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Lima PHB, Goncalves CV, Ribeiro IS, Galantini MPL, Muniz IPR, Santos GS, Silva RAADA. Diabetes and hypertension in elderly women: interactions between severity and failure to control inflammation. AN ACAD BRAS CIENC 2024; 96:e20230844. [PMID: 38922257 DOI: 10.1590/0001-3765202420230844] [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: 09/16/2023] [Accepted: 04/04/2024] [Indexed: 06/27/2024] Open
Abstract
Elderly women are more susceptible to the development of chronic non-communicable diseases. Among these, diabetes mellitus (DM) and systemic arterial hypertension (SAH) stand out. This work aimed to carry out an expanded study on the interactions of anthropometric, biochemical and inflammatory parameters associated with the risk of severity in elderly women with hypertension and diabetes. The study involved the evaluation of 126 elderly women with hypertension and diabetes mellitus. The women were divided according disease severity (low, moderate, high and very high). Anthropometric data were collected by bioimpedance analysis. The inflammatory and biochemical data were obtained from volunteer blood samples. Waist circumference, waist circumference/height ratio, and systolic and diastolic pressures increased with severity. Biochemical marker levels increased with risk of severity, except HDLc. In the very high risk group, there was a higher IL-1β, IFN-γ and TNF-α production, however, lower IL-10 levels were observed. The very high risk group showed change values for the IL-10/IL-1β, IL-10/IL-17 and IL-10/TNF-α ratios. The results showed to be extensively altered in the very high risk group, where the inflammatory profile loses its responsiveness. This is the first study that shows an expanded view of the different parameters evaluated in elderly women with hypertension and diabetes.
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Affiliation(s)
- Paulo Henrique B Lima
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua Rio de Contas, 58, Bloco 17, Lote 58, Candeias, 45029-094 Vitória da Conquista, BA, Brazil
| | - Caroline V Goncalves
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua Rio de Contas, 58, Bloco 17, Lote 58, Candeias, 45029-094 Vitória da Conquista, BA, Brazil
| | - Israel S Ribeiro
- Universidade Federal do Sul da Bahia, Centro de Formação em Ciências da Saúde, Praça Joana Angélica, 58, São José, 45988-058 Teixeira de Freitas, BA, Brazil
| | - Maria Poliana L Galantini
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua Rio de Contas, 58, Bloco 17, Lote 58, Candeias, 45029-094 Vitória da Conquista, BA, Brazil
| | - Igor P R Muniz
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua Rio de Contas, 58, Bloco 17, Lote 58, Candeias, 45029-094 Vitória da Conquista, BA, Brazil
- Universidade Estadual do Sudoeste da Bahia/UESB, Departamento de Ciências da Saúde, Campus Vitória da Conquista, Estr. Bem Querer, Km 04, 45031-300 Vitória da Conquista, BA, Brazil
| | - Gilvanéia S Santos
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua Rio de Contas, 58, Bloco 17, Lote 58, Candeias, 45029-094 Vitória da Conquista, BA, Brazil
| | - Robson A A DA Silva
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua Rio de Contas, 58, Bloco 17, Lote 58, Candeias, 45029-094 Vitória da Conquista, BA, Brazil
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Oliveira NCD, Balikian Júnior P, Júnior ATDC, Bento EDS, Tonholo J, Aquino T, Sousa FADB, Araujo GGD, Ferreira ML. Environmental Planning and Non-Communicable Diseases: A Systematic Review on the Role of the Metabolomic Profile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6433. [PMID: 37510665 PMCID: PMC10380082 DOI: 10.3390/ijerph20146433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023]
Abstract
Non-communicable diseases (NCDs) are the major cause of death worldwide and have economic, psychological, and social impacts. Air pollution is the second, contributing to NCDs-related deaths. Metabolomics are a useful diagnostic and prognostic tool for NCDs, as they allow the identification of biomarkers linked to emerging pathologic processes. The aim of the present study was to review the scientific literature on the application of metabolomics profiling in NCDs and to discuss environmental planning actions to assist healthcare systems and public managers based on early metabolic diagnosis. The search was conducted following PRISMA guidelines using Web of Science, Scopus, and PubMed databases with the following MeSH terms: "metabolomics" AND "noncommunicable diseases" AND "air pollution". Twenty-nine studies were eligible. Eleven involved NCDs prevention, eight addressed diabetes mellitus, insulin resistance, systemic arterial hypertension, or metabolic syndrome. Six studies focused on obesity, two evaluated nonalcoholic fatty liver disease, two studied cancer, and none addressed chronic respiratory diseases. The studies provided insights into the biological pathways associated with NCDs. Understanding the cost of delivering care where there will be a critical increase in NCDs prevalence is crucial to achieving universal health coverage and improving population health by allocating environmental planning and treatment resources.
