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Katial JM, Hoyte FCL, Khatiwada A, Katial RK. Allergen skin test responses in broad U.S. asthma population in those with and without rhinitis. Allergy Asthma Proc 2024; 45:158-165. [PMID: 38755783 DOI: 10.2500/aap.2024.45.240012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Background: Asthma and allergic rhinitis are pathologically interlinked conditions. Despite skin testing (ST) being pivotal for evaluating allergic sensitization, U.S. data that date back to 1960s on ST reactivity patterns in subjects with asthma remain sparse. Objective: The purpose of this study was to elucidate seasonal, perennial ST responses, and their relationship with asthma severity, early versus late onset disease, and immunoglobulin E (IgE) levels. Methods: Five hundred patients with asthma were randomly selected from the National Jewish Health electronic medical record over a 3-year span. Demographic, clinical, and allergen ST reactivity data for a battery of seasonal and perennial allergens were procured, including total IgE levels, asthma onset, and severity, by using t-tests, χ² tests, and Analysis of Variance (ANOVA), patterns of reactivity were assessed for overall, seasonal, and perennial allergens in relation to IgE levels, asthma onset, and severity. Results: Of the 500 patients, 398 were analyzed. 63.3% were women, 50.1% had adult-onset asthma, and 86.1% had rhinitis; 75.3% tested positive to one or more allergens, with men demonstrating higher overall (p = 0.039) and perennial (p = 0.035) sensitization. ST reactivity varied based on the presence of rhinitis for seasonal (p = 0.028) but not perennial (p = 0.733) allergens. Asthma severity was not significantly associated with ST reactivity (p > 0.10). ST positivity for perennial (p < 0.001) but not seasonal (p = 0.128) allergens was higher in childhood-onset asthma versus adult-onset asthma despite both groups having a large percentage of reactors. Elevated IgE levels correlated with ST reactivity (p < 0.01). Conclusion: Our study represents a unique comprehensive evaluation of ST reactivity in a U.S. asthma population, which is lacking in the literature, when factoring in asthma onset, severity, and IgE levels. Our findings underscore the importance of allergen sensitization in asthma, regardless of severity, concurrent rhinitis symptoms, or asthma onset, which challenge some of the prevailing assumptions about the relationship between allergen sensitization and asthma onset.
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Affiliation(s)
- John M Katial
- From the College of Arts and Sciences, Georgetown University, Washington, DC, and
| | - Flavia C L Hoyte
- Division of Allergy and Clinical Immunology, National Jewish Health, Denver, Colorado
| | - Aastha Khatiwada
- Division of Allergy and Clinical Immunology, National Jewish Health, Denver, Colorado
| | - Rohit K Katial
- Division of Allergy and Clinical Immunology, National Jewish Health, Denver, Colorado
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Gaietto K, Han YY, Rosser FJ, Acosta-Pérez E, Forno E, Canino G, Celedón JC. Socioeconomic status, diet, and recurrent severe asthma exacerbations in Puerto Rican youth. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100220. [PMID: 38375461 PMCID: PMC10875262 DOI: 10.1016/j.jacig.2024.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 02/21/2024]
Abstract
Background Why Puerto Rican youths have higher rates of severe asthma exacerbations (SAEs) than their non-Hispanic White peers is unclear. Objective We aimed to identify risk factors associated with recurrent SAEs in Puerto Rican youths with asthma. Methods We performed cross-sectional and longitudinal analyses of recurrent SAEs in 209 Puerto Rican youths with asthma who participated in 2 cross-sectional studies approximately 5.2 years apart: the Puerto Rico Genetics of Asthma and Lifestyle study (visit 1, participants aged 6-14 years) and the Epigenetic Variation and Childhood Asthma in Puerto Ricans study (visit 2, participants aged 9-20 years). Recurrent SAEs were defined as at least 2 SAEs in the previous year. Results Of the youths in our study, there were 80 (38.3%) and 47 (22.4%) with recurrent SAEs at visit 1 and visit 2, respectively, and 31 participants (14.8%) had persistent recurrent SAEs (ie, recurrent SAEs at both visits). In multivariable analyses, low household income was significantly associated with 2.4 to 12.3 times increased odds of recurrent SAEs in all analyses, with stronger longitudinal associations. Low parental education level, nonprivate or employer-based health insurance, overweight or obesity, residential proximity to a major road, and low or moderate level of outdoor activity were each significantly associated with recurrent SAEs in at least 1 analysis. Further, persistence of low parental numeracy level, low household income, and an unhealthy diet were each associated with persistent recurrent SAEs. Conclusion In this study of Puerto Rican youths with asthma, persistence of low parental numeracy level, a low household income, and an unhealthy diet were associated with persistent recurrent SAEs. Our findings support policies promoting equity and healthy lifestyles for Puerto Rican children and their families.
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Affiliation(s)
- Kristina Gaietto
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Yueh-Ying Han
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Franziska J. Rosser
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Edna Acosta-Pérez
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Erick Forno
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Juan C. Celedón
- Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center (UPMC) Children’s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
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3
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Liu YL, Zhang Y. Prediction of Clinical Response to Dupilumab in Patients with Severe Asthma Using Fractional Exhaled Nitric Oxide Combined with Pulmonary Function Testing. Int Arch Allergy Immunol 2024:1-9. [PMID: 38688250 DOI: 10.1159/000538542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/22/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION This study aimed to assess the effectiveness of fractional exhaled nitric oxide (FeNO) combined with pulmonary function testing (PFT) for predicting the treatment outcome of patients with severe asthma receiving dupilumab. METHODS A total of 31 patients with severe asthma visiting our hospital from January 2022 to June 2023 were included in this study, with 28 patients completing a 16-week course of dupilumab treatment. Baseline clinical data, including demographic information, blood eosinophil counts, serum IgE levels, FeNO, asthma control test (ACT), asthma control questionnaire (ACQ), and other parameters, were collected. A predictive model using a generalized linear model was established. RESULTS Following the 16-week course of dupilumab treatment, 22 patients showed effective response based on GETE scores, while 6 patients were nonresponders. Notably, significant improvements were observed in clinical parameters such as blood eosinophil counts, serum IgE levels, FeNO, FEV1, FEV1%, ACT, and ACQ in both response groups (p < 0.05). FeNO and pulmonary function tests demonstrated AUC values of 0.530, 0.561, and 0.765, respectively, in predicting the clinical efficacy of dupilumab, which were lower than when FeNO was combined with FEV1%. The combination of FeNO and FEV1% had a sensitivity of 1.000 and specificity of 0.591 in predicting treatment response. CONCLUSION The combined assessment of FeNO and FEV1% provides improved accuracy for predicting the clinical efficacy of dupilumab in managing severe asthma. However, further larger scale clinical studies with comprehensive follow-up data are needed to validate the therapeutic efficacy and applicability across diverse patient populations.
