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Tarek M, Ghoniem NS, Hegazy MA, Wagdy HA. Design of Experiment-Based Green UPLC-DAD Method for the Simultaneous Determination of Indacaterol, Glycopyrronium and Mometasone in their Combined Dosage Form and Spiked Human Plasma. J Chromatogr Sci 2024; 62:676-685. [PMID: 37635399 DOI: 10.1093/chromsci/bmad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 06/14/2023] [Accepted: 08/06/2023] [Indexed: 08/29/2023]
Abstract
Indacaterol, is an ultra-long-acting β2 agonist, glycopyrronium is a long-acting muscarinic-antagonist and mometasone is a synthetic corticosteroid. They were used recently in combination for the treatment of severe asthma symptoms and chronic obstructive pulmonary disease. In this work, it was the first time to develop a green and environment friendly ultra-performance liquid chromatographic method using design expert program for the analysis of the three drugs in their combined dosage form. Also, the method was bioanalytically validated for the analysis of the three drugs in spiked human plasma samples. The method was linear in range from 0.50 to 100.0 μg mL-1 for indacaterol and mometasone and from 1.0 to 150.0 μg mL-1 for glycopyrronium. It showed high accuracy where, the % recovery for indacaterol, glycopyrronium and mometasone in plasma were ranged from 94.27 to 97.86%, 96.43 to 98.75% and 96.86 to 98.43%, respectively. Also, it was precise where, the % relative standard deviation for the inter-day precision was ranged from 2.571 to 3.484%, 3.180 to 4.123% and 3.150 to 3.984% and the intra-day precision was ranged from 2.351 to 3.125%, 2.512 to 3.544% and 2.961 to 3.983% for indacaterol, glycopyrronium and mometasone, respectively. The limit of detection and the limit of quantification for indacaterol and mometasone were 0.03 and 0.10 μg mL-1 while for glycopyrronium, they were 0.16 and 0.50 μg mL-1. HIGHLIGHTS
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Affiliation(s)
- Mohamed Tarek
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, P.O. Box 43, Cairo, 11837, Egypt
- The Center for Drug Research and Development (CDRD), Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, P.O. Box 43, Cairo, 11837, Egypt
| | - Nermine S Ghoniem
- Analytical Chemistry Department, Faculty of Pharmacy, Cairo University, Kasr-El Aini Street, 11562 Cairo, Egypt
| | - Maha A Hegazy
- Analytical Chemistry Department, Faculty of Pharmacy, Cairo University, Kasr-El Aini Street, 11562 Cairo, Egypt
| | - Hebatallah A Wagdy
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, P.O. Box 43, Cairo, 11837, Egypt
- The Center for Drug Research and Development (CDRD), Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, P.O. Box 43, Cairo, 11837, Egypt
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Gao X, Long C, Zhang LF, Lin RJ, Liu XM, Zhang X, Jiang Y, Lin H. The effect of telephone and short-message follow-ups on compliance and efficacy in asthmatic children treated with inhaled corticosteroid: A randomized controlled trial. Medicine (Baltimore) 2024; 103:e37794. [PMID: 38701297 PMCID: PMC11062738 DOI: 10.1097/md.0000000000037794] [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: 12/20/2023] [Accepted: 03/14/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND This study aims to evaluate the effect of telephone and short-message follow-ups on compliance and efficacy in asthmatic children treated with inhaled corticosteroids. METHODS A total of 120 children with moderate bronchial asthma who visited the Asthma Outpatient Department of the Affiliated Hospital of Qingdao University were enrolled in the study. They were divided randomly into 3 groups based on the type of follow-up given: a combined telephone and short-message service (Tel + SMS) group, a SMS group, and a control group. After being followed up for 12 weeks, each child's asthma control level was assessed and their lung function was measured. RESULTS The compliance rates of children in the Tel + SMS group and SMS group were 86.49% and 56.25%, respectively. The total effective rates of these 2 groups (94.59% and 75.0%, respectively) were significantly higher than the rate of the control group (P < .01). The lung function indicators of the children in all 3 groups were better than those before treatment, although only the Tel + SMS group and SMS group improved significantly (P < .05). The lung function indicators of the large and small airways in the Tel + SMS group and the SMS group were also significantly better than those of the control group (P < .01). The results of the study suggest that 1 of the causes of poor compliance in asthmatic children is fear of an adverse reaction to inhaled corticosteroids. CONCLUSION Telephone and short-message follow-ups can increase compliance with inhaled corticosteroid treatment and improve the asthma control levels and lung function of asthmatic children.
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Affiliation(s)
- Xiang Gao
- Department of Allergy, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chao Long
- Department of Allergy, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Li-Feng Zhang
- Department of Allergy, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Rong-Jun Lin
- Department of Pediatrics, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiao-Mei Liu
- Department of Child Health Care, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xu Zhang
- Department of Clinical Psychology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yan Jiang
- Department of Otorhinolaryngology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hang Lin
- Department of Allergy, The Affiliated Hospital of Qingdao University, Qingdao, China
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Younan R, Augy JL, Hermann B, Guidet B, Aegerter P, Guerot E, Novara A, Hauw-Berlemont C, Hamdan A, Bailleul C, Santi F, Diehl JL, Peron N, Aissaoui N. Severe asthma exacerbation: Changes in patient characteristics, management, and outcomes from 1997 to 2016 in 40 ICUs in the greater Paris area. JOURNAL OF INTENSIVE MEDICINE 2024; 4:209-215. [PMID: 38681794 PMCID: PMC11043637 DOI: 10.1016/j.jointm.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/07/2023] [Accepted: 08/05/2023] [Indexed: 05/01/2024]
Abstract
Background Despite advances in asthma treatments, severe asthma exacerbation (SAE) remains a life-threatening condition in adults, and there is a lack of data derived from adult patients admitted to intensive care units (ICUs) for SAE. The current study investigated changes in adult patient characteristics, management, and outcomes of SAE over a 20-year period in 40 ICUs in the greater Paris area. Methods In this retrospective observational study, admissions to 40 ICUs in the greater Paris area for SAE from January 1, 1997, to December 31, 2016 were analyzed. The primary outcome was the proportion of ICU admissions for SAE during 5-year periods. Secondary outcomes were ICU and hospital mortality, and the use of mechanical ventilation and catecholamine. Multivariate analysis was performed to assess factors associated with ICU mortality. Results A total of 7049 admissions for SAE were recorded. For each 5-year period, the proportion decreased over time, with SAE accounting for 2.84% of total ICU admissions (n=2841) between 1997 and 2001, 1.76% (n=1717) between 2002 and 2006, 1.05% (n=965) between 2007 and 2011, and 1.05% (n=1526) between 2012 and 2016. The median age was 46 years (interquartile range [IQR]: 32-59 years), 55.41% were female, the median Simplified Acute Physiology Score II was 20 (IQR: 13-28), and 19.76% had mechanical ventilation. The use of mechanical ventilation remained infrequent throughout the 20-year period, whereas the use of catecholamine decreased. ICU and hospital mortality rates decreased. Factors associated with ICU mortality were renal replacement therapy, catecholamine, cardiac arrest, pneumothorax, acute respiratory distress syndrome, sepsis, and invasive mechanical ventilation (IMV). Non-survivors were older, had more severe symptoms, and were more likely to have received IMV. Conclusion ICU admission for SAE remains uncommon, and the proportion of cases decreased over time. Despite a slight increase in symptom severity during a 20-year period, ICU and hospital mortality decreased. Patients requiring IMV had a higher mortality rate.
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Affiliation(s)
- Romy Younan
- Intensive Care Unit, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Jean Loup Augy
- Intensive Care Unit, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Bertrand Hermann
- Intensive Care Unit, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Bertrand Guidet
- Intensive Care Unit, AP-HP, Saint Antoine Hospital, Universités de Sorbonne, Université Pierre et Marie Curie, Paris, France
- INSERM U1136, Paris, France
| | - Philippe Aegerter
- Versailles Saint-Quentin-en-Yvelines University, INSERM U1018, Groupe Interrégional de Recherche Clinique et d'Innovation, Île-de-France, France
| | - Emmanuel Guerot
- Intensive Care Unit, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Ana Novara
- Intensive Care Unit, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Caroline Hauw-Berlemont
- Intensive Care Unit, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Amer Hamdan
- Respiratory Medicine Department, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Clotilde Bailleul
- Intensive Care Unit, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Francesca Santi
- Intensive Care Unit, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Jean-Luc Diehl
- Intensive Care Unit, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
- Innovative Therapies in Hemostasis, INSERM UMR-S1140, Université de Paris, Paris, France
- Intensive Care Unit and Biosurgical Research Lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Nicolas Peron
- Intensive Care Unit, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
| | - Nadia Aissaoui
- Intensive Care Unit, AP-HP, Georges Pompidou European Hospital, Université de Paris, Paris, France
- Paris-Cardiovascular-Research-Center, INSERM U970, Paris, France
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Mohany KM, Gamal Y, Abdel Raheem YF. Heavy metal levels are positively associated with serum periostin and miRNA-125b levels, but inversely associated with miRNA-26a levels in pediatric asthma cases. A case-control study. J Trace Elem Med Biol 2024; 82:127364. [PMID: 38104433 DOI: 10.1016/j.jtemb.2023.127364] [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: 08/10/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND The study investigated heavy metals levels [urinary cadmium (U-Cd), erythrocytic cadmium (E-Cd), urinary arsenic (U-As), and whole blood lead (WB-Pb)] in children with bronchial asthma (BA) and tested their associations with serum periostin, miRNA-125b and miRNA-26a levels, and with asthma severity clinically and laboratory [blood eosinophils count (BEC) and serum total immunoglobin E (IgE)]. Also, we tested cut-off points, for the studied parameters, to distinguish BA cases from healthy children. METHODS This case-control study included 158 children divided into control group; n = 72 and BA group; n = 86. Heavy metals were measured by an inductively coupled plasma-optical emission spectrophotometer. Serum periostin and IgE levels were measured by their corresponding ELISA kits. miRNAs relative expressions were estimated by RT-qPCR using the 2-ΔΔCT method. RESULTS Heavy metals, serum periostin, and miR-125b levels were significantly high in BA group (p < 0.001). Heavy metals levels correlated positively with serum periostin, miR-125b and IgE levels, BEC, and asthma severity. The reverse was observed regarding serum miR-26a levels. Receiver operating characteristics (ROC) curve analysis showed good to excellent abilities of U-Cd, E-Cd, U-As, WB-Pb, serum periostin, miRNA-125b, and miRNA - 26a, and total IgE levels to distinguish BA cases from healthy children. CONCLUSIONS Heavy metal toxicity in children is associated with BA severity, increased serum periostin and miRNA-125b levels, and decreased miRNA-26a levels. Specific measures to reduce children's exposure to heavy metals should be taken. Future research should consider blocking miRNA-125b action or enhancing miRNA-26a action to manage BA cases.
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Affiliation(s)
- Khalid M Mohany
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt.
| | - Yasser Gamal
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Yaser F Abdel Raheem
- Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
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Pendolino AL, Bandino F, Navaratnam A, Ross T, Qureishi A, Randhawa P, Andrews P. The role of large cavity sinus surgery in the management of chronic rhinosinusitis in non-steroidal anti-inflammatory drug exacerbated respiratory disease: a single-centre experience and long-term outcomes. J Laryngol Otol 2023; 137:883-889. [PMID: 36443933 DOI: 10.1017/s0022215122002468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to discuss the role of large cavity functional endoscopic sinus surgery in the management of chronic rhinosinusitis with nasal polyps in patients with non-steroidal anti-inflammatory drug exacerbated respiratory disease. METHODS This was a retrospective review of patients undergoing large cavity functional endoscopic sinus surgery for non-steroidal anti-inflammatory drug exacerbated respiratory disease from January 2016 to March 2022. Population characteristics, pre- and post-operative number of functional endoscopic sinus surgical procedures, endoscopic polyp grade, Lund-Mackay score and nasal symptoms were recorded. RESULTS Thirteen consecutive patients with a median age of 47 years were included. They all failed maximal medical treatment and/or conservative functional endoscopic sinus surgery and underwent large cavity sinus surgery followed by post-operative maximal medical therapy. All patients showed an improvement in nasal symptoms with improved Lund-Mackay scores post-operatively. The median length of follow up was 1.5 years. CONCLUSION Large cavity functional endoscopic sinus surgery seems to halt the progression of chronic rhinosinusitis with nasal polyps in non-steroidal anti-inflammatory drug exacerbated respiratory disease. In this case series, large cavity functional endoscopic sinus surgery combined with optimal post-operative medical treatment appeared to switch off chronic rhinosinusitis with nasal polyps in patients with non-steroidal anti-inflammatory drug exacerbated respiratory disease.
