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Pelizzo G, Calcaterra V, Baldassarre P, Marinaro M, Taranto S, Ceresola M, Capelo G, Gazzola C, Zuccotti G. The impact of hormones on lung development and function: an overlooked aspect to consider from early childhood. Front Endocrinol (Lausanne) 2024; 15:1425149. [PMID: 39371928 PMCID: PMC11449876 DOI: 10.3389/fendo.2024.1425149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 08/29/2024] [Indexed: 10/08/2024] Open
Abstract
The impact of hormones on the respiratory system constitutes a multifaceted and intricate facet of human biology. We propose a comprehensive review of recent advancements in understanding the interactions between hormones and pulmonary development and function, focusing on pediatric populations. We explore how hormones can influence ventilation, perfusion, and pulmonary function, from regulating airway muscle tone to modulating the inflammatory response. Hormones play an important role in the growth and development of lung tissues, influencing them from early stages through infancy, childhood, adolescence, and into adulthood. Glucocorticoids, thyroid hormones, insulin, ghrelin, leptin, glucagon-like peptide 1 (GLP-1), retinoids, cholecalciferol sex steroids, hormones derived from adipose tissue, factors like insulin, granulocyte-macrophage colony-stimulating factor (GM-CSF) and glucagon are key players in modulating respiratory mechanics and inflammation. While ample evidence underscores the impact of hormones on lung development and function, along with sex-related differences in the prevalence of respiratory disorders, further research is needed to clarify their specific roles in these conditions. Further research into the mechanisms underlying hormonal effects is essential for the development of customizing therapeutic approaches for respiratory diseases. Understanding the impact of hormones on lung function could be valuable for developing personalized monitoring approaches in both medical and surgical pediatric settings, in order to improve outcomes and the quality of care for pediatric patients.
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Affiliation(s)
- Gloria Pelizzo
- Pediatric Surgery Department, Buzzi Children’s Hospital, Milan, Italy
- Department of Biomedical and Clinical Science, University of Milan, Milan, Italy
| | - Valeria Calcaterra
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy
- Pediatric Department, Buzzi Children’s Hospital, Milan, Italy
| | | | - Michela Marinaro
- Pediatric Surgery Department, Buzzi Children’s Hospital, Milan, Italy
| | - Silvia Taranto
- Pediatric Department, Buzzi Children’s Hospital, Milan, Italy
| | - Michele Ceresola
- Pediatric Surgery Department, Buzzi Children’s Hospital, Milan, Italy
| | - Gerson Capelo
- Pediatric Surgery Department, Buzzi Children’s Hospital, Milan, Italy
| | | | - Gianvincenzo Zuccotti
- Department of Biomedical and Clinical Science, University of Milan, Milan, Italy
- Pediatric Department, Buzzi Children’s Hospital, Milan, Italy
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Trivedi S, Deering-Rice CE, Aamodt SE, Huecksteadt TP, Myers EJ, Sanders KA, Paine R, Warren KJ. Progesterone amplifies allergic inflammation and airway pathology in association with higher lung ILC2 responses. Am J Physiol Lung Cell Mol Physiol 2024; 327:L65-L78. [PMID: 38651968 PMCID: PMC11380947 DOI: 10.1152/ajplung.00207.2023] [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: 07/07/2023] [Revised: 03/02/2024] [Accepted: 04/22/2024] [Indexed: 04/25/2024] Open
Abstract
Perimenstrual worsening of asthma occurs in up to 40% of women with asthma, leading to increased acute exacerbations requiring clinical care. The role of sex hormones during these times remains unclear. In the current study, we used a translational approach to determine whether progesterone exacerbates allergic inflammation in the traditional chicken egg ovalbumin (OVA) model in BALB/c mice. Simultaneously, we used peripheral blood mononuclear cells (PBMC) from healthy human donors to assess the effects of progesterone on circulating group 2 innate lymphoid cells (ILC2). Briefly, lungs of ovariectomized (OVX) or sham-operated female (F-Sham) controls were implanted with a progesterone (P4, 25 mg) (OVX-P4) or placebo pellet (OVX-Placebo), followed by sensitization and challenge with ovalbumin (OVA). Progesterone increased total inflammatory histologic scores, increased hyper-responsiveness to methacholine (MCh), increased select chemokines in the bronchoalveolar lavage (BAL) and serum, and increased ILC2 and neutrophil numbers, along the airways compared with F-Sham-OVA and OVX-Placebo-OVA animals. Lung ILC2 were sorted from F-Sham-OVA, OVX-Placebo-OVA and OVX-P4-OVA treated animals and stimulated with IL-33. OVX-P4-OVA lung ILC2 were more responsive to interleukin 33 (IL-33) compared with F-Sham-OVA treated, producing more IL-13 and chemokines following IL-33 stimulation. We confirmed the expression of the progesterone receptor (PR) on human ILC2, and showed that P4 + IL-33 stimulation also increased IL-13 and chemokine production from human ILC2. We establish that murine ILC2 are capable of responding to P4 and thereby contribute to allergic inflammation in the lung. We confirmed that human ILC2 are also hyper-responsive to P4 and IL-33 and likely contribute to airway exacerbations following allergen exposures in asthmatic women with increased symptoms around the time of menstruation.NEW & NOTEWORTHY There is a strong association between female biological sex and severe asthma. We investigated the allergic immune response, lung pathology, and airway mechanics in the well-described chicken egg ovalbumin (OVA) model with steady levels of progesterone delivered throughout the treatment period. We found that progesterone enhances the activation of mouse group 2 innate lymphoid cells (ILC2). Human ILC2 are also hyper-responsive to progesterone and interleukin 33 (IL-33), and likely contribute to airway exacerbations following allergen exposures in women with asthma.
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Affiliation(s)
- Shubhanshi Trivedi
- Division of Infectious Disease, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States
| | - Cassandra E Deering-Rice
- Department of Pharmacology and Toxicology, University of Utah College of Pharmacy, Salt Lake City, Utah, United States
| | - Samuel E Aamodt
- Division of Pulmonary Medicine, Department of Internal Medicine, University of Utah Health, Salt Lake City, Utah, United States
| | - Thomas P Huecksteadt
- George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States
| | - Elizabeth J Myers
- Division of Neuroimmunology, Department of Neurology, University of Utah Health, Salt Lake City, Utah, United States
| | - Karl A Sanders
- Division of Pulmonary Medicine, Department of Internal Medicine, University of Utah Health, Salt Lake City, Utah, United States
- George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States
| | - Robert Paine
- Division of Pulmonary Medicine, Department of Internal Medicine, University of Utah Health, Salt Lake City, Utah, United States
- George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States
| | - Kristi J Warren
- Division of Pulmonary Medicine, Department of Internal Medicine, University of Utah Health, Salt Lake City, Utah, United States
- George E. Whalen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, United States
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Wang KCW, Blakey JD. Impacts of sex and gender on severe asthma. Thorax 2024; 79:391-392. [PMID: 38453471 DOI: 10.1136/thorax-2023-221117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Kimberley C W Wang
- The University of Western Australia School of Human Sciences, Perth, Western Australia, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - John D Blakey
- Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- Medical School, Curtin University, Perth, Western Australia, Australia
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Awonuga AO, Camp OG, Abu-Soud HM. A review of nitric oxide and oxidative stress in typical ovulatory women and in the pathogenesis of ovulatory dysfunction in PCOS. Reprod Biol Endocrinol 2023; 21:111. [PMID: 37996893 PMCID: PMC10666387 DOI: 10.1186/s12958-023-01159-6] [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: 07/06/2023] [Accepted: 11/05/2023] [Indexed: 11/25/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a heterogeneous functional endocrine disorder associated with a low-grade, chronic inflammatory state. Patients with PCOS present an increased risk of metabolic comorbidities and often menstrual dysregulation and infertility due to anovulation and/or poor oocyte quality. Multiple mechanisms including oxidative stress and low-grade inflammation are believed to be responsible for oocyte deterioration; however, the influence of nitric oxide (NO) insufficiency in oocyte quality and ovulatory dysfunction in PCOS is still a matter for debate. Higher production of superoxide (O2•-) mediated DNA damage and impaired antioxidant defense have been implicated as contributory factors for the development of PCOS, with reported alteration in superoxide dismutase (SOD) function, an imbalanced zinc/copper ratio, and increased catalase activity. These events may result in decreased hydrogen peroxide (H2O2) accumulation with increased lipid peroxidation events. A decrease in NO, potentially due to increased activity of NO synthase (NOS) inhibitors such as asymmetric dimethylarginine (ADMA), and imbalance in the distribution of reactive oxygen species (ROS), such as decreased H2O2 and increased O2•-, may offset the physiological processes surrounding follicular development, oocyte maturation, and ovulation contributing to the reproductive dysfunction in patients with PCOS. Thus, this proposal aims to evaluate the specific roles of NO, oxidative stress, ROS, and enzymatic and nonenzymatic elements in the pathogenesis of PCOS ovarian dysfunction, including oligo- anovulation and oocyte quality, with the intent to inspire better application of therapeutic options. The authors believe more consideration into the specific roles of oxidative stress, ROS, and enzymatic and nonenzymatic elements may allow for a more thorough understanding of PCOS. Future efforts elaborating on the role of NO in the preoptic nucleus to determine its influence on GnRH firing and follicle-stimulating hormone/Luteinizing hormone (FSH/LH) production with ovulation would be of benefit in PCOS. Consequently, treatment with an ADMA inhibitor or NO donor may prove beneficial to PCOS patients experiencing reproductive dysfunction and infertility.
