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Roth-Walter F, Berni Canani R, O'Mahony L, Peroni D, Sokolowska M, Vassilopoulou E, Venter C. Nutrition in chronic inflammatory conditions: Bypassing the mucosal block for micronutrients. Allergy 2024; 79:353-383. [PMID: 38084827 DOI: 10.1111/all.15972] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 02/01/2024]
Abstract
Nutritional Immunity is one of the most ancient innate immune responses, during which the body can restrict nutrients availability to pathogens and restricts their uptake by the gut mucosa (mucosal block). Though this can be a beneficial strategy during infection, it also is associated with non-communicable diseases-where the pathogen is missing; leading to increased morbidity and mortality as micronutritional uptake and distribution in the body is hindered. Here, we discuss the acute immune response in respect to nutrients, the opposing nutritional demands of regulatory and inflammatory cells and particularly focus on some nutrients linked with inflammation such as iron, vitamins A, Bs, C, and other antioxidants. We propose that while the absorption of certain micronutrients is hindered during inflammation, the dietary lymph path remains available. As such, several clinical trials investigated the role of the lymphatic system during protein absorption, following a ketogenic diet and an increased intake of antioxidants, vitamins, and minerals, in reducing inflammation and ameliorating disease.
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Affiliation(s)
- Franziska Roth-Walter
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Roberto Berni Canani
- Department of Translational Medical Science and ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Liam O'Mahony
- Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Diego Peroni
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
- Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Emilia Vassilopoulou
- Pediatric Area, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Carina Venter
- Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA
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Wang K, Zhao L, Luo H, Deng C, Gong L, Chen Z. Association of serum vitamin C levels with Asthma in adults: results of NHANES 2003-2006 and mendelian randomization study. BMC Pulm Med 2024; 24:4. [PMID: 38166915 PMCID: PMC10759650 DOI: 10.1186/s12890-023-02821-w] [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: 09/19/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The protective effect of vitamin C as an antioxidant against asthma in adults remains controversial. This study used an observational study and Mendelian randomization (MR) analysis to investigate the association between adult asthma and serum vitamin C levels. METHODS Using information from the National Health and Nutrition Examination Survey (NHANES) 2003-2006, we carried out an observational study. A multivariate logistic regression model was employed to examine the connection between adult asthma and serum vitamin C levels. We used the inverse-variance weighted (IVW) method of MR analysis as the primary method to analyze the causal effect of serum vitamin C levels on asthma in adults. RESULTS A total of 8,504 participants were included in the observational study, including 639 in the asthma group and 7,865 in the non-asthma group. Before sample weighting, serum vitamin C was associated with a reduced risk of asthma in adults (OR = 0.798, 95% CI: 0.673-0.945, P = 0.009). After sample weighting, serum vitamin C was not associated with adult asthma risk (OR = 0.829, 95% CI: 0.660 ~ 1.042, P = 0.104). MR analysis showed no causal relationship between serum vitamin C and adult asthma in either the UK Biobank (OR = 0.957, 95% CI: 0.871 ~ 1.053, P = 0.370) or FinnGen (OR = 0.973, 95% CI: 0.824 ~ 1.149, P = 0.750) cohorts. CONCLUSION Our study did not support a causal association between serum vitamin C levels and adult asthma risk. The relationship between serum vitamin C and adult asthma requires further research.
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Affiliation(s)
- Kang Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of the Army Medical University, No. 30 Gaotanyanzheng Road, Shapingba District, Chongqing, 400038, China
| | - Lintao Zhao
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of the Army Medical University, No. 30 Gaotanyanzheng Road, Shapingba District, Chongqing, 400038, China
| | - Hu Luo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of the Army Medical University, No. 30 Gaotanyanzheng Road, Shapingba District, Chongqing, 400038, China
| | - Caixia Deng
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of the Army Medical University, No. 30 Gaotanyanzheng Road, Shapingba District, Chongqing, 400038, China
| | - Liang Gong
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of the Army Medical University, No. 30 Gaotanyanzheng Road, Shapingba District, Chongqing, 400038, China.
| | - Zhujun Chen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of the Army Medical University, No. 30 Gaotanyanzheng Road, Shapingba District, Chongqing, 400038, China.
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Qin Z, Chen Y, Wang Y, Xu Y, Liu T, Mu Q, Huang C. Immunometabolism in the pathogenesis of asthma. Immunology 2024; 171:1-17. [PMID: 37652466 DOI: 10.1111/imm.13688] [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: 04/06/2023] [Accepted: 08/14/2023] [Indexed: 09/02/2023] Open
Abstract
Bronchial asthma is a heterogeneous disease characterised by chronic airway inflammation. A variety of immune cells such as eosinophils, mast cells, T lymphocytes, neutrophils and airway epithelial cells are involved in the airway inflammation and airway hyperresponsiveness in asthma pathogenesis, resulting in extensive and variable reversible expiratory airflow limitation. However, the precise molecular mechanisms underlying the allergic immune responses, particularly immunometabolism, remains unclear. Studies have detected enhanced oxidative stress, and abnormal metabolic progresses of glycolysis, fatty acid and amino acid in various immune cells, inducing dysregulation of innate and adaptive immune responses in asthma pathogenesis. Immunometabolism mechanisms contain multiple signalling pathways, providing novel therapy targets for asthma. This review summarises the current knowledge on immunometabolism reprogramming in asthma pathogenesis, as well as potential therapy strategies.
