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Scadding GK, Gray C, Conti DM, McDonald M, Backer V, Scadding G, Bernal-Sprekelsen M, De Corso E, Diamant Z, Hopkins C, Jesenak M, Johansen P, Kappen J, Mullol J, Price D, Quirce S, Reitsma S, Toppila-Salmi S, Senior B, Thyssen JP, Wahn U, Hellings PW. Pre-asthma: a useful concept? A EUFOREA paper. Part 2-late onset eosinophilic asthma. FRONTIERS IN ALLERGY 2024; 5:1404735. [PMID: 38812719 PMCID: PMC11133565 DOI: 10.3389/falgy.2024.1404735] [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: 03/21/2024] [Accepted: 04/23/2024] [Indexed: 05/31/2024] Open
Abstract
The concept of pre-diabetes has led to provision of measures to reduce disease progression through identification of subjects at risk of diabetes. We previously considered the idea of pre-asthma in relation to allergic asthma and considered that, in addition to the need to improve population health via multiple measures, including reduction of exposure to allergens and pollutants and avoidance of obesity, there are several possible specific means to reduce asthma development in those most at risk (pre- asthma). The most obvious is allergen immunotherapy (AIT), which when given for allergic rhinitis (AR) has reasonable evidence to support asthma prevention in children (2) but also needs further study as primary prevention. In this second paper we explore the possibilities for similar actions in late onset eosinophilic asthma.
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Affiliation(s)
- G. K. Scadding
- Department of Allergy & Rhinology, Royal National ENT Hospital, London, United Kingdom
- Division of Immunity and Infection, University College, London, United Kingdom
| | - C. Gray
- Paediatric Allergist, Red Cross Children's Hospital and University of Cape Town, Cape Town, South Africa
- Kidsallergy Centre, Cape Town, South Africa
| | - D. M. Conti
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium
- Escuela de Doctorado UAM, Centro de Estudios de Posgrado, Universidad Autónoma de Madrid, Calle Francisco Tomás y Valiente, no 2, Ciudad Universitaria de Cantoblanco, Madrid, Spain
| | - M. McDonald
- The Allergy Clinic, Blairgowrie, Randburg, South Africa
| | - V. Backer
- Department of Otorhinolaryngology, Head & Neck Surgery, and Audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - G. Scadding
- Allergy, Royal Brompton Hospital, London, United Kingdom
| | - M. Bernal-Sprekelsen
- Otolaryngology-Department, Clinic Barcelona, Barcelona, Spain
- Otolaryngology-Department, University of Barcelona, Barcelona, Spain
| | - E. De Corso
- Otolaryngology Head and Neck Surgery, A. Gemelli University Hospital Foundation IRCCS, Rome, Italy
| | - Z. Diamant
- Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
- Department Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Microbiology Immunology & Transplantation, KU Leuven, Catholic University of Leuven, Leuven, Belgium
| | - C. Hopkins
- Department of Rhinology and Skull Base Surgery, Guy’s and St Thomas’ Hospital NHS Foundation Trust, London, United Kingdom
| | - M. Jesenak
- Department of Clinical Immunology and Allergology, University Teaching Hospital in Martin, Martin, Slovak Republic
- Department of Paediatrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovak Republic
- Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovak Republic
| | - P. Johansen
- Department of Dermatology, University of Zurich, Zurich, Switzerland
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - J. Kappen
- Department of Pulmonology, STZ Centre of Excellence for Asthma, COPD and Respiratory Allergy, Franciscus Gasthuis & Vlietland, Rotterdam, Netherlands
| | - J. Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, FRCB-IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Spain
| | - D. Price
- Observational and Pragmatic Research Institute, Singapore, Singapore
- Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | - S. Quirce
- Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - S. Reitsma
- Department of Otorhinolarynogology and Head/Neck Surgery, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
| | - S. Toppila-Salmi
- Department of Otorhinolaryngology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
- Department of Allergy, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - B. Senior
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - J. P. Thyssen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - U. Wahn
- Department for Pediatric Pneumology and Immunology, Charite University Medicine, Berlin, Germany
| | - P. W. Hellings
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals, Leuven, Belgium
- Laboratory of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium
- Upper Airways Research Laboratory, Department of Head and Skin, Ghent University, Ghent, Belgium
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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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Williams EJ, Berthon BS, Stoodley I, Williams LM, Wood LG. Nutrition in Asthma. Semin Respir Crit Care Med 2022; 43:646-661. [PMID: 35272384 DOI: 10.1055/s-0042-1742385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
An emerging body of evidence suggests that diet plays an important role in both the development and management of asthma. The relationship between dietary intake and asthma risk has been explored in epidemiological studies, though intervention trials examining the effects of nutrient intake and dietary patterns on asthma management are scarce. Evidence for diets high in fruits and vegetables, antioxidants, omega-3 fatty acids and soluble fiber such as the Mediterranean diet is conflicting. However, some studies suggest that these diets may reduce the risk of asthma, particularly in young children, and could have positive effects on disease management. In contrast, a Westernized dietary pattern, high in saturated fatty acids, refined grains, and sugars may promote an inflammatory environment resulting in the onset of disease and worsening of asthma outcomes. This review will summarize the state of the evidence for the impact of whole dietary patterns, as well as individual nutrients on the prevalence and management of asthma.
