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Rahman A, Haider MF. A comprehensive review on glucocorticoids induced osteoporosis: A medication caused disease. Steroids 2024; 207:109440. [PMID: 38754651 DOI: 10.1016/j.steroids.2024.109440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/11/2024] [Accepted: 05/13/2024] [Indexed: 05/18/2024]
Abstract
Glucocorticoids (GCs) are steroid hormones that are extensively used in the treatment of autoimmune diseases, inflammation, and cancer. The major ill effect of administering GCs is that it has a deleterious effect on bone, which leads to GC-induced osteoporosis. GC therapy induces bone loss and is associated with the risk of nonvertebral and vertebral fractures, as it works in combination by increasing bone reabsorption and suppressing bone formation during the initial phase of therapy. It is seen and established that GC in excess or in low dose for 3 months or more can be a risk factor for fracture, and the risk increases with an increase in dose and duration of usage. The most common cause of secondary osteoporosis is the administration of GC inside the body to treat various diseases. The degree of bone loss is directly proportional to the GC dose and the exposure duration. The first step is to evaluate the patients' risk factors for the development of glucocorticoids that induce osteoporosis, which include the dose, duration of use, patient age, sex, previous fractures, and other medical conditions.
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Affiliation(s)
- Asim Rahman
- Faculty of Pharmacy, Integral University, Lucknow 226026, India
| | - Md Faheem Haider
- Faculty of Pharmacy, Integral University, Lucknow 226026, India.
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Ren X, Kong Y, Yu H, Dong A, Wang Y, Wei L, Song Y, Wang Z, Wang L, Guo Y, Sun L. YiQi GuBen capsule alleviates OVA-induced asthma through improving mitochondrial dysfunction. J Asthma 2024; 61:725-735. [PMID: 38647486 DOI: 10.1080/02770903.2024.2303755] [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] [Received: 09/07/2023] [Accepted: 01/07/2024] [Indexed: 04/25/2024]
Abstract
Objective: This study aims to explore the effect of YiQi GuBen capsule on improving mitochondrial dysfunction in an animal model of asthma.Methods: The mice (n = 8) were divided into four groups including control (NC), ovalbumin (OVA), dexamethasone (OVA + DEX), and YiQi GuBen (OVA + YQGB) groups. Firstly, we established an OVA-induced mouse asthma model except for the NC group, which then were treated with dexamethasone and YiQi GuBen capsule. Subsequently, HE staining and Masson staining were used for pathological analysis of mice lung tissues. Next, we used transmission electron microscopy (TEM) to observe the effect of the Yiqi Guben capsule on the ultrastructure of mitochondria. Flow cytometry was used to analyze the ROS level, membrane potential, and the number of mitochondria in lung tissue. Moreover, we analyzed the copy number of mitochondrial DNA (mtDNA) and the expression levels of activator peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) and mitochondrial transcription factor A (TFAM).Results: The results of the pathological analysis showed that after treatment with the YiQi GuBen capsule, the lung tissue damage was significantly reduced. In addition, we observed that the ultrastructural damage of mitochondria was improved. Flow cytometry proved that after treatment with the YiQi GuBen capsule, the level of ROS in the mitochondria was effectively reduced, while the mitochondrial membrane potential decreased and the number increased significantly. Moreover, we found that the copy number of mtDNA was significantly increased and the expression levels of PGC-1α and TFAM were significantly upgraded.Conclusion: This study suggests YiQi GuBen capsule can effectively improve mitochondrial dysfunction in the OVA-induced mouse model.
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Affiliation(s)
- Xiaoting Ren
- College of Traditional Chinese Medicine, Changchun University of Chinese Medical, Changchun, China
| | - Yibu Kong
- Department of Pediatrics, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Hongjun Yu
- Department of Pediatrics, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Aiai Dong
- Department of Pediatrics, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Yongji Wang
- Department of Pediatrics, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Lina Wei
- Department of Pediatrics, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Yongfu Song
- College of Traditional Chinese Medicine, Changchun University of Chinese Medical, Changchun, China
| | - Zhongtian Wang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medical, Changchun, China
| | - Lie Wang
- Department of Pediatrics, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Yinan Guo
- Department of Pediatrics, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Liping Sun
- Department of Pediatrics, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China
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Martínez-Moragón E, Antepara Ercoreca I, Muñoz García M, Casas Maldonado F, Calvín Lamas M, Chiner Vives E, Crespo Diz C, Díaz-Pérez D, Eguiluz Gracia I, García Gil S, González-Pérez R, Habernau Mena A, Hermida Valverde T, Jornet Montaña S, López-Carrasco V, Martínez López I, Merino-Bohórquez V, Moreno-Ancillo Á, Mínguez Cabeza AC, Monte-Boquet E, Revuelta-Herrero JL, Sánchez-Cuellar S. Patient-reported outcome measures in severe asthma: an expert consensus. J Asthma 2024; 61:619-631. [PMID: 38146964 DOI: 10.1080/02770903.2023.2297372] [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] [Received: 10/16/2023] [Accepted: 12/16/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE The study aimed to reach a consensus on the most relevant patient-reported outcomes (PROs), the corresponding measures (PROMs), and measurement frequency during severe asthma patient follow-up. METHODS Two Delphi rounds were conducted. The questionnaire was developed based on a systematic literature review, a focus group with patients, and a nominal group with experts. It assessed PROs' relevance and the appropriateness (A) and feasibility (F) of PROMs using a Likert scale (1=totally agree; 9=totally disagree). The consensus was established when ≥75% of participants agreed (1-3) or disagreed (7-9). RESULTS Sixty-three professionals (25 hospital pharmacists, 14 allergists, 13 pulmonologists, and 11 nurses) and 5 patients answered the Delphi questionnaire. A consensus was reached on all PROs regarding their relevance. Experts agreed on the use of ACT (A:95.24%; F:95.24%), mini AQLQ (A:93.65; F:79.37%), mMRC dyspnea scale (A:85.71%; F:85.71%), TAI (A:92.06%; F:85.71%), MMAS (A:75.40%; F:82%), and the dispensing register (A:96.83%; F:92.06%). Also considered suitable were: SNOT-22 (A:90.48%; F:73.80%), PSQI (A:82.54; F:63.90%), HADS (A:82.54; F:64%), WPAI (A:77.78%; F:49.20%), TSQM-9 (A:79.37; F:70.50%) and knowledge of asthma questionnaire (A:77%; F:68.80%); however, their use in clinical practice was considered unfeasible. Panelists also agreed on the appropriateness of EQ-5D, which was finally included despite being considered unfeasible (A: 84.13%; F:67.20%) in clinical practice. Agreement was reached on using ACT, TAI, mMRC, and a dispensing register every three months; mini-AQLQ and MMAS every six months; and EQ-5D every twelve months. CONCLUSION This consensus paves the way toward patient-centered care, promoting the development of strategies supporting routine assessment of PROs in severe asthma management.
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Affiliation(s)
| | | | - María Muñoz García
- Servicio de Farmacia, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | | | - Marta Calvín Lamas
- Servicio de Farmacia, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Eusebi Chiner Vives
- Servicio de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Carlos Crespo Diz
- Servicio de Farmacia, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | - David Díaz-Pérez
- Servicio de Neumología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Ibon Eguiluz Gracia
- Servicio de Alergología, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Sara García Gil
- Servicio de Farmacia, Hospital Universitario de Canarias, La Laguna, Spain
| | | | | | | | | | | | - Icíar Martínez López
- Servicio de Farmacia, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | | | - Álvaro Moreno-Ancillo
- Servicio de Alergología, Hospital General Nuestra Señora del Prado, Talavera de la Reina, Spain
| | | | - Emilio Monte-Boquet
- Servicio de Farmacia, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Montazeri Ghahjaverestan N, Chavoshian S, Cao X, Bradley TD, Tarlo SM, Stanbrook M, Chapman KR, Yadollahi A. The Effect of Simulated Obstructive Apneas on Mechanical Characteristics of Lower Airways in Individuals with Asthma. Ann Biomed Eng 2024; 52:1617-1624. [PMID: 38433152 DOI: 10.1007/s10439-024-03475-3] [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] [Received: 11/07/2023] [Accepted: 02/14/2024] [Indexed: 03/05/2024]
Abstract
Increased negative intrathoracic pressure that occurs during pharyngeal obstruction can increase thoracic fluid volume that may contribute to lower airway narrowing in individuals with obstructive sleep apnea (OSA) and asthma. Our previous study showed that fluid accumulation in the thorax induced by simulated OSA can increase total respiratory resistance. However, the effect of fluid shift on lower airway narrowing has not been investigated. To examine the effect of fluid accumulation in the thorax on the resistance of the lower airway. Non-asthma participants and individuals with (un)controlled asthma were recruited and underwent a single-day experiment. A catheter with six pressure sensors was inserted through the nose to continuously measure pressure at different sites of the airway, while a pneumotachograph was attached to a mouthpiece to record airflow. To simulate obstructive apneas, participants performed 25 Mueller maneuvers (MMs) while lying supine. Using the recordings of pressure sensor and airflow, total respiratory (RT), lower respiratory components (RL), and upper airway (RUA) resistances were calculated before and after MMs. Generalized estimation equation method was used to find the predictors of RL among variables including age, sex, body mass index, and the effect of MMs and asthma. Eighteen participants were included. Performing MMs significantly increased RT (2.23 ± 2.08 cmH2O/L/s, p = 0.003) and RL (1.52 ± 2.00 cmH2O/L/s, p = 0.023) in participants with asthma, while only RL was increased in non-asthma group (1.96 ± 1.73 cmH2O/L/s, p = 0.039). We found the model with age, and the effect of MMs and asthma severity generated the highest correlation (R2 = 0.69, p < 0.001). We provide evidence that fluid accumulation in the thorax caused by excessive intrathoracic pressure increases RL in both non-asthma and asthma groups. The changes in RL were related to age, having asthma and the effect of simulated OSA. This can explain the interrelationship between OSA and asthma.
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Affiliation(s)
- Nasim Montazeri Ghahjaverestan
- KITE, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Shaghayegh Chavoshian
- KITE, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Xiaoshu Cao
- KITE, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - T Douglas Bradley
- KITE, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Susan M Tarlo
- Department of Medicine, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Matthew Stanbrook
- Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Kenneth R Chapman
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Asthma & Airway Centre, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Azadeh Yadollahi
- KITE, University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada.
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
- University Health Network Toronto Rehabilitation Institute, Room 12-106, 550 University Ave., Toronto, ON, M5G 2A2, Canada.
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Lu H, Liu H, Wang K, Shi J, Sun Y. Association Between Serum Amyloid A Expression and Disease Control after Endoscopic Sinus Surgery in Patients With Chronic Rhinosinusitis With Nasal Polyps. EAR, NOSE & THROAT JOURNAL 2024; 103:NP331-NP339. [PMID: 34814741 DOI: 10.1177/01455613211051311] [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: 11/16/2022] Open
Abstract
OBJECTIVE Our previous study revealed that serum amyloid A (SAA) levels in polyp tissues could serve as a biomarker for the prediction of corticosteroid insensitivity in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). However, their association with disease control status in the patients after endoscopic sinus surgery remains to be assessed. METHODS Polyp tissues and control uncinate process mucosa were collected from 48 patients with CRSwNP and 10 healthy control subjects. SAA expression was examined using immunohistochemistry and enzyme-linked immunosorbent assay. Receiver operating characteristic (ROC) curves were performed to determine the predictive value of SAA in nasal polyps. The clinical characteristics of 2 CRSwNP subtypes (SAAhigh and SAAlow) were evaluated. RESULTS The SAA expression levels in polyp tissues were significantly elevated both in non-eosinophilic and eosinophilic CRSwNP as compared to the healthy controls. In patients with CRSwNP, the tissue SAA level was significantly higher in the disease-controlled patients than those of the partly controlled and uncontrolled. ROC curve analysis revealed that a cut-off value of 114.9 ng/mL for the tissue SAA level predicted the patients with disease-controlled status with 93.33% sensitivity and 63.64% specificity (AUC = .8727, P < .001). Furthermore, The SAAhigh subgroup showed higher tissue eosinophil numbers and percentage of the disease-controlled patients compared to the SAAlow subgroup. CONCLUSIONS Our findings suggest that measurements of SAA in polyp tissues may provide useful information for evaluating CRSwNP conditions, especially identifying the CRSwNP patients with disease-controlled status after endoscopic sinus surgery.
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Affiliation(s)
- Hangui Lu
- Department of Otolaryngology, Shantou Central Hospital, Shantou, China
| | - Haiyan Liu
- Department of Otolaryngology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Kanghua Wang
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jianbo Shi
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yueqi Sun
- Department of Otolaryngology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
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Szczesny B, Boorgula MP, Chavan S, Campbell M, Johnson RK, Kammers K, Thompson EE, Cox MS, Shankar G, Cox C, Morin A, Lorizio W, Daya M, Kelada SNP, Beaty TH, Doumatey AP, Cruz AA, Watson H, Naureckas ET, Giles BL, Arinola GA, Sogaolu O, Falade AG, Hansel NN, Yang IV, Olopade CO, Rotimi CN, Landis RC, Figueiredo CA, Altman MC, Kenny E, Ruczinski I, Liu AH, Ober C, Taub MA, Barnes KC, Mathias RA. Multi-omics in nasal epithelium reveals three axes of dysregulation for asthma risk in the African Diaspora populations. Nat Commun 2024; 15:4546. [PMID: 38806494 PMCID: PMC11133339 DOI: 10.1038/s41467-024-48507-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 05/02/2024] [Indexed: 05/30/2024] Open
Abstract
Asthma has striking disparities across ancestral groups, but the molecular underpinning of these differences is poorly understood and minimally studied. A goal of the Consortium on Asthma among African-ancestry Populations in the Americas (CAAPA) is to understand multi-omic signatures of asthma focusing on populations of African ancestry. RNASeq and DNA methylation data are generated from nasal epithelium including cases (current asthma, N = 253) and controls (never-asthma, N = 283) from 7 different geographic sites to identify differentially expressed genes (DEGs) and gene networks. We identify 389 DEGs; the top DEG, FN1, was downregulated in cases (q = 3.26 × 10-9) and encodes fibronectin which plays a role in wound healing. The top three gene expression modules implicate networks related to immune response (CEACAM5; p = 9.62 × 10-16 and CPA3; p = 2.39 × 10-14) and wound healing (FN1; p = 7.63 × 10-9). Multi-omic analysis identifies FKBP5, a co-chaperone of glucocorticoid receptor signaling known to be involved in drug response in asthma, where the association between nasal epithelium gene expression is likely regulated by methylation and is associated with increased use of inhaled corticosteroids. This work reveals molecular dysregulation on three axes - increased Th2 inflammation, decreased capacity for wound healing, and impaired drug response - that may play a critical role in asthma within the African Diaspora.
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Affiliation(s)
- Brooke Szczesny
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Meher Preethi Boorgula
- Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Sameer Chavan
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Monica Campbell
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Randi K Johnson
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
- Quantitative Sciences Division, Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kai Kammers
- Departments of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Emma E Thompson
- Division of Allergy and Infectious Diseases, Dept of Medicine, University of Washington, Seattle, WA, USA
| | - Madison S Cox
- Division of Allergy and Infectious Diseases, Dept of Medicine, University of Washington, Seattle, WA, USA
| | - Gautam Shankar
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Corey Cox
- Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Andréanne Morin
- Departments of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Wendy Lorizio
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Michelle Daya
- Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Samir N P Kelada
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
- Marsico Lung Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Terri H Beaty
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ayo P Doumatey
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Alvaro A Cruz
- Fundacao ProAR and Federal University of Bahia, Salvador, Bahia, Brazil
| | - Harold Watson
- Faculty of Medical Sciences, The University of the West Indies, Queen Elizabeth Hospital, St. Michael, Bridgetown, Barbados
| | | | - B Louise Giles
- Departments of Pediatrics, University of Chicago, Chicago, IL, USA
| | - Ganiyu A Arinola
- Department of Immunology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olumide Sogaolu
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adegoke G Falade
- Department of Pediatrics, University of Ibadan, and University College Hospital, Ibadan, Nigeria
| | - Nadia N Hansel
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Ivana V Yang
- Departments of Biomedical Informatics and Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | | | - Charles N Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - R Clive Landis
- Edmund Cohen Laboratory for Vascular Research, George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, The University of the West Indies, Cave Hill Campus, Wanstead, Barbados
| | - Camila A Figueiredo
- Federal University of Bahia and Funda. Program for Control of Asthma in Bahia (ProAR), Salvador, Brazil
- Instituto de Ciências de Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Matthew C Altman
- Systems Immunology Program, Benaroya Research Institute, Seattle, WA, 98101, USA
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, 98109, USA
| | - Eimear Kenny
- Center for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ingo Ruczinski
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrew H Liu
- Department of Pediatrics, Childrens Hospital Colorado and University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - Carole Ober
- Departments of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Margaret A Taub
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kathleen C Barnes
- Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
| | - Rasika A Mathias
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
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Muanprasong S, Aqilah S, Hermayurisca F, Taneepanichskul N. Effectiveness of Asthma Home Management Manual and Low-Cost Air Filter on Quality of Life Among Asthma Adults: A 3-Arm Randomized Controlled Trial. J Multidiscip Healthc 2024; 17:2613-2622. [PMID: 38813091 PMCID: PMC11134058 DOI: 10.2147/jmdh.s397388] [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: 02/13/2024] [Accepted: 05/15/2024] [Indexed: 05/31/2024] Open
Abstract
Background Asthma affects the quality of life (QoL) of millions of people worldwide. Effective control is paramount to a decline in prevalence and severity. To address this, we aimed to investigate the effectiveness of an asthma home management manual and low-cost air filter in improving resource-limited settings. Patients and Methods This randomized controlled trial was conducted between March to July 2022. The participants were 18-55 years old outpatient with asthmatic patients. A total of 114 participants were recruited and randomly assigned to three groups: home management only, home management and air filtering, and control. Validated measurement tools were applied, and the Wilcoxon test was used to evaluate changes in QoL. Results Asthma burden was found in at least one-third of participants in each group. At baseline, there was no difference in mAQLQ scores among participants in all group allocations (p-value > 0.05), and the air filter group had an increase in the total mAQLQ score (p-value = 0.044) and post-intervention activity quality of life (p-value = 0.002). The environmental quality of life increased post-intervention (p-value = 0.004) and remained higher after four weeks of follow-up compared to baseline (p-value = 0.041) in the home management group participants. Conclusion The findings indicate that the enforcement of a home management manual and the application of low-cost filters in air circulation systems offer advantages in improving the quality of life of patients with moderate and mild asthma.