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Affiliation(s)
- A L Pendolino
- Department of ENT, Royal National ENT & Eastman Dental Hospitals, London, United Kingdom
- Ear Institute, University College London, United Kingdom
| | - F Bandino
- Department of ENT, Royal National ENT & Eastman Dental Hospitals, London, United Kingdom
| | - A Navaratnam
- Department of ENT, Royal National ENT & Eastman Dental Hospitals, London, United Kingdom
| | - T Ross
- Department of ENT, Royal National ENT & Eastman Dental Hospitals, London, United Kingdom
| | - A Qureishi
- ENT Department, Oxford University Hospital, United Kingdom
| | - P Randhawa
- Department of ENT, Royal National ENT & Eastman Dental Hospitals, London, United Kingdom
| | - P Andrews
- Department of ENT, Royal National ENT & Eastman Dental Hospitals, London, United Kingdom
- Ear Institute, University College London, United Kingdom
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Vega-Rioja A, Chacón P, Fernández-Delgado L, Doukkali B, del Valle Rodríguez A, Perkins JR, Ranea JAG, Dominguez-Cereijo L, Pérez-Machuca BM, Palacios R, Rodríguez D, Monteseirín J, Ribas-Pérez D. Regulation and directed inhibition of ECP production by human neutrophils. Front Immunol 2022; 13:1015529. [PMID: 36518751 PMCID: PMC9744134 DOI: 10.3389/fimmu.2022.1015529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background Neutrophils are involved in the pathophysiology of allergic asthma, where the Eosinophil Cationic Protein (ECP) is a critical inflammatory mediator. Although ECP production is attributed to eosinophils, we reported that ECP is also present in neutrophils from allergic patients where, in contrast to eosinophils, it is produced in an IgE-dependent manner. Given the key role of ECP in asthma, we investigated the molecular mechanisms involved in ECP production as well as the effects induced by agonists and widely used clinical approaches. We also analyzed the correlation between ECP production and lung function. Methods Neutrophils from allergic asthmatic patients were challenged with allergens, alone or in combination with cytokines, in the presence of cell-signaling inhibitors and clinical drugs. We analyzed ECP levels by ELISA and confocal microscopy. Lung function was assessed by spirometry. Results IgE-mediated ECP release is dependent on phosphoinositide 3-kinase, the extracellular signal-regulated kinase (ERK1/2) and the production of reactive oxygen species by NADPH-oxidase. Calcineurin phosphatase and the transcription factor NFAT are also involved. ECP release is enhanced by the cytokines interleukin (IL)-5 and granulocyte macrophage-colony stimulating factor, and inhibited by interferon-γ, IL-10, clinical drugs (formoterol, tiotropium and budesonide) and allergen-specific IT. We also found an inverse correlation between asthma severity and ECP levels. Conclusions Our results suggest the molecular pathways involved in ECP production and potential therapeutic targets. We also provide a new method to evaluate disease severity in asthmatic patients based on the quantification of in vitro ECP production by peripheral neutrophils.
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Affiliation(s)
- Antonio Vega-Rioja
- UGC de Alergología, Hospital Universitario Virgen Macarena, Sevilla, Spain,Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain,*Correspondence: Antonio Vega-Rioja, ; Pedro Chacón, ; Javier Monteseirín,
| | - Pedro Chacón
- UGC de Alergología, Hospital Universitario Virgen Macarena, Sevilla, Spain,Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain,*Correspondence: Antonio Vega-Rioja, ; Pedro Chacón, ; Javier Monteseirín,
| | | | - Bouchra Doukkali
- UGC de Alergología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - James R. Perkins
- Departamento de Biología Molecular y Bioquímica. Facultad de Ciencias, Universidad de Málaga, Málaga, Spain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain,Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | - Juan A. G. Ranea
- Departamento de Biología Molecular y Bioquímica. Facultad de Ciencias, Universidad de Málaga, Málaga, Spain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain,Instituto de Investigación Biomédica de Málaga-IBIMA, Málaga, Spain
| | | | | | | | | | - Javier Monteseirín
- Hospital Quirón Sagrado Corazón and Hospital Quirón Infanta-Luisa, Sevilla, Spain,*Correspondence: Antonio Vega-Rioja, ; Pedro Chacón, ; Javier Monteseirín,
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The plight of the 'asthmatic patient' in South Africa - a subgroup analysis of the SABINA III study. Afr J Thorac Crit Care Med 2022; 28:10.7196/AJTCCM.2022.v28i4.298. [PMID: 36911653 PMCID: PMC9997649 DOI: 10.7196/ajtccm.2022.v28i4.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Almeshari MA, Stockley J, Sapey E. The diagnosis of asthma. Can physiological tests of small airways function help? Chron Respir Dis 2021; 18:14799731211053332. [PMID: 34693751 PMCID: PMC8543738 DOI: 10.1177/14799731211053332] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Asthma is a common, chronic, and heterogeneous disease with a global impact and substantial economic costs. It is also associated with significant mortality and morbidity and the burden of undiagnosed asthma is significant. Asthma can be difficult to diagnose as there is no gold standard test and, while spirometry is central in diagnosing asthma, it may not be sufficient to confirm or exclude the diagnosis. The most commonly reported spirometric measures (forced expiratory volume in one second (FEV1) and forced vital capacity assess function in the larger airways. However, small airway dysfunction is highly prevalent in asthma and some studies suggest small airway involvement is one of the earliest disease manifestations. Moreover, there are new inhaled therapies with ultrafine particles that are specifically designed to target the small airways. Potentially, tests of small airways may more accurately diagnose early or mild asthma and assess the response to treatment than spirometry. Furthermore, some assessment techniques do not rely on forced ventilatory manoeuvres and may, therefore, be easier for certain groups to perform. This review discusses the current evidence of small airways tests in asthma and future research that may be needed to further assess their utility.
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Affiliation(s)
- Mohammed A Almeshari
- Rehabilitation Health Sciences
Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Institute of Inflammation and
Ageing, University of
Birmingham, Birmingham, UK
- Mohammed A. Almeshari, Institute of
Inflammation and Ageing, University of Birmingham, Edgbaston, Birmingham B152TT,
UK.
| | - James Stockley
- Department of Lung Function and
Sleep, University Hospitals Birmingham NHS
Foundation Trust, Birmingham, UK
| | - Elizabeth Sapey
- Institute of Inflammation and
Ageing, University of
Birmingham, Birmingham, UK
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Chiu C, Chou H, Chang L, Fan W, Dinh MCV, Kuo Y, Chung W, Lai H, Hsieh W, Su S. Integration of metagenomics-metabolomics reveals specific signatures and functions of airway microbiota in mite-sensitized childhood asthma. Allergy 2020; 75:2846-2857. [PMID: 32506557 DOI: 10.1111/all.14438] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/28/2020] [Accepted: 05/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Childhood asthma is a multifactorial inflammatory condition of the airways, associated with specific changes in respiratory microbiome and circulating metabolome. METHODS To explore the functional capacity of asthmatic microbiome and its intricate connection with the host, we performed shotgun sequencing of airway microbiome and untargeted metabolomics profiling of serum samples in a cohort of children with mite-sensitized asthma and non-asthmatic controls. RESULTS We observed higher gene counts and sample-to-sample dissimilarities in asthmatic microbiomes, indicating a more heterogeneous community structure and functionality among the cases than in controls. Moreover, we identified airway microbial species linked to changes in circulating metabolites and IgE responses of the host, including a positive correlation between Prevotella sp oral taxon 306 and dimethylglycine that were both decreased in patients. Several control-enriched species (Eubacterium sulci, Prevotella pallens, and Prevotella sp oral taxon 306) were inversely correlated with total and allergen-specific IgE levels. Genes related to microbial carbohydrate, amino acid, and lipid metabolism were differentially enriched, suggesting that changes in microbial metabolism may contribute to respiratory health in asthmatics. Pathway modules relevant to allergic responses were differentially abundant in asthmatic microbiome, such as enrichments for biofilm formation by Pseudomonas aeruginosa, membrane trafficking, histidine metabolism, and glycosaminoglycan degradation, and depletions for polycyclic aromatic hydrocarbon degradation. Further, we identified metagenomic and metabolomic markers (eg, Eubacterium sulci) to discriminate cases from the non-asthmatic controls. CONCLUSIONS Our dual-omics data reveal the connections between respiratory microbes and circulating metabolites perturbed in mite-sensitized pediatric asthma, which may be of etiological and diagnostic implications.
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Affiliation(s)
- Chih‐Yung Chiu
- Division of Pediatric Pulmonology Chang Gung Memorial Hospital at LinkouCollege of MedicineChang Gung University Taoyuan Taiwan
- Clinical Metabolomics Core Laboratory Chang Gung Memorial Hospital at Linkou Taoyuan Taiwan
| | - Hsin‐Cheng Chou
- Institute of Statistics National Tsing‐Hua University Hsinchu Taiwan
| | - Lun‐Ching Chang
- Department of Mathematical Sciences Florida Atlantic University Florida USA
| | - Wen‐Lang Fan
- Genomic Medicine Core Laboratory Chang Gung Memorial Hospital Linkou Taiwan
| | | | - Yu‐Lun Kuo
- Biotools, Co. Ltd New Taipei City Taiwan
| | - Wen‐Hung Chung
- Whole‐Genome Research Core Laboratory of Human Diseases Chang Gung Memorial Hospital Keelung Taiwan
| | - Hsin‐Chih Lai
- Department of Medical Biotechnology and Laboratory Science Microbiota Research CenterCollege of MedicineChang Gung University Taoyuan Taiwan
- Central Research Laboratory XiaMen Chang Gung Hospital XiaMen China
| | - Wen‐Ping Hsieh
- Institute of Statistics National Tsing‐Hua University Hsinchu Taiwan
| | - Shih‐Chi Su
- Whole‐Genome Research Core Laboratory of Human Diseases Chang Gung Memorial Hospital Keelung Taiwan
- Central Research Laboratory XiaMen Chang Gung Hospital XiaMen China
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Serum BPI as a novel biomarker in asthma. Allergy Asthma Clin Immunol 2020; 16:50. [PMID: 32565845 PMCID: PMC7301491 DOI: 10.1186/s13223-020-00450-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 06/05/2020] [Indexed: 01/07/2023] Open
Abstract
Background Neutrophils, eosinophils and inflammatory cells contribute to asthmatic inflammation. The anti-bactericidal/permeability-increasing protein (BPI), produced by neutrophils, peripheral blood monocytes or epithelial cells, can neutralize lipopolysaccharide activity and enhance phagocytosis regulation function. This study aimed to assess the clinical significance of BPI in asthmatic patients. Methods We recruited 18 controlled asthma, 39 uncontrolled asthma and 35 healthy controls individuals. Clinical characteristics (age, gender, allergy history, body mass index (BMI) and smoking history), clinical indicators [whole blood count, forced expiratory volume in one second as percentage of predicted volume (FEV1% predicted), IgE level, high sensitivity C-reactive protein (hs-CRP) and fractional expiratory nitric oxide (FeNO)] and serum BPI levels were measured to compare among each group. We then evaluated the correlation between BPI, clinical characteristics and clinical indicators. Finally, linear regression analysis was performed to exclude the influence of other factors and to find the independent influencing factors of BPI. Results Our results showed that the serum BPI levels increased by twofold in the controlled asthma group (12.83 ± 6.04 ng/mL) and threefold in the uncontrolled asthma group (18.10 ± 13.48 ng/mL), compared to the healthy control group (6.00 ± 2.58 ng/mL) (p < 0.001). We further found that serum BPI levels were positively correlated with the hs-CRP (p = 0.002). There was no significant association among BPI, age, gender, BMI, allergy, blood eosinophils, blood neutrophils, IgE, FeNO or FEV1% predicted. Conclusion BPI levels were increased in asthma and positively correlated with hs-CRP. BPI as a potential asthma biomarker that still needs further research.
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Back HM, Lee JB, Kim A, Park SJ, Kim J, Chae JW, Sheen SS, Kagan L, Park HS, Ye YM, Yun HY. Exposure-Response and Clinical Outcome Modeling of Inhaled Budesonide/Formoterol Combination in Asthma Patients. Pharmaceutics 2020; 12:pharmaceutics12040336. [PMID: 32283726 PMCID: PMC7238265 DOI: 10.3390/pharmaceutics12040336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 11/18/2022] Open
Abstract
Exposure-response and clinical outcome (CO) model for inhaled budesonide/formoterol was developed to quantify the relationship among pharmacokinetics (PK), pharmacodynamics (PD) and CO of the drugs and evaluate the covariate effect on model parameters. Sputum eosinophils cationic proteins (ECP) and forced expiratory volume (FEV1) were selected as PD markers and asthma control score was used as a clinical outcome. One- and two-compartment models were used to describe the PK of budesonide and formoterol, respectively. The indirect response model (IDR) was used to describe the PD effect for ECP and FEV1. In addition, the symptomatic effect on the disease progression model for CO was connected with IDR on each PD response. The slope for the effect of ECP and FEV1 to disease progression were estimated as 0.00008 and 0.644, respectively. Total five covariates (ex. ADRB2 genotype etc.) were searched using a stepwise covariate modeling method, however, there was no significant covariate effect. The results from the simulation study were showed that a 1 puff b.i.d. had a comparable effect of asthma control with a 2 puff b.i.d. As a result, the 1 puff b.i.d. of combination drug could be suggested as a standardized dose to minimize the side effects and obtain desired control of disease compared to the 2 puff b.i.d.
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Affiliation(s)
- Hyun-moon Back
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (H.-m.B.); (J.B.L.); (L.K.)
