1
|
Anthony R, Macartney MJ, Heileson JL, McLennan PL, Peoples GE. A review and evaluation of study design considerations for omega-3 fatty acid supplementation trials in physically trained participants. Nutr Res Rev 2024; 37:1-13. [PMID: 36620998 DOI: 10.1017/s095442242300001x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Long-chain omega-3 polyunsaturated fatty acid (LC n-3 PUFA) supplements, rich in eicosapentaenoic acid and/or docosahexaenoic acid, are increasingly being recommended within athletic institutions. However, the wide range of doses, durations and study designs implemented across trials makes it difficult to provide clear recommendations. The importance of study design characteristics in LC n-3 PUFA trials has been detailed in cardiovascular disease research, and these considerations may guide LC n-3 PUFA study design in healthy cohorts. This systematic review examined the quality of studies and study design considerations used in evaluating the evidence for LC n-3 PUFA improving performance in physically trained adults. SCOPUS, PubMed and Web of Science electronic databases were searched to identify studies that supplemented LC n-3 PUFA in physically trained participants. Forty-six (n = 46) studies met inclusion. Most studies used a randomised control design. Risk of bias, assessed using the design-appropriate Cochrane Collaboration tool, revealed that studies had a predominant judgment of 'some concerns', 'high risk' or 'moderate risk' in randomised controlled, randomised crossover or non-randomised studies, respectively. A custom five-point quality assessment scale demonstrated that no study satisfied all recommendations for LC n-3 PUFA study design. This review has highlighted that the disparate range of study designs is likely contributing to the inconclusive state of outcomes pertaining to LC n-3 PUFA as a potential ergogenic aid. Further research must adequately account for the specific LC n-3 PUFA study design considerations, underpinned by a clear hypothesis, to achieve evidence-based dose, duration and composition recommendations for physically trained individuals.
Collapse
Affiliation(s)
- Ryan Anthony
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
- Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Michael J Macartney
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
- Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Jeffery L Heileson
- Department of Health, Human Performance and Recreation, Robbins College of Health and Human Sciences, Baylor University, Texas, USA
| | - Peter L McLennan
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
- Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Gregory E Peoples
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
- Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| |
Collapse
|
2
|
Li J, Sun J, Liu L, Zhang C, Liu Z. Association between n-3 PUFA and lung function: results from the NHANES 2007-2012 and Mendelian randomisation study. Br J Nutr 2024; 131:1720-1729. [PMID: 38275085 DOI: 10.1017/s0007114524000266] [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] [Indexed: 01/27/2024]
Abstract
This study aimed to investigate the association between n-3 PUFA and lung function. First, a cross-sectional study was conducted based on the National Health and Nutrition Examination Survey (NHANES) 2007-2012 data. n-3 PUFA intake was obtained from 24-h dietary recalls. A multivariable linear regression model was used to assess the observational associations of n-3 PUFA intake with lung function. Subsequently, a two-sample Mendelian randomisation (MR) was performed to estimate the potential causal effect of n-3 PUFA on lung function. Genetic instrumental variables were extracted from published genome-wide association studies. Summary statistics about n-3 PUFA was from UK Biobank. Inverse variance weighted was the primary analysis approach. The observational study did not demonstrate a significant association between n-3 PUFA intake and most lung function measures; however, a notable exception was observed with significant findings in the highest quartile for forced vital capacity (FVC) and % predicted FVC. The MR results also showed no causal effect of circulating n-3 PUFA concentration on lung function (forced expiratory volume in one second (FEV1), β = 0·01301, se = 0·01932, P = 0·5006; FVC, β = -0·001894, se = 0·01704, P = 0·9115; FEV1:FVC, β = 0·03118, se = 0·01743, P = 0·07359). These findings indicate the need for further investigation into the impact of higher n-3 PUFA consumption on lung health.
Collapse
Affiliation(s)
- Jingli Li
- Department of Pulmonary and Critical Care Medicine, Shaoxing People's Hospital, Shaoxing312000, Zhejiang, People's Republic of China
| | - Jian Sun
- Department of Pulmonary and Critical Care Medicine, Shaoxing People's Hospital, Shaoxing312000, Zhejiang, People's Republic of China
| | - Lingjing Liu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou325000, Zhejiang, People's Republic of China
| | - Chunyi Zhang
- Department of Pulmonary and Critical Care Medicine, Shaoxing People's Hospital, Shaoxing312000, Zhejiang, People's Republic of China
| | - Zixiang Liu
- Department of Pulmonary and Critical Care Medicine, Shaoxing People's Hospital, Shaoxing312000, Zhejiang, People's Republic of China
| |
Collapse
|
3
|
Wisseman BL, Edwards ES, Akers JD, Kurti SP. The Effect of Varying Fatty Acid Composition on Postprandial Airway Inflammation, Pulmonary Function, and Airway Resistance in Healthy, Young Adults. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:131-138. [PMID: 37399335 DOI: 10.1080/27697061.2023.2229877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 06/08/2023] [Accepted: 06/21/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE To examine the effect of varying fatty acid composition in a HFM on eNO, pulmonary function, and airway resistance. METHODS Fifteen individuals [6 M/9 F; 21.9 ± 1.5 years old] each completed three HFM conditions {SF, O6FA, and O3FA; 12 kcal/kg body weight, 63% total fat, and 0.72 g/kg sugar smoothies} in random order separated by at least 48 h. Airway inflammation assessed via eNO, pulmonary function measured using the maximum flow volume loop (MFVL) and airway resistance measured using impulse oscillometry (iOS) were taken at baseline, 2h and 4h postprandially. RESULTS There was no difference in eNO or iOS across time in any condition or between conditions (p > 0.05). There was a significant time by condition effect for FEV1 post-HFM in the SF and O6FA conditions (p < 0.05). CONCLUSION Different fatty acid compositions do not increase eNO or iOS in healthy, college-aged participants after consumption of a HFM, though the minimally processed meals with fruit added may contribute to these findings.
Collapse
Affiliation(s)
- Breanna L Wisseman
- Department of Kinesiology, Human Performance Laboratory, James Madison University, Harrisonburg, VA, USA
- Department of Kinesiology, Human Performance Laboratory, East Carolina University, Greenville, NC, USA
| | - Elizabeth S Edwards
- Department of Kinesiology, Human Performance Laboratory, James Madison University, Harrisonburg, VA, USA
| | - Jeremy D Akers
- Department of Kinesiology, Human Performance Laboratory, James Madison University, Harrisonburg, VA, USA
- Department of Health Professions, Integrated Nutrition and Physiology Laboratory, James Madison University, Harrisonburg, VA, USA
| | - Stephanie P Kurti
- Department of Kinesiology, Human Performance Laboratory, James Madison University, Harrisonburg, VA, USA
| |
Collapse
|
4
|
Illidi CR, Romer LM, Johnson MA, Williams NC, Rossiter HB, Casaburi R, Tiller NB. Distinguishing science from pseudoscience in commercial respiratory interventions: an evidence-based guide for health and exercise professionals. Eur J Appl Physiol 2023; 123:1599-1625. [PMID: 36917254 PMCID: PMC10013266 DOI: 10.1007/s00421-023-05166-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/19/2023] [Indexed: 03/16/2023]
Abstract
Respiratory function has become a global health priority. Not only is chronic respiratory disease a leading cause of worldwide morbidity and mortality, but the COVID-19 pandemic has heightened attention on respiratory health and the means of enhancing it. Subsequently, and inevitably, the respiratory system has become a target of the multi-trillion-dollar health and wellness industry. Numerous commercial, respiratory-related interventions are now coupled to therapeutic and/or ergogenic claims that vary in their plausibility: from the reasonable to the absurd. Moreover, legitimate and illegitimate claims are often conflated in a wellness space that lacks regulation. The abundance of interventions, the range of potential therapeutic targets in the respiratory system, and the wealth of research that varies in quality, all confound the ability for health and exercise professionals to make informed risk-to-benefit assessments with their patients and clients. This review focuses on numerous commercial interventions that purport to improve respiratory health, including nasal dilators, nasal breathing, and systematized breathing interventions (such as pursed-lips breathing), respiratory muscle training, canned oxygen, nutritional supplements, and inhaled L-menthol. For each intervention we describe the premise, examine the plausibility, and systematically contrast commercial claims against the published literature. The overarching aim is to assist health and exercise professionals to distinguish science from pseudoscience and make pragmatic and safe risk-to-benefit decisions.
Collapse
Affiliation(s)
- Camilla R Illidi
- Clinical Exercise and Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montréal, QC, Canada
| | - Lee M Romer
- Division of Sport, Health and Exercise Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Michael A Johnson
- Exercise and Health Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, Nottinghamshire, UK
| | - Neil C Williams
- Exercise and Health Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, Nottinghamshire, UK
| | - Harry B Rossiter
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA
| | - Richard Casaburi
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA
| | - Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA.
| |
Collapse
|
5
|
Olave CJ, Ivester KM, Couetil LL, Burgess J, Park JH, Mukhopadhyay A. Effects of low-dust forages on dust exposure, airway cytology, and plasma omega-3 concentrations in Thoroughbred racehorses: A randomized clinical trial. J Vet Intern Med 2022; 37:338-348. [PMID: 36478588 PMCID: PMC9889630 DOI: 10.1111/jvim.16598] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Racehorses commonly develop evidence of mild asthma in response to dust exposure. Diets deficient in omega-3 polyunsaturated fatty acids (Ω-3) might exacerbate this response. HYPOTHESIS To compare dust exposure, bronchoalveolar lavage fluid (BALF) cytology, and plasma Ω-3 and specialized pro-resolving mediators (SPM) concentrations amongst racehorses fed dry hay, steamed hay, and haylage. ANIMALS Forty-three Thoroughbred racehorses. METHODS Prospective clinical trial. Horses were randomly assigned to be fed dry hay, steamed hay, or haylage for 6 weeks. Measures of exposure to dust in the breathing zone were obtained twice. At baseline, week-3, and week-6, BALF cytology was examined. Plasma lipid profiles and plasma SPM concentrations were examined at baseline and week 6. Generalized linear mixed models examined the effect of forage upon dust exposure, BALF cytology, Ω-3, and SPM concentrations. RESULTS Respirable dust was significantly higher for horses fed hay (least-square mean ± s.e.m. 0.081 ± 0.007 mg/m3 ) when compared with steamed hay (0.056 ± 0.005 mg/m3 , P = .01) or haylage (0.053 ± 0.005 mg/m3 , P < .01). At week 6, BALF neutrophil proportions in horses eating haylage (3.0% ± 0.6%) were significantly lower compared with baseline (5.1 ± 0.7, P = .04) and horses eating hay (6.3% ± 0.8%, P < .01). Plasma eicosapentaenoic acid to arachidonic acid ratios were higher in horses eating haylage for 6 weeks (0.51 ± 0.07) when compared with baseline (0.34 ± 0.05, P < .01) and horses eating steamed (0.24 ± 0.02, P < .01) or dry hay (0.25 ± 0.03, P < .01). CONCLUSIONS AND CLINICAL IMPORTANCE Steamed hay and haylage reduce dust exposure compared with dry hay, but only haylage increased the ratio of anti-inflammatory to pro-inflammatory lipids while reducing BAL neutrophil proportions within 6 weeks.
Collapse
Affiliation(s)
- Carla J. Olave
- Department of Veterinary Clinical Sciences, College of Veterinary MedicinePurdue UniversityWest LafayetteIndianaUSA
| | - Kathleen M. Ivester
- Department of Veterinary Clinical Sciences, College of Veterinary MedicinePurdue UniversityWest LafayetteIndianaUSA
| | - Laurent L. Couetil
- Department of Veterinary Clinical Sciences, College of Veterinary MedicinePurdue UniversityWest LafayetteIndianaUSA
| | - John Burgess
- Department of Nutrition Science, College of Health and Human SciencesPurdue UniversityWest LafayetteIndianaUSA
| | - Jae Hong Park
- School of Health Sciences, College of Health and Human SciencesPurdue UniversityWest LafayetteIndianaUSA
| | - Abhijit Mukhopadhyay
- Department of Veterinary Clinical Sciences, College of Veterinary MedicinePurdue UniversityWest LafayetteIndianaUSA
| |
Collapse
|
6
|
Imai T, Takada Y, Watanabe K. Effect of Omega-3 Polyunsaturated Fatty Acids Intake on Eosinophil Airway Inflammation in University Athletes. J Clin Med Res 2022; 14:466-473. [PMID: 36578368 PMCID: PMC9765320 DOI: 10.14740/jocmr4825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/07/2022] [Indexed: 12/03/2022] Open
Abstract
Background Though athletes have a high risk of respiratory disorders, effective prevention has not yet to be identified. Omega-3 (n-3) polyunsaturated fatty acids (PUFA) have some practical anti-inflammatory effects in allergy, and therefore may reduce airway inflammation in athletes. This study aimed to assess whether n-3 PUFA intake affects airway inflammation in university athletes. Methods Twenty-three males were divided into three groups: 1) the eosinophilic airway inflammation group (I_PUFA group; fractional exhaled nitric oxide (FeNO ≥ 25 ppb, n = 10); 2) the non-eosinophilic airway inflammation group (N_PUFA group; FeNO < 25 ppb, exhaled carbon dioxide (eCO) ≥ 3.6 ppm, n = 5); and 3) the control group (FeNO < 25 ppb, eCO < 3.6 ppm, n = 8). Participants took supplements containing 260 mg of docosapentaenoic acid and 600 mg of eicosapentaenoic acid (EPA) daily for 3 weeks. Baseline measurements of FeNO, respiratory impedance, respiratory function, dietary intake (food frequency questionnaires), and blood tests were performed. FeNO and respiratory impedance were measured weekly, and the rest were measured after 3 weeks. Results There was a significant decrease in FeNO levels from baseline at 2 and 3 weeks in the I_PUFA group (54.7 ± 8.5 ppb vs. 45.1 ± 9.1 and 45.4 ± 7.7 ppb; mean ± standard error (SE), P < 0.05). After 3 weeks, FeNO levels remained unchanged in the N_PUFA and control groups, and respiratory impedance and function remained unchanged in all groups. Blood EPA levels significantly increased in the I_PUFA and N_PUFA groups (I_PUFA, 27.7 ± 16.9 vs. 52.1 ± 12.3 µg/mL; N_PUFA, 20.8 ± 8.7 vs. 70.4 ± 36.1 µg/mL; mean ± standard deviation (SD), P < 0.05). No changes were observed in dietary intake over the 3 weeks. Conclusions n-3 PUFA supplementation for 3 weeks reduced airway inflammation in athletes with FeNO levels ≥ 25 ppb.