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Affiliation(s)
- Evan J Williams
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| | - Bronwyn S Berthon
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| | - Isobel Stoodley
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| | - Lily M Williams
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| | - Lisa G Wood
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
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Al-Samarrai RFM, Jassim AA, Abd-AlWahab WIA. Effect of Asian jerry fish oil silurus triostegus (Heckel, 1843) on some biochemical and physiological variables in male rabbits with induced asthma. 1ST SAMARRA INTERNATIONAL CONFERENCE FOR PURE AND APPLIED SCIENCES (SICPS2021): SICPS2021 2022. [DOI: 10.1063/5.0121438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Jaiswal V, Chauhan S, Lee HJ. The Bioactivity and Phytochemicals of Pachyrhizus erosus (L.) Urb.: A Multifunctional Underutilized Crop Plant. Antioxidants (Basel) 2021; 11:58. [PMID: 35052562 PMCID: PMC8773301 DOI: 10.3390/antiox11010058] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/23/2022] Open
Abstract
Pachyrhizus erosus (L.) Urb. is an underutilized crop plant belonging to the Fabaceae family. In recent years, the plant received huge attention and was introduced in different countries owing to properties such as a high nutritional content, its nitrogen-fixing abilities, and different biological activities such as its antioxidant, immune modulation, anticancer, anti-diabetes, anti-osteoporosis, antiviral, and antiaging affects, among others. In this review, an attempt has been made to comprehensively compile the biological activities of the plant to provide a panoramic view of the current efforts and further directions, which may lead to the development of pharmacological applications. This information will be helpful in creating interest towards P. erosus and it may be useful in developing the plant for medical applications and/or as a functional food. More than 50 phytochemicals have been reported from the plant, which belong to different chemical classes such as triterpenoids, organic acid, flavonoids, and fatty acids. Numerous biological activities were reported from the plant through in vivo, in vitro, ex vivo, and human studies. However, well-defined clinical studies are still lacking for the establishment of any biological properties that could be further developed. Suggestions for the further development of P. erosus, according to current knowledge about the different biological properties, has also been provided.
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Affiliation(s)
- Varun Jaiswal
- Department of Food and Nutrition, College of BioNano Technology, Gachon University, Seongnam-si 13120, Korea; (V.J.); (S.C.)
| | - Shweta Chauhan
- Department of Food and Nutrition, College of BioNano Technology, Gachon University, Seongnam-si 13120, Korea; (V.J.); (S.C.)
| | - Hae-Jeung Lee
- Department of Food and Nutrition, College of BioNano Technology, Gachon University, Seongnam-si 13120, Korea; (V.J.); (S.C.)