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Affiliation(s)
| | - Pedro Balikian Júnior
- Institute of Physical Education and Sport (IEFE), Federal University of Alagoas, Campus AC Simões, Maceió 57072-900, AL, Brazil
| | - Arnaldo Tenório da Cunha Júnior
- Kineanthropometry, Physical Activity and Health Promotion Laboratory (LACAPS), Physical Education Department, Federal University of Alagoas, Campus Arapiraca, Arapiraca 57309-005, AL, Brazil
| | - Edson de Souza Bento
- Institute of Chemistry and Biotechnology (IQB), Federal University of Alagoas, Campus AC Simões, Maceió 57072-900, AL, Brazil
| | - Josealdo Tonholo
- Institute of Chemistry and Biotechnology (IQB), Federal University of Alagoas, Campus AC Simões, Maceió 57072-900, AL, Brazil
| | - Thiago Aquino
- Institute of Chemistry and Biotechnology (IQB), Federal University of Alagoas, Campus AC Simões, Maceió 57072-900, AL, Brazil
| | - Filipe Antonio de Barros Sousa
- Institute of Physical Education and Sport (IEFE), Federal University of Alagoas, Campus AC Simões, Maceió 57072-900, AL, Brazil
| | - Gustavo Gomes de Araujo
- Institute of Physical Education and Sport (IEFE), Federal University of Alagoas, Campus AC Simões, Maceió 57072-900, AL, Brazil
| | - Maurício Lamano Ferreira
- Department of Geoenvironmental Analysis, Guarulhos University, Central Campus, Guarulhos 07023-070, SP, Brazil
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Elgormus Y. Biomarkers and their Clinical Applications in Pediatrics. Biomark Med 2022. [DOI: 10.2174/9789815040463122010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Biomarker studies are becoming increasingly interesting for many fields of
medicine. The use of biomarkers in medicine is involved in detecting diseases and
supporting diagnosis and treatment decisions. New research and new discoveries on the
molecular basis of the disease show that there may be a number of promising new
biomarkers for use in daily clinical practice. Clinical trials in children lag behind adult
research both in quality and quantity. The number of biomarkers validated to optimize
pediatric patient management is limited. In the pathogenesis of many diseases, it should
not be extrapolated to the pediatric clinical setting, taking into account that biomarkers
that are effective in adults are clearly different in children and that ontogeny directly
affects disease development and therapeutic response in children. The search for ideal
biomarkers or markers that can make an early and definitive diagnosis in neonatal
sepsis is still ongoing. The ideal biomarker for pediatric diseases should be costeffective,
noninvasive, applicable to pediatric specific diseases, and its results should
correspond to age-related physiological changes. Lactate, troponin and B-type
natriuretic peptide are valuable biomarkers in the evaluation and management of
critically ill children with cardiac disease. Tumor markers in children are biochemical
substances used in the clinical treatment of pediatric tumors and to detect the presence
of cancer (regression or progression). In this chapter, current and brief information
about biomarkers and their clinical applications used in the diagnosis and monitoring of
pediatric diseases is presented.;
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Affiliation(s)
- Yusuf Elgormus
- Medicine Hospital,Department of Pediatric Health and Diseases,Department of Pediatric Health and Diseases, Medicine Hospital, Istanbul, Turkey,Istanbul,Turkey
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Fritzsche MC, Buyx AM, Hangel N. Mapping ethical and social aspects of biomarker research and its application in atopic dermatitis and psoriasis - A systematic review of reason. J Eur Acad Dermatol Venereol 2022; 36:1201-1213. [PMID: 35366351 DOI: 10.1111/jdv.18128] [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: 08/09/2021] [Accepted: 03/15/2022] [Indexed: 11/27/2022]
Abstract