Collapse
Affiliation(s)
- Tomoko Imai
- Center for Genera Education, Aichi Institute of Technology, Toyota 470-0392, Japan,Corresponding Author: Tomoko Imai, Center for General Education, Aichi Institute of Technology, Toyota 470-0392, Japan.
| | - Yutaro Takada
- University of Hawai’I at Manoa Athletic Department, Honolulu, HI 96822, Japan
| | - Koichi Watanabe
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| |
Collapse
|
7
|
Price OJ, Walsted ES, Bonini M, Brannan JD, Bougault V, Carlsen K, Couto M, Kippelen P, Moreira A, Pite H, Rukhadze M, Hull JH. Diagnosis and management of allergy and respiratory disorders in sport: An EAACI task force position paper. Allergy 2022; 77:2909-2923. [PMID: 35809082 PMCID: PMC9796481 DOI: 10.1111/all.15431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/02/2022] [Accepted: 07/06/2022] [Indexed: 01/27/2023]
Abstract
Allergy and respiratory disorders are common in young athletic individuals. In the context of elite sport, it is essential to secure an accurate diagnosis in order to optimize health and performance. It is also important, however, to consider the potential impact or consequences of these disorders, in recreationally active individuals engaging in structured exercise and/or physical activity to maintain health and well-being across the lifespan. This EAACI Task Force was therefore established, to develop an up-to-date, research-informed position paper, detailing the optimal approach to the diagnosis and management of common exercise-related allergic and respiratory conditions. The recommendations are informed by a multidisciplinary panel of experts including allergists, pulmonologists, physiologists and sports physicians. The report is structured as a concise, practically focussed document, incorporating diagnostic and treatment algorithms, to provide a source of reference to aid clinical decision-making. Throughout, we signpost relevant learning resources to consolidate knowledge and understanding and conclude by highlighting future research priorities and unmet needs.
Collapse
Affiliation(s)
- Oliver J. Price
- School of Biomedical SciencesFaculty of Biological Sciences, University of LeedsLeedsUK
- Leeds Institute of Medical Research at St James'sUniversity of LeedsLeedsUK
| | - Emil S. Walsted
- Department of Respiratory MedicineRoyal Brompton HospitalLondonUK
- Department of Respiratory MedicineBispebjerg HospitalCopenhagenDenmark
| | - Matteo Bonini
- Fondazione Policlinico Universitario A. Gemelli – IRCCSUniversità Cattolica del Sacro CuoreRomeItaly
- National Heart and Lung Institute (NHLI)Imperial College LondonLondonUK
| | | | | | - Kai‐Håkon Carlsen
- Division of Paediatric and Adolescent MedicineOslo University HospitalOsloNorway
- Faculty of Medicine, University of OsloInstitute of Clinical MedicineOsloNorway
| | - Mariana Couto
- Allergy CenterCUF Descobertas HospitalLisbonPortugal
| | - Pascale Kippelen
- Division of Sport, Health and Exercise SciencesCollege of Health, Medicine and Life Sciences, Brunel University LondonUK
| | - André Moreira
- Centro Hospitalar Universitário de São JoãoPortoPortugal
- Epidemiology Unit (EPIUnit)Laboratory for Integrative and Translational Research in Population Health (ITR)Basic and Clinical Immunology, Department of Pathology, Faculty of MedicineUniversity of PortoPortoPortugal
| | - Helena Pite
- Allergy Center, CUF Descobertas Hospital and CUF Tejo HospitalCEDOC, NOVA University, Universidade NOVA de LisboaLisbonPortugal
| | | | - James H. Hull
- Department of Respiratory MedicineRoyal Brompton HospitalLondonUK
- Institute of Sport, Exercise and Health (ISEH)Division of Surgery and Interventional Science, University College London (UCL)LondonUK
| |
Collapse
|
8
|
Zhao M, Li C, Zhang J, Yin Z, Zheng Z, Wan J, Wang M. Maresin-1 and Its Receptors RORα/LGR6 as Potential Therapeutic Target for Respiratory Diseases. Pharmacol Res 2022; 182:106337. [PMID: 35781060 DOI: 10.1016/j.phrs.2022.106337] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/18/2022] [Accepted: 06/28/2022] [Indexed: 12/15/2022]
Abstract
Maresin-1 is one of the representative specialized pro-resolving mediators that has shown beneficial effects in inflammatory disease models. Recently, two distinct types of receptor molecules were discovered as the targets of maresin-1, further revealing the pro-resolution mechanism of maresin-1. One is retinoic acid-related orphan receptor α (RORα) and the another one is leucine-rich repeat domain-containing G protein-coupled receptor 6 (LGR6). In this review, we summarized the detailed role of maresin-1 and its two different receptors in respiratory diseases. RORα and LGR6 are potential targets for the treatment of respiratory diseases. Future basic research and clinical trials on MaR1 and its receptors should provide useful information for the treatment of respiratory diseases.
Collapse
Affiliation(s)
- Mengmeng Zhao
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, PR China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, PR China; Hubei Key Laboratory of Cardiology, Wuhan 430060, PR China
| | - Chenfei Li
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, PR China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, PR China
| | - Jishou Zhang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, PR China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, PR China
| | - Zheng Yin
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, PR China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, PR China; Hubei Key Laboratory of Cardiology, Wuhan 430060, PR China
| | - Zihui Zheng
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, PR China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, PR China; Hubei Key Laboratory of Cardiology, Wuhan 430060, PR China
| | - Jun Wan
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, PR China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, PR China; Hubei Key Laboratory of Cardiology, Wuhan 430060, PR China.
| | - Menglong Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, PR China; Cardiovascular Research Institute, Wuhan University, Wuhan 430060, PR China; Hubei Key Laboratory of Cardiology, Wuhan 430060, PR China.
| |
Collapse
|
9
|
Schwellnus M, Adami PE, Bougault V, Budgett R, Clemm HH, Derman W, Erdener U, Fitch K, Hull JH, McIntosh C, Meyer T, Pedersen L, Pyne DB, Reier-Nilsen T, Schobersberger W, Schumacher YO, Sewry N, Soligard T, Valtonen M, Webborn N, Engebretsen L. International Olympic Committee (IOC) consensus statement on acute respiratory illness in athletes part 2: non-infective acute respiratory illness. Br J Sports Med 2022; 56:bjsports-2022-105567. [PMID: 35623888 DOI: 10.1136/bjsports-2022-105567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 01/03/2023]
Abstract
Acute respiratory illness (ARill) is common and threatens the health of athletes. ARill in athletes forms a significant component of the work of Sport and Exercise Medicine (SEM) clinicians. The aim of this consensus is to provide the SEM clinician with an overview and practical clinical approach to non-infective ARill in athletes. The International Olympic Committee (IOC) Medical and Scientific Committee appointed an international consensus group to review ARill in athletes. Key areas of ARill in athletes were originally identified and six subgroups of the IOC Consensus group established to review the following aspects: (1) epidemiology/risk factors for ARill, (2) infective ARill, (3) non-infective ARill, (4) acute asthma/exercise-induced bronchoconstriction and related conditions, (5) effects of ARill on exercise/sports performance, medical complications/return-to-sport (RTS) and (6) acute nasal/laryngeal obstruction presenting as ARill. Following several reviews conducted by subgroups, the sections of the consensus documents were allocated to 'core' members for drafting and internal review. An advanced draft of the consensus document was discussed during a meeting of the main consensus core group, and final edits were completed prior to submission of the manuscript. This document (part 2) of this consensus focuses on respiratory conditions causing non-infective ARill in athletes. These include non-inflammatory obstructive nasal, laryngeal, tracheal or bronchial conditions or non-infective inflammatory conditions of the respiratory epithelium that affect the upper and/or lower airways, frequently as a continuum. The following aspects of more common as well as lesser-known non-infective ARill in athletes are reviewed: epidemiology, risk factors, pathology/pathophysiology, clinical presentation and diagnosis, management, prevention, medical considerations and risks of illness during exercise, effects of illness on exercise/sports performance and RTS guidelines.
Collapse
Affiliation(s)
- Martin Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- SEMLI, IOC Research Centre, Pretoria, Gauteng, South Africa
| | - Paolo Emilio Adami
- Health & Science Department, World Athletics, Monaco, Monaco Principality
| | - Valerie Bougault
- Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice, Provence-Alpes-Côte d'Azu, France
| | - Richard Budgett
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Hege Havstad Clemm
- Department of Pediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Wayne Derman
- Institute of Sport and Exercise Medicine (ISEM), Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
- ISEM, IOC Research Center, South Africa, Stellenbosch, South Africa
| | - Uğur Erdener
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
| | - Ken Fitch
- School of Human Science; Sports, Exercise and Health, The University of Western Australia, Perth, Western Australia, Australia
| | - James H Hull
- Department of Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
- Institute of Sport, Exercise and Health (ISEH), University College London (UCL), London, UK
| | - Cameron McIntosh
- Dr CND McIntosh INC, Edge Day Hospital, Port Elizabeth, South Africa
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrucken, Germany
| | - Lars Pedersen
- Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - David B Pyne
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Tonje Reier-Nilsen
- Oslo Sports Trauma Research Centre, The Norwegian Olympic Sports Centre, Oslo, Norway
- Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Wolfgang Schobersberger
- Insitute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), Kliniken Innsbruck and Private University UMIT Tirol, Hall, Austria
| | | | - Nicola Sewry
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- SEMLI, IOC Research Centre, Pretoria, Gauteng, South Africa
| | - Torbjørn Soligard
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, Calgary, Alberta, Canada
| | - Maarit Valtonen
- KIHU, Research Institute for Olympic Sports, Jyväskylä, Finland
| | - Nick Webborn
- Centre for Sport and Exercise Science and Medicine, University of Brighton, Brighton, UK
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
- Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| |
Collapse
|
10
|
Cuthbertson L, Turner SE, Jackson A, Ranson C, Loosemore M, Kelleher P, Moffatt MF, Cookson WO, Hull JH, Shah A. Evidence of immunometabolic dysregulation and airway dysbiosis in athletes susceptible to respiratory illness. EBioMedicine 2022; 79:104024. [PMID: 35490556 PMCID: PMC9062742 DOI: 10.1016/j.ebiom.2022.104024] [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: 01/15/2022] [Revised: 04/04/2022] [Accepted: 04/10/2022] [Indexed: 11/03/2022] Open
Abstract
Background Methods Findings Interpretation Funding
Collapse
|
11
|
Vassilopoulou E, Guibas GV, Papadopoulos NG. Mediterranean-Type Diets as a Protective Factor for Asthma and Atopy. Nutrients 2022; 14:1825. [PMID: 35565792 PMCID: PMC9105881 DOI: 10.3390/nu14091825] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 12/25/2022] Open
Abstract
We are currently riding the second wave of the allergy epidemic, which is ongoing in affluent societies, but now also affecting developing countries. This increase in the prevalence of atopy/asthma in the Western world has coincided with a rapid improvement in living conditions and radical changes in lifestyle, suggesting that this upward trend in allergic manifestations may be associated with cultural and environmental factors. Diet is a prominent environmental exposure that has undergone major changes, with a substantial increase in the consumption of processed foods, all across the globe. On this basis, the potential effects of dietary habits on atopy and asthma have been researched rigorously, but even with a considerable body of evidence, clear associations are far from established. Many factors converge to obscure the potential relationship, including methodological, pathophysiological and cultural differences. To date, the most commonly researched, and highly promising, candidate for exerting a protective effect is the so-called Mediterranean diet (MedDi). This dietary pattern has been the subject of investigation since the mid twentieth century, and the evidence regarding its beneficial health effects is overwhelming, although data on a correlation between MedDi and the incidence and severity of asthma and atopy are inconclusive. As the prevalence of asthma appears to be lower in some Mediterranean populations, it can be speculated that the MedDi dietary pattern could indeed have a place in a preventive strategy for asthma/atopy. This is a review of the current evidence of the associations between the constituents of the MedDi and asthma/atopy, with emphasis on the pathophysiological links between MedDi and disease outcomes and the research pitfalls and methodological caveats which may hinder identification of causality. MedDi, as a dietary pattern, rather than short-term supplementation or excessive focus on single nutrient effects, may be a rational option for preventive intervention against atopy and asthma.