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Affiliation(s)
- Ziwen Qin
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yujuan Chen
- Experimental Center, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yue Wang
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Yeyang Xu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Tingting Liu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qian Mu
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Chuanjun Huang
- Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Barnabas M, Awakan OJ, Rotimi DE, Akanji MA, Adeyemi OS. Exploring redox imbalance and inflammation for asthma therapy. Mol Biol Rep 2023; 50:7851-7865. [PMID: 37517067 DOI: 10.1007/s11033-023-08688-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/17/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Asthma is a prolonged inflammatory disorder of the airways, that affects an estimated 300 million people worldwide. Asthma is triggered by numerous endogenous and exogenous stimuli with symptoms like wheezing, cough, short of breath, chest tightening, airway obstruction, and hyperreactivity observed in patients. OBJECTIVE The review seeks to identify targets of redox imbalance and inflammation that could be explored to create effective treatments for asthma. METHODS The methodology involved a search and review of literature relating to asthma pathogenesis, redox homeostasis, and inflammation. RESULTS Eosinophils and neutrophils are involved in asthma pathogenesis. These inflammatory cells generate high levels of endogenous oxidants such as hydrogen peroxide and superoxide, which could result in redox imbalance in the airways of asthmatics. Redox imbalance occurs when the antioxidant systems becomes overwhelmed resulting in oxidative stress. Oxidative stress and inflammation have been linked with asthma inflammation and severity. Reactive oxygen species (ROS)/reactive nitrogen species (RNS) cause lung inflammation by activating nuclear factor kappa-B (NF-κB), mitogen-activated protein kinase (MAPK), activator protein-1, as well as additional transcription factors. These factors stimulate cytokine production which ultimately activates inflammatory cells in the bronchi, causing lung cellular injury and destruction. ROS/RNS is also produced by these inflammatory cells to eradicate invading bacteria. Antioxidant treatments for asthma have not yet been fully explored. CONCLUSION Redox and inflammatory processes are viable targets that could be explored to create better therapy for asthma.
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Affiliation(s)
- Morayo Barnabas
- SDG 03 Group - Good Health & Well-being, Landmark University, Omu-Aran, 251101, Kwara State, Nigeria
- Department of Biochemistry, Medicinal Biochemistry, Nanomedicine & Toxicology Laboratory, Landmark University, PMB 1001, Omu-Aran, 251101, Nigeria
| | - Oluwakemi J Awakan
- SDG 03 Group - Good Health & Well-being, Landmark University, Omu-Aran, 251101, Kwara State, Nigeria
- Department of Biochemistry, Medicinal Biochemistry, Nanomedicine & Toxicology Laboratory, Landmark University, PMB 1001, Omu-Aran, 251101, Nigeria
| | - Damilare Emmanuel Rotimi
- SDG 03 Group - Good Health & Well-being, Landmark University, Omu-Aran, 251101, Kwara State, Nigeria
- Department of Biochemistry, Medicinal Biochemistry, Nanomedicine & Toxicology Laboratory, Landmark University, PMB 1001, Omu-Aran, 251101, Nigeria
| | - Musbau A Akanji
- Department of Biochemistry, Kwara State University, Malete, Ilorin, Kwara State, Nigeria
| | - Oluyomi Stephen Adeyemi
- SDG 03 Group - Good Health & Well-being, Landmark University, Omu-Aran, 251101, Kwara State, Nigeria.
- Department of Biochemistry, Medicinal Biochemistry, Nanomedicine & Toxicology Laboratory, Landmark University, PMB 1001, Omu-Aran, 251101, Nigeria.
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Cordiano R, Di Gioacchino M, Mangifesta R, Panzera C, Gangemi S, Minciullo PL. Malondialdehyde as a Potential Oxidative Stress Marker for Allergy-Oriented Diseases: An Update. Molecules 2023; 28:5979. [PMID: 37630231 PMCID: PMC10457993 DOI: 10.3390/molecules28165979] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Malondialdehyde (MDA) is a compound that is derived from the peroxidation of polyunsaturated fatty acids. It has been used as a biomarker to measure oxidative stress in various biological samples in patients who are affected by a wide range of diseases. The aim of our work is to provide an updated overview of the role of MDA as a marker of oxidative stress in allergy-related diseases. We considered studies involving both paediatric and adult patients affected by rhinitis, asthma, urticaria and atopic dermatitis. The measurement of MDA was performed on different types of samples. The reported data highlight the role of serum MDA in inflammatory airway diseases. According to the literature review, the oxidative stress status in asthmatic patients, assessed via MDA determination, appears to worsen in the presence of other allergic airway diseases and in relation to the disease severity. This suggests that MDA can be a suitable marker for monitoring the disease status. However, there are several limitations in the considered studies due to the different samples used and the lack of phenotyping and description of the clinical period of patients examined. In cutaneous allergic diseases, the role of MDA is controversial because of the smallness of the studies and the heterogeneity of the samples and patients.
