101
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Balan I, Mahmood SN, Jaiswal R, Pleshkova Y, Manivannan D, Negit S, Shah V, Desai P, Akula NV, Nawaz MU, Gurram N, Tirupathi R, Patel U, Venkata VS. Prevalence of active and passive smoking among asthma and asthma-associated emergency admissions: a nationwide prevalence survey study. J Investig Med 2023; 71:730-741. [PMID: 37199268 DOI: 10.1177/10815589231169239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Asthma affects 7% of children and 8% of adults in the United States. There is a paucity of studies examining the association between passive smoking and an increased risk of asthma exacerbations that led the authors to examine the association between various modes of smoking and rates of asthma exacerbations. A retrospective cross-sectional/case-control study was conducted using the National Health and Nutrition Examination Survey dataset (2013-2018). Out of 312,979 respondents, 35,758 (11.43%) had a history of asthma, 9083 (2.9%) had asthma attacks in the past year, and 4731 (1.51%) had asthma-related emergency room admissions in the past year. Prevalence of asthma-related emergency admissions were higher among active cigarette smoking (46.25 vs 35.46%), e-cigarette smoking (26.63 vs 16.07%), and passive smoking at home (37.53 vs 25.67%), workplace passive smoking (14.35 vs 12.11%), in bar (32.38 vs 26.16%), and car (26.21 vs 14.44%) (p < 0.0001). In multivariate regression analysis, we found regular cigarette smoking (OR 1.13, 95% confidence interval (CI) 1.009-1.260, p = 0.0252), e-cigarette (OR 2.13, 95% CI 1.92-2.36, p = 0.0043), cigar use (OR 1.21, 95% CI 1.1-1.33, p < 0.001), ultra-long cigarette length (OR 4.85, 95% CI 3.33-7.06, p < 0.0001), and passive smoking (OR 5.25, 95% CI 3.43-8.06, p < 0.0001) were associated with increased rates of asthma exacerbations over last 12 months. The study shows increased odds of asthma exacerbations among those using ultra-long cigarettes, e-cigarettes, and cigars. Consequently, passive inhalation from even a single smoker in the home, workplace, bars and cars is associated with worsening outcomes in asthma patients.
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Affiliation(s)
- Irina Balan
- Montefiore Medical Center - Wakefield, Division of Geriatrics, Bronx, NY, USA
| | | | - Richa Jaiswal
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Divya Manivannan
- Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Shayaan Negit
- University of the Caribbean School of Medicine, BV Cupecoy, Sint Maarten (Dutch part)
| | - Viraj Shah
- Hackensack Meridian Ocean University Medical Center, Brick, NJ, USA
| | - Prarthana Desai
- The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, India
| | | | | | | | | | - Urvish Patel
- Department of Public Health and Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Liu F, Sun Y, Zhou Y, Gao Y, Song Q, Yang J, Xu C, Li G. ORMDL3‑mediated bronchial epithelial pyroptosis leads to lung inflammation in obese mice with asthma. Mol Med Rep 2023; 28:186. [PMID: 37594074 PMCID: PMC10463223 DOI: 10.3892/mmr.2023.13073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/20/2023] [Indexed: 08/19/2023] Open
Abstract
Asthma associated with obesity is a chronic disease that poses a threat to health in children and results in severe wheezing, earlier airway remodeling and increased insensitivity to hormone therapy compared with those who only have asthma. Despite its clinical importance, knowledge on the underlying mechanisms of this disease is limited. The present study aimed to elucidate the pathogenesis of asthma associated with obesity using a murine model. A total of 30 female BALB/c mice were divided into three groups: Normal, mice with asthma and obese mice with asthma. Obese mice with asthma were fed a high‑fat diet to induce obesity. Mice with asthma were sensitized and challenged with ovalbumin (OVA). Obese mice were subjected to OVA sensitization and challenge to develop asthma associated with obesity. Airway remodeling was observed in obese mice with asthma through HE and Masson staining. Proteomic and bioinformatics analyses were conducted on lung tissue from obese mice with asthma and normal mice. A total of 200 proteins were differentially expressed in obese mice with asthma compared with normal mice; of these, 53 and 47% were up‑ and downregulated, respectively. Pathway analysis revealed that asthma associated with obesity primarily affected the 'lysosome', 'phagosome', and 'sphingolipid metabolism' pathways. Gene Set Enrichment Analysis demonstrated the presence of pyroptosis in obese asthmatic mice, along with significant increases in pyroptosis‑-associated factors such as GSDMD and Caspase. High protein expression of orosomucoid‑like 3 (ORMDL3), NOD‑like receptor thermal protein domain associated protein 3 (NLRP3) and Gasdermin‑D (GSDMD) was observed in obese mice with asthma. In vitro experiments using HBE cells infected with ORMDL3‑overexpressing lentivirus demonstrated that the overexpression of ORMDL3 led to increased expression of NLRP3, GSDMD and cathepsin D (CTSD). These findings suggested that ORMDL3 may regulate pyroptosis and subsequent airway remodeling in asthma associated with obesity via the CTSD/NLRP3/GSDMD pathway.
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Affiliation(s)
- Fan Liu
- Children's Hospital Capital Institute of Pediatrics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, P.R. China
- Graduate School of Peking Union Medical College, Beijing 100020, P.R. China
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, P.R. China
| | - Yan Sun
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
| | - Yun Zhou
- Department of Pediatrics, Shandong Provincial Lanling People's Hospital, Linyi, Shandong 277799, P.R. China
| | - Yuye Gao
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
| | - Qijun Song
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
| | - Jianmei Yang
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
| | - Chao Xu
- Department of Endocrinology and Metabolism, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
| | - Guimei Li
- Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
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103
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Akaba T, Jo T, Iwagami M, Hashimoto Y, Matsui H, Fushimi K, Tagaya E, Yasunaga H. Reduced Asthma Exacerbations in Adult Patients Treated With Bronchial Thermoplasty. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3076-3083.e3. [PMID: 37169286 DOI: 10.1016/j.jaip.2023.04.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/10/2023] [Accepted: 04/17/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Bronchial thermoplasty (BT) has been shown to be effective in randomized controlled trials of patients with severe asthma who failed to achieve disease control with high-dose inhaled corticosteroids combined with bronchodilators. However, the effectiveness of BT in real-world clinical settings, especially among the Asian population, has not been determined. OBJECTIVE To evaluate the effectiveness of BT using a nationwide database. METHODS Using the inpatient and outpatient data from the Japanese Diagnosis Procedure Combination database, we applied a self-controlled case series design to evaluate changes in the composite outcome of hospital admissions and emergency department visits, as well as systemic corticosteroid dose, between 1 year before and after BT. We also conducted subgroup analyses based on patients' profiles. RESULTS Among the 561 patients with asthma who underwent BT treatment between September 2014 and March 2020, 102 patients with at least 1 outcome were analyzed. Bronchial thermoplasty was significantly associated with an improvement in the composite outcome of hospital admission and emergency department visits (incidence rate ratio 0.53; 95% CI 0.44-0.64). Systemic corticosteroid use was reduced after BT sessions (1931.5 mg [1,341.2-3,725.3 mg] to 641.3 mg [134.2-1,691.1 mg] per person-year; P < .001). Although all groups showed a significant improvement in the composite outcome in the subgroup analyses, BT tended to be less effective among people older than 65 years and those with higher body mass index (>25 kg/m2). CONCLUSIONS The present study using real-world data suggests that BT may improve asthma control; however, the effectiveness of BT can vary depending on patient baseline profiles.
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Affiliation(s)
- Tomohiro Akaba
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan; Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
| | - Taisuke Jo
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masao Iwagami
- Department of Health Services Research, University of Tsukuba, Ibaraki, Japan
| | - Yohei Hashimoto
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
| | - Etsuko Tagaya
- Department of Respiratory Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
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104
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Wilson BE, Kwong CG. Total Diet Replacement for Patients With Obesity and Difficult-to-Treat Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3280-3281. [PMID: 37805227 DOI: 10.1016/j.jaip.2023.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 10/09/2023]
Affiliation(s)
- Bridget E Wilson
- Division of Allergy, Asthma, and Clinical Immunology, Department of Medicine, Mayo Clinic, Scottsdale, Ariz; Section of Allergy and Immunology, Division of Pulmonology, Phoenix Children's Hospital, Phoenix, Ariz
| | - Christina G Kwong
- Section of Allergy and Immunology, Division of Pulmonology, Phoenix Children's Hospital, Phoenix, Ariz.
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105
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Johnstone J, Castro M. Bronchial Thermoplasty in the Biologic Era. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3084-3085. [PMID: 37805223 DOI: 10.1016/j.jaip.2023.07.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 10/09/2023]
Affiliation(s)
- Joseph Johnstone
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Kansas Medical Center, Kansas City, Kan
| | - Mario Castro
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Kansas Medical Center, Kansas City, Kan.
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106
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Pirmoradi S, Hosseiniyan Khatibi SM, Zununi Vahed S, Homaei Rad H, Khamaneh AM, Akbarpour Z, Seyedrezazadeh E, Teshnehlab M, Chapman KR, Ansarin K. Unraveling the link between PTBP1 and severe asthma through machine learning and association rule mining method. Sci Rep 2023; 13:15399. [PMID: 37717070 PMCID: PMC10505163 DOI: 10.1038/s41598-023-42581-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/12/2023] [Indexed: 09/18/2023] Open
Abstract
Severe asthma is a chronic inflammatory airway disease with great therapeutic challenges. Understanding the genetic and molecular mechanisms of severe asthma may help identify therapeutic strategies for this complex condition. RNA expression data were analyzed using a combination of artificial intelligence methods to identify novel genes related to severe asthma. Through the ANOVA feature selection approach, 100 candidate genes were selected among 54,715 mRNAs in blood samples of patients with severe asthmatic and healthy groups. A deep learning model was used to validate the significance of the candidate genes. The accuracy, F1-score, AUC-ROC, and precision of the 100 genes were 83%, 0.86, 0.89, and 0.9, respectively. To discover hidden associations among selected genes, association rule mining was applied. The top 20 genes including the PTBP1, RAB11FIP3, APH1A, and MYD88 were recognized as the most frequent items among severe asthma association rules. The PTBP1 was found to be the most frequent gene associated with severe asthma among those 20 genes. PTBP1 was the gene most frequently associated with severe asthma among candidate genes. Identification of master genes involved in the initiation and development of asthma can offer novel targets for its diagnosis, prognosis, and targeted-signaling therapy.
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Affiliation(s)
- Saeed Pirmoradi
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Mahdi Hosseiniyan Khatibi
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Rahat Breath and Sleep Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | | | - Hamed Homaei Rad
- Rahat Breath and Sleep Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Amir Mahdi Khamaneh
- Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Akbarpour
- Rahat Breath and Sleep Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Ensiyeh Seyedrezazadeh
- Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Teshnehlab
- Department of Electric and Computer Engineering, K.N. Toosi University of Technology, Tehran, Iran
| | - Kenneth R Chapman
- Division of Respiratory Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Khalil Ansarin
- Rahat Breath and Sleep Research Center, Tabriz University of Medical Science, Tabriz, Iran.
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107
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To M, Arimoto Y, Honda N, Kurosawa Y, Haruki K, To Y. Clinical characteristics and cytokine profiles of adult obese asthma with type2 inflammation. Sci Rep 2023; 13:14799. [PMID: 37684314 PMCID: PMC10491644 DOI: 10.1038/s41598-023-41889-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
Obesity-related non-eosinophilic asthma has been identified as a phenotype of asthma. However, mepolizumab and omalizumab improve asthma control in severe asthma with obesity, implying that type-2 cytokines may be involved in the deterioration of control in obese asthma. Despite this, the clinical details of obese asthma with positive type-2 inflammation markers have not yet been reported. The objective of this study was to investigate the clinical characteristics of patients with obese asthma with positive type-2 inflammation markers. Adult obese asthmatic patients were enrolled and were classified into two groups: obese asthma with positive type-2 inflammation markers (T2) and obese asthma with negative type-2 inflammation markers (NT2), then data were compared. In total, 434 patients were enrolled (85% of patients were at GINA therapy step 4-5). The T2 group had a higher proportion of patients with persistent asthma since childhood and with allergic rhinitis. A higher percentage of patients used high-dose inhaled corticosteroids (ICS) and experienced acute exacerbations (annual exacerbation ratio ≥ 1) in the T2 group. Multivariate logistic regression analysis showed that the T2 group was independently associated with younger age, comorbidity of allergic rhinitis, persistent asthma since childhood, use of high-dose ICS, and acute exacerbation rate ≥ 1. Adipocytokine levels were similar between the groups. Collectively, obese asthma with positive type-2 inflammation markers is characterised by a higher percentage of persistent asthma since childhood and more severe asthma.
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Affiliation(s)
- Masako To
- Department of Laboratory Medicine, Dokkyo Medical University, Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya City, Saitama, 343-8555, Japan.
- Department of Allergy and Respiratory Medicine, The Fraternity Memorial Hospital, 2-1-11 Yokoami, Sumida, Tokyo, 130-8587, Japan.
| | - Yoshihito Arimoto
- Department of Laboratory Medicine, Dokkyo Medical University, Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya City, Saitama, 343-8555, Japan
| | - Natsue Honda
- Department of Laboratory Medicine, Dokkyo Medical University, Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya City, Saitama, 343-8555, Japan
| | - Yusuke Kurosawa
- Department of Pulmonary Medicine, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba, 286-8520, Japan
| | - Kosuke Haruki
- Department of Laboratory Medicine, Dokkyo Medical University, Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya City, Saitama, 343-8555, Japan
| | - Yasuo To
- Department of Pulmonary Medicine, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba, 286-8520, Japan
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108
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Abi Saleh W, Alameh Z, Aoun Bacha Z, Bahous J, Bou Khalil P, Chahine Z, Chami H, Dabar G, Dheiny H, Dib A, Farhat D, Irani C, Juvelekian G, Kanj N, Mansour B, Riachi M, Waked M, Yassine M, Youakim C, Zeinedine S, Zaitoun F. PRevalence of the Eosinophilic Phenotype Among SeveRE asthma patients in Lebanon: results of the PREPARE study. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2023; 19:80. [PMID: 37684679 PMCID: PMC10492315 DOI: 10.1186/s13223-023-00815-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/14/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND The prevalence of eosinophilic asthma in Lebanon, one of the most severe phenotypes among severe asthma, is not known. This study aimed at determining the prevalence of the eosinophilic phenotype defined as an eosinophil count ≥ 300 cells/mm3 among severe asthma patients in Lebanon. METHODS The Lebanese Chapter of the PREPARE study was a national, multicenter, cross-sectional observational study. Patients aged ≥ 12 years with severe asthma were identified and prospectively enrolled during clinic visits and completed the Global Initiative for Asthma (GINA) assessment of asthma control questionnaire. Patients' health characteristics were collected from medical records and blood samples were obtained for measurement of serum IgE levels and blood eosinophils count. RESULTS Overall, 101 patients (with mean age of 46.3 ± 17.0 years and 73.27% females) with severe asthma were included and, among them, 37% had eosinophilic phenotype, 67.3% had atopic phenotype with IgE > 100 IU/mL and 25.7% patients had overlapping atopic and eosinophilic phenotypes. Close to 80% had late-onset asthma, beyond 12 years of age, and around 85% had at least one severe exacerbation in the 12 months prior to study enrolment. The majority of participants [64.4%] had uncontrolled asthma, 24.7% had partially controlled symptoms and 10.9% had controlled symptoms. 19.8% of participants were on chronic oral corticosteroids, 78.2% had short course treatment of corticosteroids and all were prescribed a combination of inhaled corticosteroids and long-acting beta-agonist. CONCLUSIONS The majority of patients with severe asthma were uncontrolled of which 37% present with an eosinophilic phenotype, which should be taken into consideration for better management of these patients in view of the novel phenotype-specific therapeutic options.