Collapse
Affiliation(s)
- Emilia Vassilopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - George V. Guibas
- Department of Allergy and Clinical Immunology, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston PR2 9HT, UK;
- School of Biological Sciences, Medicine and Health, University of Manchester, Manchester M13 9PL, UK;
| | - Nikolaos G. Papadopoulos
- School of Biological Sciences, Medicine and Health, University of Manchester, Manchester M13 9PL, UK;
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Thivon and Levadias 1, 11527 Athens, Greece
| |
Collapse
|
12
|
Fainardi V, Passadore L, Labate M, Pisi G, Esposito S. An Overview of the Obese-Asthma Phenotype in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020636. [PMID: 35055456 PMCID: PMC8775557 DOI: 10.3390/ijerph19020636] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 12/14/2022]
Abstract
Asthma is the most common chronic disease in childhood. Overweight and obesity are included among the comorbidities considered in patients with difficult-to-treat asthma, suggesting a specific phenotype of the disease. Therefore, the constant increase in obesity prevalence in children and adolescents raises concerns about the parallel increase of obesity-associated asthma. The possible correlation between obesity and asthma has been investigated over the last decade by different authors, who suggest a complex multifactorial relationship. Although the particular non-eosinophilic endotype of obesity-related asthma supports the concept that high body weight precedes asthma development, there is ongoing debate about the direct causality of these two entities. A number of mechanisms may be involved in asthma in combination with obesity disease in children, including reduced physical activity, abnormal ventilation, chronic systemic inflammation, hormonal influences, genetics and additional comorbidities, such as gastroesophageal reflux and dysfunctional breathing. The identification of the obesity-related asthma phenotype is crucial to initiate specific therapeutic management. Besides the cornerstones of asthma treatment, lifestyle should be optimized, with interventions aiming to promote physical exercise, healthy diet, and comorbidities. Future studies should clarify the exact association between asthma and obesity and the mechanisms underlying the pathogenesis of these two related conditions with the aim to define personalized therapeutic strategies for asthma management in this population.
Collapse
|
13
|
Pigakis KM, Stavrou VT, Pantazopoulos I, Daniil Z, Kontopodi AK, Gourgoulianis K. Exercise-Induced Bronchospasm in Elite Athletes. Cureus 2022; 14:e20898. [PMID: 35145802 PMCID: PMC8807463 DOI: 10.7759/cureus.20898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2022] [Indexed: 11/05/2022] Open
|
14
|
Kotlyarov S, Kotlyarova A. Anti-Inflammatory Function of Fatty Acids and Involvement of Their Metabolites in the Resolution of Inflammation in Chronic Obstructive Pulmonary Disease. Int J Mol Sci 2021; 22:ijms222312803. [PMID: 34884621 PMCID: PMC8657960 DOI: 10.3390/ijms222312803] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/24/2021] [Accepted: 11/24/2021] [Indexed: 12/13/2022] Open
Abstract
Lipid metabolism plays an important role in many lung functions. Disorders of lipid metabolism are part of the pathogenesis of chronic obstructive pulmonary disease (COPD). Lipids are involved in numerous cross-linkages with inflammation. Recent studies strongly support the involvement of fatty acids as participants in inflammation. They are involved in the initiation and resolution of inflammation, including acting as a substrate for the formation of lipid mediators of inflammation resolution. Specialized pro-inflammatory mediators (SPMs) belonging to the classes of lipoxins, resolvins, maresins, and protectins, which are formed enzymatically from unsaturated fatty acids, are now described. Disorders of their production and function are part of the pathogenesis of COPD. SPMs are currently the subject of active research in order to find new drugs. Short-chain fatty acids are another important participant in metabolic and immune processes, and their role in the pathogenesis of COPD is of great clinical interest.
Collapse
Affiliation(s)
- Stanislav Kotlyarov
- Department of Nursing, Ryazan State Medical University, 390026 Ryazan, Russia
- Correspondence:
| | - Anna Kotlyarova
- Department of Pharmacology and Pharmacy, Ryazan State Medical University, 390026 Ryazan, Russia;
| |
Collapse
|
15
|
Gatterer H, Dünnwald T, Turner R, Csapo R, Schobersberger W, Burtscher M, Faulhaber M, Kennedy MD. Practicing Sport in Cold Environments: Practical Recommendations to Improve Sport Performance and Reduce Negative Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9700. [PMID: 34574624 PMCID: PMC8471173 DOI: 10.3390/ijerph18189700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 11/17/2022]
Abstract
Although not a barrier to perform sport, cold weather environments (low ambient temperature, high wind speeds, and increased precipitation, i.e., rain/water/snow) may influence sport performance. Despite the obvious requirement for practical recommendations and guidelines to better facilitate training and competition in such cold environments, the current scientific evidence-base is lacking. Nonetheless, this review summarizes the current available knowledge specifically related to the physiological impact of cold exposure, in an attempt to provide practitioners and coaches alike with practical recommendations to minimize any potential negative performance effects, mitigate health issues, and best optimize athlete preparation across various sporting disciplines. Herein, the review is split into sections which explore some of the key physiological effects of cold exposure on performance (i.e., endurance exercise capacity and explosive athletic power), potential health issues (short-term and long-term), and what is currently known with regard to best preparation or mitigation strategies considered to negate the potential negative effects of cold on performance. Specific focus is given to "winter" sports that are usually completed in cold environments and practical recommendations for physical preparation.
Collapse
Affiliation(s)
- Hannes Gatterer
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy;
| | - Tobias Dünnwald
- Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Private University for Health Sciences, Medical Informatics and Technology, 6060 Hall i.T., Tirol, Austria and Tirol-Kliniken GmbH, 6020 Innsbruck, Austria; (T.D.); (W.S.)
| | - Rachel Turner
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy;
| | - Robert Csapo
- Centre for Sport Science and University Sports, University of Vienna, 1010 Vienna, Austria;
| | - Wolfgang Schobersberger
- Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Private University for Health Sciences, Medical Informatics and Technology, 6060 Hall i.T., Tirol, Austria and Tirol-Kliniken GmbH, 6020 Innsbruck, Austria; (T.D.); (W.S.)
- Austrian Society for Alpine and High-Altitude Medicine, 6414 Mieming, Austria; (M.B.); (M.F.)
| | - Martin Burtscher
- Austrian Society for Alpine and High-Altitude Medicine, 6414 Mieming, Austria; (M.B.); (M.F.)
- Department of Sport Science, University Innsbruck, 6020 Innsbruck, Austria
| | - Martin Faulhaber
- Austrian Society for Alpine and High-Altitude Medicine, 6414 Mieming, Austria; (M.B.); (M.F.)
- Department of Sport Science, University Innsbruck, 6020 Innsbruck, Austria
| | - Michael D. Kennedy
- Athlete Health Lab, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| |
Collapse
|
16
|
Management of Exercise-Induced Bronchoconstriction in Athletes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:2183-2192. [PMID: 32620432 DOI: 10.1016/j.jaip.2020.03.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/25/2020] [Accepted: 03/13/2020] [Indexed: 11/22/2022]
Abstract
Exercise-induced bronchoconstriction (EIB) is a phenomenon observed in asthma but is also seen in healthy individuals and frequently in athletes. High prevalence rates are observed in athletes engaged in endurance sports, winter sports, and swimming. The pathophysiology of EIB is thought to be related to hyperventilation, cold air, and epithelial damage caused by chlorine and fine particles in inspired air. Several diagnostic procedures can be used; however, the diagnosis of EIB based on self-reported symptoms is not reliable and requires an objective examination. The hyperosmolar inhalation test and eucapnic voluntary hyperpnea test, which involve indirect stimulation of the airway, are useful for the diagnosis of EIB. A short-acting β-agonist is the first choice for prevention of EIB, and an inhaled corticosteroid is essential for patients with asthma. Furthermore, treatment should accommodate antidoping requirements in elite athletes. Tailoring of the therapeutic strategy to the individual case and the prognosis after cessation of athletic activity are issues that should be clarified in the future.
Collapse
|
17
|
Omega-3 Fatty Acids for Sport Performance-Are They Equally Beneficial for Athletes and Amateurs? A Narrative Review. Nutrients 2020; 12:nu12123712. [PMID: 33266318 PMCID: PMC7760705 DOI: 10.3390/nu12123712] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 02/07/2023] Open
Abstract
Omega-3 fatty acids, specifically eicosapentanoic acid (EPA, 20:5n-3) and docosahexanoic acid (DHA, 22:6n-3) are receiving increasing attention in sports nutrition. While the usual focus is that of athletes, questions remain if the different training status between athletes and amateurs influences the response to EPA/DHA, and as to whether amateurs would benefit from EPA/DHA supplementation. We critically examine the efficacy of EPA/DHA on performance, recovery and injury/reduced risk of illness in athletes as well as amateurs. Relevant studies conducted in amateurs will not only broaden the body of evidence but shed more light on the effects of EPA/DHA in professionally trained vs. amateur populations. Overall, studies of EPA/DHA supplementation in sport performance are few and research designs rather diverse. Several studies suggest a potentially beneficial effect of EPA/DHA on performance by improved endurance capacity and delayed onset of muscle soreness, as well as on markers related to enhanced recovery and immune modulation. The majority of these studies are conducted in amateurs. While the evidence seems to broadly support beneficial effects of EPA/DHA supplementation for athletes and more so in amateurs, strong conclusions and clear recommendations about the use of EPA/DHA supplementation are currently hampered by inconsistent translation into clinical endpoints.
Collapse
|
18
|
Hogenkamp A, Ehlers A, Garssen J, Willemsen LEM. Allergy Modulation by N-3 Long Chain Polyunsaturated Fatty Acids and Fat Soluble Nutrients of the Mediterranean Diet. Front Pharmacol 2020; 11:1244. [PMID: 32973501 PMCID: PMC7472571 DOI: 10.3389/fphar.2020.01244] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/29/2020] [Indexed: 12/12/2022] Open
Abstract
The Mediterranean diet, containing valuable nutrients such as n-3 long chain poly-unsaturated fatty acids (LCPUFAs) and other fat-soluble micronutrients, is known for its health promoting and anti-inflammatory effects. Its valuable elements might help in the battle against the rising prevalence of non-communicable diseases (NCD), including the development of allergic diseases and other (chronic) inflammatory diseases. The fat fraction of the Mediterranean diet contains bioactive fatty acids but can also serve as a matrix to dissolve and increase the uptake of fat-soluble vitamins and phytochemicals, such as luteolin, quercetin, resveratrol and lycopene with known immunomodulatory and anti-inflammatory capacities. Especially n-3 LCPUFAs such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) derived from marine oils can target specific receptors or signaling cascades, act as eicosanoid precursors and/or alter membrane fluidity and lipid raft formation, hereby exhibiting anti-inflammatory properties. Beyond n-3 LCPUFAs, fat-soluble vitamins A, D, E, and K1/2 have the potential to affect pro-inflammatory signaling cascades by interacting with receptors or activating/inhibiting signaling proteins or phosphorylation in immune cells (DCs, T-cells, mast cells) involved in allergic sensitization or the elicitation/effector phase of allergic reactions. Moreover, fat-soluble plant-derived phytochemicals can manipulate signaling cascades, mostly by interacting with other receptors or signaling proteins compared to those modified by fat-soluble vitamins, suggesting potential additive or synergistic actions by applying a combination of these nutrients which are all part of the regular Mediterranean diet. Research concerning the effects of phytochemicals such as polyphenols has been hampered due to their poor bio-availability. However, their solubility and uptake are improved by applying them within the dietary fat matrix. Alternatively, they can be prepared for targeted delivery by means of pharmaceutical approaches such as encapsulation within liposomes or even unique nanoparticles. This review illuminates the molecular mechanisms of action and possible immunomodulatory effects of n-3 LCPUFAs and fat-soluble micronutrients from the Mediterranean diet in allergic disease development and allergic inflammation. This will enable us to further appreciate how to make use of the beneficial effects of n-3 LCPUFAs, fat-soluble vitamins and a selection of phytochemicals as active biological components in allergy prevention and/or symptom reduction.
