1
|
Muñoz MP, Iglesias V, Saavedra M, Saavedra G, Yohannessen K, Pino P. Urinary Arsenic Concentration and Its Relationship with Bronchial Asthma in Children from Arica, Chile. TOXICS 2022; 10:625. [PMID: 36287905 PMCID: PMC9610820 DOI: 10.3390/toxics10100625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
In the city of Arica, northern Chile, the population has been involuntarily exposed to arsenic of natural and anthropogenic origin. This study aims to evaluate the association between urinary arsenic concentration and bronchial asthma diagnosis in the children of Arica. A cross-sectional analysis of a database of 1892 subjects under 18 years of age enrolled in the Environmental Health Centre between 2009 and 2021 was carried out. Arsenic exposure was obtained from a urine sample and bronchial asthma diagnosis from the database of the system for the management of explicit health guarantees. Logistic regression models were used to assess the association between inorganic arsenic and asthma. The median inorganic arsenic was 15 μg/L, and the prevalence of asthma was 7.4%. After adjusting for sex, age, ethnicity, and urinary creatinine, children with the highest tertile of urinary arsenic concentration (≥21.4 μg/L) had a greater chance of developing asthma (odds ratio (OR) 1.90; 95% confidence interval (CI) [1.13-3.18]). When exploring the modifying effect of ethnicity, the association increased among children belonging to any ethnic group (OR 3.51, 95%CI [1.43-8.65]). These findings suggest a relationship between arsenic exposure and bronchial asthma in children. While further studies are needed to assess the impact of arsenic on respiratory health, mitigation efforts to reduce arsenic exposure should be maintained.
Collapse
Affiliation(s)
- María Pía Muñoz
- Programa Doctorado en Salud Pública, Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Independencia 939, Santiago 8380453, Chile
| | - Verónica Iglesias
- Programa de Epidemiología, Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Independencia 939, Santiago 8380453, Chile
| | - Marta Saavedra
- Departamento de Salud Pública, Secretaría Regional Ministerial de Salud Arica y Parinacota, Maipú 410, Arica 1000426, Chile
| | - Gina Saavedra
- Departamento de Salud Pública, Secretaría Regional Ministerial de Salud Arica y Parinacota, Maipú 410, Arica 1000426, Chile
| | - Karla Yohannessen
- Programa de Epidemiología, Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Independencia 939, Santiago 8380453, Chile
| | - Paulina Pino
- Programa de Epidemiología, Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Independencia 939, Santiago 8380453, Chile
| |
Collapse
|
2
|
HSP70 upregulation in nasal mucosa of symptomatic children with allergic rhinitis and potential risk of asthma development. Sci Rep 2022; 12:14104. [PMID: 35982171 PMCID: PMC9388484 DOI: 10.1038/s41598-022-18443-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/11/2022] [Indexed: 11/18/2022] Open
Abstract
Allergic rhinitis and asthma are the most common causes of chronic inflammation of the upper and lower airways in childhood. However, a nasal biomarker that can link to pulmonary inflammation is yet to be found. The present paper aims to investigate the possible role in inflammation of two inducible 70-kDa Heat Shock Proteins (HSP70) members, HSPA1A/B and HSPA6, in nasal mucosa cells of allergic children through their mRNA expression analysis, and their correlation to both spirometric and FeNO values. The relationship between FeNO in lower airways and ∆Cts of HSPA1A/B in nasal mucosa seems to be influenced by clinical symptoms regardless of age, sex, and sensitization patterns. Therefore, HSP70 expression, as well as FeNO levels, could have a predictive capability to identify lower airways inflammation and thus to recognize rhinitic children having a potential risk of asthma development.
Collapse
|
3
|
Current Insights into Atopic March. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8111067. [PMID: 34828780 PMCID: PMC8620020 DOI: 10.3390/children8111067] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/10/2021] [Accepted: 11/16/2021] [Indexed: 11/20/2022]
Abstract
The incidence of allergic diseases is increasing, and research on their epidemiology, pathophysiology, and the prevention of onset is urgently needed. The onset of allergic disease begins in infancy with atopic dermatitis and food allergy and develops into allergic asthma and allergic rhinitis in childhood; the process is defined as “atopic march”. Atopic march is caused by multiple immunological pathways, including allergen exposure, environmental pollutants, skin barrier dysfunction, type 2 inflammation, and oxidative stress, which promote the progression of atopic march. Using recent evidence, herein, we explain the involvement of allergic inflammatory conditions and oxidative stress in the process of atopic march, its epidemiology, and methods for prevention of onset.
Collapse
|
4
|
Taniguchi A, Tsuge M, Miyahara N, Tsukahara H. Reactive Oxygen Species and Antioxidative Defense in Chronic Obstructive Pulmonary Disease. Antioxidants (Basel) 2021; 10:antiox10101537. [PMID: 34679673 PMCID: PMC8533053 DOI: 10.3390/antiox10101537] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 02/06/2023] Open
Abstract
The respiratory system is continuously exposed to endogenous and exogenous oxidants. Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation of the airways, leading to the destruction of lung parenchyma (emphysema) and declining pulmonary function. It is increasingly obvious that reactive oxygen species (ROS) and reactive nitrogen species (RNS) contribute to the progression and amplification of the inflammatory responses related to this disease. First, we described the association between cigarette smoking, the most representative exogenous oxidant, and COPD and then presented the multiple pathophysiological aspects of ROS and antioxidative defense systems in the development and progression of COPD. Second, the relationship between nitric oxide system (endothelial) dysfunction and oxidative stress has been discussed. Third, we have provided data on the use of these biomarkers in the pathogenetic mechanisms involved in COPD and its progression and presented an overview of oxidative stress biomarkers having clinical applications in respiratory medicine, including those in exhaled breath, as per recent observations. Finally, we explained the findings of recent clinical and experimental studies evaluating the efficacy of antioxidative interventions for COPD. Future breakthroughs in antioxidative therapy may provide a promising therapeutic strategy for the prevention and treatment of COPD.
Collapse
Affiliation(s)
- Akihiko Taniguchi
- Department of Hematology, Oncology, Allergy and Respiratory Medicine, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan;
| | - Mitsuru Tsuge
- Department of Pediatrics, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan;
| | - Nobuaki Miyahara
- Department of Medical Technology, Okayama University Academic Field of Health Sciences, Okayama 700-8558, Japan;
| | - Hirokazu Tsukahara
- Department of Pediatrics, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan;
- Correspondence:
| |
Collapse
|
5
|
Fainardi V, Saglani S. An approach to the management of children with problematic severe asthma. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020055. [PMID: 32921752 PMCID: PMC7717010 DOI: 10.23750/abm.v91i3.9603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 12/18/2022]
Abstract
Children with poor asthma control despite high levels of prescribed treatment are described as having problematic severe asthma. Most of these children have steroid sensitive disease which improves with adherence to daily inhaled corticosteroids and after having removed modifiable factors like poor inhalation technique, persistent adverse environmental exposures and psychosocial factors. These children are described as having “difficult-to-treat asthma” while children with persistent symptoms despite above-mentioned factors having been addressed are described as having “severe therapy-resistant asthma”. In this review, we will describe the 6-step approach to the diagnosis and management of a child with problematic severe asthma adopted by The Royal Brompton Hospital (London, UK). The role of a multidisciplinary team is crucial for identification and treatment of modifiable factors and comorbidities in order to avoid invasive examinations and useless pharmacological treatments. The current knowledge on add-on therapies will be discussed.
