Airway Remodeling in Asthma: Mechanisms, Diagnosis, Treatment, and Future Directions

Questionnaire for Clinical Diagnosis of House Dust Mite's Allergy Approved by Delphi Consensus

Despite house dust mite (HDM)-allergy is the most frequent in the world, no standard questionnaire exists to help physicians in their clinical practice for screening patients with this possible diagnosis. The objective of this survey was to develop a questionnaire that could be used to identify patients with suspicion of HDM-allergy. The survey was conducted using the Delphi methodology. Nineteen international experts in allergology constituted the scientific board who established the items included in the first version of the questionnaire, defined the criteria of the selection for the next steps, and validated the final questionnaire and its interpretation. The initial version of the questionnaire included 15 items. For each item, five answers were suggested graduated by scores from "no importance" to "very high importance." The predefined conditions for the item selection after each round were a median score ≥ 7 and > 50% of responses according "high importance" and "very high importance." The electronic survey circulated within the Interasma Scientific Network platform. Eight questions based on the occurrence/worsening of symptoms induced by HDM-allergen exposure meet the survey criteria after the second and the third rounds and were included in the final questionnaire. Binomial answers for each question with 1 point accorded for "Yes" and none for "No" were suggested for the final version with a score ≥ 5 points associated with a high probability for HDM-allergy. By applying the Delphi process, we generated a brief questionnaire with binomial answers, easy to use in clinical practice for screening patients with HDM-allergy.

Correlation of neutrophil percentage-to-albumin ratio with lung function in American adults: a population study

BACKGROUND

Chronic respiratory diseases pose a significant threat to global health, underscoring the urgent need for effective preventative and therapeutic interventions. The neutrophil-to-albumin ratio (NPAR), an emerging biomarker for inflammation and nutritional status, has shown promising associations with respiratory health, necessitating an investigation into its potential for predicting lung function decline.

OBJECTIVE

This study aimed to delineate the relationship between the NPAR and pulmonary function within a sample of the American adult population and assess the viability of the NPAR as a prognostic indicator for compromised lung function.

METHODS

With data available from the National Health and Nutrition Examination Survey (NHANES) for the years 2007 to 2012, 10,055 American adults who met the exclusion criteria were included in the current study. Multivariate linear regression, smoothed curve fitting, and subgroup analyses were applied to evaluate the associations observed between the NPAR and lung function indicators.

RESULTS

Even after accounting for all potential confounding factors, a significant inverse relationship persisted between the NPAR and key lung function indicators, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow rate (PEF). This association remained robust even after potential confounding factors were considered. Subgroup analysis revealed that the negative correlation was more pronounced in certain demographic groups, such as young individuals, males, and current smokers. The study also revealed an "N-shaped" relationship between the NPAR and fractional exhaled nitric oxide (FENO), suggesting that the NPAR may play a role in promoting airway inflammation.

CONCLUSIONS

A significant correlation between the NPAR and the decline in lung function among American adults was revealed in this research, emphasizing the potential clinical relevance of the NPAR as a respiratory health biomarker, as well as the importance of considering systemic inflammation in the management and prevention of respiratory disorders.