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Affiliation(s)
- Raffaele Cordiano
- Unit and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (R.C.); (C.P.); (S.G.); (P.L.M.)
| | - Mario Di Gioacchino
- Center of Advanced Science and Technology (CAST), G. D’Annunzio University, 66100 Chieti, Italy;
- YDA—Institute of Clinical Immunotherapy and Advanced Biological Treatments, 65121 Pescara, Italy
| | - Rocco Mangifesta
- Center of Advanced Science and Technology (CAST), G. D’Annunzio University, 66100 Chieti, Italy;
| | - Claudia Panzera
- Unit and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (R.C.); (C.P.); (S.G.); (P.L.M.)
| | - Sebastiano Gangemi
- Unit and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (R.C.); (C.P.); (S.G.); (P.L.M.)
| | - Paola Lucia Minciullo
- Unit and School of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (R.C.); (C.P.); (S.G.); (P.L.M.)
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Alsharairi NA. Antioxidant Intake and Biomarkers of Asthma in Relation to Smoking Status-A Review. Curr Issues Mol Biol 2023; 45:5099-5117. [PMID: 37367073 DOI: 10.3390/cimb45060324] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023] Open
Abstract
Asthma is considered a chronic inflammatory disorder associated with airway hyperresponsiveness (AHR). Increased oxidative stress (OS) is a clinical feature of asthma, which promotes the inflammatory responses in bronchial/airway epithelial cells. Smokers and nonsmokers with asthma have been shown to have increases in several OS and inflammatory biomarkers. However, studies suggest significant differences in OS and inflammation biomarkers between smokers and nonsmokers. A few studies suggest associations between antioxidant intake from diet/supplements and asthma in patients with different smoking status. Evidence is lacking on the protective role of antioxidant vitamin and/or mineral consumption against asthma by smoking status with respect to inflammation and OS biomarkers. Therefore, the aim of this review is to highlight current knowledge regarding the relations between antioxidant intake, asthma, and its associated biomarkers, according to smoking status. This paper can be used to guide future research directions towards the health consequences of antioxidant intake in smoking and nonsmoking asthmatics.
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Affiliation(s)
- Naser A Alsharairi
- Heart, Mind & Body Research Group, Griffith University, Gold Coast P.O. Box 4222, QLD, Australia
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Ben Anes A, Ben Nasr H, Tabka Z, Tabka O, Zaouali M, Chahed K. Plasma Lipid Profiling Identifies Phosphatidylcholine 34:3 and Triglyceride 52:3 as Potential Markers Associated with Disease Severity and Oxidative Status in Chronic Obstructive Pulmonary Disease. Lung 2022; 200:495-503. [PMID: 35816208 DOI: 10.1007/s00408-022-00552-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/20/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To identify plasma alterations in lipid species in patients with chronic obstructive pulmonary disease (COPD), as well as, relationships with smoking status, oxidative and inflammatory markers. METHODS Plasma was obtained from 100 patients with COPD and 120 healthy controls. Pulmonary function was assessed by plethysmography. Serum levels of IL-6 and TNF-α were determined by ELISA. Oxidative stress parameters were measured using standard methods. Lipids were extracted then analyzed by Matrix-Assisted Laser Desorption and Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF-TOF-MS). RESULTS More than 40 lipid compounds were identified within plasma samples. Among these 19 lipid species including plasmalogens (PC O-), phosphatidylcholines (PC), and triglycerides (TG) were significantly altered in COPD. A decreased expression of PC O- (36:1, 36:2, 36:3, 36:4, 38:4, 38:5) species was found in patients with different severities compared to healthy controls. There was also a decrease in PC (34:3, 36:0, 36:4, 36:5, 40:6, 40:7) species in COPD patients. PC (34:3) levels were positively correlated with disease progression and pulmonary function decline (forced expiratory volume in 1 s (FEV1)) (r = 0.84, p < 0.001) and inversely correlated with thiobarbituric acid-reactive substances (TBARS) (r = - 0.77, p < 0.001). TG (50:0, 50:1, 52:1, 52:2, 52:3, 52:4, 54:4) species were altered in COPD patients and in those with advanced disease stages. Significant correlations between FEV1, TBARS, peroxynitrite, and TG (52:3) were found among COPD patients (r = - 0.69; r = 0.86; r = 0.77, p < 0.001, respectively). CONCLUSION PC (34:3) and TG (52:3) could be potential lipid signatures of COPD that correlate with altered pulmonary function and oxidative status.