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Affiliation(s)
- Yi-Liang Liu
- Department of Respiratory and Critical Care Medicine, The First People's Hospital of Shuangliu District, Chengdu, China
| | - Yong Zhang
- Department of Respiratory and Critical Care Medicine, The First People's Hospital of Shuangliu District, Chengdu, China
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Elbany C, Braun C, Lazizi S, Paradis L, Des Roches A, Samaan K, Labrosse R, Graham F, Bégin P. Effect-modifying impact of age on sex-based differences during oral immunotherapy. Allergy 2024; 79:526-529. [PMID: 38087863 DOI: 10.1111/all.15980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/28/2023] [Accepted: 12/03/2023] [Indexed: 02/01/2024]
Affiliation(s)
- Charles Elbany
- Department of Pediatrics, Section of Allergy and Clinical Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
- AP-HP, Hôpital Necker-Enfants Malades, Service de Pneumologie et Allergologie Pédiatriques, Paris, France
- Service de Pédiatrie, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Camille Braun
- Department of Pediatrics, Section of Allergy and Clinical Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
- Department of Pediatrics, Pneumology, Allergy, Cystic Fibrosis, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
- Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR 5308, Université Lyon 1, ENS de Lyon, Lyon, France
| | - Selma Lazizi
- Department of Pediatrics, Section of Allergy and Clinical Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
- Department of Medicine, Section of Allergy and Clinical Immunology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Louis Paradis
- Department of Pediatrics, Section of Allergy and Clinical Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
- Department of Medicine, Section of Allergy and Clinical Immunology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Anne Des Roches
- Department of Pediatrics, Section of Allergy and Clinical Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | - Kathryn Samaan
- Department of Pediatrics, Section of Allergy and Clinical Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | - Roxane Labrosse
- Department of Pediatrics, Section of Allergy and Clinical Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
| | - François Graham
- Department of Pediatrics, Section of Allergy and Clinical Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
- Department of Medicine, Section of Allergy and Clinical Immunology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Philippe Bégin
- Department of Pediatrics, Section of Allergy and Clinical Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Canada
- Department of Medicine, Section of Allergy and Clinical Immunology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
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Barosova R, Baranovicova E, Hanusrichterova J, Mokra D. Metabolomics in Animal Models of Bronchial Asthma and Its Translational Importance for Clinics. Int J Mol Sci 2023; 25:459. [PMID: 38203630 PMCID: PMC10779398 DOI: 10.3390/ijms25010459] [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: 11/15/2023] [Revised: 12/17/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Bronchial asthma is an extremely heterogenous chronic respiratory disorder with several distinct endotypes and phenotypes. These subtypes differ not only in the pathophysiological changes and/or clinical features but also in their response to the treatment. Therefore, precise diagnostics represent a fundamental condition for effective therapy. In the diagnostic process, metabolomic approaches have been increasingly used, providing detailed information on the metabolic alterations associated with human asthma. Further information is brought by metabolomic analysis of samples obtained from animal models. This article summarizes the current knowledge on metabolomic changes in human and animal studies of asthma and reveals that alterations in lipid metabolism, amino acid metabolism, purine metabolism, glycolysis and the tricarboxylic acid cycle found in the animal studies resemble, to a large extent, the changes found in human patients with asthma. The findings indicate that, despite the limitations of animal modeling in asthma, pre-clinical testing and metabolomic analysis of animal samples may, together with metabolomic analysis of human samples, contribute to a novel way of personalized treatment of asthma patients.
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Affiliation(s)
- Romana Barosova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (R.B.); (J.H.)
| | - Eva Baranovicova
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia;
| | - Juliana Hanusrichterova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (R.B.); (J.H.)
- Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia;
| | - Daniela Mokra
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (R.B.); (J.H.)
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Naftel J, Mistry H, Mitchell FA, Belson J, Kyyaly MA, Barber C, Haitchi HM, Dennison P, Djukanovic R, Seumois G, Vijayanand P, Arshad SH, Kurukulaaratchy RJ. How Does Mild Asthma Differ Phenotypically from Difficult-to-Treat Asthma? J Asthma Allergy 2023; 16:1333-1345. [PMID: 38144877 PMCID: PMC10748667 DOI: 10.2147/jaa.s430183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/08/2023] [Indexed: 12/26/2023] Open
Abstract
Background Despite most of the asthma population having mild disease, the mild asthma phenotype is poorly understood. Here, we aim to address this gap in knowledge by extensively characterising the mild asthma phenotype and comparing this with difficult-to-treat asthma. Methods We assessed two real-world adult cohorts from the South of England using an identical methodology: the Wessex AsThma CoHort of difficult asthma (WATCH) (n=498) and a mild asthma cohort from the comparator arm of the Epigenetics Of Severe Asthma (EOSA) study (n=67). Data acquisition included detailed clinical, health and disease-related questionnaires, anthropometry, allergy and lung function testing, plus biological samples (blood and sputum) in a subset. Results Mild asthma is predominantly early-onset and is associated with type-2 (T2) inflammation (atopy, raised fractional exhaled nitric oxide (FeNO), blood/sputum eosinophilia) plus preserved lung function. A high prevalence of comorbidities and multimorbidity was observed in mild asthma, particularly depression (58.2%) and anxiety (56.7%). In comparison to difficult asthma, mild disease showed similar female predominance (>60%), T2-high inflammation and atopy prevalence, but lower peripheral blood/airway neutrophil counts and preserved lung function. Mild asthma was also associated with a greater prevalence of current smokers (20.9%). A multi-component T2-high inflammatory measure was comparable between the cohorts; T2-high status 88.1% in mild asthma and 93.5% in difficult asthma. Conclusion Phenotypic characterisation of mild asthma identified early-onset disease with high prevalence of current smokers, T2-high inflammation and significant multimorbidity burden. Early comprehensive assessment of mild asthma patients could help prevent potential later progression to more complex severe disease.