Collapse
Affiliation(s)
- Astrid Hogenkamp
- Division of Pharmacology, Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
| | - Anna Ehlers
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.,Department of Dermatology/Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Johan Garssen
- Division of Pharmacology, Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands.,Global Centre of Excellence Immunology, Danone Nutricia Research B.V., Utrecht, Netherlands
| | - Linette E M Willemsen
- Division of Pharmacology, Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands
| |
Collapse
|
19
|
Dreßler M, Fussbroich D, Böhler L, Herrmann E, Benker N, Tytyk M, Schulze J, Schubert R, Beermann C, Zielen S. Oil supplementation with a special combination of n-3 and n-6 long-chain polyunsaturated fatty acids does not protect for exercise induced asthma: a double-blind placebo-controlled trial. Lipids Health Dis 2020; 19:167. [PMID: 32660564 PMCID: PMC7359229 DOI: 10.1186/s12944-020-01343-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 07/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many patients suffering from exercise-induced asthma (EIA) have normal lung function at rest and show symptoms and a decline in FEV1 when they do sports or during exercise-challenge. It has been described that long-chain polyunsaturated fatty acids (LCPUFA) could exert a protective effect on EIA. METHODS In this study the protective effect of supplementation with a special combination of n-3 and n-6 LCPUFA (sc-LCPUFA) (total 1.19 g/ day) were investigated in an EIA cold air provocation model. PRIMARY OUTCOME MEASURE Decrease in FEV1 after exercise challenge and secondary outcome measure: anti-inflammatory effects monitored by exhaled NO (eNO) before and after sc-LCPUFA supplementation versus placebo. RESULTS Ninety-nine patients with exercise-induced symptoms aged 10 to 45 were screened by a standardized exercise challenge in a cold air chamber at 4 °C. Seventy-three patients fulfilled the inclusion criteria of a FEV1 decrease > 15% and were treated double-blind placebo-controlled for 4 weeks either with sc-LCPUFA or placebo. Thirty-two patients in each group completed the study. Mean FEV1 decrease after cold air exercise challenge and eNO were unchanged after 4 weeks sc-LCPUFA supplementation. CONCLUSION Supplementation with sc-LCPUFA at a dose of 1.19 g/d did not have any broncho-protective and anti-inflammatory effects on EIA. TRIAL REGISTRATION Clinical trial registration number: NCT02410096. Registered 7 February 2015 at Clinicaltrial.gov.
Collapse
Affiliation(s)
- M Dreßler
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany
| | - D Fussbroich
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany.,Department of Food Technology, University of Applied Science, Fulda, Germany.,Faculty of Biological Sciences, Goethe-University, Frankfurt/Main, Germany
| | - L Böhler
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany
| | - E Herrmann
- Institute of Biostatistics and Mathematical Modelling, Goethe-University, Frankfurt/Main, Germany
| | - N Benker
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany
| | - M Tytyk
- Department of Food Technology, University of Applied Science, Fulda, Germany
| | - J Schulze
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany
| | - R Schubert
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany
| | - C Beermann
- Department of Food Technology, University of Applied Science, Fulda, Germany
| | - S Zielen
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic fibrosis, Goethe-University, Frankfurt/Main, Germany.
| |
Collapse
|
20
|
Greiwe J, Cooke A, Nanda A, Epstein SZ, Wasan AN, Shepard KV, Capão-Filipe M, Nish A, Rubin M, Gregory KL, Dass K, Blessing-Moore J, Randolph C. Work Group Report: Perspectives in Diagnosis and Management of Exercise-Induced Bronchoconstriction in Athletes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:2542-2555. [PMID: 32636147 DOI: 10.1016/j.jaip.2020.05.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 11/26/2022]
Abstract
Exercise-induced bronchoconstriction, otherwise known as exercise-induced bronchoconstriction with asthma or without asthma, is an acute airway narrowing that occurs as a result of exercise and can occur in patients with asthma. A panel of members from the American Academy of Allergy, Asthma & Immunology Sports, Exercise, & Fitness Committee reviewed the diagnosis and management of exercise-induced bronchoconstriction in athletes of all skill levels including recreational athletes, high school and college athletes, and professional athletes. A special emphasis was placed on the recommendations and regulations set forth by professional athletic organizations after a detailed review of their collective bargaining agreements, substance abuse policies, antidoping program manuals, and the World Anti-Doping Agency antidoping code. The recommendations in this review are based on currently available evidence in addition to providing guidance for athletes of all skill levels as well as their treating physicians to better understand which pharmaceutical and nonpharmaceutical management options are appropriate as well as which medications are permitted or prohibited, and the proper documentation required to remain compliant.
Collapse
Affiliation(s)
- Justin Greiwe
- Bernstein Allergy Group Inc, Cincinnati, Ohio; Division of Immunology/Allergy Section, Department of Internal Medicine, The University of Cincinnati College of Medicine, Cincinnati, Ohio.
| | - Andrew Cooke
- Lake Allergy, Asthma & Immunology PA, Tavares, Fla
| | - Anil Nanda
- Asthma and Allergy Center, Lewisville and Flower Mound, Texas; Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | | | - Kirk V Shepard
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine and James A. Haley Veterans' Hospital, Tampa, Fla
| | | | - Andy Nish
- Northeast Georgia Physician's Group Allergy and Asthma, Gainesville, Ga
| | - Mark Rubin
- Asthma and COPD Emmi Solutions, Chicago, Ill; CME Education Program Steering Committee, The France Foundation, Old Lyme, Conn
| | - Karen L Gregory
- Oklahoma Allergy and Asthma Clinic, Oklahoma City, Okla; School of Nursing and Health Studies, Georgetown University, Washington, DC
| | - Kathleen Dass
- Michigan Allergy, Asthma & Immunology Center PLLC, Oak Park, Mich; Division of Immunology/Allergy Section, Department of Internal Medicine, Oakland University William Beaumont Hospital, Rochester, Mich
| | | | | |
Collapse
|
21
|
Fish Oil Supplementation in Overweight/Obese Patients with Uncontrolled Asthma. A Randomized Trial. Ann Am Thorac Soc 2020; 16:554-562. [PMID: 30678465 DOI: 10.1513/annalsats.201807-446oc] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Rationale: Omega-3 fatty acid (n3PUFA) supplementation has been proposed as a promising antiasthma strategy. The rs59439148 ALOX5 polymorphism affects leukotriene production and possibly inflammatory responses to n3PUFA. Objectives: Assess the effects of n3PUFA supplementation and ALOX5 genotype on asthma control in patients with obesity and uncontrolled asthma. Methods: This multicenter trial among 12- to 25-year-olds with overweight/obesity and uncontrolled asthma randomized subjects in a 3:1 allotment to n3PUFA (4 g/d) or soy oil control for 24 weeks. Asthma Control Questionnaire was the primary outcome; secondary outcomes included blood leukocyte n3PUFA levels, urinary leukotriene-E4, spirometry, and asthma-related events. The number of SP1 tandem repeats in rs59439148 determined ALOX5 genotype status. Simple and multivariable generalized linear models assessed effects on outcomes. Results: Ninety-eight participants were randomized (77 to PUFA, 21 to control), and more than 86% completed all visits. Asthma and demographic characteristics were similar among treatment groups. n3PUFA treatment increased the n3-to-n6 PUFA ratio in circulating granulocytes (P = 0.029) and monocytes (P = 0.004) but did not affect mean Asthma Control Questionnaire change at 6 months (n3PUFA: mean, -0.09; 95% confidence interval [CI], 0.09 to 0.10; vs. control: mean, -0.18; 95% CI, -0.42 to 0.06; P = 0.58). Changes in urinary leukotriene-E4 (P = 0.24), forced expiratory volume in 1 second % predicted (P = 0.88), and exacerbations (relative risk [RR], 0.92; 95% CI, 0.30-2.89) at 6 months were similar in both groups. n3PUFA treatment was associated with reduced asthma-related phone contacts (RR, 0.34; 95% CI, 0.13-0.86; P = 0.02). ALOX5 genotype did not affect n3PUFA treatment responses. Conclusions: We did not find evidence that n3PUFA use improves most asthma-related outcomes and cannot recommend it as a prevention strategy for overweight/obese patients with asthma. Clinical trial registered with www.clinicaltrials.gov (NCT01027143).
Collapse
|
22
|
Lewis NA, Daniels D, Calder PC, Castell LM, Pedlar CR. Are There Benefits from the Use of Fish Oil Supplements in Athletes? A Systematic Review. Adv Nutr 2020; 11:1300-1314. [PMID: 32383739 PMCID: PMC7490155 DOI: 10.1093/advances/nmaa050] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/14/2020] [Accepted: 04/02/2020] [Indexed: 01/18/2023] Open
Abstract
Despite almost 25 y of fish oil supplementation (FS) research in athletes and widespread use by the athletic community, no systematic reviews of FS in athletes have been conducted. The objectives of this systematic review are to: 1) provide a summary of the effect of FS on the athlete's physiology, health, and performance; 2) report on the quality of the evidence; 3) document any side effects as reported in the athlete research; 4) discuss any risks associated with FS use; and 5) provide guidance for FS use and highlight gaps for future research. Electronic databases (PubMed, Embase, Web of Science, Google Scholar) were searched up until April 2019. Only randomized placebo-controlled trials (RCTs) in athletes, assessing the effect of FS on a health, physiological/biochemical, or performance variable were included. Of the 137 papers identified through searches, 32 met inclusion criteria for final analysis. Athletes varied in classification from recreational to elite, and from Olympic to professional sports. Mean age for participants was 24.9 ± 4.5 y, with 70% of RCTs in males. We report consistent effects for FS on reaction time, mood, cardiovascular dynamics in cyclists, skeletal muscle recovery, the proinflammatory cytokine TNF-α, and postexercise NO responses. No clear effects on endurance performance, lung function, muscle force, or training adaptation were evident. Methodological quality, applying the Physiotherapy Evidence Database (PEDro) scale, ranged from 6 to a maximum of 11, with only 4 RCTs reporting effect sizes. Few negative outcomes were reported. We report various effects for FS on the athlete's physiology; the most consistent findings were on the central nervous system, cardiovascular system, proinflammatory cytokines, and skeletal muscle. We provide recommendations for future research and discuss the potential risks with FS use.
Collapse
Affiliation(s)
- Nathan A Lewis
- English Institute of Sport, Sports Training Village, University of Bath, United Kingdom,Faculty of Sport, Health and Applied Science, St Mary's University, London, United Kingdom,Orreco, Research & Innovation Centre, National University of Ireland, Galway, Ireland,Address correspondence to NAL (e-mail: )
| | - Diarmuid Daniels
- Faculty of Sport, Health and Applied Science, St Mary's University, London, United Kingdom,Orreco, Research & Innovation Centre, National University of Ireland, Galway, Ireland,School of Medicine, National University of Ireland, Galway, Ireland
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - Lindy M Castell
- Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - Charles R Pedlar
- Faculty of Sport, Health and Applied Science, St Mary's University, London, United Kingdom,Orreco, Research & Innovation Centre, National University of Ireland, Galway, Ireland,Division of Surgery and Interventional Science, University College London (UCL), London, United Kingdom
| |
Collapse
|
23
|
Higher Omega-3 Index Is Associated with Better Asthma Control and Lower Medication Dose: A Cross-Sectional Study. Nutrients 2019; 12:nu12010074. [PMID: 31892115 PMCID: PMC7019867 DOI: 10.3390/nu12010074] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/11/2019] [Accepted: 12/19/2019] [Indexed: 01/01/2023] Open
Abstract
Asthma is a chronic inflammatory airway disease, associated with systemic inflammation. Omega-3 polyunsaturated fatty acids (n-3 PUFA) have established anti-inflammatory effects, thus having potential as an adjunct therapy in asthma. This study aimed to compare erythrocyte n-3 PUFA in adults with (n = 255) and without (n = 137) asthma and determine the relationship between erythrocyte n-3 PUFA and clinical asthma outcomes. Subjects had blood collected, lung function measured and Juniper Asthma Control Questionnaire (ACQ) score calculated. Fatty acids were measured in erythrocyte membranes by gas chromatography, and the omega-3 index (O3I) was calculated (% eicosapentaenoic acid + % docosahexaenoic acid). O3I was similar in subjects with and without asthma (p = 0.089). A higher O3I was observed in subjects with controlled or partially controlled asthma (ACQ < 1.5) compared to subjects with uncontrolled asthma (ACQ ≥ 1.5) (6.0% (5.4–7.2) versus 5.6% (4.6–6.4) p = 0.033). Subjects with a high O3I (≥8%) had a lower maintenance dose of inhaled corticosteroids (ICS) compared to those with a low O3I (<8%) (1000 μg (400–1000) versus 1000 μg (500–2000) p = 0.019). This study demonstrates that a higher O3I is associated with better asthma control and with lower ICS dose, suggesting that a higher erythrocyte n-3 PUFA level may have a role in asthma management.
Collapse
|
24
|
Radzikowska U, Rinaldi AO, Çelebi Sözener Z, Karaguzel D, Wojcik M, Cypryk K, Akdis M, Akdis CA, Sokolowska M. The Influence of Dietary Fatty Acids on Immune Responses. Nutrients 2019; 11:E2990. [PMID: 31817726 PMCID: PMC6950146 DOI: 10.3390/nu11122990] [Citation(s) in RCA: 160] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/25/2019] [Accepted: 12/02/2019] [Indexed: 12/16/2022] Open
Abstract
Diet-derived fatty acids (FAs) are essential sources of energy and fundamental structural components of cells. They also play important roles in the modulation of immune responses in health and disease. Saturated and unsaturated FAs influence the effector and regulatory functions of innate and adaptive immune cells by changing membrane composition and fluidity and by acting through specific receptors. Impaired balance of saturated/unsaturated FAs, as well as n-6/n-3 polyunsaturated FAs has significant consequences on immune system homeostasis, contributing to the development of many allergic, autoimmune, and metabolic diseases. In this paper, we discuss up-to-date knowledge and the clinical relevance of the influence of dietary FAs on the biology, homeostasis, and functions of epithelial cells, macrophages, dendritic cells, neutrophils, innate lymphoid cells, T cells and B cells. Additionally, we review the effects of dietary FAs on the pathogenesis of many diseases, including asthma, allergic rhinitis, food allergy, atopic dermatitis, rheumatoid arthritis, multiple sclerosis as well as type 1 and 2 diabetes.
