1
|
Reddy KD, Oliver BGG. Sexual dimorphism in chronic respiratory diseases. Cell Biosci 2023; 13:47. [PMID: 36882807 PMCID: PMC9993607 DOI: 10.1186/s13578-023-00998-5] [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: 01/08/2023] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
Sex differences in susceptibility, severity, and progression are prevalent for various diseases in multiple organ systems. This phenomenon is particularly apparent in respiratory diseases. Asthma demonstrates an age-dependent pattern of sexual dimorphism. However, marked differences between males and females exist in other pervasive conditions such as chronic obstructive pulmonary disease (COPD) and lung cancer. The sex hormones estrogen and testosterone are commonly considered the primary factors causing sexual dimorphism in disease. However, how they contribute to differences in disease onset between males and females remains undefined. The sex chromosomes are an under-investigated fundamental form of sexual dimorphism. Recent studies highlight key X and Y-chromosome-linked genes that regulate vital cell processes and can contribute to disease-relevant mechanisms. This review summarises patterns of sex differences in asthma, COPD and lung cancer, highlighting physiological mechanisms causing the observed dimorphism. We also describe the role of the sex hormones and present candidate genes on the sex chromosomes as potential factors contributing to sexual dimorphism in disease.
Collapse
Affiliation(s)
- Karosham Diren Reddy
- Respiratory and Cellular Molecular Biology Group, Woolcock Institute of Medical Research, Glebe, NSW, 2037, Australia.
- School of Life Science, University of Technology Sydney, Ultimo, NSW, 2007, Australia.
| | - Brian Gregory George Oliver
- Respiratory and Cellular Molecular Biology Group, Woolcock Institute of Medical Research, Glebe, NSW, 2037, Australia
- School of Life Science, University of Technology Sydney, Ultimo, NSW, 2007, Australia
| |
Collapse
|
2
|
Gencer A, Caliskaner Ozturk B, Borekci S, Gemicioglu B. Bronchodilator Reversibility Testing in Long-Term Cough and Dyspnea after Covid-19 Viral Infection: A Trigger for Asthma? J Asthma 2022; 60:1221-1226. [PMID: 36279253 DOI: 10.1080/02770903.2022.2139719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Objective: This study aims to investigate the presence of underlying chronic airway disease in individuals with chronic cough and dyspnea lasting longer than eight weeks and who had previously Coronavirus disease 2019 (COVID-19) and had no known lung disease.Methods: A total of 151 patients admitted to the respiratory diseases outpatient room with the complaint of cough and/or dyspnea that persisted for at least eight weeks following COVID-19 infection were accrued to the study. Demographic characteristics, smoking history, the severity of lung involvement on chest computed tomography in the acute phase of Covid-19 infection, and bronchodilator reversibility test results were recorded. Smoking history and forced expiratory volume in the first second (FEV1) were compared.Results: FEV1 increase ≥ 200 ml was observed in 40 (26.5%) patients. In 24 (15.9%) patients, an increase in FEV1 was found to be 200 ml and above, and the percentage of FEV1 was 12% or more. While 14 (9.3%) patients were diagnosed with asthma, 13 (8.6%) patients were diagnosed with nonreversible airflow obstruction (NRAO), and 1 (0.7%) patient was diagnosed with chronic obstructive pulmonary disease (COPD).Conclusions: COVID-19 infection may play a vital role in initiating asthma pathogenesis. It should be kept in mind that viral infection-related asthma may be the underlying cause of prolonged cough and dyspnea after COVID-19 infection.