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Affiliation(s)
- Jennifer Naftel
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre at University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Heena Mistry
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre at University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences Department, Faculty of Medicine, University of Southampton, Southampton, UK
- Asthma, Allergy and Clinical Immunology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- The David Hide Asthma & Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
- Vijayanand Laboratory, La Jolla Institute of Immunology, San Diego, CA, 92037, USA
| | - Frances Ann Mitchell
- The David Hide Asthma & Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
| | - Jane Belson
- The David Hide Asthma & Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
| | - Mohammed Aref Kyyaly
- Clinical and Experimental Sciences Department, Faculty of Medicine, University of Southampton, Southampton, UK
- The David Hide Asthma & Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
| | - Clair Barber
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre at University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences Department, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Hans Michael Haitchi
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre at University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences Department, Faculty of Medicine, University of Southampton, Southampton, UK
- Asthma, Allergy and Clinical Immunology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Paddy Dennison
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre at University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences Department, Faculty of Medicine, University of Southampton, Southampton, UK
- Asthma, Allergy and Clinical Immunology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Ratko Djukanovic
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre at University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences Department, Faculty of Medicine, University of Southampton, Southampton, UK
- Asthma, Allergy and Clinical Immunology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Gregory Seumois
- Vijayanand Laboratory, La Jolla Institute of Immunology, San Diego, CA, 92037, USA
| | - Pandurangan Vijayanand
- Clinical and Experimental Sciences Department, Faculty of Medicine, University of Southampton, Southampton, UK
- Vijayanand Laboratory, La Jolla Institute of Immunology, San Diego, CA, 92037, USA
| | - Syed Hasan Arshad
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre at University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences Department, Faculty of Medicine, University of Southampton, Southampton, UK
- Asthma, Allergy and Clinical Immunology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- The David Hide Asthma & Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
- Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Ramesh J Kurukulaaratchy
- National Institute for Health Research (NIHR) Southampton Biomedical Research Centre at University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences Department, Faculty of Medicine, University of Southampton, Southampton, UK
- Asthma, Allergy and Clinical Immunology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- The David Hide Asthma & Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
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Herrera-De La Mata S, Ramírez-Suástegui C, Mistry H, Castañeda-Castro FE, Kyyaly MA, Simon H, Liang S, Lau L, Barber C, Mondal M, Zhang H, Arshad SH, Kurukulaaratchy RJ, Vijayanand P, Seumois G. Cytotoxic CD4 + tissue-resident memory T cells are associated with asthma severity. MED 2023; 4:875-897.e8. [PMID: 37865091 PMCID: PMC10964988 DOI: 10.1016/j.medj.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 07/02/2023] [Accepted: 09/18/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Patients with severe uncontrolled asthma represent a distinct endotype with persistent airway inflammation and remodeling that is refractory to corticosteroid treatment. CD4+ TH2 cells play a central role in orchestrating asthma pathogenesis, and biologic therapies targeting their cytokine pathways have had promising outcomes. However, not all patients respond well to such treatment, and their effects are not always durable nor reverse airway remodeling. This observation raises the possibility that other CD4+ T cell subsets and their effector molecules may drive airway inflammation and remodeling. METHODS We performed single-cell transcriptome analysis of >50,000 airway CD4+ T cells isolated from bronchoalveolar lavage samples from 30 patients with mild and severe asthma. FINDINGS We observed striking heterogeneity in the nature of CD4+ T cells present in asthmatics' airways, with tissue-resident memory T (TRM) cells making a dominant contribution. Notably, in severe asthmatics, a subset of CD4+ TRM cells (CD103-expressing) was significantly increased, comprising nearly 65% of all CD4+ T cells in the airways of male patients with severe asthma when compared to mild asthma (13%). This subset was enriched for transcripts linked to T cell receptor activation (HLA-DRB1, HLA-DPA1) and cytotoxicity (GZMB, GZMA) and, following stimulation, expressed high levels of transcripts encoding for pro-inflammatory non-TH2 cytokines (CCL3, CCL4, CCL5, TNF, LIGHT) that could fuel persistent airway inflammation and remodeling. CONCLUSIONS Our findings indicate the need to look beyond the traditional T2 model of severe asthma to better understand the heterogeneity of this disease. FUNDING This research was funded by the NIH.
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Affiliation(s)
| | | | - Heena Mistry
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton Foundation Trust, Southampton SO16 6YD, UK; The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport PO30 5TG, Isle of Wight, UK
| | | | - Mohammad A Kyyaly
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport PO30 5TG, Isle of Wight, UK
| | - Hayley Simon
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Shu Liang
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Laurie Lau
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton Foundation Trust, Southampton SO16 6YD, UK
| | - Clair Barber
- National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton Foundation Trust, Southampton SO16 6YD, UK
| | | | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN 38152, USA
| | - Syed Hasan Arshad
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton Foundation Trust, Southampton SO16 6YD, UK; The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport PO30 5TG, Isle of Wight, UK
| | - Ramesh J Kurukulaaratchy
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton Foundation Trust, Southampton SO16 6YD, UK; The David Hide Asthma and Allergy Research Centre, St. Mary's Hospital, Newport PO30 5TG, Isle of Wight, UK.
| | - Pandurangan Vijayanand
- La Jolla Institute for Immunology, La Jolla, CA 92037, USA; Department of Medicine, University of California San Diego, La Jolla, CA 92037, USA; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool L69 3BX, UK.
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Weckmann M, Reddy KD. Epigenome-wide association studies: the exposures of yesterday form the methylations of tomorrow. Eur Respir J 2023; 62:2301552. [PMID: 38128955 DOI: 10.1183/13993003.01552-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Markus Weckmann
- Division of Epigenetics in Chronic Lung Disease, Priority Area Chronic Lung Diseases, Leibniz Lung Center, Research Center Borstel, Borstel, Germany
- Airway Research Centre North (ARCN), German Centre for Lung Research (DZL), Germany
- Department of Pediatric Pneumology and Allergology, University Children's Hospital Lübeck, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Karosham Diren Reddy
- Division of Epigenetics in Chronic Lung Disease, Priority Area Chronic Lung Diseases, Leibniz Lung Center, Research Center Borstel, Borstel, Germany
- Airway Research Centre North (ARCN), German Centre for Lung Research (DZL), Germany
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Celik GE, Aydin O, Gokmen D, Koycu Buhari G, Celebi Sozener Z, Gemicioglu B, Bulut I, Beyaz S, Orcen C, Ozdemir SK, Keren M, Damadoglu E, Yakut T, Kalpaklioglu AF, Baccioglu A, Yalim SA, Yilmaz I, Koca Kalkan I, Uysal MA, Ozgun Niksarlioglu EY, Kalyoncu AF, Karakaya G, Erbay M, Nayci S, Tepetam FM, Gelincik AA, Dirol H, Goksel O, Karaoglanoglu S, Oner Erkekol F, Isik SR, Yildiz F, Yavuz Y, Karadogan D, Bozkurt N, Seker U, Oguzulgen IK, Basyigit I, Baris SA, Yilmazel Ucar E, Erdogan T, Polatli M, Ediger D, Gunaydin FE, Turk M, Pur L, Katran ZY, Sekibag Y, Aykac EF, Mungan D, Gul O, Cengiz A, Akkurt B, Ozden S, Demir S, Unal D, Aslan AF, Can A, Gumusburun R, Bogatekin G, Akten HS, Inan S, Erdinc M, Ogus AC, Kavas M, Polat Yulug D, Cakmak ME, Kaya SB, Alpagat G, Ozgur ES, Uzun O, Tas Gulen S, Pekbak G, Kizilirmak D, Havlucu Y, Donmez H, Arslan B, Cetin GP, Soyyigit S, Kara BY, Pasaoglu Karakis G, Dursun AB, Kendirlinan R, Ozturk AB, Sevinc C, Omeroglu Simsek G, Abadoglu O, Cerci P, Yucel T, Yorulmaz I, Tezcaner ZC, Tatar EC, Suslu AE, Ozer S, Dursun E, Yorgancioglu A. Picturing asthma in Turkey: results from the Turkish adult asthma registry. J Asthma 2023; 60:1973-1986. [PMID: 37096963 DOI: 10.1080/02770903.2023.2206902] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/10/2023] [Accepted: 04/20/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION National data on asthma characteristics and the factors associated with uncontrolled asthma seem to be necessary for every country. For this purpose, we developed the Turkish Adult Asthma Registry for patients with asthma aiming to take a snapshot of our patients, thereby assigning the unmet needs and niche areas of intervention. METHODS Case entries were performed between March 2018 and March 2022. A web-based application was used to record data. Study outcomes were demographic features, disease characteristics, asthma control levels, and phenotypes. RESULTS The registry included 2053 patients from 36 study centers in Turkey. Female subjects dominated the group (n = 1535, 74.8%). The majority of the patients had allergic (n = 1158, 65.3%) and eosinophilic (n = 1174, 57.2%) asthma. Six hundred nineteen (32.2%) of the patients had obese asthma. Severe asthma existed in 670 (32.6%) patients. Majority of cases were on step 3-5 treatment (n: 1525; 88.1%). Uncontrolled asthma was associated with low educational level, severe asthma attacks in the last year, low FEV1, existence of chronic rhinosinusitis and living in particular regions. CONCLUSION The picture of this registry showed a dominancy of middle-aged obese women with moderate-to-severe asthma. We also determined particular strategic targets such as low educational level, severe asthma attacks, low FEV1, and chronic rhinosinusitis to decrease uncontrolled asthma in our country. Moreover, some regional strategies may also be needed as uncontrolled asthma is higher in certain regions. We believe that these data will guide authorities to reestablish national asthma programs to improve asthma service delivery.