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Affiliation(s)
- Awoniyi O Awonuga
- Departments of Obstetrics and Gynecology and Biochemistry and Molecular Biology, The C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, 275 E. Hancock Detroit, Detroit, MI, 48201, USA.
| | - Olivia G Camp
- Departments of Obstetrics and Gynecology and Biochemistry and Molecular Biology, The C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, 275 E. Hancock Detroit, Detroit, MI, 48201, USA
| | - Husam M Abu-Soud
- Departments of Obstetrics and Gynecology and Biochemistry and Molecular Biology, The C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, 275 E. Hancock Detroit, Detroit, MI, 48201, USA
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI, 48201, USA
- Department of Microbiology, Immunology and Biochemistry, Wayne State University School of Medicine, Detroit, MI, 48201, USA
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Zhang GQ, Özuygur Ermis SS, Rådinger M, Bossios A, Kankaanranta H, Nwaru B. Sex Disparities in Asthma Development and Clinical Outcomes: Implications for Treatment Strategies. J Asthma Allergy 2022; 15:231-247. [PMID: 35210789 PMCID: PMC8863331 DOI: 10.2147/jaa.s282667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/11/2022] [Indexed: 11/23/2022] Open
Abstract
A gender-related disparity exists in asthma morbidity and mortality, which shifts at around puberty from a male predominance to a female predominance. This is clinically reflected in the fact that asthma that occurs in childhood (childhood-onset asthma) mainly affects boys, and that asthma that occurs in adulthood (adult-onset asthma) mainly affects women. Adult-onset asthma is often non-atopic, more severe, and associated with a poorer prognosis, thus posing a marked burden to women’s health and healthcare system. Many factors have been indicated to explain this gender-related disparity, including sociocultural and environmental factors as well as biological sex differences (genetic, pulmonary and immunological factors). It has long been suggested that sex hormones may be implicated in at least these biological sex differences. Overall, the evidence remains equivocal for the role of most sex hormones in asthma pathogenesis and clinical outcomes. Well-designed randomized clinical trials are required assessing the potential preventive or therapeutic effects of hormonal contraceptives on asthma in women, thereby helping to advance the evidence to inform future practice guidelines. The mechanisms underlying the role of sex hormones in asthma are complex, and our understanding is not yet complete. Additional mechanistic studies elucidating sex hormone signaling pathways and their interactions involved in the pathogenesis and clinical manifestations of asthma will help to identify potential sex hormone-driven asthma endotypes and novel therapeutic targets, providing the basis for a more personalized asthma management strategy.
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Affiliation(s)
- Guo-Qiang Zhang
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Saliha Selin Özuygur Ermis
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Respiratory Medicine, Dokuz Eylul University, İzmir, Turkey
| | - Madeleine Rådinger
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Apostolos Bossios
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Hannu Kankaanranta
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Bright Nwaru
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Correspondence: Bright Nwaru, Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, P.O. Box 424, Gothenburg, SE-405 30, Sweden, Tel +46 076 064 2614, Email
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Ambhore NS, Kalidhindi RSR, Sathish V. Sex-Steroid Signaling in Lung Diseases and Inflammation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1303:243-273. [PMID: 33788197 DOI: 10.1007/978-3-030-63046-1_14] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Sex/gender difference exists in the physiology of multiple organs. Recent epidemiological reports suggest the influence of sex-steroids in modulating a wide variety of disease conditions. Sex-based discrepancies have been reported in pulmonary physiology and various chronic inflammatory responses associated with lung diseases like asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, and rare lung diseases. Notably, emerging clinical evidence suggests that several respiratory diseases affect women to a greater degree, with increased severity and prevalence than men. Although sex-specific differences in various lung diseases are evident, such differences are inherent to sex-steroids, which are major biological variables in men and women who play a central role to control these differences. The focus of this chapter is to comprehend the sex-steroid biology in inflammatory lung diseases and to understand the mechanistic role of sex-steroids signaling in regulating these diseases. Exploring the roles of sex-steroid signaling in the regulation of lung diseases and inflammation is crucial for the development of novel and effective therapy. Overall, we will illustrate the importance of differential sex-steroid signaling in lung diseases and their possible clinical implications for the development of complementary and alternative medicine to treat lung diseases.
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Affiliation(s)
- Nilesh Sudhakar Ambhore
- Department of Pharmaceutical Sciences, School of Pharmacy, College of Health Professions, North Dakota State University, Fargo, ND, USA
| | | | - Venkatachalem Sathish
- Department of Pharmaceutical Sciences, School of Pharmacy, College of Health Professions, North Dakota State University, Fargo, ND, USA.
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Lázár Z, Mészáros M, Bikov A. The Nitric Oxide Pathway in Pulmonary Arterial Hypertension: Pathomechanism, Biomarkers and Drug Targets. Curr Med Chem 2021; 27:7168-7188. [PMID: 32442078 DOI: 10.2174/0929867327666200522215047] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/03/2020] [Accepted: 02/20/2020] [Indexed: 11/22/2022]
Abstract
The altered Nitric Oxide (NO) pathway in the pulmonary endothelium leads to increased vascular smooth muscle tone and vascular remodelling, and thus contributes to the development and progression of pulmonary arterial hypertension (PAH). The pulmonary NO signalling is abrogated by the decreased expression and dysfunction of the endothelial NO synthase (eNOS) and the accumulation of factors blocking eNOS functionality. The NO deficiency of the pulmonary vasculature can be assessed by detecting nitric oxide in the exhaled breath or measuring the degradation products of NO (nitrite, nitrate, S-nitrosothiol) in blood or urine. These non-invasive biomarkers might show the potential to correlate with changes in pulmonary haemodynamics and predict response to therapies. Current pharmacological therapies aim to stimulate pulmonary NO signalling by suppressing the degradation of NO (phosphodiesterase- 5 inhibitors) or increasing the formation of the endothelial cyclic guanosine monophosphate, which mediates the downstream effects of the pathway (soluble guanylate cyclase sensitizers). Recent data support that nitrite compounds and dietary supplements rich in nitrate might increase pulmonary NO availability and lessen vascular resistance. This review summarizes current knowledge on the involvement of the NO pathway in the pathomechanism of PAH, explores novel and easy-to-detect biomarkers of the pulmonary NO.
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Affiliation(s)
- Zsófia Lázár
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Martina Mészáros
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Andras Bikov
- Department of Pulmonology, Semmelweis University, Budapest, Hungary,Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Zhang GQ, Bossios A, Rådinger M, Nwaru BI. Sex steroid hormones and asthma in women: state-of-the-art and future research perspectives. Expert Rev Respir Med 2020; 14:543-545. [PMID: 32151191 DOI: 10.1080/17476348.2020.1741351] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Guo-Qiang Zhang
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Apostolos Bossios
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Huddinge, and Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.,Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Madeleine Rådinger
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Abstract
Chronic obstructive pulmonary disease (COPD) is a common and progressive disorder
which is characterised by pathological abnormalities driven by chronic airway inflammation. The
assessment of airway inflammation in routine clinical practice in COPD is limited to surrogate blood
markers. Fractional exhaled nitric oxide (FENO) is a marker of eosinophilic airway inflammation in
asthma, and it can predict steroid responsiveness and help tailor corticosteroid treatment. The clinical
value of FENO in COPD is less evident, but some studies suggest that it may be a marker of the
eosinophilic endotype. More importantly, mathematical methods allow investigation of the
alveolar/small airway production of NO which potentially better reflects inflammatory changes in
anatomical sites, most affected by COPD. This review summarises the pathophysiological role of
nitric oxide in COPD, explains the methodology of its measurement in exhaled air and discusses
clinical findings of FENO in COPD.
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Affiliation(s)
- Andras Bikov
- NIHR Manchester Clinical Research Facility, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Martina Meszaros
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Zsofia Lazar
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
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Nerpin E, Olivieri M, Gislason T, Olin AC, Nielsen R, Johannessen A, Ferreira DS, Marcon A, Cazzoletti L, Accordini S, Pin I, Corsico A, Demoly P, Weyler J, Nowak D, Jõgi R, Forsberg B, Zock JP, Sigsgaard T, Heinric J, Bono R, Leynaert B, Jarvis D, Janson C, Malinovschi A. Determinants of fractional exhaled nitric oxide in healthy men and women from the European Community Respiratory Health Survey III. Clin Exp Allergy 2019; 49:969-979. [PMID: 30934155 DOI: 10.1111/cea.13394] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 03/18/2019] [Accepted: 03/28/2019] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The fractional exhaled nitric oxide (FE NO) is a marker for type 2 inflammation used in diagnostics and management of asthma. In order to use FE NO as a reliable biomarker, it is important to investigate factors that influence FE NO in healthy individuals. Men have higher levels of FE NO than women, but it is unclear whether determinants of FE NO differ by sex. OBJECTIVE To identify determinants of FE NO in men and women without lung diseases. METHOD Fractional exhaled nitric oxide was validly measured in 3881 healthy subjects that had answered the main questionnaire of the European Community Respiratory Health Survey III without airways or lung disease. RESULTS Exhaled NO levels were 21.3% higher in men compared with women P < 0.001. Being in the upper age quartile (60.3-67.6 years), men had 19.2 ppb (95% CI: 18.3, 20.2) higher FE NO than subjects in the lowest age quartile (39.7-48.3 years) P = 0.02. Women in the two highest age quartiles (54.6-60.2 and 60.3-67.6 years) had 15.4 ppb (14.7, 16.2), P = 0.03 and 16.4 ppb (15.6, 17.1), P = <0.001 higher FE NO, compared with the lowest age quartile. Height was related to 8% higher FE NO level in men (P < 0.001) and 5% higher FE NO levels in women (P = 0.008). Men who smoked had 37% lower FE NO levels and women had 30% lower levels compared with never-smokers (P < 0.001 for both). Men and women sensitized to both grass and perennial allergens had higher FE NO levels compared with non-sensitized subjects 26% and 29%, P < 0.001 for both. CONCLUSION AND CLINICAL RELEVANCE Fractional exhaled nitric oxide levels were higher in men than women. Similar effects of current smoking, height, and IgE sensitization were found in both sexes. FE NO started increasing at lower age in women than in men, suggesting that interpretation of FE NO levels in adults aged over 50 years should take into account age and sex.
