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Type 2 Innate Lymphoid Cells and Eosinophil Progenitor Cells Are Preferentially Increased in Lesional Skin of Subjects with Atop All abstracts are strictly embargoed until the date of presentation at the 2018 AAAAI/WAO Joint Congress J ALLERGY CLIN IMMUNOL Abstracts AB207 VOLUME 141, NUMBER 2 School-based self-management educational episodic ISFP. Median cumulative ICS dose in daily IFP group (45,000 649 interventions for asthma in children and micrograms) and episodic ISFP group (5,250 micrograms) was signifi- adolescents: A systematic review cantly different (P<0.001). No adverse event was found in episodic ISFP group. Kate M. Harris1, Dylan Kneale2, Toby Lasserson3, Vanessa McDonald4, CONCLUSIONS: There were no significant difference in reducing James Thomas5, and Jonathan Grigg, BSc, MB, BS, MD1; 1Queen Mary exacerbation and height suppression between daily IFP and episodic University of London, London, United Kingdom, 2UCL Institute of Edu- ISFP in 6-month period. cation, London, 3Cochrane Editorial Unit, London, United Kingdom, Assessing the Relationship between Age and 4School of Nursing and Midwifery, Newcastle, Australia, 5EPPI-Centre, Clinical Outcomes in Adult Patients Using the London, United Kingdom. 651 ASTHMA-Educator, a Novel Smartphone RATIONALE: Children with asthma are at risk of asthma exacerbations, Application unscheduled medical care and school absences. To date, the evidence for schools-based interventions for these adverse outcomes is unclear. We Brian Hsia1,2, Sammy Wu1,2, Kristine Colon1, and Sunit P. Jariwala, therefore performed a systematic review of the effectiveness of school- MD1; 1Montefiore Medical Center, Bronx, NY, 2Albert Einstein College based self-management interventions on children’s asthma outcomes. of Medicine/Montefiore Medical Center, Bronx, NY. METHODS: We searched 19 databases to identify eligible students for RATIONALE: There is a lack of published literature regarding sub- inclusion. The review investigated studies across a range of population populations that benefit from smartphone applications for asthma. This groups and environments, including primary/elementary and secondary/ study examines the relationship between age, asthma knowledge, and high schools. The inclusion criteria stated that interventions must be clinical asthma outcomes in patients that used the ASTHMA-Educator delivered to children with asthma, aged 5 to 18 years, within the school mobile application. setting. Meta-analyses were conducted to evaluate the effectiveness of the METHODS: 25 adult patients (mean age 53 years) completed the interventions across 11 outcomes, compared with usual care. ASTHMA-Educator program via tablet (iPad) at baseline, 2 months, and RESULTS: 34 studies, from 7 countries, met the inclusion criteria for the 4 months. At each visit, patients received the program and we administered review, and 24 were included in the meta-analyses. School-based in- the Asthma Knowledge Questionnaire (AKQ), Asthma Control Test terventions were effective in reducing hospitalisations (SMD -0.19, 95% (ACT), and Mini-Asthma Quality of Life Questionnaire (mini-AQLQ). CI -0.35 to -0.04) and emergency department visits (OR 0.71, 95% CI 0.53 Patients reported the time spent to complete the ASTHMA-Educator. We to 0.95). Days of restricted activity was also lower among intervention evaluated patient satisfaction with the application. We assessed relation- groups (SMD -0.30, 95% CI -0.41 to -0.18). Children in intervention ships between age, AKQ, ACT, mini-AQLQ, and time spent to complete groups also had higher levels of quality of life at follow-up (SMD 0.27, the program using the Pearson’s correlation. 95% CI 0.18 to 0.36). The effect of the intervention on school absences, RESULTS: We observed a significant negative correlation between age day and night time symptoms, and the use of reliever therapies was less and patient satisfaction (r5-0.37, p50.04). At 2 and 4 months, age consistent. negatively correlated with mini-AQLQ (r5-0.18, p50.28; r5-0.33, CONCLUSIONS: School-based interventions for children with asthma p50.11); at both time points, age positively correlated with time spent are effective in improving a number of outcomes, including quality of life using the application (r50.20, p50.24; r50.17, p50.42). Patient satis- and healthcare use. faction was positively associated with AKQ score (r50.23, p50.21) at 2 Comparative efficacy of daily inhaled fluticasone months. There were negative correlations between time spent and AKQ 650 propionate and episodic inhaled combined score at 2 months and 4 months (r5-0.38, p50.02; r5-0.33, p50.11). salmeterol/fluticasone propionate in children CONCLUSIONS: Older patients demonstrated decreased post-interven- with recurrent wheezing tion asthma quality of life, diminished satisfaction with the intervention, and spent more time using the software program relative to younger Jiratchaya Chamnanrua, MD1, and Tassalapa Daengsuwan, MD2; participants. We will need to validate these findings on a larger scale, and 1Queen Sirikit National Institute of Child Health, Bangkok, Thailand, determine how to adapt the program’s features for older patients. 