- Center of Excellence in Pharmaceutical Translational Research and Education, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Jong Bong Lee
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (H.-m.B.); (J.B.L.); (L.K.)
| | - Anhye Kim
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do 13496, Korea;
| | - Seon-Jong Park
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea; (S.-J.P.); (J.K.); (J.-w.C.)
| | - Junyeong Kim
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea; (S.-J.P.); (J.K.); (J.-w.C.)
| | - Jung-woo Chae
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea; (S.-J.P.); (J.K.); (J.-w.C.)
| | - Seung Soo Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Gyeonggi-do 16499, Korea;
| | - Leonid Kagan
- Department of Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA; (H.-m.B.); (J.B.L.); (L.K.)
- Center of Excellence in Pharmaceutical Translational Research and Education, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Gyeonggi-do 16499, Korea;
| | - Young-Min Ye
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Gyeonggi-do 16499, Korea;
- Correspondence: (Y.-M.Y.); (H.-y.Y.)
| | - Hwi-yeol Yun
- College of Pharmacy, Chungnam National University, Daejeon 34134, Korea; (S.-J.P.); (J.K.); (J.-w.C.)
- Correspondence: (Y.-M.Y.); (H.-y.Y.)
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12
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Zhang HH, Li CX, Tang LF. The Differential Expression Profiles of miRNA-let 7a, 7b, and 7c in Bronchoalveolar Lavage Fluid From Infants With Asthma and Airway Foreign Bodies. J Evid Based Integr Med 2019; 24:2515690X18821906. [PMID: 30789054 PMCID: PMC6343437 DOI: 10.1177/2515690x18821906] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to investigate the expression patterns of miRNA-let 7a, 7b, and 7c in bronchoalveolar lavage fluid in infants with asthma and airway foreign bodies. Between January 2016 and February 2017, 27 infants were included and divided into observation group (infants with asthma, n = 15) and control group (infants with airway foreign bodies, n = 12). The differential expression profiles of miRNA-let 7a, 7b, and 7c were determined by reverse transcription–polymerase chain reaction in bronchoalveolar lavage fluid (BALF) from infants of the 2 groups. The BALF was collected from infants undergoing flexible bronchoscopy. MiRNA-let 7a, 7b, and 7c increased significantly in infants from observation group as compared with control group (2.72 ± 0.48 vs 1, 8.23 ± 1.64 vs 1, 3.16 ± 0.62 vs 1, respectively). The increased expression of miRNA-let 7a, 7b, and 7c were associated with the asthma of infants.
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Affiliation(s)
- Hang-Hu Zhang
- 1 The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,2 Shaoxing People's Hospital, Shaoxing, China
| | - Cai-Xue Li
- 1 The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,3 Hangzhou Children's Hospital, Hangzhou, China
| | - Lan-Fang Tang
- 1 The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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13
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Ferreira MKM, Ferreira RDO, Castro MML, Magno MB, Almeida APCPSC, Fagundes NCF, Maia LC, Lima RR. Is there an association between asthma and periodontal disease among adults? Systematic review and meta-analysis. Life Sci 2019; 223:74-87. [PMID: 30849418 DOI: 10.1016/j.lfs.2019.03.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 12/28/2022]
Abstract
This systematic review and meta-analysis aimed to investigate a possible association between asthma and periodontal disease in adults. This study was conducted by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the searches were performed on the following databases: PubMed, Scopus, Web of Science, Cochrane, LILACS, OpenGrey e Google Scholar. In this systematic review, observational studies with adult humans, which evaluated patients with and without asthma, were selected to verify the association between both diseases. To qualitative analysis, Fowkes and Fulton guidelines was used and for the quantitative analysis, it was used the mean and standard deviation from each group (with and without asthma), using confidence interval (CI) 95% and heterogeneity were tested using I2 index. Furthermore, a summary of the overall strength of evidence was presented using Grading of recommendations, assessment, development, and evaluation (GRADE). 3395 studies were identified, 11 were included on this systematic review to qualitative analysis and 6 of them to quantitative synthesis. Six meta-analyses were performed to the following clinical parameters: plaque index (PI), gingival index (GI), bleeding on probing (BOP), papillary bleeding index (PBI), calculus index (CI), clinical attachment loss (CAL). The meta-analysis results for CI was (p < 0.00001, I2 = 0%) PBI (p < 0.00001, I2 = 0%), CAL (p = 0,03, I2 = 98%) showed higher means for the asthmatic group. For BOP (p = 0.20 I2 = 83%), GI (p = 0.14 I2 = 97%) and PI (p = 0.53 I2 = 95%) non-statistical difference was found. The level of evidence analysis (GRADE) presented a low level of evidence among the clinical parameters. This systematic review and meta-analysis observed that asthmatic individuals present more periodontal disease, especially gingivitis, when compared to healthy individuals, but further studies with similar methods are necessary to evaluate interactions between both diseases.
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Affiliation(s)
- Maria Karolina Martins Ferreira
- Laboratory of Structural and Functional Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Railson de Oliveira Ferreira
- Laboratory of Structural and Functional Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Micaele Maria Lopes Castro
- Laboratory of Structural and Functional Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Marcela Barauna Magno
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Nathalia Carolina Fernandes Fagundes
- Laboratory of Structural and Functional Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Pará, Brazil; School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Structural and Functional Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Pará, Brazil.
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14
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Li HF, Yan LP, Wang K, Li XT, Liu HX, Tan W. Association between ADAM33 polymorphisms and asthma risk: a systematic review and meta-analysis. Respir Res 2019; 20:38. [PMID: 30791911 PMCID: PMC6385425 DOI: 10.1186/s12931-019-1006-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 02/13/2019] [Indexed: 02/06/2023] Open
Abstract
Background Asthma is a common complex chronic, inflammatory polygenic disease with heterogeneous manifestations, affecting individuals of all age groups and posing an immense burden on healthcare resources. A number of studies have identified the association between a disintegrin and metalloprotease 33 (ADAM33) polymorphisms and asthma risk, however, the results still remain inconclusive. The objective of the present study was to identify the effect of ADAM33 variants in asthma susceptibility. Methods Eligible case-control studies published between January 2000 and June 2018 was searched and retrieved from online electronic databases. The odds ratio (OR) with its 95% confidence interval (CI) was employed to calculate the effect. Results A total of 63 case-control studies were finally screened out, including 13,280 asthma patients and 13,340 controls. Eleven SNPs of ADAM33 gene were identified. Our results detected a significant association between ADAM33 T2, Q1, F + 1 and AA genotype of T + 1 polymorphisms and asthma risk in total population. Subgroup analysis by ethnicities showed that the alleles and genotypes of T2, Q1 and F + 1 polymorphisms were associated with asthma susceptibility among Asian populations, while V4 polymorphism was associated with asthma among Caucasian populations. Subgroup analysis by ages showed that T2, F + 1 and ST + 4 polymorphisms were associated with childhood asthma, while Q1 and V4 polymorphisms were associated with asthma risk in adults. Subgroup analysis by asthma severity showed that only the G allele of ADAM33 T1 polymorphism was associated with the severity of asthma when compared with the controls. In addition, T2, Q1 and F + 1 polymorphisms of ADAM33 were significantly associated with increased the asthma risk in Chinese asthma patients. Conclusions Our results found that T2, Q1 and F + 1 polymorphisms of ADAM33 gene might contribute to asthma risk. Future well-designed case-control studies with large population and more ethnicities are still needed to estimate the association.
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Affiliation(s)
- Hui-Fang Li
- Postgraduate Department of Internal Medicine, Weifang Medical University, Weifang, 261053, China
| | - Li-Ping Yan
- Department of Human Resource Department, Weifang People's Hospital, Weifang, 261041, China
| | - Kun Wang
- Department of Respiratory Medicine, Weifang People's Hospital, Weifang, 261041, Shandong, China
| | - Xiao-Tong Li
- Postgraduate Department of Internal Medicine, Weifang Medical University, Weifang, 261053, China
| | - Hai-Xian Liu
- Department of Respiratory Medicine, Weifang People's Hospital, Weifang, 261041, Shandong, China
| | - Wei Tan
- Department of Respiratory Medicine, Weifang People's Hospital, Weifang, 261041, Shandong, China.
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15
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Kogan V, Millstein J, London SJ, Ober C, White SR, Naureckas ET, Gauderman WJ, Jackson DJ, Barraza-Villarreal A, Romieu I, Raby BA, Breton CV. Genetic-Epigenetic Interactions in Asthma Revealed by a Genome-Wide Gene-Centric Search. Hum Hered 2019; 83:130-152. [PMID: 30669148 PMCID: PMC7365350 DOI: 10.1159/000489765] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES There is evidence to suggest that asthma pathogenesis is affected by both genetic and epigenetic variation independently, and there is some evidence to suggest that genetic-epigenetic interactions affect risk of asthma. However, little research has been done to identify such interactions on a genome-wide scale. The aim of this studies was to identify genes with genetic-epigenetic interactions associated with asthma. METHODS Using asthma case-control data, we applied a novel nonparametric gene-centric approach to test for interactions between multiple SNPs and CpG sites simultaneously in the vicinities of 18,178 genes across the genome. RESULTS Twelve genes, PF4, ATF3, TPRA1, HOPX, SCARNA18, STC1, OR10K1, UPK1B, LOC101928523, LHX6, CHMP4B, and LANCL1, exhibited statistically significant SNP-CpG interactions (false discovery rate = 0.05). Of these, three have previously been implicated in asthma risk (PF4, ATF3, and TPRA1). Follow-up analysis revealed statistically significant pairwise SNP-CpG interactions for several of these genes, including SCARNA18, LHX6, and LOC101928523 (p = 1.33E-04, 8.21E-04, 1.11E-03, respectively). CONCLUSIONS Joint effects of genetic and epigenetic variation may play an important role in asthma pathogenesis. Statistical methods that simultaneously account for multiple variations across chromosomal regions may be needed to detect these types of effects on a genome-wide scale.
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Affiliation(s)
- Vladimir Kogan
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Joshua Millstein
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA,
| | - Stephanie J London
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, RTP, Research Triangle Park, North Carolina, USA
| | - Carole Ober
- Department of Human Genetics, University of Chicago, Chicago, Illinois, USA
| | - Steven R White
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | | | - W James Gauderman
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Daniel J Jackson
- University of Wisconsin School of Medicine and Public Health, Madison, Illinois, USA
| | - Albino Barraza-Villarreal
- Department of Environmental Health, Population Health Center, National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | - Isabelle Romieu
- International Agency for Research on Cancer, Section of Nutrition and Metabolism, Lyon, France
| | - Benjamin A Raby
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Carrie V Breton
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
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16
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Zairina E, Nugraheni G, Achmad GN, Sulistyarini A, Nita Y, Bakhtiar A, Amin M. Efficacy of an Education Session by Pharmacists for Patients With Asthma: Protocol and Design of a Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e10210. [PMID: 30563816 PMCID: PMC6315257 DOI: 10.2196/10210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 07/31/2018] [Accepted: 09/04/2018] [Indexed: 11/30/2022] Open
Abstract
Background Asthma is a chronic disease that requires indefinite long-term therapy. Many approaches have been developed to enable people with asthma to live as normally as possible. In medication therapy management, pharmacists could play important roles in supporting the everyday life of asthmatic patients, such as by providing education therapy management to ensure that patients achieve optimal therapeutic outcomes. A good collaboration between health care practitioners and patients will produce a better system in terms of therapeutic management, which will lead to health care cost savings related to emergency visits. Although the Government has made various efforts to manage asthma in Indonesia, without commitment and support from both patients and health care professionals, the expected outcomes cannot be achieved. Objective This study aims to evaluate the effectiveness of an educational intervention provided by pharmacists compared with that of usual care. Methods A randomized controlled trial comparing usual care with an education session by pharmacists is underway. The intervention comprises a one-on-one education session of 60 minutes with a pharmacist comprising information regarding (1) asthma medication that has been used; (2) how to use asthma medication devices correctly; (3) asthma symptoms and how to prevent exacerbation of asthma; and (4) how to manage asthma triggers and environmental control measures. The primary outcome measure is change in asthma control, as measured using the Asthma Control Questionnaire. Secondary outcomes include changes in Asthma Quality of Life Questionnaire score, lung function, asthma-related health visits, days off from work or study, and oral corticosteroid use. Research assistants who are masked to the group allocation will collect outcome data at the baseline and every month for a 3-month period. Informed consent will be sought at enrollment and intention-to-treat analysis will be performed. Results This study was funded in January 2017 and ethical approval was obtained in June 2017. The enrollment was started in August 2017, and about 72 participants have been enrolled. First results are expected to be submitted for publication in 2019. Conclusions This is the first study to evaluate the effectiveness of a pharmacist-guided asthma education session compared with that of usual care in Indonesia. If it is proven effective, this intervention program could improve asthma self-management by patients, which may reduce risks of poorly controlled asthma. This intervention could also be implemented in addition to the current usual care for patients with asthma. Trial Registration Thai Clinical Trials Registry TCTR20171219001; http://www.clinicaltrials.in.th/index.php? tp =regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=3068 (Archived by WebCite at http://www.webcitation.org/73Ci5eKtv) International Registered Report Identifier (IRRID) DERR1-10.2196/10210
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Affiliation(s)
- Elida Zairina
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | - Gesnita Nugraheni
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | - Gusti Nv Achmad
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | - Arie Sulistyarini
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | - Yunita Nita
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
| | - Arief Bakhtiar
- Faculty of Medicine, Department of Pulmonology and Respiratory Medicine, Universitas Airlangga, Surabaya, Indonesia.,Department of Pulmonology, Dr Soetomo Hospital, Surabaya, Indonesia.,Department of Pulmonology, Universitas Airlangga Hospital, Surabaya, Indonesia
| | - Muhammad Amin
- Faculty of Medicine, Department of Pulmonology and Respiratory Medicine, Universitas Airlangga, Surabaya, Indonesia.,Department of Pulmonology, Dr Soetomo Hospital, Surabaya, Indonesia.,Department of Pulmonology, Universitas Airlangga Hospital, Surabaya, Indonesia
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17
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Liu F, Zhao Y, Gong C, Xu T, Zhang Y, Mei J, Lu J, Feng X, Rong Y, Wu Y. Identification of Methylated Gene Markers in Childhood Atopic Asthma by Integrating Gene Expression and Methylation Profiles Based on Bioinformatic Analysis. PEDIATRIC ALLERGY, IMMUNOLOGY, AND PULMONOLOGY 2018. [DOI: 10.1089/ped.2017.0793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Fang Liu
- Department of Pediatrics, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
| | - YuHua Zhao
- Department of Pediatrics, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
| | - ChunHua Gong
- Department of Pediatrics, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
| | - Tong Xu
- Department of Pediatrics, Changzheng Hospital Affiliated to the Second Military Medical University, Shanghai, China
| | - YanBin Zhang
- Department of Pediatrics, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
| | - Jun Mei
- Department of Pediatrics, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
| | - JieMin Lu
- Department of Pediatrics, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
| | - XiaoYan Feng
- Department of Pediatrics, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
| | - YanMing Rong
- Department of Pediatrics, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
| | - YaHui Wu
- Department of Pediatrics, Shanghai East Hospital affiliated to Tongji University, Shanghai, China
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18
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Charrad R, Kaabachi W, Rafrafi A, Berraies A, Hamzaoui K, Hamzaoui A. IL-8 Gene Variants and Expression in Childhood Asthma. Lung 2017; 195:749-757. [PMID: 28993876 PMCID: PMC7101950 DOI: 10.1007/s00408-017-0058-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 09/18/2017] [Indexed: 01/14/2023]
Abstract
PURPOSE To examine the IL-8 expression levels and association of genetic variants with the risk of childhood persistent asthma prognosis. METHODS Overall, 170 asthmatic children and 170 healthy controls were included in this case-control study. The human IL-8 serum levels were measured using ELISA. The IL-8 mRNA expression levels were assessed by a real-time quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods. RESULTS The IL-8 expression at both protein and mRNA levels was found to be significantly elevated in asthmatic children compared to healthy subjects (P < 0.0001, P = 0.004; respectively). Higher levels of IL-8 mRNA are detected in subjects with moderate to severe asthma. The presence of IL8-251 A/T (rs4073) and + 781C/T (rs2227306) polymorphisms was significantly associated with an increased risk of asthma (P = 0.002, P = 0.036, respectively). In addition, we noted a significant association between these polymorphisms and an elevated risk of atopic asthma (P < 0.05). For rs2227306 SNP, the highest median level of IgE was detected for the presence of TT genotype (865 ± 99.74 IU/mL). Although, the rs4073 polymorphism conferred a higher risk to develop asthma at an advanced stage of severity (P = 0.008). The rs4073 T and rs2227306 C alleles are considered as risk factors for asthma development. The rs4073 T allele is represented also as a risk factor for asthma severity in Tunisian children. CONCLUSIONS Both IL-8 gene and protein expression may play a key role in asthma pathogenesis.