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Affiliation(s)
- Amel Ben Anes
- Research Laboratory (LR19ES09): Exercise Physiology and Pathophysiology - From the Integrated to the Molecular Biology, Medicine and Health, Faculty of Medicine of Sousse, University of Sousse, 4002, Sousse, Tunisia.
| | - Hela Ben Nasr
- Research Laboratory (LR19ES09): Exercise Physiology and Pathophysiology - From the Integrated to the Molecular Biology, Medicine and Health, Faculty of Medicine of Sousse, University of Sousse, 4002, Sousse, Tunisia
- Higher Institute of Nursing Sciences, Sousse, Tunisia
| | - Zouhair Tabka
- Research Laboratory (LR19ES09): Exercise Physiology and Pathophysiology - From the Integrated to the Molecular Biology, Medicine and Health, Faculty of Medicine of Sousse, University of Sousse, 4002, Sousse, Tunisia
| | - Oussama Tabka
- Research Laboratory (LR19ES09): Exercise Physiology and Pathophysiology - From the Integrated to the Molecular Biology, Medicine and Health, Faculty of Medicine of Sousse, University of Sousse, 4002, Sousse, Tunisia
| | - Monia Zaouali
- Research Laboratory (LR19ES09): Exercise Physiology and Pathophysiology - From the Integrated to the Molecular Biology, Medicine and Health, Faculty of Medicine of Sousse, University of Sousse, 4002, Sousse, Tunisia
| | - Karim Chahed
- Research Laboratory (LR19ES09): Exercise Physiology and Pathophysiology - From the Integrated to the Molecular Biology, Medicine and Health, Faculty of Medicine of Sousse, University of Sousse, 4002, Sousse, Tunisia
- Faculty of Sciences of Sfax, Sfax, Tunisia
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Ammar M, Bahloul N, Amri O, Omri R, Ghozzi H, Kammoun S, Zeghal K, Ben Mahmoud L. Oxidative stress in patients with asthma and its relation to uncontrolled asthma. J Clin Lab Anal 2022; 36:e24345. [PMID: 35318723 PMCID: PMC9102642 DOI: 10.1002/jcla.24345] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 02/04/2022] [Accepted: 02/27/2022] [Indexed: 11/17/2022] Open
Abstract
This study aims to evaluate markers of oxidative stress in Tunisian asthmatic patients and investigate whether their markers are correlated with uncontrolled asthma. This prospective cohort study was conducted on 48 healthy subjects and 60 patients with asthma (34 patients with controlled asthma and 26 patients with uncontrolled asthma). The levels of malondialdehyde (MDA), advanced oxidation protein products (AOPP), and glutathione (GSH), as well as the activities of glutathione peroxidase (GPx) and superoxide dismutase (SOD), were estimated in plasma by spectrophotometry. Asthmatic patients have significantly higher plasmatic levels of MDA and AOPP than healthy controls (p < 0.001). Lower GSH level and GPx activity were found in patients with asthma compared to controls (p < 0.001). In contrast, higher SOD activity was noted in asthmatic patients (p < 0.001). The comparison among the patients with controlled asthma and uncontrolled asthma revealed increased MDA and AOPP levels and SOD activity (p < 0.001) as well as a decreased GSH level and GPx activity (p = 0.004, p = 0.019) in patients with uncontrolled asthma. Spirometry level was significantly correlated with SOD activity (r = 0.447; p = 0.010), whereas no significant correlations were found with the other parameters (MDA, AOPP, GSH, and GPx). Asthmatic patients, especially those with uncontrolled asthma, suffer a high degree of reactive oxygen species (ROS) formation causing considerable oxidative stress. Increased MDA level and SOD activity and reduced GPx activity were predictors of poorly controlled asthma.
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Affiliation(s)
- Mariam Ammar
- Department of pharmacology, Faculty of Medicine, Sfax University, Sfax, Tunisia
| | - Najla Bahloul
- Department of Pneumoallergology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Oumayma Amri
- Department of pharmacology, Faculty of Medicine, Sfax University, Sfax, Tunisia
| | - Ribh Omri
- Department of pharmacology, Faculty of Medicine, Sfax University, Sfax, Tunisia
| | - Hanene Ghozzi
- Department of pharmacology, Faculty of Medicine, Sfax University, Sfax, Tunisia
| | - Samy Kammoun
- Department of Pneumoallergology, Hedi Chaker Hospital, University of Sfax, Sfax, Tunisia
| | - Khaled Zeghal
- Department of pharmacology, Faculty of Medicine, Sfax University, Sfax, Tunisia
| | - Lobna Ben Mahmoud
- Department of pharmacology, Faculty of Medicine, Sfax University, Sfax, Tunisia
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Abboud MM, Al-Rawashde FA, Al-Zayadneh EM. Alterations of serum and saliva oxidative markers in patients with bronchial asthma. J Asthma 2021; 59:2154-2161. [PMID: 34855555 DOI: 10.1080/02770903.2021.2008426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUNDS The development of asthma is highly affected by exposure to exogenous and endogenous oxidative molecules, but the impact of this exposure on the pathophysiology of asthma has received little attention. OBJECTIVES Evaluating group of selective oxidative stress markers as a tool in the management of asthma disease. METHODS In comparison with matched healthy controls, levels of the oxidant and antioxidant markers: lipid peroxidation malondialdehyde (MDA), Total glutathione (tGSH), Uric acid (UA), Glutathione peroxidase (GPx), Catalase (CAT) superoxide dismutase (SOD), and Total antioxidant capacity (TAC) were assessed in serum and saliva of different asthma groups. RESULTS All oxidative markers in serum and saliva of asthma patients showed significant alterations from normal healthy controls (P < 0.05), except the salivary SOD (P = 0.441). Their levels in serum were significantly correlated with asthma severity (P < 0.05), and the distinguishing between childhood and adult asthma was significantly accomplished by GPx, SOD, TAC markers (P < 0.05). However, in patients with childhood asthma no significant differences were detected between the levels of GPx, CAT, UA, MDA in serum and saliva samples (P > 0.05). CONCLUSION Determination of the oxidative markers GPx, CAT, UA in serum or saliva can distinguish asthma from healthy states. The serum levels of UA and TAC are highly effective in monitoring asthma severity, while the salivary GPx, CAT, UA, MDA are beneficial in the management of childhood asthma. Discrimination of the age factor between asthma groups can be achieved by testing GPx, SOD, TAC in serum.
