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Clemente-Suárez VJ, Mielgo-Ayuso J, Ramos-Campo DJ, Beltran-Velasco AI, Martínez-Guardado I, Navarro Jimenez E, Redondo-Flórez L, Yáñez-Sepúlveda R, Tornero-Aguilera JF. Basis of preventive and non-pharmacological interventions in asthma. Front Public Health 2023; 11:1172391. [PMID: 37920579 PMCID: PMC10619920 DOI: 10.3389/fpubh.2023.1172391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/18/2023] [Indexed: 11/04/2023] Open
Abstract
Asthma is one of the most common atopic disorders in all stages of life. Its etiology is likely due to a complex interaction between genetic, environmental, and lifestyle factors. Due to this, different non-pharmacological interventions can be implemented to reduce or alleviate the symptoms caused by this disease. Thus, the present narrative review aimed to analyze the preventive and non-pharmacological interventions such as physical exercise, physiotherapy, nutritional, ergonutritional, and psychological strategies in asthma treatment. To reach these aims, an extensive narrative review was conducted. The databases used were MedLine (PubMed), Cochrane (Wiley), Embase, PsychINFO, and CinAhl. Asthma is an immune-mediated inflammatory condition characterized by increased responsiveness to bronchoconstrictor stimuli. Different factors have been shown to play an important role in the pathogenesis of asthma, however, the treatments used to reduce its incidence are more controversial. Physical activity is focused on the benefits that aerobic training can provide, while physiotherapy interventions recommend breathing exercises to improve the quality of life of patients. Nutritional interventions are targeted on implement diets that prioritize the consumption of fruits and vegetables and supplementation with antioxidants. Psychological interventions have been proposed as an essential non-pharmacological tool to reduce the emotional problems associated with asthma.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Studies Centre in Applied Combat (CESCA), Toledo, Spain
| | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, Burgos, Spain
| | - Domingo Jesús Ramos-Campo
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | | | - Ismael Martínez-Guardado
- BRABE Group, Department of Psychology, Faculty of Life and Natural Sciences, Universidad Camilo José Cela, Madrid, Spain
| | | | - Laura Redondo-Flórez
- Department of Health Sciences, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | - Jose Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Studies Centre in Applied Combat (CESCA), Toledo, Spain
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2
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Murphy RC, Lai Y, Altman MC, Barrow KA, Dill-McFarland KA, Liu M, Hamerman JA, Lacy-Hulbert A, Piliponsky AM, Ziegler SF, Altemeier WA, Debley JS, Gharib SA, Hallstrand TS. Rhinovirus infection of the airway epithelium enhances mast cell immune responses via epithelial-derived interferons. J Allergy Clin Immunol 2023; 151:1484-1493. [PMID: 36708815 PMCID: PMC10257743 DOI: 10.1016/j.jaci.2022.12.825] [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: 03/16/2022] [Revised: 12/15/2022] [Accepted: 12/22/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Mast cells (MCs) within the airway epithelium in asthma are closely related to airway dysfunction, but cross talk between airway epithelial cells (AECs) and MCs in asthma remains incompletely understood. Human rhinovirus (RV) infections are key triggers for asthma progression, and AECs from individuals with asthma may have dysregulated antiviral responses. OBJECTIVE We utilized primary AECs in an ex vivo coculture model system to examine cross talk between AECs and MCs after epithelial rhinovirus infection. METHODS Primary AECs were obtained from 11 children with asthma and 10 healthy children, differentiated at air-liquid interface, and cultured in the presence of laboratory of allergic diseases 2 (LAD2) MCs. AECs were infected with rhinovirus serogroup A 16 (RV16) for 48 hours. RNA isolated from both AECs and MCs underwent RNA sequencing. Direct effects of epithelial-derived interferons on LAD2 MCs were examined by real-time quantitative PCR. RESULTS MCs increased expression of proinflammatory and antiviral genes in AECs. AECs demonstrated a robust antiviral response after RV16 infection that resulted in significant changes in MC gene expression, including upregulation of genes involved in antiviral responses, leukocyte activation, and type 2 inflammation. Subsequent ex vivo modeling demonstrated that IFN-β induces MC type 2 gene expression. The effects of AEC donor phenotype were small relative to the effects of viral infection and the presence of MCs. CONCLUSIONS There is significant cross talk between AECs and MCs, which are present in the epithelium in asthma. Epithelial-derived interferons not only play a role in viral suppression but also further alter MC immune responses including specific type 2 genes.