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Affiliation(s)
- Rihab Charrad
- Abderrahman Mami Hospital, Unit Research 12SP15 "Expression Moleculaires des Interactions Cellulaires et de leur mode de Communication dans le Poumon Profond" Ariana; Tunisia, University of Tunis El Manar & A. Mami Hospital Pavillon B. Ariana; Tunisia, 2082, Ariana, Tunisia. .,University Tunis El Manar, Tunis Tunisia, Medicine Faculty of Tunis, Djebel Lakdar, Bab Saadoun, Tunis, Tunisia.
| | - Wajih Kaabachi
- University Tunis El Manar, Tunis Tunisia, Medicine Faculty of Tunis, Djebel Lakdar, Bab Saadoun, Tunis, Tunisia
| | - Ahlem Rafrafi
- University Tunis El Manar, Tunis Tunisia, Medicine Faculty of Tunis, Djebel Lakdar, Bab Saadoun, Tunis, Tunisia
| | - Anissa Berraies
- Abderrahman Mami Hospital, Unit Research 12SP15 "Expression Moleculaires des Interactions Cellulaires et de leur mode de Communication dans le Poumon Profond" Ariana; Tunisia, University of Tunis El Manar & A. Mami Hospital Pavillon B. Ariana; Tunisia, 2082, Ariana, Tunisia.,University Tunis El Manar, Tunis Tunisia, Medicine Faculty of Tunis, Djebel Lakdar, Bab Saadoun, Tunis, Tunisia
| | - Kamel Hamzaoui
- University Tunis El Manar, Tunis Tunisia, Medicine Faculty of Tunis, Djebel Lakdar, Bab Saadoun, Tunis, Tunisia
| | - Agnes Hamzaoui
- Abderrahman Mami Hospital, Unit Research 12SP15 "Expression Moleculaires des Interactions Cellulaires et de leur mode de Communication dans le Poumon Profond" Ariana; Tunisia, University of Tunis El Manar & A. Mami Hospital Pavillon B. Ariana; Tunisia, 2082, Ariana, Tunisia.,University Tunis El Manar, Tunis Tunisia, Medicine Faculty of Tunis, Djebel Lakdar, Bab Saadoun, Tunis, Tunisia
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19
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Zheng S, Yu Q, Zeng X, Sun W, Sun Y, Li M. The influence of inhaled corticosteroid discontinuation in children with well-controlled asthma. Medicine (Baltimore) 2017; 96:e7848. [PMID: 28858095 PMCID: PMC5585489 DOI: 10.1097/md.0000000000007848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Asthma is a chronic inflammatory disease that requires adherence to both preventative and therapeutic interventions in disease management. Children with asthma are likely to discontinue inhaled corticosteroids (ICS), especially when symptoms are under control. We aimed to investigate the impact of ICS adherence in children whose symptoms were under control.The study is cohort study; 35 children with controlled asthma that had undergone 3 years of follow-up were included. Serum eosinophil count, serum total IgE (tIgE), and lung function (FEV1, FEV1/FVC, PEF, FEF20-75%, and PC20) were evaluated at the beginning and end of the follow-up.At baseline, patients in both the adherent and nonadherent groups were similar. After 3 years, the nonadherent group who had discontinued ICS had a decrease in FEV1 (P < .05), FEV1/FVC (P < .05), PEF (P < .05), and FEF20-75% (P < .05). The nonadherent group had no significant improvement in PC20 compared with their values at the beginning of the follow-up, whereas the adherent group had improvement in PC20. Furthermore, there was an increase in serum eosinophil (P < .001) and tIgE (P < .05) in the nonadherent compared with the adherent group.Despite good asthma control, airway hyperresponsiveness (AHR) was detected in a large proportion of children with asthma. ICS discontinuation affected lung function, serum eosinophil count, tIgE, and AHR. Adequate adherence is important in asthma management. The benefits of ICS and the influence of drug discontinuation despite good asthma control may encourage better adherence from patients.
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20
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Larose MC, Archambault AS, Provost V, Laviolette M, Flamand N. Regulation of Eosinophil and Group 2 Innate Lymphoid Cell Trafficking in Asthma. Front Med (Lausanne) 2017; 4:136. [PMID: 28848734 PMCID: PMC5554517 DOI: 10.3389/fmed.2017.00136] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/27/2017] [Indexed: 12/17/2022] Open
Abstract
Asthma is an inflammatory disease usually characterized by increased Type 2 cytokines and by an infiltration of eosinophils to the airways. While the production of Type 2 cytokines has been associated with TH2 lymphocytes, increasing evidence indicates that group 2 innate lymphoid cells (ILC2) play an important role in the production of the Type 2 cytokines interleukin (IL)-5 and IL-13, which likely amplifies the recruitment of eosinophils from the blood to the airways. In that regard, recent asthma treatments have been focusing on blocking Type 2 cytokines, notably IL-4, IL-5, and IL-13. These treatments mainly result in decreased blood or sputum eosinophil counts as well as decreased asthma symptoms. This supports that therapies blocking eosinophil recruitment and activation are valuable tools in the management of asthma and its severity. Herein, we review the mechanisms involved in eosinophil and ILC2 recruitment to the airways, with an emphasis on eotaxins, other chemokines as well as their receptors. We also discuss the involvement of other chemoattractants, notably the bioactive lipids 5-oxo-eicosatetraenoic acid, prostaglandin D2, and 2-arachidonoyl-glycerol. Given that eosinophil biology differs between human and mice, we also highlight and discuss their responsiveness toward the different eosinophil chemoattractants.
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Affiliation(s)
- Marie-Chantal Larose
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Faculté de Médecine, Département de Médecine, Université Laval, Québec City, QC, Canada
| | - Anne-Sophie Archambault
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Faculté de Médecine, Département de Médecine, Université Laval, Québec City, QC, Canada
| | - Véronique Provost
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Faculté de Médecine, Département de Médecine, Université Laval, Québec City, QC, Canada
| | - Michel Laviolette
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Faculté de Médecine, Département de Médecine, Université Laval, Québec City, QC, Canada
| | - Nicolas Flamand
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Faculté de Médecine, Département de Médecine, Université Laval, Québec City, QC, Canada
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Yang CJ, Liu D, Xu ZS, Shi SX, Du YJ. The pro-inflammatory cytokines, salivary cortisol and alpha-amylase are associated with generalized anxiety disorder (GAD) in patients with asthma. Neurosci Lett 2017; 656:15-21. [PMID: 28716529 DOI: 10.1016/j.neulet.2017.07.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 06/30/2017] [Accepted: 07/14/2017] [Indexed: 01/08/2023]
Abstract
Generalized anxiety disorder (GAD) is common in patients with asthma. High levels of GAD may lead both to exacerbation of the condition and poor management. However, the physiological mechanisms of GAD in asthma patient is unclear. This study investigated the associations between the diurnal rhythm of sputum cytokines, salivary cortisol, α-amylase and GAD in asthma patients. Patients with co-morbid GAD and asthma showed higher sputum IL-1 AUC, sputum IL-6 AUC and sAA AUC. And there were positive correlations between Hamilton anxiety scale (HAMA) scores and sputum IL-1 AUC concentrations (r=0.37, P=0.002), HAMA scores and sputum IL-6 AUC (r=0.56, P<0.001), HAMA scores and sAA AUC (r=0.75, P<0.001). Also, there were positive correlations between Sputum IL-1 AUC and sAA AUC (r=0.40, P<0.001), between Sputum IL-6 AUC and sAA AUC. Stepwise multiple regression analyses showed the combination of sputum sAA AUC, IL-1 AUC, IL-6 AUC and cortisol AUC was the best predictor of HAMA scores (ΔR2=0.439, F(4,63)=14.086, p<0.001). Therefore, pro-inflammatory cytokines, salivary cortisol and alpha-amylase may all be involved in the occurrence of GAD in asthma patients.
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Affiliation(s)
- Chang-Jiang Yang
- Faculty of Education, East China Normal University, Shanghai, China
| | - Di Liu
- Faculty of Education, East China Normal University, Shanghai, China.
| | - Zhen-Sheng Xu
- The medical examination center of Huashan Hospital, Fudan University, Shanghai, China
| | - Shen-Xun Shi
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, China
| | - Yi-Jie Du
- Lab of Integrative Medicine for Lung, Inflammation and Cancers, Huashan Hospital, Fudan University, Shanghai, China.
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Inhaled corticosteroids do not reduce initial high activity of matrix metalloproteinase (MMP)-9 in exhaled breath condensates of children with asthma exacerbation: a proof of concept study. Cent Eur J Immunol 2016; 41:221-7. [PMID: 27536209 PMCID: PMC4967657 DOI: 10.5114/ceji.2016.60998] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/07/2016] [Indexed: 12/13/2022] Open
Abstract
Inhaled corticosteroids (ICS) are the key component of asthma treatment. However, it is unclear whether they could control the activity and level of matrix metalloproteinase (MMP)-9, which is an important factor in asthma-associated inflammation and airway remodeling. Therefore, the aim of this proof of concept study was to analyze the influence of increased doses of ICS on MMP-9 in exhaled breath condensates (EBC) of patients with allergic asthma exacerbation. Apart from MMP-9, the assessment concerned selected inflammation markers – exhaled nitric oxide (eNO) and cytokines (IL-8 and TNF). The study involved a small group (n = 4) of individuals with asthma exacerbation. The intervention concerned increased doses of ICS with β-mimetics for 4 weeks. In addition to clinical evaluation, eNO measurements and EBC collections were done before and after 4 weeks of intense ICS treatment. The biochemical assessment of EBC concerned MMP-9, IL-8 and TNF. The data were compared to results of healthy controls (n = 6). The initial levels of eNO, MMP-9 and TNF in EBC were higher in the asthma group than in controls. In all subjects IL-8 levels were below the detection limit. After 4 weeks of ICS treatment in all patients we observed improvement of clinical and laboratory parameters. Interestingly, despite reduction of eNO and TNF, the activity of MMP-9/EBC remained on the initial level. Practical relevance of our results is limited by a small group. Nevertheless, our data suggest that ICS, although sufficient to control symptoms and inflammatory markers, may be ineffective to reduce MMP-9/EBC activity in asthma exacerbation and, possibly, airway remodeling.