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Affiliation(s)
- Sirilak Muanprasong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Syarifah Aqilah
- College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | | | - Nutta Taneepanichskul
- College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
- HAUS IAQ Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Zhou Z, Wang Y, Wang Y, Yang B, Xu C, Wang S, Yang W. A Diagnostic Nomogram for Predicting Hypercapnic Respiratory Failure in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2024; 19:1079-1091. [PMID: 38783895 PMCID: PMC11112130 DOI: 10.2147/copd.s454558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
Purpose To develop and validate a nomogram for assessing the risk of developing hypercapnic respiratory failure (HRF) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Patients and Methods From January 2019 to August 2023, a total of 334 AECOPD patients were enrolled in this research. We employed the Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression to determine independent predictors and develop a nomogram. This nomogram was appraised by the area under the receiver operating characteristic curve (AUC), calibration curve, Hosmer-Lemeshow goodness-of-fit test (HL test), decision curve analysis (DCA), and clinical impact curve (CIC). The enhanced bootstrap method was used for internal validation. Results Sex, prognostic nutritional index (PNI), hematocrit (HCT), and activities of daily living (ADL) were independent predictors of HRF in AECOPD patients. The developed nomogram based on the above predictors showed good performance. The AUCs for the training, internal, and external validation cohorts were 0.841, 0.884, and 0.852, respectively. The calibration curves and HL test showed excellent concordance. The DCA and CIC showed excellent clinical usefulness. Finally, a dynamic nomogram was developed (https://a18895635453.shinyapps.io/dynnomapp/). Conclusion This nomogram based on sex, PNI, HCT, and ADL demonstrated high accuracy and clinical value in predicting HRF. It is a less expensive and more accessible approach to assess the risk of developing HRF in AECOPD patients, which is more suitable for primary hospitals, especially in developing countries with high COPD-related morbidity and mortality.
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Affiliation(s)
- Zihan Zhou
- Department of Respiratory and Critical Care Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People’s Hospital of Hefei, Hefei, Anhui, 230011, People’s Republic of China
- The Fifth Clinical College of Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
| | - Yuhui Wang
- The Fifth Clinical College of Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
- Department of Cardiology, Hefei Hospital Affiliated to Anhui Medical University, Hefei, The Second People’s Hospital of Hefei, Hefei, Anhui, 230011, People’s Republic of China
| | - Yongsheng Wang
- Department of Respiratory and Critical Care Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People’s Hospital of Hefei, Hefei, Anhui, 230011, People’s Republic of China
- The Fifth Clinical College of Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
| | - Bo Yang
- Affiliated Hospital of West Anhui Health Vocational College, The Second People’s Hospital of Lu’an City, Lu’an, 237005, People’s Republic of China
| | - Chuchu Xu
- Department of Respiratory and Critical Care Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People’s Hospital of Hefei, Hefei, Anhui, 230011, People’s Republic of China
- The Fifth Clinical College of Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
| | - Shuqin Wang
- Department of Respiratory and Critical Care Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People’s Hospital of Hefei, Hefei, Anhui, 230011, People’s Republic of China
- The Fifth Clinical College of Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
| | - Wanchun Yang
- Department of Respiratory and Critical Care Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People’s Hospital of Hefei, Hefei, Anhui, 230011, People’s Republic of China
- The Fifth Clinical College of Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China
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9
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Al-Zayadneh E, Al-Darraji G, Momani A, Sa'ed RA, Abu Qutaish AF, Algallab N, Alzayadneh EM, Alrowwad KA, Alhalaki MM, Al-Iede M. Parental knowledge and attitudes toward asthma in Jordanian children with asthma, a multi-center cross-sectional study. J Asthma 2024; 61:501-510. [PMID: 38047590 DOI: 10.1080/02770903.2023.2289165] [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] [Received: 09/28/2023] [Accepted: 11/25/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE We explored Jordanian caregivers' knowledge, attitudes, and practices (KAP) toward asthma in their children. METHODS This cross-sectional investigation was conducted on caregivers visiting the pediatrics clinic at the Jordan University Hospital and King Abdullah University Hospital between December 2021 and January 2023. KAP were measured using a literature-validated questionnaire. Differences in KAP scores across participants' characteristics were examined using the student-t test and ANOVA. RESULTS A total of 108 caregivers were included in the final analysis. Caregivers were aged 30 to 40 years (54.6%) and had at least secondary education (90.7%). The majority of participants displayed appropriate knowledge with respect to asthma's clinical course. Furthermore, the greater portion of caregivers were knowledgeable about preventing asthma attacks and treating their children during said attacks. Factors affecting knowledge of asthma included age of mothers (p < .05). On the other hand, attitude scores were affected by occupation, type of medication, and family history of asthma (all p < .05). Moreover, employee mothers, children well controlled on both Asthma Control Test and Global Initiative for Asthma scores, and having no pediatric intensive care unit admissions were associated with higher practice treatment scores (all p < .05). Overall practice score was weakly, yet positively correlated with knowledge scores (r = 0.195, p = .043). Similarly, negative attitudes were weakly correlated with higher knowledge scores (r = 0.199, p = .039). CONCLUSION While the knowledge and practice scores were satisfactory, the clinical status of children with asthma was unsatisfactory. Future studies should examine factors associated with caregiver insecurity and measure their extent of applying asthma prevention guidelines.
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Affiliation(s)
- Enas Al-Zayadneh
- Department of Pediatrics, School of Medicine, The University of Jordan, Amman, Jordan
| | | | - Ameera Momani
- School of Medicine, The University of Jordan, Amman, Jordan
| | | | | | | | - Eba M Alzayadneh
- Department of Physiology and Biochemistry, School of Medicine, The University of Jordan, Amman, Jordan
| | | | | | - Montaha Al-Iede
- Department of Pediatrics, School of Medicine, The University of Jordan, Amman, Jordan
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10
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Gao YQ, Seah JJ, Wang ML, Tang QP, Wang DY, Bi XY, Han HW, Zhang TS, Ma J. An unusually high prevalence of allergic rhinitis at high altitudes in 6-7 year old children - An epidemiological study. World Allergy Organ J 2024; 17:100887. [PMID: 38742158 PMCID: PMC11089395 DOI: 10.1016/j.waojou.2024.100887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 05/16/2024] Open
Abstract
Objectives To compare the epidemiology and disease patterns of allergic rhinitis (AR) at 2 different altitudes in children aged 6-7 years, and subsequently to compare with and augment data from international studies. Materials and methods This is a multistage, clustered and stratified random sample study. The study area comprises 2 distinct areas within Yunnan Province, China. Low altitude was represented by Xishuangbanna Prefecture (XB), while high altitude was represented by Diqing Prefecture (DiQ). Each study area was subdivided into 3 sub-areas, and children aged 6-7 years were randomly sampled based on proportion-weighted sampling. The area studied includes the well-known area of Shangri-La city. Questionnaires were distributed and jointly completed by study participants and their parents or guardians, under the guidance of professional medical staff. Results 2796 valid questionnaires out of 2933 distributed were obtained (survey response rate 95.3%). The prevalence of AR is statistically significantly higher at high altitude (DiQ, 36.0%, 95%CI 33.2-38.8) as compared to low altitude (XB, 19.7%, 95%CI 17.8-21.6) (p < 0.001). Both areas studied had a greater prevalence of AR compared to international data. In both XB and DiQ, male gender, history of early antibiotic use, urban place of birth and place of residence, presence of smokers within the same household, family history of allergic diseases (such as atopic dermatitis), as well as higher parental educational level were all associated with a higher prevalence of AR (p < 0.05). In DiQ, the prevalence of AR in Han ethnicity was greater than that of ethnic minorities (p < 0.05). In XB, being a single child was associated with an increased prevalence of AR compared to those who had siblings (p < 0.05). Conclusion Our study found that the prevalence of AR is relatively greater at higher altitudes. Genetic and environmental factors both play an important role in the pathogenesis of AR. While altitude may be an important environmental factor, confounding factors may include humidity, temperature and distribution pattern of common aeroallergens.
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Affiliation(s)
- Ying-Qin Gao
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
| | - Jun Jie Seah
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mei-Lan Wang
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
| | - Qing-ping Tang
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
| | - De-Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Infectious Diseases Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xian-Yun Bi
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
| | - Hua-wei Han
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
| | - Tie-Song Zhang
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
| | - Jing Ma
- Department of Otolaryngology, Head and Neck Surgery, Kunming Children's Hospital, Kunming, China
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11
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Zhi L, Bai Y, Liao W, Chen G, Gao T, Wan X, Liang J, Liu L, Chen L, Zhang W, Bai J. The safety and tolerability of a one strength dose-escalation scheme for subcutaneous immunotherapy with a native house dust mite extract in Chinese children: A multicenter, randomized, open label clinical trial. Heliyon 2024; 10:e29450. [PMID: 38655350 PMCID: PMC11036000 DOI: 10.1016/j.heliyon.2024.e29450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
Background Allergen immunotherapy (AIT) is still the only treatment that may affect the natural cause of allergic disease. This study is to investigate whether an accelerated up-dosing scheme for subcutaneous allergen immunotherapy (SCIT) using a native house dust mite (HDM) allergen extract is as safe as the standard 3-strengths dose-escalation scheme in children with moderate to severe allergic rhinitis or rhinoconjunctivitis with or without asthma in China. Methods In this multicenter, open label, randomized controlled trial, the children aged 5-14 years were randomized 1:1 either to One Strength group or the Standard group. The dose escalation scheme for patients in the One Strength group included 6 injections of strength 3, whereas the Standard group comprised 14 injections using strength 1, 2, and 3. All treatment-emergent adverse events (TEAEs) were recorded and analyzed. The 5-point Likert scale was used to assess tolerability (ChiCTR2100050311). Results Overall, 101 children were included in the Safety Set (One Strength group: 50 vs. Standard group: 51). A total of 26 TEAEs were reported for 15 children. TEAEs related to AIT occurred in 10 % of the children in the One Strength group and 11.8 % of the Standard group. The number of systemic adverse reactions was comparable in both groups (One Strength: 5 vs. Standard: 4). No serious TEAEs was recorded for either group. 90.0 % of patients in the One Strength group reached the maintenance dose without an interventional dose adjustment due to adverse events, compared to 78.4 % in the Standard group. All patients who completed the dose-escalation phase reached the recommended maintenance dose of 1.0 ml of strength 3.Investigators and patients rated the tolerability of the One Strength regimen slightly better than the Standard scheme. Conclusions This exploratory study suggests that the accelerated One Strength dose-escalation scheme is comparable in safety and tolerability to the Standard regimen. However, due to the preliminary nature and small sample size, further research with larger sample sizes and robust study designs is necessary for confirmation.
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Affiliation(s)
- Lili Zhi
- Department of Allergy, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250014, China
| | - Yan Bai
- Department of Pediatrics, Union Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Wang Liao
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Guohua Chen
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Tingting Gao
- Department of Allergy, The First Affiliated Hospital of Shandong First Medical University, Jinan, 250014, China
| | - Xia Wan
- Department of Pediatrics, Union Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Jiawen Liang
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Lingling Liu
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Liang Chen
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Wenna Zhang
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
| | - Jun Bai
- Department of Pediatrics, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, 528000, China
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12
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Sui H, Shen H, Zhang C, Wang M, Zhen Z, Zhang J. Elevated Saliva Pepsin Concentration as a Risk Factor for Asthma in Children with Allergic Rhinitis: A Preliminary Study. J Asthma Allergy 2024; 17:391-397. [PMID: 38681237 PMCID: PMC11048294 DOI: 10.2147/jaa.s447145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/08/2024] [Indexed: 05/01/2024] Open
Abstract
Objective This study aimed to explore whether saliva pepsin concentration (SPC) could be regarded as a risk factor for the occurrence and unfavorable control of asthma in children with allergic rhinitis. Methods A prospective study was conducted on a group of 20 consecutive children newly diagnosed with allergic rhinitis and asthma (referred to as the asthma group). All these children underwent fractional exhaled nitric oxide (FeNO) measurement, lung function tests, and assessment of asthma control using the 7-item Childhood Asthma Control Test (C-ACT) score. Simultaneously, a control group consisting of 20 children with simple allergic rhinitis, matched for baseline characteristics, was included. SPC measurement was performed in the two groups. Results The SPC value was significantly higher in the asthma group than that in the control group (165.0 ± 82.8 ng/mL vs 68.4 ± 34.5 ng/mL) (P < 0.001). In the asthma group, SPC was independently associated with FeNO, the ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC), and forced expiratory flow at 50% and 75% of FVC (FEF50 and FEF75) (all P < 0.05). The severity of nasal symptoms evaluated by the visual analogue scale (N-VAS) was independently associated with FEF75, the maximal mid-expiratory flow (MMEF), and C-ACT score (P < 0.05). Conclusion Direct pepsin exposure and uncontrolled nasal symptoms may play crucial roles in the pathogenesis and progression of childhood allergic asthma. The SPC value can be considered as a risk factor for asthma in children with allergic rhinitis.
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Affiliation(s)
- Haijing Sui
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, People’s Republic of China
| | - Hong Shen
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, People’s Republic of China
| | - Chi Zhang
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, People’s Republic of China
| | - Minghui Wang
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, People’s Republic of China
| | - Zhen Zhen
- Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, People’s Republic of China
| | - Junbo Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, People’s Republic of China
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13
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Zhang J, Wurzel DF, Perret JL, Lodge CJ, Walters EH, Dharmage SC. Chronic Bronchitis in Children and Adults: Definitions, Pathophysiology, Prevalence, Risk Factors, and Consequences. J Clin Med 2024; 13:2413. [PMID: 38673686 PMCID: PMC11051495 DOI: 10.3390/jcm13082413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
The complex nature of chronic bronchitis (CB) and changing definitions have contributed to challenges in understanding its aetiology and burden. In children, CB is characterised by persistent airway inflammation often linked to bacterial infections and is therefore termed "protracted bacterial bronchitis" (PBB). Longitudinal studies suggest that CB in childhood persists into adulthood in a subgroup. It can also be associated with future chronic respiratory diseases including asthma, bronchiectasis, and chronic obstructive pulmonary disease (COPD). Adult CB is traditionally associated with smoking, occupational exposures, and lower socioeconomic status. The interplay between risk factors, childhood CB, adult CB, and other chronic respiratory diseases is intricate, requiring comprehensive longitudinal studies for a clearer understanding of the natural history of CB across the lifespan. Such longitudinal studies have been scarce to date given the logistic challenges of maintaining them over time. In this review, we summarise current evidence on the evolution of the definitions, pathophysiology, risk factors, and consequences of childhood and adulthood chronic bronchitis.
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Affiliation(s)
- Jingwen Zhang
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (J.Z.); (D.F.W.); (J.L.P.); (C.J.L.); (E.H.W.)
| | - Danielle F. Wurzel
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (J.Z.); (D.F.W.); (J.L.P.); (C.J.L.); (E.H.W.)
- Murdoch Children’s Research Institute, The Royal Children’s Hospital, Melbourne, VIC 3052, Australia
| | - Jennifer L. Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (J.Z.); (D.F.W.); (J.L.P.); (C.J.L.); (E.H.W.)
- Institute for Breathing and Sleep (IBAS), Melbourne, VIC 3084, Australia
| | - Caroline J. Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (J.Z.); (D.F.W.); (J.L.P.); (C.J.L.); (E.H.W.)
| | - E. Haydn Walters
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (J.Z.); (D.F.W.); (J.L.P.); (C.J.L.); (E.H.W.)
- School of Medicine, University of Tasmania, Hobart, TAS 7000, Australia
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; (J.Z.); (D.F.W.); (J.L.P.); (C.J.L.); (E.H.W.)