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Affiliation(s)
- Muayad M Abboud
- Department of Basic Medical Sciences, Faculty of Medicine, Hashemite University, Zerga, Jordan
| | - Futoon A Al-Rawashde
- School of Biomedicine, Faculty of Health Sciences, University Sultan Zainal Abidin (UniSZA), Terengganu, Malaysia
| | - Enas M Al-Zayadneh
- Department of Pediatrics, School of Biomedicine, University of Jordan, Amman, Jordan
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Adam-Bonci TI, Bonci EA, Pârvu AE, Herdean AI, Moț A, Taulescu M, Ungur A, Pop RM, Bocșan C, Irimie A. Vitamin D Supplementation: Oxidative Stress Modulation in a Mouse Model of Ovalbumin-Induced Acute Asthmatic Airway Inflammation. Int J Mol Sci 2021; 22:7089. [PMID: 34209324 PMCID: PMC8268667 DOI: 10.3390/ijms22137089] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 01/15/2023] Open
Abstract
Asthma oxidative stress disturbances seem to enable supplementary proinflammatory pathways, thus contributing to disease development and severity. The current study analyzed the impact of two types of oral vitamin D (VD) supplementation regimens on the redox balance using a murine model of acute ovalbumin-induced (OVA-induced) asthmatic inflammation. The experimental prevention group received a long-term daily dose of 50 µg/kg (total dose of 1300 µg/kg), whereas the rescue group underwent a short-term daily dose of 100 µg/kg (total dose of 400 µg/kg). The following oxidative stress parameters were analyzed in serum, bronchoalveolar lavage fluid (BALF) and lung tissue homogenate (LTH): total oxidative status, total antioxidant response, oxidative stress index, malondialdehyde and total thiols. Results showed that VD significantly reduced oxidative forces and increased the antioxidant capacity in the serum and LTH of treated mice. There was no statistically significant difference between the two types of VD supplementation. VD also exhibited an anti-inflammatory effect in all treated mice, reducing nitric oxide formation in serum and the expression of nuclear factor kappa B p65 in the lung. In conclusion, VD supplementation seems to exhibit a protective role in oxidative stress processes related to OVA-induced acute airway inflammation.
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Affiliation(s)
- Teodora-Irina Adam-Bonci
- Department of Pathophysiology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (T.-I.A.-B.); (A.-E.P.)
| | - Eduard-Alexandru Bonci
- Department of Oncological Surgery and Gynecologic Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania;
| | - Alina-Elena Pârvu
- Department of Pathophysiology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (T.-I.A.-B.); (A.-E.P.)
| | - Andrei-Ioan Herdean
- Department of Anatomy and Embryology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania;
| | - Augustin Moț
- Department of Chemistry, Faculty of Chemistry and Chemical Engineering, “Babeș-Bolyai” University, 400028 Cluj-Napoca, Romania;
| | - Marian Taulescu
- Department of Pathology, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania; (M.T.); (A.U.)
- Synevovet Laboratory, 81 Pache Protopopescu, 021408 Bucharest, Romania
| | - Andrei Ungur
- Department of Pathology, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania; (M.T.); (A.U.)
| | - Raluca-Maria Pop
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (R.-M.P.); (C.B.)
| | - Corina Bocșan
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (R.-M.P.); (C.B.)
| | - Alexandru Irimie
- Department of Oncological Surgery and Gynecologic Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania;
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Mani S, Norel X, Varret M, Bchir S, Ben Anes A, Garrouch A, Tabka Z, Longrois D, Chahed K. Polymorphisms rs2745557 in PTGS2 and rs2075797 in PTGER2 are associated with the risk of chronic obstructive pulmonary disease development in a Tunisian cohort. Prostaglandins Leukot Essent Fatty Acids 2021; 166:102252. [PMID: 33545665 DOI: 10.1016/j.plefa.2021.102252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 01/23/2023]
Abstract
We hypothesized that polymorphisms of genes involved in the prostaglandin pathway could be associated with COPD. In this study we explored the involvement of genetic polymorphisms in PTGS2, PTGER2 and PTGER4 genes in the development and severity of COPD and their effects on plasma concentrations of inflammatory/oxidative stress markers. We identified genotypes of PTGS2, PTGER2 and PTGER4 SNPs in a Tunisian cohort including COPD patients (n = 138) and control subjects (n = 216) using PCR-RFLP and PCR TaqMan. Pulmonary function (FEV1 and FVC) were assessed by plethsmography. PGE2, PGD2 and cytokine plasma (IL-6, IL-18, TNF-α, TGF-β) concentrations were measured using ELISA and colorimetric standard methods were used to determine oxidative stress concentrations. Genotype frequencies of rs2745557 in PTGS2 and rs2075797 in PTGER2 were different between COPD cases and controls. There was no correlation between these polymorphisms and lung function parameters. For rs2745557, the A allele frequency was higher in COPD cases than in controls. For rs2075797, carriers of the GG genotype were more frequent in the COPD group than in controls. Only rs2745557 in PTGS2 had an effect on PGD2 and cytokine plasma concentrations. PGD2 was significantly decreased in COPD patients with the GA or AA genotypes. In contrast, IL-18 and NO plasma concentrations were increased in COPD rs2745557 A allele carriers as compared to homozygous GG subjects. Our findings suggest that rs2745557 in PTGS2 and rs2075797 in PTGER2 are associated with COPD development but not with its severity.