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Affiliation(s)
- Gulfem Elif Celik
- Department of Chest Disease, Division of Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Omur Aydin
- Department of Chest Disease, Division of Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Derya Gokmen
- Department of Biostatistics and Informatics, Ankara University School of Medicine, Ankara, Turkey
| | - Gozde Koycu Buhari
- Department of Immunology and Allergy, University of Health Sciences, Ankara Ataturk Sanatoryum Training and Research Hospital, Ankara, Turkey
| | - Zeynep Celebi Sozener
- Department of Chest Disease, Division of Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
- Ankara City Hospital Clinic of Immunology and Allergic Diseases, Ankara, Turkey
| | - Bilun Gemicioglu
- Cerrahpaşa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Ismet Bulut
- Department of Immunology and Allergy, University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sengul Beyaz
- Ankara City Hospital Clinic of Immunology and Allergic Diseases, Ankara, Turkey
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Immunology and Allergic Diseases, Istanbul University, Istanbul, Turkey
| | - Cihan Orcen
- Clinic of Allergy and Immunology, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
| | - Secil Kepil Ozdemir
- Department of Chest Diseases, Division of Allergy and Immunology, University of Health Sciences, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, Izmir, Turkey
| | - Metin Keren
- Department of Immunology and Allergy, University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ebru Damadoglu
- Faculty of Medicine, Department of Chest Diseases, Division of Allergy and Clinical Immunology, Hacettepe University, Ankara, Turkey
| | - Tugce Yakut
- Clinic of Immunology and Allergic Diseases, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakır, Turkey
| | - Ayse Fusun Kalpaklioglu
- Faculty of Medicine, Department of Allergy and Immunology, Kirikkale University, Kirikkale, Turkey
| | - Ayse Baccioglu
- Faculty of Medicine, Department of Allergy and Immunology, Kirikkale University, Kirikkale, Turkey
| | - Sumeyra Alan Yalim
- Faculty of Medicine, Department of Allergy and Immunology, Kirikkale University, Kirikkale, Turkey
| | - Insu Yilmaz
- School of Medicine, Department of Chest Diseases, Division of Allergy and Immunology, Erciyes University, Kayseri, Turkey
| | - Ilkay Koca Kalkan
- Department of Immunology and Allergy, University of Health Sciences, Ankara Ataturk Sanatoryum Training and Research Hospital, Ankara, Turkey
| | - Mehmet Atilla Uysal
- Department of Chest Diseases, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Elif Yelda Ozgun Niksarlioglu
- Department of Chest Diseases, University of Health Sciences, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ali Fuat Kalyoncu
- Faculty of Medicine, Department of Chest Diseases, Division of Allergy and Clinical Immunology, Hacettepe University, Ankara, Turkey
| | - Gul Karakaya
- Faculty of Medicine, Department of Chest Diseases, Division of Allergy and Clinical Immunology, Hacettepe University, Ankara, Turkey
| | - Muge Erbay
- Clinic of Immunology and Allergy Diseases, Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey
| | - Sibel Nayci
- Faculty of Medicine, Department of Chest Diseases, Mersin University, Mersin, Turkey
| | - Fatma Merve Tepetam
- Department of Immunology and Allergy, University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Asli Akkor Gelincik
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Immunology and Allergic Diseases, Istanbul University, Istanbul, Turkey
| | - Hulya Dirol
- Faculty of Medicine, Department of Chest Diseases, Akdeniz University, Antalya, Turkey
| | - Ozlem Goksel
- Faculty of Medicine, Pulmonary, Immunology and Allergy, Ege University, Izmir, Turkey
| | - Selen Karaoglanoglu
- Department of Pulmonology, Ordu University, Training and Research Hospital, Ordu, Turkey
| | - Ferda Oner Erkekol
- Faculty of Medicine, Ankara City Hospital, Clinic of Immunology and Allergic Diseases, Ankara Yildirim Beyazit University, Ankara, Turkey
- Division of Allergy and Immunology, Medicana International Ankara Hospital, Ankara, Turkey
| | - Sacide Rana Isik
- Adult Allergy and Immunology Department, American Hospital, Istanbul, Turkey
| | - Fusun Yildiz
- Faculty of Medicine, Department of Pulmonary Diseases, Kocaeli University, Kocaeli, Turkey
- School of Medicine, Department of Pulmonary Diseases, Cyprus Internatıonal Unıversıty, Cyprus
| | - Yasemin Yavuz
- Department of Biostatistics and Informatics, Ankara University School of Medicine, Ankara, Turkey
| | - Dilek Karadogan
- School of Medicine, Department of Chest Diseases, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Nurgul Bozkurt
- Faculty of Medicine, Department of Chest Diseases, Akdeniz University, Antalya, Turkey
| | - Ummuhan Seker
- Clinic of Immunology and Allergic Diseases, Bursa City Hospital, Bursa, Turkey
| | | | - Ilknur Basyigit
- Faculty of Medicine, Department of Pulmonary Diseases, Kocaeli University, Kocaeli, Turkey
| | - Serap Argun Baris
- Faculty of Medicine, Department of Pulmonary Diseases, Kocaeli University, Kocaeli, Turkey
| | - Elif Yilmazel Ucar
- Faculty of Medicine, Department of Pulmonary Disease, Ataturk University, Erzurum, Turkey
| | - Tuba Erdogan
- Faculty of Medicine, Department of Internal Medicine, Division of Immunology and Allergy, Baskent University, Ankara, Turkey
| | - Mehmet Polatli
- School of Medicine, Department of Pulmonology, Aydin Adnan Menderes University, Aydin, Turkey
| | - Dane Ediger
- Faculty of Medicine, Department of Chest Diseases, Division of Immunology and Allergy, Bursa Uludag University, Bursa, Turkey
| | - Fatma Esra Gunaydin
- Faculty of Medicine, Department of Chest Diseases, Division of Immunology and Allergy, Bursa Uludag University, Bursa, Turkey
| | - Murat Turk
- School of Medicine, Department of Chest Diseases, Division of Allergy and Immunology, Erciyes University, Kayseri, Turkey
- Clinic of Immunologic and Allergic Diseases, Kayseri City Hospital, Kayseri, Turkey
| | - Leyla Pur
- Adult Allergy Service, Glenfield Hospital, University Hospitals of Leicester, Leicester, UK
| | - Zeynep Yegin Katran
- Department of Immunology and Allergy, University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Yonca Sekibag
- Cerrahpaşa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Enes Furkan Aykac
- Cerrahpaşa Faculty of Medicine, Department of Pulmonary Diseases, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Dilsad Mungan
- Department of Chest Disease, Division of Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Ozcan Gul
- Department of Chest Disease, Division of Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Ali Cengiz
- Department of Chest Disease, Division of Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Bulent Akkurt
- Department of Chest Diseases, Division of Allergy and Immunology, University of Health Sciences, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, Izmir, Turkey
| | - Seyma Ozden
- Department of Immunology and Allergy, University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Semra Demir
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Immunology and Allergic Diseases, Istanbul University, Istanbul, Turkey
| | - Derya Unal
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Immunology and Allergic Diseases, Istanbul University, Istanbul, Turkey