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14
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Liu Y, Chen F, Zeng Z, Lei C, Chen D, Zhang X. Neopterin in patients with COPD, asthma, and ACO: association with endothelial and lung functions. Respir Res 2024; 25:171. [PMID: 38637774 PMCID: PMC11027266 DOI: 10.1186/s12931-024-02784-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/22/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Endothelial dysfunction has been widely recognized in chronic airway diseases, including chronic obstructive pulmonary disease (COPD) and asthma; however, it remains unclear in asthma-COPD overlap (ACO). Neopterin (NP), a metabolite of guanosine triphosphate, is a novel biomarker for identifying the increased risk of adverse cardiovascular events. This study aims to investigate the association of NP with endothelial dysfunction and impaired lung function in COPD, asthma, and ACO patients. METHODS A total of 77 subjects were prospectively recruited. All the participants underwent lung function test, endothelial function evaluation, including pulse wave velocity (PWV) and flow-mediated dilation (FMD), and blood sample detection. Moreover, the effect of NP on endothelial cells (ECs) in anoxic environments was assessed in vitro. RESULTS Endothelial function was significantly decreased in the COPD and ACO patients compared with that in the healthy controls (P < 0.05). Forced expiratory volume in 1 s (FEV1) was negatively correlated with PWV and positively correlated with FMD (P < 0.05). NP was significantly increased in patients with chronic respiratory diseases compared with that in the control group, with COPD being the highest, followed by asthma, and ACO as the last (P < 0.05). The plasma level of NP exhibited negative correlations with FEV1 and positive correlations with PWV (P < 0.05). In vitro, a high level of NP increased the reactive oxygen species (ROS) and decreased the mitochondrial membrane potential (ΔΨm) of ECs dose-dependently in a hypoxic environment (P < 0.05). CONCLUSION NP was related to disease severity of chronic airway diseases and involved in the pathogenesis of endothelial dysfunction. A high NP level may contribute to endothelial dysfunction by increasing the oxidative stress of ECs dose-dependently in a hypoxic environment. Our findings may provide a novel evaluation and therapeutic target for endothelial dysfunction related to chronic airway diseases.
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Affiliation(s)
- Yangli Liu
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Province Guangdong, Guangzhou, 510080, PR China
| | - Fengjia Chen
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Province Guangdong, Guangzhou, 510080, PR China
| | - Zhimin Zeng
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Province Guangdong, Guangzhou, 510080, PR China
| | - Chengcheng Lei
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Province Guangdong, Guangzhou, 510080, PR China
| | - Dubo Chen
- Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Province Guangdong, 510080, PR China.
| | - Xiaoyu Zhang
- Department of Hypertension and Vascular Disease, The First Affiliated Hospital of Sun Yat-sen University, Province Guangdong, Guangzhou, 510080, PR China.
- National-Guangdong Joint Engineering Laboratory for Diagnosis and Treatment of Vascular Diseases, Guangzhou, 510080, PR China.
- Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou, 510080, PR China.
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15
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Jakwerth CA, Weckmann M, Illi S, Charles H, Zissler UM, Oelsner M, Guerth F, Omony J, Nemani SSP, Grychtol R, Dittrich AM, Skevaki C, Foth S, Weber S, Alejandre Alcazar MA, van Koningsbruggen-Rietschel S, Brock R, Blau S, Hansen G, Bahmer T, Rabe KF, Brinkmann F, Kopp MV, Chaker AM, Schaub B, von Mutius E, Schmidt-Weber CB. 17q21 Variants Disturb Mucosal Host Defense in Childhood Asthma. Am J Respir Crit Care Med 2024; 209:947-959. [PMID: 38064241 DOI: 10.1164/rccm.202305-0934oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/07/2023] [Indexed: 03/13/2024] Open
Abstract
Rationale: The strongest genetic risk factor for childhood-onset asthma, the 17q21 locus, is associated with increased viral susceptibility and disease-promoting processes.Objectives: To identify biological targets underlying the escalated viral susceptibility associated with the clinical phenotype mediated by the 17q21 locus.Methods: Genome-wide transcriptome analysis of nasal brush samples from 261 children (78 healthy, 79 with wheezing at preschool age, 104 asthmatic) within the ALLIANCE (All-Age-Asthma) cohort, with a median age of 10.0 (range, 1.0-20.0) years, was conducted to explore the impact of their 17q21 genotype (SNP rs72163891). Concurrently, nasal secretions from the same patients and visits were collected, and high-sensitivity mesoscale technology was employed to measure IFN protein levels.Measurements and Main Results: This study revealed that the 17q21 risk allele induces a genotype- and asthma/wheeze phenotype-dependent enhancement of mucosal GSDMB expression as the only relevant 17q21-encoded gene in children with preschool wheeze. Increased GSDMB expression correlated with the activation of a type-1 proinflammatory, cell-lytic immune, and natural killer signature, encompassing key genes linked to an IFN type-2-signature (IFNG, CXCL9, CXCL10, KLRC1, CD8A, GZMA). Conversely, there was a reduction in IFN type 1 and type 3 expression signatures at the mRNA and protein levels.Conclusions: This study demonstrates a novel disease-driving mechanism induced by the 17q21 risk allele. Increased mucosal GSDMB expression is associated with a cell-lytic immune response coupled with compromised airway immunocompetence. These findings suggest that GSDMB-related airway cell death and perturbations in the mucosal IFN signature account for the increased vulnerability of 17q21 risk allele carriers to respiratory viral infections during early life, opening new options for future biological interventions.The All-Age-Asthma (ALLIANCE) cohort is registered at www.clinicaltrials.gov (pediatric arm, NCT02496468).
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Affiliation(s)
- Constanze A Jakwerth
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Markus Weckmann
- Member of the German Center for Lung Research (DZL), Germany
- Division of Epigenetics in Chronic Lung Disease, Priority Area Chronic Lung Diseases, Research Center Borstel-Leibniz Lung Center, Borstel, Germany
- Department of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
| | - Sabina Illi
- Member of the German Center for Lung Research (DZL), Germany
- Institute for Asthma and Allergy Prevention, Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany
- Comprehensive Pneumology Center-Munich, Munich, Germany
| | - Helen Charles
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Ulrich M Zissler
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Madlen Oelsner
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Ferdinand Guerth
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
| | - Jimmy Omony
- Member of the German Center for Lung Research (DZL), Germany
- Institute for Asthma and Allergy Prevention, Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany
- Comprehensive Pneumology Center-Munich, Munich, Germany
| | - Sai Sneha Priya Nemani
- Member of the German Center for Lung Research (DZL), Germany
- Department of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
| | - Ruth Grychtol
- Member of the German Center for Lung Research (DZL), Germany
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hanover, Germany
| | - Anna-Maria Dittrich
- Member of the German Center for Lung Research (DZL), Germany
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hanover, Germany
| | - Chrysanthi Skevaki
- Member of the German Center for Lung Research (DZL), Germany
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics and
| | - Svenja Foth
- Member of the German Center for Lung Research (DZL), Germany
- Universities of Giessen and Marburg Lung Center, Philipps University Marburg and University Children's Hospital Marburg, University of Marburg, Marburg, Germany
| | - Stefanie Weber
- Member of the German Center for Lung Research (DZL), Germany
- Universities of Giessen and Marburg Lung Center, Philipps University Marburg and University Children's Hospital Marburg, University of Marburg, Marburg, Germany
| | - Miguel A Alejandre Alcazar
- Member of the German Center for Lung Research (DZL), Germany
- Institute for Lung Health and Cardio-Pulmonary Institute, Universities of Giessen and Marburg Lung Center, Giessen, Germany
- Translational Experimental Pediatrics, Experimental Pulmonology, Department of Pediatrics
- Center for Molecular Medicine Cologne and Cologne Excellence Cluster on Stress Responses in Aging-associated Diseases, and
- Pediatric Pulmonology and Allergology, Department of Pediatrics, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; and
| | - Silke van Koningsbruggen-Rietschel
- Member of the German Center for Lung Research (DZL), Germany
- Pediatric Pulmonology and Allergology, Department of Pediatrics, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; and
| | - Robert Brock
- Member of the German Center for Lung Research (DZL), Germany
- Pediatric Pulmonology and Allergology, Department of Pediatrics, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; and
| | - Samira Blau
- Member of the German Center for Lung Research (DZL), Germany
- Pediatric Pulmonology and Allergology, Department of Pediatrics, Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany; and
| | - Gesine Hansen
- Member of the German Center for Lung Research (DZL), Germany
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hanover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Hanover, Germany
- Cluster of Excellence 2115 (RESIST), Hannover Medical School, Hanover, Germany
| | - Thomas Bahmer
- Member of the German Center for Lung Research (DZL), Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
- Internal Medicine Department I, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Klaus F Rabe
- Member of the German Center for Lung Research (DZL), Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
- LungenClinic Grosshansdorf GmbH and Medical Clinics, Christian Albrechts University, Kiel, Germany
| | - Folke Brinkmann
- Member of the German Center for Lung Research (DZL), Germany
- Division of Epigenetics in Chronic Lung Disease, Priority Area Chronic Lung Diseases, Research Center Borstel-Leibniz Lung Center, Borstel, Germany
- Department of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
| | - Matthias Volkmar Kopp
- Department of Pediatric Pneumology and Allergology, University Medical Center Schleswig-Holstein, Lübeck, Germany
- Pediatric Respiratory Medicine, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Airway Research Center North, Borstel, Lübeck, Kiel, Grosshansdorf, Germany
| | - Adam M Chaker
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical School, Technical University of Munich, Munich, Germany
| | - Bianca Schaub
- Member of the German Center for Lung Research (DZL), Germany
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany
- Comprehensive Pneumology Center-Munich, Munich, Germany
| | - Erika von Mutius
- Member of the German Center for Lung Research (DZL), Germany
- Institute for Asthma and Allergy Prevention, Helmholtz Center Munich, German Research Center for Environmental Health, Munich, Germany
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany
| | - Carsten B Schmidt-Weber
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
- Member of the German Center for Lung Research (DZL), Germany
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16
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Alzahrani YA, Foley S, Becker EA. Development and psychometric evaluation of the asthma Action plan questionnaire (AAPQ). J Asthma 2024:1-10. [PMID: 38563676 DOI: 10.1080/02770903.2024.2337081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To develop a practical and psychometrically sound tool to evaluate caregiver knowledge of their child's asthma action plan (AAP). METHODS A pilot study was conducted in a sample of 40 caregivers of children with asthma to assess the content validity, item difficulty, and item discrimination of the Asthma Action Plan Questionnaire (AAPQ). The inter-rater and intra-rater agreement of the AAPQ's scoring rubric were also examined. Subsequently, a large-scale study was conducted in a sample of 80 caregivers of children with asthma and 40 caregivers of children without current asthma and no prior exposure to patients with asthma to evaluate the internal consistency, test-retest reliability, and known-groups validity of the AAPQ. RESULTS The 7-item AAPQ demonstrated acceptable content validity (a scale-content validity index of 0.98) and internal consistency (Cronbach's alpha =.63 and mean inter-item correlation coefficient of.20) and very strong test-retest reliability over a two-to-four-week period (r = .88, p < .001). The AAPQ discriminated between caregivers of children with asthma and caregivers of children without asthma (M ± SD 8.3 ± 1.6 vs. 4.3 ± 1.7, p < .001, respectively). CONCLUSION The AAPQ is a valid and reliable questionnaire that provides an assessment of caregivers' knowledge of their child's AAP and can guide educational interventions by healthcare providers.
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Affiliation(s)
- Yahya A Alzahrani
- Respiratory Care Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sharon Foley
- Department of Clinical Nutrition, Rush University, Chicago, IL, USA
| | - Ellen A Becker
- Department of Cardiopulmonary Sciences, Rush University, Chicago, IL, USA
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17
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Gutiérrez-Vera C, García-Betancourt R, Palacios PA, Müller M, Montero DA, Verdugo C, Ortiz F, Simon F, Kalergis AM, González PA, Saavedra-Avila NA, Porcelli SA, Carreño LJ. Natural killer T cells in allergic asthma: implications for the development of novel immunotherapeutical strategies. Front Immunol 2024; 15:1364774. [PMID: 38629075 PMCID: PMC11018981 DOI: 10.3389/fimmu.2024.1364774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/06/2024] [Indexed: 04/19/2024] Open
Abstract
Allergic asthma has emerged as a prevalent allergic disease worldwide, affecting most prominently both young individuals and lower-income populations in developing and developed countries. To devise effective and curative immunotherapy, it is crucial to comprehend the intricate nature of this condition, characterized by an immune response imbalance that favors a proinflammatory profile orchestrated by diverse subsets of immune cells. Although the involvement of Natural Killer T (NKT) cells in asthma pathology is frequently implied, their specific contributions to disease onset and progression remain incompletely understood. Given their remarkable ability to modulate the immune response through the rapid secretion of various cytokines, NKT cells represent a promising target for the development of effective immunotherapy against allergic asthma. This review provides a comprehensive summary of the current understanding of NKT cells in the context of allergic asthma, along with novel therapeutic approaches that leverage the functional response of these cells.
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Affiliation(s)
- Cristián Gutiérrez-Vera
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Programa de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Richard García-Betancourt
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Programa de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Pablo A. Palacios
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Programa de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Marioly Müller
- Departamento de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - David A. Montero
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Programa de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Carlos Verdugo
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Programa de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Francisca Ortiz
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Programa de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Felipe Simon
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago, Chile
| | - Alexis M. Kalergis
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo A. González
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Noemi A. Saavedra-Avila
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Steven A. Porcelli
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Leandro J. Carreño
- Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- Programa de Inmunología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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18
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Sha J, Zhang M, Feng J, Shi T, Li N, Jie Z. Promyelocytic leukemia zinc finger controls type 2 immune responses in the lungs by regulating lineage commitment and the function of innate and adaptive immune cells. Int Immunopharmacol 2024; 130:111670. [PMID: 38373386 DOI: 10.1016/j.intimp.2024.111670] [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] [Received: 12/28/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/21/2024]
Abstract
Type 2 immune responses are critical for host defense, mediate allergy and Th2-high asthma. The transcription factor, promyelocytic leukemia zinc finger (PLZF), has emerged as a significant regulator of type 2 inflammation in the lung; however, its exact mechanism remains unclear. In this review, we summarized recent findings regarding the ability of PLZF to control the development and function of innate lymphoid cells (ILCs), iNKT cells, memory T cells, basophils, and other immune cells that drive type 2 responses. We discussed the important role of PLZF in the pathogenesis of Th2-high asthma. Collectively, prior studies have revealed the critical role of PLZF in the regulation of innate and adaptive immune cells involved in type 2 inflammation in the lung. Therefore, targeting PLZF signaling represents a promising therapeutic approach to suppress Th2-high asthma.
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Affiliation(s)
- Jiafeng Sha
- Department of Pulmonary and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Meng Zhang
- Department of Pulmonary and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Jingjing Feng
- Department of Pulmonary and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Tianyun Shi
- Department of Pulmonary and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Na Li
- Department of Pulmonary and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Zhijun Jie
- Department of Pulmonary and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China; Center of Community-Based Health Research, Fudan University, Shanghai, China.
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19
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Chavoshian S, Cao X, Thommandram A, Stanbrook MB, Tarlo SM, Fossat Y, Yadollahi A. Designing and validating an experimental protocol to induce airway narrowing in older adults with and without asthma. Biomed Eng Online 2024; 23:28. [PMID: 38448963 PMCID: PMC10916193 DOI: 10.1186/s12938-023-01197-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/20/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Persons with asthma may experience excessive airway narrowing due to exercise or exposure to cold air, worsening their daily functionality. Exercise has several benefits for asthma control, but it may induce airway narrowing in some persons with asthma. When combined with cold temperatures, it introduces another layer of challenges. Therefore, managing this interaction is crucial to increase the quality of life in individuals with asthma. The purpose of this study was to develop a reliable experimental protocol to assess the effects of exercise and cold air on airway narrowing in adults with asthma in a controlled and safe environment. METHODS This study was a randomized cross-over study in adults with and without asthma. Participants underwent a protocol involving a 10-min seated rest, followed by a 10-min cycling on a stationary bike in different temperatures of 0, 10, or 20 ∘ C. The sequence of room temperatures was randomized, and there was a 30-min interval for recovery between each temperature transition. In each temperature, to measure lung function and respiratory symptoms, oscillometry and a questionnaire were used at 0 min (baseline), after 10 min of sitting and before starting biking (pre-exercise), and after 10 min of biking (post-exercise). At each room temperature, the changes in airway mechanics and asthma symptoms among baseline, pre-exercise, and post-exercise were compared with one-way repeated measures ANOVA or Friedman Rank Test. Within each arm, cardiac and thoraco-abdominal motion respiration signals were also measured continuously using electrodes and calibrated respiratory inductance plethysmographs, respectively. RESULTS A total of 23 persons with asthma (11 females, age: 56.3 ± 10.9 years, BMI: 27.4 ± 5.7 kg/m2) and 6 healthy subjects (3 females, age: 61.8 ± 9.1 years, BMI: 28.5 ± 3.1 kg/m2) were enrolled in the study. Cold temperature of 0∘ C induced airway narrowing in those with and without asthma after 10 and 20 min, respectively. Exercise intervention had significant changes in airway narrowing in participants with asthma in the range of 10-20∘ C. Our results showed that in asthma, changes in subjective respiratory symptoms were due to both cold temperatures of 0 and 10∘ C and exercise in the 0-20∘ C range. Respiratory symptoms were not noticed among the healthy participants. CONCLUSION In conclusion, our findings suggest that exposure to cold temperatures of 0∘ C could serve as a reliable method in the experimental protocol for inducing airway narrowing in asthma. The impact of exercise on airway narrowing was more variable among participants. Understanding these triggers in the experimental protocol is essential for the successful management of asthma in future studies.