Collapse
Affiliation(s)
- Aysegul Gencer
- Istanbul Bakirkoy Dr. Sadi Konuk Trainig and Research Hospital, Istanbul, Turkey
| | - Buket Caliskaner Ozturk
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul, Turkey
| | - Sermin Borekci
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul, Turkey
| | - Bilun Gemicioglu
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul, Turkey
| |
Collapse
|
3
|
Asthma with Fixed Airflow Obstruction: From Fixed to Personalized Approach. J Pers Med 2022; 12:jpm12030333. [PMID: 35330333 PMCID: PMC8953236 DOI: 10.3390/jpm12030333] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/14/2022] [Accepted: 02/22/2022] [Indexed: 02/01/2023] Open
Abstract
Asthma is generally characterized by variable symptoms such as dyspnea and wheezing and variable airflow obstruction. This review focuses on a subset of patients suffering from asthma with persistent airflow limitation that is not fully reversible (asthma with fixed airflow obstruction, FAO). The pathophysiology, the risk factors and the clinical outcomes associated with FAO are presented, as well as the distinct clinical entity of severe asthma and its inflammatory subtypes (T2 and non-T2). The current strategies for the treatment of these endotypes and treatment of the distinct Asthma/COPD overlap (ACO) phenotype are described. Management and medical interventions in FAO and/or ACO patients demand a holistic approach, which is not yet clearly established in guidelines worldwide. Finally, a treatment algorithm that includes FAO/ACO management based on pharmacological and non-pharmacological treatment, guideline-based management for specific co-morbidities, and modification of the risk factors is proposed.
Collapse
|
4
|
Blöndal V, Malinovschi A, Sundbom F, James A, Middelveld R, Franklin KA, Lundbäck B, Janson C. Multimorbidity in asthma, association with allergy, inflammatory markers and symptom burden, results from the Swedish GA 2 LEN study. Clin Exp Allergy 2020; 51:262-272. [PMID: 33053244 PMCID: PMC7983924 DOI: 10.1111/cea.13759] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/10/2020] [Accepted: 10/03/2020] [Indexed: 12/19/2022]
Abstract
Background Asthma is common worldwide and a large part of subjects with asthma have concomitant allergic multimorbidity in the form of rhinitis and/or eczema. Objective The aim of this study is to investigate whether the presence of allergic multimorbidity in asthma relates to allergic sensitization, allergic and respiratory symptoms, quality of life, inflammatory markers, lung function, use of medication and background factors. Methods A total of 437 asthmatics from the (GA2LEN) cross‐sectional survey in Sweden were grouped depending on the presence of rhinitis and/or eczema. The impact of allergic multimorbidity was assessed in terms of allergic sensitization, allergic and respiratory symptoms, quality of life, type‐2 inflammatory markers (exhaled nitric oxide, eosinophil activation markers, periostin), lung function, use of medication and background factors. Results Subjects with asthma, rhinitis and eczema were more likely to be sensitized to seasonal allergens (67% vs 32%, P < .001), food allergens (54% vs 18%, P < .001) and to have a higher degree of sensitization than subjects with only asthma (23% vs 10%, P < .001). Subjects with allergic multimorbidity more often had allergic reactions to food (28% vs 10%, P = .002), more respiratory symptoms and anxiety/depression (40% vs, 14%, P < .001) than subjects with only asthma, despite having similar levels of type 2 inflammatory markers. Individuals with allergic multimorbidity were more likely to be diagnosed with asthma before the age of 12 (48% vs 27%, P = .016) and to have maternal heredity for allergy (53% vs 33%, P = .011) than subjects with only asthma. Conclusion and clinical relevance Asthmatics with allergic multimorbidity are more likely to be sensitized to seasonal aeroallergens, food allergens and they have a higher degree of sensitization compared with those with only asthma. Allergic multimorbidity is associated with respiratory and allergy symptoms, anxiety and/or depression.