| | - Ayse Feyza Aslan
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Immunology and Allergic Diseases, Istanbul University, Istanbul, Turkey
| | - Ali Can
- Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Immunology and Allergic Diseases, Istanbul University, Istanbul, Turkey
| | - Reyhan Gumusburun
- Faculty of Medicine, Pulmonary, Immunology and Allergy, Ege University, Izmir, Turkey
| | - Gulhan Bogatekin
- Faculty of Medicine, Pulmonary, Immunology and Allergy, Ege University, Izmir, Turkey
| | - Hatice Serpil Akten
- Faculty of Medicine, Pulmonary, Immunology and Allergy, Ege University, Izmir, Turkey
| | - Sinem Inan
- Faculty of Medicine, Pulmonary, Immunology and Allergy, Ege University, Izmir, Turkey
| | - Munevver Erdinc
- Faculty of Medicine, Department of Pulmonology, Ege University, Izmir, Turkey
| | - Aliye Candan Ogus
- Faculty of Medicine, Department of Chest Diseases, Akdeniz University, Antalya, Turkey
| | - Murat Kavas
- Department of Immunology and Allergy, University of Health Sciences Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Demet Polat Yulug
- Clinic of Chest Diseases, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Mehmet Erdem Cakmak
- Faculty of Medicine, Department of Chest Diseases, Division of Allergy and Clinical Immunology, Hacettepe University, Ankara, Turkey
| | - Saltuk Bugra Kaya
- Faculty of Medicine, Department of Chest Diseases, Division of Allergy and Clinical Immunology, Hacettepe University, Ankara, Turkey
| | - Gulistan Alpagat
- Faculty of Medicine, Department of Allergy and Immunology, Kirikkale University, Kirikkale, Turkey
| | - Eylem Sercan Ozgur
- Faculty of Medicine, Department of Chest Diseases, Mersin University, Mersin, Turkey
| | - Oguz Uzun
- Department of Pulmonary Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Sule Tas Gulen
- School of Medicine, Department of Pulmonology, Aydin Adnan Menderes University, Aydin, Turkey
| | - Gulseren Pekbak
- Faculty of Medicine, Department of Chest Diseases, Division of Immunology and Allergy, Bursa Uludag University, Bursa, Turkey
| | - Deniz Kizilirmak
- Faculty of Medicine, Department of Pulmonology, Manisa Celal Bayar University, Manisa, Turkey
| | - Yavuz Havlucu
- Faculty of Medicine, Department of Pulmonology, Manisa Celal Bayar University, Manisa, Turkey
| | - Halil Donmez
- School of Medicine, Department of Chest Diseases, Division of Allergy and Immunology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Bahar Arslan
- School of Medicine, Department of Chest Diseases, Division of Allergy and Immunology, Erciyes University, Kayseri, Turkey
| | - Gulden Pacaci Cetin
- School of Medicine, Department of Chest Diseases, Division of Allergy and Immunology, Erciyes University, Kayseri, Turkey
| | - Sadan Soyyigit
- Faculty of Medicine, Ankara City Hospital, Clinic of Immunology and Allergic Diseases, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Bilge Yilmaz Kara
- School of Medicine, Department of Chest Diseases, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Gulden Pasaoglu Karakis
- School of Medicine, Department of Chest Diseases, Adult Allergy-Immunology Unit, Biruni University, Istanbul, Turkey
| | - Adile Berna Dursun
- School of Medicine, Department of Chest Diseases, Division of Allergy and Immunology, Recep Tayyip Erdogan University, Rize, Turkey
- Medical School, Department of Respiratory Medicine, Lokman Hekim University, Ankara, Turkey
| | - Resat Kendirlinan
- Clinic of Immunology and Allergic Diseases, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Ayse Bilge Ozturk
- Faculty of Medicine, Department of Allergy and Immunology, Medeniyet University, Istanbul, Turkey
| | - Can Sevinc
- School of Medicine, Department of Respiratory Diseases, Dokuz Eylul University, Izmir, Turkey
| | - Gokcen Omeroglu Simsek
- School of Medicine, Department of Respiratory Diseases, Dokuz Eylul University, Izmir, Turkey
| | | | - Pamir Cerci
- Clinic of Immunology and Allergic Diseases, Van Regional Training and Research Hospital, Van, Turkey
| | - Taskin Yucel
- School of Medicine Department of Ear Nose and Throat, Hacettepe University, Ankara, Turkey
| | - Irfan Yorulmaz
- School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Ankara University, Ankara, Turkey
| | - Zahide Ciler Tezcaner
- School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Ankara University, Ankara, Turkey
| | - Emel Cadalli Tatar
- Department of Otolaryngology, University of Health Sciences, Etlik City Hospital, Ankara, Turkey
| | - Ahmet Emre Suslu
- School of Medicine Department of Ear Nose and Throat, Hacettepe University, Ankara, Turkey
- Ahmet Emre Suslu Private Ear Nose and Throat Clinic, Ankara, Turkey
| | - Serdar Ozer
- School of Medicine Department of Ear Nose and Throat, Hacettepe University, Ankara, Turkey
| | - Engin Dursun
- Faculty of Medicine, Department of Otorhinolaryngology, Lokman Hekim University, Ankara, Turkey
| | - Arzu Yorgancioglu
- Faculty of Medicine, Department of Pulmonology, Manisa Celal Bayar University, Manisa, Turkey
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10
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Bal C, Pohl W, Milger K, Skowasch D, Schulz C, Gappa M, Koerner-Rettberg C, Jandl M, Schmidt O, Zehetmayer S, Taube C, Hamelmann E, Buhl R, Korn S, Idzko M. Characterization of Obesity in Severe Asthma in the German Asthma Net. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3417-3424.e3. [PMID: 37406803 DOI: 10.1016/j.jaip.2023.06.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Asthma is increasingly recognized as heterogeneous, characterized by different endotypes, with obesity not only a distinct phenotype but a risk factor for severe asthma. OBJECTIVE We sought to understand the associations of obesity with relevant parameters of severe asthma, including asthma control, disease burden, and lung function. METHODS The German Asthma Net registry is a multicenter international real-life registry capturing long-term follow-up data. This analysis included 2213 patients (52 ± 16 years, 58% female, 29% with obesity [body mass index ≥30 kg/m2], 4.2 ± 4.3 exacerbations/year). The primary analysis assessed relationships between BMI and variables through univariate tests, followed by a multiple regression model. Secondary outcomes regarded clinically relevant variables in relation to weight groups. RESULTS Patients with obesity were more frequently female, more likely to have depression and gastroesophageal reflux, and suffered from worse asthma control, lower quality of life, reduced static lung volumes, more pronounced hypoxemia, and higher blood neutrophil counts, all statistically significant. Blood eosinophils, exhaled nitric oxide, and total IgE were independent of obesity. In the multiple regression analysis, obesity was significantly associated with more frequent reflux and depression, reduced static lung function values, older age, poor asthma control, and long-acting muscarinic antagonist therapy, and inversely associated with bronchiectasis and nonsmoking status. CONCLUSION In this large, well-characterized cohort, we identified the association of obesity with a significantly higher disease burden and a similar portfolio of inflammation type 2 markers in patients with and without obesity; therefore, patients with obesity seem similarly eligible for the treatment with biologics targeting these disease endotypes.