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Affiliation(s)
- Shaghayegh Chavoshian
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto, M5G 2A2, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada
| | - Xiaoshu Cao
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto, M5G 2A2, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada
| | - Anirudh Thommandram
- Labs Department, Klick Health, Klick Inc, 175 Bloor St. East, Toronto, M4W 3R8, ON, Canada
| | - Matthew B Stanbrook
- Department of Medicine, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada
- Department of Medicine, University Health Network Toronto Western Hospital, 399 Bathurst St., Toronto, M5T 2S8, ON, Canada
| | - Susan M Tarlo
- Department of Medicine, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada
- Department of Medicine, University Health Network Toronto Western Hospital, 399 Bathurst St., Toronto, M5T 2S8, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, M5T 1P8, ON, Canada
| | - Yan Fossat
- Labs Department, Klick Health, Klick Inc, 175 Bloor St. East, Toronto, M4W 3R8, ON, Canada
| | - Azadeh Yadollahi
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto, M5G 2A2, ON, Canada.
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada.
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20
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Anzueto A, Cohen M, Echazarreta AL, Elassal G, Godoy I, Paramo R, Sayiner A, Torres-Duque CA, Acharya S, Aggarwal B, Erkus H, Levy G. Delphi Consensus on Clinical Applications of GOLD 2023 Recommendations in COPD Management: How Aligned are Recommendations with Clinical Practice? Pulm Ther 2024; 10:69-84. [PMID: 38112909 PMCID: PMC10881920 DOI: 10.1007/s41030-023-00248-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION The objective of this Delphi study was to understand and assess the level of consensus among respiratory experts on the clinical application of GOLD 2023 recommendations in management of patients with chronic obstructive pulmonary disease (COPD). METHODS The study comprised two online surveys and a participant meeting with 34 respiratory experts from 16 countries. Responses of 73 questions were recorded using a Likert scale ranging from 0 (disagreement) to 9 (agreement). The consensus threshold was 75%. RESULTS Survey 1 and survey 2 had 34 and 32 participants, respectively; and 25 attended the participant meeting. Consensus was reached on survey 1: 28/42; survey 2: 18/30 close-ended questions. A consensus was reached on the clinical relevance of most updates in definitions and diagnosis of COPD. Mixed results for the treatment recommendations by GOLD were noted: 74% agreed with the recommendation to initiate treatment with dual bronchodilators for group E patients; 63% agreed for including inhaled corticosteroids (ICS)/long-acting β2 agonist(LABA)/ Long-acting muscarinic receptor antagonists (LAMA) as a treatment option for GOLD B patients. Also, consensus lacked on removing ICS + LABA as an initial therapeutic option, in countries with challenges in access to other treatment option;. 88% agreed that they use GOLD recommendations in their daily clinical practice. CONCLUSIONS This Delphi study demonstrated a high level of consensus regarding key concepts of GOLD 2023 report, with most participants favoring recent updates in definitions, diagnosis, management, and prevention of COPD. More evidence on the etiotype based management and treatment options for group B and E are required which could further strengthen clinical application of the GOLD report.
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Affiliation(s)
- Antonio Anzueto
- University of Texas Health and South Texas Veterans Health Care System, San Antonio, TX, USA.
| | - Mark Cohen
- Hospital Centro Medico, Guatemala City, Guatemala
| | | | - Gehan Elassal
- Department of Pulmonology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Irma Godoy
- Department of Internal Medicine, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu Campus, Pneumology Area, São Paulo, Brazil
| | | | - Abdullah Sayiner
- Department of Chest Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
| | | | | | | | | | - Gur Levy
- Emerging Markets, GSK, Panama City, Panama
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Lee JU, Chang HS, Shim JS, Kim MH, Cho YJ, Kim MK, Park SL, Lee SJ, Park JS, Park CS. Aspirin Challenge-Induced Genome-Wide DNA Methylation Profile of Peripheral Blood Lymphocytes in Aspirin-Exacerbated Respiratory Disease. DNA Cell Biol 2024; 43:132-140. [PMID: 38386995 DOI: 10.1089/dna.2023.0218] [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: 02/24/2024] Open
Abstract
Genetic variation and epigenetic factors are thought to contribute to the development of hypersensitivity to aspirin. DNA methylation fluctuates dynamically throughout the day. To discover new CpG methylation in lymphocytes associated with aspirin-exacerbated respiratory disease (AERD), we evaluated changes in global CpG methylation profiles from before to after an oral aspirin challenge in patients with AERD and aspirin-tolerant asthma (ATA). Whole-genome CpG methylation levels of peripheral blood mononuclear cells were quantified with an Illumina 860K Infinium Methylation EPIC BeadChip array and then adjusted for inferred lymphocyte fraction (ILF) with GLINT and Tensor Composition Analysis. Among the 866,091 CpGs in the array, differentially methylated CpGs (DMCs) were found in 6 CpGs in samples from all 12 patients with asthma included in the study (AERD, n = 6; ATA, n = 6). DMCs were found in 3 CpGs in the 6 ATA samples and in 615 CpGs in the 6 AERD samples. A total of 663 DMCs in 415 genes and 214 intergenic regions differed significantly in the AERD compared with the ATA. In promoters, 126 CpG loci were predicted to bind to 38 transcription factors (TFs), many of which were factors already known to be involved in the pathogenesis of asthma and immune responses. In conclusion, we identified 615 new CpGs methylated in peripheral blood lymphocytes by oral aspirin challenge in AERD but not in ATA. These findings indicate that oral aspirin challenge induces epigenetic changes in ILFs, specifically in AERD patients, possibly via changes in TF binding, which may have epigenetic effects on the development of AERD.
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Affiliation(s)
- Jong-Uk Lee
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hun Soo Chang
- Department of Microbiology and BK21 FOUR Project, College of Medicine, Soonchunhyang University, Cheonan, Korea
| | - Ji-Su Shim
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Min-Hye Kim
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Young-Joo Cho
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Min Kyung Kim
- Department of Interdisciplinary Program in Biomedical Science Major, Soonchuhyang University, Asan, Korea
| | - Seung-Lee Park
- Department of Interdisciplinary Program in Biomedical Science Major, Soonchuhyang University, Asan, Korea
| | - Sun Ju Lee
- Department of Interdisciplinary Program in Biomedical Science Major, Soonchuhyang University, Asan, Korea
| | - Jong-Sook Park
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Choon-Sik Park
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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22
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Liu YJ, Gao KX, Peng X, Wang Y, Wang JY, Hu MB. The great potential of polysaccharides from natural resources in the treatment of asthma: A review. Int J Biol Macromol 2024; 260:129431. [PMID: 38237839 DOI: 10.1016/j.ijbiomac.2024.129431] [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] [Received: 11/09/2023] [Revised: 12/26/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024]
Abstract
Despite significant progress in diagnosis and treatment, asthma remains a serious public health challenge. The conventional therapeutic drugs for asthma often have side effects and unsatisfactory clinical efficacy. Therefore, it is very urgent to develop new drugs to overcome the shortcomings of conventional drugs. Natural polysaccharides provide enormous resources for the development of drugs or health products, and they are receiving a lot of attention from scientists around the world due to their safety, effective anti-inflammatory and immune regulatory properties. Increasing evidence shows that polysaccharides have favorable biological activities in the respiratory disease, including asthma. This review provides an overview of primary literature on the recent advances of polysaccharides from natural resources in the treatment of asthma. The mechanisms and practicability of polysaccharides, including polysaccharides from plants, fungus, bacteria, alga, animals and others are reviewed. Finally, the further research of polysaccharides in the treatment of asthma are discussed. This review can provide a basis for further study of polysaccharides in the treatment of asthma and provides guidance for the development and clinical application of novel asthma treatment drugs.
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Affiliation(s)
- Yu-Jie Liu
- School of Traditional Chinese Medicine and Food Engineering, Shanxi Provincial Key Laboratory of Traditional Chinese Medicine Processing, Shanxi University of Chinese Medicine, Jinzhong 030619, PR China
| | - Kui-Xu Gao
- School of Traditional Chinese Medicine and Food Engineering, Shanxi Provincial Key Laboratory of Traditional Chinese Medicine Processing, Shanxi University of Chinese Medicine, Jinzhong 030619, PR China
| | - Xi Peng
- School of Traditional Chinese Medicine and Food Engineering, Shanxi Provincial Key Laboratory of Traditional Chinese Medicine Processing, Shanxi University of Chinese Medicine, Jinzhong 030619, PR China
| | - Yao Wang
- School of Traditional Chinese Medicine and Food Engineering, Shanxi Provincial Key Laboratory of Traditional Chinese Medicine Processing, Shanxi University of Chinese Medicine, Jinzhong 030619, PR China
| | - Jing-Ya Wang
- School of Traditional Chinese Medicine and Food Engineering, Shanxi Provincial Key Laboratory of Traditional Chinese Medicine Processing, Shanxi University of Chinese Medicine, Jinzhong 030619, PR China
| | - Mei-Bian Hu
- School of Traditional Chinese Medicine and Food Engineering, Shanxi Provincial Key Laboratory of Traditional Chinese Medicine Processing, Shanxi University of Chinese Medicine, Jinzhong 030619, PR China.
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Dong R, Sun S, Sun Y, Wang Y, Zhang X. The association of depressive symptoms and medication adherence in asthma patients: The mediation effect of medication beliefs. Res Social Adm Pharm 2024; 20:335-344. [PMID: 38110324 DOI: 10.1016/j.sapharm.2023.12.002] [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] [Received: 09/21/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND The significant role of depression in influencing medication beliefs, which are pivotal cognitive factors that strongly influence medication adherence, has been established. Poor adherence to asthma-controlled medication poses an significant barrier to achieving optimal asthma management. OBJECTIVE To explore the potential mediating effects of medication beliefs on the relationship between depressive symptoms and medication adherence in patients with asthma. METHODS Demographic and clinical characteristics, depressive symptoms, medication adherence, and medication beliefs were collected using questionnaires. Structural equation modeling, was utilized to model medication beliefs as mediators in the relationship between depressive symptoms and medication adherence. Bootstrapping was performed to analyze the mediation- and contrast-specific indirect effects of the two medication beliefs. RESULTS Among the patients who participated in the study, 29.6 % with depressive symptoms were more prone to poor adherence and exhibited skepticism toward asthma medications. Depression had a direct effect (direct effect = -0.275, 95%CI: -0.369 to -0.190) and an indirect effect on adherence mediated by medication beliefs (indirect effect = -0.168, 95%CI: -0.224 to -0.121). The specific mediation effect of concern belief was stronger than that of necessity belief (difference = -0.076, 95%CI: -0.132 to -0.029). CONCLUSION Depressive symptoms have a direct impact on medication adherence as well as an indirect effect mediated by beliefs about medication, particularly concerns belief.
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Affiliation(s)
- Ruiying Dong
- The First Affiliated Hospital of China Medical University, China
| | - Shanwen Sun
- The First Affiliated Hospital of China Medical University, China
| | - Yajun Sun
- The First Affiliated Hospital of China Medical University, China
| | - Yali Wang
- The First Affiliated Hospital of China Medical University, China
| | - Xiaochun Zhang
- The First Affiliated Hospital of China Medical University, China.
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Wang J, Jiang T, Hu JD. Risk prediction model construction for asthma after allergic rhinitis by blood immune T effector cells. Medicine (Baltimore) 2024; 103:e37287. [PMID: 38394538 PMCID: PMC10883636 DOI: 10.1097/md.0000000000037287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Allergic rhinitis (AR) and asthma (AS) are prevalent and frequently co-occurring respiratory diseases, with mutual influence on each other. They share similar etiology, pathogenesis, and pathological changes. Due to the anatomical continuity between the upper and lower respiratory tracts, allergic inflammation in the nasal cavity can readily propagate downwards, leading to bronchial inflammation and asthma. AR serves as a significant risk factor for AS by potentially inducing airway hyperresponsiveness in patients. Currently, there is a lack of reliable predictors for the progression from AR to AS. METHODS In this exhaustive investigation, we reexamined peripheral blood single cell RNA sequencing datasets from patients with AS following AR and healthy individuals. In addition, we used the bulk RNA sequencing dataset as a validation lineup, which included AS, AR, and healthy controls. Using marker genes of related cell subtype, signatures predicting the progression of AR to AS were generated. RESULTS We identified a subtype of immune-activating effector T cells that can distinguish patients with AS after AR. By combining specific marker genes of effector T cell subtype, we established prediction models of 16 markers. The model holds great promise for assessing AS risk in individuals with AR, providing innovative avenues for clinical diagnosis and treatment strategies. CONCLUSION Subcluster T effector cells may play a key role in post-AR AS. Notably, ACTR3 and HSPA8 genes were significantly upregulated in the blood of AS patients compared to healthy patients.
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Affiliation(s)
- Jian Wang
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated People’s Hospital of Ningbo University, Ningbo, Zhejiang Province, China
| | - Tao Jiang
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated People’s Hospital of Ningbo University, Ningbo, Zhejiang Province, China
| | - Jian-Dao Hu
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated People’s Hospital of Ningbo University, Ningbo, Zhejiang Province, China
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Han M, Liu H, Liu G, Li X, Zhou L, Liu Y, Dou T, Yang S, Tang W, Wang Y, Li L, Ding H, Liu Z, Wang J, Chen X. Mogroside V alleviates inflammation response by modulating miR-21-5P/SPRY1 axis. Food Funct 2024; 15:1909-1922. [PMID: 38258992 DOI: 10.1039/d3fo01901b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Mogroside V (MV) is a natural sweetener extracted from the edible plant Siraitia grosvenorii that possesses anti-inflammatory bioactivity. It has been reported that microRNAs (miRNAs) play an important role in the inflammation response suppression by natural agents. However, whether the anti-inflammation effect of mogroside V is related to miRNAs and the underlying mechanism remains unclear. Our study aimed to identify the key miRNAs important for the anti-inflammation effect of MV and reveal its underlying mechanisms. Our results showed that MV effectively alleviated lung inflammation in ovalbumin-induced (OVA-induced) asthmatic mice. miRNA-seq and mRNA-seq combined analysis identified miR-21-5p as an important miRNA for the inflammation inhibition effect of MV and it predicted SPRY1 to be a target gene of miR-21-5p. We found that MV significantly inhibited the production of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-2 (IL-2), interleukin-6 (IL-6), and nitric oxide (NO), as well as the protein expression of p-P65/P65, cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS) in OVA-induced asthmatic mice and LPS-treated RAW 264.7 cells. Moreover, the release of ROS increased in LPS-stimulated RAW 264.7 cells but was mitigated by MV pretreatment. In the meantime, the expression of miR-21-5p was decreased by MV, leading to an increase in the expression of SPRY1 in RAW 264.7 cells. Furthermore, miR-21-5p overexpression or SPRY1 knockdown reversed MV's protective effect on inflammatory responses. Conversely, miR-21-5p inhibition or SPRY1 overexpression enhanced MV's effect on inflammatory responses in LPS-exposed RAW 264.7 cells. Therefore, the significant protective effect of mogroside V on inflammation response is related to the downregulation of miR-21-5p and upregulation of SPRY1 in vitro and in vivo, MiR-21-5p/SPRY1 may be novel therapeutic targets of MV for anti-inflammation treatment.
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Affiliation(s)
- Mengjie Han
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
| | - Haiping Liu
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
- School of Pharmacy, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, P.R. China
| | - Guoxiang Liu
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
| | - Xiaojuan Li
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
| | - Luwei Zhou
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
| | - Yisa Liu
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
| | - Tong Dou
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
- School of Pharmacy, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau, 999078, P.R. China
| | - Sijie Yang
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
| | - Wei Tang
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
| | - Yan Wang
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
| | - Linjun Li
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
| | - Hongfang Ding
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
| | - Zhangchi Liu
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
| | - Juan Wang
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
- Guangxi Key Laboratory of Molecular Medicine in Liver Injury and Repair, Guilin Medical University, 541001, P.R. China
- Guangxi Health Commission Key Laboratory of Basic Research in Sphingolipid Metabolism Related Diseases, the Affiliated Hospital of Guilin Medical University, Guilin, 541001, Guangxi, China
- Faculty of Basic Medicine, Guilin Medical University, Guilin, 541001, Guangxi, China
| | - Xu Chen
- Department of Pharmacy, Guilin Medical University, Guilin 541199, P.R. China.