Collapse
Affiliation(s)
- Urszula Radzikowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos Wolfgang, Switzerland
- Christine Kühne-Center for Allergy Research and Education, 7265 Davos Wolfgang, Switzerland
- Department of Regenerative Medicine and Immune Regulation, Medical University of Bialystok, 15-269 Bialystok, Poland
| | - Arturo O Rinaldi
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos Wolfgang, Switzerland
- Christine Kühne-Center for Allergy Research and Education, 7265 Davos Wolfgang, Switzerland
| | - Zeynep Çelebi Sözener
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos Wolfgang, Switzerland
- Department of Chest Disease, Division of Allergy and Clinical Immunology, Ankara University School of Medicine, 06100 Ankara, Turkey
| | - Dilara Karaguzel
- Department of Biology, Faculty of Science, Hacettepe University, 06800 Ankara, Turkey
| | - Marzena Wojcik
- Department of Structural Biology, Medical University of Lodz, 90-752 Lodz, Poland
| | - Katarzyna Cypryk
- Department of Internal Medicine and Diabetology, Medical University of Lodz, 90-549 Lodz, Poland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos Wolfgang, Switzerland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos Wolfgang, Switzerland
- Christine Kühne-Center for Allergy Research and Education, 7265 Davos Wolfgang, Switzerland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7265 Davos Wolfgang, Switzerland
- Christine Kühne-Center for Allergy Research and Education, 7265 Davos Wolfgang, Switzerland
| |
Collapse
|
25
|
Modena BD, White AA. Can Diet Modification Be an Effective Treatment in Aspirin-Exacerbated Respiratory Disease? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 6:832-833. [PMID: 29747986 DOI: 10.1016/j.jaip.2017.11.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 11/18/2017] [Indexed: 10/17/2022]
Affiliation(s)
- Brian D Modena
- Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif; Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, Calif
| | - Andrew A White
- Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, Calif.
| |
Collapse
|
26
|
Venter C, Meyer RW, Nwaru BI, Roduit C, Untersmayr E, Adel‐Patient K, Agache I, Agostoni C, Akdis CA, Bischoff S, du Toit G, Feeney M, Frei R, Garn H, Greenhawt M, Hoffmann‐Sommergruber K, Lunjani N, Maslin K, Mills C, Muraro A, Pali I, Poulson L, Reese I, Renz H, Roberts GC, Smith P, Smolinska S, Sokolowska M, Stanton C, Vlieg‐Boerstra B, O'Mahony L. EAACI position paper: Influence of dietary fatty acids on asthma, food allergy, and atopic dermatitis. Allergy 2019; 74:1429-1444. [PMID: 31032983 DOI: 10.1111/all.13764] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/12/2019] [Accepted: 02/21/2019] [Indexed: 12/11/2022]
Abstract
The prevalence of allergic diseases such as allergic rhinitis, asthma, food allergy, and atopic dermatitis has increased dramatically during the last decades, which is associated with altered environmental exposures and lifestyle practices. The purpose of this review was to highlight the potential role for dietary fatty acids, in the prevention and management of these disorders. In addition to their nutritive value, fatty acids have important immunoregulatory effects. Fatty acid-associated biological mechanisms, human epidemiology, and intervention studies are summarized in this review. The influence of genetics and the microbiome on fatty acid metabolism is also discussed. Despite critical gaps in our current knowledge, it is increasingly apparent that dietary intake of fatty acids may influence the development of inflammatory and tolerogenic immune responses. However, the lack of standardized formats (ie, food versus supplement) and standardized doses, and frequently a lack of prestudy serum fatty acid level assessments in clinical studies significantly limit our ability to compare allergy outcomes across studies and to provide clear recommendations at this time. Future studies must address these limitations and individualized medical approaches should consider the inclusion of specific dietary factors for the prevention and management of asthma, food allergy, and atopic dermatitis.
Collapse
Affiliation(s)
- Carina Venter
- Section of Allergy and Immunology University of Colorado Denver School of Medicine, Children's Hospital Colorado Colorado
| | | | - Bright I. Nwaru
- Krefting Research Centre, Institute of Medicine University of Gothenburg Gothenburg Sweden
| | - Caroline Roduit
- University Children's Hospital Zurich Switzerland
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
| | - Eva Untersmayr
- Institute for Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Karine Adel‐Patient
- Service de Pharmacologie et d'Immunoanalyse, Laboratoire d'Immuno‐Allergie Alimentaire (LIAA) INRA, CEA, Université Paris Saclay Gif sur Yvette Cedex France
| | | | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda ‐ Ospedale Maggiore Policlinico Milano Italy
- Dipartimento di Scienze Cliniche e di Comunita Universita' degli Studi Milano Italy
| | - Cezmi A. Akdis
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Stephan Bischoff
- Institut für Ernährungsmedizin Universität Hohenheim Stuttgart Germany
| | - George du Toit
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy King's College London London UK
- Guy's & St Thomas' Hospital London UK
| | - Mary Feeney
- Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy King's College London London UK
- Guy's & St Thomas' Hospital London UK
| | - Remo Frei
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Holger Garn
- Center for Tumor‐ and Immunobiology (ZTI), Institute of Laboratory Medicine and Pathobiochemistry Philipps University of Marburg ‐ Medical Faculty Marburg Germany
| | - Matthew Greenhawt
- School of Medicine, Section of Allergy and Immunology Children's Hospital Colorado, University of Colorado Aurora Colorado
| | - Karin Hoffmann‐Sommergruber
- Institute for Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Nonhlanhla Lunjani
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- University of Cape Town Cape Town South Africa
| | - Kate Maslin
- MRC Lifecourse Epidemiology Unit University of Southampton Southampton UK
| | - Clare Mills
- School of Biological Sciences, Manchester Academic Health Sciences Centre, Manchester Institute of Biotechnology The University of Manchester Manchester UK
| | - Antonella Muraro
- Centro di Specializzazione Regionale per lo Studio e la Cura delle Allergie e delle Intolleranze Alimentari presso l'Azienda Ospedaliera Università di Padova Padova Italy
| | - Isabella Pali
- Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna Medical University Vienna Vienna Austria
| | - Lars Poulson
- Allergy Clinic, Dept. of Skin and Allergy Diseases Copenhagen University Hospital at Gentofte Copenhagen Denmark
| | - Imke Reese
- Dietary Counseling and Nutrition Therapy Centre Munich Germany
| | - Harald Renz
- Institute of Laboratory Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), German Center for Lung Research (DZL) Philipps Universität Marburg Marburg Germany
| | - Graham C. Roberts
- The David Hide Asthma and Allergy Research Centre St Mary's Hospital Newport UK
- NIHR Biomedical Research Centre University Hospital Southampton NHS Foundation Trust Southampton UK
- Faculty of Medicine, Clinical and Experimental Sciences and Human Development in Health Academic Units University of Southampton Southampton UK
| | - Peter Smith
- School of Medicine Griffith University Southport Australia
| | - Sylwia Smolinska
- Department of Clinical Immunology Wroclaw Medical University Wroclaw Poland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | | | | | - Liam O'Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Depts of Medicine and Microbiology APC Microbiome Ireland, National University of Ireland Cork Ireland
| |
Collapse
|
27
|
Omega-3 Fatty Acids for Obesity and Asthma: Is the Good Fat Not Quite Good Enough? Ann Am Thorac Soc 2019; 16:542-544. [PMID: 31042092 DOI: 10.1513/annalsats.201901-049ed] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
28
|
Abstract
PURPOSE OF REVIEW Sarcoidosis is a chronic disease, which is routinely treated with corticosteroids. Steroid resistance or steroid-induced adverse effects require alternatives. Other immune-modulating pharmacological treatments have been developed, and therefore expanded tremendously. Until now, the role of nutrition in the overall management of sarcoidosis has been neglected although anti-inflammatory properties of nutritional components have been known for many years now. New nutritional possibilities emerge from already existing data and offer new therapeutic avenues in the treatment of sarcoidosis. RECENT FINDINGS Various dietary components have been shown to reduce pulmonary inflammatory processes. It is increasingly recognized, however, that the specificity and magnitude of the effect of nutrition differs from pharmacological interventions. Conventional randomized clinical trials are less suitable to test the effect of nutrition in comparison with testing drugs. Mechanistic knowledge on the action of dietary components in conjunction with an increasing understanding of the molecular processes underlying steroid resistance (as investigated in asthma and COPD and unfortunately hardly in sarcoidosis) lead to exciting suggestions on combinations of nutrition/nutritional bioactive compounds and corticosteroids that may benefit sarcoidosis patients. SUMMARY In order to understand the effects of nutrition in chronic disease, it is important to elucidate mechanisms and pathways of effects. Several complementing lines of evidence should be integrated in order to be able to advise sarcoidosis patients on a healthy diet as such or in combination with prescribed anti-inflammatory therapy.
Collapse
|
29
|
Dickinson J, Amirav I, Hostrup M. Nonpharmacologic Strategies to Manage Exercise-Induced Bronchoconstriction. Immunol Allergy Clin North Am 2019; 38:245-258. [PMID: 29631733 DOI: 10.1016/j.iac.2018.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Pharmacologic management of exercise-induced bronchoconstriction (EIB) is the mainstay of preventative therapy. There are some nonpharmacologic interventions, however, that may assist the management of EIB. This review discusses these nonpharmacologic interventions and how they may be applied to patients and athletes with EIB.
Collapse
Affiliation(s)
- John Dickinson
- School of Sport and Exercise Sciences, University of Kent, UK
| | - Israel Amirav
- Department of Paediatrics, University of Alberta, Edmonton, Canada
| | - Morten Hostrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, August Krogh 2nd Floor, Universitetsparken 13, Copenhagen DK-2100, Denmark; Department of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
| |
Collapse
|
30
|
Brannan JD, Porsbjerg C. Testing for Exercise-Induced Bronchoconstriction. Immunol Allergy Clin North Am 2019; 38:215-229. [PMID: 29631731 DOI: 10.1016/j.iac.2018.01.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Exercise-induced bronchoconstriction (EIB) is a form of airway hyperresponsiveness that occurs with or without current symptoms of asthma. EIB is an indicator of active and treatable pathophysiology in persons with asthma. The objective documentation of EIB permits the identification of an individual who may be at risk during a recreational sporting activity or when exercising as an occupational duty. EIB can be identified with laboratory exercise testing or surrogate tests for EIB. These include eucapnic voluntary hyperpnea and osmotic stimuli (eg, inhaled mannitol) and offer improved diagnostic sensitivity to identify EIB and improved standardization when compared with laboratory exercise.
Collapse
Affiliation(s)
- John D Brannan
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Lookout Road, New Lambton, New South Wales 2305, Australia.
| | - Celeste Porsbjerg
- Respiratory Research Unit, Department of Respiratory Medicine, Bispebjerg Hospital, Bispebjerg Bakke 23, Copenhagen 2400, Denmark
| |
Collapse
|
31
|
Adams S, Lopata AL, Smuts CM, Baatjies R, Jeebhay MF. Relationship between Serum Omega-3 Fatty Acid and Asthma Endpoints. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:E43. [PMID: 30585204 PMCID: PMC6338947 DOI: 10.3390/ijerph16010043] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/10/2018] [Accepted: 12/20/2018] [Indexed: 01/14/2023]
Abstract
Recent studies have highlighted the potential protective role of omega-3 polyunsaturated fatty acids (n-3 PUFA) in asthma. This study aimed at determining the association between seafood intake, serum PUFA composition and clinical endpoints of asthma in adults. A cross-sectional study of 642 subjects used the European Committee Respiratory Health Survey (ECRHS) questionnaire, skin prick tests, spirometry and methacholine challenge tests following ATS guidelines. Sera was analysed for n-3 and n-6 PUFA composition. Subjects had a mean age of 34 years, were largely female (65%) and 51% were current smokers. While 99% reported fish consumption, rock lobster, mussels, squid and abalone were also consumed less frequently. The prevalence of asthma symptoms was 11%, current asthma (ECRHS definition) was 8% and non-specific bronchial hyperresponsiveness (NSBH) was much higher (26%) In adjusted models the n-3 PUFAs 20:5 (EPA) and 22:5 (DPA) were significantly associated with a decreased risk of having NSBH. Total n-3 PUFA composition was associated with decreased NSBH risk (OR = 0.92), while high n-6 PUFA composition was associated with an increased risk (OR = 1.14).
Collapse
Affiliation(s)
- Shahieda Adams
- Occupational Medicine Division and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Observatory, 7925 Cape Town, South Africa.
| | - Andreas L Lopata
- Molecular Allergy Research Laboratory, School of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Douglas, QLD 4814, Australia.