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Affiliation(s)
- Elisabet Nerpin
- Department of Medical Sciences, Respiratory Medicine, Allergy and Sleep, Uppsala University, Uppsala, Sweden.,Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden.,Department of Medicine, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Mario Olivieri
- Unit of Occupational Medicine, University of Verona, Verona, Italy
| | - Thorainn Gislason
- Department of Sleep, Landspítali University Hospital, Reykjavík, Iceland.,Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Anna C Olin
- Section of Occupational and Environmental Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Rune Nielsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Diogenes S Ferreira
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Alergia e Imunologia, Complexo Hospital de Clinicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Isabelle Pin
- Department of Pediatrics, CHU Grenoble Alpes, Grenoble, France.,Institute for Advanced Biosciences, Inserm, Grenoble, France.,Université Grenoble Alpes, Grenoble, France
| | - Angelo Corsico
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.,Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Pascal Demoly
- Département de Pneumologie et Addictologie, Centre Hospitalier Universitaire de Montpellier, Hôpital Arnaud-de-Villeneuve, univ Montpellier, Montpellier, France.,Institut Pierre-Louis D'épidémiologie et de Santé Publique, Équipe EPAR, Sorbonne Université, INSERM, Paris, France
| | - Joost Weyler
- Epidemiology and Social Medicine, University of Antwerp StatUA Statistics Center, University of Antwerp, Antwerp, Belgium
| | - Dennis Nowak
- Hospital of the Ludwig-Maximilian University Munich, LMU Munich, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany
| | - Rain Jõgi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Jan P Zock
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Joachim Heinric
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig Maximilians University Munich, Munich, Germany.,Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Bénédicte Leynaert
- INSERM, UMR1152, Paris, France.,DHU FIRE, Université Paris-Diderot, Paris, France
| | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College, London, UK
| | - Christer Janson
- Department of Medical Sciences, Respiratory Medicine, Allergy and Sleep, Uppsala University, Uppsala, Sweden
| | - Anderi Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
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11
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Studying allergic inflammation and spirometry over menstrual cycles in well-controlled asthmatic women: Changes in progesterone and estradiol affect neither FENO levels nor lung function. Nitric Oxide 2018; 75:95-100. [PMID: 29486305 DOI: 10.1016/j.niox.2018.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/17/2018] [Accepted: 02/21/2018] [Indexed: 11/22/2022]
Abstract
It has been reported that female sex hormones influence on allergic inflammation and ventilation parameters in asthma but conclusions drawn by different researchers are divergent. The aim of our study was to assess the impact of progesterone (Pg) and estradiol (E) on the dynamics of allergic inflammation and spirometry test results in regularly menstruating women with stable allergic asthma. 13 women (28 days menstrual cycle), aged 18-45, taking no hormonal contraceptives, with mild and moderate asthma, without reported exacerbations at the near-ovulation and/or menstruation time, were monitored during two consecutive menstrual cycles. They had 4 visits per cycle (the first day of menstruation was assumed to be day 1 of the cycle; visits were carried out on days: 3-4, 10-11, 13-14 and 23-24). At each visit asthma symptoms, asthma control test (ACT) results, asthma treatment, fractioned nitric oxide (FENO) levels, spirometry test results, Pg and E, levels were analyzed. As a result of the study, no essential variability in FENO values and ventilation parameters' values in the course of menstruation cycle were observed. Negative correlation between FENO values and Pg concentrations was demonstrated (r = 0.27), but no correlation between FENO values and E levels was shown. No relationship between the ACT values and ventilation parameters and the levels of the sex hormones under investigation was detected. We conclude that changing levels of estradiol and progesterone (regardless of the negative correlation of progesterone and FENO values) affect neither the dynamics of allergic inflammation nor pulmonary function in women with stable allergic mild/moderate asthma.
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Sensitivity of airway cough-related afferents is influenced by female sex hormones. Respir Physiol Neurobiol 2018; 257:12-17. [PMID: 29326052 DOI: 10.1016/j.resp.2018.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/12/2017] [Accepted: 01/08/2018] [Indexed: 01/06/2023]
Abstract
Chronic hypersensitivity cough syndrome affects mainly postmenopausal women; however, the pathogenesis of cough hypersensitivity in this demographic is not entirely understood. The role of sex hormones in cough has never been studied in detail; however, sex hormones seem to play an important role in the lung health of women. Our study was aimed to analyse the effect of female sex hormones (oestrogen - E2 and progesterone - Pg) on cough sensitivity measured by inhalation of capsaicin in follicular and luteal phases of menstrual cycle, characterized by significantly different concentrations of sex hormones. These data were compared with a matched group of women taking oral contraceptives. Cough sensitivity to capsaicin increased in luteal phase in subjects with normal menstrual cycle, and this functional change was not present in group with contraceptive pills. The cough sensitivity correlates with the Pg/E2 ratio, and relative lack of oestrogen in luteal phase is associated with higher cough sensitivity to capsaicin.
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McCleary N, Nwaru BI, Nurmatov UB, Critchley H, Sheikh A. Endogenous and exogenous sex steroid hormones in asthma and allergy in females: A systematic review and meta-analysis. J Allergy Clin Immunol 2018; 141:1510-1513.e8. [PMID: 29305316 PMCID: PMC5883329 DOI: 10.1016/j.jaci.2017.11.034] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 11/20/2017] [Accepted: 11/30/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Nicola McCleary
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
| | - Bright I Nwaru
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom; Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Ulugbek B Nurmatov
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom; Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Hilary Critchley
- Medical Research Council Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
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Murri V, Antoniazzi F, Piazza M, Cavarzere P, Banzato C, Boner A, Gaudino R. Lung Function in Women with Idiopathic Central Precocious Puberty: A Pilot Study
. Horm Res Paediatr 2017; 87:95-102. [PMID: 28114141 DOI: 10.1159/000454729] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 11/21/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studies have reported that women with early menarche (≤10 years) have lower lung function. AIM To investigate lung function in women with a history of idio pathic central precocious puberty (ICPP) treated during childhood with gonadotropin-releasing hormone agonist (GnRHa). METHODS ICPP women (n = 23) were compared with healthy age-matched controls (n = 23). Subjects were clinically evaluated by means of a questionnaire, baseline and post-β<Sub>2</Sub> agonist spirometry, impulse oscillometry (a measure of airway resistance), and measurement of fractional exhaled nitric oxide (FeNO). RESULTS Patients had lower lung function values than controls: forced expiratory volume in 1 s (FEV<Sub>1</Sub>) (median 97.90 vs. 109.45; p = 0.011), FEV<Sub>1</Sub> after β<Sub>2</Sub> agonist (100.80 vs. 114.10; p = 0.013), peak expiratory flow (92.90 vs. 97.95; p = 0.031), and maximum mid-expiratory flow (MMEF) (80.80 vs. 106.30; p = 0.008). FeNO was significantly lower in the patients (p < 0.001). Significant reversibility of FEV<Sub>1</Sub> after β<Sub>2</Sub> agonist was observed in 8.7% of the patients. FEV<Sub>1</Sub>/forced vital capacity and MMEF after β<Sub>2</Sub> agonist correlated negatively with hysterometry at diagnosis (p = 0.009 and p = 0.03, respectively). There was a negative correlation between age at diagnosis and airway resistance. CONCLUSIONS Women with ICPP seem to have lower lung function despite treatment with GnRHa. Further research on the effects of sex hormones on the airways should take into account potential interplay with factors affecting the start of puberty.
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Abstract
CONTEXT AND OBJECTIVE: The relationship between sex hormones and asthma has been evaluated in several studies. The aim of this review article was to investigate the association between asthma and female sex hormones, under different conditions (premenstrual asthma, use of oral contraceptives, menopause, hormone replacement therapy and pregnancy). DESIGN AND SETTING: Narrative review of the medical literature, Universidade Federal do Tocantins (UFT) and Universidade Federal de São Paulo (Unifesp). METHODS: We searched the CAPES journal portal, a Brazilian platform that provides access to articles in the MEDLINE, PubMed, SciELO, and LILACS databases. The following keywords were used based on Medical Subject Headings: asthma, sex hormones, women and use of oral contraceptives. RESULTS: The associations between sex hormones and asthma remain obscure. In adults, asthma is more common in women than in men. In addition, mortality due to asthma is significantly higher among females. The immune system is influenced by sex hormones: either because progesterone stimulates progesterone-induced blocking factor and Th2 cytokines or because contraceptives derived from progesterone and estrogen stimulate the transcription factor GATA-3. CONCLUSIONS: The associations between asthma and female sex hormones remain obscure. We speculate that estrogen fluctuations are responsible for asthma exacerbations that occur in women. Because of the anti-inflammatory action of estrogen, it decreases TNF-α production, interferon-γ expression and NK cell activity. We suggest that further studies that highlight the underlying physiopathological mechanisms contributing towards these interactions should be conducted.
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Affiliation(s)
| | - Ivaldo Silva
- MD, PhD. Adjunct Professor, Gynecology, Universidade Federal do São Paulo (SP), Brazil.
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Sánchez-Ramos JL, Pereira-Vega AR, Alvarado-Gómez F, Maldonado-Pérez JA, Svanes C, Gómez-Real F. Risk factors for premenstrual asthma: a systematic review and meta-analysis. Expert Rev Respir Med 2016; 11:57-72. [DOI: 10.1080/17476348.2017.1270762] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
| | | | - Francisco Alvarado-Gómez
- Library, Juan Ramón Jiménez Hospital, Huelva, Spain
- Andalusian Health Service e-Library, Seville, Spain
| | | | - Cecilie Svanes
- Centre for International Health, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Francisco Gómez-Real
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
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Ritz T, Kullowatz A, Bill MN, Rosenfield D. Daily life negative mood and exhaled nitric oxide in asthma. Biol Psychol 2016; 118:176-183. [PMID: 27283368 DOI: 10.1016/j.biopsycho.2016.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 06/01/2016] [Accepted: 06/05/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Psychosocial stress and negative affect have been linked to asthma exacerbations, but longitudinal studies demonstrating a daily life association between negative affect and airway nitric oxide are missing. OBJECTIVE The longitudinal association between negative mood fluctuations, exhaled nitric oxide, and lung function in asthma was examined. METHODS Self-assessments of the fraction of exhaled nitric oxide (FeNO), spirometry (forced expiratory volume in the first second, FEV1), negative mood, and daily activities were obtained from 20 patients with asthma for 2 months, resulting in 1108 assessments for the analyses (approximately 55 per patient). Concurrent and prospective associations between FeNO, FEV1, and negative mood were analyzed using mixed effects regression models for longitudinal data. RESULTS Negative mood was positively associated with changes in FeNO during the same day, and to a stronger extent when prior day negative mood was included in the prediction. FeNO and negative mood were positively associated with same-day FEV1, with the latter relation being partially mediated by changes in FeNO. Associations between FeNO and FEV1 were stronger in younger patients, with earlier onset of asthma, or with lower asthma control. Findings were not changed when controlling for physical activity, medication, cold symptoms, air pollution, and hours spent outside. CONCLUSION Daily life changes of negative mood in asthma are positively associated with FeNO changes and FeNO increases are associated with a mild bronchodilation. These findings indicate that psychological influences need to be considered when using FeNO as indicator of airway inflammation and guide for treatment decisions.