Collapse
Affiliation(s)
| | - Sejal Saglani
- Department of Respiratory Paediatrics, Royal Brompton and Harefield NHS Foundation Trust, London, UK..
| |
Collapse
|
6
|
Heffler E, Carpagnano GE, Favero E, Guida G, Maniscalco M, Motta A, Paoletti G, Rolla G, Baraldi E, Pezzella V, Piacentini G, Nardini S. Fractional Exhaled Nitric Oxide (FENO) in the management of asthma: a position paper of the Italian Respiratory Society (SIP/IRS) and Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC). Multidiscip Respir Med 2020; 15:36. [PMID: 32269772 PMCID: PMC7137762 DOI: 10.4081/mrm.2020.36] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 02/05/2020] [Indexed: 02/08/2023] Open
Abstract
Asthma prevalence in Italy is on the rise and is estimated to be over 6% of the general population. The diagnosis of asthma can be challenging and elusive, especially in children and the last two decades has brought evidences that asthma is not a single disease but consists of various phenotypes. Symptoms can be underestimated by the patient or underreported to the clinician and physical signs can be scanty. Usual objective measures, like spirometry, are necessary but sometimes not significant. Despite proper treatment, asthma can be a very severe condition (even leading to death), however new drugs have recently become available which can be very effective in its control. Since asthma is currently thought to be caused by inflammation, a direct measure of the latter can be of paramount importance. For this purpose, the measurement of Fractional Exhaled Nitric Oxide (FENO) has been used since the early years of the current century as a non-invasive, easy-to-assess tool useful for diagnosing and managing asthma. This SIP-IRS/SIAAIC Position Paper is a narrative review which summarizes the evidence behind the usefulness of FENO in the diagnosis, management and phenotypization of asthma.
Collapse
Affiliation(s)
- Enrico Heffler
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano (MI).,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI)
| | - Giovanna Elisiana Carpagnano
- Department of Medical and Surgical Sciences, University of Foggia; Section of Respiratory Diseases, Hospital d'Avanzo, Foggia
| | - Elisabetta Favero
- Department of Medicine-DIMED, Immunological and Respiratory Rare Disease, Allergologic Clinic Ca' Foncello Hospital, Treviso
| | - Giuseppe Guida
- Allergy and Pneumology Unit, A.O. S. Croce e Carle, Cuneo
| | - Mauro Maniscalco
- Respiratory Rehabilitation Unit, ICS Maugeri, Institute of Telese Terme IRCCS
| | - Andrea Motta
- Institute of Biomolecular Chemistry, National Research Council, Pozzuoli (NA)
| | - Giovanni Paoletti
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano (MI).,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI)
| | - Giovanni Rolla
- Allergy and Clinical Immunology, University of Turin and A.O. Mauriziano, Turin
| | - Eugenio Baraldi
- Department of Woman's and Child's Health, University Hospital of Padua
| | - Vincenza Pezzella
- Department of Woman, Child and of General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples
| | - Giorgio Piacentini
- Paediatric Section, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona
| | - Stefano Nardini
- Italian Respiratory Society-Società Italiana di Pneumologia, Milan, Italy
| |
Collapse
|
7
|
Parisi GF, Papale M, Tardino L, Nenna R, Midulla F, Leonardi S. Biomarkers in Pediatric Lung Diseases Including Cystic Fibrosis. CURRENT RESPIRATORY MEDICINE REVIEWS 2020. [DOI: 10.2174/1573398x15666190521112824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In recent decades, scientific studies of chemical processes involving metabolites have been
steadily increasing, indicating that we are well into the metabolomics era. This has resulted in
numerous studies that explore the field of biomarkers. One of the medical areas most concerned with
these innovations is certainly that of childhood respiratory disorders, including asthma and cystic
fibrosis. This current study is a review of the literature about biomarkers used or studied in the field
of pediatric pulmonology, including asthma and cystic fibrosis.
Collapse
Affiliation(s)
- Giuseppe Fabio Parisi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Maria Papale
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Lucia Tardino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Raffaella Nenna
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - Fabio Midulla
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | | |
Collapse
|
8
|
Venkatesh HN, Ravish H, Wilma Delphine Silvia CR, Srinivas H. Molecular Signature of the Immune Response to Yoga Therapy in Stress-related Chronic Disease Conditions: An Insight. Int J Yoga 2020; 13:9-17. [PMID: 32030016 PMCID: PMC6937878 DOI: 10.4103/ijoy.ijoy_82_18] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The world Health Organization defines health as complete well-being in terms of physical, mental and social, and not merely the absence of disease. To attain this, individual should adapt and self-mange the social, physical and emotional challenges of life. Exposure to chronic stress due to urbanization, work stress, nuclear family, pollution, unhealthy food habits, lifestyle, accidental death in the family, and natural calamities are the triggering factors, leading to hormonal imbalance and inflammation in the tissue. The relationship between stress and illness is complex; all chronic illnesses such as cardiovascular disease and asthma have their root in chronic stress attributed by inflammation. In recent times, yoga therapy has emerged as an important complementary alternative medicine for many human diseases. Yoga therapy has a positive impact on mind and body; it acts by incorporating appropriate breathing techniques and mindfulness to attain conscious direction of our awareness of the present moment by meditation, which helps achieve harmony between the body and mind. Studies have also demonstrated the important regulatory effects of yoga therapy on brain structure and functions. Despite these advances, the cellular and molecular mechanisms by which yoga therapy renders its beneficial effects are inadequately known. A growing body of evidence suggests that yoga therapy has immunomodulatory effects. However, the precise mechanistic basis has not been addressed empirically. In this review, we have attempted to highlight the effect of yoga therapy on immune system functioning with an aim to identify important immunological signatures that index the effect of yoga therapy. Toward this, we have summarized the available scientific evidence showing positive impacts of yoga therapy. Finally, we have emphasized the efficacy of yoga in improving physical and mental well-being. Yoga has been a part of Indian culture and tradition for long; now, the time has come to scientifically validate this and implement this as an alternative treatment method for stress-related chronic disease.
Collapse
Affiliation(s)
- H N Venkatesh
- Department of Human Genetics, NIMHANS, Bangalore, India
| | - H Ravish
- Department of Neurochemistry, NIMHANS, Bangalore, India
| | - C R Wilma Delphine Silvia
- Department of Biochemistry, Bowring and Lady Curzon Medical College and Research Institute, Bangalore, India
| | - H Srinivas
- Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
| |
Collapse
|
9
|
Eftekhar N, Moghimi A, Mohammadian Roshan N, Saadat S, Boskabady MH. Immunomodulatory and anti-inflammatory effects of hydro-ethanolic extract of Ocimum basilicum leaves and its effect on lung pathological changes in an ovalbumin-induced rat model of asthma. Altern Ther Health Med 2019; 19:349. [PMID: 31801507 PMCID: PMC6894265 DOI: 10.1186/s12906-019-2765-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 11/21/2019] [Indexed: 02/06/2023]
Abstract
Background Ocimum species (Lamiaceae) has been traditionally used for treatment of upper respiratory tract infections, bronchitis, coughs, sore throat, and wound healing. The Immunomodulatory and anti-inflammatory effects of hydro-ethanolic extract of Ocimum basilicum (O. basilicum) leaves was examined in ovalbumin sensitized animals. Methods Wistar rats were divided to six groups; non-sensitized, sensitized to ovalbumin, sensitized and treated with dexamethasone (1.25 μg/mL), and O. basilicum extract (0.75, 1.50 and 3.00 mg/mL) in drinking water for 21 days. The levels of interleukin 4 (IL-4), interferon gamma (IFN-γ), IFN-γ/IL-4 ratio, immunoglobulin E (IgE), phospholipase A2 (PLA2) and total protein (TP) in BALF, and lung pathological changes were examined. Results A significant increase in IL-4, IgE, PLA2 and TP levels, all lung pathological indices as well as significant decrease in IFN-γ/IL-4 ratio was seen in the asthmatic compared to the control rats (P < 0.05 to P < 0.001). Treatment with O. basilicum extract resulted in decreased IL-4, IgE, PLA2 and TP levels, but increased IFN-γ/IL-4 ratio compared to untreated sensitized rats (P < 0.01 to P < 0.001). The plant significantly improved the pathological changes of sensitized rats (P < 0.05 to P < 0.01). The improvement effects of higher concentrations of the O. basilicum extract were significantly more than those of dexamethasone (P < 0.05 to P < 0.001). Conclusion The improvement effects of O. basilicum on pathological changes, immunological and inflammatory markers in sensitized rats comparable or even more potent than dexamethasone suggests the therapeutic potential of the plant in asthma.