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Affiliation(s)
- Christina Bal
- Department of Pneumology, University Hospital Vienna AKH, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Pohl
- Karl Landsteiner Institute for Clinical and Experimental Pneumology, Vienna, Austria
| | - Katrin Milger
- Department of Medicine V, Ludwig-Maximilians-University (LMU) of Munich, Munich, Germany; Comprehensive Pneumology Center (CPC-M), German Center for Lung Research (DZL), Munich, Germany
| | - Dirk Skowasch
- Department of Internal Medicine II-Pneumology, University Hospital Bonn, Bonn, Germany
| | - Christian Schulz
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Monika Gappa
- Evangelisches Krankenhaus Düsseldorf, Children's Hospital, Düsseldorf, Germany
| | | | - Margret Jandl
- Hamburger Institut für Therapieforschung GmbH, Hamburg, Germany
| | - Olaf Schmidt
- Pneumologische Gemeinschaftspraxis und Studienzentrum KPPK, Koblenz, Germany
| | - Sonja Zehetmayer
- Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Christian Taube
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Essen, Germany
| | - Eckard Hamelmann
- Kinderzentrum Bethel, Evangelisches Klinikum Bethel, University Bielefeld, Bielefeld, Germany
| | - Roland Buhl
- Pulmonary Department, Mainz University Hospital, Mainz, Germany
| | - Stephanie Korn
- Department of Pneumology/Respiratory Medicine, Thoraxklinik Heidelberg, Heidelberg, Germany; IKF Pneumologie Mainz, Mainz, Germany.
| | - Marco Idzko
- Department of Pneumology, University Hospital Vienna AKH, Medical University of Vienna, Vienna, Austria
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11
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Sogard AS, Mickleborough TD. The therapeutic role of inspiratory muscle training in the management of asthma: a narrative review. Am J Physiol Regul Integr Comp Physiol 2023; 325:R645-R663. [PMID: 37720997 DOI: 10.1152/ajpregu.00325.2022] [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: 12/28/2022] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023]
Abstract
Asthma is a disorder of the airways characterized by chronic airway inflammation, hyperresponsiveness, and variable recurring airway obstruction. Treatment options for asthma include pharmacological strategies, whereas nonpharmacological strategies are limited. Established pharmacological approaches to treating asthma may cause unwanted side effects and do not always afford adequate protection against asthma, possibly because of an individual's variable response to medications. A potential nonpharmacological intervention that is most available and cost effective is inspiratory muscle training (IMT), which is a technique targeted at increasing the strength and endurance of the diaphragm and accessory muscles of inspiration. Studies examining the impact of IMT on asthma have reported increases in inspiratory muscle strength and a reduction in the perception of dyspnea and medication use. However, because of the limited number of studies and discordant methods between studies more evidence is required to elucidate in individuals with asthma the efficacy of IMT on inspiratory muscle endurance, exercise capacity, asthma control, symptoms, and quality of life as well as in adolescents with differing severities of asthma. Large randomized controlled trials would be a significant step forward in clarifying the effectiveness of IMT in individuals with asthma. Although IMT may have favorable effects on inspiratory muscle strength, dyspnea, and medication use, the current evidence that IMT is an effective treatment for asthma is inconclusive.
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Affiliation(s)
- Abigail S Sogard
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, United States
| | - Timothy D Mickleborough
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, United States
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12
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Romero-Tapia SDJ, Becerril-Negrete JR, Castro-Rodriguez JA, Del-Río-Navarro BE. Early Prediction of Asthma. J Clin Med 2023; 12:5404. [PMID: 37629446 PMCID: PMC10455492 DOI: 10.3390/jcm12165404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/26/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
The clinical manifestations of asthma in children are highly variable, are associated with different molecular and cellular mechanisms, and are characterized by common symptoms that may diversify in frequency and intensity throughout life. It is a disease that generally begins in the first five years of life, and it is essential to promptly identify patients at high risk of developing asthma by using different prediction models. The aim of this review regarding the early prediction of asthma is to summarize predictive factors for the course of asthma, including lung function, allergic comorbidity, and relevant data from the patient's medical history, among other factors. This review also highlights the epigenetic factors that are involved, such as DNA methylation and asthma risk, microRNA expression, and histone modification. The different tools that have been developed in recent years for use in asthma prediction, including machine learning approaches, are presented and compared. In this review, emphasis is placed on molecular mechanisms and biomarkers that can be used as predictors of asthma in children.
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Affiliation(s)
- Sergio de Jesus Romero-Tapia
- Health Sciences Academic Division (DACS), Juarez Autonomous University of Tabasco (UJAT), Villahermosa 86040, Mexico
| | - José Raúl Becerril-Negrete
- Department of Clinical Immunopathology, Universidad Autónoma del Estado de México, Toluca 50000, Mexico;
| | - Jose A. Castro-Rodriguez
- Department of Pediatric Pulmonology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330077, Chile;
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Hansen ESH, Aasbjerg K, Moeller AL, Meaidi A, Gade E, Ulrik CS, Torp-Pedersen C, Backer V. Hormonal Contraceptives Are Associated With an Increase in Incidence of Asthma in Women. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2484-2490.e3. [PMID: 37178764 DOI: 10.1016/j.jaip.2023.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Use of exogenous female sex hormones is associated with the development of asthma, but the question of whether the effect is protective or harmful remains unresolved. OBJECTIVE To investigate whether initiation of hormonal contraceptive (HC) treatment was associated with development of asthma. METHODS We performed a register-based, exposure-matched cohort study including women who initiated HC treatment of any kind between 10 and 40 years of age and compared the incidence of asthma with women who did not initiate HCs. Asthma was defined as 2 redeemed prescriptions of inhaled corticosteroids within 2 years. Data were analyzed using Cox regression models adjusted for income and urbanization. RESULTS We included 184,046 women with a mean age of 15.5 years (SD 1.5 y), in which 30,669 initiated HC treatment and 153,377 did not. We found that initiation of HCs was associated with an increased hazard ratio (HR) of developing new asthma by 1.78 (95% CI 1.58-2.00; P < .001). The cumulative risk of new asthma was 2.7% after 3 years among users of HCs compared with 1.5% in nonusers. In the different subtypes of HCs, second- and third-generation contraceptives carried significant associations (second-generation HR 1.76; 95% CI 1.52-2.03; P < .001; third-generation HR 1.62 95% CI 1.23-2.12; P < .001). The association with increased incidence was seen only in women younger than 18 years. CONCLUSIONS In this study, first-time users of HCs had an increased incidence of asthma compared with nonusers. Clinicians prescribing HCs should be aware that airway symptoms may develop.