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Yang B, Yu H, Yao W, Diao R, Li B, Wang Y, Li T, Ge L, Hu Y, Wang H. Food-specific IgG4-guided diet elimination improves allergy symptoms in children. Front Immunol 2024; 15:1281741. [PMID: 38420126 PMCID: PMC10899459 DOI: 10.3389/fimmu.2024.1281741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024] Open
Abstract
Allergic diseases in children are major public health concerns due to their widespread and rising prevalence. Food-specific immunoglobulin G4(FS-IgG4) has been detected in patients with allergic diseases, but its clinical significance is still debated. In the present study, 407 children with allergic diseases were recruited and categorized into three groups according to the different systems involved: the respiratory system group, the skin system group, and a multiple system group, with the collection of clinical symptoms and serum antibodies, including total immunoglobulin E (IgE), house dust mite (HDM) IgE, food-specific IgE (FS-IgE), and FS-IgG4. Part of these patients were followed up with the intervention of FS-IgG4-guided diet elimination with or without add-on probiotics supplement. The analysis at baseline revealed distinct serum levels of different antibodies. The positive rate of FS-IgG4 in all groups was more than 80%, and the proportion of total IgE and FS-IgG4 both positive in the multi-system group was the highest (p=0.039). Egg and milk were the foods with the highest positive rate of FS-IgG4 in all groups. After diet elimination for more than 3 months, serum FS-IgG4 in children significantly decreased (P<0.05) along with the improvement of clinical symptoms, regardless of the add-on of probiotics. However, the intervention did not impact the serum levels of total IgE, FS-IgE, and HDM IgE. There was no further decrease of serum FS-IgG4 level in children followed up for more than 1 year, which may be related to noncompliance with diet elimination. Multivariate regression analysis revealed that the decline of serum FS-IgG4 was an independent predictable factor for the improvement of clinical symptoms (adjusted OR:1.412,95%CI 1.017-1.96, p=0.039). The add-on of probiotics showed less efficiency in reducing the FS-IgG4 level in more patients with relief of clinical symptoms. Our results confirmed the correlation between FS-IgG4 and allergic diseases, and the decreased FS-IgG4 could be a useful predictor for the improvement of allergic symptoms. FS-IgG4-guided diet elimination is an efficient treatment for allergic diseases. Our study adds solid data to the clinical significance of FS-IgG4 in allergic diseases.
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Affiliation(s)
- Boyun Yang
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hanxiao Yu
- Clinical Research Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wo Yao
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ran Diao
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Bohui Li
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yongfang Wang
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ting Li
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Liuya Ge
- Outpatient Care Department, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yingying Hu
- Outpatient Care Department, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Huiying Wang
- Department of Allergy, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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He Y, Cui J, Xiao B, Hou L, Li Z, Zuo H, He Y, Yao D. Atomized inhalation of Icaritin reduces airway inflammation and remodeling in asthmatic mice. J Asthma 2024:1-10. [PMID: 38294683 DOI: 10.1080/02770903.2024.2313131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/29/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Asthma is a disease characterized by airway hyperresponsiveness and airway inflammation. Icaritin (ICT) is a plant hormone with various pharmacological activities such as anti-inflammatory, immune regulation, and anti-tumor. This study mainly explored the effects of nebulized inhalation of ICT on airway inflammation and airway remodeling in asthmatic mice. METHOD Different groups of ovalbumin (OVA)-induced asthma mice with acute and chronic airway inflammation received ICT. Asthmatic mice received budesonide (BDND) aerosol inhalation as a positive control, while normal control and asthma model mice received the same volume of saline. Following finishing of the study, analyses were conducted on behavioral tests, biochemical indices, and histological structures of lung tissues. RESULTS Aerosol inhalation of ICT can notably reduce inflammatory cells infiltration around the airways and pulmonary vessels, and suppressed goblet cell hyperplasia in asthmatic mice. Long-term inhalation of ICT can decrease airway collagen deposition and airway smooth muscle hyperplasia, and alleviate airway hyperresponsiveness, mirroring the effects observed with hormone employed in clinical practice. CONCLUSION Nebulized inhalation of ICT can effectively inhibit airway inflammation in asthmatic mice, improve airway remodeling, and reduce airway hyperresponsiveness, with effects similar to those of hormones. It may serve as a potential candidate used as a hormone replacement asthma treatment.
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Affiliation(s)
- Yintong He
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, China
- The Fifth Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Jian Cui
- The Fifth Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Bo Xiao
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Lixia Hou
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Zhimei Li
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Huiqin Zuo
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Yutong He
- Department of Anatomy, School of Basic Medical Sciences, Guangzhou Medical University, Guangzhou, China
- National Center for Translational Medicine (Shanghai) SHU Branch, Shanghai University, Shanghai, China
| | - Dong Yao
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Guilin Medical University, Guilin, China
- Guangxi Clinical Research Center for Diabetes and Metabolic Diseases, Guangxi Health Commission Key Laboratory of Glucose and Lipid Metabolism Disorders, The Second Affiliated Hospital of Guilin Medical University, Guilin, China
- Guangxi Key Laboratory of Metabolic Reprogramming and Intelligent Medical Engineering for Chronic Diseases, The key laboratory of Respiratory Diseases, Education Department of Guangxi Zhuang Autonomous Region, Guilin Medical University, Guilin, China
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Abdullah S, Iqbal A, Ashok AK, Kaouche FC, Aslam M, Hussain S, Rahman J, Hayat MM, Ashraf M. Anti-enzymatic and DNA docking studies of montelukast: A multifaceted molecular scaffold with in vitro investigations, molecular expression analysis and molecular dynamics simulations. Heliyon 2024; 10:e24470. [PMID: 38298631 PMCID: PMC10828691 DOI: 10.1016/j.heliyon.2024.e24470] [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: 09/27/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 02/02/2024] Open
Abstract
Montelukast, an approved leukotriene receptor 1 (Cys-LT 1) antagonist with anti-inflammatory properties is used for the treatment of asthma and allergic rhinitis. In the present studies, montelukast was subjected to in vitro inhibitory assays followed by kinetic and in silico investigations. Montelukast demonstrated inhibitory activity against yeast α-glucosidase (IC50 44.31 ± 1.21 μM), jack bean urease (JB urease, IC50 8.72 ± 0.23 μM), human placental alkaline phosphatase (hPAP, IC50 17.53 ± 0.19 μM), bovine intestinal alkaline phosphatase (bIAP, IC50 15.18 ± 0.23 μM) and soybean 15-lipoxygenase (15-LOX, IC50 2.41 ± 0.13 μM). Kinetic studies against α-glucosidase and urease enzymes revealed its competitive mode of inhibition. Molecular expression analysis of montelukast in breast cancer cell line MCF-7 down-regulated AP by a factor of 0.27 (5 μM) compared with the 0.26 value for standard inhibitor levamisole (10 μM). Molecular docking estimated a binding affinity ranging -8.82 to -15.65 kcal/mol for the enzymes. Docking against the DNA dodecamer (ID: 1BNA) observed -9.13 kcal/mol via minor groove binding. MD simulations suggested stable binding between montelukast and the target proteins predicting strong inhibitory potential of the ligand. Montelukast features a chloroquinoline, phenyl ring, a cyclopropane group, a carboxylic group and a sulfur atom all of which collectively enhance its inhibitory potential against the said enzymes. These in vitro and computational investigations demonstrate that it is possible and suggested that the interactions of montelukast with more than one targets presented herein may be linked with the side effects presented by this drug and necessitate additional work. The results altogether suggest montelukast as an important structural scaffold possessing multitargeted features and warrant further investigations in repurposing beyond its traditional pharmacological use.
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Affiliation(s)
- Shawana Abdullah
- Institute of Chemistry, Baghdad-ul-Jadeed Campus, The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Ambar Iqbal
- Institute of Chemistry, Baghdad-ul-Jadeed Campus, The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
- Department of Biochemistry and Molecular Biology, Institute of Biochemistry, Biotechnology & Bioinformatics, Baghdad-ul-Jadeed Campus, The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Avinash Karkada Ashok
- Department of Biotechnology, Siddaganga Institute of Technology, Tumakuru, Karnataka, 572103, India
| | - Farah Chafika Kaouche
- Department of Chemistry, Faculty of Sciences of Mater, Ibn Khaldoun University, BP 78 Zaaoura, 14000, Tiaret, Algeria
| | - Misbah Aslam
- Institute of Chemistry, Baghdad-ul-Jadeed Campus, The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Safdar Hussain
- Institute of Chemistry, Baghdad-ul-Jadeed Campus, The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | - Jameel Rahman
- Institute of Chemistry, Baghdad-ul-Jadeed Campus, The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
| | | | - Muhammad Ashraf
- Institute of Chemistry, Baghdad-ul-Jadeed Campus, The Islamia University of Bahawalpur, Bahawalpur, 63100, Pakistan
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Wong MWH, Chien LC, Bhammar DM. Acute Effects of Albuterol on Ventilatory Capacity in Children with Asthma. Pediatr Rep 2024; 16:46-56. [PMID: 38251314 PMCID: PMC10801572 DOI: 10.3390/pediatric16010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/20/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Children with asthma may have a reduced ventilatory capacity, which could lead to symptoms and early termination of a cardiopulmonary exercise test (CPET). The purpose of this study was to examine the effects of short-acting beta agonist (albuterol) administration on estimated ventilatory capacity in children with asthma. METHODS Fifteen children (eleven boys, 10.6 ± 0.9 years) completed spirometry at baseline, after 180 µg of albuterol, and after the CPET in this cross-sectional study. Ventilatory capacity was calculated from forced vital capacity (FVC) and isovolume forced expiratory time from 25 to 75% of FVC (isoFET25-75) as follows: FVC/2 × [60/(2 × isoFET25-75)]. Differences in outcome variables between baseline, after albuterol administration, and after the CPET were detected with repeated measures mixed models with Bonferroni post hoc corrections. RESULTS Estimated ventilatory capacity was higher after albuterol (68.7 ± 21.2 L/min) and after the CPET (75.8 ± 25.6 L/min) when compared with baseline (60.9 ± 22.0 L/min; P = 0.003). Because forced vital capacity did not change, the increased ventilatory capacity was primarily due to a decrease in isoFET25-75 (i.e., an increase in mid-flows or isoFEF25-75). CONCLUSION Albuterol administration could be considered prior to CPET for children with asthma with relatively well-preserved FEV1 values to increase ventilatory capacity pre-exercise and potentially avoid symptom-limited early termination of testing.
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Affiliation(s)
- Michael W. H. Wong
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA;
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV 89154, USA;
| | - Dharini M. Bhammar
- Center for Tobacco Research, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
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De Soomer K, Vaerenberg H, Weyler J, Pauwels E, Cuypers H, Verbraecken J, Oostveen E. Effects of Weight Change and Weight Cycling on Lung Function in Overweight and Obese Adults. Ann Am Thorac Soc 2024; 21:47-55. [PMID: 37870395 DOI: 10.1513/annalsats.202212-1026oc] [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] [Received: 12/16/2022] [Accepted: 10/19/2023] [Indexed: 10/24/2023] Open
Abstract
Rationale: Epidemiological studies have reported on the detrimental effects on lung function after natural, and thus limited, weight gain in unselected populations. Studies on bariatric surgery, on the contrary, have indicated large improvements in lung function after substantial weight loss. Objectives: To study the associations between profound weight loss or gain and pulmonary function within the same population. A second objective was to investigate the effect of weight cycling on pulmonary function. Methods: From our lung function database, we selected the records of subjects in follow-up for continuous positive airway pressure therapy for sleep apnea with a weight change of ⩾20 kg within 5 years. Lung function (N = 255) at baseline was normal except for a tendency toward mild restriction in morbid obesity. Within this sample, 73 subjects were identified with significant "weight cycling", defined as a ⩾10-kg opposite change in body weight before or after the ⩾20-kg weight change. Results: Weight change affected pulmonary function more in men than in women (P < 0.001). In men, forced vital capacity (FVC) increased an average of 1.4% predicted per unit of body mass index after weight loss and the reverse after weight gain, whereas women exhibited a smaller change of 0.9% predicted per unit of body mass index. Weight loss slightly increased the ratio of forced expiratory volume in 1 second to FVC and decreased the specific airway resistance, whereas the opposite occurred with weight gain. Greater effects of weight change on lung function were observed in leaner subjects (P = 0.02) and in older subjects (P < 0.002). Changes in total lung capacity followed the changes in FVC, with no change in residual volume, and the greatest change was observed in functional residual capacity. In subjects with weight cycling, the improvement in lung function due to weight loss was reversed by subsequent weight gain and vice versa. Conclusions: This study provides evidence that the detrimental effect of obesity on lung function is a passive and reversible process.
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Affiliation(s)
- Kevin De Soomer
- Department of Respiratory Medicine, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Hilde Vaerenberg
- Department of Respiratory Medicine, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Joost Weyler
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium; and
| | - Evelyn Pauwels
- Department of Respiratory Medicine, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Hilde Cuypers
- Department of Respiratory Medicine, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Johan Verbraecken
- Department of Respiratory Medicine, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
- Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital, Antwerp, Belgium
| | - Ellie Oostveen
- Department of Respiratory Medicine, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
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Gil-Rojas Y, Lasalvia P, Sáenz V, Virgüez O, Peña MP, Castañeda-Cardona C, Laucho-Contreras ME, González AL, García-Nuncira CY, Rosselli D. Study of the Direct Costs of Asthma at a Healthcare Service Provider in Bogotá, Colombia. Value Health Reg Issues 2024; 39:6-13. [PMID: 37967491 DOI: 10.1016/j.vhri.2023.09.006] [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] [Received: 08/25/2021] [Revised: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVES This study aimed to describe clinical characteristics and direct medical costs associated with disease treatment in Colombia patients with asthma from 1 healthcare provider. METHODS This was a descriptive study with a retrospective data collection from a healthcare provider's electronic medical records in Colombia. A clinical, demographic, and healthcare resource utilization profile was developed over a 12-month observation period after the identification of eligible patients. To determine the mean cost per patient per year, the total frequencies of resource utilization were added, and the result was multiplied by the unit cost of each of them. RESULTS A total of 7919 patients were included in the analysis. The mean ± SD cost per patient per year ranged from $189.5 ± $1.900.6 to $240.2 ± $1.903.6 depending on the price guidebook. The total cost had been driven by the medication use (79% of total cost) and by the outpatient visits (20% of total cost). CONCLUSIONS In the population analyzed, the mean total direct cost per patient per year of asthma was $189.5 and $240.2, depending on the cost source. Direct medical costs were higher in cases classified as severe and in the adult and elderly population. When comparing the sources of resource utilization, it was found that the mean cost per patient obtained from real-life data is lower than the theoretical cost obtained from the bottom-up method with quantification of resources from experts. It is important to consider limitations related to study design and the evolving landscape of asthma treatments.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Diego Rosselli
- Clinical Epidemiology and Biostatistics Department, Pontificia Universidad Javeriana, Bogotá, Bogotá DC, Colombia
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Yao L, Meng L, Liu X, Li X, Liu F, Shang Y, Feng Y. The initial angle of the maximum expiratory flow-volume curve: a novel start-of-test criteria of spirometry in children. Eur J Pediatr 2024; 183:435-444. [PMID: 37924349 DOI: 10.1007/s00431-023-05323-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 10/11/2023] [Accepted: 10/29/2023] [Indexed: 11/06/2023]
Abstract
The aim of the present study was to define an initial angle called β and to assess its diagnostic value for identifying poor-quality maneuvers in spirometry testing in children. Furthermore, its predictive equation or normal value was explored. Children aged 4-14 years with respiratory symptoms who underwent spirometry were enrolled. Based on the efforts labeled during maneuvering and the quality control criteria of the guidelines, children were categorized into good-quality and poor-quality groups. According to ventilatory impairment, children in the good-quality group were divided into three subgroups: normal, restricted, and obstructed. Angle β was the angle between the line from the expiratory apex to the origin of coordinates and the x-axis of the maximal expiratory flow-volume (MEFV) curve. Demographic characteristics, angle β, and other spirometric parameters were compared among groups. The diagnostic values of angle β, forced expiratory time (FET), and their combination were assessed using receiver operating characteristic curves. Data from 258 children in the good-quality group and 702 healthy children in our previous study were used to further explore the predictive equation or normal value of angle β. The poor-quality group exhibited a significantly smaller angle β (76.44° vs. 79.36°; P < 0.001), significantly lower peak expiratory flow (PEF), FET, and effective FET (ETe), and significantly higher expiratory volume at peak flow rate (FEV-PEF) and ratio of extrapolated volume and forced vital capacity (EV/FVC) than the good-quality group. There was no significant difference in angle β among the normal, restricted, and obstructed groups. Logistic regression analysis revealed that smaller angle β and FET values indicated poor-quality MEFV curves. The combination of angle β < 74.58° and FET < 4.91 s had a significantly larger area under the curve than either one alone. The normal value of angle β of children aged 4-14 years was 78.40 ± 0.12°. Conclusions: Angle β contributes to the quality control evaluation of spirometry in children. Both angle β < 74.58° and FET < 4.91 s are predictors of poor-quality MEFV curves, while their combination offers the highest diagnostic value. What is Known: • A slow start is one of the leading causes of poor-quality maximal expiratory flow-volume (MEFV) curves, which is a particularly prominent issue among children due to limited cooperation, especially those younger than 6 years old. • It is relatively difficult to differentiate between ventilatory dysfunction and poor cooperation when a slow start occurs in children; therefore, there is an urgent need for an objective indicator that is unaffected by ventilatory impairment to evaluate quality control of spirometry. What is New: • The initial angle β, which was introduced at the ascending limb of the MEFV curve in the present study, has a certain diagnostic value for poor-quality MEFV curves in children. • Angle β < 74.58° is a predictor of poor-quality MEFV curves, and its combination with FET < 4.91 s offers a higher diagnostic value.