Collapse
|
10
|
Lin HH, Hung YP, Weng SH, Lee PY, Sun WZ. Effects of parent-based social media and moderate exercise on the adherence and pulmonary functions among asthmatic children. Kaohsiung J Med Sci 2019; 36:62-70. [PMID: 31512391 DOI: 10.1002/kjm2.12126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 08/12/2019] [Indexed: 11/06/2022] Open
Abstract
Our previous study showed Tai-Chi-Chuan (TCC) training, a moderate exercise, at school improved pulmonary function and inflammation profiles in children with mild asthma. However, habitual practice is hard to maintain with the lack of continuous family and peer support. We investigated whether parental intervention with social media could enhance children's adherence to exercise at home and improve asthmatic outcome measures. Parents were opted to attend a 12-week TCC classroom training, supervise home practice, and report to a four-step web-based social media platform to stay updated and motivated through logging activity and tracking competition. Fractional exhaled nitric oxide (FeNO), FEV1/FVC and peak expiratory flow (PEF) were measured before and after 12 weeks of training. Fifty-three asthmatic children were allocated into non-TCC (control, n = 12), TCC groups with moderate-to-severe (TCC-S, n = 26) and mild-to-moderate (TCC-M, n = 15) asthma. We found both TCC groups exhibited better pulmonary function than the non-TCC control. TCC increased FVC in mild-to-moderate asthma children while more pronounced improvement in FEV1, FEV1/FVC, PEF and FeNO was noticed in moderate-to-severe asthmatic children. All TCC subjects retained greater participation and better interaction online except for low-ranking families who dramatically dropped their practice 9 weeks later. For asthmatic children, moderate exercise improves pulmonary functions in a severity-dependent fashion. Parent-based Learn-Practice-Persuade-Award wheel is a useful platform to motivate children engagement in physical activity. Classical social persuasive skills could enhance general parent-child relationship but tend to decrease in persuasiveness over time in low-ranking families.
Collapse
Affiliation(s)
- Han-Hong Lin
- Graduate Institute of Networking and Multimedia, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan
| | - Yi-Ping Hung
- Graduate Institute of Networking and Multimedia, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Animation and Film Art, Tainan National University of the Arts, Tainan, Taiwan
| | | | | | - Wei-Zen Sun
- Department of Anaesthesiology, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
11
|
Pappalardo MG, Parisi GF, Tardino L, Savasta S, Brambilla I, Marseglia GL, Licari A, Leonardi S. Measurement of nitric oxide and assessment of airway diseases in children: an update. Minerva Pediatr 2019; 71:524-532. [PMID: 31352766 DOI: 10.23736/s0026-4946.19.05513-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Nitric oxide (NO) is a gas synthesized by the inducible NO synthase enzyme in airway cells and it is thought to make important functions in the airway inflammation of several respiratory diseases. EVIDENCE ACQUISITION This current study is a review of the literature from 1990 to present about NO and its use in clinical practice. The databases used were PubMed, Scopus, and Cochrane Library. EVIDENCE SYNTHESIS At the respiratory level there are three different measurements sites of NO: nNO (nasal nitric oxide), FeNO (exhaled fraction of nitric oxide), CaNO (alveolar nitric oxide). Each of them is produced at different levels of the respiratory tract and is involved in various diseases. nNO finds its use, principally, in the allergic rhinitis in fact it can be used as a measure of therapeutic efficacy, but not for the evaluation of the severity; also in primary ciliary dyskinesia (PCD), where high levels exclude the disease, and in chronic rhinosinusitis, but it is not currently used as a diagnostic or prognostic marker. FeNO has a greatest use in bronchial asthma, particularly, it is considered a non-invasive biomarker to identify and to monitor airway inflammation but currently, there is not a consensus on the use of the FeNO in the management of asthma treatment. Finally, CaNO is the least used in clinical practice, because lack of standardization of measurement techniques. CONCLUSIONS Nitric oxide is a sensitive indicator of the presence of airway inflammation and ciliary dysfunction, although some studies have shown varying or conflicting results.
Collapse
Affiliation(s)
- Maria G Pappalardo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giuseppe F Parisi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy -
| | - Lucia Tardino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Salvatore Savasta
- Department of Pediatrics, San Matteo Polyclinic, IRCCS and Foundation, University of Pavia, Pavia, Italy
| | - Ilaria Brambilla
- Department of Pediatrics, San Matteo Polyclinic, IRCCS and Foundation, University of Pavia, Pavia, Italy
| | - Gian L Marseglia
- Department of Pediatrics, San Matteo Polyclinic, IRCCS and Foundation, University of Pavia, Pavia, Italy
| | - Amelia Licari
- Department of Pediatrics, San Matteo Polyclinic, IRCCS and Foundation, University of Pavia, Pavia, Italy
| | - Salvatore Leonardi
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| |
Collapse
|
12
|
Eftekhar N, Moghimi A, Hossein Boskabady M, Kaveh M, Shakeri F. Ocimum basilicum affects tracheal responsiveness, lung inflammatory cells and oxidant-antioxidant biomarkers in sensitized rats. Drug Chem Toxicol 2018; 42:286-294. [PMID: 29683006 DOI: 10.1080/01480545.2018.1459672] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The anti-inflammatory and antioxidant effects of Ocimum basilicum (O. basilicum) was shown previously. In the present study, the effect of O. basilicum on tracheal responsiveness (TR) to methacholine and ovalbumin (OVA), bronchoalveolar lavage fluid (BALF) levels of oxidant-antioxidant biomarkers as well as total and differential white blood cell (WBC) in sensitized rats was examined. Six groups of rats including control (group C), sensitized rats to OVA (group S), S groups treated with three concentrations of O. basilicum (0.75, 1.50, and 3.00 mg/ml) and one concentration of dexamethasone (1.25 μg/ml) (n = 8 for all groups) were studied. TR to methacholine and OVA, total WBC count, percentages of eosinophils, monocytes, neutrophils, and levels of oxidant biomarkers were significantly increased but other measured parameters were significantly decreased in group S compared to group C. TR to methacholine and OVA, percentages of eosinophils, monocytes, neutrophils, and levels of oxidant biomarkers were significantly decreased but lymphocytes and antioxidant biomarkers were significantly increased in S groups treated with dexamethasone and at least two higher concentrations of the extract compared to group S. Total WBC count was also decreased in treated S groups with dexamethasone and high extract concentration. The effect of extract on most measured parameters was significantly lower than dexamethasone treatment. The effects of two higher concentrations of the extract on most variables were significantly higher than the effect of low extract concentration. These results showed the concentration-dependent effect of O. basilicum on tracheal responses, lung inflammatory cells, and oxidant-antioxidant parameters in sensitized rats.