- Institute for Aging and Clinical Nutrition Research, Gachon University, Seongnam-si 13120, Korea
- Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon 21999, Korea
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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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7
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Knuplez E, Sturm EM, Marsche G. Emerging Role of Phospholipase-Derived Cleavage Products in Regulating Eosinophil Activity: Focus on Lysophospholipids, Polyunsaturated Fatty Acids and Eicosanoids. Int J Mol Sci 2021; 22:4356. [PMID: 33919453 PMCID: PMC8122506 DOI: 10.3390/ijms22094356] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 12/19/2022] Open
Abstract
Eosinophils are important effector cells involved in allergic inflammation. When stimulated, eosinophils release a variety of mediators initiating, propagating, and maintaining local inflammation. Both, the activity and concentration of secreted and cytosolic phospholipases (PLAs) are increased in allergic inflammation, promoting the cleavage of phospholipids and thus the production of reactive lipid mediators. Eosinophils express high levels of secreted phospholipase A2 compared to other leukocytes, indicating their direct involvement in the production of lipid mediators during allergic inflammation. On the other side, eosinophils have also been recognized as crucial mediators with regulatory and homeostatic roles in local immunity and repair. Thus, targeting the complex network of lipid mediators offer a unique opportunity to target the over-activation and 'pro-inflammatory' phenotype of eosinophils without compromising the survival and functions of tissue-resident and homeostatic eosinophils. Here we provide a comprehensive overview of the critical role of phospholipase-derived lipid mediators in modulating eosinophil activity in health and disease. We focus on lysophospholipids, polyunsaturated fatty acids, and eicosanoids with exciting new perspectives for future drug development.
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Affiliation(s)
| | | | - Gunther Marsche
- Otto Loewi Research Center, Division of Pharmacology, Medical University of Graz, 8010 Graz, Austria; (E.K.); (E.M.S.)
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8
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Singh N, Kulkarni GT, Kumar Y. Therapeutic Potential of Antileukotriene Drug- Camellia sinensis Extract Co-Formulation on Histamine Induced Asthma in Guinea Pigs. Curr Drug Res Rev 2021; 13:59-72. [PMID: 32787770 DOI: 10.2174/2589977512666200812151620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/07/2020] [Accepted: 06/29/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND/OBJECTIVE To study the therapeutic potential of Antileukotriene drug- Camellia sinensis extract co-formulation on histamine induced asthma in guinea pigs. METHODS SRSD of Montelukast sodium was prepared by the solvent evaporation method. Lyophilized aqueous extract of Camellia sinensis leaves and SRSD mixture was filled in capsule and the capsule shell was coated to achieve initial release lag time. In vitro and pharmacokinetic study of capsules was performed and compared with commercial tablets. A further role of green tea, as an antioxidant adjunct for asthma management, has been analyzed by lung histology, mast cell count and oxidative stress assay in the serum of control and experimental animals. RESULTS The drug release from the commercial tablet was immediate and rapid, but capsule has shown an initial 3.5 hr lag time followed by sustained action up to 8 hr. Pharmacokinetic results show that studied formulations are bioequivalent with respect to Cmax and AUC, while rest parameters showed asignificant difference. Mast cells count in lung tissue were increased (p<0.001) in the experimental group along with glycoprotein deposition in asthmatic bronchioles. Levels of SOD and GPX were decreased (p<0.05) while CAT was increased (p<0.04) in the asthma group in comparison to control. CONCLUSION In the experimental animal model, co-formulation was effective in modulating allergic inflammation and contributing to better control of the inflammatory response. Our findings suggest that Camellia sinensis leaves extract may be used as an adjunct for future improvements in asthma treatment and prevention.