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Affiliation(s)
- Ryan C Murphy
- Division of Pulmonary, Critical Care, and Sleep Medicine, Seattle, Wash; Center for Lung Biology, University of Washington, Seattle, Wash.
| | - Ying Lai
- Division of Pulmonary, Critical Care, and Sleep Medicine, Seattle, Wash; Center for Lung Biology, University of Washington, Seattle, Wash
| | - Matthew C Altman
- Division of Allergy and Infectious Disease, Department of Medicine, Seattle, Wash; Immunology Program, Benaroya Research Institute, Seattle, Wash
| | - Kaitlyn A Barrow
- Division of Pulmonary and Sleep Medicine, Seattle Children's Hospital, Department of Pediatrics, Seattle, Wash; Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Wash
| | | | - Matthew Liu
- Division of Pulmonary, Critical Care, and Sleep Medicine, Seattle, Wash; Center for Lung Biology, University of Washington, Seattle, Wash
| | | | | | - Adrian M Piliponsky
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Wash
| | | | - William A Altemeier
- Division of Pulmonary, Critical Care, and Sleep Medicine, Seattle, Wash; Center for Lung Biology, University of Washington, Seattle, Wash
| | - Jason S Debley
- Division of Pulmonary and Sleep Medicine, Seattle Children's Hospital, Department of Pediatrics, Seattle, Wash; Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Wash
| | - Sina A Gharib
- Division of Pulmonary, Critical Care, and Sleep Medicine, Seattle, Wash; Center for Lung Biology, University of Washington, Seattle, Wash
| | - Teal S Hallstrand
- Division of Pulmonary, Critical Care, and Sleep Medicine, Seattle, Wash; Center for Lung Biology, University of Washington, Seattle, Wash
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Couillard S, Petousi N, Smigiel KS, Molfino NA. Toward a Predict and Prevent Approach in Obstructive Airway Diseases. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:704-712. [PMID: 36682536 DOI: 10.1016/j.jaip.2023.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 01/22/2023]
Abstract
Asthma and chronic obstructive pulmonary disease are currently diagnosed and treated after the demonstration of variable airflow limitation and symptoms. Under this framework, undiagnosed and unchecked airway inflammation is associated with recurrent acute attacks, airway remodeling, airflow limitation, adverse effects of corticosteroids, and impaired quality of life, ultimately leading to the collection of side effects termed "people remodeling." This one-size-fits-all damage control approach aims to control symptoms and treat exacerbations rather than modify the underlying disease process. The advent of highly effective therapies targeting proximal drivers of airway inflammation calls for a paradigm shift; upstream-acting therapies offer potential to alter the disease course and achieve clinical remission. We propose moving away from downstream firefighting and toward a "predict and prevent" model, measuring inflammation and providing anti-inflammatory therapy early, without waiting for further clinical deterioration. Much in the same way that high blood pressure and cholesterol are used to predict and prevent heart attacks, in asthma, elevated blood eosinophils and/or exhaled nitric oxide can be used to predict and prevent asthma attacks. We also advocate moving research further upstream by identifying patients with subclinical airway inflammation or disease who may be at risk of progressing to airflow limitation and associated morbidities and intervening early to prevent them. In summary, we call for a predict and prevent approach in obstructive airway disease.