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Aldakheel FM, Thomas PS, Bourke JE, Matheson MC, Dharmage SC, Lowe AJ. Relationships between adult asthma and oxidative stress markers and pH in exhaled breath condensate: a systematic review. Allergy 2016; 71:741-57. [PMID: 26896172 DOI: 10.1111/all.12865] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2016] [Indexed: 01/02/2023]
Abstract
Oxidative stress has a recognized role in the pathophysiology of asthma. Recently, interest has increased in the assessment of pH and airway oxidative stress markers. Collection of exhaled breath condensate (EBC) and quantification of biomarkers in breath samples can potentially indicate lung disease activity and help in the study of airway inflammation, and asthma severity. Levels of oxidative stress markers in the EBC have been systematically evaluated in children with asthma; however, there is no such systematic review conducted for adult asthma. A systematic review of oxidative stress markers measured in EBC of adult asthma was conducted, and studies were identified by searching MEDLINE and SCOPUS databases. Sixteen papers met the inclusion criteria. Concentrations of exhaled hydrogen ions, nitric oxide products, hydrogen peroxide and 8-isoprostanes were generally elevated and related to lower lung function tests in adults with asthma compared to healthy subjects. Assessment of EBC markers may be a noninvasive approach to evaluate airway inflammation, exacerbations, and disease severity of asthma, and to monitor the effectiveness of anti-inflammatory treatment regimens. Longitudinal studies, using standardized analytical techniques for EBC collection, are required to establish reference values for the interpretation of EBC markers in the context of asthma.
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Affiliation(s)
- F. M. Aldakheel
- Allergy and Lung Health Unit; The University of Melbourne; Melbourne Australia
- Department of Clinical Laboratory Sciences; College of Applied Medical Sciences; King Saud University; Riyadh Saudi Arabia
| | - P. S. Thomas
- Department of Respiratory Medicine and Prince of Wales Hospital Clinical School; University of New South Wales; Sydney Australia
| | - J. E. Bourke
- Biomedicine Discovery Institute; Department of Pharmacology; Monash University; Clayton Australia
| | - M. C. Matheson
- Allergy and Lung Health Unit; The University of Melbourne; Melbourne Australia
- Murdoch Childrens Research Institute; Melbourne Australia
| | - S. C. Dharmage
- Allergy and Lung Health Unit; The University of Melbourne; Melbourne Australia
- Murdoch Childrens Research Institute; Melbourne Australia
| | - A. J. Lowe
- Allergy and Lung Health Unit; The University of Melbourne; Melbourne Australia
- Murdoch Childrens Research Institute; Melbourne Australia
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Dahn CM, Milne WK, Carpenter CR. Hot Off the Press: Do Emergency Department-based Predischarge Educational Interventions for Adult Asthma Patients Improve Outcomes? Acad Emerg Med 2016; 23:650-2. [PMID: 27120501 DOI: 10.1111/acem.12958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 02/04/2016] [Indexed: 11/28/2022]
Affiliation(s)
| | - William K. Milne
- Department of Emergency Medicine; University of Western Ontario; Goderich Ontario Canada
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Wang HY, Shen YH, Yang XY, Tang LF, Zhou JY. Diagnosis and treatment of allergic diseases in Zhejiang Province: a cross-sectional survey. J Zhejiang Univ Sci B 2016; 16:640-50. [PMID: 26160722 DOI: 10.1631/jzus.b1400284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The specialty of allergy developed quickly in western countries because of the rapid increase of allergic diseases, whereas it developed relatively slowly in China. The prevalence of allergen sensitization and allergic diseases in Zhejiang Province of China is high and improving the medical services for these diseases is critically needed. OBJECTIVE To investigate the working status of the diagnosis and treatment of allergic diseases, including doctor resources, diagnostic methods, and allergen-specific immunotherapy in patients of Zhejiang Province, and to provide instructions for the strategic development of subspecialties of allergic diseases. METHODS First we defined the doctors who treat allergic diseases, and designed a comprehensive questionnaire to collect personal and hospital information for these doctors. The questionnaires were distributed to hospitals with different ranks and from different areas in the province. The general condition of doctor's resources, carryout of diagnostic methods, and allergen-specific immunotherapy were described and variations in the different specialties, hospitals, and areas were further analyzed. RESULTS Doctors in their thirties with bachelor's degrees were the mainstream for diagnosing and treating allergic diseases. The main specialties of the doctor resources were the specialties of Ear, Nose and Throat (ENT), Respirology, Pediatrics, and Dermatology. The Pediatrics specialty had a more reasonable infrastructure of doctor resources with more young doctors working in this subspecialty. The development of allergy subspecialty varied within hospitals at different levels or from different areas. The carryout of the skin prick test (SPT), serum specific IgE (ssIgE), and subcutaneous immunotherapy (SCIT) was best performed in provincial hospitals, while sublingual immunotherapy (SLIT) was prescribed most commonly in municipal hospitals. The performance of SPT and ssIgE in Hangzhou, Jiaxing, and Wenzhou areas was much better than that in other places. The performance of SCIT and SLIT was best in Wenzhou. CONCLUSIONS Our survey revealed a very initial and unbalanced development for the allergy subspecialty in Zhejiang Province. Doctor resources for allergic diseases were mainly from the specialties of ENT, Respirology, and Pediatrics, and the performance of diagnosis and treatment was mainly focused on provincial and municipal hospitals. Continuous education of allergies could be extended to primary healthcare centers and more efforts should be directed to those areas with poor medical resources.
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Affiliation(s)
- Hui-ying Wang
- Department of Allergy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; Department of Respirology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China; Department of Rheumatology and Clinical Immunology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; Department of Respirology, Children's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
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Chantaphakul H, Ruxrungtham K. Fixed-Dose combination of the inhaled corticosteroid and long-acting beta2-agonist therapy in adults with persistent asthma. Expert Opin Pharmacother 2016; 17:631-42. [PMID: 26799114 DOI: 10.1517/14656566.2016.1145659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Asthma is a respiratory condition characterized by airway inflammation, airflow obstruction, and bronchial hyperresponsiveness. The standard treatment of asthma comprises inhaled corticosteroid and beta2-agonist. Inhaled short-acting-beta2-agonists have been used as rescue medication for exacerbation. However, long-acting-beta2-agonists (LABA) used as monotherapy for asthma had been reported for having a safety concern. Consequently, it had been recommended as an add-on treatment to inhaled corticosteroid (ICS) in moderate to severe persistent asthma. The fixed-dose combination (FDC) of ICS and LABA has been approved since the year 2000. Evidences revealed using the combination of these medications is more effective in asthma control. AREAS COVERED The rational and phase III onward randomized-controlled studies were reviewed. Sources of evidences were from studies published in Medline until November 2015. EXPERT OPINION There are six FDC inhaler regimens approved worldwide. The significant synergistic effects of ICS and LABA in one device are well evidenced. A FDC reduces the daily dosage of ICS and asthma exacerbation. It is safe to use regularly as controller. The efficacy of each individual combination on asthma treatment is generally similar. Clinical experience, ease of use, cost and side effects of medication would guide the clinician's preferences.
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Affiliation(s)
- Hiroshi Chantaphakul
- a Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine , Chulalongkorn University , Bangkok , Thailand
| | - Kiat Ruxrungtham
- a Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine , Chulalongkorn University , Bangkok , Thailand
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Durham AL, Caramori G, Chung KF, Adcock IM. Targeted anti-inflammatory therapeutics in asthma and chronic obstructive lung disease. Transl Res 2016; 167:192-203. [PMID: 26334389 PMCID: PMC4728194 DOI: 10.1016/j.trsl.2015.08.004] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 08/11/2015] [Accepted: 08/12/2015] [Indexed: 11/29/2022]
Abstract
Asthma and chronic obstructive pulmonary disease (COPD) are chronic inflammatory diseases of the airway, although the drivers and site of the inflammation differ between diseases. Asthmatics with a neutrophilic airway inflammation are associated with a poor response to corticosteroids, whereas asthmatics with eosinophilic inflammation respond better to corticosteroids. Biologicals targeting the Th2-eosinophil nexus such as anti-interleukin (IL)-4, anti-IL-5, and anti-IL-13 are ineffective in asthma as a whole but are more effective if patients are selected using cellular (eg, eosinophils) or molecular (eg, periostin) biomarkers. This highlights the key role of individual inflammatory mediators in driving the inflammatory response and for accurate disease phenotyping to allow greater understanding of disease and development of patient-oriented antiasthma therapies. In contrast to asthmatic patients, corticosteroids are relatively ineffective in COPD patients. Despite stratification of COPD patients, the results of targeted therapy have proved disappointing with the exception of recent studies using CXC chemokine receptor (CXCR)2 antagonists. Currently, several other novel mediator-targeted drugs are undergoing clinical trials. As with asthma specifically targeted treatments may be of most benefit in specific COPD patient endotypes. The use of novel inflammatory mediator-targeted therapeutic agents in selected patients with asthma or COPD and the detection of markers of responsiveness or nonresponsiveness will allow a link between clinical phenotypes and pathophysiological mechanisms to be delineated reaching the goal of endotyping patients.
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Key Words
- ahr, airway hyperresponsiveness
- acq, asthma control questionnaire
- acos, asthma-copd overlap syndrome
- bal, bronchoalveolar lavage
- clca1, chloride channel regulator 1
- copd, chronic obstructive lung disease
- cs, corticosteroids
- cxcr, cxc chemokine receptor
- egf, epidermal growth factor
- egfr, epidermal growth factor receptor
- fkbp51, fk506-binding protein 51
- fp, fluticasone propionate
- fev1, forced expiratory volume in 1 second
- feno, fraction of exhaled nitric oxide
- gr, glucocorticoid receptor
- gm-csf, granulocyte-macrophage colony-stimulating factor
- hdacs, histone deacetylases
- hne, human neutrophil elastase
- ige, immunoglobulin e
- ics, inhaled corticosteroids
- labas, long-acting beta-adrenoceptor agonists
- mrna, messenger rna
- mabs, monoclonal antibodies
- pde, phosphodiesterase
- pi3k, phosphoinositide-3-kinase
- rt-qpcr, real time quantative polymerase chain reaction
- sal, salmeterol
- serpinb2, serpin peptidase inhibitor
- clade b, member 2
- sil-4r, soluble il-4 receptor
- gold, the global initiative for chronic obstructive lung disease
- tslp, thymic stromal lymphopoietin
- torch, towards a revolution in copd health
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Affiliation(s)
- Andrew L Durham
- Airway Diseases Section, National Heart and Lung Institute, Imperial College London, London, UK; Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, UK.
| | - Gaetano Caramori
- Section of Respiratory Diseases, Centro per lo Studio delle Malattie Infiammatorie Croniche delle Vie Aeree e Patologie Fumo Correlate dell'Apparato Respiratorio (CEMICEF; ex Centro di Ricerca su Asma e BPCO), Sezione di Medicina Interna e Cardiorespiratoria, Università di Ferrara, Ferrara, Italy
| | - Kian F Chung
- Airway Diseases Section, National Heart and Lung Institute, Imperial College London, London, UK; Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, UK
| | - Ian M Adcock
- Airway Diseases Section, National Heart and Lung Institute, Imperial College London, London, UK; Biomedical Research Unit, Royal Brompton and Harefield NHS Trust, London, UK
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Yun HS, Rah WJ, Choi YJ, Kim JH, Oh JW, Kim HH, Chang YS, Yoo KH, Sohn KT. The development of patient-tailored asthma prediction model for the alarm system. ALLERGY ASTHMA & RESPIRATORY DISEASE 2016. [DOI: 10.4168/aard.2016.4.5.328] [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]
Affiliation(s)
- Hey-Suk Yun
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Wee Jin Rah
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Young Jin Choi
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Joo-Hwa Kim
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun-Hee Kim
- Department of Pediatrics, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang-Ha Yoo
- School of Medicine, Konkuk University, Seoul, Korea
| | - Keon-Tae Sohn
- Department of Statistics, Pusan National University, Busan, Korea
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Maezawa Y, Paltser G, Tsui H, Cheung R, Wu P, Nicholas AP, Dosch HM. 2-Chloroacetamidine, a novel immunomodulator, suppresses antigen-induced mouse airway inflammation. Allergy 2015; 70:1130-8. [PMID: 25969859 DOI: 10.1111/all.12651] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Citrullination is a presently under-recognized posttranslational protein modification catalyzed by PAD enzymes. Immune responses to citrullinated neo-epitopes are identified in a growing number of inflammatory and autoimmune diseases. However, the involvement of hypercitrullination in the pathogenesis of bronchial asthma is still unknown. METHODS As main experimental tool, we examined the effect of 2-chloroacetamidine (2CA), a PAD enzyme inhibitor, on OVA-immunized and airway-challenged BALB/c mice; a commonly used model of allergic airway inflammation. We also measured the effect of 2CA on ex vivo lymphocytes and cell lines. RESULTS In vivo, 2CA dramatically suppressed lung tissue hypercitrullination, inflammatory cell recruitment, and airway-Th2 cytokine secretion. 2CA also suppressed systemic OVA-specific and total IgE production dramatically, effectively preventing de novo and diminishing established disease without measurably impacting general immunocompetence. In vitro, 2CA markedly inhibited the proliferation of mouse and human T cells with cell cycle block and apoptosis during a limited, postactivation phase. CONCLUSIONS 2CA acts as narrow-spectrum immunosuppressant that selectively targets lymphocyte populations involved in active inflammatory tissue lesions. If hypercitrullination is generated in patients with asthma, 2CA may represent a novel disease modulator for human asthmatics/allergic diseases.