Collapse
Affiliation(s)
- Naeima Eftekhar
- a Department of Biology, Faculty of Science , Ferdowsi University of Mashhad , Mashhad , Iran
| | - Ali Moghimi
- a Department of Biology, Faculty of Science , Ferdowsi University of Mashhad , Mashhad , Iran
| | - Mohammad Hossein Boskabady
- b Neurogenic Inflammation Research Center , Mashhad University of Medical Sciences , Mashhad , Iran.,c Department of Physiology, School of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Mahsa Kaveh
- d Department of Biology , Science and Research Branch, Islamic Azad University , Tehran , Iran
| | - Farzaneh Shakeri
- e Natural Products and Medicinal Plants Research Center , North Khorasan University of Medical Sciences , Bojnurd , Iran
| |
Collapse
|
13
|
Tai-Chi-Chuan Exercise Improves Pulmonary Function and Decreases Exhaled Nitric Oxide Level in Both Asthmatic and Nonasthmatic Children and Improves Quality of Life in Children with Asthma. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:6287642. [PMID: 28491110 PMCID: PMC5406730 DOI: 10.1155/2017/6287642] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 06/19/2016] [Accepted: 03/21/2017] [Indexed: 01/07/2023]
Abstract
Tai-Chi-Chuan (TCC) is an exercise of low-to-moderate intensity which is suitable for asthmatic patients. The aim of our study is to investigate improvements of the lung function, airway inflammation, and quality of life of asthmatic children after TCC. Participants included sixty-one elementary school students and they were divided into asthmatic (n = 29) and nonasthmatic (n = 32) groups by the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Among them, 20 asthmatic and 18 nonasthmatic children volunteered to participate in a 60-minute TCC exercise weekly for 12 weeks. Baseline and postintervention assessments included forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR), fractional exhaled nitric oxide (FeNO) level, and Standardised Pediatric Asthma Quality of Life Questionnaire (PAQLQ(S)). After intervention, the level of FeNO decreased significantly; PEFR and the FEV1/FVC also improved significantly in both asthmatic group and nonasthmatic group after TCC. The asthmatic children also had improved quality of life after TCC. The results indicated that TCC could improve the pulmonary function and decrease airway inflammation in both children with mild asthma and those without asthma. It also improves quality of life in mild asthmatic children. Nevertheless, further studies are required to determine the effect of TCC on children with moderate-to-severe asthma.
Collapse
|
14
|
Harnan SE, Essat M, Gomersall T, Tappenden P, Pavord I, Everard M, Lawson R. Exhaled nitric oxide in the diagnosis of asthma in adults: a systematic review. Clin Exp Allergy 2017; 47:410-429. [PMID: 27906490 DOI: 10.1111/cea.12867] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 10/24/2016] [Accepted: 11/01/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To identify and synthesize evidence on the diagnostic accuracy of FE NO for asthma in adults. MATERIALS AND METHODS Systematic searches (nine key biomedical databases and trial registers) were carried out on November 2014. Records were included if they recruited patients with the symptoms of asthma; used a single set of inclusion criteria; measured FE NO50 in accordance with American Thoracic Society guidelines, 2005 (off-line excluded); reported/allowed calculation of true-positive, true-negative, false-positive and false-negative patients as classified against any reference standard. Study quality was assessed using QUADAS II. Meta-analysis was planned where clinical study heterogeneity allowed. Rule-in and rule-out uses of FE NO were considered. RESULTS A total of 4861 records were identified originally and 1312 in an update. Twenty-seven studies were included. Heterogeneity precluded meta-analysis. Results varied even within subgroups of studies. Cut-off values for the best sum of sensitivity and specificity varied from 12 to 55 p.p.b., but did not produce high accuracy. 100% sensitivity or 100% specificity was reported by some studies indicating potential use as a rule-in or rule-out strategy. CONCLUSIONS AND CLINICAL RELEVANCE FE NO50 had variable diagnostic accuracy even within subgroups of studies with similar characteristics. Diagnostic accuracy, optimal cut-off values and best position for FE NO50 within a pathway remain poorly evidenced.
Collapse
Affiliation(s)
- S E Harnan
- Health Economics and Decision Science, ScHARR, University of Sheffield, Sheffield, UK
| | - M Essat
- Health Economics and Decision Science, ScHARR, University of Sheffield, Sheffield, UK
| | - T Gomersall
- Health Economics and Decision Science, ScHARR, University of Sheffield, Sheffield, UK
| | - P Tappenden
- Health Economics and Decision Science, ScHARR, University of Sheffield, Sheffield, UK
| | - I Pavord
- Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - M Everard
- School of Paediatrics & Child Health, Princess Margaret Hospital, University of Western Australia, Crawley, WA, Australia
| | - R Lawson
- Department of Respiratory Medicine, Royal Hallamshire Hospital, Sheffield, UK
| |
Collapse
|
15
|
Gomersal T, Harnan S, Essat M, Tappenden P, Wong R, Lawson R, Pavord I, Everard ML. A systematic review of fractional exhaled nitric oxide in the routine management of childhood asthma. Pediatr Pulmonol 2016; 51:316-28. [PMID: 26829581 DOI: 10.1002/ppul.23371] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 08/11/2015] [Accepted: 08/22/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Fractional exhaled nitric oxide (FeNO) is a non-invasive biomarker of eosinophilic inflammation which may be used to guide the management of asthma in childhood. OBJECTIVES To synthesise the available evidence on the efficacy of FeNO-guided management of childhood asthma. METHODS Databases including MEDLINE and the Cochrane Library were searched, and randomised controlled trials (RCTs) comparing FeNO-guided management with any other monitoring strategy were included. Study quality was assessed using the Cochrane risk of bias tool for RCTs, and a number of outcomes were examined, including: exacerbations, medication use, quality of life, adverse events, and other markers of asthma control. Meta-analyses were planned if multiple studies with suitable heterogeneity were available. However, due to wide variations in study characteristics, meta-analysis was not possible. RESULTS Seven RCTs were identified. There was some evidence that FeNO-guided monitoring results in improved asthma control during the first year of management, although few results attained statistical significance. The impact on severe exacerbations was unclear. Similarly, the impact on use of anti-asthmatic drugs was unclear, and appears to depend on the step up/down protocols, and the clinical characteristics of patients. CONCLUSIONS The potential benefit of FeNO monitoring is equivocal. Trends toward reduced exacerbation and increased medication use were seen, but typically failed to reach statistical significance. There are a number of issues that complicate data interpretation, including differences in the likely severity of included cohorts and variations in treatment algorithms. Further work is needed to systematically explore the impact of these parameters.
Collapse
Affiliation(s)
- Tim Gomersal
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Sue Harnan
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Munira Essat
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Paul Tappenden
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Ruth Wong
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Rod Lawson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Ian Pavord
- University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Mark Lloyd Everard
- School of Paediatrics and Child Health, Princess Margaret Hospital, Respiratory Medicine, University of Western Australia, Crawley, Australia
| |
Collapse
|
16
|
Sayão LB, de Britto MCA, Burity E, Rattes C, Reinaux CMA, Fink J, Dornelas de Andrade A. Exhaled nitric oxide as a diagnostic tool for wheezing in preschool children: A diagnostic accuracy study. Respir Med 2016; 113:15-21. [PMID: 27021575 DOI: 10.1016/j.rmed.2016.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 02/16/2016] [Accepted: 02/18/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Airways inflammation may precede pulmonary dysfunction in wheezing individuals. The fraction of exhaled nitric oxide (FENO) has been described as a useful method for wheezing diagnosis in children, however, its application requires evidence. This study aimed to determine the accuracy of FENO in identifying wheezing in preschoolers. METHODS A cross-sectional study was carried out with children from 3 to 5 years old, from Brazilian day care centers and public schools. They were evaluated by FENO measurement through the single breath method, and by ATS-DLD-78-C questionnaire that is used as a gold standard to phenotype wheezing patterns. RESULTS The sample consisted of 243 non-wheezing children, 118 non-recurrent wheezing and 62 recurrent wheezing. The means of FENO and confidence intervals of 95%, were 5.4 (CI 95%, 5.2-5.6); 7.5 (CI 95%, 6.9-8.2) and 11.2 (CI 95%, 9.6-12.7), respectively. The sensitivity, specificity, positive and negative predictive FENO values in the 6 parts per billion (ppb) cut-off point that best diagnosed wheezing of non-wheezing children, were: 65.5%, 84.3%, 75.6% and 76.7%, respectively, with an area under the curve (AUC) = 0.77. At 10 ppb, the best cut-off points for differentiating recurrent wheezing of non-recurrent wheezing were: 56.4%, 81.3%, 61.4%, 78.0%, respectively, with an AUC = 0.69. The post-test probability for each FENO cut-off points was increased by 33% for wheezing and 20% for recurrent wheezing diagnosis when associated with clinical examination. CONCLUSION FENO can provide a reliable and accurate method to discriminate the presence and type of wheezing in preschoolers with 92% of acceptable in this study population.