Biomarker research is associated with high hopes for atopic dermatitis/psoriasis research. Although various effective treatments have been developed, many challenges remain concerning diagnostics and the development of targeted treatments, but also regarding a number of ethical and social issues. In this paper, building on a systematic literature review and review of reason, we examine the ethical and social debate on biomarker research for atopic dermatitis/psoriasis. We discuss topics such as risks and benefits of stratification of patient groups, ethical aspects of big data and advanced analytics for biomarker use in atopic dermatitis/psoriasis. Our systematic literature review of reason, based on established methodological standards, includes argument-based ethics publications and scientific literature with implicitly ethically relevant aspects. The first search of biomarker research in dermatology and adjacent fields (e.g., oncology) resulted in a large amount of literature concerning general normative aspects of biomarker research, but suggested a lack of explicit argument-based ethical literature in atopic dermatitis/psoriasis research. We therefore conducted a second systematic search, focusing specifically on atopic dermatitis/psoriasis biomarker research. The 43 relevant articles identified through both systematic searches were clustered into three topic groups: (1) ethical aspects of stratification and precision medicine, (2) digital ethics, and (3) research ethics with a focus on complexity and validation. We found that compared to other fields, such as cancer research, the ethical aspects of atopic dermatitis/psoriasis are rarely explained and addressed in detail. In particular, more work is required on scientific standards, digital ethics and responsible clinical application of biomarkers for atopic dermatitis/psoriasis, patient participation, and ethical implications of biomarker use for children or young people with atopic dermatitis/psoriasis. We close with suggestions on how to address the ethical and social dimension of atopic dermatitis/psoriasis research and practice more directly in future.
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Affiliation(s)
- M-Ch Fritzsche
- Institute for History and Ethics in Medicine, Technical University of Munich, Munich, Germany
| | - A M Buyx
- Institute for History and Ethics in Medicine, Technical University of Munich, Munich, Germany
| | - N Hangel
- Institute for History and Ethics in Medicine, Technical University of Munich, Munich, Germany
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Su KW, Chiu CY, Tsai MH, Liao SL, Chen LC, Hua MC, Yao TC, Huang JL, Yeh KW. Cord blood soluble Fas ligand linked to allergic rhinitis and lung function in seven-year-old children. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2021; 55:300-306. [PMID: 33879403 DOI: 10.1016/j.jmii.2021.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/01/2021] [Accepted: 03/19/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Serum or cord blood soluble Fas ligand (FasL) has been related to asthma, allergic rhinitis, and atopic dermatitis in cross-sectional and short-term follow-up studies. However, the association of cord blood soluble FasL with long-term allergic outcomes has seldom been investigated. METHODS The Prediction of Allergies in Taiwanese Children birth cohort study recruited healthy newborns upon delivery. At birth, blood was collected from the umbilical cords of these children, and the cord blood soluble Fas ligand levels were measured. At the age of seven years, the allergic outcome of each child was diagnosed by pediatric allergists and pulmonologists. Tests were conducted to measure the specific immunoglobulin E, fractional exhaled nitric oxide (FeNO), and pulmonary function levels of each child. RESULTS Cord blood soluble FasL levels were higher in seven-year-old children with allergic rhinitis (Odds ratio [OR] = 2.41, p = 0.012) and expiratory airway obstruction (the highest forced expiratory volume in 1 second/forced vital capacity < 90%, OR = 2.11, p = 0.022). The FeNO and Dermatophagoides pteronyssinus-specific immunoglobulin E levels of seven-year-old children were positively correlated with cord blood soluble FasL levels (p = 0.006 and 0.02, respectively). CONCLUSION In this birth cohort, the cord blood soluble FasL levels were associated with allergic rhinitis, obstructive-type lung function, FeNO, and house dust mite sensitization in 7-year-old children. The cord blood soluble FasL level might be used as a predictor for allergic diseases in children who are 7 years old.
