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Jiang S, Chen H, Shen P, Zhou Y, Li Q, Zhang J, Chen Y. Gasotransmitter Research Advances in Respiratory Diseases. Antioxid Redox Signal 2024; 40:168-185. [PMID: 37917094 DOI: 10.1089/ars.2023.0410] [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] [Indexed: 11/03/2023]
Abstract
Significance: Gasotransmitters are small gas molecules that are endogenously generated and have well-defined physiological functions. The most well-defined gasotransmitters currently are nitric oxide (NO), carbon monoxide (CO), and hydrogen sulfide (H2S), while other potent gasotransmitters include ammonia, methane, cyanide, hydrogen gas, and sulfur dioxide. Gasotransmitters play a role in various respiratory diseases such as asthma, chronic obstructive pulmonary disease, obstructive sleep apnea, lung infection, bronchiectasis, cystic fibrosis, primary ciliary dyskinesia, and COVID-19. Recent Advances: Gasotransmitters can act as biomarkers that facilitate disease diagnosis, indicate disease severity, predict disease exacerbation, and evaluate disease outcomes. They also have cell-protective properties, and many studies have been conducted to explore their pharmacological applications. Innovative drug donors and drug delivery methods have been invented to amplify their therapeutic effects. Critical Issues: In this article, we briefly reviewed the physiological and pathophysiological functions of some gasotransmitters in the respiratory system, the progress in detecting exhaled gasotransmitters, as well as innovative drugs derived from these molecules. Future Directions: The current challenge for gasotransmitter research includes further exploring their physiological and pathological functions, clarifying their complicated interactions, exploring suitable drug donors and delivery devices, and characterizing new members of gasotransmitters. Antioxid. Redox Signal. 40, 168-185.
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Affiliation(s)
- Simin Jiang
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Haijie Chen
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Pu Shen
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Yumou Zhou
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Qiaoyu Li
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Jing Zhang
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Yahong Chen
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
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Chapman KR, An L, Bosnic-Anticevich S, Campomanes CM, Espinosa J, Jain P, Lavoie KL, Li J, Butta AK. Asthma patients' and physicians' perspectives on the burden and management of asthma. Respir Med 2021; 186:106524. [PMID: 34265629 DOI: 10.1016/j.rmed.2021.106524] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/16/2021] [Accepted: 06/27/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The 2021 Global Initiative for Asthma (GINA) report recommends as-needed inhaled corticosteroid (ICS)/formoterol irrespective of severity, and maintenance and reliever treatment (MART) from GINA Step 3 as part of Treatment Track 1, partly based on the SYGMA studies. We investigated how current clinical practice in Australia, Canada, China and the Philippines relates to latest GINA recommendations. METHODS Patients and physicians were recruited from online panels between July and August 2020 and invited to complete an online survey. INCLUSION CRITERIA age ≥18 years, current/past physician diagnosis of asthma (patients); primary care (Canada also included respirologists/respiratory therapists), treating ≥4 patients with asthma per month, ≥3 years in clinical practice (physicians). RESULTS Overall, 1216/70,183 patients and 803/8376 physicians replied and were eligible for inclusion. Only 8-15% of patients were using MART; 66-81% used regular maintenance therapy with/without an as-needed reliever. Across the four countries, physicians classified 48-63% of their patients as mild (GINA Steps 1-2) and 28-36% as moderate (GINA Steps 3-4). Generally, physicians rated symptom control over exacerbation reduction as their main treatment goal; patients also ranked symptom relief as very important. Approximately 9-29% of patients and 24-45% of physicians were unaware of MART, and among those who prescribed MART, 80-95% prescribed an additional (non-ICS) as-needed reliever. INTERPRETATION Most physicians prioritized managing asthma symptoms over exacerbations. A lack of awareness and understanding of MART dosing exists among physicians. Practical strategies are required to implement GINA recommendations effectively in real-world clinical practice and to identify appropriate patients for MART.