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Affiliation(s)
- Luanjie Yao
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China
| | - Lingdong Meng
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China
| | - Xin Liu
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China
| | - Xiaowen Li
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China
| | - Fen Liu
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China
| | - Yunxiao Shang
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China
| | - Yong Feng
- Department of Pediatrics, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, China.
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Wang T, Song G, Sun M, Zhang Y, Zhang B, Peng M, Li M. Nerolidol attenuates airway inflammation and airway remodeling and alters gut microbes in ovalbumin-induced asthmatic mice. Cell Biochem Funct 2024; 42:e3899. [PMID: 38088534 DOI: 10.1002/cbf.3899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/24/2023] [Accepted: 11/26/2023] [Indexed: 01/26/2024]
Abstract
Asthma is a common respiratory disease associated with airway inflammation. Nerolidol is an acyclic sesquiterpenoid with anti-inflammatory properties. BALB/C mice were sensitized with ovalbumin (OVA) to induce asthma symptoms and given different doses of Nerolidol. We found that Nerolidol reduced OVA-induced inflammatory cell infiltration, the number of goblet cells and collagen deposition in lung tissue. Nerolidol reduced the OVA-specific IgE levels in serum and alveolar lavage fluid in an asthma model. Immunohistochemical staining of α-SMA (the marker of airway smooth muscle) showed that Nerolidol caused bronchial basement membrane thinning in asthmatic mice. The hyperplasia of airway smooth muscle cells (ASMCs) is an important feature of airway remodeling in asthma. ASMCs were treated with 10 ng/mL TGF-β to simulate the pathological environment of asthma in vitro and then treated with different doses of Nerolidol. Nerolidol inhibited the activity of TGF-β/Smad signaling pathway both in the lung tissue of OVA-induced mouse and TGF-β-stimulated ASMCs. 16s rRNA sequencing was performed on feces of normal mice, the changes of intestinal flora in OVA-induced asthmatic mice and Nerolidol-treated asthmatic mice were studied. The results showed that Nerolidol reversed the reduced gut microbial alpha diversity in asthmatic mice. Nerolidol changed the relative abundance of gut bacteria at different taxonomic levels. At the phylum level, the dominant bacteria were Bacteroidota, Firmicutes, and Proteobacteria. At the genus level, the dominant bacteria were Lactobacillus, Muribaculaceae, Bacteroides, and Lachnospiraceae. We conclude that Nerolidol attenuates OVA-induced airway inflammation and alters gut microbes in mice with asthma via TGF-β/Smad signaling.
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Affiliation(s)
- Tingting Wang
- Department of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Guihua Song
- Department of Pediatrics, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Mengmeng Sun
- Department of Pediatrics, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Yan Zhang
- Department of Pediatrics, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Bingxue Zhang
- Department of Pediatrics, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Minghao Peng
- Department of Pediatrics, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Mengyin Li
- Department of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, Henan, China
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Martínez Moragón E, Entrenas Costa LM, Sánchez-Covisa Hernández J, de Prado Moncusí A, Monteagudo Ruiz G. A cross-sectional study to evaluate utility measure and health-related quality of life (HRQoL) among patients with severe uncontrolled asthma in Spain. J Asthma 2024; 61:27-38. [PMID: 37647295 DOI: 10.1080/02770903.2023.2241891] [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] [Received: 03/10/2023] [Revised: 06/23/2023] [Accepted: 07/24/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND AND PURPOSE OF THE STUDY The utility measure is a method to quantify health-related quality of life according to the preference values that patients attach to their health status. This study aimed to estimate the utility measure of patients with controlled and uncontrolled severe asthma (SA) in Spain, separately. Additionally, other characteristics (sociodemographic, clinical, and healthcare resource use [HCRU]) were also assessed for both SA populations. METHODS This cross-sectional study included 159 patients with SA in Spain. Data were collected from medical records and directly from the patients during the study visit. Asthma Control Questionnaire (ACQ)-5 was used to classify patients with controlled and uncontrolled SA. RESULTS Most of the patients were female (72.0% uncontrolled SA and 63.6% controlled SA). The mean (SD) EuroQol-5D (EQ-5D-5L) score was 0.88 (0.14) and 0.70 (0.25) in controlled and uncontrolled SA, respectively. The mean (SD) Asthma Quality-of-Life-5D (AQL-5D) score was 0.93 (0.09) and 0.85 (0.09) in controlled and uncontrolled SA, respectively. Emergency visits (19.2 vs. 2.7%) and hospitalizations (7.7% vs. no hospitalization) were more common among uncontrolled SA than controlled SA. Mean (SD) number of visits to primary care and pneumologists in uncontrolled SA vs. controlled SA was 4.1 (2.8) vs. 2.5 (3.0) and 3.7 (3.5) vs. 2.8 (2.2), respectively. CONCLUSION The study provides data on utility measures among patients with SA in Spain for the first time. Patients with uncontrolled SA had lower HRQoL and higher HCRU than patients with controlled SA. Therefore, the implementation of measures that improve HRQoL among patients with uncontrolled SA is highly recommended.
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Affiliation(s)
| | - Luis Manuel Entrenas Costa
- Hospital Universitario Reina Sofía, Universidad de Córdoba e Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
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McDowell R, Heaney L, Brown T, Bunting B, Burhan H, Chaudhuri R, Dennison P, Faruqi S, Gore R, Jackson DJ, Menzies-Gow A, Pantin T, Patel M, Pfeffer P, Siddiqui S, Busby J. An examination of factorial invariance of the Asthma Control Questionnaire among adults with severe asthma. PLoS One 2023; 18:e0295493. [PMID: 38060586 PMCID: PMC10703262 DOI: 10.1371/journal.pone.0295493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The Asthma Control Questionnaire (ACQ) is used to assess asthma symptom control. The relationship between the questionnaire items and symptom control has not been fully studied in severe asthmatic patients, and its validity for making comparisons between subgroups of patients is unknown. METHODS Data was obtained from patients in the United Kingdom Severe Asthma Registry whose symptom control was assessed using the five-item ACQ (ACQ5) (n = 2,951). Confirmatory factor analysis determined whether a latent factor for asthma symptom control, as measured by the ACQ5, was consistent with the data. Measurement invariance was examined in relation to ethnicity, sex and age; this included testing for approximate measurement invariance using Bayesian Structural Equation Modelling (BSEM). The fitted models were used to estimate the internal consistency reliability of the ACQ5. Invariance of factor means across subgroups was assessed. RESULTS A one-factor construct with residual correlations for the ACQ5 was an excellent fit to the data in all subgroups (Root Mean Square Error Approximation 0.03 [90%CI 0.02,0.05], p-close fit 0.93, Comparative Fit Index 1.00, Tucker Lewis Index 1.00}. Expected item responses were consistent for Caucasian and non-Caucasian patients with the same absolute level of symptom control. There was some evidence that females and younger adults reported wakening more frequently during the night than males and older adults respectively with the same absolute level of symptom control (p<0.001). However approximate measurement invariance was tenable and any failure to observe strong measurement invariance had minimal impact when comparing mean levels of asthma symptom control between patients of different sexes or ages. Average levels of asthma symptom control were lower for non-Caucasians (p = 0.001), females (p<0.01)and increased with age (p<0.01). Reliability of the instrument was high (over 88%) in all subgroups studied. CONCLUSION The ACQ5 is informative in comparing levels of symptom control between severe asthmatic patients of different ethnicities, sexes and ages. It is important that analyses are replicated in other severe asthma registries to determine whether measurement invariance is observed.
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Affiliation(s)
- Ronald McDowell
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, United Kingdom
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Liam Heaney
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, United Kingdom
- Belfast Health & Social Care NHS Trust, Belfast, United Kingdom
| | - Thomas Brown
- Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
| | - Brendan Bunting
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | | | | | - Paddy Dennison
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Shoaib Faruqi
- Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom
| | - Robin Gore
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - David J. Jackson
- Guy’s Severe Asthma Centre, Guy’s and St Thomas’ Hospitals, London, United Kingdom
- School of Immunology & Microbial Sciences, King’s College London, London, United Kingdom
| | | | - Thomas Pantin
- Wythenshawe Hospital, Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Mitesh Patel
- University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
| | | | - Salman Siddiqui
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - John Busby
- School of Medicine, Dentistry and Biomedical Sciences, Queen’s University, Belfast, United Kingdom
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Capaldi DPI, Konyer NB, Kjarsgaard M, Dvorkin-Gheva A, Dandurand RJ, Nair P, Svenningsen S. Specific Ventilation in Severe Asthma Evaluated with Noncontrast Tidal Breathing 1H MRI. Radiol Cardiothorac Imaging 2023; 5:e230054. [PMID: 38166343 PMCID: PMC11163249 DOI: 10.1148/ryct.230054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/21/2023] [Accepted: 11/01/2023] [Indexed: 01/04/2024]
Abstract
Purpose To determine if proton (1H) MRI-derived specific ventilation is responsive to bronchodilator (BD) therapy and associated with clinical biomarkers of type 2 airway inflammation and airways dysfunction in severe asthma. Materials and Methods In this prospective study, 27 participants with severe asthma (mean age, 52 years ± 9 [SD]; 17 female, 10 male) and seven healthy controls (mean age, 47 years ± 16; five female, two male), recruited between 2018 and 2021, underwent same-day spirometry, respiratory oscillometry, and tidal breathing 1H MRI. Participants with severe asthma underwent all assessments before and after BD therapy, and type 2 airway inflammatory biomarkers were determined (blood eosinophil count, sputum eosinophil percentage, sputum eosinophil-free granules, and fraction of exhaled nitric oxide) to generate a cumulative type 2 biomarker score. Specific ventilation was derived from tidal breathing 1H MRI and its response to BD therapy, and relationships with biomarkers of type 2 airway inflammation and airway dysfunction were evaluated. Results Mean MRI specific ventilation improved with BD inhalation (from 0.07 ± 0.04 to 0.11 ± 0.04, P < .001). Post-BD MRI specific ventilation (P = .046) and post-BD change in MRI specific ventilation (P = .006) were greater in participants with asthma with type 2 low biomarkers compared with participants with type 2 high biomarkers of airway inflammation. Post-BD change in MRI specific ventilation was correlated with change in forced expiratory volume in 1 second (r = 0.40, P = .04), resistance at 5 Hz (r = -0.50, P = .01), resistance at 19 Hz (r = -0.42, P = .01), reactance area (r = -0.54, P < .01), and reactance at 5 Hz (r = 0.48, P = .01). Conclusion Specific ventilation evaluated with tidal breathing 1H MRI was responsive to BD therapy and was associated with clinical biomarkers of airways disease in participants with severe asthma. Keywords: MRI, Severe Asthma, Ventilation, Type 2 Inflammation Supplemental material is available for this article. © RSNA, 2023 See also the commentary by Moore and Chandarana in this issue.
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Affiliation(s)
- Dante P. I. Capaldi
- From the Department of Radiation Oncology, Division of Physics,
University of California San Francisco, San Francisco, Calif (D.P.I.C.);
Division of Respirology, Department of Medicine (A.D.G., P.N., S.S.), Imaging
Research Centre (N.B.K., S.S.), and Firestone Institute for Respiratory Health
(M.K., P.N., S.S.), St Joseph's Healthcare Hamilton, McMaster University,
50 Charlton Ave E, Hamilton, ON, Canada L8N 4A6; and Lakeshore General Hospital,
Montreal Chest Institute, Meakins-Christie Laboratories, and Oscillometry Unit
of the Centre for Innovative Medicine, McGill University Health Centre and
Research Institute, and McGill University, Montreal, Canada (R.J.D.)
| | - Norman B. Konyer
- From the Department of Radiation Oncology, Division of Physics,
University of California San Francisco, San Francisco, Calif (D.P.I.C.);
Division of Respirology, Department of Medicine (A.D.G., P.N., S.S.), Imaging
Research Centre (N.B.K., S.S.), and Firestone Institute for Respiratory Health
(M.K., P.N., S.S.), St Joseph's Healthcare Hamilton, McMaster University,
50 Charlton Ave E, Hamilton, ON, Canada L8N 4A6; and Lakeshore General Hospital,
Montreal Chest Institute, Meakins-Christie Laboratories, and Oscillometry Unit
of the Centre for Innovative Medicine, McGill University Health Centre and
Research Institute, and McGill University, Montreal, Canada (R.J.D.)
| | - Melanie Kjarsgaard
- From the Department of Radiation Oncology, Division of Physics,
University of California San Francisco, San Francisco, Calif (D.P.I.C.);
Division of Respirology, Department of Medicine (A.D.G., P.N., S.S.), Imaging
Research Centre (N.B.K., S.S.), and Firestone Institute for Respiratory Health
(M.K., P.N., S.S.), St Joseph's Healthcare Hamilton, McMaster University,
50 Charlton Ave E, Hamilton, ON, Canada L8N 4A6; and Lakeshore General Hospital,
Montreal Chest Institute, Meakins-Christie Laboratories, and Oscillometry Unit
of the Centre for Innovative Medicine, McGill University Health Centre and
Research Institute, and McGill University, Montreal, Canada (R.J.D.)
| | - Anna Dvorkin-Gheva
- From the Department of Radiation Oncology, Division of Physics,
University of California San Francisco, San Francisco, Calif (D.P.I.C.);
Division of Respirology, Department of Medicine (A.D.G., P.N., S.S.), Imaging
Research Centre (N.B.K., S.S.), and Firestone Institute for Respiratory Health
(M.K., P.N., S.S.), St Joseph's Healthcare Hamilton, McMaster University,
50 Charlton Ave E, Hamilton, ON, Canada L8N 4A6; and Lakeshore General Hospital,
Montreal Chest Institute, Meakins-Christie Laboratories, and Oscillometry Unit
of the Centre for Innovative Medicine, McGill University Health Centre and
Research Institute, and McGill University, Montreal, Canada (R.J.D.)
| | - Ronald J. Dandurand
- From the Department of Radiation Oncology, Division of Physics,
University of California San Francisco, San Francisco, Calif (D.P.I.C.);
Division of Respirology, Department of Medicine (A.D.G., P.N., S.S.), Imaging
Research Centre (N.B.K., S.S.), and Firestone Institute for Respiratory Health
(M.K., P.N., S.S.), St Joseph's Healthcare Hamilton, McMaster University,
50 Charlton Ave E, Hamilton, ON, Canada L8N 4A6; and Lakeshore General Hospital,
Montreal Chest Institute, Meakins-Christie Laboratories, and Oscillometry Unit
of the Centre for Innovative Medicine, McGill University Health Centre and
Research Institute, and McGill University, Montreal, Canada (R.J.D.)
| | - Parameswaran Nair
- From the Department of Radiation Oncology, Division of Physics,
University of California San Francisco, San Francisco, Calif (D.P.I.C.);
Division of Respirology, Department of Medicine (A.D.G., P.N., S.S.), Imaging
Research Centre (N.B.K., S.S.), and Firestone Institute for Respiratory Health
(M.K., P.N., S.S.), St Joseph's Healthcare Hamilton, McMaster University,
50 Charlton Ave E, Hamilton, ON, Canada L8N 4A6; and Lakeshore General Hospital,
Montreal Chest Institute, Meakins-Christie Laboratories, and Oscillometry Unit
of the Centre for Innovative Medicine, McGill University Health Centre and
Research Institute, and McGill University, Montreal, Canada (R.J.D.)
| | - Sarah Svenningsen
- From the Department of Radiation Oncology, Division of Physics,
University of California San Francisco, San Francisco, Calif (D.P.I.C.);
Division of Respirology, Department of Medicine (A.D.G., P.N., S.S.), Imaging
Research Centre (N.B.K., S.S.), and Firestone Institute for Respiratory Health
(M.K., P.N., S.S.), St Joseph's Healthcare Hamilton, McMaster University,
50 Charlton Ave E, Hamilton, ON, Canada L8N 4A6; and Lakeshore General Hospital,
Montreal Chest Institute, Meakins-Christie Laboratories, and Oscillometry Unit
of the Centre for Innovative Medicine, McGill University Health Centre and
Research Institute, and McGill University, Montreal, Canada (R.J.D.)