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Affiliation(s)
- Salma Mani
- Sorbonne Paris nord University, 93430 Villetaneuse, France; INSERM, UMRS1148, CHU X.Bichat, Paris, France; Institut supérieur de biotechnologies de Monastir, University of Monastir, Tunisia; UR12ES06, Physiologie de l'exercice et physiopathologie: de l'intégré au moléculaire, Faculté de médecine de Sousse, University of Sousse, Tunisia.
| | - Xavier Norel
- Sorbonne Paris nord University, 93430 Villetaneuse, France; INSERM, UMRS1148, CHU X.Bichat, Paris, France
| | - Mathilde Varret
- INSERM, UMRS1148, CHU X.Bichat, Paris, France; Université de Paris, France
| | - Sarra Bchir
- Institut supérieur de biotechnologies de Monastir, University of Monastir, Tunisia; UR12ES06, Physiologie de l'exercice et physiopathologie: de l'intégré au moléculaire, Faculté de médecine de Sousse, University of Sousse, Tunisia
| | - Amel Ben Anes
- UR12ES06, Physiologie de l'exercice et physiopathologie: de l'intégré au moléculaire, Faculté de médecine de Sousse, University of Sousse, Tunisia
| | | | - Zouhair Tabka
- UR12ES06, Physiologie de l'exercice et physiopathologie: de l'intégré au moléculaire, Faculté de médecine de Sousse, University of Sousse, Tunisia
| | - Dan Longrois
- Sorbonne Paris nord University, 93430 Villetaneuse, France; INSERM, UMRS1148, CHU X.Bichat, Paris, France; Université de Paris, Assistance Publique-Hôpitaux de Paris,Hôpital Bichat-Claude Bernard, DMU PARABOL, Paris, France
| | - Karim Chahed
- UR12ES06, Physiologie de l'exercice et physiopathologie: de l'intégré au moléculaire, Faculté de médecine de Sousse, University of Sousse, Tunisia; Faculté des sciences de Sfax, University of Sfax, Tunisia
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12
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Youness ER, Shady M, Nassar MS, Mostafa R, Abuelhamd W. The role of serum nuclear factor erythroid 2-related factor 2 in childhood bronchial asthma. J Asthma 2019; 57:347-352. [PMID: 30729848 DOI: 10.1080/02770903.2019.1571081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Asthma is one of the most common chronic airway disease of childhood. Poor asthma control has been associated with antioxidant deficiencies. Objective: To assess the association of bronchial asthma in Egyptian children with serum nuclear factor erythroid 2-related factor2 (NRF2) and its relation to disease severity. Subjects and methods: The study included 60 asthmatic children with comparable 60 controls (age ranged from 6-16 years). Subjects were classified according to the severity of asthma into mild or moderate asthma in group I, and severe asthma in group II. Antioxidant markers including superoxide-dismutase (SOD), glutathione peroxidase (GPX) and NRF2 were assessed once in blood and serum of both subjects and controls. Results: Mean serum NRF2 and GPX were significantly lower in asthmatic group than controls group (26.36 ± 4.18 pg/mL and 5.76 ± 0.81 mU/mL vs 29.05 ± 3.87 and 6.23 ± 0.97 respectively, p < 0.05). No significant difference was detected regarding SOD (p > 0.05). In severe bronchial asthma, mean serum NRF2 and GPX were significantly lower than in mild and moderate asthma (24.29 ± 1.86 pg/mL and 5.56 ± 0.67 mU/mL vs 27.95 ± 4.77 and 6.03 ± 0.90 respectively, p < 0.05). No significant difference was found in SOD regarding severity of bronchial asthma. Low NRF2 was the only predictor of the severity of bronchial asthma (OR = 0.749 and 95% CI 0.595 - 0.942). Conclusion: The pathogenesis of childhood bronchial asthma may be associated with low serum NRF2 which may be a strong predictor of the disease severity.