Collapse
Affiliation(s)
| | | | - Edjane Burity
- Department of Pediatric Pneumology, Instituto de Medicina Integral Fernando Figueira - IMIP, Recife, Brazil
| | - Catarina Rattes
- Department of Physiotherapy, Universidade Federal de Pernambuco, Recife, Brazil
| | | | - James Fink
- Rush University Medical Center, Georgia State University, USA
| | | |
Collapse
|
17
|
Receptor of advanced glycation end products in childhood asthma exacerbation. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2016. [DOI: 10.1016/j.ejcdt.2015.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
18
|
Korhonen PH, Suursalmi PH, Kopeli T, Nieminen R, Lehtimäki L, Luukkaala T, Korppi M, Saari A, Moilanen E, Tammela OKT. Inflammatory activity at school age in very low birth weight bronchopulmonary dysplasia survivors. Pediatr Pulmonol 2015; 50:683-90. [PMID: 24668942 DOI: 10.1002/ppul.23038] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 02/28/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Airway inflammation is involved in the pathogenesis of bronchopulmonary dysplasia (BPD). The aim of the study was to evaluate the inflammatory activity in plasma and exhaled air in very low birth weight (VLBW) BPD survivors at school age. METHODS Twenty-one 6-14-year-old former VLBW (birth weight ≤1,500 g) children with severe radiographic BPD (radBPD), 19 without radBPD (nonBPD group) and 19 non-asthmatic term controls underwent measurement of eosinophil cationic protein, IL-6, IL-8, adiponectin, adipsin, leptin, and resistin in plasma, leukotriene B4 and 8-isoprostane in exhaled breath condensate, and NO in exhaled breath. Background data were obtained from patient records, clinical examination and parental questionnaire. Both univariate and multivariate models were applied in the statistical analysis. RESULTS There were no significant differences between the groups in any of the inflammatory markers measured. Five (25%) radBPD and 2 (11%) nonBPD children reported asthma (P = 0.058). In logistic regression analysis, exposure to chorioamnionitis was associated with low IL-8 (OR 29.0, 95% CI 3.27-258) and postnatal corticosteroid therapy with high adiponectin (OR 32.0, 95% CI 1.29-793). High body mass index standard deviation score (BMI-SDS) was associated with high plasma adipsin (OR 2.47, 95% CI 1.07-5.75) and leptin (OR 5.76, 95%CI 1.83-18.2) levels. CONCLUSIONS The inflammatory activity seems to decrease by school age in VLBW BPD survivors. Chorioamnionitis and postnatal corticosteroid treatment may modulate the inflammatory responsiveness in VLBW subjects even up to school age. The respiratory outcome in VLBW infants might be improved by preventing excessive weight gain.
Collapse
Affiliation(s)
- Päivi H Korhonen
- Tampere Center for Child Health Research, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Piia H Suursalmi
- Tampere Center for Child Health Research, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Tarja Kopeli
- Department of Pediatrics, Päijät-Häme Central Hospital, Lahti, Finland
| | - Riina Nieminen
- The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Lauri Lehtimäki
- The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland.,Allergy Centre, Tampere University Hospital, Tampere, Finland
| | - Tiina Luukkaala
- Science Center, Pirkanmaa Hospital District and School of Health Sciences, University of Tampere, Tampere, Finland
| | - Matti Korppi
- Tampere Center for Child Health Research, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Antti Saari
- Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Eeva Moilanen
- The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Outi K T Tammela
- Tampere Center for Child Health Research, Tampere University Hospital and University of Tampere, Tampere, Finland
| |
Collapse
|
19
|
Gomes ELDFD, Costa D. Evaluation of functional, autonomic and inflammatory outcomes in children with asthma. World J Clin Cases 2015; 3:301-309. [PMID: 25789303 PMCID: PMC4360502 DOI: 10.12998/wjcc.v3.i3.301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 11/18/2014] [Accepted: 12/19/2014] [Indexed: 02/05/2023] Open
Abstract
Asthma is common in childhood. This respiratory disease is characterized by persistent inflammation of the airways even when the child is not in the throes of an attack. Chronic inflammation is caused by an imbalance between pro-inflammatory and anti-inflammatory mechanisms as well as autonomic dysfunction, which plays an important role in the pathogenesis and control of this condition. The impact of these physiopathological aspects leads to inactivity and a sedentary lifestyle, which exerts an influence on functional capacity and control of the disease. The main objective of non-pharmacological therapy is the clinical control of asthma and the minimization of airway obstruction and hyperinflation during an attack. These factors can be controlled with noninvasive ventilation. The aim or the present review was to describe important neural, inflammatory and functional mechanisms that affect children with asthma.
Collapse
|
20
|
Brown SB, Reeves KW, Bertone-Johnson ER. Maternal folate exposure in pregnancy and childhood asthma and allergy: a systematic review. Nutr Rev 2014; 72:55-64. [PMID: 24551950 DOI: 10.1111/nure.12080] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Adequate folate status in early pregnancy is critical to prevent congenital malformations, yet little is known about whether exposure to folate, specifically folic acid supplementation beyond the recommended dose, influences chronic health outcomes. The link between maternal folate levels and risk of childhood asthma and allergic disease has been investigated in 10 large prospective cohort studies that reported conflicting results. While the majority of studies reported no association, those supporting a positive relationship found a small increase in risk that was generally transient in nature, confined to early childhood, and associated with folic acid supplementation in late pregnancy. This systematic review presents background information on maternal folate exposure and childhood asthma, synthesizes the current epidemiologic evidence in the context of the methodological differences among studies and their potential limitations, and offers direction for future research.
Collapse
|
21
|
Abstract
OBJECTIVE Oxidative stress plays an important role in inflammatory diseases of the airways, such as bronchial asthma. This study highlights the effects of the imbalance of oxidant/antioxidant parameters and their roles in the severity of asthma, in order to target the deficiency of antioxidants when treating asthmatic patients. METHODS The study included 45 male and 45 female subjects, aged 18-48 years, with and without asthma. They were classified into 3 groups: G1 was healthy volunteers (CT, n = 15), G2 included patients with stable (chronic) conditions of asthma from the outpatients department (OP, n = 15), and G3 included patients admitted emergency room (ER, n = 15) with acute asthma attacks. For all subjects, the levels of total antioxidant capacity (TAC), reduced glutathione (GSH), malondialdehyde (MDA), and uric acid were colorimetrically estimated. The correlations between the studied parameters were statistically analyzed. RESULTS The levels of TAC and GSH in asthmatic patients, either male or female, were significantly decreased in the ER more than in the OP group as compared to the control (p < 0.001). MDA increased significantly in the ER group and over the OP group when compared with healthy subjects. Significant positive correlations (p < 0.001) were observed between MDA and other studied parameters TAC (r = -0.74), GSH (r = -0.69), and uric acid (r = -0.35). CONCLUSIONS The levels of total antioxidants were inversely related to the severity of asthma as observed in asthmatic patients visiting outpatient clinics and patients with acute asthmatic attacks admitted to emergency rooms. Meanwhile, those patients with acute attacks showed increased oxidative stress as reflected in the raised MDA levels.