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Affiliation(s)
- Wajdi Abi Saleh
- Department of Pulmonary and Critical Care Medicine, Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Zuhair Alameh
- Pulmonology Practice, Private Practice, Beirut, Lebanon
| | - Zeina Aoun Bacha
- Department of Pulmonology and Critical Care, Hôtel-Dieu De France Medical Center (UMC), Saint-Joseph University (USJ), P.O. Box 2064-6613, Beirut, 1104 2020, Lebanon.
| | - Joudy Bahous
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Pierre Bou Khalil
- Department of Internal Medicine, Division of Pulmonary and Critical Care, American University of Beirut Medical Center, Beirut, Lebanon
| | - Zahia Chahine
- Department of Pneumology, NINI Hospital, Tripoli, Lebanon
| | - Hassan Chami
- Department of Internal Medicine, Division of Pulmonary and Critical Care, American University of Beirut Medical Center, Beirut, Lebanon
- Division of Pulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Georges Dabar
- Department of Pulmonology and Critical Care, Hôtel-Dieu De France Medical Center (UMC), Saint-Joseph University (USJ), P.O. Box 2064-6613, Beirut, 1104 2020, Lebanon
| | - Hassan Dheiny
- Respiratory Diseases, Allergies and Sleep Medicine, Private Practice, Beirut, Lebanon
| | - Alfred Dib
- Department of Internal Medicine, Division of Pulmonology, Sacre-Coeur Hospital, Baabda, Lebanon
| | | | - Carla Irani
- Department of Internal Medicine & Clinical Immunology at Hôtel-Dieu de France, St Joseph University, Beirut, Lebanon
| | - Georges Juvelekian
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Saint George Hospital University Medical Center, Beirut, Lebanon
| | - Nadim Kanj
- Department of Internal Medicine, Division of Pulmonary and Critical Care, American University of Beirut Medical Center, Beirut, Lebanon
| | - Bassam Mansour
- Department of Pulmonary and Critical Care Medicine, Zahraa Hospital, Beirut, Lebanon
| | - Moussa Riachi
- Department of Pulmonology and Critical Care, Hôtel-Dieu De France Medical Center (UMC), Saint-Joseph University (USJ), P.O. Box 2064-6613, Beirut, 1104 2020, Lebanon
| | - Mirna Waked
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Saint George Hospital University Medical Center, Beirut, Lebanon
| | | | - Carole Youakim
- Department of Internal Medicine, Division of Pulmonary, Mount Lebanon Hospital Balamand University Medical Center, Beirut, Lebanon
| | - Salah Zeinedine
- Department of Internal Medicine, Division of Pulmonary and Critical Care, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fares Zaitoun
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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109
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Perez-Garcia J, Espuela-Ortiz A, Hernández-Pérez JM, González-Pérez R, Poza-Guedes P, Martin-Gonzalez E, Eng C, Sardón-Prado O, Mederos-Luis E, Corcuera-Elosegui P, Sánchez-Machín I, Korta-Murua J, Villar J, Burchard EG, Lorenzo-Diaz F, Pino-Yanes M. Human genetics influences microbiome composition involved in asthma exacerbations despite inhaled corticosteroid treatment. J Allergy Clin Immunol 2023; 152:799-806.e6. [PMID: 37301411 PMCID: PMC10522330 DOI: 10.1016/j.jaci.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/21/2023] [Accepted: 05/11/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND The upper-airway microbiome is involved in asthma exacerbations despite inhaled corticosteroid (ICS) treatment. Although human genetics regulates microbiome composition, its influence on asthma-related airway bacteria remains unknown. OBJECTIVE We sought to identify genes and biological pathways regulating airway-microbiome traits involved in asthma exacerbations and ICS response. METHODS Saliva, nasal, and pharyngeal samples from 257 European patients with asthma were analyzed. The association of 6,296,951 genetic variants with exacerbation-related microbiome traits despite ICS treatment was tested through microbiome genome-wide association studies. Variants with 1 × 10-4 RESULTS Genes associated with exacerbation-related airway-microbiome traits were enriched in asthma comorbidities development (ie, reflux esophagitis, obesity, and smoking), and were likely regulated by trichostatin A and the nuclear factor-κB, the glucocorticosteroid receptor, and CCAAT/enhancer-binding protein transcription factors (7.8 × 10-13 ≤ false discovery rate ≤ 0.022). Enrichment in smoking, trichostatin A, nuclear factor-κB, and glucocorticosteroid receptor were replicated in the saliva samples from diverse populations (4.42 × 10-9 ≤ P ≤ .008). The ICS-response-associated single nucleotide polymorphisms rs5995653 (APOBEC3B-APOBEC3C), rs6467778 (TRIM24), and rs5752429 (TPST2) were identified as microbiome quantitative trait loci of Streptococcus, Tannerella, and Campylobacter in the upper airway (0.027 ≤ false discovery rate ≤ 0.050). CONCLUSIONS Genes associated with asthma exacerbation-related microbiome traits might influence asthma comorbidities. We reinforced the therapeutic interest of trichostatin A, nuclear factor-κB, the glucocorticosteroid receptor, and CCAAT/enhancer-binding protein in asthma exacerbations.
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Affiliation(s)
- Javier Perez-Garcia
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna, Tenerife, Spain
| | - Antonio Espuela-Ortiz
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna, Tenerife, Spain
| | - José M Hernández-Pérez
- Pulmonary Medicine Service, Hospital Universitario N.S de Candelaria, La Laguna, Tenerife, Spain; Pulmonary Medicine Section, Hospital Universitario de La Palma, La Palma, Spain
| | - Ruperto González-Pérez
- Severe Asthma Unit, Allergy Department, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
| | - Paloma Poza-Guedes
- Severe Asthma Unit, Allergy Department, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
| | - Elena Martin-Gonzalez
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna, Tenerife, Spain
| | - Celeste Eng
- Department of Medicine, University of California San Francisco (UCSF), San Francisco, Calif
| | - Olaia Sardón-Prado
- Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia, San Sebastián, Spain; Department of Pediatrics, University of the Basque Country (UPV/EHU), San Sebastián, Spain
| | - Elena Mederos-Luis
- Allergy Department, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
| | - Paula Corcuera-Elosegui
- Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia, San Sebastián, Spain
| | | | - Javier Korta-Murua
- Division of Pediatric Respiratory Medicine, Hospital Universitario Donostia, San Sebastián, Spain
| | - Jesús Villar
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Multidisciplinary Organ Dysfunction Evaluation Research Network, Research Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain; Li Ka Shing Knowledge Institute at the St. Michael's Hospital, Toronto, Ontario, Canada
| | - Esteban G Burchard
- Department of Medicine, University of California San Francisco (UCSF), San Francisco, Calif; Department of Bioengineering and Therapeutic Sciences, University of California San Francisco (UCSF), San Francisco, Calif
| | - Fabian Lorenzo-Diaz
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna, Tenerife, Spain; Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna (ULL), La Laguna, Tenerife, Spain.
| | - Maria Pino-Yanes
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology and Genetics, Universidad de La Laguna (ULL), La Laguna, Tenerife, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Instituto de Tecnologías Biomédicas, Universidad de La Laguna (ULL), La Laguna, Tenerife, Spain.
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Lim JY, Templeton SP. Regulation of lung inflammation by adiponectin. Front Immunol 2023; 14:1244586. [PMID: 37724101 PMCID: PMC10505393 DOI: 10.3389/fimmu.2023.1244586] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/21/2023] [Indexed: 09/20/2023] Open
Abstract
Adiponectin is an insulin sensitizing hormone that also plays a role in the regulation of inflammation. Although adiponectin can exert pro-inflammatory effects, more studies have reported anti-inflammatory effects, even in non-adipose tissues such as the lung. Obesity is considered an inflammatory disease, is a risk factor for lung diseases, and is associated with decreased levels of plasma adiponectin. The results of recent studies have suggested that adiponectin exerts anti-inflammatory activity in chronic obstructive pulmonary disease, asthma and invasive fungal infection. The signaling receptors of adiponectin, AdipoR1 and AdipoR2, are expressed by epithelial cells, endothelial cells, and immune cells in the lung. In this mini-review, we discuss the anti-inflammatory mechanisms of adiponectin in lung cells and tissues.
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Affiliation(s)
| | - Steven P. Templeton
- Department of Microbiology and Immunology, Indiana University School of Medicine-Terre Haute, Terre Haute, IN, United States
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Abstract
In the United States, asthma and chronic obstructive pulmonary disease (COPD) disproportionately affect African Americans, Puerto Ricans, and other minority groups. Compared with non-Hispanic whites, minorities have been marginalized and more frequently exposed to environmental risk factors such as tobacco smoke and outdoor and indoor pollutants. Such divergent environmental exposures, alone or interacting with heredity, lead to disparities in the prevalence, morbidity, and mortality of asthma and COPD, which are worsened by lack of access to health care. In this article, we review the burden and risk factors for racial or ethnic disparities in asthma and COPD and discuss future directions in this field.
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Affiliation(s)
- Erick Forno
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA
| | - Victor E Ortega
- Division of Respiratory Medicine, Department of Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Juan C Celedón
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA.
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112
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Björkander S, Maier P, Kere M, Merid SK, Wirth L, Wiegel W, Ekström S, Kull I, Bergström A, Melén E, Mjösberg J, Tibbitt CA. Innate lymphoid cells type 2 and CD8 + T cells are perturbed in overweight and obese individuals with asthma. Allergy 2023; 78:2533-2536. [PMID: 36994759 DOI: 10.1111/all.15728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023]
Affiliation(s)
- Sophia Björkander
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Paul Maier
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Maura Kere
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Simon Kebede Merid
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Lorenz Wirth
- Mechanistic & Structural Biology, Discovery Sciences, R&D, AstraZeneca, Gothenburg, Sweden
| | - Whitney Wiegel
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Sandra Ekström
- Centre for Occupational and Environmental Medicine, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Inger Kull
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Anna Bergström
- Centre for Occupational and Environmental Medicine, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Erik Melén
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden
| | - Jenny Mjösberg
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Clinical Lung- and Allergy Research Unit, Medical unit for Lung and Allergy Diseases, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Christopher Andrew Tibbitt
- Department of Medicine Huddinge, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Clinical Lung- and Allergy Research Unit, Medical unit for Lung and Allergy Diseases, Karolinska University Hospital Huddinge, Stockholm, Sweden
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113
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Inoue K, Seeman TE, Nianogo R, Okubo Y. The effect of poverty on the relationship between household education levels and obesity in U.S. children and adolescents: an observational study. LANCET REGIONAL HEALTH. AMERICAS 2023; 25:100565. [PMID: 37559944 PMCID: PMC10407960 DOI: 10.1016/j.lana.2023.100565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023]
Abstract
Background Although ample evidence has shown the link between childhood obesity and socioeconomic status including family income and household education levels, the mediating role of poverty in the association between household education levels and childhood obesity is unclear. This study aimed to quantify the extent to which family poverty levels contribute to the association between household education levels and obesity among US children and adolescents. Methods This cohort study used the nationally representative data of 21,754 US children and adolescents aged 6-17 years (National Health and Nutrition Examination Survey 1999-2018). We applied mediation analysis of the association between household education levels (less than high school, high school, and college or above) and obesity mediated through poverty (≤138% vs. >138% federal poverty level), adjusting for demographic characteristics of household head and their offspring. Obesity was defined as age- and sex-specific body mass index in the 95th percentile or greater using the 2000 Centers for Disease Control and Prevention growth charts. Findings Among 21,754 children and adolescents (weighted N = 43,544,684; mean age, 11.6 years; female, 49%), 9720 (weighted percentage, 33.0%) were classified as living in poverty and 4671 (weighted percentage, 19.1%) met the criteria for obesity. Low household education level (less than high school) showed increased risks of poverty (adjusted relative risk [95% CI], 5.82 [4.90-6.91]) and obesity (adjusted relative risk [95% CI], 1.94 [1.68-2.25]) compared to high household education level (college or above). We also quantified that poverty mediated 18.9% of the association between household education levels and obesity among children and adolescents. The mediation effect was consistently observed across age, gender, and race/ethnicity. Interpretation Poverty mediated the association between the low educational status of household heads and their offspring's obesity. Our findings highlight the importance of reducing obesity risk among the low-income population to minimize the burden of intergenerational health disparities due to socioeconomic status. Funding Japan Society for the Promotion of Sciences (22K17392).
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Affiliation(s)
- Kosuke Inoue
- Department of Social Epidemiology, Graduate School of Medicine, Kyoto University, Japan
- Hakubi Center, Kyoto University, Japan
| | - Teresa E. Seeman
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Division of Geriatrics, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Roch Nianogo
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Yusuke Okubo
- Department of Social Medicine, National Center for Child Health and Development, Japan
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Jackson P, Muyanja SZ, Siddharthan T. Health Equity and Respiratory Diseases in Low- and Middle-Income Countries. Clin Chest Med 2023; 44:623-634. [PMID: 37517840 DOI: 10.1016/j.ccm.2023.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Over 80% of the morbidity and mortality related to acute and chronic respiratory diseases occur in low- and middle-income countries (LMICs), a reflection of vast disparities in care for these conditions. Over the next decade, the prevalence of respiratory diseases is expected to increase, as population growth in LMICs exceeds high-income countries (HICs). Pediatric morbidity and mortality from lower respiratory tract infections and asthma occur almost exclusively in LMICs, contributing to a greater loss of quality adjusted life years from these conditions when compared with HICs.
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Affiliation(s)
- Peter Jackson
- Division of Pulmonary and Critical Care Medicine, Virginia Commonwealth University, 1200 East Broad Street, Box 980050, Richmond, VA 23298, USA
| | | | - Trishul Siddharthan
- Division of Pulmonary and Critical Care Medicine, University of Miami, 1951 Northwest 7th Avenue, Miami, FL 33136, USA.