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Affiliation(s)
| | - Mones Shady
- Child Health, National Research Centre, Cairo, Egypt
| | | | - Rehab Mostafa
- Child Health, National Research Centre, Cairo, Egypt
| | - Walaa Abuelhamd
- Neonatology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
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13
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Zhang N, Deng C, Zhang X, Zhang J, Bai C. Inhalation of hydrogen gas attenuates airway inflammation and oxidative stress in allergic asthmatic mice. Asthma Res Pract 2018; 4:3. [PMID: 29568538 PMCID: PMC5856384 DOI: 10.1186/s40733-018-0040-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/08/2018] [Indexed: 01/07/2023] Open
Abstract
Background Asthma is a worldwide common chronic airway disease that cannot be cured and results in the huge burden in public health. Oxidative stress was considered an important mechanism in the pathogenesis of asthma. Hydrogen gas been demonstrated to function as a novel antioxidant and exert therapeutic antioxidant activity in a number of diseases and the function of this nontoxic gas in asthma was unclear. The purpose of the study aims to examine the effect of inhalation hydrogen gas on the pathophysiology of a mouse model of asthma. Methods A murine model of ovalbumin (OVA)-induced allergic airway inflammation was used in this study. Briefly, Mice were sensitized to ovalbumin and received inhalation of 67% high concentration of hydrogen gas for 60 min once a day for 7 consecutive days after OVA or PBS challenge respectively. Lung function was assessed in the apparatus with 4 channels of biological signal system. Morphology and goblet cell hyperplasia were stained by H/E and Periodic acid-Schiff staining. Cytologic classification in the bronchial alveolar lavage fluid (BALF) was analyzed by Wright Giemsa staining. Serum, BALF and lung tissue were collected for biochemical assay. One-way analysis of variance (ANOVA) was used to determine statistical significance between groups. Multiple comparisons were made by Bonferroni’s Multiple Comparison Test by using GraphPad Prism 5 software. Results Inhalation of hydrogen gas abrogated ovalbumin-induced the increase in lung resistance. Concomitantly, the asthmatic mice showed severe inflammatory infiltration and goblet cell hyperplasia which were reversed by hydrogen gas inhalation. Hydrogen gas inhalation reduced significantly the number of total cells, eosinophils and lymphocytes in BALF. Increased level of IL-4, IL-13, TNF-α and CXCL15 in the BALF and IL-4 in the serum were decreased significantly after inhalation. Hydrogen gas inhalation markedly upregulated the activity of decreased superoxide dismutase and significantly attenuated the increased level of malondialdehyde and myeloperoxidase. Conclusions Hydrogen gas inhalation improves lung function and protects established airway inflammation in the allergic asthmatic mice model which may be associated with the inhibition of oxidative stress process. This study provides a potential alternative therapeutic opportunity for the clinical management of asthma.
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Affiliation(s)
- Ning Zhang
- 1Department of Naval Aeromedicine, The Second Military Medical University, Shanghai, 200433 China
| | - Changwen Deng
- 2Department of Respiratory and Critical care medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433 China
| | - Xingxing Zhang
- 2Department of Respiratory and Critical care medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433 China
| | - Jingxi Zhang
- 2Department of Respiratory and Critical care medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433 China
| | - Chong Bai
- 2Department of Respiratory and Critical care medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 200433 China
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Pathinayake PS, Hsu ACY, Waters DW, Hansbro PM, Wood LG, Wark PAB. Understanding the Unfolded Protein Response in the Pathogenesis of Asthma. Front Immunol 2018; 9:175. [PMID: 29472925 PMCID: PMC5810258 DOI: 10.3389/fimmu.2018.00175] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/19/2018] [Indexed: 01/14/2023] Open
Abstract
Asthma is a heterogeneous, chronic inflammatory disease of the airways. It is a complex disease with different clinical phenotypes and results in a substantial socioeconomic burden globally. Poor understanding of pathogenic mechanisms of the disease hinders the investigation into novel therapeutics. Emerging evidence of the unfolded protein response (UPR) in the endoplasmic reticulum (ER) has demonstrated previously unknown functions of this response in asthma development. A worsening of asthmatic condition can be brought on by stimuli such as oxidative stress, pathogenic infections, and allergen exposure. All of which can induce ER stress and activate UPR leading to activation of different inflammatory responses and dysregulate the innate immune functions in the airways. The UPR as a central regulator of asthma pathogenesis may explain several unknown mechanism of the disease onset, which leads us in new directions for future asthma treatments. In this review, we summarize and discuss the causes and impact of ER–UPR in driving the pathogenesis of asthma and highlight its importance in clinical implications.