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Affiliation(s)
- Simon Couillard
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Nayia Petousi
- Respiratory Medicine Unit and NIHR Oxford Respiratory BRC, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Murphy RC, Morrell ED, Hallstrand TS. The Intersection between Autoimmunity, Macrophage Dysfunction, Endotype, and Exacerbations in Severe Asthma. Am J Respir Crit Care Med 2023; 207:383-385. [PMID: 36413362 PMCID: PMC9940143 DOI: 10.1164/rccm.202211-2074ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ryan C. Murphy
- Division of Pulmonary, Critical Care and Sleep,Center for Lung Biology, Department of MedicineUniversity of WashingtonSeattle, Washington
| | - Eric D. Morrell
- Division of Pulmonary, Critical Care and Sleep, Department of MedicineUniversity of WashingtonSeattle, Washington
| | - Teal S. Hallstrand
- Division of Pulmonary, Critical Care and Sleep,Center for Lung Biology, Department of MedicineUniversity of WashingtonSeattle, Washington
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Samanas NB, Murphy RC, Miralda I, Hallstrand TS, Piliponsky AM. Neutrophilic asthma at an inhibitory checkpoint: A PD-1-targeted approach. J Allergy Clin Immunol 2023; 151:420-422. [PMID: 36463980 DOI: 10.1016/j.jaci.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/11/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022]
Affiliation(s)
- Nyssa B Samanas
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Wash
| | - Ryan C Murphy
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep, University of Washington, Seattle, Wash; Center for Lung Biology, University of Washington, Seattle, Wash
| | - Irina Miralda
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Wash
| | - Teal S Hallstrand
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep, University of Washington, Seattle, Wash; Center for Lung Biology, University of Washington, Seattle, Wash
| | - Adrian M Piliponsky
- Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, Wash; Department of Pediatrics, Seattle, Wash; Department of Pathology, Seattle, Wash; Department of Global Health, University of Washington School of Medicine, Seattle, Wash.
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Increased Risk of Hypothyroidism in People with Asthma: Evidence from a Real-World Population-Based Study. J Clin Med 2022; 11:jcm11102776. [PMID: 35628903 PMCID: PMC9146804 DOI: 10.3390/jcm11102776] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Non-T2 asthma and hypothyroidism share several inflammatory mechanisms in common. However, large-scale, real-world studies evaluating the association between asthma and hypothyroidism are lacking. The objective of this study was to evaluate the risk for asthma patients of developing hypothyroidism. Methods: In the retrospective cohort study, people with asthma were recruited from the Longitudinal Health Insurance Database in Taiwan. After excluding ineligible patients with a previous history of hypothyroidism, 1:1 propensity matching was conducted to select a non-asthma control group. Based on the multivariate Cox regression model, the adjusted hazard ratio of asthma patients developing hypothyroidism was calculated. Results: In total, 95,321 asthma patients were selected as the asthma group and the same amount of people without asthma were selected as the control group. The incidence levels of new-onset hypothyroidism in asthma and non-asthma groups were 8.13 and 6.83 per 100,000 people per year, respectively. Compared with the non-asthma group, the adjusted hazard ratio of the asthma group developing hypothyroidism was 1.217 (95% confidence interval, 1.091–1.357). Conclusions: We found having asthma to be associated with an increased risk of hypothyroidism. Clinicians should be concerned regarding the endocrinological and inflammatory interaction between the two diseases while caring for people with asthma.