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Khan J, Moran B, McCarthy C, Butler MW, Franciosi AN. Management of comorbidities in difficult and severe asthma. Breathe (Sheff) 2023; 19:230133. [PMID: 38020342 PMCID: PMC10644109 DOI: 10.1183/20734735.0133-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Difficult-to-treat and severe asthma are challenging clinical entities. In the face of suboptimal asthma control, the temptation for clinicians is to reflexively escalate asthma-directed therapy, including increasing exposure to corticosteroids and commencement of costly but potent biologic therapies. However, asthma control is objectively and subjectively assessed based on measurable parameters (such as exacerbations or variability in pulmonary physiology), symptoms and patient histories. Crucially, these features can be confounded by common untreated comorbidities, affecting clinicians' assessment of asthma treatment efficacy.
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Affiliation(s)
- Jehangir Khan
- University College Dublin, Dublin, Ireland
- St Vincent's University Hospital, Dublin, Ireland
- Shared first authorship
| | - Barry Moran
- St Vincent's University Hospital, Dublin, Ireland
- Shared first authorship
| | - Cormac McCarthy
- University College Dublin, Dublin, Ireland
- St Vincent's University Hospital, Dublin, Ireland
| | - Marcus W. Butler
- University College Dublin, Dublin, Ireland
- St Vincent's University Hospital, Dublin, Ireland
- Shared senior authorship
| | - Alessandro N. Franciosi
- University College Dublin, Dublin, Ireland
- St Vincent's University Hospital, Dublin, Ireland
- Shared senior authorship
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116
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Shen X, Zhang P, Gao YC, Xuan WB, Wang F, Song P, Wang SJ, Gao ZX. Which surgery is better for obese patients with lumbar degenerative diseases: open TLIF or Endo-LIF? A retrospective matched case-control study. Neurochirurgie 2023; 69:101479. [PMID: 37562539 DOI: 10.1016/j.neuchi.2023.101479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE This study aimed to evaluate short-term clinical efficacy of percutaneous endoscopic posterior lumbar interbody fusion (Endo-LIF) in the treatment of obese patients with lumbar degenerative diseases (LDD). METHODS Patients who underwent single-level lumbar fusion surgery from July 2020 to July 2022 were retrospectively analyzed in this study. The main inclusion criterion was a body mass index (BMI) ≥30kg/m2. A matched case-control design was conducted to compare the short-term outcomes between the Endo-LIF and transforaminal lumbar interbody fusion (TLIF) in obese patients. Cases were defined as those who underwent Endo-LIF, and controls were matched from those patients with open TLIF according to corresponding matched criteria. Surgeon satisfaction was evaluated by questionnaires at the end of each surgery, patient satisfaction and their willingness to undergo the same surgery again were collected. RESULTS Two groups of patients were successfully completed surgery. In comparison with the open TLIF group, the Endo-LIF group had significantly less blood loss, less time to postoperative ambulation, less postoperative complications and shorter hospitalization days, but longer operation time and x-ray exposure times. The satisfaction of surgeons and patients in Endo-LIF group significantly were superior to open TLIF group. CONCLUSION Endo-LIF is a safe and effective surgery in the treatment of obese patients. Although this procedure needs longer operation time and x-ray exposure times, it still maybe a promising option for obese patients with LDD.
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Affiliation(s)
- Xu Shen
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Pei Zhang
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Yu-Cheng Gao
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Wen-Bin Xuan
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Feng Wang
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Peng Song
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Shu-Jiang Wang
- Department of Outpatient, General Hospital of Eastern Theater Command, Nanjing 210009, China.
| | - Zeng-Xin Gao
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China; Department of Orthopedics, Nanjing Lishui People,s Hospital, Zhongda Lishui Brach, Nanjing 210009, China.
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117
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Park TH, Lin JH, Chung CH, Zheng Z, Li C. The skeletal and dental age advancements of children and adolescents with overweight and obesity: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2023; 164:325-339. [PMID: 37367707 DOI: 10.1016/j.ajodo.2023.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Over the past decades, a trend of increasing obesity among children has emerged. This study aimed to evaluate and summarize the impacts of overweight and obesity on children's and adolescents' skeletal and dental developmental advancement that may influence orthodontic management. METHODS Registered with the Prospective Register of Systematic Reviews (registration no. CRD42022347488), this study complies with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Particularly, relevant original studies on skeletal or dental age evaluation were screened from accessible electronic databases and supplemented by hand-searching. Meta-analysis was recruited to calculate differences (and their 95% confidence interval [CI]) between subjects with overweight or obese and normal-weight counterparts. RESULTS After applying the inclusion and exclusion criteria, 17 articles were selected for the final review. Two of the 17 selected studies were found to have a high risk of bias and moderate the other 15. A meta-analysis detected no statistically significant difference in skeletal age between children and adolescents with overweight and normal-weight counterparts (P = 0.24). However, the dental age of children and adolescents with overweight was found to be 0.49 years (95% CI, 0.29-0.70) advanced in comparison with normal-weight counterparts (P <0.00001). In contrast, children and adolescents with obesity were found to have advanced skeletal age by 1.17 (95% CI, 0.48-1.86) years (P = 0.0009) and dental age by 0.56 (95% CI, 0.37-0.76) years (P <0.00001) compared with their normal-weight counterparts. CONCLUSION Because the orthopedic outcomes of the orthodontic intervention are closely tied to the skeletal age of the patients, these results suggest that the orthodontic evaluation and treatment of children and adolescents with obesity might occur earlier than that of the normal-weight population.
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Affiliation(s)
- Tiffany H Park
- School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Jia-Hong Lin
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Zhong Zheng
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Calif.
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa.
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Lotfata A, Moosazadeh M, Helbich M, Hoseini B. Socioeconomic and environmental determinants of asthma prevalence: a cross-sectional study at the U.S. County level using geographically weighted random forests. Int J Health Geogr 2023; 22:18. [PMID: 37563691 PMCID: PMC10413687 DOI: 10.1186/s12942-023-00343-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/04/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Some studies have established associations between the prevalence of new-onset asthma and asthma exacerbation and socioeconomic and environmental determinants. However, research remains limited concerning the shape of these associations, the importance of the risk factors, and how these factors vary geographically. OBJECTIVE We aimed (1) to examine ecological associations between asthma prevalence and multiple socio-physical determinants in the United States; and (2) to assess geographic variations in their relative importance. METHODS Our study design is cross sectional based on county-level data for 2020 across the United States. We obtained self-reported asthma prevalence data of adults aged 18 years or older for each county. We applied conventional and geographically weighted random forest (GWRF) to investigate the associations between asthma prevalence and socioeconomic (e.g., poverty) and environmental determinants (e.g., air pollution and green space). To enhance the interpretability of the GWRF, we (1) assessed the shape of the associations through partial dependence plots, (2) ranked the determinants according to their global importance scores, and (3) mapped the local variable importance spatially. RESULTS Of the 3059 counties, the average asthma prevalence was 9.9 (standard deviation ± 0.99). The GWRF outperformed the conventional random forest. We found an indication, for example, that temperature was inversely associated with asthma prevalence, while poverty showed positive associations. The partial dependence plots showed that these associations had a non-linear shape. Ranking the socio-physical environmental factors concerning their global importance showed that smoking prevalence and depression prevalence were most relevant, while green space and limited language were of minor relevance. The local variable importance measures showed striking geographical differences. CONCLUSION Our findings strengthen the evidence that socio-physical environments play a role in explaining asthma prevalence, but their relevance seems to vary geographically. The results are vital for implementing future asthma prevention programs that should be tailor-made for specific areas.
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Affiliation(s)
- Aynaz Lotfata
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Mohammad Moosazadeh
- Integrated Engineering, Department of Environmental Science and Engineering, College of Engineering, KyungHee University, Yongin, 446-701, Republic of Korea
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, University Utrecht, Utrecht, The Netherlands
| | - Benyamin Hoseini
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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119
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Nanzer AM, Taylor V, Hearn AP, Kavanagh JE, Patrick T, Green L, Thomson L, Lam J, Fernandes M, Roxas C, d'Ancona G, Kent BD, Dhariwal J, Jackson DJ. The impact of steroid-sparing biologic therapies on weight loss in obese individuals with severe eosinophilic asthma. Eur Respir J 2023; 62:2300245. [PMID: 37474156 DOI: 10.1183/13993003.00245-2023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/25/2023] [Indexed: 07/22/2023]
Affiliation(s)
- Alexandra M Nanzer
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- King's Centre for Lung Health, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Victoria Taylor
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Andrew P Hearn
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- King's Centre for Lung Health, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Joanne E Kavanagh
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- King's Centre for Lung Health, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Tanya Patrick
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Linda Green
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Louise Thomson
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jodie Lam
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Mariana Fernandes
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Cris Roxas
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Grainne d'Ancona
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- King's Centre for Lung Health, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Brian D Kent
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Department of Respiratory Medicine, St James' Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Jaideep Dhariwal
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - David J Jackson
- Guy's Severe Asthma Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- King's Centre for Lung Health, School of Immunology and Microbial Sciences, King's College London, London, UK
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Twinkle RH, Sain Y, Pinjar MJ, Manik KA, Mondal H. Comparative Dynamic Pulmonary Function Tests Between Apparently Healthy Young Adult Offspring of Asthmatic and Non-asthmatic Parents: A Pilot Study. Cureus 2023; 15:e44259. [PMID: 37772245 PMCID: PMC10526921 DOI: 10.7759/cureus.44259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
Background While the hereditary component of asthma has been established, its influence on early respiratory function changes in otherwise healthy offspring remains to be explored. Dynamic lung function tests assess airflow in and out of the lungs, providing valuable insights into respiratory health and detecting potential airflow limitations. This study aimed to compare the dynamic lung functions between offspring of asthmatic and non-asthmatic parents. Methodology A case-control design was employed comprising 30 cases (offspring of asthmatic parents) and 30 controls (offspring of non-asthmatic parents). Lung function parameters including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio, forced expiratory flow between 25% and 75% of the FVC (FEF 25-75%), and maximum mid-expiratory flow at 50% of the FVC (Vmax 50%) were measured. Statistical analysis was conducted to compare the parameters between cases and controls using the unpaired t-test. Results The mean age of controls was 20.46 ± 2.82 years and the cases was 19.83 ± 1.41 years. The study revealed that cases exhibited lower FEV1 and Vmax 50% values compared to controls, indicating potential airflow limitations and altered mid-exhalation flow rates in the offspring of asthmatic parents. While trends were observed in FVC, FEV1/FVC ratio, and FEF 25-75%, these differences were not statistically significant. Conclusions The findings suggest a potential association between parental asthma and altered lung function parameters, specifically in FEV1 and Vmax 50%, among their offspring. These early respiratory function changes underscore the potential impact of hereditary factors on lung health. Healthcare professionals should take parental asthma into account when evaluating lung functions. This may lead to earlier detection and intervention. Further investigation is warranted to elucidate the underlying mechanisms and long-term implications of these findings.
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Affiliation(s)
| | - Yukta Sain
- Medical School, Great Eastern Medical School and Hospital, Ragolu, IND
| | | | - Khaleel Ahmed Manik
- Physiology, Integral Institute of Medical Sciences & Research, Faculty of Medicine & Health Sciences, Integral University, Lucknow, IND
| | - Himel Mondal
- Physiology, All India Institute of Medical Sciences, Deoghar, Deoghar, IND
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121
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Wang Y, Wan R, Hu C. Leptin/obR signaling exacerbates obesity-related neutrophilic airway inflammation through inflammatory M1 macrophages. Mol Med 2023; 29:100. [PMID: 37488474 PMCID: PMC10367413 DOI: 10.1186/s10020-023-00702-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/18/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Obesity-related asthma is a kind of nonallergic asthma with excessive neutrophil infiltration in the airways. However, the underlying mechanisms have been poorly elucidated. Among the adipokines related to obesity, leptin is related to the inflammatory response. However, little is understood about how leptin acts on the leptin receptor (obR) in neutrophilic airway inflammation in obesity-associated asthma. We explored the inflammatory effects of leptin/obR signaling in an obesity-related neutrophilic airway inflammation mouse model. METHODS We established a neutrophilic airway inflammation mouse model using lipopolysaccharide (LPS)/ovalbumin (OVA) sensitization and OVA challenge (LPS + OVA/OVA) in lean, obese, or db/db (obR deficiency) female mice. Histopathological, bronchoalveolar lavage fluid (BALF) inflammatory cell, and lung inflammatory cytokine analyses were used to analyze airway inflammation severity. Western blotting, flow cytometry, reverse transcription-polymerase chain reaction (RT-PCR), and enzyme-linked immunosorbent assay (ELISA) were used to evaluate the underlying mechanisms. In vitro bone marrow-derived macrophage (BMDM) and bone marrow-derived neutrophil experiments were performed. RESULTS We found that the serum leptin level was higher in obese than in lean female mice. Compared to LPS/OVA + OVA-treated lean female mice, LPS/OVA + OVA-treated obese female mice had higher peribronchial inflammation levels, neutrophil counts, Th1/Th17-related inflammatory cytokine levels, M1 macrophage polarization levels, and long isoform obR activation, which could be decreased by the obR blockade (Allo-Aca) or obR deficiency, suggesting a critical role of leptin/obR signaling in the pathogenesis of obesity-related neutrophilic airway inflammation in female mice. In in vitro experiments, leptin synergized with LPS/IFN-γ to promote the phosphorylation of the long isoform obR and JNK/STAT3/AKT signaling pathway members to increase M1 macrophage polarization, which was reversed by Allo-Aca. Moreover, leptin/obR-mediated M1 macrophage activity significantly elevated CXCL2 production and neutrophil recruitment by regulating the JNK/STAT3/AKT pathways. In clinical studies, obese patients with asthma had higher serum leptin levels and M1 macrophage polarization levels in induced sputum than non-obese patients with asthma. Serum leptin levels were positively correlated with M1 macrophage polarization levels in patients with asthma. CONCLUSIONS Our results demonstrate leptin/obR signaling plays an important role in the pathogenesis of obesity-related neutrophilic airway inflammation in females by promoting M1 macrophage polarization.