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Affiliation(s)
- Y. Maezawa
- The Hospital for Sick Children Research Institute; Neuroscience and Mental Health; University of Toronto; Toronto ON Canada
| | - G. Paltser
- The Hospital for Sick Children Research Institute; Neuroscience and Mental Health; University of Toronto; Toronto ON Canada
| | - H. Tsui
- The Hospital for Sick Children Research Institute; Neuroscience and Mental Health; University of Toronto; Toronto ON Canada
| | - R. Cheung
- The Hospital for Sick Children Research Institute; Neuroscience and Mental Health; University of Toronto; Toronto ON Canada
| | - P. Wu
- The Hospital for Sick Children Research Institute; Neuroscience and Mental Health; University of Toronto; Toronto ON Canada
| | - A. P. Nicholas
- Department of Neurology and Center for Neuroimmunology; University of Alabama at Birmingham; Birmingham AL USA
- Birmingham VA Medical Center; Birmingham AL USA
| | - H.-M. Dosch
- The Hospital for Sick Children Research Institute; Neuroscience and Mental Health; University of Toronto; Toronto ON Canada
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Zhao H, Li R, Lv Y, Dong H, Yao L, Wu Y, Xiao G, Cai S. Albuterol inhalation increases FeNO level in steroid-naive asthmatics but not COPD patients with reversibility. CLINICAL RESPIRATORY JOURNAL 2015; 11:328-336. [PMID: 26077165 DOI: 10.1111/crj.12340] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 05/22/2015] [Accepted: 06/12/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Fractional exhaled nitric oxide (FeNO) has been used as a marker of airway inflammation. Airway caliber is related to the level of FeNO in asthmatics. OBJECTIVES This study aimed to investigate whether airway obstruction could interfere with real FENO levels and if different FeNO changes after albuterol inhalation could assist in distinguishing asthma from chronic obstructive pulmonary disease (COPD). METHODS FeNO and spirometry measurements were performed before and after albuterol inhalation in the following three patient groups: 30 steroid-naive asthmatics, 25 asthmatics inhaling corticosteroids/long-acting β(2)-adrenergic agonists for at least 1 month and 20 COPD patients. Bronchodilator test (BDT) results were positive in all patients enrolled. The correlations among FeNO levels, pulmonary function and sputum eosinophil counts were analyzed. RESULTS FeNO increased significantly after albuterol inhalation in steroid-naive asthmatics but not in ICS-treated asthmatics or COPD patients. The FeNO levels demonstrated no significant correlation with spirometry results or sputum eosinophil counts before or after inhaling bronchodilator in all three groups. Both the levels of FeNO and changes in FENO after albuterol inhalation in steroid-naive asthma patients were higher than those in ICS-treated asthmatics and COPD patients (P < 0.001). The differences remained after proper adjustment for confounding factors (gender, age, smoking pack-years, ICS-treated and pulmonary function index). CONCLUSIONS Our results support the role of FeNO in differentiating asthmatics from COPD patients with positive BDT. FeNO detection after albuterol inhalation should be encouraged in steroid-naive asthma patients with airway obstruction.
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Affiliation(s)
- Haijin Zhao
- Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Rui Li
- Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yanhua Lv
- Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Hangming Dong
- Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Lihong Yao
- Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Yue Wu
- Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Guanhua Xiao
- Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Shaoxi Cai
- Department of Respiratory and Critical Care Medicine, Chronic Airways Diseases Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
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Attanasi M, Rapino D, Marcovecchio ML, Consilvio NP, Scaparrotta A, Cingolani A, Di Pillo S, Chiarelli F. Airway hyper-responsiveness to mannitol provides a good evaluation of atopy in childhood asthma. Acta Paediatr 2015; 104:718-23. [PMID: 25661794 DOI: 10.1111/apa.12968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 12/11/2014] [Accepted: 02/02/2015] [Indexed: 01/27/2023]
Abstract
AIM The relationship between airway hyper-responsiveness (AHR) and atopy has been previously investigated, but there are still some issues to be clarified. The aim of this study was to assess the link between AHR and mannitol and atopy in asthmatic children. METHODS We evaluated 44 children with asthma, aged 6-16 years of age, using skin prick tests (SPTs), serum total and specific immunoglobulin E (IgE) levels and the mannitol challenge test (MCT). RESULTS We found a good correlation between AHR to mannitol and specific IgE against Dermatophagoides pteronissinus (r = -0.66, p < 0.001) and a weak correlation with specific IgE against dog dander (r = -0.33, p = 0.01) and Aspergillus fumigatus (r = -0.23, p = 0.02). Furthermore, we found a weak correlation between AHR to mannitol and serum total IgE (r = -0.30; p = 0.03), the sum of specific IgE to aeroallergens (r = -0.37, p = 0.01) and the number of positive SPTs (r = -0.31, p = 0.02). CONCLUSION Measuring AHR with MCT might provide an accurate evaluation of the degree of atopy in children. The patients with a higher degree of atopy were significantly more reactive to mannitol. In clinical practice, these results indicate that children with asthma who are more atopic may require more intensive treatment strategies to reduce AHR.
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Affiliation(s)
- M Attanasi
- Allergy and Respiratory Diseases Clinic; Department of Paediatrics; University of Chieti; Chieti Italy
| | - D Rapino
- Allergy and Respiratory Diseases Clinic; Department of Paediatrics; University of Chieti; Chieti Italy
| | | | - N P Consilvio
- Allergy and Respiratory Diseases Clinic; Department of Paediatrics; University of Chieti; Chieti Italy
| | - A Scaparrotta
- Allergy and Respiratory Diseases Clinic; Department of Paediatrics; University of Chieti; Chieti Italy
| | - A Cingolani
- Allergy and Respiratory Diseases Clinic; Department of Paediatrics; University of Chieti; Chieti Italy
| | - S Di Pillo
- Allergy and Respiratory Diseases Clinic; Department of Paediatrics; University of Chieti; Chieti Italy
| | - F Chiarelli
- Department of Paediatrics; University of Chieti; Chieti Italy
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Zeng M, Li ZY, Ma J, Cao PP, Wang H, Cui YH, Liu Z. Clarithromycin and dexamethasone show similar anti-inflammatory effects on distinct phenotypic chronic rhinosinusitis: an explant model study. BMC Immunol 2015; 16:37. [PMID: 26047816 PMCID: PMC4456709 DOI: 10.1186/s12865-015-0096-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 05/08/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Phenotype of chronic rhinosinusitis (CRS) may be an important determining factor of the efficacy of anti-inflammatory treatments. Although both glucocorticoids and macrolide antibiotics have been recommended for the treatment of CRS, whether they have different anti-inflammatory functions for distinct phenotypic CRS has not been completely understood. The aim of this study is to compare the anti-inflammatory effects of clarithromycin and dexamethasone on sinonasal mucosal explants from different phenotypic CRS ex vivo. METHODS Ethmoid mucosal tissues from CRSsNP patients (n = 15), and polyp tissues from eosinophilic (n = 13) and non-eosinophilic (n = 12) CRSwNP patients were cultured in an ex vivo explant model with or without dexamethasone or clarithromycin treatment for 24 h. After culture, the production and/or expression of anti-inflammatory molecules, epithelial-derived cytokines, pro-inflammatory cytokines, T helper (Th)1, Th2 and Th17 cytokines, chemokines, dendritic cell relevant markers, pattern recognition receptors (PRRs), and tissue remodeling factors were detected in tissue explants or culture supernatants by RT-PCR or ELISA, respectively. RESULTS We found that both clarithromycin and dexamethasone up-regulated the production of anti-inflammatory mediators (Clara cell 10-kDa protein and interleukin (IL)-10), whereas down-regulated the production of Th2 response and eosinophilia promoting molecules (thymic stromal lymphopoietin, IL-25, IL-33, CD80, CD86, OX40 ligand, programmed cell death ligand 1, CCL17, CCL22, CCL11, CCL5, IL-5, IL-13, and eosinophilic cationic protein) and Th1 response and neutrophilia promoting molecules (CXCL8, CXCL5, CXCL10, CXCL9, interferon-γ, and IL-12), from sinonasal mucosa from distinct phenotypic CRS. In contrast, they had no effect on IL-17A production. The expression of PRRs (Toll-like receptors and melanoma differentiation-associated gene 5) was induced, and the production of tissue remodeling factors (transforming growth factor-β1, epidermal growth factor, basic fibroblast growth factor, platelet derived growth factor, vascular endothelial growth factor, and matrix metalloproteinase 9) was suppressed, in different phenotypic CRS by dexamethasone and clarithromycin in comparable extent. CONCLUSIONS Out of our expectation, our explant model study discovered herein that glucocorticoids and macrolides likely exerted similar regulatory actions on CRS and most of their effects did not vary by the phenotypes of CRS.
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Affiliation(s)
- Ming Zeng
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College; Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China.
| | - Zhi-Yong Li
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College; Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China.
| | - Jin Ma
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College; Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China.
| | - Ping-Ping Cao
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College; Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China.
| | - Heng Wang
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College; Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China.
| | - Yong-Hua Cui
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College; Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China.
| | - Zheng Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College; Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, 430030, People's Republic of China.
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Sakae TM, Maurici R, Trevisol DJ, Pizzichini MMM, Pizzichini E. Effects of prednisone on eosinophilic bronchitis in asthma: a systematic review and meta-analysis. J Bras Pneumol 2015; 40:552-63. [PMID: 25410844 PMCID: PMC4263337 DOI: 10.1590/s1806-37132014000500012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 06/27/2014] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE: To evaluate the effect size of oral corticosteroid treatment on eosinophilic
bronchitis in asthma, through systematic review and meta-analysis. METHODS: We systematically reviewed articles in the Medline, Cochrane Controlled Trials
Register, EMBASE, and LILACS databases. We selected studies meeting the following
criteria: comparing at least two groups or time points (prednisone vs. control,
prednisone vs. another drug, or pre- vs. post-treatment with prednisone); and
evaluating parameters before and after prednisone use, including values for sputum
eosinophils, sputum eosinophil cationic protein (ECP), and sputum IL-5-with or
without values for post-bronchodilator FEV1-with corresponding 95% CIs
or with sufficient data for calculation. The independent variables were the use,
dose, and duration of prednisone treatment. The outcomes evaluated were sputum
eosinophils, IL-5, and ECP, as well as post-bronchodilator FEV1. RESULTS: The pooled analysis of the pre- vs. post-treatment data revealed a significant
mean reduction in sputum eosinophils (↓8.18%; 95% CI: 7.69-8.67; p < 0.001),
sputum IL-5 (↓83.64 pg/mL; 95% CI: 52.45-114.83; p < 0.001), and sputum ECP
(↓267.60 µg/L; 95% CI: 244.57-290.63; p < 0.0001), as well as a significant
mean increase in post-bronchodilator FEV1 (↑8.09%; 95% CI: 5.35-10.83;
p < 0.001). CONCLUSIONS: In patients with moderate-to-severe eosinophilic bronchitis, treatment with
prednisone caused a significant reduction in sputum eosinophil counts, as well as
in the sputum levels of IL-5 and ECP. This reduction in the inflammatory response
was accompanied by a significant increase in post-bronchodilator FEV1.
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Clifford RL, Patel JK, John AE, Tatler AL, Mazengarb L, Brightling CE, Knox AJ. CXCL8 histone H3 acetylation is dysfunctional in airway smooth muscle in asthma: regulation by BET. Am J Physiol Lung Cell Mol Physiol 2015; 308:L962-72. [PMID: 25713319 PMCID: PMC4421784 DOI: 10.1152/ajplung.00021.2015] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 02/13/2015] [Indexed: 01/03/2023] Open
Abstract
Asthma is characterized by airway inflammation and remodeling and CXCL8 is a CXC chemokine that drives steroid-resistant neutrophilic airway inflammation. We have shown that airway smooth muscle (ASM) cells isolated from asthmatic individuals secrete more CXCL8 than cells from nonasthmatic individuals. Here we investigated chromatin modifications at the CXCL8 promoter in ASM cells from nonasthmatic and asthmatic donors to further understand how CXCL8 is dysregulated in asthma. ASM cells from asthmatic donors had increased histone H3 acetylation, specifically histone H3K18 acetylation, and increased binding of histone acetyltransferase p300 compared with nonasthmatic donors but no differences in CXCL8 DNA methylation. The acetylation reader proteins Brd3 and Brd4 were bound to the CXCL8 promoter and Brd inhibitors inhibited CXCL8 secretion from ASM cells by disrupting Brd4 and RNA polymerase II binding to the CXCL8 promoter. Our results show a novel dysregulation of CXCL8 transcriptional regulation in asthma characterized by a promoter complex that is abnormal in ASM cells isolated from asthmatic donors and can be modulated by Brd inhibitors. Brd inhibitors may provide a new therapeutic strategy for steroid-resistant inflammation.