Collapse
Affiliation(s)
- Sameer Hasan Fatani
- Department of Biochemistry, Faculty of Medicine, Umm AI-Qura University , Abdia, Makkah , K.S.A
| |
Collapse
|
22
|
de Paiva ACZ, Marson FADL, Ribeiro JD, Bertuzzo CS. Asthma: Gln27Glu and Arg16Gly polymorphisms of the beta2-adrenergic receptor gene as risk factors. Allergy Asthma Clin Immunol 2014; 10:8. [PMID: 24499171 PMCID: PMC3930554 DOI: 10.1186/1710-1492-10-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 01/14/2014] [Indexed: 12/17/2022] Open
Abstract
Background Asthma is caused by both environmental and genetic factors. The ADRB2 gene, which encodes the beta 2-adrenergic receptor, is one of the most extensively studied genes with respect to asthma prevalence and severity. The Arg16Gly (+46A > G) and Gln27Glu (+79C > G) polymorphisms in the ADRB2 gene cause changes in the amino acids flanking the receptor ligand site, altering the response to bronchodilators and the risk of asthma through complex pathways. The ADRB2 polymorphisms affect beta-adrenergic bronchodilator action and are a tool to identify at-risk populations. Objective To determine the frequency of these two polymorphisms in allergic asthma patients and healthy subjects and to correlate these data with the occurrence and severity of asthma. Methods Eighty-eight allergic asthma patients and 141 healthy subjects were included in this study. The ADRB2 polymorphisms were analyzed using the amplification-refractory mutation system – polymerase chain reaction (ARMS-PCR) technique. The statistical analysis was performed with the SPSS 21.0 software using the Fisher’s Exact and χ2 tests. Results The ADRB2 polymorphisms were associated with asthma occurrence. The Arg16Arg, Gln27Gln and Gln27Glu genotypes were risk factors; the odds ratios were 6.782 (CI = 3.07 to 16.03), 2.120 (CI = 1.22 to 3.71) and 8.096 (CI = 3.90 to 17.77), respectively. For the Gly16Gly and Glu27Glu genotypes, the odds ratios were 0.312 (CI = 0.17 to 0.56) and 0.084 (CI = 0.04 to 0.17), respectively. The haplotype analysis showed that there were associations between the following groups: Arg16Arg-Gln27Gln (OR = 5.108, CI = 1.82 to 16.37), Gly16Gly-Glu27Glu (OR = 2.816, CI = 1.25 to 6.54), Arg16Gly-Gln27Glu (OR = 0.048, CI = 0.01 to 0.14) and Gly16Gly-Gln27Glu (OR = 0.1036, CI = 0.02 to 0.39). The polymorphism Gln27Glu was associated with asthma severity, as the Gln27Gln genotype was a risk factor for severe asthma (OR = 2.798, CI = 1.099 to 6.674) and the Gln27Glu genotype was a protective factor for mild (OR = 3.063, CI = 1.037 to 9.041) and severe (OR = 0.182, CI = 0.048 to 0.691) asthma. Conclusions The Arg16Gly and Gln27Glu polymorphisms in the ADRB2 gene are associated with asthma presence and severity.
Collapse
Affiliation(s)
| | - Fernando Augusto de Lima Marson
- Department of Medical Genetics, Faculty of Medical Sciences, State University of Campinas (Unicamp), Campinas, São Paulo zip code: 13081-970, Brazil.
| | | | | |
Collapse
|
23
|
Children with both asthma and depression are at risk for heightened inflammation. J Pediatr 2013; 163:1443-7. [PMID: 23919906 PMCID: PMC3967500 DOI: 10.1016/j.jpeds.2013.06.046] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Revised: 06/06/2013] [Accepted: 06/21/2013] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To test whether children and adolescents with co-occurring asthma and depression are at risk for elevated inflammation-concurrently and at the next assessment. STUDY DESIGN Up to 6 yearly assessments per person from the prospective, population-based Great Smoky Mountains Study (N = 1420) were used, covering children in the community aged 10-16 years old. High-sensitivity C-reactive protein (CRP) was assayed from annual bloodspot collections and provided indicators of elevated inflammation at CRP > 1, CRP > 2, and CRP > 3 mg/L. Depression was assessed with the Child and Adolescent Psychiatric Assessment. Asthma was assessed using a form adapted from the Centers for Disease Control and Prevention National Health Interview Survey. RESULTS Controlling common covariates of CRP, the co-occurrence of asthma and depression predicted heightened CRP-concurrently and at the next assessment. In turn, elevated CRP was relatively stable from one assessment to the next. CONCLUSIONS The co-occurrence of asthma and depression in childhood poses a risk for substantially elevated inflammation concurrently and over time, which could contribute to pathophysiological processes involved in the development of additional chronic diseases and also to asthma--related morbidity and mortality.
Collapse
|
24
|
Ferrante G, Malizia V, Antona R, Corsello G, Grutta SL. The value of FeNO measurement in childhood asthma: uncertainties and perspectives. Multidiscip Respir Med 2013; 8:50. [PMID: 23902719 PMCID: PMC3750504 DOI: 10.1186/2049-6958-8-50] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 07/12/2013] [Indexed: 01/07/2023] Open
Abstract
Asthma is considered an heterogeneous disease, requiring multiple biomarkers for diagnosis and management. Fractional exhaled nitric oxide in exhaled breath (FeNO) was the first useful non-invasive marker of airway inflammation in asthma and still is the most widely used. The non-invasive nature and the relatively easy use of FeNO technique make it an interesting tool to monitor airway inflammation and rationalize corticosteroid therapy in asthmatic patients, together with the traditional clinical tools (history, physical examination and lung function tests), even if some controversies have been published regarding the use of FeNO to support the management of asthma in children. The problem of multiple confounding factors and overlap between healthy and asthmatic populations preclude the routine application of FeNO reference values in clinical practice and suggest that it would be better to consider an individual "best", taking into account the context in which the measurement is obtained and the clinical history of the patient. Besides, there is still disagreement about the role of FeNO as a marker of asthma control, due to the complexity of balance among the different items involved in its determination and the lack of homogeneity in the population groups studied in the few studies conducted so far. Heterogeneity of problematic severe asthma greatly limits utility of FeNO alone as a biomarker of inflammation to optimize the disease management on an individual basis. None of the studies conducted so far demonstrated that the use of FeNO was better than current asthma guidelines in controlling asthma exacerbations. In summary, there is a large variation in FeNO levels between individuals, which may reflect the natural heterogeneity in baseline epithelial nitric oxide synthase activity and/or the contribution of other noneosinophilic factors to epithelial nitric oxide synthase activity. FeNO is a promising biomarker, but at present some limits are highlighted. We would recommend that further research can be carried out by organizing studies aimed to obtain reliable reference values of FeNO and in order to better interpret FeNO measurements in clinical settings, taking also into account the influence of genetic and environmental factors.
