsy Study
van Huisstede, A., Rudolphus, A., van Schadewijk, A. M., Cabezas, M. C., Mannaerts, G. H. H., Taube, C., Hiemstra, P. S., & Braunstahl, G. (2014) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201407-1225le · Cited by 37 · see citing works
Supraglottoplasty as treatment of exercise induced laryngeal obstruction (EILO)
Mehlum, C. S., Walsted, E. S., Godballe, C., et al. (2015) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-015-3823-2 · Cited by 34 · see citing works
The asthmas in 2015 and beyond: a Lancet Commission
Bush, A., Kleinert, S., & Pavord, I. D. (2015) · The Lancet · doi:10.1016/s0140-6736(15)60654-7 · Cited by 33 · see citing works
Self-citationRelation between asthma and sleep disordered breathing in children: is the association causal?
Castro-Rodríguez, J. A., BROCKMANN, P. E., V, & Marcus, C. L. (2016) · Paediatric Respiratory Reviews · doi:10.1016/j.prrv.2016.08.010 · Cited by 33 · see citing works
Lang, J. E., Hossain, J., Holbrook, J. T., Teague, W. G., Gold, B. D., Wise, R. A., & Lima, J. J. (2016) · Thorax · doi:10.1136/thoraxjnl-2015-207662 · Cited by 31 · see citing works
I have taken my umbrella, so of course it does not rain: Figure 1
Postma, D. S., Brusselle, G., Bush, A., & Holloway, J. W. (2011) · Thorax · doi:10.1136/thoraxjnl-2011-200758 · Cited by 30 · see citing works
Self-citationA systematic review of early life factors which adversely affect subsequent lung function
Kouzouna, A., Gilchrist, F. J., Ball, V., Kyriacou, T., Henderson, A. J., Pandyan, A. D., & Lenney, W. (2016) · Paediatric Respiratory Reviews · doi:10.1016/j.prrv.2016.03.003 · Cited by 28 · see citing works
The utility of exhaled nitric oxide in patients with suspected asthma
Martin, M. J., Wilson, E. E., Gerrard-Tarpey, W., et al. (2016) · Thorax · doi:10.1136/thoraxjnl-2015-208014 · Cited by 28 · see citing works
Is a two‐week trial of oral prednisolone predictive of target lung function in pediatric asthma?
Lex, C., Payne, D., Zacharasiewicz, A. S., et al. (2005) · Pediatric Pulmonology · doi:10.1002/ppul.20189 · Cited by 18 · see citing works
Fleming, L., Koo, M., Bossley, C. J., et al. (2016) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2015.12.1317 · Cited by 17 · see citing works
Self-citationPublic health: The need for and the role of a coordinator in child health surveillance/promotion
Blair, M. E. (2001) · Archives of Disease in Childhood · doi:10.1136/adc.84.1.1 · Cited by 16 · see citing works
Innate helper cells: a novel cell type essential in the initiation of asthma?
Saglani, S. (2011) · Thorax · doi:10.1136/thoraxjnl-2011-200510 · Cited by 13 · see citing works
Self-citationBush, A., & Nagakumar, P. (2016) · European Medical Journal · doi:10.33590/emj/10310308 · Cited by 13 · see citing works
Self-citationNevill, A. M., Donnelly, P., Shibli, S., et al. (2014) · Journal of Physical Activity and Health · doi:10.1123/jpah.2012-0044 · Cited by 6 · see citing works
Bush, A., Pedersen, S. A., Hedlin, G., et al. (2011) · Cited by 5 · see citing works
Self-citationCartledge, N., Brown, S., Bossley, C. J., et al. (2011) · Thorax · doi:10.1136/thoraxjnl-2011-201054c.83 · Cited by 4 · see citing works
Bush, A. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-1984-0.00048-6 · Cited by 3 · see citing works
Self-citationG522(P) The role of inpatient assessment of problematic severe asthma
Gambhir, N., Longman, J., Nagakumar, P., et al. (2016) · Archives of Disease in Childhood · doi:10.1136/archdischild-2016-310863.509 · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Epidemiology of Asthma in Children and Adults
Dharmage, S. C., Perret, J. L., & Custovic, A. (2019) · Frontiers in Pediatrics · doi:10.3389/fped.2019.00246 · Cited by 1,200 · see citing works
Severe asthma: looking beyond the amount of medication
Bush, A., Saglani, S., & Fleming, L. (2017) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(17)30379-x · Cited by 33 · see citing works
Self-citationRusconi (2018) · doi:10.1183/13993003.01665-2018 · Cited by 28 · see citing works
- Authors
- Bush, A., Fleming, L., & Saglani, S.
- Affiliations
- Royal Brompton & Harefield NHS Foundation Trust (GB)
- Corresponding author
- Bush, Andrew
- Venue
- Respirology
- Publisher
- Wiley
- Published
- 2017-05-25
- Volume
- 22
- Issue
- 5
- Pages
- 886-897
- ISSN
- 1323-7799 (ISSN-L)
- 1440-1843
- OpenAlex
- W2619495389
- Cited by
- 106
- References
- 96
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 7 · 2023: 8 · 2022: 9 · 2021: 9 · 2020: 16 · 2019: 27 · 2018: 17 · 2017: 6
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Respirology (publishedVersion)
- PubMed (publishedVersion)
- Spiral (Imperial College London) (submittedVersion)
- Funders
- Imperial College London
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Life Sciences › Immunology and Microbiology › Immunology › IL-33, ST2, and ILC Pathways
- Keywords
- therapy-resistant asthma, difficult-to-treat asthma, steroid-resistant asthma, inhaled corticosteroids, bronchoscopy, eosinophilic asthma, Th2 cytokines, IL-33, innate lymphoid cells, induced sputum, asthma comorbidity, asthma classification
- MeSH terms
- Interleukin-33, Nurse Specialists, Adrenal Cortex Hormones, Asthma, Bronchoscopy, Child, Drug Resistance, Humans, Immunity, Innate, Lymphocytes, Nursing Assessment, Pulmonary Eosinophilia, Severity of Illness Index, Anti-Asthmatic Agents
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