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Affiliation(s)
- Rachel L Clifford
- Department of Respiratory Medicine and Nottingham Respiratory Research Unit, University of Nottingham, Nottingham, United Kingdom; and
| | - Jamie K Patel
- Department of Respiratory Medicine and Nottingham Respiratory Research Unit, University of Nottingham, Nottingham, United Kingdom; and
| | - Alison E John
- Department of Respiratory Medicine and Nottingham Respiratory Research Unit, University of Nottingham, Nottingham, United Kingdom; and
| | - Amanda L Tatler
- Department of Respiratory Medicine and Nottingham Respiratory Research Unit, University of Nottingham, Nottingham, United Kingdom; and
| | - Lisa Mazengarb
- Department of Respiratory Medicine and Nottingham Respiratory Research Unit, University of Nottingham, Nottingham, United Kingdom; and
| | - Christopher E Brightling
- Institute for Lung Health, Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, United Kingdom
| | - Alan J Knox
- Department of Respiratory Medicine and Nottingham Respiratory Research Unit, University of Nottingham, Nottingham, United Kingdom; and
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Prolonged Treatment with Inhaled Corticosteroids does not Normalize High Activity of Matrix Metalloproteinase-9 in Exhaled Breath Condensates of Children with Asthma. Arch Immunol Ther Exp (Warsz) 2015; 63:231-7. [PMID: 25650123 PMCID: PMC4429133 DOI: 10.1007/s00005-015-0328-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 01/17/2015] [Indexed: 10/31/2022]
Abstract
The airway remodeling in asthma is associated with increased amount of matrix metalloproteinase (MMP)-9. High levels of MMP-9 were found in mucosal biopsies, sputum and in exhaled breath condensates (EBC) of asthma patients. However, there are no data concerning real in vivo activity. Inhaled corticosteroids are effective in asthma control, but it is unclear, whether they only attenuate inflammation, or also protect against progressive remodeling of respiratory tract. Therefore, the aim of the study was to assess the amount and activity of MMP-9 in context of pro-inflammatory cytokines (IL-6, IL-8 and tumor necrosis factor, TNF), measured in EBC of asthma-suffering children, treated with inhaled steroids. The study involved 27 children with asthma, continuously treated with inhaled fluticasone propionate, and 22 healthy controls. In addition to routine clinical screening, the selected cytokines in EBC were analyzed using Ultrasensitive ELISA, whereas activity of MMP-9 was assessed using a novel immunozymography method. Despite chronic treatment with inhaled steroids mean MMP-9/EBC activity in asthma group was significantly higher than in healthy controls. Moreover, high MMP-9/EBC in asthma-suffering children significantly correlated with IgE serum levels. The IL-6 and IL-8 concentration was below the detection limit in all EBC samples. TNF/EBC levels were similar in both, asthma and healthy children. We hypothesize that MMP-9 hyperactivity in asthma may be closely related to high IgE serum levels. Our results suggest that inhaled steroids may be ineffective to prevent asthma-associated airway remodeling. Finally, we emphasize the necessity of further research focused on MMP-9 inhibition in asthma treatment.
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Abstract
Urgent visits to the clinic and emergency department for acute severe asthma exacerbations are all too frequent. Existing national guidelines do not present consistent or specific recommendations for the evaluation and treatment of individual asthma patients in respiratory distress. In this vein, we propose the term "critical asthma syndrome" (CAS) to describe any child or adult who is at high risk for fatal asthma. Acute severe asthma, refractory asthma, status asthmaticus, and near-fatal asthma all describe CAS where physical exhaustion from the overwhelming work of breathing leads to respiratory arrest and death from hypoxia or related complications. The authors of this supplement seek to emphasize the importance of early recognition, prompt and coordinated evaluation, and treatment of CAS in the emergency department, hospital, and intensive care units by experienced healthcare provider teams. CAS is not severe persistent asthma where control of symptoms and prevention of exacerbations are targets of chronic disease management in the outpatient setting. The authors address the distinctions between the two entities throughout the supplement, and elaborate on the considerations important in the care of a critically ill patient, including the common errors to avoid. In addition, gaps in knowledge and clinical experience in regards to critical asthma are highlighted. Knowledge gaps include a lack of understanding of how to recognize CAS, how to coordinate and integrate hospital and outpatient resources, when to further phenotype patients with critical asthma in order to facilitate effective treatment, and how to prevent future acute exacerbations. Lastly, CAS is complicated by the fact that asthma care in diverse healthcare settings is haphazard. We recommend that primary care physicians refer patients promptly to an asthma specialist for consultation to reduce the frequency of acute exacerbations and prevent the development of CAS.
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Affiliation(s)
- Nicholas Kenyon
- Division of Pulmonary, Critical Care, Sleep Medicine, Department of Medicine, University of California, Davis, Davis, CA, USA
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Lu X, Zhu T, Chen C, Liu Y. Right or left: the role of nanoparticles in pulmonary diseases. Int J Mol Sci 2014; 15:17577-600. [PMID: 25268624 PMCID: PMC4227179 DOI: 10.3390/ijms151017577] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 08/25/2014] [Accepted: 08/25/2014] [Indexed: 01/07/2023] Open
Abstract
Due to the rapid development of the nanotechnology industry in the last decade, nanoparticles (NPs) are omnipresent in our everyday life today. Many nanomaterials have been engineered for medical purposes. These purposes include therapy for pulmonary diseases. On other hand, people are endeavoring to develop nanomaterials for improvement or replacement of traditional therapies. On the other hand, nanoparticles, as foreign material in human bodies, are reported to have potential adverse effects on the lung, including oxidase stress, inflammation, fibrosis and genotoxicity. Further, these damages could induce pulmonary diseases and even injuries in other tissues. It seems that nanoparticles may exert two-sided effects. Toxic effects of nanomaterials should be considered when their use is developed for therapies. Hence this review will attempt to summarize the two-side roles of nanoparticles in both therapies for pulmonary diseases and initiation of lung diseases and even secondary diseases caused by lung injuries. Determinants of these effects such as physicochemical properties of nanoparticles will also be discussed.
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Affiliation(s)
- Xuefei Lu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology of China, Beijing 100190, China.
| | - Tao Zhu
- Hefei National Laboratory for Physical Sciences at Microscale and School of Life Sciences, University of Science and Technology of China, Hefei 230027, Anhui, China.
| | - Chunying Chen
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology of China, Beijing 100190, China.
| | - Ying Liu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology of China, Beijing 100190, China.
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Calapai G, Casciaro M, Miroddi M, Calapai F, Navarra M, Gangemi S. Montelukast-induced adverse drug reactions: a review of case reports in the literature. Pharmacology 2014; 94:60-70. [PMID: 25196099 DOI: 10.1159/000366164] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 07/27/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Montelukast, a leucotriene receptor antagonist, binds the cysteinyl leucotriene type 1 receptor. Montelukast is commonly prescribed to asthma patients as add-on therapy to inhaled corticosteroids. Several clinical trials emphasized that montelukast can be considered a safe drug. However, recent evidence reconsidered the benefit/risk ratio of the use of montelukast for both paediatric and adult patients. SUMMARY The present review analyzed the previous published case reports regarding montelukast-induced adverse drug reactions (ADRs). They included agitation, anxiety, depression, sleep disturbance, hallucinations, suicidal thinking and suicidality, tremor, dizziness, drowsiness, neuropathies and seizures. The immune system can be involved, in particular, cases of Churg-Strauss syndrome have been published. Furthermore, it can induce hypersensitivity reactions, including anaphylaxis and eosinophilic infiltration. In addition, hepatobiliary, pancreatic and uropoietic disorders have been observed. Some of these cases are characterized by severe prognosis (i.e. neurological deficit and fatal hepatotoxicity). Key Message: The use of montelukast can be burdened by several ADRs, of which physicians should be aware in their clinical practice. A better understanding of the mechanisms causing ADRs after using montelukast could help researchers and clinicians in defining a risk-reduction strategy aimed to lessen montelukast toxicity. More accurate epidemiological studies, in order to discover risk factors favouring montelukast-associated ADRs, are demanded.
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Affiliation(s)
- Gioacchino Calapai
- School and Division of Allergology and Clinical Immunology, University of Messina, Messina, Italy
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Zhang Y, Zhang J. Preparation of budesonide nanosuspensions for pulmonary delivery: Characterization, in vitro release and in vivo lung distribution studies. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2014; 44:285-9. [PMID: 25100657 DOI: 10.3109/21691401.2014.944645] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Yuan Zhang
- a Department of Pediatrics of Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , P. R. China
| | - Jianhua Zhang
- a Department of Pediatrics of Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , P. R. China
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Kontakioti E, Domvri K, Papakosta D, Daniilidis M. HLA and asthma phenotypes/endotypes: a review. Hum Immunol 2014; 75:930-9. [PMID: 24994462 DOI: 10.1016/j.humimm.2014.06.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 03/11/2014] [Accepted: 06/23/2014] [Indexed: 11/25/2022]
Abstract
Asthma is a complex chronic inflammatory disease of the airways caused by the interaction of genetic susceptibility with environmental influences. Genome-wide association studies (GWAS) represent the most powerful approach for asthma, that have identified several genes (e.g., IL18R1, IL33, SMAD3, ORMDL3, HLA-DQ and IL2RB loci). HLA super-locus is a genomic region in the chromosomal position 6p21. Since no gene can be considered as an asthma gene, able to reflect the complex etiology and the heterogeneity of the disease the terms 'phenotype' and more recently 'endotype' have been used. This review, according to literature availability, focuses on the relationship between human leukocyte antigens (HLA) region specifically the HLA class II genes and different asthma phenotypes/endotypes, such as allergic asthma/Th2 associated, occupational and aspirin-sensitive asthma. The most common HLA haplotypes in the different asthma phenotypes are HLA-DRB1in allergic asthma, HLA-DQB1in occupational asthma and HLA-DPB1 in aspirin-sensitive asthma. However, it is difficult to study the role of class II genes in vivo because of the heterogeneity of human population, the complexity of MHC, and the strong linkage disequilibrium among different class II genes. Despite the variation and the inconsistency of the HLA haplotypes and alleles in different types of asthma, the association between HLA class II genes and asthma has been demonstrated in the majority of studies.
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Affiliation(s)
- Eirini Kontakioti
- Asthma Clinic, Pulmonary Department, Aristotle University of Thessaloniki, George Papanikolaou Hospital, Exochi, Thessaloniki, Greece
| | - Kalliopi Domvri
- Asthma Clinic, Pulmonary Department, Aristotle University of Thessaloniki, George Papanikolaou Hospital, Exochi, Thessaloniki, Greece
| | - Despina Papakosta
- Asthma Clinic, Pulmonary Department, Aristotle University of Thessaloniki, George Papanikolaou Hospital, Exochi, Thessaloniki, Greece.
| | - Michail Daniilidis
- Immunology Research Laboratory, 1st Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Seyedrezazadeh E, Moghaddam MP, Ansarin K, Vafa MR, Sharma S, Kolahdooz F. Fruit and vegetable intake and risk of wheezing and asthma: a systematic review and meta-analysis. Nutr Rev 2014; 72:411-28. [PMID: 24947126 DOI: 10.1111/nure.12121] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Major bibliographic databases were searched for studies examining the relationship between fruit and vegetable consumption and the risk of wheezing and asthma. Random-effects models were used to pool study results. Subgroup analyses were conducted by fruit and vegetable categories, study design, and age group. Twelve cohorts, 4 population-based case-control studies, and 26 cross-sectional studies published between January 1990 and July 2013 were identified. For the meta-analysis of adults and children, the relative risk (RR) and confidence intervals (CI) when comparing the highest intake group with the lowest intake group were 0.78 (95%CI, 0.70-0.87) for fruit and 0.86 (95%CI, 0.75-0.98) for vegetables. High intake of fruit and vegetables (RR = 0.76; 95%CI, 0.68-0.86 and RR = 0.83; 95%CI, 0.72-0.96) reduced the risk of childhood wheezing. Total intake of fruit and vegetables had a negative association with risk of asthma in adults and children (RR = 0.54; 95%CI, 0.41-0.69). Consuming fruit and vegetables during pregnancy had no association with the risk of asthma in offspring. High intake of fruit and vegetables may reduce the risk of asthma and wheezing in adults and children.