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Affiliation(s)
- Neelam Singh
- Department of Pharmaceutics, ITS College of Pharmacy, NH-58, Ghaziabad 201206, India
| | - Giriraj T Kulkarni
- Department of Pharmaceutics, Amity Institute of Pharmacy, Amity University, Uttar Pradesh, Sector 125, Noida, India
| | - Yatendra Kumar
- Department of Pharmaceutics, ITS College of Pharmacy, NH-58, Ghaziabad 201206, India
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Checa J, Aran JM. Airway Redox Homeostasis and Inflammation Gone Awry: From Molecular Pathogenesis to Emerging Therapeutics in Respiratory Pathology. Int J Mol Sci 2020; 21:E9317. [PMID: 33297418 PMCID: PMC7731288 DOI: 10.3390/ijms21239317] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/05/2020] [Indexed: 02/06/2023] Open
Abstract
As aerobic organisms, we are continuously and throughout our lifetime subjected to an oxidizing atmosphere and, most often, to environmental threats. The lung is the internal organ most highly exposed to this milieu. Therefore, it has evolved to confront both oxidative stress induced by reactive oxygen species (ROS) and a variety of pollutants, pathogens, and allergens that promote inflammation and can harm the airways to different degrees. Indeed, an excess of ROS, generated intrinsically or from external sources, can imprint direct damage to key structural cell components (nucleic acids, sugars, lipids, and proteins) and indirectly perturb ROS-mediated signaling in lung epithelia, impairing its homeostasis. These early events complemented with efficient recognition of pathogen- or damage-associated recognition patterns by the airway resident cells alert the immune system, which mounts an inflammatory response to remove the hazards, including collateral dead cells and cellular debris, in an attempt to return to homeostatic conditions. Thus, any major or chronic dysregulation of the redox balance, the air-liquid interface, or defects in epithelial proteins impairing mucociliary clearance or other defense systems may lead to airway damage. Here, we review our understanding of the key role of oxidative stress and inflammation in respiratory pathology, and extensively report current and future trends in antioxidant and anti-inflammatory treatments focusing on the following major acute and chronic lung diseases: acute lung injury/respiratory distress syndrome, asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, and cystic fibrosis.
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Affiliation(s)
| | - Josep M. Aran
- Immune-Inflammatory Processes and Gene Therapeutics Group, IDIBELL, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
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Arteaga-Badillo DA, Portillo-Reyes J, Vargas-Mendoza N, Morales-González JA, Izquierdo-Vega JA, Sánchez-Gutiérrez M, Álvarez-González I, Morales-González Á, Madrigal-Bujaidar E, Madrigal-Santillán E. Asthma: New Integrative Treatment Strategies for the Next Decades. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E438. [PMID: 32872366 PMCID: PMC7558718 DOI: 10.3390/medicina56090438] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/20/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Abstract
Asthma is a chronic disease whose main anatomical-functional alterations are grouped into obstruction, nonspecific bronchial hyperreactivity, inflammation and airway remodeling. Currently, the Global Initiative of Asthma 2020 (GINA 2020) suggests classifying it into intermittent cases, slightly persistent, moderately persistent and severely persistent, thus determining the correct guidelines for its therapy. In general, the drugs used for its management are divided into two groups, those with a potential bronchodilator and the controlling agents of inflammation. However, asthmatic treatments continue to evolve, and notable advances have been made possible in biological therapy with monoclonal antibodies and in the relationship between this disease and oxidative stress. This opens a new path to dietary and herbal strategies and the use of antioxidants as a possible therapy that supports conventional pharmacological treatments and reduces their doses and/or adverse effects. This review compiles information from different published research on risk factors, pathophysiology, classification, diagnosis and the main treatments; likewise, it synthesizes the current evidence of herbal medicine for its control. Studies on integrative medicine (IM) therapies for asthmatic control are critically reviewed. An integrative approach to the prevention and management of asthma warrants consideration in clinical practice. The intention is to encourage health professionals and scientists to expand the horizons of basic and clinical research (preclinical, clinical and integrative medicine) on asthma control.
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Affiliation(s)
- Diego A. Arteaga-Badillo
- Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Ex-Hacienda de la Concepción, Tilcuautla, Pachuca de Soto 42080, Mexico; (D.A.A.-B.); (J.P.-R.); (J.A.I.-V.); (M.S.-G.)
| | - Jacqueline Portillo-Reyes
- Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Ex-Hacienda de la Concepción, Tilcuautla, Pachuca de Soto 42080, Mexico; (D.A.A.-B.); (J.P.-R.); (J.A.I.-V.); (M.S.-G.)
| | - Nancy Vargas-Mendoza
- Escuela Superior de Medicina, Instituto Politécnico Nacional, “Unidad Casco de Santo Tomas”, Ciudad de México 11340, Mexico; (N.V.-M.); (J.A.M.-G.)