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Affiliation(s)
| | - Li An
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; Sydney Local Health District, Sydney, Australia
| | | | | | - Priya Jain
- GlaxoSmithKline, Global Classic and Established Medicines, Singapore
| | - Kim L Lavoie
- University of Quebec at Montreal, Montreal, Canada; Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de Santé et de Services Sociaux Du Nord de L'Ile de Montréal (CIUSSS-NIM), Montreal, Canada
| | - Jing Li
- Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, Guangzhou, Guangdong, China
| | - Aman K Butta
- GlaxoSmithKline, Global Classic and Established Medicines, Singapore.
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Yu X, Yu L, Guo B, Chen R, Qiu C. A narrative review of research advances in mesenchymal stem cell therapy for asthma. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1461. [PMID: 33313206 PMCID: PMC7723541 DOI: 10.21037/atm-20-6389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Asthma is a chronic inflammatory disease of the airways that involves multiple cells, including inflammatory cells, structural cells, and cellular components. Glucocorticoids and beta-receptor agonists are still the first choices for asthma treatment. However, the asthma symptoms may still be poorly controlled in some patients after an optimal treatment. Mesenchymal stem cells (MSCs) are characterized by the potential for multi-directional differentiation and can exert immunomodulatory and anti-inflammatory effects. Its role in treating asthma has increasingly been recognized in recent years. In this review article, we sought to summarize the recent advances in the therapeutic effects of MSCs on several types of asthma and explain the relevant mechanisms. Articles on asthma treatment with MSCs as of January 2020 were searched in PubMed, Google Scholar, and Web of Science databases. It was found that MSCs have therapeutic effects on allergic asthma, non-allergic asthma and occupational asthma; gene-modified or pretreated MSCs improves the therapeutic effects of MSCs in asthma; MSC-derived conditioned medium or extracellular vesicles possess the considerable curative effect as MSC on asthma; and MSCs exert their therapeutic effects on asthma by restoring Th1/Th2 balance, reversing Th17/Tregs imbalance, inhibiting DC maturation, and promoting the switch of M1 to M2 and repairing epithelial injury. Thus, MSCs may be a promising treatment for asthma.
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Affiliation(s)
- Xiu Yu
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (Second Clinical Medical College of Jinan University & First Affiliated Hospital of Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases, Shenzhen, China
| | - Li Yu
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (Second Clinical Medical College of Jinan University & First Affiliated Hospital of Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases, Shenzhen, China
| | - Bingxin Guo
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (Second Clinical Medical College of Jinan University & First Affiliated Hospital of Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases, Shenzhen, China
| | - Rongchang Chen
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (Second Clinical Medical College of Jinan University & First Affiliated Hospital of Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases, Shenzhen, China
| | - Chen Qiu
- Department of Respiratory and Critical Care Medicine, Shenzhen People's Hospital (Second Clinical Medical College of Jinan University & First Affiliated Hospital of Southern University of Science and Technology), Shenzhen Institute of Respiratory Diseases, Shenzhen, China
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Dong H, Wang T, Wang M, Yan Y, Zhang X, Gu W, Ji W, Huang L, Chen Z. The role of inducible costimulatory molecular ligand (ICOSL) in children with neutrophilic asthma. Transl Pediatr 2020; 9:469-479. [PMID: 32953544 PMCID: PMC7475312 DOI: 10.21037/tp-20-172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND It has been shown that certain severe and refractory asthma cases are caused by neutrophil and not eosinophil infiltration. Inducible costimulatory molecular ligand (ICOSL) expression is closely associated with tumor and autoimmune diseases, yet a limited amount of data has been published regarding the significance of ICOSL in children with neutrophilic asthma. The present study aimed to explore the clinical significance of abnormal expression of ICOSL in peripheral blood and bronchoalveolar lavage fluid (BALF) samples of children with neutrophilic asthma. METHODS Selected children from the Children's Hospital of Soochow University who met the diagnostic criteria of asthma and excluded patients with a pathogen-positive etiology. Children who were admitted to the hospital for foreign body inhalation in the same period acted as the control group. Children with more than 50% of neutrophils in BALF samples were assigned to the neutrophilic asthma group (NA group), and the remaining subjects composed the asthma group (A group). The expression levels of ICOSL, IL-4, IL-17, IFN-γ, neutrophil elastase (NE), and matrix