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Affiliation(s)
- Prabuddha S Pathinayake
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Alan C-Y Hsu
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - David W Waters
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Philip M Hansbro
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Lisa G Wood
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Peter A B Wark
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
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Weichenthal SA, Lavigne E, Evans GJ, Godri Pollitt KJ, Burnett RT. Fine Particulate Matter and Emergency Room Visits for Respiratory Illness. Effect Modification by Oxidative Potential. Am J Respir Crit Care Med 2017; 194:577-86. [PMID: 26963193 DOI: 10.1164/rccm.201512-2434oc] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
RATIONALE Fine particulate air pollution (PM2.5; particulate matter 2.5 μm or less in diameter) is thought to contribute to acute respiratory morbidity in part through oxidative stress. OBJECTIVES To examine the association between PM2.5 oxidative burden and emergency room visits for respiratory illnesses. METHODS We conducted a case-crossover study in Ontario, Canada between 2004 and 2011, including 127,836 cases of asthma, 298,751 cases of chronic obstructive pulmonary disease, and more than 1.1 million cases of all respiratory illnesses. Daily air pollution data were collected from ground monitors, and city-level PM2.5 oxidative potential was measured on the basis of a synthetic respiratory tract lining fluid containing the antioxidants glutathione and ascorbate. Conditional logistic regression was used to estimate associations between air pollution concentrations and emergency room visits, adjusting for time-varying covariates. MEASUREMENTS AND MAIN RESULTS Three-day mean PM2.5 concentrations were consistently associated with emergency room visits for all respiratory illnesses. Among children (<9 yr), each interquartile change (5.92 μg/m(3)) in 3-day mean PM2.5 was associated with a 7.2% (95% confidence interval, 4.2-10) increased risk of emergency room visits for asthma. Glutathione-related oxidative potential modified the impact of PM2.5 on emergency room visits for respiratory illnesses (P = 0.001) but only at low concentrations (≤10 μg/m(3)). Between-city differences in ascorbate-related oxidative potential did not modify the impact of PM2.5 on respiratory outcomes. CONCLUSIONS Between-city differences in glutathione-related oxidative potential may modify the impact of PM2.5 on acute respiratory illnesses at low PM2.5 concentrations. This may explain in part how small changes in ambient PM2.5 mass concentrations can contribute to acute respiratory morbidity in low-pollution environments.
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Affiliation(s)
- Scott A Weichenthal
- 1 Health Canada, Ottawa, Ontario, Canada.,2 Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | | | - Greg J Evans
- 3 University of Toronto, Toronto, Ontario, Canada; and
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Zhu LY, Ni ZH, Luo XM, Wang XB. Advance of antioxidants in asthma treatment. World J Respirol 2017; 7:17-28. [DOI: 10.5320/wjr.v7.i1.17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 11/23/2016] [Accepted: 01/14/2017] [Indexed: 02/07/2023] Open
Abstract
Asthma is an allergic disease, characterized as a recurrent airflow limitation, airway hyperreactivity, and chronic inflammation, involving a variety of cells and cytokines. Reactive oxygen species have been proven to play an important role in asthma. The pathogenesis of oxidative stress in asthma involves an imbalance between oxidant and antioxidant systems that is caused by environment pollutants or endogenous reactive oxygen species from inflammation cells. There is growing evidence that antioxidant treatments that include vitamins and food supplements have been shown to ameliorate this oxidative stress while improving the symptoms and decreasing the severity of asthma. In this review, we summarize recent studies that are related to the mechanisms and biomarkers of oxidative stress, antioxidant treatments in asthma.
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17
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Phthalate-induced oxidative stress and association with asthma-related airway inflammation in adolescents. Int J Hyg Environ Health 2017; 220:468-477. [PMID: 28174042 DOI: 10.1016/j.ijheh.2017.01.006] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 01/24/2017] [Accepted: 01/24/2017] [Indexed: 11/21/2022]
Abstract
BACKGROUND In Belgium, around 8.5% of the children have asthmatic symptoms. Increased asthma risk in children has been reported in relation to exposure to phthalate plasticizers but the underlying mechanisms are largely unknown. AIM The aim of this study was to identify if oxidative stress, assessed by excision of 8-hydroxydeoxyguanosine (8-OHdG) from damaged DNA, is an intermediate marker for the association between phthalate exposure and doctor-diagnosed asthma. MATERIAL AND METHODS In 418 14-15-year-old youngsters, recruited as a representative sample of residents of Flanders (Belgium), personal exposure to phthalates was assessed by measuring phthalate metabolites in urine: mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-n-butyl phthalate (MnBP), mono-benzyl phthalate (MBzP), mono-isobutyl phthalate (MiBP) and mono-ethyl phthalate (MEP). Analysis of 8-OHdG in urine was used as a sensitive biomarker of oxidative stress at the level of DNA. The presence of doctor-diagnosed asthma was elicited by a self-administered questionnaire. Associations were assessed using multiple linear and logistic regression models. Mediation was tested using Baron and Kenny's regression approach. RESULTS A significant increased risk of a youngster being diagnosed with asthma was found for both urinary MnBP (metabolite of dibutyl phthalate (DBP)) and the sum of the three di(2-ethylhexyl) phthalate metabolites (ΣDEHP=MEHP+MEHHP+MEOHP), with respective odds ratio of 1.84 [95% CI: 1.02, 3.32] for MnBP and 1.94 [95% CI: 1.07, 3.51] for ΣDEHP. In addition, we observed significant associations between all urinary phthalate metabolites and increased urinary levels of 8-OHdG. The associations were stronger in girls than in boys. We did not found evidence that 8-OHdG was associated with doctor-diagnosed asthma. CONCLUSION The results of our study are in line with other findings from epidemiological surveys and raise further concern about DEHP and DBP as risk factors for asthma, however, the underlying mechanisms are not yet well understood.
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