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Affiliation(s)
- Ensiyeh Seyedrezazadeh
- Tuberculosis and Lung Research Disease Center, Tabriz University of Medical Sciences, Tabriz, Iran; School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Fernandes ALG, Amorim MM, Caetano LB, Dracoulakis S, Araruna AAR, Faresin SM, Santoro IL. Bronchodilator response as a hallmark of uncontrolled asthma: a randomised clinical trial. J Asthma 2014; 51:405-10. [PMID: 24404797 DOI: 10.3109/02770903.2013.878845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The goal of this study is to determine whether bronchodilator (BD) response can be used as a reliable measure of asthma control by analyzing the effects of a short course of oral corticosteroids (OC) or placebo (P) on spirometry, sputum cytology and BD response in controlled asthma patients scoring less than 1.5 on the ACQ5. METHODS Seventy patients with moderate to severe asthma who were undergoing combination therapy and were considered to be controlled based on ACQ5 scores, but who exhibited persistent positive BD response, were randomly assigned to two groups, one receiving OC and the other P. Patients were evaluated before and after 2 weeks of treatment. Intervention response (comparison of FEV(1) before and after OC or P treatment) was used as a measure of intervention efficacy, with values equal to or greater than 200 mL considered positive. RESULTS Patients who received OC showed significant improvement in FEV(1), and no longer exhibited a positive BD response. Those in the P group showed no change. In addition, sputum eosinophil counts significantly decreased in the OC group. CONCLUSIONS BD response can be used as a reliable measure of asthma control. This study suggests that ACQ5 scores alone are not sufficient to fully assess asthma control, and that BD response should be included as an essential measurement in any algorithm of asthma control evaluation.
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Affiliation(s)
- Ana Luisa Godoy Fernandes
- Respiratory Division, Universidade Federal de São Paulo/Escola Paulista de Medicina , São Paulo-SP , Brasil
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Zhao Z, Miao Y, Pan P, Cheng B, Bai G, Wu H. Qingfei Xiaoyan Wan alleviates asthma through multi-target network regulation. Altern Ther Health Med 2013; 13:206. [PMID: 23919426 PMCID: PMC3765495 DOI: 10.1186/1472-6882-13-206] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 08/02/2013] [Indexed: 01/02/2023]
Abstract
BACKGROUND Qingfei Xiaoyan Wan (QFXY), a traditional Chinese formula, is widely used for relieving cough, asthma, upper respiratory tract infection, bronchitis, pneumonia, and etc. in clinic. Comparing with other anti-asthma drugs, it is characterised with moderate and persistent efficacy as well as few side effects, however, the underlying action mechanism still remains elusive. This study aimed to identify QFXY multi-target network regulation as an asthma controller. METHODS This study established asthma model induced by histamine phosphate and acetylcholine chloride (His&Ach) in guinea pigs, which then were administered orally with QFXY. Hematoxylin-Eosin staining sections were applied for evaluating QFXY effect. In both Model and QFXY groups, customized microarrays and 2D electrophoresis were adopted to detect differentially expressed genes (diff genes) and proteins (diff proteins) respectively, and some diff proteins were identified with MALDI-TOF/MS. The checked diff genes and proteins underwent Cluster, GO and KEGG analysis. Based on GAD and HPRD databases, QFXY-asthma target regulation network was constructed. RESULTS His&Ach-induced asthma model of guinea pigs was established. HE sections presented anti-inflammation and anti-remodelling effects of QFXY. Comparing with the Model group, 55 diff genes and 6 diff proteins were identified in QFXY group. Validation by qPCR and Western blot showed the microarray and 2D data reliable. Furthermore, QFXY-asthma target regulation network was achieved. CONCLUSIONS A primarily combined genomic and proteomic screening of QFXY targets displayed a series of candidate genes and proteins, which indicated that the effect of QFXY relied on the combined mechanism, anti-inflammation and anti-remodelling, as well as influencing signal transduction in vivo.
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Kato G, Takahashi K, Izuhara K, Komiya K, Kimura S, Hayashi S. Markers that can Reflect Asthmatic Activity before and after Reduction of Inhaled Corticosteroids: A Pilot Study. Biomark Insights 2013; 8:97-105. [PMID: 23943655 PMCID: PMC3738382 DOI: 10.4137/bmi.s12537] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Evaluation of airway inflammation is important in achieving adequate dosing of inhaled corticosteroids (ICS) for treating bronchial asthma. However, there is no evaluation tool that can be used in clinical settings. We examined biomarkers that can precisely reflect airway inflammation when ICS are decreased in stable asthmatic patients. This was a 12-week, single-arm, open-label clinical study performed at a single university hospital. Twenty-five patients (6 male and 19 female) with stable asthma were included in this study. We investigated whether the levels of nitrite and nitrate in exhaled breath condensate (EBC) increase after ICS reduction. We also investigated whether blood eosinophils, serum immunoglobulin E (IgE), high-sensitivity C reactive protein (hs-CRP), interleukin (IL)-13, IL-17, and periostin are different before and after ICS reduction. Peak expiratory flow (PEF), pulmonary function tests, asthma control test (ACT), and asthma quality of life questionnaire (AQLQ) were also examined. We considered an unscheduled hospital visit due to asthmatic symptoms and decline in average PEF over one week by more than 10% to indicate disease instability, and compared patients with stable and unstable disease for analysis. Unstable status was detected in 5 patients. Age, sex, asthma duration, ACT and AQLQ scores, and the level of serum IgE did not differ between stable and unstable groups. In the unstable group, the total concentration of nitrite and nitrate at the last visit was 9.84 (6.65-11.24) μM. Surprisingly, this was similar to the concentration at the first visit (5.58 (2.94-17.29) μM). Serum periostin before ICS reduction (141.9 [107.7-147.7] pg/mL) was higher in the unstable group than in the stable group (91.5 [78.75-103.5] pg/mL). The unstable group had a higher peripheral blood eosinophil count and wider diurnal variation of PEF at the first visit compared to the stable group. Higher eosinophils in peripheral blood and wider diurnal variation of PEF were predictive markers for unstable disease after ICS reduction. Serum periostin is another candidate for the predictive marker.
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Affiliation(s)
- Go Kato
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Saga University Medical School, Saga, Japan
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Kim YM, Kim YS, Jeon SG, Kim YK. Immunopathogenesis of allergic asthma: more than the th2 hypothesis. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2013; 5:189-96. [PMID: 23814671 PMCID: PMC3695232 DOI: 10.4168/aair.2013.5.4.189] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Accepted: 10/10/2012] [Indexed: 11/26/2022]
Abstract
Asthma is a chronic obstructive airway disease that involves inflammation of the respiratory tract. Biological contaminants in indoor air can induce innate and adaptive immune responses and inflammation, resulting in asthma pathology. Epidemiologic surveys indicate that the prevalence of asthma is higher in developed countries than in developing countries. The prevalence of asthma in Korea has increased during the last several decades. This increase may be related to changes in housing styles, which result in increased levels of indoor biological contaminants, such as house dust mite-derived allergens and bacterial products such as endotoxin. Different types of inflammation are observed in those suffering from mild-to-moderate asthma compared to those experiencing severe asthma, involving markedly different patterns of inflammatory cells and mediators. As described in this review, these inflammatory profiles are largely determined by the involvement of different T helper cell subsets, which orchestrate the recruitment and activation of inflammatory cells. It is becoming clear that T helper cells other than Th2 cells are involved in the pathogenesis of asthma; specifically, both Th1 and Th17 cells are crucial for the development of neutrophilic inflammation in the airways, which is related to corticosteroid resistance. Development of therapeutics that suppress these immune and inflammatory cells may provide useful asthma treatments in the future.
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Affiliation(s)
- You-Me Kim
- Department of Life Science, Pohang University of Science and Technology (POSTECH), Pohang, Korea
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Da Silva AL, Santos RS, Xisto DG, Alonso SDV, Morales MM, Rocco PRM. Nanoparticle-based therapy for respiratory diseases. AN ACAD BRAS CIENC 2013; 85:137-46. [PMID: 23460424 DOI: 10.1590/s0001-37652013005000018] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 06/28/2011] [Indexed: 11/21/2022] Open
Abstract
Nanotechnology is an emerging science with the potential to create new materials and strategies involving manipulation of matter at the nanometer scale (<100 nm). With size-dependent properties, nanoparticles have introduced a new paradigm in pharmacotherapy - the possibility of cell-targeted drug delivery with minimal systemic side effects and toxicity. The present review provides a summary of published findings, especially regarding to nanoparticle formulations for lung diseases. The available data have shown some benefits with nanoparticle-based therapy in the development of the disease and lung remodeling in respiratory diseases. However, there is a wide gap between the concepts of nanomedicine and the published experimental data and clinical reality. In addition, studies are still required to determine the potential of nanotherapy and the systemic toxicity of nanomaterials for future human use.
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Affiliation(s)
- Adriana L Da Silva
- Laboratório de Investigação Pulmonar, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Centro de Ciências da Saúde, Rio de Janeiro, RJ, Brasil
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Shi Y, Aledia AS, Galant SP, George SC. Peripheral airway impairment measured by oscillometry predicts loss of asthma control in children. J Allergy Clin Immunol 2012; 131:718-23. [PMID: 23146376 DOI: 10.1016/j.jaci.2012.09.022] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 09/07/2012] [Accepted: 09/25/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND We previously showed that impulse oscillometry (IOS) indices of peripheral airway function are associated with asthma control in children. However, little data exist on whether dysfunction in the peripheral airways can predict loss of asthma control. OBJECTIVE We sought to determine the utility of peripheral airway impairment, as measured by IOS, in predicting loss of asthma control in children. METHODS Fifty-four children (age, 7-17 years) with controlled asthma were enrolled in the study. Spirometric and IOS indices of airway function were obtained at baseline and at a follow-up visit 8 to 12 weeks later. Physicians who were blinded to the IOS measurements assessed asthma control (National Asthma Education and Prevention Program guidelines) on both visits and prescribed no medication change between visits. RESULTS Thirty-eight (70%) patients maintained asthma control between 2 visits (group C-C), and 16 patients had asthma that became uncontrolled on the follow-up visit (group C-UC). There was no difference in baseline spirometric results between the C-C and C-UC groups, except for FEV1/forced vital capacity ratio (86% vs 82%, respectively; P < .01). Baseline IOS results, including resistance of the respiratory system at 5 Hz (R5; 6.4 vs 4.3 cm H2O · L(-1) · s), frequency dependence of resistance (difference of R5 and resistance of the respiratory system at 20 Hz [R5-20]; 2.0 vs 0.7 cm H2O · L(-1) · s), and reactance area (13.1 vs 4.1 cm H2O · L(-1)), of group C-UC were significantly higher than those of group C-C (P < .01). Receiver operating characteristic analysis showed baseline R5-20 and reactance area effectively predicted asthma control status at the follow-up visit (area under the curve, 0.91 and 0.90). CONCLUSION Children with controlled asthma who have increased peripheral airway IOS indices are at risk of losing asthma control.
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Affiliation(s)
- Yixin Shi
- Department of Biomedical Engineering, University of California, Irvine, CA 92697-2730, USA
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Health-related quality of life in children and adults with respiratory allergy in Colombia: prospective study. Allergol Immunopathol (Madr) 2012; 40:379-84. [PMID: 22316550 DOI: 10.1016/j.aller.2011.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 11/16/2011] [Accepted: 11/22/2011] [Indexed: 11/22/2022]
Abstract
BACKGROUND Allergic diseases are very common, with the estimated cumulative prevalence in Colombia for asthma and allergic rhinitis being 22.7% and 31.3% respectively, and with a clear upward trend. A major social as well as economic impact associated with allergic disease has been described. Because in Colombia there are no studies that assess the Health-Related Quality of Life (HRQOL) in allergic respiratory diseases, our aim is to describe the HRQOL in subjects with respiratory allergy and its association with clinical control variables. METHODS A prospective descriptive study was conducted among 76 Colombian subjects with rhinitis and asthma/allergic rhinitis. In order to evaluate the HRQOL, the instruments Kidscreen-27 and SF-36 were applied. The scores obtained in the HRQOL fields were correlated with the following clinical variables: peak expiratory flow (PEF) and peak nasal inspiratory flow (PNIF). RESULTS In children, the better HRQL domain is present in the school environment (55.9) and the worst in psychological well-being (39.9). For adults the worst HRQL was found in the emotional function domain (55.6) while the physical function (81.7) had the best. There were no statistical differences between groups of asthma/allergic rhinitis and allergic rhinitis. Subjects with allergic asthma showed a strong correlation between the mental health domain and PEF values (r=-0717, p=0.046). CONCLUSION Mental health is more affected than physical health in Colombian subjects with respiratory allergy. There was a strong correlation between the mental health domain and the values of PEF in patients with asthma/allergic rhinitis.
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Carson KV, Labiszewski NA, Brinn MP, Esterman AJ, Peters M, Wood-Baker R, Smith BJ. Consumer guidelines for chronic disease management. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd010096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Kristin V Carson
- The Queen Elizabeth Hospital; Clinical Practice Unit; 4A Main Building 28 Woodville Road Woodville South Adelaide South Australia Australia 5011
| | - Nadina A Labiszewski
- The Queen Elizabeth Hospital; Clinical Practice Unit; 4A Main Building 28 Woodville Road Woodville South Adelaide South Australia Australia 5011
| | - Malcolm P Brinn
- The Queen Elizabeth Hospital; Clinical Practice Unit; 4A Main Building 28 Woodville Road Woodville South Adelaide South Australia Australia 5011
| | - Adrian J Esterman
- University of South Australia; Adelaide South Australia Australia 5000
| | - Matthew Peters
- The University of Sydney; Medicine, Concord Clinical School; Sydney NSW Australia 2006
| | - Richard Wood-Baker
- University of Tasmania; Menzies Research Institute Tasmania; Department of Respiratory Medicine GPO Box 1061 Hobart Tasmania Australia 7001
| | - Brian J Smith
- The Queen Elizabeth Hospital; Department of Medicine, University of Adelaide; Adelaide South Australia Australia 5011
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