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Betancor D, Valverde-Monge M, Sastre J. Upadacitinib-induced remission of allergic asthma: A case report". THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:4162-4163. [PMID: 34280588 DOI: 10.1016/j.jaip.2021.06.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Diana Betancor
- Allergology Department. Hospital Universitario Fundación Jiménez Díaz and Instituto de Investigación Sanitaria (IIS) Fundación Jiménez Díaz, Madrid; CIBER de Enfermedades Respiratorias (CIBERES).
| | - Marcela Valverde-Monge
- Allergology Department. Hospital Universitario Fundación Jiménez Díaz and Instituto de Investigación Sanitaria (IIS) Fundación Jiménez Díaz, Madrid; CIBER de Enfermedades Respiratorias (CIBERES)
| | - Joaquin Sastre
- Allergology Department. Hospital Universitario Fundación Jiménez Díaz and Instituto de Investigación Sanitaria (IIS) Fundación Jiménez Díaz, Madrid; CIBER de Enfermedades Respiratorias (CIBERES)
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Levin G, Cohen S, Springer C, Avital A, Picard E, Rottensctreich A. Factors Associated with Positive Adenosine Challenge Test in Young Children with Suspected Asthma. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2019; 32:103-108. [PMID: 32140278 DOI: 10.1089/ped.2019.1028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 06/29/2019] [Indexed: 11/12/2022]
Abstract
Background: To investigate the predictive factors associated with positive adenosine monophosphate challenge using the auscultation method (AMP-PCW) test results. Methods: This is a prospective study of young children with suspected asthma who underwent AMP-PCW test. Patients with a positive AMP-PCW test were compared with those with a negative AMP-PCW. A multivariate logistic regression model was performed to identify the independent determinants of positive AMP-PCW. Results: A total of 159 patients completed the AMP-PCW test. The median age was 53 months. In total, 54.0% of patients had a positive AMP-PCW. The prevalence of atopic dermatitis and family history of asthma and allergy were significantly higher among the positive AMP-PCW group (P = 0.04, P = 0.02, and P = 0.007, respectively), as were the prevalences of elevated immunoglobulin E (IgE), peripheral blood eosinophils percentage (P = 0.003, P < 0.001, respectively), and number of emergency department (ED) visits/hospitalizations before AMP-PCW test (P = 0.006). A significant inverse correlation exists between peripheral blood eosinophils percentage and serum IgE levels with the AMP end-point concentrations (r = -0.302, P = 0.001, and r = -0.312, P = 0.001, respectively). In multivariate logistic regression model, peripheral blood eosinophils percentage, IgE levels, and the number of ED visits/hospitalizations before the AMP-PCW test were found as independent predictors for positive AMP-PCW test result. Conclusions: Our results suggest that bronchial responsiveness to AMP-PCW is related to proxy markers of airway inflammation (elevated eosinophils and IgE levels) and clinical exacerbation of asthma before the test. This may support the role of AMP-PCW in detecting inflammatory changes and monitoring their trend among young children with suspected asthma.
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Affiliation(s)
- Gabriel Levin
- Department of Obstetrics and Gynecology, Hadassah University Medical Center, Jerusalem, Israel
| | - Shlomo Cohen
- Institute of Pulmonology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Chaim Springer
- Institute of Pulmonology, Hadassah University Medical Center, Jerusalem, Israel
| | - Avraham Avital
- Institute of Pulmonology, Hadassah University Medical Center, Jerusalem, Israel
| | - Elie Picard
- Institute of Pulmonology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Amihai Rottensctreich
- Department of Obstetrics and Gynecology, Hadassah University Medical Center, Jerusalem, Israel
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Park YA, Park HB, Kim YH, Sul IS, Yoon SH, Kim HR, Kim KW, Kim KE, Sohn MH. Airway hyperresponsiveness to mannitol and methacholine and exhaled nitric oxide in children with asthma. J Asthma 2017; 54:644-651. [PMID: 28055271 DOI: 10.1080/02770903.2016.1255751] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Asthma is characterized by airway hyperresponsiveness (AHR), inflammation, and obstruction. AHR to stimuli that indirectly cause bronchial smooth muscle (BSM) contractions via release of endogenous mediators is thought to better reflect airway inflammation than AHR to stimuli that act directly on BSM. Fractional exhaled nitric oxide (FeNO) is a useful parameter for noninvasive clinical airway inflammation assessments. Accordingly, this study aimed to examine the relationships of mannitol and methacholine challenge test outcomes with FeNO and the influence of inhaled corticosteroid treatment in children with asthma. METHODS One hundred thirty-four asthmatic children (89 males; ages: 5-17 years, median: 9 years) underwent spirometry, FeNO measurement, serum total/specific IgE testing, and blood eosinophil count. All subjects were challenged with mannitol dry powder (MDP; AridolH, Pharmaxis, Australia) and methacholine at 7-day intervals. Data of steroid-treated and steroid-naïve children were compared. RESULTS Positive responses to MDP and methacholine challenge tests were observed in 74.6% and 67.2% of total subject group, respectively, and 72 children had positive response to both challenge tests. The median FeNO level, response-dose ratio (RDR) of PC20 methacholine, and RDR of PD15 MDP were significantly higher in the steroid-treated group than in the steroid-naïve group (p < 0.001, 0.226, and 0.004, respectively). FeNO levels associated significantly with PD15 MDP and RDR PD15 MDP in total subject populations (p = 0.016 and 0.003, respectively); however, a significant correlation between FeNO and RDR PD15 MDP was observed only in the steroid-naïve group. CONCLUSIONS Compared with AHR to methacholine, AHR to MDP more closely reflected the level of FeNO in steroid-naïve asthmatic children.