Collapse
Affiliation(s)
- Viiu Blöndal
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research Unit, Uppsala University, Uppsala, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Fredrik Sundbom
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research Unit, Uppsala University, Uppsala, Sweden
| | - Anna James
- The Centre for Allergy Research and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Roelinde Middelveld
- The Centre for Allergy Research and Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Bo Lundbäck
- Department of Internal Medicine, Krefting Research Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research Unit, Uppsala University, Uppsala, Sweden
| |
Collapse
|
5
|
Differences in the Clinical Characteristics of Early- and Late-Onset Asthma in Elderly Patients. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2940296. [PMID: 32090072 PMCID: PMC7014554 DOI: 10.1155/2020/2940296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 05/17/2019] [Accepted: 06/24/2019] [Indexed: 11/24/2022]
Abstract
Differences between early-onset and late-onset asthma in elderly subjects have not been comprehensively described in China. We conducted a cross-sectional study to determine the phenotypic differences between early-onset asthma (EOA) and late-onset asthma (LOA) in elderly patients. We collected clinical and physiological data from 176 elderly patients with asthma. Participants were divided into two groups: EOA group and LOA group. Demographics, comorbidities, inflammatory parameters, lung function, severity, asthma control, and medication use among EOA and LOA elderly patients were compared. Elderly subjects with EOA had more atopic disease, a stronger positive family history of asthma, higher IgE, and exhaled nitric oxide levels as compared to those with LOA. In contrast, elderly subjects with LOA had lower lung function and more marked fixed airflow obstruction (FAO). Elderly subjects with LOA had a higher incidence of chronic obstructive pulmonary disease (COPD). No differences were observed in age, gender, BMI, history of smoking, severity, and asthma control between the two groups. Both similarities and differences exist between elderly subjects with EOA and those with LOA in China. Further work is required to determine the pathophysiological, clinical, and therapeutic implications for different asthma phenotypes in elderly subjects.
Collapse
|
6
|
Madigan LA, Wong GS, Gordon EM, Chen WS, Balenga N, Koziol-White CJ, Panettieri RA, Levine SJ, Druey KM. RGS4 Overexpression in Lung Attenuates Airway Hyperresponsiveness in Mice. Am J Respir Cell Mol Biol 2018; 58:89-98. [PMID: 28853915 DOI: 10.1165/rcmb.2017-0109oc] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A cardinal feature of asthma is airway hyperresponsiveness (AHR) to spasmogens, many of which activate G protein-coupled receptors (GPCRs) on airway smooth muscle (ASM) cells. Asthma subtypes associated with allergy are characterized by eosinophilic inflammation in the lung due to the type 2 immune response to allergens and proinflammatory mediators that promote AHR. The degree to which intrinsic abnormalities of ASM contribute to this phenotype remains unknown. The regulators of G protein signaling (RGS) proteins are a large group of intracellular proteins that inhibit GPCR signaling pathways. RGS2- and RGS5-deficient mice develop AHR spontaneously. Although RGS4 is upregulated in ASM from patients with severe asthma, the effects of increased RGS4 expression on AHR in vivo are unknown. Here, we examined the impact of forced RGS4 overexpression in lung on AHR using transgenic (Tg) mice. Tg RGS4 was expressed in bronchial epithelium and ASM in vivo, and protein expression in lung was increased at least 4-fold in Tg mice compared with wild-type (WT) mice. Lung slices from Tg mice contracted less in response to the m3 muscarinic receptor agonist methacholine compared with the WT, although airway resistance in live, unchallenged mice of both strains was similar. Tg mice were partially protected against AHR induced by fungal allergen challenge due to weakened contraction signaling in ASM and reduced type 2 cytokine (IL-5 and IL-13) levels in Tg mice compared with the WT. These results provide support for the hypothesis that increasing RGS4 expression and/or function could be a viable therapeutic strategy for asthma.