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Wang L, Zhou L, Zheng P, Mao Z, Liu H. Mild asthma is not mild: risk factors and predictive biomarkers for severe acute exacerbations and progression in mild asthma. Expert Rev Respir Med 2023; 17:1261-1271. [PMID: 38315090 DOI: 10.1080/17476348.2024.2314535] [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] [Received: 10/28/2023] [Accepted: 02/01/2024] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Asthma is a common chronic respiratory disease characterized by chronic airway inflammation, airway hyperresponsiveness, reversible airflow limitation, and airway remodeling. Mild asthma is the most common type of asthma, but it is the most neglected. Sometimes mild asthma can lead to acute severe exacerbations or even death. AREAS COVERED This article reviews the epidemiology, risk factors, and possible predictors of acute severe exacerbations and disease progression in mild asthma to improve the understanding of mild asthma and its severe acute exacerbations and progression. EXPERT OPINION There is a necessity to improve asthma patient categorization and redefine mild asthma's concept to heighten patient and physician attention. Identifying mild asthma patients that are highly vulnerable to severe acute exacerbations and researching the mechanisms are future prioritizations.
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Affiliation(s)
- Lingling Wang
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Zhou
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pengdou Zheng
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhenyu Mao
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiguo Liu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Behniafard N, Modarresi SZ, Nafei Z, Vakili M. Association Between Pet Keeping and Current Asthma Among Adolescents Living in Yazd; Evidence from Global Asthma Network (GAN) 2020 Cross-sectional Study. ARCHIVES OF IRANIAN MEDICINE 2023; 26:695-700. [PMID: 38431950 PMCID: PMC10915919 DOI: 10.34172/aim.2023.102] [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: 01/27/2023] [Accepted: 10/11/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND The relationship between current pet keeping and allergic diseases, including bronchial asthma in adolescents, is controversial. This study was conducted to evaluate these associations among children aged 13-14 years in Yazd. METHODS This study is part of a multicenter cross-sectional study of the Global Asthma Network (GAN) in Yazd, Iran, in 2020, in which 5141adolescents enrolled. Information on respiratory symptoms and pet-keeping (dog/cat/birds) was obtained by a questionnaire derived from the GAN standard questionnaire. RESULTS Of 5141 participants who completed the study, 1800 (35%) children kept pets during the last year. Birds were the most common pet kept by adolescents (88%). Severe asthma was more common in bird and cat keepers (P=0.003 and P=0.034, respectively) than dog keepers. Furthermore, there was a statistically significant association between study-defined current asthma and cat keeping, but not bird or dog ownership (P=0.02). Moreover, we found that current any pet-keeping (birds, cats, dogs) was associated with a higher prevalence of asthma-related symptoms, including wheezing, night dry cough, and exercise-induced wheezing in the past year (P=0.002, P=0.000 and P=0.000 respectively). CONCLUSION Current any pet-keeping is associated with asthma-related symptoms. Additionally, cat keeping had a significant association with study-defined current asthma. The current keeping of birds, as the most common pet in our area, or cat keeping increases the risk of severe asthma in adolescents. Therefore, as an important health tip, this needs to be reminded to families by health care providers.
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Affiliation(s)
- Nasrin Behniafard
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyedeh Zalfa Modarresi
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Nafei
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Vakili
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Lu H, Cao P. Neural Mechanisms Underlying the Coughing Reflex. Neurosci Bull 2023; 39:1823-1839. [PMID: 37606821 PMCID: PMC10661548 DOI: 10.1007/s12264-023-01104-y] [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: 02/15/2023] [Accepted: 05/15/2023] [Indexed: 08/23/2023] Open
Abstract
Breathing is an intrinsic natural behavior and physiological process that maintains life. The rhythmic exchange of gases regulates the delicate balance of chemical constituents within an organism throughout its lifespan. However, chronic airway diseases, including asthma and chronic obstructive pulmonary disease, affect millions of people worldwide. Pathological airway conditions can disrupt respiration, causing asphyxia, cardiac arrest, and potential death. The innervation of the respiratory tract and the action of the immune system confer robust airway surveillance and protection against environmental irritants and pathogens. However, aberrant activation of the immune system or sensitization of the nervous system can contribute to the development of autoimmune airway disorders. Transient receptor potential ion channels and voltage-gated Na+ channels play critical roles in sensing noxious stimuli within the respiratory tract and interacting with the immune system to generate neurogenic inflammation and airway hypersensitivity. Although recent studies have revealed the involvement of nociceptor neurons in airway diseases, the further neural circuitry underlying airway protection remains elusive. Unraveling the mechanism underpinning neural circuit regulation in the airway may provide precise therapeutic strategies and valuable insights into the management of airway diseases.
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Affiliation(s)
- Haicheng Lu
- National Institute of Biological Sciences, Beijing, 102206, China.
- School of Life Sciences, Tsinghua University, Beijing, 100084, China.
| | - Peng Cao
- National Institute of Biological Sciences, Beijing, 102206, China
- Tsinghua Institute of Multidisciplinary Biomedical Research, Tsinghua University, Beijing, 102206, China
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Dong C, Yu Z, Du J, Zhang Y, Liu W, Huang Z, Xiong S, Wang T, Song Y, Ma X. Montelukast Attenuates Retraction of Expanded Flap by Inhibiting Capsule Formation around Silicone Expander through TGF-β1 Signaling. Plast Reconstr Surg 2023; 152:1044e-1052e. [PMID: 36988445 DOI: 10.1097/prs.0000000000010459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
BACKGROUND Tissue expansion has tremendous applications in plastic surgery, but flap retraction provides insufficient tissue for use. Inspired by the use of montelukast to suppress capsular contracture, the authors investigated the effects of montelukast on capsule formation around the expander and retraction of the expanded scalp of the rat. METHODS Thirty-six male Sprague-Dawley rats were randomly divided into control and montelukast groups. In each group, 12 expanded flaps with or without capsules were harvested for histologic and molecular analysis; the six remaining expanded flaps were transferred to repair defects. Myofibroblast and transforming growth factor-β1 expression in the capsule was determined using immunofluorescence. Capsule ultrastructure was observed using transmission electron microscopy. Related protein expression in the capsules was detected using Western blot analysis. RESULTS A comparison of control and montelukast groups revealed that areas of the harvested expanded flaps with capsules were greater (2.04 ± 0.11 cm 2 versus 2.42 ± 0.12 cm 2 , respectively; P = 0.04); the retraction rate decreased (41.3% ± 2.16% versus 28.13% ± 2.17%, respectively; P < 0.01). However, the increased areas and decreased retraction disappeared after capsule removal. The number of myofibroblasts declined. Thin, sparse collagen fibers were observed in the capsules. The expression of COL1, COL3, TGF-β1, EGR1, and phosphorylated ERK1/2 in the capsules decreased. Furthermore, the recipient area repaired by the transferred expanded flap was increased from 4.25 ± 0.39 cm 2 to 6.58 ± 0.31 cm 2 ( P < 0.01). CONCLUSION Montelukast attenuates retraction of the expanded flap by inhibiting capsule formation through suppressing transforming growth factor-β1 signaling. CLINICAL RELEVANCE STATEMENT This study provides novel insights into a method for increasing the area of the expanded flap.
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Affiliation(s)
- Chen Dong
- From the Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University
| | - Zhou Yu
- From the Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University
| | - Jing Du
- From the Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University
| | - Yu Zhang
- From the Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University
| | - Wei Liu
- From the Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University
| | - Zhaosong Huang
- From the Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University
| | - Shaoheng Xiong
- From the Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University
| | - Tong Wang
- From the Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University
| | - Yajuan Song
- From the Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University
| | - Xianjie Ma
- From the Department of Plastic Surgery, Xijing Hospital, Fourth Military Medical University
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Wei W, Wang D, Liu W, Du H, Zhang Z, Che S, Ding R, Yang Y. Skills in handling Turbuhaler, Diskus in the west of China. BMC Pulm Med 2023; 23:447. [PMID: 37978359 PMCID: PMC10655486 DOI: 10.1186/s12890-023-02765-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/15/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the inhaler skills of patients with asthma and chronic obstructive pulmonary disease in a hospital in western China after receiving one medication education by pharmacists and the factors related to these skills. METHODS We included 96 subjects using Turbuhaler and 74 subjects using Diskus in a hospital in western China. They were educated once by pharmacists before medication, and then their skills of operating these inhalers were visually evaluated the next time they were used. Using the seven-step inhalation administration method designed by AnnaMurphy, a clinical pharmacist at GLENFIELD Hospital in the UK, the inhaler use technique score scale was established and scored in turn. The age, sex, time of first illness, smoking status, education level and type of health insurance purchased by each patient were recorded to assess their relationship with overall inhaler skills. RESULTS 19.8% of the subjects who used Turbuhaler could not use it correctly, and 43.2% of the subjects who used Diskus could not use it correctly. The step with the highest error rate with Turbuhaler and Diskus is to "exhale slowly to residual volume". Chi-square test was carried out for each step of the operation of the two kinds of inhalers, and it was found that there was a significant difference in the operation accuracy of the two kinds of inhalers in the first, third and eighth steps. In univariate analysis, advanced age, female and low educational level were related to the lack of inhaler technology, but in multivariate analysis, only low educational level was a significant independent risk factor. CONCLUSION Among the patients with asthma and chronic obstructive pulmonary disease in western China, some patients have good inhaler operation skills, but there are still many patients who can not use inhalers correctly, and the lower education level is significantly related to the incorrect use of inhalers.
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Affiliation(s)
- Wei Wei
- Department of Pharmacy, Lanzhou First People's Hospital, Lanzhou, China
| | - Dong Wang
- Respiratory and Critical Care Department of Lanzhou First People's Hospital, Lanzhou, China
| | - Weiting Liu
- Department of Pharmacy, Lanzhou First People's Hospital, Lanzhou, China
| | - Hui Du
- Department of Pharmacy, Lanzhou First People's Hospital, Lanzhou, China
| | - Zhiye Zhang
- Department of Pharmacy, Lanzhou First People's Hospital, Lanzhou, China
| | - Shengying Che
- Department of Pharmacy, Lanzhou First People's Hospital, Lanzhou, China
| | - Rui Ding
- Department of Pharmacy, Lanzhou First People's Hospital, Lanzhou, China
| | - YanBiao Yang
- Department of Pharmacy, Lanzhou First People's Hospital, Lanzhou, China.
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Matsumiya W, Karaca I, Pham BH, Akhavanrezayat A, Uludag G, Yasar C, Ghoraba H, Mobasserian A, Regenold J, Halim MS, Sepah YJ, Do DV, Chong V, Nguyen QD. ASSOCIATION OF ORAL MONTELUKAST WITH REDUCED ODDS OF DEVELOPING EXUDATIVE AGE-RELATED MACULAR DEGENERATION. Retina 2023; 43:1914-1921. [PMID: 37339446 DOI: 10.1097/iae.0000000000003870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
PURPOSE This study was conducted to evaluate the association of oral montelukast, selective antagonism for cysteinyl leukotriene receptor 1, with reduced odds of exudative age-related macular degeneration (exAMD) development. METHODS This case-control study was conducted using institutional cohort finder tool, and included 1913 patients with exAMD (ICD: H35.32 and 362.52) and 1913 age- and gender-matched control subjects without exAMD. Subanalysis among 1913 exAMD and 324 nonexudative AMD was also conducted. RESULTS A total of 47 (2.5%) exAMD cases were identified to have a history of oral montelukast use before exAMD diagnosis, compared with 84 (4.4%) controls. Montelukast usage was significantly associated with reduced odds of exAMD in the multivariable analysis (adjusted odds ratio [OR]: 0.50, 95% confidence interval: 0.31-0.80) and nonsteroidal anti-inflammatory drug usage (adjusted OR: 0.69). Caucasian race, history of smoking, and nonexudative macular degeneration in either eye were also found to have a significant relationship with increased odds of exAMD. In the subanalysis, montelukast usage showed significant association with reduced odds of developing exAMD from nonexudative AMD (adjusted OR: 0.53, 95% confidence interval: 0.29-0.97) and the presence of atopic disease (adjusted OR: 0.60). CONCLUSION The study results suggested that oral montelukast is linked to reduced odds of exAMD development.
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Affiliation(s)
- Wataru Matsumiya
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Irmak Karaca
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
| | - Brandon Huy Pham
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
| | - Amir Akhavanrezayat
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
| | - Gunay Uludag
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
| | - Cigdem Yasar
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
| | - Hashem Ghoraba
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
| | - Azadeh Mobasserian
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
| | - Jonathan Regenold
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
| | - Muhammad Sohail Halim
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
- Ocular Imaging Research and Reading Center, Sunnyvale, California; and
| | - Yasir J Sepah
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
| | - Diana V Do
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
| | - Victor Chong
- Institute of Ophthalmology, University College, London, United Kingdom
| | - Quan Dong Nguyen
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California
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Yao H, Wang L, Zhou X, Jia X, Xiang Q, Zhang W. Predicting the therapeutic efficacy of AIT for asthma using clinical characteristics, serum allergen detection metrics, and machine learning techniques. Comput Biol Med 2023; 166:107544. [PMID: 37866086 DOI: 10.1016/j.compbiomed.2023.107544] [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] [Received: 08/09/2023] [Revised: 09/07/2023] [Accepted: 09/28/2023] [Indexed: 10/24/2023]
Abstract
Bronchial asthma is a prevalent non-communicable disease among children. The study collected clinical data from 390 children aged 4-17 years with asthma, with or without rhinitis, who received allergen immunotherapy (AIT). Combining these data, this paper proposed a predictive framework for the efficacy of mite subcutaneous immunotherapy in asthma based on machine learning techniques. Introducing the dispersed foraging strategy into the Salp Swarm Algorithm (SSA), a new improved algorithm named DFSSA is proposed. This algorithm effectively alleviates the imbalance between search speed and traversal caused by the fixed partitioning pattern in traditional SSA. Utilizing the fusion of boosting algorithm and kernel extreme learning machine, an AIT performance prediction model was established. To further investigate the effectiveness of the DFSSA-KELM model, this study conducted an auxiliary diagnostic experiment using the immunotherapy predictive medical data collected by the hospital. The findings indicate that selected indicators, such as blood basophil count, sIgE/tIgE (Der p) and sIgE/tIgE (Der f), play a crucial role in predicting treatment outcome. The classification results showed an accuracy of 87.18% and a sensitivity of 93.55%, indicating that the prediction model is an effective and accurate intelligent tool for evaluating the efficacy of AIT.
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Affiliation(s)
- Hao Yao
- Department of Pediatric Allergy and Immunology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Lingya Wang
- Department of Pediatric Allergy and Immunology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Xinyu Zhou
- Department of Pediatric Allergy and Immunology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiaoxiao Jia
- Department of Pediatric Allergy and Immunology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China
| | - Qiangwei Xiang
- Department of Pediatric Allergy and Immunology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
| | - Weixi Zhang
- Department of Pediatric Allergy and Immunology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, China.
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Jiang Y, Yue Q, An R, Tie Z, Liu Y, Yu L, Kong X. A systematic review and meta-analysis of the prevalence and epidemiology of asthma in people over 14 years of age in China. J Asthma 2023; 60:1960-1966. [PMID: 37074261 DOI: 10.1080/02770903.2023.2203755] [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] [Received: 02/02/2023] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE Asthma is a common chronic respiratory disease that seriously affects the health of adults and children. The risk factors for asthma are constantly changing; thus, it is necessary to study the prevalence of asthma and risk factors in different populations. Currently, there have been no epidemiological studies on the prevalence and risk factors of asthma in people over 14 years in mainland China. Therefore, we performed a meta-analysis of the prevalence and risk factors for asthma in mainland China. METHODS A literature search was conducted for studies on the epidemiology of asthma in China between 2000 and 2020 using English and Chinese databases. Prevalence and epidemiological information on asthma in people aged >14 years were extracted. Meta-analysis was performed using a random-effects model (If I2>50%) with 95% confidence intervals for forest plots. RESULTS Nineteen studies (including data from 345,950 samples) met our evaluation criteria. The overall prevalence of asthma in Chinese adults is 2%, without differences between Northern and Southern China. The prevalence increased after 2010 compared with that before 2010. The prevalence of asthma also increased with age, with people aged 55-64 years being the most affected. The prevalence of asthma was independent of sex and residence area. In conclusion, the prevalence of asthma among adolescents (age >14 years) and adult population in China has increased since 2010. CONCLUSION Further studies are necessary to monitor the prevalence of asthma in mainland China. The elderly population also has a high prevalence of asthma, which should be focused on more in the future.