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Affiliation(s)
- Young A Park
- a Department of Pediatrics , Severance Children's Hospital , Seoul , Republic of Korea
| | - Hyun Bin Park
- a Department of Pediatrics , Severance Children's Hospital , Seoul , Republic of Korea
| | - Yoon Hee Kim
- b Gangnam Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine , Seoul , Republic of Korea
| | - In Sook Sul
- a Department of Pediatrics , Severance Children's Hospital , Seoul , Republic of Korea
| | - Seo Hee Yoon
- a Department of Pediatrics , Severance Children's Hospital , Seoul , Republic of Korea
| | - Hye Ran Kim
- a Department of Pediatrics , Severance Children's Hospital , Seoul , Republic of Korea
| | - Kyung Won Kim
- a Department of Pediatrics , Severance Children's Hospital , Seoul , Republic of Korea
| | - Kyu-Earn Kim
- b Gangnam Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine , Seoul , Republic of Korea
| | - Myung Hyun Sohn
- a Department of Pediatrics , Severance Children's Hospital , Seoul , Republic of Korea
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Cicala C, Ialenti A. Adenosine signaling in airways: toward a promising antiasthmatic approach. Eur J Pharmacol 2013; 714:522-5. [PMID: 23850943 DOI: 10.1016/j.ejphar.2013.06.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 06/14/2013] [Accepted: 06/21/2013] [Indexed: 12/16/2022]
Abstract
Adenosine participates to asthma physiopathology by signaling through more than just one receptor subtype. Defining the role of each receptor is complicated by evidence that often results obtained on rodents do not coincide with human studies, but what emerges is that an important condition to establish hyperresponsiveness to adenosine in any species of sensitized animals is the exposure to allergen; this feature appears to be very similar to the human situation, since allergic humans regularly undergo exposure to allergen. Furthermore, A₂B in humans, but A₃ receptor in rodents, would mediate, indirectly, the bronchoconstriction in response to adenosine and would play the main role in adenosine-induced airway inflammation and airway hyperreactivity. On the other hand, A₁ receptor over-expressed on asthmatic airways would mediate a direct adenosine bronchoconstrictor effect. Antagonists and agonists to adenosine receptors have been considered as antiasthmatic drugs but often their development has been limited by unwanted effects. Preventing adenosine accumulation in airways should be considered as a novel promising antiasthmatic strategy.
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Affiliation(s)
- Carla Cicala
- Department of Pharmacy, University of Naples Federico II, via D. Montesano 49, 80131, Naples, Italy.
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Induced Sputum, Exhaled Nitric Oxide, and Particles in Exhaled Air in Assessing Airways Inflammation in Occupational Exposures. Clin Chest Med 2012; 33:771-82. [DOI: 10.1016/j.ccm.2012.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cirillo I, Ricciardolo FLM, Medusei G, Signori A, Ciprandi G. Exhaled nitric oxide may predict bronchial hyperreactivity in patients with allergic rhinitis. Int Arch Allergy Immunol 2012; 160:322-8. [PMID: 23052027 DOI: 10.1159/000341675] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 07/06/2012] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Nowadays it is possible to assess airway inflammation by measuring the fractional concentration of exhaled nitric oxide (FeNO) during an office visit and there is international consensus on the testing methodology. The aim of this study was to evaluate whether FeNO measurement may be a predictor of bronchial hyperreactivity (BHR) in patients with allergic rhinitis (AR). METHODS Two hundred eleven patients (196 males, median age 28.5 years) suffering from persistent AR were evaluated. Values for bronchial function (FVC, FEV(1), and FEF(25-75)), bronchial provocation tests (methacholine), exhaled nitric oxide (FeNO), a visual analogue scale for nasal and bronchial symptoms, and sensitization were assessed. RESULTS A strong and inverse correlation between FeNO levels and BHR severity was found (r = -0.58). FeNO was a predictive factor for BHR, and 37 ppb was found to be the best cutoff (area under the curve 0.90) to define the presence of BHR in patients with AR. CONCLUSIONS This study highlights the relevance of FeNO as a possible predictive marker for BHR in AR patients and underlines the close link between upper and lower airways. Thus, FeNO measurement could be a useful screening tool in identifying subjects with rhinitis at risk of developing asthma.