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Affiliation(s)
- Kuan-Wen Su
- Department of Pediatrics, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Graduate Institute of Clinical Medical Science, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Yung Chiu
- Department of Pediatrics, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Division of Pediatric Pulmonology, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Han Tsai
- Department of Pediatrics, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Sui-Lin Liao
- Department of Pediatrics, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Li-Chen Chen
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Department of Pediatrics, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, Taiwan
| | - Man-Chin Hua
- Department of Pediatrics, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Tsung-Chieh Yao
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jing-Long Huang
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Department of Pediatrics, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, Taiwan
| | - Kuo-Wei Yeh
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Abstract
PURPOSE OF REVIEW Pediatric obese asthma is a complex disease that remains poorly understood. The increasing worldwide incidence of both asthma and obesity over the last few decades, their current high prevalence and the challenges in treating obese asthmatic patients all highlight the importance of a better understanding of the pathophysiological mechanisms in obese asthma. While it is well established that patients with obesity are at an increased risk of developing asthma, the mechanisms by which obesity drives the onset of asthma, and modifies existing asthma, remain unclear. Here, we will focus on mechanisms by which obesity alters immune function in asthma. RECENT FINDINGS Lung parenchyma has an altered structure in some pediatric obese asthmatics, known as dysanapsis. Central adiposity is linked to reduced pulmonary function and a better predictor of asthma risk in children than BMI. Obesity in young children is associated with an increased risk of developing asthma, as well as early puberty, and hormonal alterations are implicated in obese asthma. Obesity and asthma each yield immunometabolic dysregulation separately and we are learning more about alterations in these pathways in pediatric obese asthma and the potential impact of bariatric surgery on those processes. SUMMARY The recent progress in clarifying the connections between childhood obesity and asthma and their combined impacts on immune function moves us closer to the goals of improved understanding of the pathophysiological mechanisms underpinning obese asthma and improved therapeutic target selection. However, this common inflammatory disease remains understudied, especially in children, and much remains to be learned.
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Affiliation(s)
- Ceire Hay
- Children’s Hospital of Philadelphia, Department of Pediatrics, Division of Allergy Immunology, Philadelphia, PA
| | - Sarah E. Henrickson
- Children’s Hospital of Philadelphia, Department of Pediatrics, Division of Allergy Immunology, Philadelphia, PA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Rani R, Singh V. Overexpression of YKL-40 (CHI3L1 gene) in patient fluids may be a potential predictive marker for early detection of comorbidity in non-communicable disease. Med Hypotheses 2020; 143:110076. [PMID: 32721792 DOI: 10.1016/j.mehy.2020.110076] [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: 06/04/2020] [Revised: 07/01/2020] [Accepted: 07/02/2020] [Indexed: 10/23/2022]
Abstract
Predictive biomarkers which can diagnose the onset of non-communicable diseases and the associated comorbid conditions are lacking for clinical utility. Highly sensitive and specific biomarkers for early disease detection and risk stratification may provide timely intervention to patients and prevent secondary complications. However, till the time patients are diagnosed, cellular events and biomolecules get active effecting multiple organs at the same time. This series of events lead to disruption in normal functioning of the organs and their coordinative crosstalk, hence, increase in mortality rate of patients. The primary functional molecules of inflammatory pathways are active in NCDs. YKL-40, an anti-apoptotic molecule in inflammatory pathways, is overexpressed in patient fluids in different organs under diseased conditions. We performed a preliminary network analysis to study YKL-40 co-expression with diagnostic markers: TNNT2/I3 (Cardiac Troponin T/I) for cardiovascular diseases, LCN2 (NGAL) and CKM (Creatinine kinase M-type) in acute kidney injury and HbA1c in type-2-diabetes. It is observed that YKL-40 is actively co-expressed and linked with standard diagnostic markers and may be influencing the pathways active in organ crosstalk. The pathways may be regulating the signaling events in patients with non-communicable diseases leading to comorbidities. We, hence, postulate that if YKL-40 and disease specific pathways influenced are clinically utilized, this will provide the foundation of establishing tailored and specific approach in diagnosis and monitoring non-communicable diseases and predict the onset of comorbid conditions due to phenomenon influencing organ cross talks.