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Affiliation(s)
- Erik Soeren Halvard Hansen
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark; Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
| | - Kristian Aasbjerg
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Amalie Lykkemark Moeller
- Department of Cardiology, North Zealand Hospital, Hilleroed, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Cancer Surveillance and Pharmacoepidemiology Department, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Amani Meaidi
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth Gade
- The Fertility Partnership-Stork Fertility Clinic, Copenhagen, Denmark
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, North Zealand Hospital, Hilleroed, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Cancer Surveillance and Pharmacoepidemiology Department, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - Vibeke Backer
- Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Otorhinolaryngology, Rigshospitalet, University of Copenhagen, Denmark
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Pérez de Llano L, Marina Malanda N, Urrutia I, Martínez-Moragón E, Gullón-Blanco JA, Díaz-Campos R, Esquerre MM, Mena AH, Cosío BG, Cisneros C, Polo FJL, Laorden D, Dacal Rivas D. Factors associated with suboptimal response to monoclonal antibodies in severe asthma. Allergy 2023; 78:2305-2310. [PMID: 36866939 DOI: 10.1111/all.15693] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 02/22/2023] [Accepted: 02/25/2023] [Indexed: 03/04/2023]
Affiliation(s)
- Luis Pérez de Llano
- Pneumology Service, Lucus Augusti University Hospital, EOXI Lugo, Cervo e Monforte, Lugo, Spain
| | | | - Isabel Urrutia
- Pneumology Service, Galdakao-Usansolo University Hospital, Galdakao, Spain
| | | | | | - Rocío Díaz-Campos
- Pneumology Service, Doce de Octubre University Hospital, Madrid, Spain
| | - Mariana Muñoz Esquerre
- Pneumology Service, Bellvitge University Hospital, IBIDELL, Barcelona University, Barcelona, Spain
| | - Alicia Habernau Mena
- Allergy Section, Internal Medicine Service, Complejo Hospitalario de Mérida, Badajoz, Spain
| | - Borja G Cosío
- Pneumology Service, Son Espases University Hospital, IdISBa-Ciberes, Palma de Mallorca, Spain
| | | | | | - Daniel Laorden
- Pneumology Service, La Paz University Hospital, Madrid, Spain
| | - David Dacal Rivas
- Pneumology Service, Lucus Augusti University Hospital, EOXI Lugo, Cervo e Monforte, Lugo, Spain
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15
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Ricciardolo FLM, Guida G, Bertolini F, Di Stefano A, Carriero V. Phenotype overlap in the natural history of asthma. Eur Respir Rev 2023; 32:32/168/220201. [PMID: 37197769 DOI: 10.1183/16000617.0201-2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/23/2023] [Indexed: 05/19/2023] Open
Abstract
The heterogeneity of asthma makes it challenging to unravel the pathophysiologic mechanisms of the disease. Despite the wealth of research identifying diverse phenotypes, many gaps still remain in our knowledge of the disease's complexity. A crucial aspect is the impact of airborne factors over a lifetime, which often results in a complex overlap of phenotypes associated with type 2 (T2), non-T2 and mixed inflammation. Evidence now shows overlaps between the phenotypes associated with T2, non-T2 and mixed T2/non-T2 inflammation. These interconnections could be induced by different determinants such as recurrent infections, environmental factors, T-helper plasticity and comorbidities, collectively resulting in a complex network of distinct pathways generally considered as mutually exclusive. In this scenario, we need to abandon the concept of asthma as a disease characterised by distinct traits grouped into static segregated categories. It is now evident that there are multiple interplays between the various physiologic, cellular and molecular features of asthma, and the overlap of phenotypes cannot be ignored.
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Affiliation(s)
- Fabio L M Ricciardolo
- Department of Clinical and Biological Sciences, Severe Asthma and Rare Lung Disease Unit, San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
- Institute of Translational Pharmacology, National Research Council (IFT-CNR), section of Palermo, Palermo, Italy
| | - Giuseppe Guida
- Department of Clinical and Biological Sciences, Severe Asthma and Rare Lung Disease Unit, San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
| | - Francesca Bertolini
- Department of Clinical and Biological Sciences, Severe Asthma and Rare Lung Disease Unit, San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
| | - Antonino Di Stefano
- Department of Pneumology and Laboratory of Cytoimmunopathology of the Heart and Lung, Istituti Clinici Scientifici Maugeri SpA, IRCCS, Novara, Italy
| | - Vitina Carriero
- Department of Clinical and Biological Sciences, Severe Asthma and Rare Lung Disease Unit, San Luigi Gonzaga University Hospital, University of Turin, Turin, Italy
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16
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Guarnieri G, Iervolino M, Cavallone S, Unfer V, Vianello A. The "Asthma-Polycystic Ovary Overlap Syndrome" and the Therapeutic Role of Myo-Inositol. Int J Mol Sci 2023; 24:ijms24086959. [PMID: 37108123 PMCID: PMC10138395 DOI: 10.3390/ijms24086959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Asthma is a heterogeneous inflammatory disease characterized by abnormalities in immune response. Due to the inherent complexity of the disease and the presence of comorbidities, asthma control is often difficult to obtain. In asthmatic patients, an increased prevalence of irregular menstrual cycles, infertility, obesity, and insulin resistance has been reported. Given that these conditions are also common in patients with polycystic ovary syndrome (PCOS), we propose the definition of "asthma-PCOS overlap syndrome" to indicate a medical condition which shares characteristics of both diseases. The aim of this review is to analyze the links between asthma and PCOS and evaluate the therapeutic role of myo-inositol, a natural compound currently utilized in patients with PCOS, in the management of asthma patients.
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Affiliation(s)
- Gabriella Guarnieri
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
| | | | | | - Vittorio Unfer
- Systems Biology Group Laboratory, 00163 Rome, Italy
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy
| | - Andrea Vianello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
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17
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Reddy KD, Oliver BGG. Sexual dimorphism in chronic respiratory diseases. Cell Biosci 2023; 13:47. [PMID: 36882807 PMCID: PMC9993607 DOI: 10.1186/s13578-023-00998-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
Sex differences in susceptibility, severity, and progression are prevalent for various diseases in multiple organ systems. This phenomenon is particularly apparent in respiratory diseases. Asthma demonstrates an age-dependent pattern of sexual dimorphism. However, marked differences between males and females exist in other pervasive conditions such as chronic obstructive pulmonary disease (COPD) and lung cancer. The sex hormones estrogen and testosterone are commonly considered the primary factors causing sexual dimorphism in disease. However, how they contribute to differences in disease onset between males and females remains undefined. The sex chromosomes are an under-investigated fundamental form of sexual dimorphism. Recent studies highlight key X and Y-chromosome-linked genes that regulate vital cell processes and can contribute to disease-relevant mechanisms. This review summarises patterns of sex differences in asthma, COPD and lung cancer, highlighting physiological mechanisms causing the observed dimorphism. We also describe the role of the sex hormones and present candidate genes on the sex chromosomes as potential factors contributing to sexual dimorphism in disease.
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Affiliation(s)
- Karosham Diren Reddy
- Respiratory and Cellular Molecular Biology Group, Woolcock Institute of Medical Research, Glebe, NSW, 2037, Australia.