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2520, South Africa.
| | - Roslynn Baatjies
- Occupational Medicine Division and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Observatory, 7925 Cape Town, South Africa.
- Department of Environmental and Occupational Studies, Cape Peninsula University of Technology (CPUT), Cape Town 7535, South Africa.
| | - Mohamed F Jeebhay
- Occupational Medicine Division and Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Observatory, 7925 Cape Town, South Africa.
| |
Collapse
|
32
|
Hallstrand TS, Leuppi JD, Joos G, Hall GL, Carlsen KH, Kaminsky DA, Coates AL, Cockcroft DW, Culver BH, Diamant Z, Gauvreau GM, Horvath I, de Jongh FHC, Laube BL, Sterk PJ, Wanger J. ERS technical standard on bronchial challenge testing: pathophysiology and methodology of indirect airway challenge testing. Eur Respir J 2018; 52:13993003.01033-2018. [PMID: 30361249 DOI: 10.1183/13993003.01033-2018] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 07/20/2018] [Indexed: 12/20/2022]
Abstract
Recently, this international task force reported the general considerations for bronchial challenge testing and the performance of the methacholine challenge test, a "direct" airway challenge test. Here, the task force provides an updated description of the pathophysiology and the methods to conduct indirect challenge tests. Because indirect challenge tests trigger airway narrowing through the activation of endogenous pathways that are involved in asthma, indirect challenge tests tend to be specific for asthma and reveal much about the biology of asthma, but may be less sensitive than direct tests for the detection of airway hyperresponsiveness. We provide recommendations for the conduct and interpretation of hyperpnoea challenge tests such as dry air exercise challenge and eucapnic voluntary hyperpnoea that provide a single strong stimulus for airway narrowing. This technical standard expands the recommendations to additional indirect tests such as hypertonic saline, mannitol and adenosine challenge that are incremental tests, but still retain characteristics of other indirect challenges. Assessment of airway hyperresponsiveness, with direct and indirect tests, are valuable tools to understand and to monitor airway function and to characterise the underlying asthma phenotype to guide therapy. The tests should be interpreted within the context of the clinical features of asthma.
Collapse
Affiliation(s)
- Teal S Hallstrand
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA
| | - Joerg D Leuppi
- University Clinic of Medicine, Cantonal Hospital Baselland, Liestal, and Medical Faculty University of Basel, Basel, Switzerland
| | - Guy Joos
- Dept of Respiratory Medicine, University of Ghent, Ghent, Belgium
| | - Graham L Hall
- Children's Lung Health, Telethon Kids Institute, School of Physiotherapy and Exercise Science, Curtin University, and Centre for Child Health Research University of Western Australia, Perth, Australia
| | - Kai-Håkon Carlsen
- University of Oslo, Institute of Clinical Medicine, and Oslo University Hospital, Division of Child and Adolescent Medicine, Oslo, Norway
| | - David A Kaminsky
- Pulmonary and Critical Care, University of Vermont College of Medicine, Burlington, VT, USA
| | - Allan L Coates
- Division of Respiratory Medicine, Translational Medicine, Research Institute-Hospital for Sick Children, University of Toronto, ON, Canada
| | - Donald W Cockcroft
- Division of Respirology, Critical Care and Sleep Medicine, Royal University Hospital, Saskatoon, SK, Canada
| | - Bruce H Culver
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA
| | - Zuzana Diamant
- Dept of Clinical Pharmacy and Pharmacology and QPS-Netherlands, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.,Dept of Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Gail M Gauvreau
- Division of Respirology, Dept of Medicine, McMaster University, Hamilton, ON, Canada
| | - Ildiko Horvath
- Dept of Pulmonology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Frans H C de Jongh
- Dept of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Beth L Laube
- Division of Pediatric Pulmonology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter J Sterk
- Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Jack Wanger
- Pulmonary Function Testing and Clinical Trials Consultant, Rochester, MN, USA
| | | |
Collapse
|
33
|
Children with Obesity and Asthma: Which Are the Best Options for Their Management? Nutrients 2018; 10:nu10111634. [PMID: 30400197 PMCID: PMC6267365 DOI: 10.3390/nu10111634] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 10/27/2018] [Accepted: 10/31/2018] [Indexed: 12/12/2022] Open
Abstract
Obesity and asthma are complex disorders related to gene-environment interactions and various lifestyle factors. At present, they represent two of the most significant paediatric health problems worldwide, particularly in industrialized nations. The aim of this narrative review is to evaluate possible therapeutic strategies to manage asthma in children with overweight/obesity. PubMed was used to search for all of the studies published from January 2008 to June 2018 using the following key words: “asthma” and “overweight” or “obesity” or “obese” and “children” or “paediatric”. The literature review showed that growing evidence underlines the existence of an “obese asthma” phenotype characterised by difficult-to-control asthma with additional symptoms, worse control, more frequent and severe exacerbations, reduced response to inhaled corticosteroids, and lower quality of life than other phenotypes. Currently, therapeutic strategies centred on prevention are suggested and the development of resources to assist families with weight loss strategies seems useful for effective weight control and optimal asthma management. Studies on vitamin D supplementation and further knowledge are needed to better define the best therapeutic options to manage asthma in children with overweight/obesity and to reduce the onset and severity of this chronic respiratory disease through the design of a multifactorial intervention.
Collapse
|
34
|
Zhou J, Chen L, Liu Z, Sang L, Li Y, Yuan D. Changes in erythrocyte polyunsaturated fatty acids and plasma eicosanoids level in patients with asthma. Lipids Health Dis 2018; 17:206. [PMID: 30172255 PMCID: PMC6119583 DOI: 10.1186/s12944-018-0853-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/23/2018] [Indexed: 01/22/2023] Open
Abstract
Background To investigate the changes of polyunsaturated fatty acids (PUFAs) and their downstream eicosanoids in patients with asthma, the levels of erythrocyte membrane lipids and plasma lipid metabolites were examined. Methods Erythrocyte membrane lipids were extracted and esterificated, and then fatty acid compositions were determined by gas chromatography. The concentrations of six eicosanoids of PGE2, TXA2, LTB4, PGE1, 6-k-PGF1α and PGF2α in plasma were measured by ELISA. Results The results showed that the contents of erythrocyte membrane fatty acids in patients with asthma were mainly composed of C16:0, C18:0, C18:1, C18:2(n-6), and C20:4(n-6). The ratio n-6/n-3 PUFAs in patients and health persons were (4.42 ± 1.33):1 and (3.21 ± 0.79):1 (p < 0.01), showing statistically significant differences. ELISA results showed that the levels of plasma PGE2, TXB2, and PGE1 in patients were higher than health persons; and the levels of eicosanoids of PGF2α and 6-k-PGF1α were significantly lower in patient group than healthy group (p < 0.05), but LTB4 was no obvious difference (p = 0.09). Increased ratio of n-6/n-3 PUFAs is consistent to the increased levels of pro-inflammatory PGE2 and TXB2 and anti-inflammatory PGE1 originated from C20:4(n-6) and C18:2(n-6), indicating that increased ratio of n-6/n-3 PUFAs and eicosanoids from n-6 PUFAs might promote the progress of airway inflammation of asthma. Conclusion Changes of erythrocyte fatty acids, n-6/n-3 PUFAs ratio and the levels of plasma PGE2, TXB2, and PGE1 in patients with asthma were relevant to airway inflammation in some extent. Therefore, it could be proposed that increase of n-3/n-6 PUFAs ratio by diet supplementation of n-3 PUFAs might effectively improve airway inflammation in asthma.
Collapse
Affiliation(s)
- Jing Zhou
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China
| | - Lifang Chen
- Department of Respiratory, The affiliated hospital of Guangdong medical University, Zhanjiang, 524023, China
| | - Zhenjie Liu
- The Second Affiliated Hospital of Guangdong University of Chinese Medicine, Guangzhou, 510120, China
| | - Ling Sang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China
| | - Yimin Li
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Health, Guangzhou, 510120, China
| | - Dongjuan Yuan
- College of Veterinary Medicine, South China Agricultural University, No.483 Wushan Rd, Guangzhou, 510642, People's Republic of China. .,Department of Biochemistry, Guangdong Medical University, Zhanjiang, 524023, China.
| |
Collapse
|
35
|
Zhang YG, Xia Y, Lu R, Sun J. Inflammation and intestinal leakiness in older HIV+ individuals with fish oil treatment. Genes Dis 2018; 5:220-225. [PMID: 30320186 PMCID: PMC6176151 DOI: 10.1016/j.gendis.2018.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 07/06/2018] [Indexed: 01/27/2023] Open
Abstract
Fish oil is a natural product that has shown efficacy for managing inflammatory conditions with few side effects. There is emerging evidence that crosstalks between gut epithelial cells and immune cells contribute to chronic infectious diseases. HIV-infected (HIV+) older adults show age-related co-morbidities at a younger age than their uninfected counterparts. Persistent inflammation related to the chronic viral infection and its sequelae is thought to contribute to this disparity. However, little is known about whether fish oil reduces intestinal inflammation in HIV + patients. We measure inflammation and gut barrier function in HIV + older adults (median age = 52, N = 33), following 12 weeks of fish oil supplementation (a total daily dose of 1.6 g of omega-3 fatty acids). We showed a reduction in inflammation and gut permeability as measured by CD14, inflammatory cytokines, lipopolysaccharide, and lipopolysaccharide binding protein. The results indicate that older HIV + adults may benefit from a diet supplemented with the omega-3 fatty acids found in fish oil.
Collapse
Affiliation(s)
- Yong-Guo Zhang
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Illinois, Chicago, IL, 60612, USA
| | - Yinglin Xia
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Illinois, Chicago, IL, 60612, USA
| | - Rong Lu
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Illinois, Chicago, IL, 60612, USA
| | - Jun Sun
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Illinois, Chicago, IL, 60612, USA
| |
Collapse
|
36
|
Schneider TR, Johns CB, Palumbo ML, Murphy KC, Cahill KN, Laidlaw TM. Dietary Fatty Acid Modification for the Treatment of Aspirin-Exacerbated Respiratory Disease: A Prospective Pilot Trial. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 6:825-831. [PMID: 29133219 DOI: 10.1016/j.jaip.2017.10.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 09/27/2017] [Accepted: 10/12/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND The high levels of eicosanoid production and the clinical efficacy of leukotriene-modifying pharmacotherapies for patients with aspirin-exacerbated respiratory disease (AERD) suggest that other interventions targeting arachidonic acid dysregulation may also improve disease control. OBJECTIVE To assess the utility of a high omega-3/low omega-6 diet for the treatment of AERD. METHODS Prospective, nonblinded dietary intervention in 10 adult patients with AERD at Brigham and Women's Hospital in Boston, MA. The primary objective was for subjects to reduce dietary omega-6 fatty acid consumption to less than 4 g/d and increase omega-3 intake to more than 3 g/d. The primary outcome was change in urinary leukotriene E4, with changes in other eicosanoids, platelet activation, lung function, and patient-reported questionnaires also assessed. RESULTS Of the 10 subjects who screened for the study, all 10 completed the dietary intervention. Urinary leukotriene E4 decreased by 0.17 ng/mg (95% CI, -0.29 to -0.04; P = .02) and tetranor prostaglandin D-M decreased by 0.66 ng/mg creatinine (95% CI, -1.21 to -0.11; P = .02). There was a 15.1-point reduction in the 22-item Sino-Nasal Outcome Test score (95% CI, -24.3 to -6.0; P = .01), a 0.27-point reduction in the 7-item Asthma Control Questionnaire score (95% CI, -0.52 to -0.03; P = .03), and no change in FEV1 % predicted (P = .92) or forced vital capacity % predicted (P = .74). All patients lost some weight over the 2-week intervention period, and there were no diet-associated adverse events. CONCLUSIONS A high omega-3/low omega-6 diet may be an appropriate adjunct treatment option for patients with AERD.