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Affiliation(s)
- Raj Rani
- Centre for Life Sciences, Chitkara School of Health Sciences, Chitkara University, Punjab, India
| | - Varsha Singh
- Centre for Life Sciences, Chitkara School of Health Sciences, Chitkara University, Punjab, India.
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Wu YJ, Li YS, Tseng WL, Lu CY. Microextraction combined with microderivatization for drug monitoring and protein modification analysis from limited blood volume using mass spectrometry. Anal Bioanal Chem 2018; 410:7405-7414. [PMID: 30191273 DOI: 10.1007/s00216-018-1349-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 08/18/2018] [Accepted: 08/28/2018] [Indexed: 12/15/2022]
Abstract
In the clinic, ethosuximide is commonly used to treat generalized absence seizures but has recently been repurposed for other diseases. Because of adverse effects and drug interactions, high-throughput therapeutic drug monitoring of ethosuximide is necessary. Microextraction is a simple, effective, rapid, and low consumption of organic solvents method for sample preparation. In this study, microderivatization-increased detection (MDID)-combined microextraction was used to detect ethosuximide by mass spectrometry. Ethosuximide is a difficult to retain and ionize compound in the C18 nano-flow column and ionization interface, respectively. Hence, we developed a fast method for detecting ethosuximide in human plasma by using the MDID strategy (within 2 min). Chemical microderivatization parameters were studied and optimized to increase the sensitivity of ethosuximide detection at trace levels. The linear range for the analysis of ethosuximide in 10 μL plasma was 5-500 μg/mL with a coefficient of determination (r2) ≥ 0.995. The precision and accuracy of intraday and interday analyses of ethosuximide were below 13.0%. Furthermore, modifications of major proteins in plasma and blood cells, induced by ethosuximide, were identified. The proposed method effectively utilizes microliter samples to detect drug plasma concentrations under suitable microextraction procedures toward the eco-friendly goal of low consumption of organic solvents. Graphical abstract ᅟ.
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Affiliation(s)
- Ying-Jung Wu
- Department of Biochemistry, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan
| | - Yi-Shan Li
- Department of Biochemistry, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan
| | - Wei-Lung Tseng
- Department of Chemistry, College of Science, National Sun Yat-sen University, Kaohsiung, 80424, Taiwan
| | - Chi-Yu Lu
- Department of Biochemistry, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, 80424, Taiwan.
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan.
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Babinská K, Tomova A, Celušáková H, Babková J, Repiská G, Kubranská A, Filčíková D, Siklenková L, Ostatníková D. Fecal calprotectin levels correlate with main domains of the autism diagnostic interview-revised (ADI-R) in a sample of individuals with autism spectrum disorders from Slovakia. Physiol Res 2018; 66:S517-S522. [PMID: 29355379 DOI: 10.33549/physiolres.933801] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Autism spectrum disorders (ASD) are neurodevelopmental disorders characterized by impaired social interaction and communication, as well as repetitive behavior and restricted interests. There is convincing evidence that the intestinal inflammation is involved in etiology of ASD. Increased levels of inflammatory markers were shown to be associated with more aberrant behaviors and communication of subjects with ASD. Calprotectin in the feces is produced by activated neutrophils and epithelial cells of the gut mucosa, and its levels reflect local inflammation of the gastrointestinal tract. Concentration of fecal calprotectin was determined by ELISA method in 87 individuals with ASD and 51 controls, of that 29 siblings of children with ASD and 22 non-related controls. In non-relatives significantly lower values of fecal calprotectin were observed than in both subjects with ASD and their siblings. In the group with ASD significant correlations of fecal calprotectin with all domains of the ADI-R diagnostic tool were found: qualitative abnormalities in reciprocal social interaction and communication, restrictive and repetitive patterns of behavior. Results suggest that low grade intestinal inflammation may be one of factors implicated in the pathophysiology of ASD.