Collapse
Affiliation(s)
- Giuliana Ferrante
- Institute of Biomedicine and Molecolar Immunology, National Research Council, Palermo, Italy
- Department for Health Promotion and Mother and Child, Università di Palermo, Italy
| | - Velia Malizia
- Institute of Biomedicine and Molecolar Immunology, National Research Council, Palermo, Italy
| | - Roberta Antona
- Institute of Biomedicine and Molecolar Immunology, National Research Council, Palermo, Italy
| | - Giovanni Corsello
- Department for Health Promotion and Mother and Child, Università di Palermo, Italy
| | - Stefania La Grutta
- Institute of Biomedicine and Molecolar Immunology, National Research Council, Palermo, Italy
- Department for Health Promotion and Mother and Child, Università di Palermo, Italy
| |
Collapse
|
25
|
Byrami G, Boskabady MH, Jalali S, Farkhondeh T. The effect of the extract of Crocus sativus on tracheal responsiveness and plasma levels of IL-4, IFN-γ, total NO and nitrite in ovalbumin sensitized guinea-pigs. JOURNAL OF ETHNOPHARMACOLOGY 2013; 147:530-5. [PMID: 23506987 DOI: 10.1016/j.jep.2013.03.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 02/15/2013] [Accepted: 03/07/2013] [Indexed: 05/12/2023]
Abstract
UNLABELLED ETHNOMEDICAL RELEVANCE: Anti-inflammatory, anti oxidant and effect of Crocus sativus (C. sativus) on Th1/Th2 balance were described previously. AIM OF THE STUDY The preventive effects of the extract of Crocus sativus on tracheal responsiveness and plasma levels of IL-4, IFN-γ, total NO and nitrite were examined on sensitized guinea pigs. MATERIALS AND METHODS Five groups of sensitized guinea pigs to ovalbumin (OVA), were given drinking water containing three concentrations of the extract of Crocus sativus, dexamethasone (S+D) or alone (group S). Tracheal responses (TR) of control animals (group C) and sensitized guinea pigs (n=6, for each group) to methacholine, OVA and the levels of IL-4, IFN-γ, total NO and nitrite in serum were examined. RESULTS The TR to both methacholine and OVA, the levels of serum IL-4, total NO and nitrite in S guinea pigs were significantly increased but that of IFN-γ and IFN-γ/IL-4 ratio (Th1/Th2 balance) were decreased compared to the controls (p<0.05 to p<0.001). In the treated animals with dexamethasone and all concentrations of the extract, TR to both methacholine and OVA, IL-4, total NO and nitrite were significantly decreased but IFN-γ and IFN-γ/IL-4 ratio increased compared to S group (p<0.05 to p<0.001). The effects of the highest concentration of the extract was greater than those of other concentrations and the effect of dexamethasone (p<0.05 to p<0.01). CONCLUSIONS These results not only showed a preventive effect of C. sativus extract on tracheal responses and serum levels of inflammatory mediators in sensitized guinea pigs but also showed increased Th1/Th2 balance.
Collapse
Affiliation(s)
- Goltaj Byrami
- Applied Physiology Research Centre and Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
| | | | | | | |
Collapse
|
26
|
Komkova MA, Karyakina EE, Marken F, Karyakin AA. Hydrogen peroxide detection in wet air with a Prussian Blue based solid salt bridged three electrode system. Anal Chem 2013; 85:2574-7. [PMID: 23374034 DOI: 10.1021/ac303761h] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report on a novel electroanalytical system for hydrogen peroxide (H2O2) detection in humidity or droplets of aerosol, formed by air bubbling through a washing chamber; the resulting flow mimics the exhaled human breath. The system is based on a planar three-electrode structure (with a Prussian Blue based H2O2 transducer modified working electrode) bridged by a solid salt-saturated filament material (filter paper, cotton textile). Respective to the hydrogen peroxide content in the washing valve, the response of the aerosol-sensing system is linear in the concentration range of 0.1-10 μM, which overlaps the generally accepted H2O2 content in exhaled breath condensate (EBC), with the sensitivity of 8 A M(-1) cm(-2). The response to the upper limit of the calibration range is stable for more than 50 injection cycles recorded within 3 days. Both the stability and the suitable calibration range allow one to consider the reported aerosol-sensing system as a prototype for a simple (avoiding intermediate EBC collection) noninvasive diagnostic tool for pulmonary patients.
Collapse
|
27
|
Abstract
OBJECTIVE Studies of fractional exhaled NO (FeNO) or induced sputum are now well standardized and the exponential increase in publications about exhaled breath condensate reflects growing interest in a noninvasive diagnosis of pulmonary diseases in occupational medicine. METHODS This review describes current techniques (FeNO, induced sputum, and exhaled breath condensate) for the study of inflammation and oxidative stress biomarkers. RESULTS These biomarkers are FeNO, cytokines, H2O2, 8-isoprostane, malondialdehyde, and nitrogen oxides. These techniques also include the study of markers of the toxic burden in the lungs (heavy metals and mineral compounds) that are important in occupational health exposure assessment. CONCLUSIONS In occupational medicine, the study of both volatile and nonvolatile respiratory biomarkers can be useful in medical surveillance of exposed workers, the early identification of respiratory diseases, or the monitoring of their development.
Collapse
|
28
|
Yalcin AD, Gumuslu S, Parlak GE, Bisgin A, Yildiz M, Kargi A, Gorczynski RM. Systemic levels of ceruloplasmin oxidase activity in allergic asthma and allergic rhinitis. Immunopharmacol Immunotoxicol 2012; 34:1047-53. [PMID: 22737977 DOI: 10.3109/08923973.2012.697902] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT The role of ceruloplasmin oxidase activity (COA) involving the interaction of oxidant and antioxidant balance in allergic diseases is still unknown. OBJECTIVE Our study was designed to examine the changes in COAs in severe persistent asthma-allergic rhinitis, new diagnosed allergic asthma-allergic rhinitis and allergic rhinitis patients. METHODS The study included 20 age- and sex-matched healthy individuals as control (Group I); Group II included 15 newly diagnosed allergic asthma-allergic rhinitis; Group III included 15 patients with severe persistent asthma-allergic rhinitis and in the fourth group there were 20 patients with allergic rhinitis. Group III was divided in two groups, severe persistent asthma-allergic rhinitis who were pre-(III-A) and post-treated (III-B) with omalizumab. Group IV was divided to two groups, pretreatment (IV-A) and posttreatment (IV-B) with specific subcutaneous immunotherapy modalities. All the posttreatment measurements were 12 months after the therapy. All the patients were assessed by the skin prick test, high sensitive C-reactive protein (hs-CRP) and COA. RESULTS There were significant differences between Group I and Groups III-A, III-B, IV-A and IV-B; Group II and Groups III-A, III-B, IV-A and IV-B; Group III-A and Groups III-B, IV-A and IV-B; Group III-A and Groups IV-A and IV-B; and Group IV-A and IV-B. Interestingly, there was a correlation between the hs-CRP and COA levels in Group III-A. CONCLUSIONS Our data suggest that hs-CRP and COA levels might be an indicator of an inflammation and important in revelation of patients with allergy related diseases, especially of asthma patients.
Collapse
Affiliation(s)
- Arzu Didem Yalcin
- Internal Medicine, Allergy and Clinical Immunology Unit, Antalya Education and Research Hospital, Antalya, Turkey.
| | | | | | | | | | | | | |
Collapse
|
29
|
Adamko DJ, Sykes BD, Rowe BH. The metabolomics of asthma: novel diagnostic potential. Chest 2012; 141:1295-1302. [PMID: 22553262 DOI: 10.1378/chest.11-2028] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Asthma is one of the most common chronic illnesses, especially in children. Reaching the diagnosis of asthma and its management are more difficult than for other chronic illnesses. For example, asthma is a heterogeneous syndrome with many clinical classifications based on patient symptoms, lung function, and response to therapy. The symptoms and objective measurements of lung function, often used to guide therapy, are largely based on the inflammation of the airways. Because measuring airway dysfunction and inflammation in a typical clinical setting is difficult, it is often not done. Metabolomics is the study of small molecules generated from cellular metabolic activity. It is possible that the metabolic profile of a patient with a chronic illness such as asthma is different from that of a healthy patient or from a patient with another respiratory illness. Furthermore, if this metabolome could be measured, it might also vary with disease severity. The pattern of metabolites becomes the diagnostic representing the disease. This article outlines the more recent work that has been done to develop the metabolomic profile of asthma.