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Affiliation(s)
- Yi Jiang
- Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan, China
- The First Clinical Medical College of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Respiratory Diseases, Taiyuan, China
| | - Qianru Yue
- NHC Key Laboratory of Pneumoconiosis, Taiyuan, China
| | - Ruoli An
- Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan, China
- The First Clinical Medical College of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Respiratory Diseases, Taiyuan, China
| | - Zenghua Tie
- NHC Key Laboratory of Pneumoconiosis, Taiyuan, China
| | - Ying Liu
- NHC Key Laboratory of Pneumoconiosis, Taiyuan, China
| | - Lu Yu
- NHC Key Laboratory of Pneumoconiosis, Taiyuan, China
| | - Xiaomei Kong
- Department of Pulmonary and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan, China
- The First Clinical Medical College of Shanxi Medical University, Taiyuan, China
- Shanxi Key Laboratory of Respiratory Diseases, Taiyuan, China
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45
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Bauer RN, Xie Y, Beaudin S, Wiltshire L, Wattie J, Muñoz C, Alsaji N, Oliveria JP, Ju X, MacLean J, Sommer DD, Keith PK, Satia I, Cusack RP, O'Byrne PM, Sperinde G, Hokom M, Li O, Banerjee P, Chen C, Staton T, Sehmi R, Gauvreau GM. Evaluation of the reproducibility of responses to nasal allergen challenge and effects of inhaled nasal corticosteroids. Clin Exp Allergy 2023; 53:1187-1197. [PMID: 37794659 DOI: 10.1111/cea.14406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 08/14/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Similar immune responses in the nasal and bronchial mucosa implies that nasal allergen challenge (NAC) is a suitable early phase experimental model for drug development targeting allergic rhinitis (AR) and asthma. We assessed NAC reproducibility and the effects of intranasal corticosteroids (INCS) on symptoms, physiology, and inflammatory mediators. METHODS 20 participants with mild atopic asthma and AR underwent three single blinded nasal challenges each separated by three weeks (NCT03431961). Cohort A (n = 10) underwent a control saline challenge, followed by two allergen challenges. Cohort B (n = 10) underwent a NAC with no treatment intervention, followed by NAC with 14 days pre-treatment with saline nasal spray (placebo), then NAC with 14 days pre-treatment with INCS (220 μg triamcinolone acetonide twice daily). Nasosorption, nasal lavage, blood samples, forced expiratory volume 1 (FEV1), total nasal symptom score (TNSS), peak nasal inspiratory flow (PNIF) were collected up to 24 h after NAC. Total and active tryptase were measured as early-phase allergy biomarkers (≤30 min) and IL-13 and eosinophil cell counts as late-phase allergy biomarkers (3-7 h) in serum and nasal samples. Period-period reproducibility was assessed by intraclass correlation coefficients (ICC), and sample size estimates were performed using effect sizes measured after INCS. RESULTS NAC significantly induced acute increases in nasosorption tryptase and TNSS and reduced PNIF, and induced late increases in nasosorption IL-13 with sustained reductions in PNIF. Reproducibility across NACs varied for symptoms and biomarkers, with total tryptase 5 min post NAC having the highest reproducibility (ICC = 0.91). Treatment with INCS inhibited NAC-induced IL-13 while blunting changes in TNSS and PNIF. For a similar crossover study, 7 participants per treatment arm are needed to detect treatment effects comparable to INCS for TNSS. CONCLUSION NAC-induced biomarkers and symptoms are reproducible and responsive to INCS. NAC is suitable for assessing pharmacodynamic activity and proof of mechanism for drugs targeting allergic inflammation.
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Affiliation(s)
- Rebecca N Bauer
- Translational Medicine, Genentech Inc, South San Francisco, California, USA
| | - Yanqing Xie
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Suzanne Beaudin
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lesley Wiltshire
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Wattie
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Caroline Muñoz
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Nadia Alsaji
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - John Paul Oliveria
- Translational Medicine, Genentech Inc, South San Francisco, California, USA
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Xiaotian Ju
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jonathan MacLean
- Department of Surgery, Otolaryngology-Head & Neck Surgery Division, McMaster University, Hamilton, Ontario, Canada
| | - Doron D Sommer
- Department of Surgery, Otolaryngology-Head & Neck Surgery Division, McMaster University, Hamilton, Ontario, Canada
| | - Paul K Keith
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Imran Satia
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ruth P Cusack
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Paul M O'Byrne
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Gizette Sperinde
- Translational Medicine, Genentech Inc, South San Francisco, California, USA
| | - Martha Hokom
- Translational Medicine, Genentech Inc, South San Francisco, California, USA
| | - Olga Li
- Translational Medicine, Genentech Inc, South San Francisco, California, USA
| | - Prajna Banerjee
- Translational Medicine, Genentech Inc, South San Francisco, California, USA
| | - Chen Chen
- Translational Medicine, Genentech Inc, South San Francisco, California, USA
| | - Tracy Staton
- Translational Medicine, Genentech Inc, South San Francisco, California, USA
| | - Roma Sehmi
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Gail M Gauvreau
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Sarna M, Gebremedhin A, Richmond PC, Glass K, Levy A, Moore HC. Factors Predicting Secondary Respiratory Morbidity Following Early-Life Respiratory Syncytial Virus Infections: Population-Based Cohort Study. Open Forum Infect Dis 2023; 10:ofad450. [PMID: 37790944 PMCID: PMC10544950 DOI: 10.1093/ofid/ofad450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/27/2023] [Indexed: 10/05/2023] Open
Abstract
Background The association between early-life respiratory syncytial virus (RSV) infections and later respiratory morbidity is well established. However, there is limited evidence on factors that influence this risk. We examined sociodemographic and perinatal factors associated with later childhood respiratory morbidity requiring secondary care following exposure to a laboratory-confirmed RSV episode in the first 2 years. Methods We used a probabilistically linked whole-of-population-based birth cohort including 252 287 children born in Western Australia between 2000 and 2009 with follow-up to the end of 2012. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) of the association of various risk factors with the first respiratory episode for asthma, wheezing, and unspecified acute lower respiratory infection beyond the age of 2 years. Results The analytic cohort included 4151 children with a confirmed RSV test before age 2 years. The incidence of subsequent respiratory morbidity following early-life RSV infection decreased with child age at outcome (highest incidence in 2-<4-year-olds: 41.8 per 1000 child-years; 95% CI, 37.5-46.6), increased with age at RSV infection (6-<12-month-olds: 23.6/1000 child-years; 95% CI, 19.9-27.8; 12-<24-month-olds: 22.4/1000 child-years; 95% CI, 18.2-22.7) and decreasing gestational age (50.8/1000 child-years; 95% CI, 33.5-77.2 for children born extremely preterm, <28 weeks gestation). Risk factors included age at first RSV episode (6-<12 months: aHR, 1.42; 95% CI, 1.06-1.90), extreme prematurity (<28 weeks: aHR, 2.22; 95% CI, 1.40-3.53), maternal history of asthma (aHR, 1.33; 95% CI, 1.04-1.70), and low socioeconomic index (aHR, 1.76; 95% CI, 1.03-3.00). Conclusions Our results suggest that in addition to preterm and young infants, children aged 12-<24 months could also be potential target groups for RSV prevention to reduce the burden of later respiratory morbidities associated with RSV.
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Affiliation(s)
- Mohinder Sarna
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- Curtin School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Amanuel Gebremedhin
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- Curtin School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Peter C Richmond
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- School of Medicine, University of Western Australia, Nedlands, Western Australia, Australia
- Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Kathryn Glass
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Avram Levy
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Perth, Western Australia, Australia
- School of Biomedical Sciences, University of Western Australia, Nedlands, Perth, Western Australia, Australia
| | - Hannah C Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
- Curtin School of Population Health, Curtin University, Bentley, Western Australia, Australia
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Ma R, Zhang G, Kong Y, Jia S. Regional heterogeneity in short-term associations of meteorological factors, air pollution, and asthma hospitalizations in Guangxi, China. Public Health 2023; 223:42-49. [PMID: 37597463 DOI: 10.1016/j.puhe.2023.07.020] [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] [Received: 12/12/2022] [Revised: 07/04/2023] [Accepted: 07/14/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVES This study aimed to identify and evaluate the short-term and lag effects of environmental factors on asthma hospitalizations in different regions. STUDY DESIGN The ecological study on asthma is performed in three regions of Guangxi, China, that are distinctly different in geography and climate. METHODS We used distributed lag non-linear models to investigate the exposure-response-lag relationship between meteorological factors, air pollutants, and asthma hospital admissions across the three regions during 2015 (January 1 to December 31). RESULTS Cold was an important meteorological factor affecting asthma. At lag 0, the relative risk (RR; 23°C as reference) of cold in the Northwest, Northeast, and South was 1.10 (10°C), 1.14 (8°C), and 1.30 (11°C), respectively. NO2 was identified as the most important air pollutant affecting asthma. The RR of asthma hospitalization increased by 10.9% (at lag 4), 8.1% (at lag 0), and 4.2% (at lag 2) for every 10 μg/m3 increase in NO2 concentration in the Northwest, Northeast, and South, respectively. CONCLUSIONS In the three regions of Guangxi, there were differences in the dominant factors affecting asthma hospitalizations. Differences in geography can inform governments as to how to prepare the healthcare system to meet the expected peaks.
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Affiliation(s)
- R Ma
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng 475004, China; The College of Information Science & Technology, Zhengzhou Normal University, Zhengzhou 451044, China.
| | - G Zhang
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng 475004, China.
| | - Y Kong
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Ministry of Education, Henan University, Kaifeng 475004, China.
| | - S Jia
- The College of Information Science & Technology, Zhengzhou Normal University, Zhengzhou 451044, China.
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Seyfinejad B, Nemutlu E, Taghizadieh A, Khoubnasabjafari M, Ozkan SA, Jouyban A. Biomarkers in exhaled breath condensate as fingerprints of asthma, chronic obstructive pulmonary disease and asthma-chronic obstructive pulmonary disease overlap: a critical review. Biomark Med 2023; 17:811-837. [PMID: 38179966 DOI: 10.2217/bmm-2023-0420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024] Open
Abstract
Asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap are the third leading cause of mortality around the world. They share some common features, which can lead to misdiagnosis. To properly manage these conditions, reliable markers for early and accurate diagnosis are needed. Over the past 20 years, many molecules have been investigated in the exhaled breath condensate to better understand inflammation pathways and mechanisms related to these disorders. Recently, more advanced techniques, such as sensitive metabolomic and proteomic profiling, have been used to obtain a more comprehensive understanding. This article reviews the use of targeted and untargeted metabolomic methodology to study asthma, COPD and asthma-COPD overlap.
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Affiliation(s)
- Behrouz Seyfinejad
- Pharmaceutical Analysis Research Center & Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Emirhan Nemutlu
- Department of Analytical Chemistry, Faculty of Pharmacy, Hacettepe University, Ankara, 06100, Turkiye
| | - Ali Taghizadieh
- Tuberculosis & Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Internal Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Khoubnasabjafari
- Tuberculosis & Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Anesthesiology & Intensive Care, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sibel A Ozkan
- Ankara University, Faculty of Pharmacy, Department of Analytical Chemistry, Ankara, 06560, Turkiye
| | - Abolghasem Jouyban
- Pharmaceutical Analysis Research Center & Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
- Faculty of Pharmacy, Near East University, PO Box 99138 Nicosia, North Cyprus, Mersin 10, Turkiye
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Xiao Y, Zhu H, Lei J, Xie J, Wu K, Gu W, Ma J, wei D, Shu Z, Zhao L. MiR-182/Sestrin2 affects the function of asthmatic airway smooth muscle cells by the AMPK/mTOR pathway. J Transl Int Med 2023; 11:282-293. [PMID: 37662894 PMCID: PMC10474879 DOI: 10.2478/jtim-2023-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
Background and Objectives Asthma is a chronic inflammatory airway disease and brings heavy economic and spiritual burdens to patients' families and the society. Airway smooth muscle cells (ASMCs) afect the development of asthma by secreting cytokines, growth factors, and prostates. The stress-inducing protein, Sestrin2, plays a vital role in antioxidant defense. The aim of this study is to investigate the role of Sestrin2 in asthma and its corresponding molecular mechanism. Materials and Methods Airway remodeling was induced by construction of asthma rat model. Primary ASMCs were isolated through combining tissue block adherence and enzymatic digestion and identified by immunofluorescence staining. Gene expression was measured by quantitative real-time PCR (qPCR) and western blot (WB) experiments. Cell viability, proliferation, migration, and calcium flow of ASMCs were measured by Cell Counting Kit-8 (CCK-8), 5-ethynyl-deoxyuridine (EdU), Transwell, and Fluo-3AM, respectively. The binding of miR-182 and Sestrin2 3'-untranslated region (3'-UTR) was measured by luciferase reporter system and RNA-binding protein immunoprecipitation (RIP) analysis. Results Sestrin2 expression was upregulated in asthma rat model and cell model. Overexpression of Sestrin2 enhanced the growth, migration, and calcium flow, and inversely, repression of Sestrin2 was reduced in ASMCs from the asthma group. MiR-182, one of the microRNAs (miRNAs) that possesses the potential to regulate Sestrin2, was downregulated in ASMCs from the asthma group. Further experiments revealed that Sestrin2 was inhibited by miR-182 and that overexpression of Sestrin2 reversed the miR-182-induced inhibition of the cellular progression of ASMCs from the asthma group. This study further investigated the downstream signaling pathway of Sestrin2 and found that increased expression of Sestrin2 activated 5'-adenosine monophosphate-activated protein kinase (AMPK), leading to the inactivation of mammalian target of rapamycin (mTOR) and thus promoting the growth, migration, and calcium flow of ASMCs from the asthma group. Conclusion This study investigated the role of Sestrin2 for the first time and further dissected the regulatory factor of Sestrin2, ultimately elucidating the downstream signaling pathway of Sestrin2 in asthma, providing a novel pathway, and improving the understanding of the development and progression of asthma.
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Affiliation(s)
- Yali Xiao
- Department of Respiratory and Critical Care Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou450003, Henan Province, China
| | - He Zhu
- Department of Respiratory and Critical Care Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou450003, Henan Province, China
| | - Jiahui Lei
- Department of Respiratory and Critical Care Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou450003, Henan Province, China
| | - Jing Xie
- Department of Respiratory and Critical Care Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou450003, Henan Province, China
| | - Ke Wu
- Department of Respiratory and Critical Care Medicine, Henan Provincial People’s Hospital, Zhengzhou450003, Henan Province, China
| | - Wenbo Gu
- Department of Respiratory and Critical Care Medicine, Henan University of Traditional Chinese Medicine, Henan Provincial People’s Hospital, Zhengzhou450046, Henan Province, China
| | - Jinxin Ma
- Department of Respiratory and Critical Care Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou450003, Henan Province, China
| | - Dongxue wei
- Department of Respiratory and Critical Care Medicine, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Zhengzhou450003, Henan Province, China
| | - Zhenhui Shu
- Department of Respiratory and Critical Care Medicine, Henan University of Traditional Chinese Medicine, Henan Provincial People’s Hospital, Zhengzhou450046, Henan Province, China
| | - Limin Zhao
- Department of Respiratory and Critical Care Medicine, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Henan University People’s Hospital, Zhengzhou450003, Henan Province, China
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50
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Israel E, Farooqui N, Gillette C, Gilbert I, Gandhi H, Tervonen T, Balantac Z, Thomas C, Krucien N, George M. A Discrete Choice Experiment to Assess Patient Preferences for Asthma Rescue Therapy and Disease Management. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2781-2791.e4. [PMID: 37182565 DOI: 10.1016/j.jaip.2023.04.046] [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: 11/21/2022] [Revised: 03/10/2023] [Accepted: 04/19/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND With the expanding treatment landscape for asthma, the process of identifying best-fit, individualized management options is becoming increasingly complicated. Understanding patients' preferences can inform shared decision-making between clinicians and patients. OBJECTIVES To examine preferences of adults with asthma for therapeutic and management attributes and determine how these preferences vary among patients. METHODS We conducted an online discrete choice experiment survey in US adults with asthma. Patient preferences were analyzed using logit models. Factors affecting patients' preferences were identified by least absolute shrinkage and selection operator analysis. RESULTS A total of 1,184 patients completed the survey (60% female; mean [SD] age, 49.2 [15.0] years). Patients most valued fewer asthma attacks requiring urgent health care professional visits, fewer exacerbations requiring oral corticosteroids, and a reduced risk for oral thrush. Higher value was placed on reducing the risk of short-term (oral thrush) versus long-term side effects (diabetes). Patients were willing to increase rescue medication use in exchange for decreasing exacerbations requiring oral corticosteroids and attacks requiring urgent health care professional visits. Patients preferred a single inhaler for rescue and maintenance and least valued asthma action plans. Demographic, socioeconomic, and clinical factors affected patient preferences. CONCLUSIONS Patients sought convenient management options that focused mainly on decreasing the short-term morbidity associated with asthma exacerbations and therapies. Preferences varied by demographics, clinical factors, and socioeconomics. It is important for shared decision-making discussions to include conversations about morbidity and how available therapeutic options align with individual patient preferences.
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Affiliation(s)
- Elliot Israel
- Department of Pulmonology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | | | - Chris Gillette
- Department of PA Studies, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Ileen Gilbert
- US Medical Affairs-Respiratory, AstraZeneca, Wilmington, Del.
| | - Hitesh Gandhi
- US Medical Affairs-Respiratory, AstraZeneca, Wilmington, Del
| | - Tommi Tervonen
- Patient-Centered Research, Evidera, London, United Kingdom
| | | | - Caitlin Thomas
- Patient-Centered Research, Evidera, London, United Kingdom
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