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Affiliation(s)
- K Babinská
- Institute of Physiology, Comenius University Faculty of Medicine, Bratislava, Slovak Republic.
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Akdis CA, Ballas ZK. Precision medicine and precision health: Building blocks to foster a revolutionary health care model. J Allergy Clin Immunol 2018; 137:1359-61. [PMID: 27155031 DOI: 10.1016/j.jaci.2016.03.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 03/28/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.
| | - Zuhair K Ballas
- Internal Medicine, University of Iowa, and Iowa City VA Medical Center, Iowa City, Iowa
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van Bragt JJMH, Vijverberg SJH, Weersink EJM, Richards LB, Neerincx AH, Sterk PJ, Bel EHD, Maitland-van der Zee AH. Blood biomarkers in chronic airways diseases and their role in diagnosis and management. Expert Rev Respir Med 2018; 12:361-374. [PMID: 29575948 DOI: 10.1080/17476348.2018.1457440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The complexity and heterogeneous nature of asthma and chronic obstructive pulmonary disease (COPD) results in difficulties in diagnosing and treating patients. Biomarkers that can identify underlying mechanisms, identify patient phenotypes and to predict treatment response could be of great value for adequate treatment. Areas covered: Biomarkers play an important role for the development of novel targeted therapies in airways disease. Blood biomarkers are relatively non-invasive, easy to obtain and easy to apply in routine care. Several blood biomarkers are being used to diagnose and monitor chronic airways diseases, as well as to predict response to treatment and long-term prognosis. Blood eosinophils are the best studied biomarker, the most applied in clinical practice, and until now the most promising of all blood biomarkers. Other blood biomarkers, including serum periostin, IgE and ECP and plasma fibrinogen are less studied and less relevant in clinical practice. Recent developments include the use of antibody assays of many different cytokines at the same time, and 'omics' techniques and systems medicine. Expert commentary: With the exception of blood eosinophils, the use of blood biomarkers in asthma and COPD has been rather disappointing. Future research using new technologies like big-data analysis of blood samples from real-life patient cohorts will probably gain better insight into underlying mechanisms of different disease phenotypes. Identification of specific molecular pathways and associated biomarkers will then allow the development of new targets for precision medicine.
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Affiliation(s)
- Job J M H van Bragt
- a Department of Respiratory Medicine, Academic Medical Center (AMC) , University of Amsterdam , Amsterdam , the Netherlands
| | - Susanne J H Vijverberg
- a Department of Respiratory Medicine, Academic Medical Center (AMC) , University of Amsterdam , Amsterdam , the Netherlands
| | - Els J M Weersink
- a Department of Respiratory Medicine, Academic Medical Center (AMC) , University of Amsterdam , Amsterdam , the Netherlands
| | - Levi B Richards
- a Department of Respiratory Medicine, Academic Medical Center (AMC) , University of Amsterdam , Amsterdam , the Netherlands
| | - Anne H Neerincx
- a Department of Respiratory Medicine, Academic Medical Center (AMC) , University of Amsterdam , Amsterdam , the Netherlands
| | - Peter J Sterk
- a Department of Respiratory Medicine, Academic Medical Center (AMC) , University of Amsterdam , Amsterdam , the Netherlands
| | - Elisabeth H D Bel
- a Department of Respiratory Medicine, Academic Medical Center (AMC) , University of Amsterdam , Amsterdam , the Netherlands
| | - Anke H Maitland-van der Zee
- a Department of Respiratory Medicine, Academic Medical Center (AMC) , University of Amsterdam , Amsterdam , the Netherlands
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Shores DR, Everett AD. Children as Biomarker Orphans: Progress in the Field of Pediatric Biomarkers. J Pediatr 2018; 193:14-20.e31. [PMID: 29031860 PMCID: PMC5794519 DOI: 10.1016/j.jpeds.2017.08.077] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/04/2017] [Accepted: 08/30/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Darla R Shores
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.