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Affiliation(s)
- Thomas Ritz
- Southern Methodist University, Dallas, TX, USA.
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Al-Shamkhi N, Alving K, Dahlen SE, Hedlin G, Middelveld R, Bjerg A, Ekerljung L, Olin AC, Sommar J, Forsberg B, Janson C, Malinovschi A. Important non-disease-related determinants of exhaled nitric oxide levels in mild asthma - results from the Swedish GA(2) LEN study. Clin Exp Allergy 2016; 46:1185-93. [PMID: 27138350 DOI: 10.1111/cea.12749] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 04/17/2016] [Accepted: 04/23/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Fractional exhaled nitric oxide (FeNO) has a potential clinical role in asthma management. Constitutive factors such as age, height and gender, as well as individual characteristics, such as IgE sensitization and smoking, affect the levels of FeNO in population-based studies. However, their effect on FeNO in subjects with asthma has been scarcely studied. OBJECTIVE To study the effects on FeNO of these commonly regarded determinants, as demonstrated in healthy subjects, as well as menarche age and parental smoking, in a population of asthmatics. MATERIAL AND METHODS Fractional exhaled nitric oxide was measured in 557 subjects with asthma from the Swedish GA(2) LEN study. Allergic sensitization was assessed by skin prick tests to most common aeroallergens. Upper airway comorbidities, smoking habits, smoking exposure during childhood and hormonal status (for women) were questionnaire-assessed. RESULTS Male gender (P < 0.001), greater height (P < 0.001) and sensitization to both perennial allergens and pollen (P < 0.001) are related to higher FeNO levels. Current smoking (P < 0.001) and having both parents smoking during childhood, vs. having neither (P < 0.001) or only one parent smoking (P = 0.002), are related to lower FeNO. Women with menarche between 9 and 11 years of age had lower FeNO than those with menarche between 12 and 14 years of age (P = 0.03) or 15 and 17 years of age (P = 0.003). CONCLUSIONS AND CLINICAL RELEVANCE Interpreting FeNO levels in clinical practice is complex, and constitutional determinants, as well as smoking and IgE sensitisation, are of importance in asthmatic subjects and should be accounted for when interpreting FeNO levels. Furthermore, menarche age and parental smoking during childhood and their effects on lowering FeNO deserve further studies.
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Affiliation(s)
- N Al-Shamkhi
- Department of Medical Sciences: Lung- allergy- and sleep research, Uppsala University, Uppsala, Sweden
| | - K Alving
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - S E Dahlen
- Experimental Asthma and Allergy Research Unit, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - G Hedlin
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - R Middelveld
- Experimental Asthma and Allergy Research Unit, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - A Bjerg
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - L Ekerljung
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, University of Gothenburg, Gothenburg, Sweden
| | - A C Olin
- Section of Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - J Sommar
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, University of Umeå, Umeå, Sweden
| | - B Forsberg
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, University of Umeå, Umeå, Sweden
| | - C Janson
- Department of Medical Sciences: Lung- allergy- and sleep research, Uppsala University, Uppsala, Sweden
| | - A Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
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Uppalapati A, Gogineni S, Espiritu JR. Association between Body Mass Index (BMI) and fraction of exhaled nitric oxide (FeNO) levels in the National Health and Nutrition Examination Survey (NHANES) 2007-2010. Obes Res Clin Pract 2016; 10:652-658. [PMID: 26774499 DOI: 10.1016/j.orcp.2015.11.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 11/18/2015] [Accepted: 11/18/2015] [Indexed: 12/29/2022]
Abstract
PURPOSE Obesity is characterised by chronic, low-grade systemic inflammation. Elevated FeNO levels reflect airway inflammation in various lung diseases including asthma. METHODS This is a cross-sectional analysis of data from NHANES 2007-2010. Participants younger than 20 years old with history of cough/cold symptoms in the past 7 days, smoking, exercise in the previous hour, consumption of nitric oxide rich meats/vegetables, or use of inhaled corticosteroids during the previous 2 days were excluded. BMI (in kg/m2) was divided in to 4 categories: underweight (UW) (0-18.5), Normal (N) (≥18.5 to <25), Overweight (OW) (≥25 and <30) and Obese (O) ≥30. RESULTS There were a total of 149,629,652 weighted participants: UW (22,235,218), N (45,021,536), OW (5,1670,522) and O (50,199,974); 50.36% were men and 49.63% were women. The mean age increased with BMI category [p<.0001]. Mean FeNO levels (in ppb) increased with increasing BMI category: UW (12.52±1.05) N (16.25±0.64), OW (16.62±0.34), and O (16.78±0.39) [p=0.0035]. FEV1/FVC (%) decreased with increasing BMI category: UW (80.68) compared to N (78.51), OW (77.67) and O (78.72) [p=0.0014]. There is a weak yet statistically significant correlation between FeNO levels and both age, BMI. Multivariate analysis predicting FeNO based on BMI category, adjusting for age, gender, race and airway obstruction found age less than 60 years, male gender, certain races and UW BMI category were associated with statistically significantly lower FeNO levels. CONCLUSIONS Older age and male gender are associated with increased FeNO levels. Controlling for age, gender, and race, obese individuals have a statistically significantly higher FENO than underweight individuals.
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Affiliation(s)
- Aditya Uppalapati
- Division of Pulmonary and Critical Care Medicine, Houston Methodist Hospital, Houston, TX, USA.
| | - Sindhura Gogineni
- Division of Endocrinology and Metabolism, The University of Texas Medical Branch (UTMB), Galveston, TX, USA
| | - Joseph R Espiritu
- Division of Pulmonary, Critical Care and Sleep Medicine, Saint Louis University School of Medicine, Saint Louis, MO, USA
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Sathish V, Prakash Y. Sex Differences in Pulmonary Anatomy and Physiology. SEX DIFFERENCES IN PHYSIOLOGY 2016:89-103. [DOI: 10.1016/b978-0-12-802388-4.00006-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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21
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Pereira-Vega A, Sánchez-Ramos JL. Questions relating to premenstrual asthma. World J Respirol 2015; 5:180-187. [DOI: 10.5320/wjr.v5.i3.180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 08/05/2015] [Accepted: 10/13/2015] [Indexed: 02/06/2023] Open
Abstract
The study of asthma in fertile women needs to consider its potentially recurrent exacerbation in a specific phase of the menstrual cycle. Premenstrual asthma (PMA) refers to the deterioration of asthma in some women of fertile age during the premenstrual phase. Prevalence varies considerably according to studies (11%-47.44%) mainly because there is no standardized definition of the illness. There is a possible link between PMA and premenstrual syndrome, which is a set of physical and psychic manifestations that occur in some fertile women during the same premenstrual phase. This relation has been widely studied but there are still several unknowns. PMA etiopathogeny is not known. It involves possible causes such as hormonal variations in the premenstrual phase, the coexistence of atopy, variations during the cycle in substances related to inflammation, like LTC4 leukotrienes, catecholamines, E2 and F2α prostaglandins and certain cytokines. Also considered are psychological factors related to this phase of the menstrual cycle, a high susceptibility to infection or increased bronchial hyperreactivity prior to menstruation. Yet no factor fully explains its etiology, consequently no specific treatment exists. Researchers have investigated hormones, anti-leukotrienes, prostaglandin synthesis inhibitors, diuretics, phytoestrogens and alternative therapies, but none has been shown to be effective.
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Ilmarinen P, Tuomisto LE, Kankaanranta H. Phenotypes, Risk Factors, and Mechanisms of Adult-Onset Asthma. Mediators Inflamm 2015; 2015:514868. [PMID: 26538828 PMCID: PMC4619972 DOI: 10.1155/2015/514868] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 06/26/2015] [Accepted: 07/02/2015] [Indexed: 12/11/2022] Open
Abstract
Asthma is a heterogeneous disease with many phenotypes, and age at disease onset is an important factor in separating the phenotypes. Genetic factors, atopy, and early respiratory tract infections are well-recognized factors predisposing to childhood-onset asthma. Adult-onset asthma is more often associated with obesity, smoking, depression, or other life-style or environmental factors, even though genetic factors and respiratory tract infections may also play a role in adult-onset disease. Adult-onset asthma is characterized by absence of atopy and is often severe requiring treatment with high dose of inhaled and/or oral steroids. Variety of risk factors and nonatopic nature of adult-onset disease suggest that variety of mechanisms is involved in the disease pathogenesis and that these mechanisms differ from the pathobiology of childhood-onset asthma with prevailing Th2 airway inflammation. Recognition of the mechanisms and mediators that drive the adult-onset disease helps to develop novel strategies for the treatment. The aim of this review was to summarize the current knowledge on the pathogenesis of adult-onset asthma and to concentrate on the mechanisms and mediators involved in establishing adult-onset asthma in response to specific risk factors. We also discuss the involvement of these mechanisms in the currently recognized phenotypes of adult-onset asthma.