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Affiliation(s)
- Yang Wang
- Department of Respiratory Medicine (Department of Respiratory and Critical Care Medicine), Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
- Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
| | - Rongjun Wan
- Department of Respiratory Medicine (Department of Respiratory and Critical Care Medicine), Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
| | - Chengping Hu
- Department of Respiratory Medicine (Department of Respiratory and Critical Care Medicine), Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
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Stefani C, Pecoraro L, Flodmark CE, Zaffanello M, Piacentini G, Pietrobelli A. Allergic Diseases and Childhood Obesity: A Detrimental Link? Biomedicines 2023; 11:2061. [PMID: 37509700 PMCID: PMC10377533 DOI: 10.3390/biomedicines11072061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
Several epidemiological studies have described childhood obesity as a risk factor for atopic disease, particularly asthma. At the same time, this association seems to be more conflicting for allergic rhinitis, atopic dermatitis, and chronic urticaria. This article aims to deepen the possibility of a relationship between childhood obesity and allergic diseases. As regards asthma, the mechanical and inflammatory effects of obesity can lead to its development. In addition, excess adiposity is associated with increased production of inflammatory cytokines and adipokines, leading to low-grade systemic inflammation and an increased risk of asthma exacerbations. Allergic rhinitis, atopic dermatitis, food allergies, and chronic urticaria also seem to be related to this state of chronic low-grade systemic inflammation typical of obese children. Vitamin D deficiency appears to play a role in allergic rhinitis, while dyslipidemia and skin barrier defects could explain the link between obesity and atopic dermatitis. Starting from this evidence, it becomes of fundamental importance to act on body weight control to achieve general and allergic health, disentangling the detrimental link between obesity allergic diseases and childhood obesity. Further studies on the association between adiposity and atopy are needed, confirming the biologically active role of fat tissue in the development of allergic diseases and exploring the possibility of new therapeutic strategies.
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Affiliation(s)
- Camilla Stefani
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126 Verona, Italy
| | - Luca Pecoraro
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126 Verona, Italy
| | | | - Marco Zaffanello
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126 Verona, Italy
| | - Giorgio Piacentini
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126 Verona, Italy
| | - Angelo Pietrobelli
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126 Verona, Italy
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
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Gil-Martínez M, Lorente-Sorolla C, Rodrigo-Muñoz JM, Naharro S, García-de Castro Z, Sastre J, Valverde-Monge M, Quirce S, Caballero ML, Olaguibel JM, del Pozo V. Obese Asthma Phenotype Is Associated with hsa-miR-26a-1-3p and hsa-miR-376a-3p Modulating the IGF Axis. Int J Mol Sci 2023; 24:11620. [PMID: 37511378 PMCID: PMC10380435 DOI: 10.3390/ijms241411620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Clarifying inflammatory processes and categorising asthma into phenotypes and endotypes improves asthma management. Obesity worsens severe asthma and reduces quality of life, although its specific molecular impact remains unclear. We previously demonstrated that hsa-miR-26a-1-3p and hsa-miR-376a-3p, biomarkers related to an inflammatory profile, discriminate eosinophilic from non-eosinophilic asthmatics. We aimed to study hsa-miR-26a-1-3p, hsa-miR-376a-3p, and their target genes in asthmatic subjects with or without obesity to find biomarkers and comprehend obese asthma mechanisms. Lung tissue samples were obtained from asthmatic patients (n = 16) and healthy subjects (n = 20). We measured miRNA expression using RT-qPCR and protein levels (IGF axis) by ELISA in confirmation samples from eosinophilic (n = 38) and non-eosinophilic (n = 39) obese (n = 26) and non-obese (n = 51) asthma patients. Asthmatic lungs showed higher hsa-miR-26a-1-3p and hsa-miR-376a-3p expression than healthy lungs. A study of seven genes regulated by these miRNAs revealed differential expression of IGFBP3 between asthma patients and healthy individuals. In obese asthma patients, we found higher hsa-miR-26a-1-3p and IGF-1R values and lower values for hsa-miR-376a-3p and IGFBP-3. Hsa-miR-26a-1-3p and IGFBP-3 were directly and inversely correlated with body mass index, respectively. Hsa-miR-26a-1-3p and hsa-miR-376a-3p could be used as biomarkers to phenotype patients with eosinophilic and non-eosinophilic asthma in relation to comorbid obesity.
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Affiliation(s)
- Marta Gil-Martínez
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040 Madrid, Spain; (M.G.-M.); (C.L.-S.); (J.M.R.-M.); (S.N.); (Z.G.-d.C.)
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (J.S.); (M.V.-M.); (S.Q.); (M.L.C.); (J.M.O.)
| | - Clara Lorente-Sorolla
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040 Madrid, Spain; (M.G.-M.); (C.L.-S.); (J.M.R.-M.); (S.N.); (Z.G.-d.C.)
| | - José M. Rodrigo-Muñoz
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040 Madrid, Spain; (M.G.-M.); (C.L.-S.); (J.M.R.-M.); (S.N.); (Z.G.-d.C.)
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (J.S.); (M.V.-M.); (S.Q.); (M.L.C.); (J.M.O.)
| | - Sara Naharro
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040 Madrid, Spain; (M.G.-M.); (C.L.-S.); (J.M.R.-M.); (S.N.); (Z.G.-d.C.)
| | - Zahara García-de Castro
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040 Madrid, Spain; (M.G.-M.); (C.L.-S.); (J.M.R.-M.); (S.N.); (Z.G.-d.C.)
| | - Joaquín Sastre
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (J.S.); (M.V.-M.); (S.Q.); (M.L.C.); (J.M.O.)
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Marcela Valverde-Monge
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (J.S.); (M.V.-M.); (S.Q.); (M.L.C.); (J.M.O.)
- Allergy Department, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Santiago Quirce
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (J.S.); (M.V.-M.); (S.Q.); (M.L.C.); (J.M.O.)
- Department of Allergy, Hospital Universitario La Paz, IdiPAZ, 28046 Madrid, Spain
| | - María L. Caballero
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (J.S.); (M.V.-M.); (S.Q.); (M.L.C.); (J.M.O.)
- Department of Allergy, Hospital Universitario La Paz, IdiPAZ, 28046 Madrid, Spain
| | - José M. Olaguibel
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (J.S.); (M.V.-M.); (S.Q.); (M.L.C.); (J.M.O.)
- Severe Asthma Unit, Department of Allergy, Hospital Universitario de Navarra, NavarraBiomed, 31008 Pamplona, Spain
| | - Victoria del Pozo
- Immunoallergy Laboratory, Immunology Department, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Universidad Autónoma de Madrid (IIS-FJD, UAM), 28040 Madrid, Spain; (M.G.-M.); (C.L.-S.); (J.M.R.-M.); (S.N.); (Z.G.-d.C.)
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (J.S.); (M.V.-M.); (S.Q.); (M.L.C.); (J.M.O.)
- Department of Medicine, Faculty of Medicine, Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
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Liu H, Zhang J, Liu L, Lian G, Shi R, Xu M, Yang J, Liu X. Global Disease Burden and Attributable Risk Factor Analysis of Asthma in 204 Countries and Territories From 1990 to 2019. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:473-495. [PMID: 37153981 PMCID: PMC10359648 DOI: 10.4168/aair.2023.15.4.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 12/21/2022] [Accepted: 12/28/2022] [Indexed: 07/21/2023]
Abstract
PURPOSE Asthma is a common chronic inflammatory respiratory tract disease with high morbidity and mortality. The global trends in asthma burden remain poorly understood, and asthma incidence has increased during the worldwide coronavirus disease 2019 (COVID-19) pandemic. This study aimed to provide a comprehensive view of the global distribution of asthma burden and its attributable risk factors from 1990 to 2019. METHODS Based on the Global Burden of Disease Study 2019 Database, asthma incidence, deaths, disability-adjusted life years (DALYs), the corresponding age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), age-standardized DALY rate, and estimated annual percentage change were analyzed according to age, sex, sociodemographic index (SDI) quintiles, and locations. Risk factors contributing to asthma deaths and DALYs were also investigated. RESULTS Globally, the asthma incidence increased by 15%, but deaths and DALYs decreased. The corresponding ASIR, ASDR, and age-standardized DALY rate also decreased. The high SDI region had the highest ASIR, and the low SDI region had the highest ASDR. The ASDR and age-standardized DALY rate were negatively correlated with the SDI. The low-middle SDI region, particularly South Asia, showed the highest asthma-related deaths and DALYs. The incidence peak was under 9 years old, and more than 70% of all deaths occurred in the population over 60 years old. Smoking, occupational asthmagens, and a high body mass index were the main risk factors for asthma-related mortality and DALYs, and their distributions varied between sexes. CONCLUSIONS Globally, the asthma incidence has increased since 1990. The greatest asthma burden is borne by the low-middle SDI region. The 2 groups that need special attention are those under 9 years old and those over 60 years old. Targeted strategies are needed to reduce the asthma burden based on geographic and sex-age characteristics. Our findings also provide a platform for further investigation into the asthma burden in the era of COVID-19.
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Affiliation(s)
- Hailing Liu
- Department of Pediatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Jing Zhang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Li Liu
- Department of Pediatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Guoli Lian
- Department of Pediatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Ruiming Shi
- Department of Pediatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Man Xu
- Department of Pediatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China
| | - Juan Yang
- Department of Cell Biology and Genetics, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, P. R. China
- Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education of China, Xi'an Jiaotong University, Xi'an, P. R. China.
| | - Xiaohong Liu
- Department of Pediatrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P. R. China.
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Kuziel G, Moore BN, Haugstad GP, Arendt LM. Fibrocytes enhance mammary gland fibrosis in obesity. FASEB J 2023; 37:e23049. [PMID: 37342915 PMCID: PMC10316715 DOI: 10.1096/fj.202300399rr] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/23/2023]
Abstract
Obesity rates continue to rise, and obese individuals are at higher risk for multiple types of cancer, including breast cancer. Obese mammary fat is a site of chronic, macrophage-driven inflammation, which enhances fibrosis within adipose tissue. Elevated fibrosis within the mammary gland may contribute to risk for obesity-associated breast cancer. To understand how inflammation due to obesity enhanced fibrosis within mammary tissue, we utilized a high-fat diet model of obesity and elimination of CCR2 signaling in mice to identify changes in immune cell populations and their impact on fibrosis. We observed that obesity increased a population of CD11b+ cells with the ability to form myofibroblast-like colonies in vitro. This population of CD11b+ cells is consistent with fibrocytes, which have been identified in wound healing and chronic inflammatory diseases but have not been examined in obesity. In CCR2-null mice, which have limited ability to recruit myeloid lineage cells into obese adipose tissue, we observed reduced mammary fibrosis and diminished fibrocyte colony formation in vitro. Transplantation of myeloid progenitor cells, which are the cells of origin for fibrocytes, into the mammary glands of obese CCR2-null mice resulted in significantly increased myofibroblast formation. Gene expression analyses of the myeloid progenitor cell population from obese mice demonstrated enrichment for genes associated with collagen biosynthesis and extracellular matrix remodeling. Together these results show that obesity enhances recruitment of fibrocytes to promote obesity-induced fibrosis in the mammary gland.
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Affiliation(s)
- Genevra Kuziel
- Cancer Biology Program, University of Wisconsin-Madison,
Madison WI 53706, U.S.A
| | - Brittney N. Moore
- Department of Comparative Biosciences, University of
Wisconsin-Madison, Madison WI 53706, U.S.A
| | - Grace P. Haugstad
- Department of Comparative Biosciences, University of
Wisconsin-Madison, Madison WI 53706, U.S.A
| | - Lisa M. Arendt
- Cancer Biology Program, University of Wisconsin-Madison,
Madison WI 53706, U.S.A
- Department of Comparative Biosciences, University of
Wisconsin-Madison, Madison WI 53706, U.S.A
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Starr S, Wysocki M, DeLeon JD, Silverstein G, Arcoleo K, Rastogi D, Feldman JM. Obesity-related pediatric asthma: relationships between pulmonary function and clinical outcomes. J Asthma 2023; 60:1418-1427. [PMID: 36420526 PMCID: PMC10191971 DOI: 10.1080/02770903.2022.2152351] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/20/2022] [Accepted: 11/23/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We hypothesized that children with obesity-related asthma would have worse self-reported asthma control, report an increased number of asthma symptoms and have lower FEV1/FVC associated with worse clinical asthma outcomes compared to children with asthma only. METHODS Cross sectional analyses examined two hundred and eighteen (obesity-related asthma = 109, asthma only = 109) children, ages 7-15 that were recruited from clinics and hospitals within the Bronx, NY. Pulmonary function was assessed by forced expiratory volume in the first second (percent predicted FEV1) and the ratio of FEV1 to the forced vital capacity of the lungs (FEV1/FVC). Structural equation modeling examined if pulmonary function was associated with asthma control and clinical outcomes between groups. RESULTS Lower percent predicted FEV1 was associated with increased hospitalizations (p = 0.03) and oral steroid bursts in the past 12 months (p = 0.03) in the obesity-related asthma group but not in the asthma only group. FEV1/FVC was also associated with increased hospitalizations (p = 0.02) and oral steroid bursts (p = 0.008) in the obesity-related asthma group but not the asthma only group. Lower FEV1/FVC was associated with the number of asthma symptoms endorsed in the asthma only group but not in the obesity-related asthma group. Percent predicted FEV1 and FEV1/FVC was not associated with asthma control in either group. CONCLUSIONS Pulmonary function was associated with oral steroid bursts and hospitalizations but not self-reported asthma control, suggesting the importance of incorporating measures of pulmonary function into the treatment of pediatric obesity-related asthma.