| | - Allen D Everett
- Division of Cardiology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
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Immune monitoring for precision medicine in allergy and asthma. Curr Opin Immunol 2017; 48:82-91. [PMID: 28889067 DOI: 10.1016/j.coi.2017.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/01/2017] [Accepted: 08/16/2017] [Indexed: 11/22/2022]
Abstract
'Precision Medicine' embodies the analyses of extensive data collected from patients and their environments to identify and apply patient-specific prophylactic strategies and medical treatments to improve clinical outcomes and healthcare cost-effectiveness. Many new methods have been developed for evaluating the activity of the human immune system. Such 'immune monitoring' approaches are now being used in studies of allergy and asthma in the hope of identifying better correlates of disease status, predictors of therapeutic outcomes, and potential side-effects of treatment. Together with analyses of family histories, genetic and other biometric data, and measurements of exposures to environmental and other risk factors for developing or exacerbating disease, immune monitoring approaches promise to enable 'Precision Medicine' for allergic diseases and asthma.
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Anderson WC, Apter AJ, Dutmer CM, Searing DA, Szefler SJ. Advances in asthma in 2016: Designing individualized approaches to management. J Allergy Clin Immunol 2017; 140:671-680. [PMID: 28709967 DOI: 10.1016/j.jaci.2017.06.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 06/26/2017] [Accepted: 06/27/2017] [Indexed: 12/12/2022]
Abstract
In this year's Advances in Asthma review, we discuss viral infections in asthmatic patients and potential therapeutic agents, the microbiome, novel genetic associations with asthma, air quality and climate effects on asthma, exposures during development and long-term sequelae of childhood asthma, patient-centered outcomes research, and precision medicine. In addition, we discuss application of biomarkers to precision medicine and new information on asthma medications. New evidence indicates that rhinovirus-triggered asthma exacerbations become more severe as the degree of sensitization to dust mite and mouse increase. The 2 biggest drivers of asthma severity are an allergy pathway starting with allergic sensitization and an environmental tobacco smoke pathway. In addition, allergic sensitization and blood eosinophils can be used to select medications for management of early asthma in young children. These current findings, among others covered in this review, represent significant steps toward addressing rapidly advancing areas of knowledge that have implications for asthma management.
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Affiliation(s)
- William C Anderson
- Allergy & Immunology Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
| | - Andrea J Apter
- Section of Allergy & Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Cullen M Dutmer
- Allergy & Immunology Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
| | - Daniel A Searing
- Allergy & Immunology Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
| | - Stanley J Szefler
- Breathing Institute and Pulmonary Medicine Section, Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo.
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Saranz RJ, Lozano A, Lozano NA, Ponzio MF, Cruz ÁA. Subclinical lower airways correlates of chronic allergic and non-allergic rhinitis. Clin Exp Allergy 2017; 47:988-997. [PMID: 28421631 DOI: 10.1111/cea.12938] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The upper and lower airways behave as a physiological and pathophysiological unit. Subclinical lower airways abnormalities have been described in patients with rhinitis without asthma. These are expressed as bronchial hyperreactivity, abnormalities in lung function and bronchial inflammation, likely as a result of the same phenomenon with systemic inflammatory impact that reaches both the nose and the lungs, which for unknown reasons does not always have a full clinical expression. Patients with rhinitis are at increased risk of developing asthma; therefore, most authors suggest a careful clinical evaluation and monitoring of these patients, especially if symptoms related to inflammation in the lower airways are observed. Although current treatments, such as H1-antihistamines, intranasal steroids and allergen immunotherapy, are quite effective for the management of rhinitis, it is difficult to prove their capacity to prevent asthma among subjects with rhinitis. Evidence showing that the treatment of rhinitis has a favourable impact on indicators of bronchial hyperreactivity and inflammation among subjects that have no symptoms of asthma is more frequently described. In this review, we address the frequency and characteristics of lower airway abnormalities in subjects with rhinitis, both in paediatric and adult populations, their likely predictive value for the development of asthma and the possibilities for therapeutic intervention that could modify the risk of subjects with rhinitis towards presenting asthma.