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Affiliation(s)
- Pinja Ilmarinen
- Department of Respiratory Medicine, Seinäjoki Central Hospital, 60220 Seinäjoki, Finland
| | - Leena E. Tuomisto
- Department of Respiratory Medicine, Seinäjoki Central Hospital, 60220 Seinäjoki, Finland
| | - Hannu Kankaanranta
- Department of Respiratory Medicine, Seinäjoki Central Hospital, 60220 Seinäjoki, Finland
- Department of Respiratory Medicine, University of Tampere, 33014 Tampere, Finland
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Cabello N, Mishra V, Sinha U, DiAngelo SL, Chroneos ZC, Ekpa NA, Cooper TK, Caruso CR, Silveyra P. Sex differences in the expression of lung inflammatory mediators in response to ozone. Am J Physiol Lung Cell Mol Physiol 2015; 309:L1150-63. [PMID: 26342085 DOI: 10.1152/ajplung.00018.2015] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 08/31/2015] [Indexed: 01/06/2023] Open
Abstract
Sex differences in the incidence of respiratory diseases have been reported. Women are more susceptible to inflammatory lung disease induced by air pollution and show worse adverse pulmonary health outcomes than men. However, the mechanisms underlying these differences remain unknown. In the present study, we hypothesized that sex differences in the expression of lung inflammatory mediators affect sex-specific immune responses to environmental toxicants. We focused on the effects of ground-level ozone, a major air pollutant, in the expression and regulation of lung immunity genes. We exposed adult male and female mice to 2 ppm of ozone or filtered air (control) for 3 h. We compared mRNA levels of 84 inflammatory genes in lungs harvested 4 h postexposure using a PCR array. We also evaluated changes in lung histology and bronchoalveolar lavage fluid cell counts and protein content at 24 and 72 h postexposure. Our results revealed sex differences in lung inflammation triggered by ozone exposure and in the expression of genes involved in acute phase and inflammatory responses. Major sex differences were found in the expression of neutrophil-attracting chemokines (Ccl20, Cxcl5, and Cxcl2), the proinflammatory cytokine interleukin-6, and oxidative stress-related enzymes (Ptgs2, Nos2). In addition, the phosphorylation of STAT3, known to mediate IL-6-related immune responses, was significantly higher in ozone-exposed mice. Together, our observations suggest that a differential regulation of the lung immune response could be implicated in the observed increased susceptibility to adverse health effects from ozone observed in women vs. men.
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Affiliation(s)
- Noe Cabello
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Vikas Mishra
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Utkarshna Sinha
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Susan L DiAngelo
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Zissis C Chroneos
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania; Department of Microbiology and Immunology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Ndifreke A Ekpa
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Timothy K Cooper
- Department of Comparative Medicine, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania; Department of Pathology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Carla R Caruso
- Department of Pathology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
| | - Patricia Silveyra
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania; Department of Biochemistry and Molecular Biology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania; and Department of Humanities, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania
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Abstract
Menstrual suppression--the use of hormones to delay or eliminate menses--is often used in adolescents to manage conditions associated with the menstrual cycle and to accommodate lifestyle preferences. Reducing the frequency of menstrual bleeding does not cause any known physiologic harm and has potential short-term and long-term advantages. Different methods used for menstrual suppression, however, have associated risks and side effects that need to be weighed against the benefits of controlling menses. This article reviews the advantages and disadvantages of menstrual suppression and the different methods available for adolescents.
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Nwaru BI, Sheikh A. Hormonal contraceptives and asthma in women of reproductive age: analysis of data from serial national Scottish Health Surveys. J R Soc Med 2015; 108:358-71. [PMID: 26152676 DOI: 10.1177/0141076815588320] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Sex steroid hormones may explain known gender-related variations in asthma prevalence and clinical manifestation. We investigated the relationship between use of hormonal contraceptives and asthma in women, and assessed evidence of biological interaction between use of hormonal contraceptives and body mass index in this relationship. DESIGN Population-based analysis using data from serial (i.e. 2003, 2008 and 2010) Scottish Health Surveys. SETTING Random samples of the Scottish general population. PARTICIPANTS A total of 3257 non-pregnant, 16-45-year-old women. EXPOSURE Current use of hormonal contraceptives. MAIN OUTCOME MEASURES Self-reported current physician-diagnosed asthma, current wheezing symptoms, wheezing attacks and treatment for asthma or wheeze. RESULTS Women comprising 30.9% (95% confidence interval 29.3-32.5) were currently using any hormonal contraceptive and current physician-diagnosed asthma was present in 6.5% (95% confidence interval 5.7-7.4). Use of any hormonal contraceptive was associated with reduced risk of current physician-diagnosed asthma (odds ratio 0.68; 95% confidence interval 0.47-0.98) and receiving ≥3 asthma care episodes (odds ratio 0.45; 95% confidence interval 0.25-0.82), but the evidence was equivocal for wheezing attacks. Use of hormonal contraceptives among overweight or obese women was non-statistically significantly associated with asthma, but there was 42-135% increased risk in overweight and obese non-contraceptive using women. CONCLUSIONS Use of hormonal contraceptives may reduce asthma exacerbations and number of care episodes. Overweight and obese non-contraceptive-using women may be at increased risk of asthma. Prospective studies are now needed to confirm these findings. Both oestrogen and progesterone may stimulate smooth airway muscle function and inhibit the activities of TH2 responses. Future studies should investigate these underlying mechanisms.
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Affiliation(s)
- Bright I Nwaru
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, EH8 9AG, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, EH8 9AG, UK Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA 02120, USA Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
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27
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Sex steroid signaling: implications for lung diseases. Pharmacol Ther 2015; 150:94-108. [PMID: 25595323 DOI: 10.1016/j.pharmthera.2015.01.007] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 01/09/2015] [Indexed: 12/12/2022]
Abstract
There is increasing recognition that sex hormones (estrogen, progesterone, and testosterone) have biological and pathophysiological actions in peripheral, non-reproductive organs, including the lung. Clinically, sex differences in the incidence, morbidity and mortality of lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, lung cancer and pulmonary hypertension have been noted, although intrinsic sex differences vs. the roles of sex steroids are still not well-understood. Accordingly, it becomes important to ask the following questions: 1) Which sex steroids are involved? 2) How do they affect different components of the lung under normal circumstances? 3) How does sex steroid signaling change in or contribute to lung disease, and in this regard, are sex steroids detrimental or beneficial? As our understanding of sex steroid signaling in the lung improves, it is important to consider whether such information can be used to develop new therapeutic strategies to target lung diseases, perhaps in both sexes or in a sex-specific manner. In this review, we focus on the basics of sex steroid signaling, and the current state of knowledge regarding how they influence structure and function of specific lung components across the life span and in the context of some important lung diseases. We then summarize the potential for sex steroids as useful biomarkers and therapeutic targets in these lung diseases as a basis for future translational research in the area of gender and individualized medicine.
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Wu TJ, Wu CF, Lee YL, Hsiue TR, Guo YL. Asthma incidence, remission, relapse and persistence: a population-based study in southern Taiwan. Respir Res 2014; 15:135. [PMID: 25387792 PMCID: PMC4232728 DOI: 10.1186/s12931-014-0135-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 10/21/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In western countries, late-onset asthmatics are more severe than early-onset asthmatics in clinic-based studies. However, whether asthma occurrence rates were higher in late ages than in younger ages was inconclusive. This information is essentially lacking in Asian population. METHODS The participants were schoolchildren's parents recruited from 94 elementary and middle schools in 2004. A cross-sectional self-administered questionnaire was sent through the children to their parents to survey their respiratory health. We investigated typical asthma symptoms occurring at different ages and subsequent remission or relapse after the first asthma event. Person-years of the participants from birth to the time of survey were used as the denominator. RESULTS Among the 25,377 participants consisting of 949,807 total person-years, 860 reported ever having asthma. Highest incidences occurred at ages 0-12 and 36-40 years. The incidence of asthma was higher in males before puberty, and higher in females after puberty, with overall incidences 1.00 and 0.77 per 1000 person-years for females and males, respectively. Participants with late-onset asthma (onset age >12 years) comprised a large portion of adult current asthmatics. More than 52% of persistence or relapse was observed in early-onset asthma (onset age ≤12 years). The younger birth cohort had a more prominent later peak of asthma incidence than the older one. CONCLUSIONS In Asian population, asthma occurrence showed a U-shape age distribution with a prominent second peak in the thirties. A high proportion of early-onset asthma relapsed and most of late-onset asthma persisted or relapsed in adulthood.
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Affiliation(s)
- Tsung-Ju Wu
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan. .,Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan.
| | - Chang-Fu Wu
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan.
| | - Yungling Leo Lee
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
| | - Tzuen-Ren Hsiue
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, Medical College, National Cheng Kung University, Tainan, Taiwan.
| | - Yue Leon Guo
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan. .,Department of Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan.
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Exhaled Breath Condensate pH and FeNO as Biomarkers of Acute and Chronic Exposure to Hazards at Swine Farms. J Occup Environ Med 2014; 56:946-52. [DOI: 10.1097/jom.0000000000000151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Macsali F, Svanes C, Bjørge L, Omenaas ER, Gómez Real F. Respiratory health in women: from menarche to menopause. Expert Rev Respir Med 2014; 6:187-200; quiz 201-2. [PMID: 22455491 DOI: 10.1586/ers.12.15] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Ferenc Macsali
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
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Bijnens E, Pieters N, Dewitte H, Cox B, Janssen BG, Saenen N, Dons E, Zeegers MP, Int Panis L, Nawrot TS. Host and environmental predictors of exhaled breath temperature in the elderly. BMC Public Health 2013; 13:1226. [PMID: 24365236 PMCID: PMC3890614 DOI: 10.1186/1471-2458-13-1226] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 12/12/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exhaled breath temperature has been suggested as a new method to detect and monitor pathological processes in the respiratory system. The putative mechanism of this approach is based upon changes in the blood flow. So far potential factors that influence breath temperature have not been studied in the general population. METHODS The exhaled breath temperature was measured in 151 healthy non-smoking elderly (aged: 60-80 years) at room temperature with the X-halo device with an accuracy of 0.03°C. We related exhaled breath temperature by use of regression models with potential predictors including: host factors (sex, age) and environmental factors (BMI, physical activity, and traffic indicators). RESULTS Exhaled breath temperature was lower in women than in men and was inversely associated with age, physical activity. BMI and daily average ambient temperature were positively associated with exhaled breath temperature. Independent of the aforementioned covariates, exhaled breath temperature was significantly associated with several traffic indicators. Residential proximity to major road was inversely associated with exhaled breath temperature: doubling the distance to the nearest major intense road was observed a decrease of 0.17°C (95% CI: -0.33 to -0.01; p=0.036). CONCLUSIONS Exhaled breath temperature has been suggested as a noninvasive method for the evaluation of airway inflammation. We provide evidence that several factors known to be involved in proinflammatory conditions including BMI, physical activity and residential proximity to traffic affect exhaled breath temperature. In addition, we identified potential confounders that should be taken into account in clinical and epidemiological studies on exhaled breath temperature including sex, age, and ambient temperature.