Collapse
Affiliation(s)
- Thomas R Schneider
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Mass
| | - Christina B Johns
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Mass
| | - Marina L Palumbo
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Mass
| | - Katherine C Murphy
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Mass
| | - Katherine N Cahill
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Tanya M Laidlaw
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Boston, Mass; Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
| |
Collapse
|
37
|
Comparable reductions in hyperpnoea-induced bronchoconstriction and markers of airway inflammation after supplementation with 6·2 and 3·1 g/d of long-chain n-3 PUFA in adults with asthma. Br J Nutr 2017; 117:1379-1389. [PMID: 28606216 DOI: 10.1017/s0007114517001246] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Although high dose n-3 PUFA supplementation reduces exercise- and hyperpnoea-induced bronchoconstriction (EIB/HIB), there are concurrent issues with cost, compliance and gastrointestinal discomfort. It is thus pertinent to establish the efficacy of lower n-3 PUFA doses. Eight male adults with asthma and HIB and eight controls without asthma were randomly supplemented with two n-3 PUFA doses (6·2 g/d (3·7 g EPA and 2·5 g DHA) and 3·1 g/d (1·8 g EPA and 1·3 g DHA)) and a placebo, each for 21 d followed by 14 d washout. A eucapnic voluntary hyperpnoea (EVH) challenge was performed before and after treatments. Outcome measures remained unchanged in the control group. In the HIB group, the peak fall in forced expiratory volume in 1 s (FEV1) after EVH at day 0 (-1005 (sd 520) ml, -30 (sd 18) %) was unchanged after placebo. The peak fall in FEV1 was similarly reduced from day 0 to day 21 of 6·2 g/d n-3 PUFA (-1000 (sd 460) ml, -29 (sd 17) % v. -690 (sd 460) ml, -20 (sd 15) %) and 3·1 g/d n-3 PUFA (-970 (sd 480) ml, -28 (sd 18) % v. -700 (sd 420) ml, -21 (sd 15) %) (P<0·001). Baseline fraction of exhaled nitric oxide was reduced by 24 % (P=0·020) and 31 % (P=0·018) after 6·2 and 3·1 g/d n-3 PUFA, respectively. Peak increases in 9α, 11β PGF2 after EVH were reduced by 65 % (P=0·009) and 56 % (P=0·041) after 6·2 and 3·1 g/d n-3 PUFA, respectively. In conclusion, 3·1 g/d n-3 PUFA supplementation attenuated HIB and markers of airway inflammation to a similar extent as a higher dose. Lower doses of n-3 PUFA thus represent a potentially beneficial adjunct treatment for adults with asthma and EIB.
Collapse
|
38
|
A prebiotic galactooligosaccharide mixture reduces severity of hyperpnoea-induced bronchoconstriction and markers of airway inflammation. Br J Nutr 2017; 116:798-804. [PMID: 27523186 DOI: 10.1017/s0007114516002762] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Gut microbes have a substantial influence on systemic immune function and allergic sensitisation. Manipulation of the gut microbiome through prebiotics may provide a potential strategy to influence the immunopathology of asthma. This study investigated the effects of prebiotic Bimuno-galactooligosaccharide (B-GOS) supplementation on hyperpnoea-induced bronchoconstriction (HIB), a surrogate for exercise-induced bronchoconstriction, and airway inflammation. A total of ten adults with asthma and HIB and eight controls without asthma were randomised to receive 5·5 g/d of either B-GOS or placebo for 3 weeks separated by a 2-week washout period. The peak fall in forced expiratory volume in 1 s (FEV1) following eucapnic voluntary hyperpnoea (EVH) defined HIB severity. Markers of airway inflammation were measured at baseline and after EVH. Pulmonary function remained unchanged in the control group. In the HIB group, the peak post-EVH fall in FEV1 at day 0 (-880 (sd 480) ml) was unchanged after placebo, but was attenuated by 40 % (-940 (sd 460) v. -570 (sd 310) ml, P=0·004) after B-GOS. In the HIB group, B-GOS reduced baseline chemokine CC ligand 17 (399 (sd 140) v. 323 (sd 144) pg/ml, P=0·005) and TNF-α (2·68 (sd 0·98) v. 2·18 (sd 0·59) pg/ml, P=0·040) and abolished the EVH-induced 29 % increase in TNF-α. Baseline C-reactive protein was reduced following B-GOS in HIB (2·46 (sd 1·14) v. 1·44 (sd 0·41) mg/l, P=0·015) and control (2·16 (sd 1·02) v. 1·47 (sd 0·33) mg/l, P=0·050) groups. Chemokine CC ligand 11 and fraction of exhaled nitric oxide remained unchanged. B-GOS supplementation attenuated airway hyper-responsiveness with concomitant reductions in markers of airway inflammation associated with HIB.
Collapse
|
39
|
de Boer A, van de Worp WRPH, Hageman GJ, Bast A. The effect of dietary components on inflammatory lung diseases - a literature review. Int J Food Sci Nutr 2017; 68:771-787. [PMID: 28276906 DOI: 10.1080/09637486.2017.1288199] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Anti-inflammatory treatment in chronic inflammatory lung diseases usually involves glucocorticosteroids. With patients suffering from serious side effects or becoming resistant, specific nutrients, that are suggested to positively influence disease progression, can be considered as new treatment options. The dietary inflammatory index is used to calculate effects of dietary components on inflammation and lung function to identify most potent dietary components, based on 162 articles. The positive effects of n-3 PUFAs and vitamin E on lung function can at least partially be explained by their anti-inflammatory effect. Many other dietary components showed only small or no effects on inflammation and/or lung function, although the number of weighted studies was often too small for a reliable assessment. Optimal beneficial dietary elements might reduce the required amounts of anti-inflammatory treatments, thereby decreasing both side effects and development of resistance as to improve quality of life of patients suffering from chronic inflammatory lung diseases.
Collapse
Affiliation(s)
- Alie de Boer
- a Faculty of Humanities and Sciences , Food Claims Centre Venlo, Maastricht University Campus Venlo, Maastricht University , Venlo , The Netherlands
| | - Wouter R P H van de Worp
- b Department of Pharmacology and Toxicology, Faculty of Health Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Geja J Hageman
- b Department of Pharmacology and Toxicology, Faculty of Health Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Aalt Bast
- b Department of Pharmacology and Toxicology, Faculty of Health Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands.,c Faculty of Humanities and Sciences , Maastricht University Campus Venlo, Maastricht University , Venlo , The Netherlands
| |
Collapse
|
40
|
Weiler JM, Brannan JD, Randolph CC, Hallstrand TS, Parsons J, Silvers W, Storms W, Zeiger J, Bernstein DI, Blessing-Moore J, Greenhawt M, Khan D, Lang D, Nicklas RA, Oppenheimer J, Portnoy JM, Schuller DE, Tilles SA, Wallace D. Exercise-induced bronchoconstriction update-2016. J Allergy Clin Immunol 2016; 138:1292-1295.e36. [PMID: 27665489 DOI: 10.1016/j.jaci.2016.05.029] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/13/2016] [Accepted: 05/25/2016] [Indexed: 12/26/2022]
Abstract
The first practice parameter on exercise-induced bronchoconstriction (EIB) was published in 2010. This updated practice parameter was prepared 5 years later. In the ensuing years, there has been increased understanding of the pathogenesis of EIB and improved diagnosis of this disorder by using objective testing. At the time of this publication, observations included the following: dry powder mannitol for inhalation as a bronchial provocation test is FDA approved however not currently available in the United States; if baseline pulmonary function test results are normal to near normal (before and after bronchodilator) in a person with suspected EIB, then further testing should be performed by using standardized exercise challenge or eucapnic voluntary hyperpnea (EVH); and the efficacy of nonpharmaceutical interventions (omega-3 fatty acids) has been challenged. The workgroup preparing this practice parameter updated contemporary practice guidelines based on a current systematic literature review. The group obtained supplementary literature and consensus expert opinions when the published literature was insufficient. A search of the medical literature on PubMed was conducted, and search terms included pathogenesis, diagnosis, differential diagnosis, and therapy (both pharmaceutical and nonpharmaceutical) of exercise-induced bronchoconstriction or exercise-induced asthma (which is no longer a preferred term); asthma; and exercise and asthma. References assessed as relevant to the topic were evaluated to search for additional relevant references. Published clinical studies were appraised by category of evidence and used to document the strength of the recommendation. The parameter was then evaluated by Joint Task Force reviewers and then by reviewers assigned by the parent organizations, as well as the general membership. Based on this process, the parameter can be characterized as an evidence- and consensus-based document.
Collapse
|
41
|
Dietary and pharmacological intervention to mitigate the cardiopulmonary effects of air pollution toxicity. Biochim Biophys Acta Gen Subj 2016; 1860:2891-8. [PMID: 27189803 DOI: 10.1016/j.bbagen.2016.05.014] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 05/06/2016] [Accepted: 05/12/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Exposure to air pollution contributes importantly to excess morbidity and mortality. And while regulatory actions under the "Clean Air Act" have saved millions of lives by improving air quality, there are still millions of people in the U.S. who live in areas where particulate air pollution (PM) levels exceed the U.S. Environmental Protection Agency's National Ambient Air Quality Standards. Therefore, apart from such localities working to attain such standards the protection of the health of public and in particular those at high risk might benefit from interventional strategies that would ameliorate air pollution's adverse health effects. Because inflammation and oxidative stress appear to mediate the health effects of air pollution, one interventional approach to consider is the use of dietary supplementation or medication with anti-inflammatory or antioxidant properties to block the biological responses that initiate the pathophysiological process that culminates in adverse health effects. SCOPE OF REVIEW This article reviews the capability of dietary supplementation, such as antioxidant vitamins, polyunsaturated fatty acids, and medications as a strategy to mitigate air pollution-induced subclinical cardiopulmonary effects. MAJOR CONCLUSIONS Antioxidant vitamins C and E protect the lungs against short-term ozone and PM exposure. Polyunsaturated fatty acids, such as fish oil and olive oil appear to offer protection against short-term air pollution-induced adverse cardiovascular responses. GENERAL SIGNIFICANCE Taking dietary supplements or medications with antioxidant or anti-inflammatory properties has the potential to provide at least partial protection against air pollution-induced adverse health effects in those individuals who are known to be most susceptible, namely those with pre-existing respiratory and cardiovascular diseases. This article is part of a Special Issue entitled Air Pollution, edited by Wenjun Ding, Andrew J. Ghio and Weidong Wu.
Collapse
|
42
|
Kumar A, Mastana SS, Lindley MR. EPA/DHA dietary supplementation attenuates exercise-induced bronchoconstriction in physically active asthmatic males. COGENT MEDICINE 2016. [DOI: 10.1080/2331205x.2016.1172696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Aishwarya Kumar
- Translational Chemical Biology Research Group, Human Cellular and Molecular Biology Research Laboratory, School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
- Clinical Trial Service Unit (CTSU) and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, 20 Roosevelt Drive, Oxford OX3 7LF, UK
| | - Sarabjit S. Mastana
- Translational Chemical Biology Research Group, Human Cellular and Molecular Biology Research Laboratory, School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Martin R. Lindley
- Translational Chemical Biology Research Group, Human Cellular and Molecular Biology Research Laboratory, School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| |
Collapse
|
43
|
Simpson AJ, Bood JR, Anderson SD, Romer LM, Dahlén B, Dahlén SE, Kippelen P. A standard, single dose of inhaled terbutaline attenuates hyperpnea-induced bronchoconstriction and mast cell activation in athletes. J Appl Physiol (1985) 2016; 120:1011-7. [PMID: 26846550 PMCID: PMC4894945 DOI: 10.1152/japplphysiol.00700.2015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 01/28/2016] [Indexed: 12/30/2022] Open
Abstract
This study provides the first in vivo evidence for a mast cell stabilizing effect of the short-acting inhaled β2-adrenoceptor agonist terbutaline, when administered prophylactically at a clinically recommended dose (0.5 mg) before bronchial provocation with dry air. Our data therefore support the proposal that β2-adrenoceptor agonist-mediated mast cell stabilization is a major contributor to bronchoprotection in individuals with exercise-induced bronchoconstriction. Release of bronchoactive mediators from mast cells during exercise hyperpnea is a key factor in the pathophysiology of exercise-induced bronchoconstriction (EIB). Our aim was to investigate the effect of a standard, single dose of an inhaled β2-adrenoceptor agonist on mast cell activation in response to dry air hyperpnea in athletes with EIB. Twenty-seven athletes with EIB completed a randomized, double-blind, placebo-controlled, crossover study. Terbutaline (0.5 mg) or placebo was inhaled 15 min prior to 8 min of eucapnic voluntary hyperpnea (EVH) with dry air. Pre- and postbronchial challenge, urine samples were analyzed by enzyme immunoassay for 11β-prostaglandin F2α (11β-PGF2α). The maximum fall in forced expiratory volume in 1 s of 14 (12–20)% (median and interquartile range) following placebo was attenuated to 7 (5–9)% with the administration of terbutaline (P < 0.001). EVH caused a significant increase in 11β-PGF2α from 41 (27–57) ng/mmol creatinine at baseline to 58 (43–72) ng/mmol creatinine at its peak post-EVH following placebo (P = 0.002). The rise in 11β-PGF2α was inhibited with administration of terbutaline: 39 (28–44) ng/mmol creatinine at baseline vs. 40 (33–58) ng/mmol creatinine at its peak post-EVH (P = 0.118). These data provide novel in vivo evidence of mast cell stabilization following inhalation of a standard dose of terbutaline prior to bronchial provocation with EVH in athletes with EIB.