Collapse
Affiliation(s)
- Darryl J Adamko
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Department of Pediatrics, University of Saskatchewan, Saskatoon, SK, Canada.
| | - Brian D Sykes
- Department of Biochemistry, University of Alberta, Edmonton, AB, Canada
| | - Brian H Rowe
- Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
30
|
Melichar B, Plebani M. Cancer diagnosis: from dogs to DNA or from DNA to dogs? Clin Chem Lab Med 2012; 50:415-8. [DOI: 10.1515/cclm.2011.786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
31
|
Hsu NY, Wu JY, Liu X, Yen Y, Chen CY, Chou MC, Lin CH, Lee H, Cheng YW. Expression status of ribonucleotide reductase small subunits hRRM2/p53R2 as prognostic biomarkers in stage I and II non-small cell lung cancer. Anticancer Res 2011; 22:186-99. [PMID: 21965764 DOI: 10.1111/j.1600-0668.2011.00753.x] [Citation(s) in RCA: 158] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Overexpression of ribonucleotide reductase M2 (hRRM2) and p53-dependent RR small subunit (p53R2) has been correlated with tumor malignancy and progression in several types of cancer. The aim of this study was to determine the association of p53R2/hRRM2 expression with clinicopathological characteristics of stage I and II non-small cell lung cancer (NSCLC). Immunohistochemistry was conducted on a tissue array that included 92 samples. Correlations between hRRM2 and p53R2 expression and clinicopathological factors, recurrence/metastasis, and outcomes were analyzed. The analyses revealed that there was no correlation between p53R2 expression and clinicopathological factors; hRRM2 was only positively related to poor tumor differentiation (p=0.006). Regarding overall survival during the follow-up period, patients with p53R2+/hRRM2- tumors had the best outcomes (p<0.01). Multivariant Cox analysis revealed that p53R2 (risk=0.232, 95% CI=0.086-0.626, p=0.004) not only served as a prognostic biomarker to predict survival, but also as an independent biomarker to predict disease-free survival (risk=0.545, 95% CI=0.301-0.987, p=0.045) of patients with NSCLC. Therefore, we consider that the expression of p53R2 can be used not only as a biomarker for overall survival, but also as an indicator for tumor recurrence. Based on our finding, p53R2 expression seems more important than that of hRRM2 in prognosis of early-stage lung cancer.
Collapse
Affiliation(s)
- Nan-Yung Hsu
- Institute of Medicine, Chung Shan Medical University, No. 110. Sec. 1, Jianguo N. Rd., Taichung 4020, Taiwan, R.O.C
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Remes ST, Delezuch W, Pulkki K, Pekkanen J, Korppi M, Matinlauri IH. Association of serum-soluble CD26 and CD30 levels with asthma, lung function and bronchial hyper-responsiveness at school age. Acta Paediatr 2011; 100:e106-11. [PMID: 21401715 DOI: 10.1111/j.1651-2227.2011.02264.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM There is a need for markers of Th1 and Th2 imbalance in diseases such as asthma. CD30 is an activation marker of Th2 cells, and importance of Th1 marker CD26 was recently found in adult asthma. We studied whether serum-soluble CD30 (sCD30) or serum-soluble CD26 (sCD26) could support early diagnosis of asthma in children at school age. METHODS sCD26 and sCD30 were measured in 34 children with clinically confirmed asthma, 31 with possible asthma and in 147 controls. In addition, the associations of flow volume spirometry, methacholine inhalation challenge and free running test results with serum sCD26 or sCD30 were analysed. RESULTS Serum sCD30 was significantly higher in children with confirmed asthma (mean 91.5 IU/mL, SD 23.0) than in the controls (78.8 IU/mL, 25.9; p = 0.042). No significant differences were found in serum sCD26 levels between the groups. There was a negative correlation of mean mid expiratory flow values with serum sCD26 (r = -0.22, p = 0.0018). Neither methacholine inhalation challenge nor free running test results were associated with serum sCD26 or sCD30. CONCLUSION Serum sCD30 was higher in children with asthma. However, marked overlap in serum sCD30 between asthmatic and healthy children limits the usefulness of sCD30 as a diagnostic marker of asthma.
Collapse
Affiliation(s)
- Sami T Remes
- Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland.
| | | | | | | | | | | |
Collapse
|
33
|
Banović S, Navratil M, Vlašić Z, Topić RZ, Dodig S. Calcium and magnesium in exhaled breath condensate of children with endogenous and exogenous airway acidification. J Asthma 2011; 48:667-73. [PMID: 21815882 DOI: 10.3109/02770903.2011.599907] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND AIMS Regulation of pH in the airways is of physiological importance. As acidification of the airways causes bronchoconstriction, the aim of the present study was to find out whether there is any difference in calcium and magnesium in exhaled breath condensate (EBC) of children with uncontrolled asthma (i.e., with endogenous acidification) and children with gastroesophageal reflux disease, GERD (i.e., with exogenous acidification). MATERIAL AND METHODS A total of 142 children were included in the study: children with uncontrolled asthma (N = 51), children with GERD (N = 61), and healthy controls (N = 30). In addition, according to the pH cut-off value children with asthma and GERD were divided into two subgroups, that is, patients with pH ≤ 6.93 (subgroup A) and patients with pH > 6.93 (subgroup B). RESULTS The mean EBC pH was significantly lower in children with asthma than in children with GERD (6.791 ± 0.374 vs. 7.002 ± 0.361, p = .006). Concentration [median and interquartile range-M (IQR)] of total magnesium, but not calcium, was lower in both asthmatic [(10 (10-40) μmol/L, p = .016)] and GERD children [(20 (10-40) μmol/L, p = .012)] in comparison with controls (47 ± 27 μmol/L). There was no statistically significant difference in EBC calcium and magnesium concentrations between asthmatic and GERD children. In asthmatic children a positive correlation was confirmed between forced expiratory volume in the first second (FEV1) and magnesium in EBC (r = 0.307; p = .030), and negative correlation was found between FEV1 and calcium/magnesium ratio (r = -0.290; p = .047). In addition, positive correlation was confirmed between fractional concentration of exhaled NO and calcium/magnesium ratio (r = 0.360; p = .018). In GERD patients a negative correlation (r = -0.404; p = .003) was found between magnesium and pH values. Concentration of calcium was higher in the GERD subgroup A children [(50 (30-90) μmol/L)] than in the subgroup B children [(30 (20-45) μmol/L, p = .031)]. In addition, concentration of magnesium was higher in the GERD subgroup A children [(30 (20-70) μmol/L)] than in the subgroup B children [(10 (10-20) μmol/L, p < .001)]. CONCLUSION The present study indicates that decreased total magnesium concentration may be found in EBCs, irrespective of whether the acidification is the result of endogenous pathomechanisms or reflux-induced mechanisms. In children with GERD, EBC pH-metry should be performed after acute coughing episode. Future research is needed to investigate the mechanisms of onset and dynamics of these changes. SCIENTIFIC SIGNIFICANCE Lower concentration of magnesium may indicate its role in bronchoconstiction.
Collapse
Affiliation(s)
- S Banović
- Department for Clinical Laboratory Diagnosis, Srebrnjak Children's Hospital, Zagreb, Croatia
| | | | | | | | | |
Collapse
|