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Affiliation(s)
- Esmée Bijnens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Nicky Pieters
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Harrie Dewitte
- Department of Public Health, Leuven University (KU Leuven), Leuven, Belgium
- Primary health care center GVHV, Genk, Belgium
| | - Bianca Cox
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Bram G Janssen
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Nelly Saenen
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Evi Dons
- VITO, Flemish Institute for Technological Research, Mol, Belgium
- Transportation Research Institute, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Maurice P Zeegers
- Department of Complex Genetics, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Luc Int Panis
- VITO, Flemish Institute for Technological Research, Mol, Belgium
- Transportation Research Institute, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, Diepenbeek 3590, Belgium
- Department of Public Health, Leuven University (KU Leuven), Leuven, Belgium
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Exhaled nitric oxide is associated with cyclic changes in sexual hormones. Pulm Pharmacol Ther 2013; 26:644-8. [DOI: 10.1016/j.pupt.2013.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 04/24/2013] [Accepted: 04/25/2013] [Indexed: 11/19/2022]
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Rao CK, Moore CG, Bleecker E, Busse WW, Calhoun W, Castro M, Chung KF, Erzurum SC, Israel E, Curran-Everett D, Wenzel SE. Characteristics of perimenstrual asthma and its relation to asthma severity and control: data from the Severe Asthma Research Program. Chest 2013; 143:984-992. [PMID: 23632943 DOI: 10.1378/chest.12-0973] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Although perimenstrual asthma (PMA) has been associated with severe and difficult-to-control asthma, it remains poorly characterized and understood. The objectives of this study were to identify clinical, demographic, and inflammatory factors associated with PMA and to assess the association of PMA with asthma severity and control. METHODS Women with asthma recruited to the National Heart, Lung, and Blood Institute Severe Asthma Research Program who reported PMA symptoms on a screening questionnaire were analyzed in relation to basic demographics, clinical questionnaire data, immunoinflammatory markers, and physiologic parameters. Univariate comparisons between PMA and non-PMA groups were performed. A severity-adjusted model predicting PMA was created. Additional models addressed the role of PMA in asthma control. RESULTS Self-identified PMA was reported in 17% of the subjects (n = 92) and associated with higher BMI, lower FVC % predicted, and higher gastroesophageal reflux disease rates. Fifty-two percent of the PMA group met criteria for severe asthma compared with 30% of the non-PMA group. In multivariable analyses controlling for severity, aspirin sensitivity and lower FVC % predicted were associated with the presence of PMA. Furthermore, after controlling for severity and confounders, PMA remained associated with more asthma symptoms and urgent health-care utilization. CONCLUSIONS PMA is common in women with severe asthma and associated with poorly controlled disease. Aspirin sensitivity and lower FVC % predicted are associated with PMA after adjusting for multiple factors, suggesting that alterations in prostaglandins may contribute to this phenotype.
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Affiliation(s)
- Chitra K Rao
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, The University of Pittsburgh Asthma Institute @UPMC and the University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Charity G Moore
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, The University of Pittsburgh Asthma Institute @UPMC and the University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Eugene Bleecker
- Division of Pulmonary, Critical Care, Allergy, and Immunologic Medicine, Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC
| | - William W Busse
- Division of Allergy and Clinical Immunology, Department of Medicine, University of Wisconsin-Madison, Madison, WI
| | - William Calhoun
- Division of Allergy, Pulmonary, Immunology, Critical Care, and Sleep, Department of Internal Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX
| | - Mario Castro
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, Washington University in St Louis, St Louis, MO
| | - Kian Fan Chung
- Division of Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Imperial College London, London, England
| | | | - Elliot Israel
- Division of Pulmonary and Critical Care, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Douglas Curran-Everett
- Division of Biostatistics, Department of Preventive Medicine and Biometrics and Department of Physiology and Biophysics, University of Colorado Denver and National Jewish Health, Denver, CO
| | - Sally E Wenzel
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, The University of Pittsburgh Asthma Institute @UPMC and the University of Pittsburgh School of Medicine, Pittsburgh, PA.
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Bronchiolitis obliterans after allogeneic hematopoietic SCT: further insight—new perspectives? Bone Marrow Transplant 2013; 48:1224-9. [DOI: 10.1038/bmt.2013.17] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 01/16/2013] [Accepted: 01/23/2013] [Indexed: 01/11/2023]
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Vélez-Ortega AC, Temprano J, Reneer MC, Ellis GI, McCool A, Gardner T, Khosravi M, Marti F. Enhanced generation of suppressor T cells in patients with asthma taking oral contraceptives. J Asthma 2013; 50:223-30. [PMID: 23259774 DOI: 10.3109/02770903.2012.761231] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction. A dysregulation of regulatory T cells (Tregs) could play a major role in the pathogenesis of bronchial asthma. Sex-dependent differences as well as the impact of hormonal changes in the incidence and severity of asthma are widely recognized. Emerging evidence suggests that asthma symptoms are alleviated in female patients taking hormone oral contraceptives (OCs). The impact of OCs on the generation of induced Tregs (iTregs) was assessed in a cohort of female patients with asthma. Methods. Thirteen patients were included in this pilot study. During three distinct phases of their menstrual cycles, we measured exhaled nitric oxide (eNO) levels, forced expiratory volume at 1 second (FEV1s), asthma control test (ACT) score, sex steroid hormone levels in serum, natural Tregs in peripheral blood, and the ability of CD4(+) T cells to generate iTregs ex vivo. Results. The luteal serum levels of estradiol and progesterone negatively correlated with the proportion of iTregs generated ex vivo in patients not taking OCs. In addition, physiological doses of estradiol and progesterone prevented the acquisition of a suppressor T cell phenotype in vitro. Interestingly, patients taking OCs had reduced serum sex hormone levels associated with higher iTreg induction, a better ACT score, and a tendency toward lower eNO levels. Conclusions. Our results identify an impact of sex hormones on the capacity of T cells to polarize towards a regulatory phenotype and suggest the regulation of peripheral T cell lineage plasticity as a potential mechanism underlying the beneficial effects of OCs in women with asthma.
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Affiliation(s)
- A Catalina Vélez-Ortega
- Department of Microbiology, Immunology and Molecular Genetics, Chandler Medical Center, University of Kentucky College of Medicine, Lexington, KY 40536, USA
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Schindler AE. Non-contraceptive benefits of oral hormonal contraceptives. Int J Endocrinol Metab 2013; 11:41-7. [PMID: 23853619 PMCID: PMC3693657 DOI: 10.5812/ijem.4158] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Revised: 05/12/2012] [Accepted: 06/23/2012] [Indexed: 11/16/2022] Open
Abstract
It is becoming evident that oral hormonal contraceptives-besides being well established contraceptives-seem to become important medications for many functional or organic disturbances. So far, clinical effectiveness has been shown for treatment as well as prevention of menstrual bleeding disorders and menstrual-related pain symptoms. Also this is true for premenstrual syndrome (PMS) and premenstrual disphoric disorder (PMDD). Particular oral contraceptives (OCs) containing anti-androgenic progestogens were shown to be effective medications for treatment of androgenisation symptoms (seborrhea, acne, hirsutism, alopecia). Through perfect suppression of the hypothalamic-pituitary-ovarian axis OCs have proven to be effective in elimination of persistent follicular cysts. Endometriosis/adenomyosis related pain symptoms are well handled similar to other drugs like Gonadotropine Releasing Hormone agonists but are less expensive, with less side effects, and possibility to be used for longer periods of time. This is also true for myoma. Pelvic inflammatory disease, rheumatoid arthritis, menstrual migraine, and onset of multiple sclerosis are prevented or delayed. Bone density is preserved and asthma symptoms improved. Endometrial hyperplasia and benign breast disease can be controlled. There is definitely a significant impact on risk reduction regarding endometrial, ovarian, and colon cancers. In conclusion, it needs to be recognized that oral combined hormonal contraceptives (estrogen/ progestogen combination) are - besides being reliable forms of contraception - are cost-effective medications for many medical disorders in women. Therefore, these contraceptives drugs are important for female and global health and should be used in clinical practice.
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Affiliation(s)
- Adolf E Schindler
- Institute for Medical Research and Education, Essen, Germany
- Corresponding author: Adolf E Schindler, Institute for Medical Research and Education, University Clinic, Hufelandstrasse 55, D-45147, Essen, Germany. Tel.: +49-2017991833, Fax: +49-2017499533, E-mail:
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Macsali F, Svanes C, Sothern RB, Benediktsdottir B, Bjørge L, Dratva J, Franklin KA, Holm M, Janson C, Johannessen A, Lindberg E, Omenaas ER, Schlünssen V, Zemp E, Real FG. Menstrual cycle and respiratory symptoms in a general Nordic-Baltic population. Am J Respir Crit Care Med 2012. [PMID: 23204251 DOI: 10.1164/rccm.201206-1112oc] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
RATIONALE There is little knowledge of variations in respiratory symptoms during the menstrual cycle in a general population, and potential modifying factors are not investigated. OBJECTIVES To investigate menstrual cycle variation in respiratory symptoms in a large general population, using chronobiology methodology, and stratifying by body mass index (BMI), smoking, and asthma status. METHODS A total of 3,926 women with regular cycles less than or equal to 28 days and not taking exogenous sex hormones answered a postal questionnaire regarding the first day of their last menstruation and respiratory symptoms in the last 3 days. Moving 4-day means were computed to smooth uneven records of daily sampling; best-fitting 28-day composite cosine curves were applied to each time series to describe rhythmicity. MEASUREMENTS AND MAIN RESULTS Significant rhythmic variations over the menstrual cycle were found in each symptom for all subjects and subgroups. Wheezing was higher on cycle Days 10-22, with a midcycle dip near the time of putative ovulation (approximately Days 14-16) in most subgroups. Shortness of breath was higher on days 7-21, with a dip just before midcycle in many subgroups. Cough was higher just after putative ovulation for subjects with asthma, BMI greater than or equal to 23 kg/m(2), and smokers, or just before ovulation and menses onset for low symptomatic subgroups. CONCLUSIONS Respiratory symptoms varied significantly during the menstrual cycle and were most frequent from the midluteal to midfollicular stages, often with a dip near the time of ovulation. The patterns varied by BMI, smoking, and asthma status. These relations link respiratory symptoms with hormonal changes through the menstrual cycle and imply a potential for individualized chronotherapy for respiratory diseases.