2Samsanenai, Queen Sirikit National Institute of Child Health, Samsane- nai, Thailand. RATIONALE: Daily inhaled corticosteroid (ICS) is recommended by the world expert committee to treat patients with persistent asthma and tendency to have asthma as a controller. However, many children in Thailand tend to receive episodic inhaled corticosteroid due to their parents’ inconvenience. We compare efficacy of daily inhaled fluticasone propionate (IFP) and episodic inhaled combined salmeterol/fluticasone propionate (ISFP) in children with recurrent wheezing. METHODS: Forty-four children aged 1 to 15, with recurrent wheezing and tendency to have asthma were recruited in our study. Participants were randomized to receive either daily IFP (N524) or 14-day of ISFP started at the onset of symptoms of respiratory tract illness (N520). The primary outcome was the percentage of exacerbations which needed systemic corticosteroid. The secondary outcome was the monthly height rate. Proportional-hazards regression model and ANOVA were used for statis- tical analysis. RESULTS: At 6 months after the treatment, the percentage of exacerba- tions which needed systemic corticosteroid between 2 groups had no statistically significant difference (P50.790) with hazard ratio of 1.224 (95% confidence interval (CI) 0.278 to 5.392). Monthly height rate also had no significant difference (P50.869), 0.66 (95% CI 0.56 to 0.76) centimeters (cm) in daily IFP and 0.67 (95% CI 0.56 to 0.78) cm in MONDAY All abstracts are strictly embargoed until the date of presentation at the 2018 AAAAI/WAO Joint Congress AB208 Abstracts J ALLERGY CLIN IMMUNOL FEBRUARY 2018 Gamma Tocopherol (gT) Supplementation Reduces likely to be female (asthma only), had higher baseline comorbidities, more 652 Endotoxin-Induced Sputum Neutrophilia in Healthy respiratory specialty visits, and higher respiratory-related ambulatory Volunteers and Asthmatics Regardless of BMI or visits (all P<0.05 vs SABA pMDI); no difference with inpatient or emer- glutathione-S-transferase Mu1 (GSTM1) Genotype gency HCRU was observed. Greater proportions of albuterol MDPI versus SABA pMDI users had more severe disease at baseline (asthma: 12.71% vs Amika Sood, MD1, Allison J. Burbank, MD1, Kimberly Enders2, Haibo 8.13%; COPD: 28.57% vs 23.37%; P<0.05), with more asthma exacerba- Zhou, PhD2, David B. Peden, MD, MS, FAAAAI1, and Michelle L. Her- tions (7.64% vs 1.40%; P<0.05) but similar COPD exacerbations (19.08% nandez, MD, FAAAAI1; 1UNC Center for Environmental Medicine, vs. 21.30%, P50.108). Asthma, & Lung Biology, Chapel Hill, NC, 2UNC Department of Biosta- CONCLUSIONS: More albuterol MDPI patients saw respiratory spe- tistics, Gillings School of Global Public Health, Chapel Hill, NC. cialists and had severe disease at baseline versus SABA pMDI patients. RATIONALE: Through its unique antioxidant and anti-inflammatory Further research may elucidate how patient characteristics (eg, disease properties, gT supplementation has shown benefit in reducing airway severity, comorbidities) influence SABA inhaler choice. inflammation in preclinical and early-phase clinical studies. However, obesity increases systemic inflammation while the GSTM1 null genotype The effects of Spirulina (Arthrospira platensis) may alter host antioxidant defenses. This study, therefore, examines 654 dietary supplement as an adjunct therapy for whether BMI and/or GSTM1 genotype modifies the response to inhaled children aged 7-14 years old with asthma: A endotoxin and/or the reduction of endotoxin-induced sputum neutrophilia randomized – double blind placebo controlled following gT supplementation in healthy volunteers (HV) and asthmatics. clinical trial METHODS: Thirteen HV and 15 asthmatics underwent gT treatment Lou Ver Leigh A. Manzon-Reyes1, and Agnes G. Andaya, MD2; 1Uni- followed by inhaled endotoxin challenge in two double-blind, placebo- 2 controlled, cross-over studies. gT supplementation reduced post-challenge versity of Santo Tomas Hospital, Manila, Philippines, University of Santo sputum neutrophilia compared to placebo in HV (p50.03) and asthmatics Tomas Hospital, Manila City, Philippines. (p50.04). The effect of BMI and GSTM1 genotype on response to inhaled RATIONALE: This study amied to determine the effects of Spirulina endotoxin and the reduction in endotoxin-induced sputum neutrophilia supplementation on asthma control and lung function among children aged following gT treatment in each study was assessed using linear regression 7-14 years old. models and Wilcoxon
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