| | - José A. Morales-González
- Escuela Superior de Medicina, Instituto Politécnico Nacional, “Unidad Casco de Santo Tomas”, Ciudad de México 11340, Mexico; (N.V.-M.); (J.A.M.-G.)
| | - Jeannett A. Izquierdo-Vega
- Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Ex-Hacienda de la Concepción, Tilcuautla, Pachuca de Soto 42080, Mexico; (D.A.A.-B.); (J.P.-R.); (J.A.I.-V.); (M.S.-G.)
| | - Manuel Sánchez-Gutiérrez
- Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Ex-Hacienda de la Concepción, Tilcuautla, Pachuca de Soto 42080, Mexico; (D.A.A.-B.); (J.P.-R.); (J.A.I.-V.); (M.S.-G.)
| | - Isela Álvarez-González
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, “Unidad Profesional A. López Mateos”, Ciudad de México 07738, Mexico; (I.Á.-G.); (E.M.-B.)
| | - Ángel Morales-González
- Escuela Superior de Cómputo, Instituto Politécnico Nacional, “Unidad Profesional A. López Mateos”, Ciudad de México 07738, Mexico;
| | - Eduardo Madrigal-Bujaidar
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, “Unidad Profesional A. López Mateos”, Ciudad de México 07738, Mexico; (I.Á.-G.); (E.M.-B.)
| | - Eduardo Madrigal-Santillán
- Escuela Superior de Medicina, Instituto Politécnico Nacional, “Unidad Casco de Santo Tomas”, Ciudad de México 11340, Mexico; (N.V.-M.); (J.A.M.-G.)
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Al-Harbi NO, Nadeem A, Ahmad SF, AlThagfan SS, Alqinyah M, Alqahtani F, Ibrahim KE, Al-Harbi MM. Sulforaphane treatment reverses corticosteroid resistance in a mixed granulocytic mouse model of asthma by upregulation of antioxidants and attenuation of Th17 immune responses in the airways. Eur J Pharmacol 2019; 855:276-284. [PMID: 31100413 DOI: 10.1016/j.ejphar.2019.05.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/12/2019] [Accepted: 05/13/2019] [Indexed: 12/28/2022]
Abstract
Sulforaphane has received considerable attention in recent years due to its antioxidant and anti-inflammatory properties. Its preventive effect in the inhibition of airway inflammation is known; however, whether it affects mixed granulocyte asthma (corticosteroid resistance phenotype) is largely undiscovered. Therefore, we assessed the effect of pharmacological activation of Nrf2, a redox-sensitive transcription factor, using sulforaphane in a mouse model of mixed granulocyte airway inflammation. Mice were sensitized and challenged with cockroach allergen extract (CE), and airway inflammatory parameters and markers of steroid resistance [Nrf2 activity, oxidant-antioxidant balance in airway epithelial cells (AECs)/lung, and IL-17A-related pathway in Th17 cells and dendritic cells (DCs)] were investigated. Our results show that sulforaphane administration reduced neutrophilic airway inflammation, myeloperoxidase (MPO) activity, and Th17 immune responses in a mixed granulocyte mouse model of asthma through Nrf2 activation. On the other hand, corticosteroid treatment decreased Th2/eosinophilic immune responses but had little on Th17/neutrophilic immune responses. However, combined treatment with both almost completely blocked both neutrophilic/eosinophilic and Th17/Th2 immune responses in the lung. Sulforaphane treatment led to induction of antioxidant enzymes (SOD, GPx) in AECs and pulmonary non-enzymatic antioxidants. Further, it led to reduction in inflammatory cytokines (IL-6/IL-23/IL-17A) in Th17 cells/CD11c + DCs during mixed granulocytic inflammation. Collectively, our study presents the evidence that activation of Nrf2 by sulforaphane reduces neutrophilic airway inflammation by upregulation of antioxidants and downregulation of inflammatory cytokines in airways. This is possibly the basis for reversal of corticosteroid resistance in this model. This shows the therapeutic potential of sulforaphane in mixed granulocyte asthma.