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Affiliation(s)
- Ferenc Macsali
- Department of Gynecology and Obstetrics, Haukeland University Hospital, 5021 Bergen, Norway.
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Premenstrual asthma and leukotriene variations in the menstrual cycle. Allergol Immunopathol (Madr) 2012; 40:368-73. [PMID: 22115570 DOI: 10.1016/j.aller.2011.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 09/06/2011] [Indexed: 12/24/2022]
Abstract
BACKGROUND Several authors have reported an increase in leukotriene C4 in the premenstrual phase in women with severe premenstrual asthma, indicating that antileukotrienes could be used in treatment. OBJECTIVE To analyse the role of leukotrienes in premenstrual asthma. METHODS A questionnaire on respiratory symptoms and peak flow during one complete menstrual cycle was given to women of fertile age to define them as asthmatics who suffered from premenstrual asthma or not. Premenstrual asthma (PMA) was defined as a clinical or functional deterioration (≥20%) in the premenstrual phase compared with the preovulatory phase. Blood samples to measure leukotriene C4 were taken during the preovulatory and premenstrual phases. RESULTS Blood samples were taken in 62 asthmatic women, 34 of whom (54.3%) presented PMA criteria, all with a premenstrual deterioration of between 20 and 40%. There was no difference in leukotriene C4 levels between the preovulatory and premenstrual phases in the women who suffered from PMA (1.50ng/mL vs. 1.31ng/mL; p=0.32) and those who did not (1.40ng/mL vs. 1.29ng/mL; p=0.62). Neither were there any differences in leukotriene levels between women with or without PMA. The results were similar for each category of asthma severity. CONCLUSIONS Our data show that leukotriene C4 does not appear to be involved in the pathogenesis of premenstrual asthma, or support the use of anti-leukotrienes in the specific treatment of premenstrual asthma, at least in women with a moderate premenstrual deterioration. No differences appeared in any of the categories of asthma severity.
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Wegienka G, Hasiec E, Boushey H, Johnson CC, Strickler R, Zoratti E, Havstad S. Studying forced expiratory volume at 1 second over menstrual segments in asthmatic and non-asthmatic women: assessing protocol feasibility. BMC Res Notes 2012; 5:261. [PMID: 22642760 PMCID: PMC3392749 DOI: 10.1186/1756-0500-5-261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 05/29/2012] [Indexed: 12/25/2022] Open
Abstract
Background Sex hormones may play an important role in observed gender differences in asthma incidence and severity, as well as in the observed changes in asthma symptoms during times of hormonal fluctuation (i.e.; premenstrual, pregnancy, etc.). This pilot study sought to demonstrate the feasibility of data collection methods to investigate the effects of sex hormones on lung function in women. Findings A cohort of 13 women (6 with and 7 without prior asthma diagnoses) who were having menstrual periods and were not taking hormones collected urine samples daily for measurement of estrogen (estrone E1C) and progesterone (Pregnanediol-glucuronide PDG) metabolites over the course of a menstrual segment (bleeding episode plus the following bleeding-free interval). Hormones were used to estimate menstrual segment phase (follicular versus luteal) based on a published algorithm. Daily bleeding and FEV1 measurements were recorded and percent predicted FEV1 was calculated. Percent predicted FEV1 decreased over the course of the follicular but not the luteal phase. More specifically, among women without a prior asthma diagnosis, the E1C/PDG ratio and E1C and PDG were individually associated with FEV1 in the follicular phase. No associations were found between hormones and percent predicted FEV1 in the luteal phase or among asthmatic women. E1C was associated with FEV1 in the five days before bleeding onset only among non-asthmatic women. Discussion A study of contiguous daily hormones and symptoms over menstrual segments from a large group of women with and without asthma is needed to better determine within-woman cyclicity of the observed patterns.
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Affiliation(s)
- Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA.
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Hardie GE, Brown JK, Gold WM. Bronchial hyperresponsiveness, word descriptors, and ethnicity: women with mild asthma. J Asthma 2011; 49:36-44. [PMID: 22176690 DOI: 10.3109/02770903.2011.637839] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Few studies have examined the ethnic differences in symptom reporting and airway hyperresponsiveness (AHR) for women with mild asthma during a methacholine (McH) challenge. OBJECTIVE The purpose of this sub-analysis was to determine: (1) whether AHR to McH varied by the ethnicity of women with mild asthma and (2) whether ethnic word descriptors (EWDs) varied by the ethnicity during induced bronchoconstriction. METHODS Specific inclusion criteria included the following: FEV(1) (forced expiratory volume in 1 second) ≥ 70% predicted normal, PC(30) ≤ 8 mg/McH, β(2) inhaler only, and self-reported ethnicity of African American (AFAM), Mexican American-Hispanic-Latino (MexAMLat), Asian-Pacific Islander (Asian PI), or white. Serial pulmonary function testing (PFT) and Borg, visual analogue scale (VAS), and EWDs were collected. RESULTS A total of 44 women, mean age of 31.3 years old, with a mean baseline FEV(1) of 2.85 L comprised this sub-analysis. Ethnic-racial diversity included: 12 AFAMs, 5 MexAMLat, 13 Asian-PIs, and 14 whites. All had atopy ≥ 2 pinprick responses of 3 mm. At PC(30), Asian-PI women required a significantly (p < .05) smaller mean dose of McH 1.9 mg/mL. MexAMLat women required an McH dose of 1.6 mg/mL. At PC(30), McH dose was 2.9 mg/mL for AFAMs and 3.0 mg/mL for whites, respectively. Asian-PIs who used only upper airway EWDs at PC(30) vere itchy throat, itchy chin, and constricted throat (p < .001). AFAMs significant EWDs were itchy throat, itchy chin/face, and tight throat (p < .01). Lower airway EWD was used by both MexAMLat and whites. Significant EWD for Whites were tight chest (p < .01) and hard to inhale/lungs tight (p < .001). CONCLUSION Asian-PI women required a significantly smaller dose (p < .05) of McH to induce a PC(30). AFAM and whites required a comparable dose of Mch at PC(30). Asian-PI and AFAM women used only upper airway EWD. Asian-PI women may be at a greater risk for acute asthma episodes that are not recognized or treated due to their upper airway symptom reporting.
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Affiliation(s)
- Grace E Hardie
- San Francisco State University (SFSU), Nursing, San Francisco, CA, USA.
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Verma MK, Miki Y, Sasano H. Sex steroid receptors in human lung diseases. J Steroid Biochem Mol Biol 2011; 127:216-22. [PMID: 21856418 DOI: 10.1016/j.jsbmb.2011.07.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 07/30/2011] [Indexed: 10/17/2022]
Abstract
Several epidemiological studies have reported that gender differences exist in clinical and biological manifestations of human lung diseases. In particular, women are far more likely to develop both neoplastic and non-neoplastic lung diseases than men. This gender difference above suggests that sex steroid may be involved in the pathogenesis of various lung diseases. These sex steroids mediate their effects through sex steroid receptors including estrogen receptors (ER) i.e. ERα and ERβ progesterone receptors (PR) i.e. PR-A and PR-B and androgen receptors (ARs), all of which have been reported to be expressed in lung tissue. Therefore it becomes important to clarify the potential roles of sex steroid receptor in both neoplastic and non-neoplastic lung diseases toward improved treatment options for the patients. In this review, we summarized a number of studies in humans and experimental animals that have identified possible roles of sex steroids in respiratory physiology and pathology.
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Affiliation(s)
- Mohit K Verma
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Miyagi-ken, Japan
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Townsend EA, Meuchel LW, Thompson MA, Pabelick CM, Prakash YS. Estrogen increases nitric-oxide production in human bronchial epithelium. J Pharmacol Exp Ther 2011; 339:815-24. [PMID: 21940647 DOI: 10.1124/jpet.111.184416] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Although sex differences in asthma severity are recognized, the mechanisms by which sex steroids such as estrogen influence the airway are still under investigation. Airway tone, a key aspect of asthma, represents a balance between bronchoconstriction and dilation. Nitric oxide (NO) from the bronchial epithelium is an endogenous bronchodilator. We hypothesized that estrogens facilitate bronchodilation by generating NO in bronchial epithelium. In acutely dissociated human bronchial epithelial cells from female patients exposure to 17β-estradiol (E(2); 10 pM-100 nM) resulted in rapid increase of diaminofluorescein fluorescence (NO indicator) within minutes, comparable with that induced by ATP (20 μM). Estrogen receptor (ER) isoform-specific agonists (R,R)-5,11-diethyl-5,6,11,12-tetrahydro-2,8-chrysenediol (THC) (ERα) and diaryl-propionitrile (DPN) (ERβ) stimulated NO production to comparable levels and at comparable rates, whereas the ER antagonist 7α,17β-[9-[(4,4,5,5,5-pentafluoropentyl)sulfinyl]nonyl]estra-1,3,5(10)-triene-3,17-diol (ICI 182,780) (1 μM) was inhibitory. Estrogen effects on NO were mediated via caveolin-1 (blocked using the caveolin-1 scaffolding domain peptide) and by increased intracellular calcium concentration [prevented by 20 μM 1,2-bis(o-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid tetra(acetoxymethyl) ester but not by blocking Ca(2+) influx using LaCl(3)]. Estrogen increased endothelial NO synthase activation (inhibited by 100 μM N(G)-nitro-l-arginine methyl ester) and phosphorylated Akt. In epithelium-intact human bronchial rings contracted with acetylcholine (1 μM), E(2), THC, and DPN all produced acute bronchodilation in a dose-dependent fashion. Such bronchodilatory effects were substantially reduced by epithelial denudation. Overall, these data indicate that estrogens, acting via ERα or ERβ, can acutely produce NO in airway epithelium (akin to vascular endothelium). Estrogen-induced NO and its impairment may contribute to altered bronchodilation in women with asthma.