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Xie Y, Abel PW, Casale TB, Tu Y. T H17 cells and corticosteroid insensitivity in severe asthma. J Allergy Clin Immunol 2022; 149:467-479. [PMID: 34953791 PMCID: PMC8821175 DOI: 10.1016/j.jaci.2021.12.769] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/30/2021] [Accepted: 12/15/2021] [Indexed: 02/03/2023]
Abstract
Asthma is classically described as having either a type 2 (T2) eosinophilic phenotype or a non-T2 neutrophilic phenotype. T2 asthma usually responds to classical bronchodilation therapy and corticosteroid treatment. Non-T2 neutrophilic asthma is often more severe. Patients with non-T2 asthma or late-onset T2 asthma show poor response to the currently available anti-inflammatory therapies. These therapeutic failures result in increased morbidity and cost associated with asthma and pose a major health care problem. Recent evidence suggests that some non-T2 asthma is associated with elevated TH17 cell immune responses. TH17 cells producing Il-17A and IL-17F are involved in the neutrophilic inflammation and airway remodeling processes in severe asthma and have been suggested to contribute to the development of subsets of corticosteroid-insensitive asthma. This review explores the pathologic role of TH17 cells in corticosteroid insensitivity of severe asthma and potential targets to treat this endotype of asthma.
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Affiliation(s)
- Yan Xie
- Department of Pharmacology and Neuroscience, Creighton University School of Medicine, Omaha, NE, USA
| | - Peter W. Abel
- Department of Pharmacology and Neuroscience, Creighton University School of Medicine, Omaha, NE, USA
| | - Thomas B. Casale
- Department of Internal Medicine, University of South Florida School of Medicine, Tampa, FL, USA
| | - Yaping Tu
- Department of Pharmacology and Neuroscience, Creighton University School of Medicine, Omaha, NE, USA
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Gau SY, Huang JY, Yong SB, Cheng-Chung Wei J. Higher Risk of Hyperthyroidism in People with Asthma: Evidence from a Nationwide, Population-Based Cohort Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 10:751-758.e1. [PMID: 34563740 DOI: 10.1016/j.jaip.2021.09.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 09/06/2021] [Accepted: 09/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Studies have indicated that hyperthyroidism exacerbates asthma; however, the influence of asthma in the development of hyperthyroidism has not been adequately studied. OBJECTIVE The aim of this population-based, retrospective cohort study was to investigate the association between asthma and the development of hyperthyroidism. METHODS In this retrospective cohort study, datasets from the Longitudinal Health Insurance Database 2000 in Taiwan during 1997 to 2013 were retrieved. Patients newly diagnosed with asthma (International Classification of Diseases, Ninth Revision: 493) during 2000 to 2013 were identified as the exposure cohort. The 1:1 propensity-score-matched nonasthma individuals were selected as the comparison cohort. The hazard ratio (HR) of development of hyperthyroidism in patients with asthma and its association with age and follow-up time were examined. RESULTS A total of 45,182 individuals were included in the study, including 22,591 and 22,591 patients with (asthma group) and without (control group) asthma, respectively. Incidence rates (per 100,000 person-months) of hyperthyroidism in the study groups were 12.88 in the control group and 16.95 in the asthma group. The adjusted HR for developing hyperthyroidism was 1.31 (95% confidence interval, 1.12-1.53) in patients with asthma compared with controls. The risk of developing hyperthyroidism was higher in patients with asthma aged>30 years old and with a follow-up of <3 years than in other subgroups. CONCLUSION Patients with asthma had a higher risk of developing hyperthyroidism, especially those over 30 years of age and in the first 3 years after diagnosis of asthma. Clinicians caring for patients with asthma should be aware of this increased risk.
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Affiliation(s)
- Shuo-Yan Gau
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
| | - Jing-Yang Huang
- Center for Health Data Science, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
| | - Su-Boon Yong
- Division of Pediatric Allergy, Immunology, Rheumatology, Lin-Shin Hospital, Taichung, Taiwan, ROC
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC; Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan, ROC.
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Gern JE, Israel E. Mechanisms and Treatment of the Diverse Presentations of Acute Wheezing and Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2635-2637. [PMID: 34246436 DOI: 10.1016/j.jaip.2021.04.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 04/22/2021] [Indexed: 11/27/2022]
Affiliation(s)
- James E Gern
- Departments of Pediatrics and Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wis
| | - Elliot Israel
- Divisions of Pulmonary and Critical Care Medicine and Allergy and Immunology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.
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