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Affiliation(s)
- Sheena Starr
- Ferkauf Graduate School of Psychology, Yeshiva University, Rousso Building, 1165 Morris Park Ave., Bronx NY, 10467
| | - Matthew Wysocki
- Albert Einstein College of Medicine, Children’s Hospital at Montefiore, Department of Pediatrics, Division of Academic General Pediatrics, Department of Psychiatry & Behavioral Sciences, 3415 Bainbridge Ave, Bronx, NY 10467
| | - Jesenya D. DeLeon
- Albert Einstein College of Medicine, Children’s Hospital at Montefiore, Department of Pediatrics, Division of Academic General Pediatrics, Department of Psychiatry & Behavioral Sciences, 3415 Bainbridge Ave, Bronx, NY 10467
| | - Gabriella Silverstein
- Ferkauf Graduate School of Psychology, Yeshiva University, Rousso Building, 1165 Morris Park Ave., Bronx NY, 10467
| | - Kimberly Arcoleo
- University of Rhode Island, College of Nursing, 350 Eddy Street, Providence, RI 02903
| | - Deepa Rastogi
- Albert Einstein College of Medicine, Children’s Hospital at Montefiore, Department of Pediatrics, Division of Academic General Pediatrics, Department of Psychiatry & Behavioral Sciences, 3415 Bainbridge Ave, Bronx, NY 10467
| | - Jonathan M. Feldman
- Ferkauf Graduate School of Psychology, Yeshiva University, Rousso Building, 1165 Morris Park Ave., Bronx NY, 10467
- Albert Einstein College of Medicine, Children’s Hospital at Montefiore, Department of Pediatrics, Division of Academic General Pediatrics, Department of Psychiatry & Behavioral Sciences, 3415 Bainbridge Ave, Bronx, NY 10467
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Aziz DA, Bajwa RA, Viquar W, Siddiqui F, Abbas A. Asthma exacerbations and body mass index in children and adolescents: experience from a tertiary care center. Monaldi Arch Chest Dis 2023; 94. [PMID: 37367834 DOI: 10.4081/monaldi.2023.2581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023] Open
Abstract
The prevalence and incidence of asthma continue to rise globally. Obesity has been identified as a potential risk factor for asthma exacerbations. The association between body mass index (BMI) and asthma is not well studied in some regions. This study aims to investigate the impact of BMI on pediatric asthmatic patients. This retrospective study was conducted at the Aga Khan University Hospital from 2019 to 2022. Children and adolescents with asthma exacerbations were included. The patients were classified into four groups based on their BMI: underweight, healthy weight, overweight, and obese. The demographic characteristics, medications used, predicted forced expiratory volume in 1 second (FEV1) measurements, asthma exacerbations per year, length of stay per admission, and the number of patients requiring high dependency unit (HDU) care were recorded and analyzed. Our results demonstrated that patients in the healthy weight category had the highest percentage of FEV1 (91.46±8.58) and FEV1/forced vital capacity (FVC) (85.75±9.23) (p<0.001). The study found a significant difference in the average number of asthma exacerbations per year between the four groups. Obese patients had the highest number of episodes (3.22±0.94), followed by the underweight group (2.42±0.59) (p<0.01). The length of stay per admission was significantly shorter for patients with a healthy weight (2.0±0.81), and there was a statistically significant difference observed in the number of patients requiring HDU care among the four groups, as well as in the average length of stay at the HDU (p<0.001). Elevated BMI is related to an increased number of annual asthma exacerbations, a low FEV1 and FEV1/FVC, an increased length of stay at admission, and an increased stay in the HDU.
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Affiliation(s)
- Danish Abdul Aziz
- Department of Pediatrics and Child Health, Aga Khan University Hospital, Karachi.
| | | | | | | | - Aiza Abbas
- Medical College, Aga Khan University, Karachi.
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Kang D, Shin WC, Kim T, Kim S, Kim H, Cho JH, Song MY, Chung WS. Systematic review and meta-analysis of the anti-obesity effect of cupping therapy. Medicine (Baltimore) 2023; 102:e34039. [PMID: 37327262 PMCID: PMC10270516 DOI: 10.1097/md.0000000000034039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/30/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Cupping therapy is a common practice in Korean medicine. Despite developments in this clinical and research area, the current knowledge is insufficient to identify the effects of cupping therapy on obesity. We aimed to assess the effects and safety of cupping therapy on obesity by performing a systematic review and meta-analysis of the effects of cupping therapy. METHODS A systematic search of databases was conducted, including MEDLINE/PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, Citation Information by the National Institute of Informatics, KoreaMed, Oriental Medicine Advanced Searching Integrated System, and ScienceON, for full-text randomized controlled trials (RCTs) published through January 14, 2023, with no language restrictions. The experimental groups received cupping therapy combined with traditional Chinese medicine (TCM) and conventional therapy. The control groups received no treatment, conventional therapy, or TCM treatments alone. The experimental and control groups were compared in terms of body weight (BW), body mass index (BMI), hip circumference (HC), waist circumference (WC), waist-hip ratio (WHR), and body fat percentage (BFP). We evaluated the risk of bias using the 7 domains stipulated by the Cochrane Collaboration Group and performed a meta-analysis using Cochrane Collaboration software (Review Manager Software Version 5.3). RESULTS A total of 21 RCTs were included in this systematic review and meta-analysis. The analysis revealed improvements in BW (P < .001), BMI (P < .001), HC (P = .03), and WC (P < .001). However, there were no clinically significant changes in WHR (P = .65) or BFP (P = .90), both of which had very low certainty of evidence. No adverse events were reported. CONCLUSION Overall, our results show that cupping therapy can be used to treat obesity in terms of BW, BMI, HC, and WC and is a safe intervention for the treatment of obesity. However, the conclusions of this review should be interpreted with caution in clinical practice because of the uncertain quality of the included studies.
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Affiliation(s)
- Doyoung Kang
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Woo-Chul Shin
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
- Department of Korean Medicine Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Taeoh Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
- Department of Korean Medicine Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Sungha Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hyungsuk Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
- Department of Korean Medicine Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Jae-Heung Cho
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
- Department of Korean Medicine Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Mi-Yeon Song
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
- Department of Korean Medicine Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Won-Seok Chung
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
- Department of Korean Medicine Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
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Luettich A, Sievers C, Alfaro Almagro F, Allen M, Jbabdi S, Smith SM, Pattinson KTS. Functional connectivity between interoceptive brain regions is associated with distinct health-related domains: A population-based neuroimaging study. Hum Brain Mapp 2023; 44:3210-3221. [PMID: 36939141 PMCID: PMC10171512 DOI: 10.1002/hbm.26275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/08/2023] [Accepted: 02/27/2023] [Indexed: 03/21/2023] Open
Abstract
Interoception is the sensation, perception, and integration of signals from within the body. It has been associated with a broad range of physiological and psychological processes. Further, interoceptive variables are related to specific regions and networks in the human brain. However, it is not clear whether or how these networks relate empirically to different domains of physiological and psychological health at the population level. We analysed a data set of 19,020 individuals (10,055 females, 8965 males; mean age: 63 years, age range: 45-81 years), who have participated in the UK Biobank Study, a very large-scale prospective epidemiological health study. Using canonical correlation analysis (CCA), allowing for the examination of associations between two sets of variables, we related the functional connectome of brain regions implicated in interoception to a selection of nonimaging health and lifestyle related phenotypes, exploring their relationship within modes of population co-variation. In one integrated and data driven analysis, we obtained four statistically significant modes. Modes could be categorised into domains of arousal and affect and cardiovascular health, respiratory health, body mass, and subjective health (all p < .0001) and were meaningfully associated with distinct neural circuits. Circuits represent specific neural "fingerprints" of functional domains and set the scope for future studies on the neurobiology of interoceptive involvement in different lifestyle and health-related phenotypes. Therefore, our research contributes to the conceptualisation of interoception and may lead to a better understanding of co-morbid conditions in the light of shared interoceptive structures.
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Affiliation(s)
- Alexander Luettich
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Carolin Sievers
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Fidel Alfaro Almagro
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Micah Allen
- Center of Functionally Integrative NeuroscienceAarhus UniversityAarhusDenmark
- Aarhus Institute of Advanced StudiesAarhus UniversityAarhusDenmark
- Cambridge PsychiatryUniversity of CambridgeCambridgeUK
| | - Saad Jbabdi
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Stephen M. Smith
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
| | - Kyle T. S. Pattinson
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Wellcome Centre for Integrative NeuroimagingUniversity of OxfordOxfordUK
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Lajiness JD, Cook-Mills JM. Catching Our Breath: Updates on the Role of Dendritic Cell Subsets in Asthma. Adv Biol (Weinh) 2023; 7:e2200296. [PMID: 36755197 PMCID: PMC10293089 DOI: 10.1002/adbi.202200296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/04/2023] [Indexed: 02/10/2023]
Abstract
Dendritic cells (DCs), as potent antigen presenting cells, are known to play a central role in the pathophysiology of asthma. The understanding of DC biology has evolved over the years to include multiple subsets of DCs with distinct functions in the initiation and maintenance of asthma. Furthermore, asthma is increasingly recognized as a heterogeneous disease with potentially diverse underlying mechanisms. The goal of this review is to summarize the role of DCs and the various subsets therein in the pathophysiology of asthma and highlight some of the crucial animal models shaping the field today. Potential future avenues of investigation to address existing gaps in knowledge are discussed.
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Affiliation(s)
- Jacquelyn D Lajiness
- Department of Pediatrics, Division of Neonatology, Indiana University School of Medicine, 1030 West Michigan Street, Suite C 4600, Indianapolis, IN, 46202-5201, USA
| | - Joan M Cook-Mills
- Department of Pediatrics, Department of Microbiology and Immunology, Pediatric Pulmonary, Asthma, and Allergy Basic Research Program, Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, 1044 W. Walnut Street, R4-202A, Indianapolis, IN, 46202, USA
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Althoff MD, Peterson R, McGrath M, Jin Y, Grasemann H, Sharma S, Federman A, Wisnivesky JP, Holguin F. Phenotypic characteristics of asthma and morbidity are associated with distinct longitudinal changes in L-arginine metabolism. BMJ Open Respir Res 2023; 10:e001683. [PMID: 37270184 PMCID: PMC10254613 DOI: 10.1136/bmjresp-2023-001683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/12/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND The L-arginine metabolome is dysregulated in asthma, though it is not understood how longitudinal changes in L-arginine metabolism differ among asthma phenotypes and relate to disease outcomes. OBJECTIVES To determine the longitudinal associations between phenotypic characteristics with L-arginine metabolites and their relationships with asthma morbidity. METHODS This is a prospective cohort study of 321 patients with asthma followed semiannually for over 18 months with assessments of plasma L-arginine metabolites, asthma control, spirometry, quality of life and exacerbations. Metabolite concentrations and ratios were transformed using the natural logarithm. RESULTS There were many differences in L-arginine metabolism among asthma phenotypes in the adjusted models. Increasing body mass index was associated with increased asymmetric dimethylarginine (ADMA) and depleted L-citrulline. Latinx was associated with increased metabolism via arginase, with higher L-ornithine, proline and L-ornithine/L-citrulline levels, and was found to have higher L-arginine availability compared with white race. With respect to asthma outcomes, increasing L-citrulline was associated with improved asthma control and increasing L-arginine and L-arginine/ADMA were associated with improved quality of life. Increased variability in L-arginine, L-arginine/ADMA, L-arginine/L-ornithine and L-arginine availability index over 12 months were associated with increased exacerbations, OR 4.70 (95% CI 1.35 to 16.37), OR 8.69 (95% CI 1.98 to 38.08), OR 4.17 (95% CI 1.40 to 12.41) and OR 4.95 (95% CI 1.42 to 17.16), respectively. CONCLUSIONS Our findings suggest that L-arginine metabolism is associated with multiple measures of asthma control and may explain, in part, the relationship between age, race/ethnicity and obesity with asthma outcomes.
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Affiliation(s)
- Meghan Dolan Althoff
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ryan Peterson
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Max McGrath
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Ying Jin
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Hartmut Grasemann
- Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sunita Sharma
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Alex Federman
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Juan Pablo Wisnivesky
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Fernando Holguin
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA
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SÖZENER Z, ÖZTÜRK B, AYDIN Ö, MUNGAN D, BAVBEK S. [The profile of severe asthmatics: Results from a specialized asthma clinic]. Tuberk Toraks 2023; 71:156-165. [PMID: 37345398 PMCID: PMC10795275 DOI: 10.5578/tt.20239919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/21/2023] [Indexed: 06/23/2023] Open
Abstract
Introduction In patients with severe asthma, individualized treatment, and appropriate phenotyping are required to achieve control. In our study, our aim was to examine the characteristics of a specific patient group in a specialized tertiary asthma outpatient clinic, which is the primary setting for evaluating severe asthma patients, with the intention of obtaining national data. Materials and Methods In this cross-sectional observational study, sociodemographic, clinical presentations, laboratory results, and spirometry measurements of patients with severe asthma who were followed up in our specialized asthma outpatient clinic for at least one year were recorded. Patients were defined as eosinophilic if they had a blood eosinophil count of 300/µL or higher at least twice during the oral corticosteroid free-period or 150/µL or higher under oral corticosteroids as allergic if they had sensitization to at least one inhalant allergen consistent with their history. Result Overall, 201 severe asthma patients (74.1% female) with a median disease duration of 15 (min-max= 1-49) years and a median follow-up duration of 7 (min-max= 1-40) years were analyzed. Most of the patients (56.7%) had adult-onset asthma [median age of onset was 32 (min-max= 10-62) years]. Overweight and obese patients were in the majority (31.8%, and 41.8%, respectively) and the median body mass index was 29 (min-max= 17.5-49.5). More than half of the patients (55.2%) had controlled asthma and the median Asthma Control Test score at the last visit was 23. Biologic therapies were applied to 73.1% (n= 147) of the patients [60.5% (n= 89) omalizumab, 39.5% (n= 58) mepolizumab]. Half of the group was allergic (49.3%) and three-quarters of them were eosinophilic (72.1%). Allergic patients had earlier asthma onset and had more controlled disease than nonallergic ones. Eosinophilic patients were younger and less obese than noneosinophilic patients. Obese and late-onset asthmatics had more uncontrolled disease than normal weight subjects and early onset patients. Conclusions The high rate of disease control in the patients with severe asthma in the current study demonstrated the importance of targeted individualized therapy with accurate phenotyping in specialized asthma outpatient clinics.
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Affiliation(s)
- Z.Ç. SÖZENER
- Division of Immunology and Allergic Diseases, Department of Chest Diseases,
Ankara University Faculty of Medicine, Ankara, Türkiye
| | - B.Ö. ÖZTÜRK
- Division of Immunology and Allergic Diseases, Department of Chest Diseases,
Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Ö. AYDIN
- Division of Immunology and Allergic Diseases, Department of Chest Diseases,
Ankara University Faculty of Medicine, Ankara, Türkiye
| | - D. MUNGAN
- Division of Immunology and Allergic Diseases, Department of Chest Diseases,
Ankara University Faculty of Medicine, Ankara, Türkiye
| | - S. BAVBEK
- Division of Immunology and Allergic Diseases, Department of Chest Diseases,
Ankara University Faculty of Medicine, Ankara, Türkiye
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Meys R, Machado FV, Spruit MA, Stoffels AA, van Hees HW, van den Borst B, Klijn PH, Burtin C, Pitta F, Franssen FM. Frequency and Functional Consequences of Low Appendicular Lean Mass and Sarcopenic Obesity in Patients with Asthma Referred for Pulmonary Rehabilitation. Obes Facts 2023; 16:435-446. [PMID: 37232056 PMCID: PMC10601668 DOI: 10.1159/000531196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION One of the most prominent extrapulmonary manifestations in patients with chronic respiratory disease is changes in body weight and composition. However, the frequency and functional consequences of low appendicular lean mass (ALM) or sarcopenic obesity (SO) in patients with asthma are largely unknown. Therefore, the aim of the current study was to assess the frequency and functional consequences of low appendicular lean mass index (ALMI) and SO in patients with asthma. METHODS A retrospectively analyzed cross-sectional study was conducted in 687 patients with asthma (60% female, 58 ± 13 years, FEV1 76 ± 25% pred) referred for comprehensive pulmonary rehabilitation (PR). Body composition, pulmonary function, exercise capacity, quadriceps muscle function, and quality of life were assessed. Patients were classified as presenting low ALMI according to the 10th percentiles of age-sex-body mass index (BMI)-specific reference values and as having SO according to the diagnostic procedure proposed by the 2022 ESPEN/EASO consensus. In addition, clinical outcomes between patients with normal and low ALMI or with and without SO were compared. RESULTS The frequency of patients classified as low ALMI was 19%, whereas 45% of the patients were obese. Among the obese patients, 29% had SO. In patients with normal weight, those with low ALMI were younger and had worse pulmonary function, exercise capacity and quadriceps muscle function than those with normal ALMI (all p < 0.05). Overweight patients with low ALMI presented poorer pulmonary function and quadriceps muscle function (both strength and total work capacity). In obese class I patients, those with low ALMI showed lower quadriceps strength and maximal oxygen uptake acquired during cardiopulmonary exercise testing. Both male and female patients with SO showed lower quadriceps muscle function and reduced maximal exercise capacity compared to non-SO asthma patients. CONCLUSION Approximately one in five asthma patients presented low ALM when age-sex-BMI-specific ALMI cutoffs were applied. Obesity is common among patients with asthma referred for PR. Among the obese patients, a significant proportion presented SO. Low ALM and SO were associated with worse functional outcomes.