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Affiliation(s)
- Naif O Al-Harbi
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Nadeem
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
| | - Sheikh F Ahmad
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Sultan S AlThagfan
- Clinical and Hospital Department, College of Pharmacy, Taibah University, Medina, Saudi Arabia
| | - Mohammed Alqinyah
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Faleh Alqahtani
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Khalid E Ibrahim
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed M Al-Harbi
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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12
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El Bilbeisi AHH, Albelbeisi A, Hosseini S, Djafarian K. Dietary Pattern and Their Association With Level of Asthma Control Among Patients With Asthma at Al-Shifa Medical Complex in Gaza Strip, Palestine. Nutr Metab Insights 2019; 12:1178638819841394. [PMID: 31057326 PMCID: PMC6452430 DOI: 10.1177/1178638819841394] [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] [Received: 03/04/2019] [Accepted: 03/10/2019] [Indexed: 12/12/2022] Open
Abstract
Background: This study was conducted to identify major dietary patterns and their
association with level of asthma control among patients with asthma in Gaza
Strip, Palestine. Methods: This cross-sectional study was conducted among a representative sample of
Palestinian patients with asthma (both sex, aged 19-64 years) receiving care
in chest department at Al-Shifa Medical Complex. Asthma control level was
obtained using asthma control test. Data regarding other variables were
obtained using an interview-based questionnaire and a semi-quantitative food
frequency questionnaire. Statistical analysis was performed using SPSS
version 20. Results: Two major dietary patterns were identified including (1) Prudent pattern
characterized by a high intake of whole grains, beans and legumes, fish and
shellfish products, vegetables, tomatoes, fruits, and vegetable oils, and
(2) Western pattern characterized by a high intake of refined grains, red
meat, poultry, fast foods, eggs, low-fat dairy product, high-fat dairy
products, hydrogenated fats, olive, sugar, sweets, desserts, and snacks.
After adjustment for confounding variables, patients in the lowest tertile
(T1) of Prudent pattern had a lower odds for poorly controlled asthma (odds
ratio [OR] = 0.044, 95% confidence interval [CI] = [0.002-1.316],
P value < 0.05), whereas patients in the lowest
tertile (T1) of Western pattern had a higher odds for poorly controlled
asthma (OR = 2.499, 95% CI = [1.288-4.850], P
value < 0.05), compared with those in the highest tertile (T3). Conclusion: A Prudent pattern may be associated with a lower prevalence of poorly
controlled asthma, whereas a Western pattern may be associated with a higher
prevalence of poorly controlled asthma.
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Affiliation(s)
- Abdel Hamid Hassan El Bilbeisi
- Department of Clinical Nutrition, Faculty of Pharmacy, Al Azhar University of Gaza, Gaza Strip, Palestine.,Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Albelbeisi
- Department of Clinical Nutrition, European Gaza Hospital, Gaza Strip, Palestine
| | - Saeed Hosseini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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13
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Does a carrot a day keep the allergy away? Immunol Lett 2018; 206:54-58. [PMID: 30339818 DOI: 10.1016/j.imlet.2018.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/09/2018] [Accepted: 10/15/2018] [Indexed: 12/12/2022]
Abstract
Vitamin A is an important micronutrient, from plants diet taken up as carotenoids, from animal food sources as retinol. Its active metabolite retinoic acid (RA) binds to nuclear hormone receptors, thereby regulating gene transcription programs in various cells. Adequate nutritional intake of vitamin A is essential for pre- and postnatal development, eyesight and reproduction, and it contributes to the maintenance and regulation of the immune system. Recent molecular studies indicate that lipocalins play an important role in the bioavailability of RA and its immune modulation against Th2 responses. There is emerging evidence that supply with vitamin A determines the susceptibility to allergic diseases: significantly reduced serum vitamin A levels are commonly observed in allergic patients compared to healthy controls. In line, findings from nutritional and clinical trials suggest that sufficient vitamin A supplementation in pregnancy prevents the development of allergic diseases in the offspring, and helps in controlling symptoms in adult asthmatics. Overall, retinoids have a key role in regulating immune homeostasis on mucosal surfaces because they are able to interfere with inflammatory signalling pathways. In this mini-review we will concentrate on the current knowledge about the influence of dietary and supplementary vitamin A on allergic diseases in humans from infancy to adulthood.
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