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Affiliation(s)
- R J Saranz
- Allergy and Immunology Division, Clínica Universitaria Reina Fabiola, Facultad de Medicina Universidad Católica de Córdoba, Córdoba, Argentina
| | - A Lozano
- Allergy and Immunology Division, Clínica Universitaria Reina Fabiola, Facultad de Medicina Universidad Católica de Córdoba, Córdoba, Argentina
| | - N A Lozano
- Allergy and Immunology Division, Clínica Universitaria Reina Fabiola, Facultad de Medicina Universidad Católica de Córdoba, Córdoba, Argentina
| | - M F Ponzio
- INICSA-CONICET, Cátedra de Fisiología Humana, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Á A Cruz
- ProAR-Nucleo de Excelência em Asma da Universidade Federal da Bahia, and CNPq, Salvador, Brazil
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Mårild K, Vistnes M, Tapia G, Midttun Ø, Ueland PM, Viken MK, Magnus P, Berg JP, Stene LC, Størdal K. Midpregnancy and cord blood immunologic biomarkers, HLA genotype, and pediatric celiac disease. J Allergy Clin Immunol 2017; 139:1696-1698. [DOI: 10.1016/j.jaci.2016.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/31/2016] [Accepted: 10/03/2016] [Indexed: 12/19/2022]
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Landgraf-Rauf K, Anselm B, Schaub B. The puzzle of immune phenotypes of childhood asthma. Mol Cell Pediatr 2016; 3:27. [PMID: 27468754 PMCID: PMC4965363 DOI: 10.1186/s40348-016-0057-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 07/19/2016] [Indexed: 02/07/2023] Open
Abstract
Asthma represents the most common chronic childhood disease worldwide. Whereas preschool children present with wheezing triggered by different factors (multitrigger and viral wheeze), clinical asthma manifestation in school children has previously been classified as allergic and non-allergic asthma. For both, the underlying immunological mechanisms are not yet understood in depth in children. Treatment is still prescribed regardless of underlying mechanisms, and children are not always treated successfully. This review summarizes recent key findings on the complex mechanisms of the development and manifestation of childhood asthma. Whereas traditional classification of childhood asthma is primarily based on clinical symptoms like wheezing and atopy, novel approaches to specify asthma phenotypes are under way and face challenges such as including the stability of phenotypes over time and transition into adulthood. Epidemiological studies enclose more information on the patient’s disease history and environmental influences. Latest studies define endotypes based on molecular and cellular mechanisms, for example defining risk and protective single nucleotide polymorphisms (SNPs) and new immune phenotypes, showing promising results. Also, regulatory T cells and recently discovered T helper cell subtypes such as Th9 and Th17 cells were shown to be important for the development of asthma. Innate lymphoid cells (ILC) could play a critical role in asthma patients as they produce different cytokines associated with asthma. Epigenetic findings showed different acetylation and methylation patterns for children with allergic and non-allergic asthma. On a posttranscriptional level, miRNAs are regulating factors identified to differ between asthma patients and healthy controls and also indicate differences within asthma phenotypes. Metabolomics is another exciting chapter important for endotyping asthmatic children. Despite the development of new biomarkers and the discovery of new immunological molecules, the complex puzzle of childhood asthma is still far from being completed. Addressing the current challenges of distinct clinical asthma and wheeze phenotypes, including their stability and underlying endotypes, involves addressing the interplay of innate and adaptive immune regulatory mechanisms in large, interdisciplinary cohorts.
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Affiliation(s)
- Katja Landgraf-Rauf
- Department of Pulmonary and Allergy, Dr. von Hauner Children's Hospital, LMU, Lindwurmstraße 4, 80337, Munich, Germany.,Member of German Lung Centre (DZL), CPC, Munich, Germany
| | - Bettina Anselm
- Department of Pulmonary and Allergy, Dr. von Hauner Children's Hospital, LMU, Lindwurmstraße 4, 80337, Munich, Germany
| | - Bianca Schaub
- Department of Pulmonary and Allergy, Dr. von Hauner Children's Hospital, LMU, Lindwurmstraße 4, 80337, Munich, Germany. .,Member of German Lung Centre (DZL), CPC, Munich, Germany.
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