metalloproteinase-9 (MMP-9) were detected in plasma and BALF samples by enzyme-linked immunosorbent assays, in order to analyze the differences in the levels of cytokines and clinical characteristics between children with neutrophilic asthma and non-neutrophilic asthma. Moreover, the potential mechanism of ICOSL in neutrophilic asthma was explored. RESULTS 32 children were enrolled: 12 children in the NA group and 20 children in the A group. The mean hospitalization time of the NA group was longer than that of the A group (P<0.05). The concentration levels of ICOSL, IL-17, NE, and MMP-9 in plasma and BALF samples in the NA group were higher than those in the A group, while the levels of IFN-γ exhibited opposite. A significant correlation was found between ICOSL and IL-17 levels in plasma (r=0.753, P=0.012) and BALF (r=0.774, P=0.009) samples in the NA group. CONCLUSIONS Children with neutrophilic asthma were more severely affected, experiencing a considerably more difficult clinical treatment and longer hospitalization time. ICOSL may regulate the secretion of IL-17 by Th17 and increase the levels of NE and MMP-9, which are involved in the development of immune inflammation in neutrophils.
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Affiliation(s)
- Heting Dong
- Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Ting Wang
- Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Meijuan Wang
- Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yongdong Yan
- Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Xinxing Zhang
- Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wenjing Gu
- Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wei Ji
- Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Li Huang
- Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Zhengrong Chen
- Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
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Wang T, Dong H, Jiang W, Li Y, Sun H, Huang L, Wang M, Zhu C, Ji W, Wang Y, Hao C, Chen Z, Yan Y. Viral etiology and atopic characteristics in high-risk asthmatic children hospitalized for lower respiratory tract infection. Transl Pediatr 2020; 9:541-550. [PMID: 32953552 PMCID: PMC7475309 DOI: 10.21037/tp-20-165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Viral etiology and atopic characteristics, e.g., allergens and fractional exhaled nitric oxide (FeNO), play essential roles in asthma development. This study aimed to investigate associations among them in children at high risk of developing asthma to guide reliable diagnosis and treatment of wheezing. METHODS From April 2016 to August 2017, 135 children aged <3 years identified as being at high risk of asthma and hospitalized for lower respiratory tract infection (LRTI) with wheezing were recruited as research subjects (observation group). Real-time fluorescent polymerase chain reaction (PCR) was used to explore their etiology. Samples were also evaluated with Phadiatop (Pharmacia Diagnostics AB, Uppsala, Sweden). Additionally, 200 non-asthmatic, non-allergic, healthy children who were screened and followed up in the Echocardiography clinic during the study period were recruited as a healthy control group for FeNO measurement, and the observation group also underwent FeNO measurement. RESULTS Among the observation group, viruses were positively detected in 49.63%. The most often detected virus was human rhinovirus (HRV; 25.19%). Compared with children aged <12 months, those aged 1-3 years were more susceptible to HRV infection and had lower sensitivity rates for inhalant allergens and higher T-IgE. The virus-detected group had a higher sensitivity rate for inhalant allergens compared with the virus-undetected group. FeNO in the observation group was lower than that in the healthy control group. The second-wheezing group had higher sensitivity rates for dust mites and fungi and higher T-IgE levels compared with the first-wheezing group. CONCLUSIONS HRV was the most common viral pathogen present during an asthmatic attack in infants and young children at elevated risk of asthma. Allergy is a risk factor for both initial wheezing and repeated wheezing. Inhalant allergen-sensitive children are more susceptible than others to viral infection.
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Affiliation(s)
- Ting Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Heting Dong
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wujun Jiang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yan Li
- Department of Infectious Diseases, Children's Hospital of Soochow University, Suzhou, China
| | - Huiming Sun
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Li Huang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Meijuan Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Canhong Zhu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wei Ji
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yuqing Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Chuangli Hao
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Zhengrong Chen
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yongdong Yan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
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