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Tam A, Morrish D, Wadsworth S, Dorscheid D, Man SFP, Sin DD. The role of female hormones on lung function in chronic lung diseases. BMC WOMENS HEALTH 2011; 11:24. [PMID: 21639909 PMCID: PMC3129308 DOI: 10.1186/1472-6874-11-24] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 06/03/2011] [Indexed: 01/25/2023]
Abstract
Background The prevalence, morbidity, and mortality of inflammatory lung diseases such as asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF) are increasing in women. There is a dearth of data on the biological mechanisms to explain such observations. However, some large epidemiologic studies suggest that lung function fluctuates during the menstrual cycle in female patients with airways disease but not in women without disease, suggesting that circulating estradiol and progesterone may be involved in this process. Discussion In asthma, estradiol shuttles adaptive immunity towards the TH2 phenotype while in smokers estrogens may be involved in the generation of toxic intermediate metabolites in the airways of female smokers, which may be relevant in COPD pathogenesis. In CF, estradiol has been demonstrated to up-regulate MUC5B gene in human airway epithelial cells and inhibit chloride secretion in the airways. Progesterone may augment airway inflammation. Summary Taken together, clinical and in-vivo data have demonstrated a sex-related difference in that females may be more susceptible to the pathogenesis of lung diseases. In this paper, we review the effect of female sex hormones in the context of these inflammatory airway diseases.
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Affiliation(s)
- Anthony Tam
- The UBC James Hogg Research Centre, Providence Heart+Lung Centre & Department of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada
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Abstract No. 36: Cyclical hormone-related changes in long saphenous venous insufficiency. J Vasc Interv Radiol 2011. [DOI: 10.1016/j.jvir.2011.01.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pereira-Vega A, Sánchez JL, Maldonado JA, Borrero F, Rico IV, Vázquez R, Alvarez F, Ignacio JM, Romero P, Gil FL. Premenstrual asthma and atopy markers. Ann Allergy Asthma Immunol 2010; 105:218-22. [PMID: 20800788 DOI: 10.1016/j.anai.2010.06.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 06/11/2010] [Accepted: 06/29/2010] [Indexed: 12/27/2022]
Abstract
BACKGROUND The frequency of atopy in women with premenstrual asthma (PMA) and its possible effect on the premenstrual exacerbation of asthma are unknown. OBJECTIVE To analyze the relation between atopy markers (total IgE, Phadiatop, and specific IgE) and PMA. METHODS Asthmatic women of reproductive age completed a questionnaire about respiratory symptoms and recorded peak flow during an entire menstrual cycle to be classified as asthmatic patients with or without PMA. Their asthma severity was graded according to the 2005 Global Initiative for Asthma scale. PMA was defined as a clinical or functional exacerbation (>or=20%) in the premenstrual phase compared with the preovulatory phase. Blood tests for several atopy markers were conducted for: total IgE and screening for aeroallergens (Phadiatop) and specific IgE. RESULTS Blood determinations were performed in 59 asthmatic women, of whom 31 (53%) had PMA. Twenty-six patients with PMA (84%) and 12 without PMA (43%) had total IgE values greater than 100 kU/L (P=.001). Twenty-one patients with PMA (68%) and 14 without PMA (50%) tested positive for Phadiatop (P=.17). Those who were positive for Phadiatop were also tested for specific IgE. No relation was found between specific IgE and PMA; values for ryegrass (63%), olive (60%), and Dermatophagoides pteronyssinus (54%) exceeded 0.35 kU/L. CONCLUSIONS PMA seems to be closely linked to total IgE levels but not to specific allergens. The atopy affects the clinical manifestations of PMA in women of reproductive age.
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Affiliation(s)
- Antonio Pereira-Vega
- Pneumology Section, Hospital Juan Ramón Jiménez de Huelva, Department of Nursing, University of Huelva, Huelva, Spain.
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Exhaled nitric oxide and influencing factors in a random population sample. Respir Med 2010; 105:713-8. [PMID: 21146387 DOI: 10.1016/j.rmed.2010.11.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Revised: 10/31/2010] [Accepted: 11/05/2010] [Indexed: 12/17/2022]
Abstract
The aim of the current study was to determine the impact and interaction of important influencing factors on the fraction of exhaled nitric oxide (FeNO). FeNO was measured in a population-based sample of 1250 middle-aged subjects from the KORA F4 cohort (Augsburg, Germany). Analysis of covariance models was performed including the factors age, height, FVC, FEV(1), sex, current smoking status, recent respiratory tract infection, and respiratory allergy. Geometric mean (SD as factor; 95% confidence interval as factor) FeNO was 13.9 (1.9; 1.033) ppb. FeNO significantly depended on age, height, smoking, infection and allergy. Smoking reduced FeNO by 21%, while infection and allergy led to increases by 9 and 11%, respectively. Increases in age by 10 years and in height by 10 cm were associated with increases of FeNO by 15 and 10%, respectively. Non-smokers demonstrated independent multiplicative superposition of factors affecting FeNO while the effect of allergy was virtually eliminated in smokers without infection. We conclude that in middle-aged non-smokers the effects of infection, age and height can be easily taken into account and do not significantly disturb the effect of respiratory tract allergies on FeNO. In current smokers, however, effects were heterogeneous and information on smoking intensity seems to be useful for better adjustment.
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Santmyire BR, Venkat V, Beinder E, Baylis C. Impact of the estrus cycle and reduction in estrogen levels with aromatase inhibition, on renal function and nitric oxide activity in female rats. Steroids 2010; 75:1011-5. [PMID: 20619284 PMCID: PMC2926238 DOI: 10.1016/j.steroids.2010.06.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Revised: 06/24/2010] [Accepted: 06/25/2010] [Indexed: 11/20/2022]
Abstract
Estradiol increases mRNA and/or protein expression of the nitric oxide synthase (NOS) isoforms in a variety of tissues including kidney. In this study we determined the relationship between cyclical variations in estradiol levels and renal function and total NO production in the virgin female rat. In addition, we used an aromatase inhibitor (Anastrozole), to inhibit synthesis of estradiol from testosterone. Estradiol levels were higher in proestrus vs. diestrus, and were markedly suppressed by 7 days treatment with aromatase inhibitor. There was no difference in total NO production (from urinary and plasma nitrate+nitrite=NO(X)) between proestrus and diestrus but aromatase inhibition resulted in increases in total NO production. The renal cortical NOS activity and protein abundance also increased in aromatase-inhibited female rats. There were no differences in blood pressure (BP) in any group but the renal vascular resistance (RVR) was low in proestrus, increased in diestrus and did not change further after aromatase inhibition. In summary, the cyclical changes in renal function correlate with estradiol but not NO levels. Pharmacologic castration with aromatase inhibition leads to a marked increase in total and renal NOS. This contrasts to earlier work where surgical castration causes decreased NOS.
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Affiliation(s)
| | - Vasuki Venkat
- Department of Physiology, West Virginia University, Morgantown, WV
| | - Ernst Beinder
- Department of Obstetrics, University Hospital, Zurich, Switzerland
| | - Chris Baylis
- Department of Physiology and Functional Genomics and Department of Medicine, University of Florida, Gainesville, Fl
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Choi IS. Gender-specific asthma treatment. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2010; 3:74-80. [PMID: 21461245 PMCID: PMC3062799 DOI: 10.4168/aair.2011.3.2.74] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2010] [Accepted: 09/24/2010] [Indexed: 01/16/2023]
Abstract
Because genetic characteristics vary among subjects, the therapeutic effects of a certain drug differ among patients with the same disease. For this reason, special interest has focused on tailored treatments. Although it is well known that sex is genetically determined, little attention has been paid to sex differences in the clinical features and treatment of asthma. Females are more likely to suffer allergic asthma, to have difficulty controlling asthma symptoms, and to show adverse effects to drugs. As asthma symptoms show cyclic changes depending on female hormone levels in many women of child-bearing age, the use of contraceptives may specifically help to treat female patients with asthma such as those with perimenstrual asthma and severe asthma. Generally, testosterone seems to suppress asthma, and dehydroepiandrosterone (DHEA), a less virilizing androgen, may be effective for treating asthma. Evidence exists for a therapeutic and steroid-sparing effect of DHEA. However, further studies on the optimal dose and route of DHEA for each sex are needed. Monitoring of the serum DHEA-S level is necessary for patients with asthma on inhaled steroid treatment, and at minimum, replacement therapy for patients with a low level of DHEA may be helpful for treating their asthma.
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Affiliation(s)
- Inseon S Choi
- Department of Allergy, Chonnam National University Medical School, Gwangju, Korea
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Pereira-Vega A, Sánchez JL, Gil FL, Maldonado JA, Bravo JM, Ignacio JM, Vázquez R, Álvarez F, Romero P, Sánchez I. Premenstrual asthma and symptoms related to premenstrual syndrome. J Asthma 2010; 47:835-40. [PMID: 20874438 DOI: 10.3109/02770903.2010.495810] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND It is unclear whether premenstrual asthma is associated with premenstrual syndrome. The objective of this study is to compare premenstrual symptoms among asthmatic women according to whether they have premenstrual asthma or not. METHODS A questionnaire on respiratory symptoms during a single menstrual cycle was developed for asthmatics of fertile age, together with another on symptoms related to premenstrual syndrome. These included dysphoric-psychiatric symptoms (anxiety, depression, fatigue, irritability, and mood swings), edematous symptoms (abdominal and mammary tension, swelling, acne, and migraine), and other symptoms (leg pains, nausea, sweating, vomiting, and tiredness). Morning and evening peak flow scores were collected to evaluate lung function. Premenstrual asthma was determined to be a ≥ 20% objective exacerbation in the premenstrual phase over the preovulatory phase in terms of both respiratory symptoms and/or peak flow. The intensity of the change in symptoms was evaluated according to the effect size. RESULTS The study examined 103 patients of fertile age, 46 of whom (44.7%) presented with premenstrual asthma. Practically all of the monitored symptoms increased in the premenstrual phase with respect to the preovulatory phase. This increase was greater in women with premenstrual asthma, especially for abdominal tension (effect size .88 against .33; p = .009) and mammary tension (.95 against .49; p = .018). CONCLUSIONS A clear link was found between premenstrual asthma and the premenstrual exacerbation of dysphoric symptoms, and certain edematous symptoms such as abdominal and mammary tension as well as a swelling sensation.
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News in brief. Nat Med 2009. [DOI: 10.1038/nm1209-1344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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