Collapse
Affiliation(s)
- Laura A Madigan
- 1 Molecular Signal Transduction Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, and
| | - Gordon S Wong
- 1 Molecular Signal Transduction Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, and
| | - Elizabeth M Gordon
- 2 Laboratory of Asthma and Lung Inflammation, Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland; and
| | - Wei-Sheng Chen
- 1 Molecular Signal Transduction Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, and
| | - Nariman Balenga
- 1 Molecular Signal Transduction Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, and
| | - Cynthia J Koziol-White
- 3 Rutgers Institute for Translational Medicine and Science, Child Health Institute, Rutgers University, New Brunswick, New Jersey
| | - Reynold A Panettieri
- 3 Rutgers Institute for Translational Medicine and Science, Child Health Institute, Rutgers University, New Brunswick, New Jersey
| | - Stewart J Levine
- 2 Laboratory of Asthma and Lung Inflammation, Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland; and
| | - Kirk M Druey
- 1 Molecular Signal Transduction Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, and
| |
Collapse
|
7
|
Bennett GH, Carpenter L, Hao W, Song P, Steinberg J, Baptist AP. Risk factors and clinical outcomes associated with fixed airflow obstruction in older adults with asthma. Ann Allergy Asthma Immunol 2018; 120:164-168.e1. [PMID: 29290515 PMCID: PMC5803342 DOI: 10.1016/j.anai.2017.10.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/27/2017] [Accepted: 10/04/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Asthma in older adults is associated with increased morbidity and mortality compared with asthma in younger patients. Fixed airflow obstruction (FAO) is associated with decreased survival in younger patients, but its significance remains unclear in older adults with asthma. OBJECTIVE To identify risk factors and outcomes related to FAO in older adults with asthma. METHODS Subjects older than 55 years with a physician diagnosis of persistent asthma were evaluated. Collected data included participant demographic information, medications, asthma exacerbations, Asthma Control Test (ACT) score, Asthma Quality of Life (AQLQ) score, comorbidities, spirometry, atopic status, and fractional exhaled nitric oxide. Clinical characteristics and outcomes associated with FAO (defined as post-bronchodilator ratio of forced expiratory volume in 1 second to forced vital capacity ≤70%) were assessed. RESULTS A total of 186 participants were analyzed (48 men and 138 women, mean age 66 years). FAO was demonstrated in 30% of participants. Using regression analysis, predictors of FAO included advanced age, African American race, male sex, and longer duration of asthma. In outcomes analysis, FAO was associated with worsened ACT and AQLQ scores; however, after controlling for confounding factors, logistic regression showed no association. No significant association was found between FAO and exacerbations, fractional exhaled nitric oxide, atopy, rhinitis, education level, depression, smoking, or body mass index. CONCLUSION Risk factors associated with FAO in older adults with asthma include advanced age, African American race, increased asthma duration, and male sex. Unlike younger patients, FAO is not independently associated with worsened asthma control, quality of life, or exacerbations in older patients with asthma. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01979055.
Collapse
Affiliation(s)
- Gregory H Bennett
- Division of Allergy and Clinical Immunology, University of Michigan Health System, Ann Arbor, Michigan.
| | - Laurie Carpenter
- University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Wei Hao
- University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Peter Song
- University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Joel Steinberg
- Department of Internal Medicine, Wayne State University, Detroit, Michigan
| | - Alan P Baptist
- Division of Allergy and Clinical Immunology, University of Michigan Health System, Ann Arbor, Michigan; University of Michigan School of Public Health, Ann Arbor, Michigan
| |
Collapse
|
8
|
Immunomodulatory Effects of Adjuvants CPG, MPLA, and BCG on the Derp2-Induced Acute Asthma at Early Life in an Animal Model of BALB/c Mice. Inflammation 2017; 40:259-274. [PMID: 27896542 DOI: 10.1007/s10753-016-0476-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The Th1- and Treg cell-related immune responses play key roles in the modulation of Th2 cell-related allergic disorders. The aim was to evaluate the effects of CPG, MPLA, and BCG on the number of Th1-, Th2-, and Treg cell-related parameters in an animal model of asthma. BALB/c mice were divided into five groups and immunized subcutaneously (SC) on days 1, 15, and 22 with allergen Derp2. Three groups of mice were pretreated SC on days 0, 14, and 21 with CPG, CPG + MPLA, or CPG + BCG. All mice were then challenged intranasally with Derp2 on days 28-37. Blood samples were collected from the retro-orbital sinus, on days 0, 23, and 40. The serum levels of IL-4, IFN-γ, IgE, and IgG2a were measured using ELISA technique. The blood number of Th1 and Treg cells was determined using flow cytometry. At the sensitization phase, the number of Th1 and the serum levels of IFN-γ and IgG2a were significantly increased in the Derp2-sensitized group pretreated with CPG plus MPLA, and the number of Treg cells was significantly elevated in Derp2-sensitized mice pretreated with CPG or CPG plus MPLA as compared with that in Derp2-sensitized control mice. At the challenge phase, the number of Th1 was significantly elevated in Derp2-sensitized mice pretreated with CPG plus MPLA, CPG plus BCG, or CPG; the count of Treg cells was significantly increased in Derp2-sensitized mice pretreated with CPG plus BCG group; and the levels of IFN-γ and IgG2a were significantly enhanced in the Derp2-sensitized group pretreated with CPG plus MPLA in comparison with those in Derp2-sensitized control mice. The scores of inflammation and mucus secretion in the lung were significantly decreased in the Derp2-sensitized group pretreated with CPG, BCG, and CPG plus MPLA in comparison with those in the Derp2-sensitized control group. These results showed that BCG, MPLA, and CPG modulate Th1-, Th2-, and Treg-related parameters and ameliorate lung inflammatory parameters in a mouse model of asthma.