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Affiliation(s)
- Roy Meys
- Department of Research and Development, Ciro, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Felipe V.C. Machado
- Department of Research and Development, Ciro, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
- Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Martijn A. Spruit
- Department of Research and Development, Ciro, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Anouk A.F. Stoffels
- Department of Research and Development, Ciro, Horn, The Netherlands
- Department of Pulmonary Diseases, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hieronymus W.H. van Hees
- Department of Pulmonary Diseases, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bram van den Borst
- Department of Pulmonary Diseases, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter H. Klijn
- Department of Pulmonology, Merem Pulmonary Rehabilitation Centre, Hilversum, The Netherlands
- Department of Pulmonary Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Chris Burtin
- REVAL–Rehabilitation Research Center, BIOMED–Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Fabio Pitta
- Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Frits M.E. Franssen
- Department of Research and Development, Ciro, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
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Dimasuay KG, Berg B, Schaunaman N, Holguin F, Winnica D, Chu HW. High-fat diet and palmitic acid amplify airway type 2 inflammation. FRONTIERS IN ALLERGY 2023; 4:1193480. [PMID: 37287831 PMCID: PMC10243139 DOI: 10.3389/falgy.2023.1193480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/08/2023] [Indexed: 06/09/2023] Open
Abstract
Introduction Metabolic dysfunction such as elevated levels of saturated fatty acids (SFA) may play a role in obese asthma, but its contribution to airway inflammation remains unclear. We sought to determine the role of high-fat diet (HFD) and palmitic acid (PA), a major form of SFA, in regulating type 2 inflammation. Methods Airway samples from asthma patients with or without obesity, mouse models and human airway epithelial cell culture were utilized to test if SFA amplify type 2 inflammation. Results Asthma patients with obesity had higher levels of airway PA than asthma patients without obesity. HFD increased the levels of PA in mice, and subsequently enhanced IL-13-induced airway eosinophilic inflammation. PA treatment amplified airway eosinophilic inflammation in mice that were previously exposed to IL-13 or house dust mite. IL-13 alone or in combination with PA increased dipeptidyl peptidase 4 (DPP4) release (soluble DPP4) and/or activity in mouse airways and human airway epithelial cells. Inhibition of DPP4 activity by linagliptin in mice pre-exposed to IL-13 or both IL-13 and PA increased airway eosinophilic and neutrophilic inflammation. Discussion Our results demonstrated the exaggerating effect of obesity or PA on airway type 2 inflammation. Up-regulation of soluble DPP4 by IL-13 and/or PA may serve as a mechanism to prevent excessive type 2 inflammation. Soluble DPP4 may have the therapeutic potential in asthma patients with obesity who have an endotype with mixed airway eosinophilic and neutrophilic inflammation.
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Affiliation(s)
| | - Bruce Berg
- Department of Medicine, National Jewish Health, Denver, CO, United States
| | | | - Fernando Holguin
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Daniel Winnica
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Hong Wei Chu
- Department of Medicine, National Jewish Health, Denver, CO, United States
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135
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Liu Q, Han X, Chen Y, Gao Y, Yang W, Huang L. Asthma prevalence is increased in patients with high metabolism scores for visceral fat: study reports from the US. Front Endocrinol (Lausanne) 2023; 14:1162158. [PMID: 37260450 PMCID: PMC10227585 DOI: 10.3389/fendo.2023.1162158] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/05/2023] [Indexed: 06/02/2023] Open
Abstract
Objective Data from NHANES 2001-2018 were used to examine the relationship between metabolism score for visceral fat (METS-VF) and asthma prevalence. Methods We assessed the association between METS-VF and asthma disease using multiple logistic regression analysis from the National Health and Nutrition Examination Survey (NHANES), 2001-2018, followed by subgroup analysis for sensitive populations. To determine whether METS-VF and asthma disease had a non-linear relationship, smooth curve fitting was used, and threshold effect analysis was used to verify the relationship. Results Among the 36,876 participants, 4,919 self-reported having asthma. When all confounders were controlled for, a positive association was found between METS-VF and asthma prevalence (OR = 1.27, 95% CI: 1.22,1.32), and this positive association was stronger with elevated METS-VF (P for trend = 0.01). According to the smooth curve fitting analysis, METS-VF and asthma prevalence do not have a linear relationship. The double-segmented threshold effect analysis suggested a negative correlation but no statistically significant difference between METS-VF less than 5.24 and asthma prevalence (OR = 0.60, 95% CI: 0.33, 0.91). Besides, other METS-VF showed positive associations with asthma prevalence before and after the effective inflection point. According to subgroup analysis, METS-VF is associated with asthma prevalence among participants aged 40 - 59, male, Mexican American, with hypertension and diabetes, and without asthma history. Conclusion A positive correlation between METS-VF and asthma was observed and this positive correlation was non-linear, and participants with METS-VF above 5.24 should be cautious about the high risk of asthma. The relationship should be given more attention to participants who are aged 40-59 years old, male, Mexican American, have hypertension, diabetes, and who do not have a family history of asthma.
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Affiliation(s)
- Qiushi Liu
- Department of Respiratory, General Hospital of Northern Theater Command, Shenyang, China
| | - Xiaoxiao Han
- Department of Hyperbaric Oxygen, The Second People’s Hospital of Hefei, Hefei, China
| | - Yan Chen
- Department of General Practice, Wuhu City Second People`s Hospital, Wuhu, China
| | - Ying Gao
- Department of Respiratory, General Hospital of Northern Theater Command, Shenyang, China
| | - Wei Yang
- Department of Respiratory, General Hospital of Northern Theater Command, Shenyang, China
| | - Lewei Huang
- Department of Respiratory, General Hospital of Northern Theater Command, Shenyang, China
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Parasuaraman G, Ayyasamy L, Aune D, Sen A, Nagarajan R, Rajkumar P, Velusamy S, Manickam P, Sivaprakasam S. The association between body mass index, abdominal fatness, and weight change and the risk of adult asthma: a systematic review and meta-analysis of cohort studies. Sci Rep 2023; 13:7745. [PMID: 37173338 PMCID: PMC10182066 DOI: 10.1038/s41598-023-31373-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 03/10/2023] [Indexed: 05/15/2023] Open
Abstract
Obesity has been associated with increased risk of adult asthma, however, not all studies have found a clear association between overweight and the incidence of asthma, and data on other adiposity measures have been limited. Hence, we aimed to summarize evidence on association between adiposity and adult asthma. Relevant studies were retrieved through searches conducted in PubMed, and EMBASE up to March 2021. A total of sixteen studies (63,952 cases and 1,161,169 participants) were included in the quantitative synthesis. The summary RR was 1.32 (95% CI 1.21-1.44, I2 = 94.6%, pheterogeneity < 0.0001, n = 13) per 5 kg/m2 increase in BMI, 1.26 (95% CI 1.09-1.46, I2 = 88.6%, pheterogeneity < 0.0001, n = 5) per 10 cm increase in waist circumference and 1.33 (95% CI 1.22-1.44, I2 = 62.3%, pheterogeneity= 0.05, n = 4) per 10 kg increase in weight gain. Although the test for nonlinearity was significant for BMI (pnonlinearity < 0.00001), weight change (pnonlinearity = 0.002), and waist circumference (pnonlinearity = 0.02), there was a clear dose-response relationship between higher levels of adiposity and asthma risk. The magnitude of the associations and the consistency of the results across studies and adiposity measures provide strong evidence that overweight and obesity, waist circumference and weight gain increases asthma risk. These findings support policies to curb the global epidemic of overweight and obesity.
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Affiliation(s)
| | - Lavanya Ayyasamy
- Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
| | - Dagfinn Aune
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Abhijit Sen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Center for Oral Health Services and Research (TkMidt), Trondheim, Norway
| | - Ramya Nagarajan
- Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
| | - Prabhu Rajkumar
- Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
| | | | - P Manickam
- Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
| | - Satish Sivaprakasam
- Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
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Das A, Pathak MP, Pathak K, Saikia R, Gogoi U. Herbal medicine for the treatment of obesity-associated asthma: a comprehensive review. Front Pharmacol 2023; 14:1186060. [PMID: 37251328 PMCID: PMC10213975 DOI: 10.3389/fphar.2023.1186060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/25/2023] [Indexed: 05/31/2023] Open
Abstract
Obesity is fast growing as a global pandemic and is associated with numerous comorbidities like cardiovascular disease, hypertension, diabetes, gastroesophageal reflux disease, sleep disorders, nephropathy, neuropathy, as well as asthma. Studies stated that obese asthmatic subjects suffer from an increased risk of asthma, and encounter severe symptoms due to a number of pathophysiology. It is very vital to understand the copious relationship between obesity and asthma, however, a clear and pinpoint pathogenesis underlying the association between obesity and asthma is scarce. There is a plethora of obesity-asthma etiologies reported viz., increased circulating pro-inflammatory adipokines like leptin, resistin, and decreased anti-inflammatory adipokines like adiponectin, depletion of ROS controller Nrf2/HO-1 axis, nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 (NLRP3) associated macrophage polarization, hypertrophy of WAT, activation of Notch signaling pathway, and dysregulated melanocortin pathway reported, however, there is a very limited number of reports that interrelates these pathophysiologies. Due to the underlying complex pathophysiologies exaggerated by obese conditions, obese asthmatics respond poorly to anti-asthmatic drugs. The poor response towards anti-asthmatic drugs may be due to the anti-asthmatics approach only that ignores the anti-obesity target. So, aiming only at the conventional anti-asthmatic targets in obese-asthmatics may prove to be futile until and unless treatment is directed towards ameliorating obesity pathogenesis for a holistic approach towards amelioration of obesity-associated asthma. Herbal medicines for obesity as well as obesity-associated comorbidities are fast becoming safer and more effective alternatives to conventional drugs due to their multitargeted approach with fewer adverse effects. Although, herbal medicines are widely used for obesity-associated comorbidities, however, a limited number of herbal medicines have been scientifically validated and reported against obesity-associated asthma. Notable among them are quercetin, curcumin, geraniol, resveratrol, β-Caryophyllene, celastrol, tomatidine to name a few. In view of this, there is a dire need for a comprehensive review that may summarize the role of bioactive phytoconstituents from different sources like plants, marine as well as essential oils in terms of their therapeutic mechanisms. So, this review aims to critically discuss the therapeutic role of herbal medicine in the form of bioactive phytoconstituents against obesity-associated asthma available in the scientific literature to date.
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Affiliation(s)
- Aparoop Das
- Department of Pharmaceutical Sciences, Dibrugarh University, Dibrugarh, Assam, India
| | - Manash Pratim Pathak
- Faculty of Pharmaceutical Science, Assam Down Town University, Guwahati, Assam, India
| | - Kalyani Pathak
- Department of Pharmaceutical Sciences, Dibrugarh University, Dibrugarh, Assam, India
| | - Riya Saikia
- Department of Pharmaceutical Sciences, Dibrugarh University, Dibrugarh, Assam, India
| | - Urvashee Gogoi
- Department of Pharmaceutical Sciences, Dibrugarh University, Dibrugarh, Assam, India
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Konjevod M, Sreter KB, Popovic-Grle S, Lampalo M, Tudor L, Jukic I, Nedic Erjavec G, Bingulac-Popovic J, Safic Stanic H, Nikolac Perkovic M, Markeljevic J, Samarzija M, Pivac N, Svob Strac D. Platelet Serotonin (5-HT) Concentration, Platelet Monoamine Oxidase B (MAO-B) Activity and HTR2A, HTR2C, and MAOB Gene Polymorphisms in Asthma. Biomolecules 2023; 13:biom13050800. [PMID: 37238670 DOI: 10.3390/biom13050800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
The complex role of the serotonin system in respiratory function and inflammatory diseases such as asthma is unclear. Our study investigated platelet serotonin (5-HT) levels and platelet monoamine oxidase B (MAO-B) activity, as well as associations with HTR2A (rs6314; rs6313), HTR2C (rs3813929; rs518147), and MAOB (rs1799836; rs6651806) gene polymorphisms in 120 healthy individuals and 120 asthma patients of different severity and phenotypes. Platelet 5-HT concentration was significantly lower, while platelet MAO-B activity was considerably higher in asthma patients; however, they did not differ between patients with different asthma severity or phenotypes. Only the healthy subjects, but not the asthma patients, carrying the MAOB rs1799836 TT genotype had significantly lower platelet MAO-B activity than the C allele carriers. No significant differences in the frequency of the genotypes, alleles, or haplotypes for any of the investigated HTR2A, HTR2C and MAOB gene polymorphisms have been observed between asthma patients and healthy subjects or between patients with various asthma phenotypes. However, the carriers of the HTR2C rs518147 CC genotype or C allele were significantly less frequent in severe asthma patients than in the G allele carriers. Further studies are necessary to elucidate the involvement of the serotonergic system in asthma pathophysiology.