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Hyperresponsiveness to adenosine in sensitized Wistar rats over-expressing A1 receptor. Eur J Pharmacol 2012; 695:120-5. [PMID: 23000391 DOI: 10.1016/j.ejphar.2012.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 09/04/2012] [Accepted: 09/12/2012] [Indexed: 11/23/2022]
Abstract
Airway hyperreactivity is characterized by increased responsiveness to bronchoconstrictor stimuli and it is hallmark of asthma. Adenosine is an ubiquitous signaling nucleoside resulting from ATP catabolism, whose extracellular levels increase following cellular damage or stress. Adenosine plays a role in asthma; asthmatics, but not normal subjects, present bronchoconstriction following inhalation of adenosine or of its precursor, adenosine-5'-monophosphate, most likely via adenosine A(2B) receptor on mast cells. However, the mechanism underling the increased airway smooth muscle sensitivity to adenosine in asthmatics remains to be elucidated. Early experimental studies suggested the involvement of A(1) receptor; this hypothesis has been confirmed by more recent studies on guinea pigs and is corroborated by the finding of an increased adenosine A(1) expression on asthmatic bronchial tissues. Brown Norway rats, the strain usually used to assess asthma models, develop hyperresponsiveness to adenosine 3h following allergen challenge, but not 24h thereafter, without involvement of A(1) receptor. Here, we investigated the role of adenosine A(1) receptor in sensitized Wistar rats showing airway hyperresponsiveness 24h following allergen challenge. We found that on bronchi of sensitized Wistar rats challenged with allergen there is an increased adenosine A(1) receptor expression on smooth muscle that is responsible for hyperresponsiveness to adenosine and ovalbumin.
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Andregnette‐Roscigno V, Fernández‐Nieto M, Arochena L, García Del Potro M, Aguado E, Sastre J. Methacholine is more sensitive than mannitol for evaluation of bronchial hyper-responsiveness in youth athletes with exercise-induced bronchoconstriction. Pediatr Allergy Immunol 2012; 23:501-3. [PMID: 22816660 DOI: 10.1111/j.1399-3038.2012.01293.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Mar Fernández‐Nieto
- Department of Allergy, Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain.
| | - Lourdes Arochena
- Department of Allergy, Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain.
| | - Manuela García Del Potro
- Department of Allergy, Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain.
| | - Erika Aguado
- Department of Allergy, Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain.
| | - Joaquín Sastre
- Department of Allergy, Fundación Jiménez Díaz and CIBER de Enfermedades Respiratorias (CIBERES) Madrid, Spain.
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Manso L, Reche M, Padial M, Valbuena T, Pascual C. Diagnostic tools assessing airway remodelling in asthma. Allergol Immunopathol (Madr) 2012; 40:108-16. [PMID: 22236733 DOI: 10.1016/j.aller.2011.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 11/11/2011] [Indexed: 12/18/2022]
Abstract
Asthma is an inflammatory disease of the lower airways characterised by the presence of airway inflammation, reversible airflow obstruction and airway hyperresponsiveness and alterations on the normal structure of the airways, known as remodelling. Remodelling is characterised by the presence of metaplasia of mucous glands, thickening of the lamina reticularis, increased angiogenesis, subepithelial fibrosis and smooth muscle hypertrophy/hyperplasia. Several techniques are being optimised at present to achieve a suitable diagnosis for remodelling. Diagnostic tools could be divided into two groups, namely invasive and non-invasive methods. Invasive techniques bring us information about bronchial structural alterations, obtaining this information directly from pathological tissue, and permit measure histological modification placed in bronchi layers as well as inflammatory and fibrotic cell infiltration. Non-invasive techniques were developed to reduce invasive methods disadvantages and measure airway remodelling-related markers such as cytokines, inflammatory mediators and others. An exhaustive review of diagnostic tools used to analyse airway remodelling in asthma, including the most useful and usually employed methods, as well as the principal advantages and disadvantages of each of them, bring us concrete and summarised information about all techniques used to evaluate alterations on the structure of the airways. A deep knowledge of these diagnostic tools will make an early diagnosis of airway remodelling possible and, probably, early diagnosis will play an important role in the near future of asthma.
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Bobolea I, Barranco P, Lopez-Carrasco V, Calderon O, Guillén D, Quirce S. Is methacholine challenge sufficient to rule out bronchial hyperresponsiveness in patients with suspected asthma? Ann Allergy Asthma Immunol 2011; 108:130-1. [PMID: 22289737 DOI: 10.1016/j.anai.2011.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 11/23/2011] [Accepted: 12/07/2011] [Indexed: 10/14/2022]
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