Collapse
|
9
|
Kim SK, Seok H, Park HJ, Han K, Kang SW, Ban JY, Jung HJ, Kim KI, Lee BJ, Kim J, Chung JH. Association Between Secretoglobin Family 3A Member 2 (SCGB3A2) Gene Polymorphisms and Asthma in a Korean Population. Med Sci Monit 2017; 23:1880-1885. [PMID: 28422086 PMCID: PMC5405786 DOI: 10.12659/msm.903983] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Secretoglobin family 3A member 2 (SCGB3A2) plays an important role in secreting lung surfactant protein, which is a downstream target of thyroid transcription factor. Material/Methods We investigated whether single-nucleotide polymorphisms (SNPs) of SCGB3A2 gene contribute to susceptibility to asthma. To explore this possible association, 2 promoter SNPs (rs6882292, 659 G/A and rs1368408, −112 G/A) and missense SNP (rs151333009, stop codon) were tested in SCGB3A2 gene in 101 asthma patients and 377 healthy control subjects. SNPStats was used to obtain odds ratio (OR), 95% confidence intervals (CI), and P value adjusted for age and sex as covariables. Logistic regression method in each model (dominant, recessive, and log-additive) was applied to analyze genetic data. Results rs151333009 SNP showed a monomorphic genotype. Two promoter SNPs (rs6882292, −659 G/A and rs1368408, −112 G/A) showed significant association with asthma (rs6882292, OR=2.66, 95% CI=1.42–5.01, p=0.0033 in dominant model, OR=2.45, 95% CI=1.33–4.54, p=0.0055 in log-additive model; rs1368408, OR=1.59, 95% CI=1.02–2.49, p=0.041 in dominant model, OR=3.02, 95% CI=1.15–7.90, p=0.03 in recessive model, OR=1.63, 95% CI=1.63, 95% CI=1.12–2.37, p=0.012 in log-additive model). Conclusions These results suggest that the promoter SNPs (rs6882292 and rs1368408) of SCGB3A2 gene may contribute to susceptibility to asthma in a Korean population.
Collapse
Affiliation(s)
- Su Kang Kim
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Hosik Seok
- Department of Pharmacology, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Hae Jeong Park
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Kyuup Han
- Department of Pharmacology, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Sang Wook Kang
- Department of Dental Pharmacology, School of Dentistry, Dankook University, Cheonan, South Korea
| | - Ju Yeon Ban
- Department of Dental Pharmacology, School of Dentistry, Dankook University, Cheonan, South Korea
| | - Hee-Jae Jung
- Division of Allergy and Respiratory System, Department of Korean Internal Medicine, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Kwan-Il Kim
- Division of Allergy and Respiratory System, Department of Korean Internal Medicine, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Beom-Joon Lee
- Division of Allergy and Respiratory System, Department of Korean Internal Medicine, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Jinju Kim
- Department of Korean Physiology, College of Pharmacy, Kyung Hee University, Seoul, South Korea
| | - Joo-Ho Chung
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, South Korea
| |
Collapse
|