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Affiliation(s)
- Marcela Konjevod
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000 Zagreb, Croatia
| | - Katherina B Sreter
- Department of Clinical Immunology, Pulmonology and Rheumatology, University Hospital Centre "Sestre Milosrdnice", 10000 Zagreb, Croatia
| | - Sanja Popovic-Grle
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marina Lampalo
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Lucija Tudor
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000 Zagreb, Croatia
| | - Irena Jukic
- Croatian Institute of Transfusion Medicine, 10000 Zagreb, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Gordana Nedic Erjavec
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000 Zagreb, Croatia
| | | | | | - Matea Nikolac Perkovic
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000 Zagreb, Croatia
| | - Jasenka Markeljevic
- Department of Clinical Immunology, Pulmonology and Rheumatology, University Hospital Centre "Sestre Milosrdnice", 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Miroslav Samarzija
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Nela Pivac
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000 Zagreb, Croatia
- University of Applied Sciences "Hrvatsko Zagorje Krapina", 49000 Krapina, Croatia
| | - Dubravka Svob Strac
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000 Zagreb, Croatia
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139
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Dang B, Gao Q, Zhang L, Zhang J, Cai H, Zhu Y, Zhong Q, Liu J, Niu Y, Mao K, Xiao N, Liu WH, Lin SH, Huang J, Huang SCC, Ho PC, Cheng SC. The glycolysis/HIF-1α axis defines the inflammatory role of IL-4-primed macrophages. Cell Rep 2023; 42:112471. [PMID: 37149865 DOI: 10.1016/j.celrep.2023.112471] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/08/2023] [Accepted: 04/19/2023] [Indexed: 05/09/2023] Open
Abstract
T helper type 2 (Th2) cytokine-activated M2 macrophages contribute to inflammation resolution and wound healing. This study shows that IL-4-primed macrophages exhibit a stronger response to lipopolysaccharide stimulation while maintaining M2 signature gene expression. Metabolic divergence between canonical M2 and non-canonical proinflammatory-prone M2 (M2INF) macrophages occurs after the IL-4Rα/Stat6 axis. Glycolysis supports Hif-1α stabilization and proinflammatory phenotype of M2INF macrophages. Inhibiting glycolysis blunts Hif-1α accumulation and M2INF phenotype. Wdr5-dependent H3K4me3 mediates the long-lasting effect of IL-4, with Wdr5 knockdown inhibiting M2INF macrophages. Our results also show that the induction of M2INF macrophages by IL-4 intraperitoneal injection and transferring of M2INF macrophages confer a survival advantage against bacterial infection in vivo. In conclusion, our findings highlight the previously neglected non-canonical role of M2INF macrophages and broaden our understanding of IL-4-mediated physiological changes. These results have immediate implications for how Th2-skewed infections could redirect disease progression in response to pathogen infection.
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Affiliation(s)
- Buyun Dang
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China; Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361004, China
| | - Qingxiang Gao
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | - Lishan Zhang
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | - Jia Zhang
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | - Hanyi Cai
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | - Yanhui Zhu
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | - Qiumei Zhong
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | - Junqiao Liu
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | - Yujia Niu
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | - Kairui Mao
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | - Nengming Xiao
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | - Wen-Hsien Liu
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | - Shu-Hai Lin
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | - Jialiang Huang
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China
| | | | - Ping-Chih Ho
- Ludwig Institute for Cancer Research, University of Lausanne, Epalinges, Vaud, Switzerland; Department of Oncology, University of Lausanne, Epalinges, Switzerland
| | - Shih-Chin Cheng
- State Key Laboratory of Cellular Stress Biology, School of Life Science, Faculty of Medicine and Life Sciences, Xiamen University, Xiamen 361102, China; Department of Gastroenterology, The National Key Clinical Specialty, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian 361004, China; Department of Digestive Disease, School of Medicine, Xiamen University, Xiamen, Fujian 361004, China.
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140
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Guerrero SC, Panettieri RA, Rastogi D. Mechanistic Links Between Obesity and Airway Pathobiology Inform Therapies for Obesity-Related Asthma. Paediatr Drugs 2023; 25:283-299. [PMID: 36656428 PMCID: PMC11071627 DOI: 10.1007/s40272-022-00554-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/27/2022] [Indexed: 01/20/2023]
Abstract
Obesity-related asthma is associated with a high disease burden and a poor response to existent asthma therapies, suggesting that it is a distinct asthma phenotype. The proposed mechanisms that contribute to obesity-related asthma include the effects of the mechanical load of obesity, adipokine perturbations, and immune dysregulation. Each of these influences airway smooth muscle function. Mechanical fat load alters airway smooth muscle stretch affecting airway wall geometry, airway smooth muscle contractility, and agonist delivery; weight loss strategies, including medically induced weight loss, counter these effects. Among the metabolic disturbances, insulin resistance and free fatty acid receptor activation influence distinct signaling pathways in the airway smooth muscle downstream of both the M2 muscarinic receptor and the β2 adrenergic receptor, such as phospholipase C and the extracellular signal-regulated kinase signaling cascade. Medications that decrease insulin resistance and dyslipidemia are associated with a lower asthma disease burden. Leptin resistance is best understood to modulate muscarinic receptors via the neural pathways but there are no specific therapies for leptin resistance. From the immune perspective, monocytes and T helper cells are involved in systemic pro-inflammatory profiles driven by obesity, notably associated with elevated levels of interleukin-6. Clinical trials on tocilizumab, an anti-interleukin antibody, are ongoing for obesity-related asthma. This armamentarium of therapies is distinct from standard asthma medications, and once investigated for its efficacy and safety among children, will serve as a novel therapeutic intervention for pediatric obesity-related asthma. Irrespective of the directionality of the association between asthma and obesity, airway-specific mechanistic studies are needed to identify additional novel therapeutic targets for obesity-related asthma.
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Affiliation(s)
- Silvia Cabrera Guerrero
- Division of Pediatric Pulmonary and Sleep Medicine, Children's National Hospital, George Washington University, 111 Michigan Ave NW, Washington, DC, 20010, USA
| | - Reynold A Panettieri
- Rutgers Institute for Translational Medicine and Science, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Deepa Rastogi
- Division of Pediatric Pulmonary and Sleep Medicine, Children's National Hospital, George Washington University, 111 Michigan Ave NW, Washington, DC, 20010, USA.
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141
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Diver S, Green RH. Improving Outcomes in Difficult Asthma: Watch and Weight. Chest 2023; 163:999-1000. [PMID: 37164582 DOI: 10.1016/j.chest.2023.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 05/12/2023] Open
Affiliation(s)
- Sarah Diver
- Department of Respiratory Sciences, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Ruth H Green
- Department of Respiratory Sciences, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
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142
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Louis LM, Buckley JP, Kuiper JR, Meeker JD, Hansel NN, McCormack MC, Diette G, Quirós-Alcalá L. Exposures to Organophosphate Esters and Respiratory Morbidity among School-Aged Children with Asthma. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:6435-6443. [PMID: 37040548 DOI: 10.1021/acs.est.2c05911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Organophosphate esters (OPEs) are an emerging class of chemicals used in a variety of consumer products as flame retardants, plasticizers, and additives. While prior epidemiologic studies suggest that OPEs may impact respiratory health, results remain inconclusive. We examined associations between urinary biomarkers of OPEs and symptoms of respiratory morbidity in a panel study of 147 predominantly Black school-aged children with asthma living in Baltimore City, Maryland. The study consisted of up to four seasonal, week-long, in-home visits where urine samples and self-reported asthma symptoms were collected on days 4 and 7 (nsamples = 438). We quantified concentrations of nine urinary OPE biomarkers: bis(2-chloroethyl) phosphate (BCEtp), bis(1-chloro-2-propyl) phosphate (BCPP), bis(1,3-dichloro-2-propyl) phosphate (BDCIPP), di-n-butyl phosphate (DBuP), di-benzyl phosphate (DBzP), di-o-cresylphosphate (DOCP), di-p-cresylphosphate (DPCP), di-(2-propylheptyl) phthalate (DPHP), and 2,3,4,5-tetrabromo benzoic acid (TBBA). We estimated prevalence odds ratios (POR) of respiratory morbidity symptoms using logistic regression with generalized estimating equations to account for our repeated measure design. We assessed BDCIPP and DPHP as continuous (log2) concentrations and dichotomized exposure of BCEtP, DBuP, and DPCP (detect vs non-detect) based on their lower detection frequencies. We adjusted models for season, visit day, age, gender, caregiver education, health insurance type, exposure to household smoking, atopy, and PM2.5. Higher DPHP concentrations were significantly associated with odds of daytime symptoms (POR: 1.26; 95% CI: 1.04-1.53; p = 0.02) where daytime symptoms consisted of trouble breathing due to asthma, reporting bother caused by asthma, and/or limitation in activities due to asthma. DBuP detection was associated with use of rescue medication on the day of sample collection (POR: 2.36; 95% CI: 1.05-5.29; p = 0.04). We also observed several consistent, albeit non-significant (p > 0.05), positive associations for BCEtP and DPCP and respiratory morbidity measures. This is the first study to evaluate the relationship between OPE biomarkers and respiratory morbidity symptoms in children with asthma, and findings suggest that further studies are warranted to confirm whether these associations are causal.
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Affiliation(s)
- Lydia M Louis
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, United States
| | - Jessie P Buckley
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, United States
| | - Jordan R Kuiper
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, United States
| | - John D Meeker
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Nadia N Hansel
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, United States
- School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, United States
| | - Meredith C McCormack
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, United States
- School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, United States
| | - Gregory Diette
- School of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, United States
| | - Lesliam Quirós-Alcalá
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, United States
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143
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Li N, He F, Shang Y. Growth differentiation factor 15 protects the airway by inhibiting cell pyroptosis in obese asthmatic mice through the phosphoinositide 3-kinase/AKT pathway. Int Immunopharmacol 2023; 119:110149. [PMID: 37058747 DOI: 10.1016/j.intimp.2023.110149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/11/2023] [Accepted: 03/31/2023] [Indexed: 04/16/2023]
Abstract
Obese asthma is a form of refractory asthma with inflammation as the underlying mechanism. The specific mechanism of action of anti-inflammatory growth differentiation factor 15 (GDF15) in obese asthma is unclear. The purpose of this study was to explore the effect of GDF15 on cell pyroptosis in obese asthma and to determine its mechanism of airway protection. Male C57BL6/J mice were fed with a high-fat diet, sensitized, and challenged with ovalbumin. Recombinant human (rh)GDF15 was administered 1 h before the challenge. GDF15 treatment significantly reduced airway inflammatory cell infiltration, mucus hypersecretion and airway resistant, and decreased cell counts and inflammatory factors in bronchoalveolar lavage fluid. Serum inflammatory factors decreased, and the increased levels of NLR family pyrin domain containing 3 (NLRP3), caspase-1, apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), and gasdermin-D (GSDMD-N) in obese asthmatic mice were inhibited. Furthermore, the suppressed phosphoinositide 3-kinase (PI3K)/AKT signal pathway was activated after rhGDF15 treatment. The same result was obtained by overexpression of GDF15 in human bronchial epithelial cells induced by lipopolysaccharide (LPS) in vitro, and the effect of GDF15 was reversed after the application of a PI3K pathway inhibitor. Thus, GDF15 could protect the airway by inhibiting cell pyroptosis in obese asthmatic mice through the PI3K/AKT signaling pathway.
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Affiliation(s)
- Na Li
- Department of Pediatrics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China; Department of Pediatrics, The Second Hospital of Dalian Medical University, No. 467, Zhongshan Road, Shahekou District, Dalian 116021, Liaoning Province, China
| | - Fanghan He
- Department of Pediatrics, Xi'an Children's Hospital, No. 69, Xi Ju Yuan Xiang, Lianhu District, Xi'an 710002, Shanxi Province, China
| | - Yunxiao Shang
- Department of Pediatrics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China.
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144
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Dixon AE, Poynter ME, Garrow OJ, Kaminsky DA, Tharp WG, Bates JHT. Peripheral Airway Dysfunction in Obesity and Obese Asthma. Chest 2023; 163:753-762. [PMID: 36610669 PMCID: PMC10107055 DOI: 10.1016/j.chest.2022.12.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/30/2022] [Accepted: 12/20/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The purpose of this study was to investigate physiological phenotypes of asthma in obesity. RESEARCH QUESTION Do physiological responses during bronchoconstriction distinguish different groups of asthma in people with obesity, and also differentiate from responses simply related to obesity? STUDY DESIGN AND METHODS Cross-sectional study of people with obesity (31 with asthma and 22 without lung disease). Participants underwent methacholine challenge testing with measurement of spirometry and respiratory system impedance by oscillometry. RESULTS Participants had class III obesity (BMI, 46.7 ± 6.6 kg/m2 in control subjects and 47.2 ± 8.2 kg/m2 in people with asthma). Most participants had significant changes in peripheral airway impedance in response to methacholine: in control subjects, resistance at 5 Hz measured by oscillometry increased by 45% ± 27% and area under the reactance curve (AX) by 268% ± 236% in response to 16 mg/mL methacholine; in people with asthma, resistance at 5 Hz measured by oscillometry increased by 52% ± 38% and AX by 361% ± 295% in response to provocation concentration producing a 20% fall in FEV1 dose of methacholine. These responses suggest that obesity predisposes to peripheral airway reactivity. Two distinct groups of asthma emerged based on respiratory system impedance: one with lower reactance (baseline AX, 11.8; interquartile range, 9.9-23.4 cm H2O/L) and more concordant bronchoconstriction in central and peripheral airways; the other with high reactance (baseline AX, 46.7; interquartile range, 23.2-53.7 cm H2O/L) and discordant bronchoconstriction responses in central and peripheral airways. The high reactance asthma group included only women, and reported significantly more gastroesophageal reflux disease, worse chest tightness, more wheeze, and more asthma exacerbations than the low reactance group. INTERPRETATION Peripheral airway reactivity detected by oscillometry is common in obese control subjects and obese people with asthma. There is a subgroup of obese asthma characterized by significant peripheral airway dysfunction by oscillometry out of proportion to spirometric airway dysfunction. This peripheral dysfunction represents clinically significant respiratory disease not readily assessed by spirometry.
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Affiliation(s)
- Anne E Dixon
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT.
| | - Matthew E Poynter
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT
| | - Olivia Johnson Garrow
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT
| | - David A Kaminsky
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT
| | - W G Tharp
- Department of Anesthesiology, Larner College of Medicine, University of Vermont, Burlington, VT
| | - Jason H T Bates
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT
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145
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Kozik AJ, Begley LA, Lugogo N, Baptist A, Erb-Downward J, Opron K, Huang YJ. Airway microbiota and immune mediator relationships differ in obesity and asthma. J Allergy Clin Immunol 2023; 151:931-942. [PMID: 36572355 PMCID: PMC10566565 DOI: 10.1016/j.jaci.2022.11.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 11/09/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Asthma and obesity are both complex conditions characterized by chronic inflammation, and obesity-related severe asthma has been associated with differences in the microbiome. However, whether the airway microbiome and microbiota-immune response relationships differ between obese persons with or without nonsevere asthma is unestablished. OBJECTIVE We compared the airway microbiome and microbiota-immune mediator relationships between obese and nonobese subjects, with and without mild-moderate asthma. METHODS We performed cross-sectional analyses of the airway (induced sputum) microbiome and cytokine profiles from blood and sputum using 16S ribosomal RNA gene and internal transcribed spacer region sequencing to profile bacteria and fungi, and multiplex immunoassays. Analysis tools included QIIME 2, linear discriminant analysis effect size (aka LEfSe), Piphillin, and Sparse inverse covariance estimation for ecological association inference (aka SPIEC-EASI). RESULTS Obesity, irrespective of asthma status, was associated with significant differences in sputum bacterial community structure and composition (unweighted UniFrac permutational analysis of variance, P = .02), including a higher relative abundance of Prevotella, Gemella, and Streptococcus species. Among subjects with asthma, additional differences in sputum bacterial composition and fungal richness were identified between obese and nonobese individuals. Correlation network analyses demonstrated differences between obese and nonobese asthma in relationships between cytokine mediators, and these together with specific airway bacteria involving blood PAI-1, sputum IL-1β, GM-CSF, IL-8, TNF-α, and several Prevotella species. CONCLUSION Obesity itself is associated with an altered sputum microbiome, which further differs in those with mild-moderate asthma. The distinct differences in airway microbiota and immune marker relationships in obese asthma suggest potential involvement of airway microbes that may affect mechanisms or outcomes of obese asthma.