Collapse
Affiliation(s)
- A J Simpson
- Centre for Human Performance, Exercise and Rehabilitation, College of Health and Life Sciences, Brunel University London, United Kingdom
| | - J R Bood
- Unit for Experimental Asthma Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Unit for Clinical Asthma Research, Department of Internal Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; and
| | - S D Anderson
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia
| | - L M Romer
- Centre for Human Performance, Exercise and Rehabilitation, College of Health and Life Sciences, Brunel University London, United Kingdom
| | - B Dahlén
- Unit for Clinical Asthma Research, Department of Internal Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; and
| | - S-E Dahlén
- Unit for Experimental Asthma Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; and
| | - P Kippelen
- Centre for Human Performance, Exercise and Rehabilitation, College of Health and Life Sciences, Brunel University London, United Kingdom;
| |
Collapse
|
44
|
Abstract
Asthma is one of the most common and prevalent problems worldwide affecting over 300 million individuals. There is some evidence from observational and intervention studies to suggest a beneficial effect of n-3 PUFA in inflammatory diseases, specifically asthma. Marine-based n-3 PUFA have therefore been proposed as a possible complementary/alternative therapy for asthma. The proposed anti-inflammatory effects of n-3 fatty acids may be linked to a change in cell membrane composition. This altered membrane composition following n-3 fatty acid supplementation (primarily EPA and DHA) can modify lipid mediator generation via the production of eicosanoids with a reduced inflammatory potential/impact. A recently identified group of lipid mediators derived from EPA including E-series resolvins are proposed to be important in the resolution of inflammation. Reduced inflammation attenuates the severity of asthma including symptoms (dyspnoea) and exerts a bronchodilatory effect. There have been no major health side effects reported with the dietary supplementation of n-3 fatty acids or their mediators; consequently supplementing with n-3 fatty acids is an attractive non-pharmacological intervention which may benefit asthma.
Collapse
|
45
|
Rundell KW, Anderson SD, Sue-Chu M, Bougault V, Boulet LP. Air quality and temperature effects on exercise-induced bronchoconstriction. Compr Physiol 2016; 5:579-610. [PMID: 25880506 DOI: 10.1002/cphy.c130013] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Exercise-induced bronchoconstriction (EIB) is exaggerated constriction of the airways usually soon after cessation of exercise. This is most often a response to airway dehydration in the presence of airway inflammation in a person with a responsive bronchial smooth muscle. Severity is related to water content of inspired air and level of ventilation achieved and sustained. Repetitive hyperpnea of dry air during training is associated with airway inflammatory changes and remodeling. A response during exercise that is related to pollution or allergen is considered EIB. Ozone and particulate matter are the most widespread pollutants of concern for the exercising population; chronic exposure can lead to new-onset asthma and EIB. Freshly generated emissions particulate matter less than 100 nm is most harmful. Evidence for acute and long-term effects from exercise while inhaling high levels of ozone and/or particulate matter exists. Much evidence supports a relationship between development of airway disorders and exercise in the chlorinated pool. Swimmers typically do not respond in the pool; however, a large percentage responds to a dry air exercise challenge. Studies support oxidative stress mediated pathology for pollutants and a more severe acute response occurs in the asthmatic. Winter sport athletes and swimmers have a higher prevalence of EIB, asthma and airway remodeling than other athletes and the general population. Because of fossil fuel powered ice resurfacers in ice rinks, ice rink athletes have shown high rates of EIB and asthma. For the athlete training in the urban environment, training during low traffic hours and in low traffic areas is suggested.
Collapse
Affiliation(s)
- Kenneth W Rundell
- Department of The Basic Sciences, The Commonwealth Medical College, Scranton, PA, USA
| | - Sandra D Anderson
- Clinical Professor Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Malcolm Sue-Chu
- Department of Thoracic Medicine, St Olavs Hospital, Trondheim University Hospital, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | | | | |
Collapse
|
46
|
Smith JR, Kurti SP, Johnson AM, Kolmer SA, Harms C. Impact of varying physical activity levels on airway sensitivity and bronchodilation in healthy humans. Appl Physiol Nutr Metab 2015; 40:1287-93. [DOI: 10.1139/apnm-2015-0185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to determine if the amount of physical activity influences airway sensitivity and bronchodilation in healthy subjects across a range of physical activity levels. Thirty healthy subjects (age, 21.9 ± 2.6 years; 13 men/17 women) with normal pulmonary function reported to the laboratory on 2 separate occasions where they were randomized to breathe either hypertonic saline (HS) (nebulized hypertonic saline (25%) for 20 min) or HS followed by 5 deep inspirations (DIs), which has been reported to bronchodilate the airways. Pulmonary function tests (PFTs) were performed prior to both conditions and following the HS breathing or 5 DIs. Moderate to vigorous physical activity (MVPA) level was measured via accelerometer worn for 7 days. Following the HS breathing, forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) significantly decreased from baseline by –11.8% ± 8.4% and –9.3% ± 6.7%, respectively. A 2-segment linear model determined significant relationships between MVPA and percent change in FEV1 (r = 0.50) and FVC (r = 0.55). MVPA above ∼497 and ∼500 min/week for FEV1 and FVC, respectively, resulted in minor additional improvements (p > 0.05) in PFTs following the HS breathing. Following the DIs, FEV1 and FVC decreased (p < 0.05) by –7.3% ± 8.6% and –5.7% ± 5.7%, respectively, from baseline, but were not related (p > 0.05) to MVPA. In conclusion, these data demonstrate that higher MVPA levels attenuated airway sensitivity but not bronchodilation in healthy subjects.
Collapse
Affiliation(s)
- Joshua R. Smith
- Department of Kinesiology, Kansas State University, 1A Natatorium, Manhattan, KS 66506, USA
- Department of Kinesiology, Kansas State University, 1A Natatorium, Manhattan, KS 66506, USA
| | - Stephanie P. Kurti
- Department of Kinesiology, Kansas State University, 1A Natatorium, Manhattan, KS 66506, USA
- Department of Kinesiology, Kansas State University, 1A Natatorium, Manhattan, KS 66506, USA
| | - Ariel M. Johnson
- Department of Kinesiology, Kansas State University, 1A Natatorium, Manhattan, KS 66506, USA
- Department of Kinesiology, Kansas State University, 1A Natatorium, Manhattan, KS 66506, USA
| | - Sarah A. Kolmer
- Department of Kinesiology, Kansas State University, 1A Natatorium, Manhattan, KS 66506, USA
- Department of Kinesiology, Kansas State University, 1A Natatorium, Manhattan, KS 66506, USA
| | - Craig Harms
- Department of Kinesiology, Kansas State University, 1A Natatorium, Manhattan, KS 66506, USA
- Department of Kinesiology, Kansas State University, 1A Natatorium, Manhattan, KS 66506, USA
| |
Collapse
|
47
|
Shin TR, Kim JH, Kim CH, Hyun IG, Choi JH. Urinary excretion of 9α,11β-prostaglandin F2 and leukotriene E4 in patients with exercise-induced bronchoconstriction. J Thorac Dis 2015; 7:1198-204. [PMID: 26380736 DOI: 10.3978/j.issn.2072-1439.2015.06.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 06/01/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND Increased levels of mast cell-derived eicosanoids, such as prostaglandin (PG) D2 and cysteinyl leukotrienes (CysLTs), have been reported in patients with exercise-induced bronchoconstriction (EIB), suggesting that mast cell activation is involved in the mechanism of EIB. However, it is still controversial since these results have not been reproduced in other studies. The aim of this study was to evaluate the role of PGD2 and LTE4 in adult asthma with EIB, as measuring urinary levels of their metabolites-9α,11β-PGF2 and LTE4 before and after an exercise challenge test. METHODS Eight patients with asthma and EIB and five normal controls without EIB were enrolled. Exercise challenge tests comprised of 6 min of treadmill exercise or free running were performed in all study subjects, and urine samples before and 1 h after the challenge were collected. Urinary levels of 9α,11β-PGF2 and LTE4 were measured by enzyme immunoassay (EIA). RESULTS No significant differences were observed in 9α,11β-PGF2 and LTE4 levels before/after the exercise challenge between patients with EIB and normal controls. No significant increases in urinary levels of 9α,11β-PGF2 or LTE4 were detected during the exercise challenge in patients with EIB and normal controls. No significant correlations were observed between the percent decrease in forced expiratory volume in 1 s (FEV1) or percent changes in 9α,11β-PGF2 and LTE4 levels after the exercise challenge. CONCLUSIONS Urinary 9α,11β-PGF2 and LTE4 levels did not increase after an exercise challenge in patients with EIB, suggesting that urinary excretion of 9α,11β-PGF2 and LTE4 may not be a good marker of mast cell activation in patients with EIB.
Collapse
Affiliation(s)
- Tae-Rim Shin
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Joo-Hee Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Cheol-Hong Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - In-Gyu Hyun
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Jeong-Hee Choi
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| |
Collapse
|
48
|
Brannan JD, Bood J, Alkhabaz A, Balgoma D, Otis J, Delin I, Dahlén B, Wheelock CE, Nair P, Dahlén SE, O'Byrne PM. The effect of omega-3 fatty acids on bronchial hyperresponsiveness, sputum eosinophilia, and mast cell mediators in asthma. Chest 2015; 147:397-405. [PMID: 25321659 DOI: 10.1378/chest.14-1214] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Omega-3 fatty acid supplements have been reported to inhibit exercise-induced bronchoconstriction (EIB). It has not been determined whether omega-3 supplements inhibit airway sensitivity to inhaled mannitol, a test for bronchial hyperresponsiveness (BHR) and model for EIB in people with mild to moderate asthma. METHODS In a double-blind, crossover trial, subjects with asthma who had BHR to inhaled mannitol (n = 23; 14 men; mean age, 28 years; one-half taking regular inhaled corticosteroids) were randomized to omega-3 supplements (4.0 g/d eicosapentaenoic acid and 2.0 g/d docosahexaenoic acid) or matching placebo for 3 weeks separated by a 3-week washout. The primary outcome was the provoking dose of mannitol (mg) to cause a 15% fall in FEV1 (PD15). Secondary outcomes were sputum eosinophil count, spirometry, Asthma Control Questionnaire (ACQ) score, serum triacylglyceride level, and lipid mediator profile in urine and serum. RESULTS PD15 (geometric mean, 95% CI) to mannitol following supplementation with omega-3s (78 mg, 51-119 mg) was not different from placebo (88 mg, 56-139 mg, P = .5). There were no changes in sputum eosinophils (mean ± SD) in a subgroup of 11 subjects (omega-3, 8.4% ± 8.2%; placebo, 7.8% ± 11.8%; P = .9). At the end of each treatment period, there were no differences in FEV1 % predicted (omega-3, 85% ± 13%; placebo, 84% ± 11%; P = .9) or ACQ score (omega-3, 1.1% ± 0.5%; placebo, 1.1% ± 0.5%; P = .9) (n = 23). Omega-3s caused significant lowering of blood triglyceride levels and expected shifts in serum fatty acids and eicosanoid metabolites, confirming adherence to the supplements; however, no changes were observed in urinary mast cell mediators. CONCLUSIONS Three weeks of omega-3 supplements does not improve BHR to mannitol, decrease sputum eosinophil counts, or inhibit urinary excretion of mast cell mediators in people with mild to moderate asthma, indicating that dietary omega-3 supplementation is not useful in the short-term treatment of asthma. TRIAL REGISTRY ClinicalTrials.gov; No.: NCT00526357; URL: www.clinicaltrials.gov.
Collapse
Affiliation(s)
- John D Brannan
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare and McMaster University, Hamilton, ON, Canada.
| | - Johan Bood
- National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Ahmad Alkhabaz
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare and McMaster University, Hamilton, ON, Canada
| | - David Balgoma
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden; National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Joceline Otis
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare and McMaster University, Hamilton, ON, Canada
| | - Ingrid Delin
- National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Barbro Dahlén
- Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Craig E Wheelock
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Parameswaran Nair
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare and McMaster University, Hamilton, ON, Canada
| | - Sven-Erik Dahlén
- National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Paul M O'Byrne
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare and McMaster University, Hamilton, ON, Canada
| |
Collapse
|
49
|
Price OJ, Hull JH, Howatson G, Robson-Ansley P, Ansley L. Vitamin D and omega-3 polyunsaturated fatty acid supplementation in athletes with exercise-induced bronchoconstriction: a pilot study. Expert Rev Respir Med 2015; 9:369-78. [PMID: 25864870 DOI: 10.1586/17476348.2015.1036032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this pilot study was to determine the combined effect of vitamin D and omega-3 polyunsaturated fatty acid (PUFA) supplementation on airway function and inflammation in recreational athletes with exercise-induced bronchoconstriction (EIB). METHODS Ten recreational athletes with EIB participated in a single-blind, placebo-controlled trial over six consecutive weeks. All subjects attended the laboratory on three occasions. Each visit was separated by a period of 3 weeks: visit 1 (usual diet), visit 2 (placebo) and visit 3 (SMARTFISH® NutriFriend 2000; 30 µg vitamin D3-3000 mg eicosapentaenoic acid, 3000 mg docosahexaenoic acid) consumed once daily for a period of 3 weeks. Venous blood was collected at the beginning of each trial to determine vitamin D status. Spirometry was performed pre- and post-eucapnic voluntary hyperpnoea (EVH). RESULTS The Maximum fall in FEV1 (ΔFEV1max) post-EVH was not different between visits (usual diet: -15.9 ± 3.6%, placebo: -16.1 ± 6.1%, vitamin D + omega-3 PUFA: -17.8 ± 7.2%). Serum vitamin D remained unchanged between visits. CONCLUSION Vitamin D and omega-3 PUFA supplementation does not attenuate the reduction in lung function post-EVH. This finding should be viewed as preliminary until the results of randomised controlled trials are made available.
Collapse
Affiliation(s)
- Oliver J Price
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, Tyne, UK
| | | | | | | | | |
Collapse
|
50
|
|