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Affiliation(s)
- Ariangela J Kozik
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ann Arbor, Mich.
| | - Lesa A Begley
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ann Arbor, Mich
| | - Njira Lugogo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ann Arbor, Mich
| | - Alan Baptist
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Ann Arbor, Mich
| | - John Erb-Downward
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ann Arbor, Mich
| | - Kristopher Opron
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ann Arbor, Mich
| | - Yvonne J Huang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ann Arbor, Mich; Department of Microbiology and Immunology, University of Michigan, Ann Arbor, Mich.
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146
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Job SA, Kaniuka AR, Reeves KM, Brooks BD. Interactions of Sexual Orientation and Gender Identity with Race/Ethnicity in Prevalence of Lifetime and Current Asthma Diagnosis. LGBT Health 2023. [PMID: 36946646 DOI: 10.1089/lgbt.2022.0186] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Purpose: The current study explored how sexual orientation and gender identity interact with race/ethnicity to predict self-reported lifetime and current diagnosis of asthma. Methods: Using the 2020 Behavioral Risk Factor Surveillance System survey, we conducted logistic regression analyses, weighted for complex samples, stratified by sexual orientation and gender identity, and controlling for race/ethnicity, age, smoking, population density, and body mass index. Results: Analyses showed that there were significantly higher adjusted odds of lifetime asthma among gay men and bisexual men in comparison to heterosexual men, gay/lesbian women and bisexual women in comparison to heterosexual women, and transgender men in comparison to cisgender individuals. In addition, analyses showed that there were significantly higher odds of current asthma among women with other minority sexual orientations in comparison to heterosexual women. Finally, there was a significant interaction between race/ethnicity and sexual orientation among men. Conclusions: Sexual minority men of color might be particularly vulnerable to chronic asthma. Future research should examine asthma prevalence in sexual and gender minority (SGM) individuals of specific marginalized racial/ethnic groups. Future responses to SGM asthma inequities should include low-cost screening and treatment targeting SGM individuals, and policies improving air quality in urban areas.
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Affiliation(s)
- Sarah A Job
- Department of Population Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Andréa R Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Karli M Reeves
- Department of Population Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Byron D Brooks
- Department of Psychology, Loyola University Chicago, Chicago, Illinois, USA
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147
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Hidden Comorbidities in Asthma: A Perspective for a Personalized Approach. J Clin Med 2023; 12:jcm12062294. [PMID: 36983294 PMCID: PMC10059265 DOI: 10.3390/jcm12062294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/05/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Bronchial asthma is the most frequent inflammatory non-communicable condition affecting the airways worldwide. It is commonly associated with concomitant conditions, which substantially contribute to its burden, whether they involve the lung or other districts. The present review aims at providing an overview of the recent acquisitions in terms of asthma concomitant systemic conditions, besides the commonly known respiratory comorbidities. The most recent research has highlighted a number of pathobiological interactions between asthma and other organs in the view of a shared immunological background underling different diseases. A bi-univocal relationship between asthma and common conditions, including cardiovascular, metabolic or neurodegenerative diseases, as well as rare disorders such as sickle cell disease, α1-Antitrypsin deficiency and immunologic conditions with hyper-eosinophilia, should be considered and explored, in terms of diagnostic work-up and long-term assessment of asthma patients. The relevance of that acquisition is of utmost importance in the management of asthma patients and paves the way to a new approach in the light of a personalized medicine perspective, besides targeted therapies.
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148
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Predictive and prognostic value of leptin status in asthma. NPJ Prim Care Respir Med 2023; 33:10. [PMID: 36914629 PMCID: PMC10011586 DOI: 10.1038/s41533-023-00332-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 02/13/2023] [Indexed: 03/16/2023] Open
Abstract
Asthma is closely associated with inflammation. We evaluated the predictive and prognostic value of leptin status in asthma. We searched the electronic databases for articles that determined the leptin level in asthma cases through May 2020. We compared the differences of leptin level between asthma and non-asthma controls, as well as between severe and mild asthma cases. We also investigated the impact of age and gender on these differences by using meta-regression analysis. 59 studies were included in our pooled analysis. Asthma cases demonstrated significantly higher leptin level than that in non-asthma controls among overall populations (SMD:1.061, 95% CI: 0.784-1.338, p < 10-4), Caucasians (SMD:0.287, 95% CI: 0.125-0.448, p = 0.001), Asians (SMD:1.500, 95% CI: 1.064-1.936, p < 10-4) and Africans (SMD: 8.386, 95% CI: 6.519-10.253, p < 10-4). Severe asthma cases showed markedly higher leptin level than that in mild asthma cases among overall populations (SMD:1.638, 95% CI: 0.952-2.323, p < 10-4) and Asians (SMD:2.600, 95% CI: 1.854-3.345, p < 10-4). No significant difference of leptin level between severe and mild asthma was observed in Caucasians (SMD:-0.819, 95% CI: -1.998-0.360, p = 0.173). Cumulative analyses yielded similar results regarding the difference of leptin status between asthma and non-asthma controls, as well as between severe and mild asthma cases among overall populations. Age and male/ female ratio were not associated with the difference of leptin status between asthma and non-asthma controls (coefficient:-0.031, 95% CI: -0.123-0.061, p = 0.495; coefficient:0.172, 95% CI: -2.445-2.789, p = 0.895), as well as between severe and mild asthma cases among overall populations (coefficient:-0.072, 95% CI: -0.208-0.063, p = 0.279; coefficient: 2.373, 95% CI: -0.414-5.161, p = 0.090). Asthma demonstrated significantly higher level of leptin than that in non-asthma controls among overall populations, Caucasians, Asians and Africans. Severe asthma cases showed markedly higher leptin level than that in mild cases among overall populations and Asians. Leptin may be a risk predictor and prognostic marker of asthma. Early monitoring and intervention of leptin may be needed for asthma.
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149
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Kim JG, Kang J, Lee JH, Koo HK. Association of rheumatoid arthritis with bronchial asthma and asthma-related comorbidities: A population-based national surveillance study. Front Med (Lausanne) 2023; 10:1006290. [PMID: 36968830 PMCID: PMC10036351 DOI: 10.3389/fmed.2023.1006290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
BackgroundThe aim of this study was to investigate the impact of rheumatoid arthritis (RA) on the prevalence of bronchial asthma and asthma-related comorbidities. We also aimed to identify the influence of RA on interrelationship between asthma and asthma-related comorbidities.MethodsFrom the Korean National Health and Nutrition Examination Survey, participants >40 years of age who completed questionnaires and spirometry tests were enrolled. Patient data on RA, asthma, allergic rhinitis, atopic dermatitis, chronic obstructive pulmonary disease (COPD), sinusitis, otitis media, and body mass index (BMI) were collected. Logistic regression and network analyses were performed.ResultsA total of 14,272 subjects were enrolled, among which, 334 (2.4%) had RA. RA was significantly associated with asthma (OR 2.32; 95% CI 1.51–3.57), allergic rhinitis (OR 1.51; 95% CI 1.08–2.10), and sinusitis (OR 1.64; 95% CI 1.08–2.50). The network analysis of total patients revealed a positive interrelationship between asthma and allergic rhinitis, sinusitis, otitis media, atopic dermatitis, BMI, and RA. The interrelationship between asthma and sinusitis was stronger in the RA group. Of note, the relationship between asthma and BMI was distinctively found only in the RA group (r = 0.214, P < 0.05). In patients with asthma, the prevalence of obesity was 64% in the presence of RA, and 40% in the absence of RA (P = 0.034).ConclusionThis study supports the positive association of RA with asthma, allergic rhinitis, and sinusitis. Our analysis suggests a notable interrelationship between the presence of asthma and higher BMI values in patients with RA, indicating that asthma is more obesity-related in patients with RA.
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Affiliation(s)
- Jung Gon Kim
- Division of Rheumatology, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang-si, Republic of Korea
| | - Jiyeon Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang-si, Republic of Korea
| | - Joo-Hyun Lee
- Division of Rheumatology, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang-si, Republic of Korea
| | - Hyeon-Kyoung Koo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang-si, Republic of Korea
- *Correspondence: Hyeon-Kyoung Koo,
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Björkander S, Klevebro S, Hernandez‐Pacheco N, Kere M, Ekström S, Sparreman Mikus M, van Hage M, James A, Kull I, Bergström A, Mjösberg J, Tibbitt CA, Melén E. Obese asthma phenotypes display distinct plasma biomarker profiles. Clin Transl Allergy 2023; 13:e12238. [PMID: 36973952 PMCID: PMC10032201 DOI: 10.1002/clt2.12238] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/06/2023] [Accepted: 03/13/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Obese asthma is a complex phenotype and further characterization of the pathophysiology is needed. This study aimed to explore inflammation-related plasma biomarkers in lean and overweight/obese asthmatics. METHODS We elucidated levels of inflammation-related plasma proteins in obese asthma phenotypes in the population-based cohort BAMSE (Swedish: Children, Allergy, Milieu, Stockholm, Epidemiology) using data from 2069 24-26-year-olds. Subjects were divided into lean asthma (n = 166), lean controls (n = 1440), overweight/obese asthma (n = 73) and overweight/obese controls (n = 390). Protein levels (n = 92) were analysed using the Olink Proseek Multiplex Inflammation panel. RESULTS Of the 92 included proteins, 41 were associated with lean and/or overweight/obese asthma. The majority of proteins associated with overweight/obese asthma also associated with overweight/obesity among non-asthmatics. Beta-nerve growth factor (BetaNGF), interleukin 10 (IL-10), and matrix metalloproteinase 10 (MMP10) were associated only with lean asthma while C-C motif chemokine 20 (CCL20), fibroblast growth factor 19 (FGF19), interleukin 5 (IL-5), leukemia inhibitory factor (LIF), tumor necrosis factor ligand superfamily member 9 (TNFRSF9), and urokinase-type plasminogen activator (uPA) were associated only with overweight/obese asthma. Overweight/obesity modified the association between asthma and 3 of the proteins: fibroblast growth factor 21 (FGF21), interleukin 4 (IL-4), and urokinase-type plasminogen activator (uPA). In the overweight/obese group, interleukin-6 (IL-6) was associated with non-allergic asthma but not allergic asthma. CONCLUSION These data indicate distinct plasma protein phenotypes in lean and overweight/obese asthmatics which, in turn, can impact upon therapeutic approaches.
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Grants
- Region Stockholm, ALF project, Clinical postdoctoral appointment (SK), and database maintenance
- Hjärt-Lungfonden
- European Academy of Allergy and Clinical Immunology, Medium-Term Research Fellowship (NHP)
- Thermo Fisher Scientific, reagents for the allergen-specific IgE analyses
- Insamlingsstiftelsen Cancer- och Allergifonden
- 757919 H2020 European Research Council
- LTRF202101-00861 European Respiratory Society (NHP)
- 2016-01646 Svenska Forskningsrådet Formas
- 2017-00526 Forskningsrådet om Hälsa, Arbetsliv och Välfärd
- 2016-03086 Vetenskapsrådet
- 2018-02524 Vetenskapsrådet
- 2019-01060 Vetenskapsrådet
- 2020-02170 Vetenskapsrådet
- Astma- och Allergiförbundet
- Region Stockholm, ALF project, Clinical postdoctoral appointment (SK), and database maintenance
- Hjärt‐Lungfonden
- European Academy of Allergy and Clinical Immunology, Medium‐Term Research Fellowship (NHP)
- Thermo Fisher Scientific, reagents for the allergen‐specific IgE analyses
- Insamlingsstiftelsen Cancer‐ och Allergifonden
- H2020 European Research Council
- European Respiratory Society (NHP)
- Svenska Forskningsrådet Formas
- Forskningsrådet om Hälsa, Arbetsliv och Välfärd
- Vetenskapsrådet
- Astma‐ och Allergiförbundet
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Affiliation(s)
- Sophia Björkander
- Department of Clinical Science and EducationSödersjukhusetKarolinska InstitutetStockholmSweden
| | - Susanna Klevebro
- Department of Clinical Science and EducationSödersjukhusetKarolinska InstitutetStockholmSweden
- Sachs' Children and Youth HospitalSödersjukhusetStockholmSweden
| | - Natalia Hernandez‐Pacheco
- Department of Clinical Science and EducationSödersjukhusetKarolinska InstitutetStockholmSweden
- CIBER de Enfermedades Respiratorias (CIBERES)MadridSpain
| | - Maura Kere
- Department of Clinical Science and EducationSödersjukhusetKarolinska InstitutetStockholmSweden
| | - Sandra Ekström
- Institute of Environmental MedicineKarolinska InstitutetStockholmSweden
- Centre for Occupational and Environmental Medicine, Region StockholmStockholmSweden
| | | | - Marianne van Hage
- Department of Medicine, SolnaDivision of Immunology and AllergyKarolinska Institutet and Karolinska University HospitalStockholmSweden
| | - Anna James
- Institute of Environmental MedicineKarolinska InstitutetStockholmSweden
| | - Inger Kull
- Department of Clinical Science and EducationSödersjukhusetKarolinska InstitutetStockholmSweden
- Sachs' Children and Youth HospitalSödersjukhusetStockholmSweden
| | - Anna Bergström
- Institute of Environmental MedicineKarolinska InstitutetStockholmSweden
- Centre for Occupational and Environmental Medicine, Region StockholmStockholmSweden
| | - Jenny Mjösberg
- Department of Medicine HuddingeCentre for Infectious MedicineKarolinska InstitutetStockholmSweden
| | | | - Erik Melén
- Department of Clinical Science and EducationSödersjukhusetKarolinska InstitutetStockholmSweden
- Sachs' Children and Youth HospitalSödersjukhusetStockholmSweden
- Institute of Environmental MedicineKarolinska InstitutetStockholmSweden
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