- School of Life Science, University of Technology Sydney, Ultimo, NSW, 2007, Australia.
| | - Brian Gregory George Oliver
- Respiratory and Cellular Molecular Biology Group, Woolcock Institute of Medical Research, Glebe, NSW, 2037, Australia
- School of Life Science, University of Technology Sydney, Ultimo, NSW, 2007, Australia
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18
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Martin-Almeida M, Perez-Garcia J, Herrera-Luis E, Rosa-Baez C, Gorenjak M, Neerincx AH, Sardón-Prado O, Toncheva AA, Harner S, Wolff C, Brandstetter S, Valletta E, Abdel-Aziz MI, Hashimoto S, Berce V, Corcuera-Elosegui P, Korta-Murua J, Buntrock-Döpke H, Vijverberg SJH, Verster JC, Kerssemakers N, Hedman AM, Almqvist C, Villar J, Kraneveld AD, Potočnik U, Kabesch M, der Zee AHMV, Pino-Yanes M, Consortium OBOTS. Epigenome-Wide Association Studies of the Fractional Exhaled Nitric Oxide and Bronchodilator Drug Response in Moderate-to-Severe Pediatric Asthma. Biomedicines 2023; 11:biomedicines11030676. [PMID: 36979655 PMCID: PMC10044864 DOI: 10.3390/biomedicines11030676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/14/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023] Open
Abstract
Asthma is the most prevalent pediatric chronic disease. Bronchodilator drug response (BDR) and fractional exhaled nitric oxide (FeNO) are clinical biomarkers of asthma. Although DNA methylation (DNAm) contributes to asthma pathogenesis, the influence of DNAm on BDR and FeNO is scarcely investigated. This study aims to identify DNAm markers in whole blood associated either with BDR or FeNO in pediatric asthma. We analyzed 121 samples from children with moderate-to-severe asthma. The association of genome-wide DNAm with BDR and FeNO has been assessed using regression models, adjusting for age, sex, ancestry, and tissue heterogeneity. Cross-tissue validation was assessed in 50 nasal samples. Differentially methylated regions (DMRs) and enrichment in traits and biological pathways were assessed. A false discovery rate (FDR) < 0.1 and a genome-wide significance threshold of p < 9 × 10−8 were used to control for false-positive results. The CpG cg12835256 (PLA2G12A) was genome-wide associated with FeNO in blood samples (coefficient= −0.015, p = 2.53 × 10−9) and nominally associated in nasal samples (coefficient = −0.015, p = 0.045). Additionally, three CpGs were suggestively associated with BDR (FDR < 0.1). We identified 12 and four DMRs associated with FeNO and BDR (FDR < 0.05), respectively. An enrichment in allergic and inflammatory processes, smoking, and aging was observed. We reported novel associations of DNAm markers associated with BDR and FeNO enriched in asthma-related processes.
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Affiliation(s)
- Mario Martin-Almeida
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology, and Genetics, Universidad de La Laguna (ULL), 38200 San Cristóbal de La Laguna, Spain
| | - Javier Perez-Garcia
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology, and Genetics, Universidad de La Laguna (ULL), 38200 San Cristóbal de La Laguna, Spain
| | - Esther Herrera-Luis
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology, and Genetics, Universidad de La Laguna (ULL), 38200 San Cristóbal de La Laguna, Spain
| | - Carlos Rosa-Baez
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology, and Genetics, Universidad de La Laguna (ULL), 38200 San Cristóbal de La Laguna, Spain
| | - Mario Gorenjak
- Center for Human Molecular Genetics and Pharmacogenomics, Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
| | - Anne H. Neerincx
- Department of Respiratory Medicine, Amsterdam University Medical Centres—Loc. AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Olaia Sardón-Prado
- Division of Pediatric Respiratory Medicine, Donostia University Hospital, 20014 San Sebastián, Spain
- Department of Pediatrics, University of the Basque Country (UPV/EHU), 48013 San Sebastián, Spain
| | - Antoaneta A. Toncheva
- Department of Pediatric Pneumology and Allergy, University Children’s Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, D-93049 Regensburg, Germany
| | - Susanne Harner
- Department of Pediatric Pneumology and Allergy, University Children’s Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, D-93049 Regensburg, Germany
| | - Christine Wolff
- Department of Pediatric Pneumology and Allergy, University Children’s Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, D-93049 Regensburg, Germany
| | - Susanne Brandstetter
- Department of Pediatric Pneumology and Allergy, University Children’s Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, D-93049 Regensburg, Germany
| | - Elisa Valletta
- Department of Pediatric Pneumology and Allergy, University Children’s Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, D-93049 Regensburg, Germany
| | - Mahmoud I. Abdel-Aziz
- Department of Respiratory Medicine, Amsterdam University Medical Centres—Loc. AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Department of Clinical Pharmacy, Faculty of Pharmacy, Assiut University, Assiut 71515, Egypt
| | - Simone Hashimoto
- Department of Respiratory Medicine, Amsterdam University Medical Centres—Loc. AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Department of Pediatric Respiratory Medicine, Emma Children’s Hospital, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Vojko Berce
- Center for Human Molecular Genetics and Pharmacogenomics, Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
- Clinic of Pediatrics, University Medical Centre Maribor, 2000 Maribor, Slovenia
| | - Paula Corcuera-Elosegui
- Division of Pediatric Respiratory Medicine, Donostia University Hospital, 20014 San Sebastián, Spain
| | - Javier Korta-Murua
- Division of Pediatric Respiratory Medicine, Donostia University Hospital, 20014 San Sebastián, Spain
- Department of Pediatrics, University of the Basque Country (UPV/EHU), 48013 San Sebastián, Spain
| | - Heike Buntrock-Döpke
- Department of Pediatric Pneumology and Allergy, University Children’s Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, D-93049 Regensburg, Germany
| | - Susanne J. H. Vijverberg
- Department of Respiratory Medicine, Amsterdam University Medical Centres—Loc. AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Joris C. Verster
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia
| | - Nikki Kerssemakers
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands
| | - Anna M Hedman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, 171 77 Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, 171 77 Stockholm, Sweden
| | - Jesús Villar
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Multidisciplinary Organ Dysfunction Evaluation Research Network, Research Unit, Hospital Universitario Dr. Negrín, 35010 Las Palmas de Gran Canaria, Spain
| | - Aletta D. Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands
| | - Uroš Potočnik
- Center for Human Molecular Genetics and Pharmacogenomics, Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
- Clinic of Pediatrics, University Medical Centre Maribor, 2000 Maribor, Slovenia
- Laboratory for Biochemistry, Molecular Biology, and Genomics, Faculty of Chemistry and Chemical Engineering, University of Maribor, 2000 Maribor, Slovenia
| | - Michael Kabesch
- Department of Pediatric Pneumology and Allergy, University Children’s Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, D-93049 Regensburg, Germany
| | - Anke H. Maitland-van der Zee
- Department of Respiratory Medicine, Amsterdam University Medical Centres—Loc. AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Department of Pediatric Respiratory Medicine, Emma Children’s Hospital, Amsterdam UMC, 1105 AZ Amsterdam, The Netherlands
| | - Maria Pino-Yanes
- Genomics and Health Group, Department of Biochemistry, Microbiology, Cell Biology, and Genetics, Universidad de La Laguna (ULL), 38200 San Cristóbal de La Laguna, Spain
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Tecnologías Biomédicas (ITB), Universidad de La Laguna (ULL), 38200 San Cristóbal de La Laguna, Spain
- Correspondence: ; Tel.: +34-9223-16502-6343
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19
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Radzyukevich YV, Kosyakova NI, Prokhorenko IR. Impact of Comorbidity of Bronchial Asthma and Type 2 Diabetes Mellitus on the Expression and Functional Activity of TLR2 and TLR4 Receptors. Life (Basel) 2023; 13:life13020550. [PMID: 36836906 PMCID: PMC9965069 DOI: 10.3390/life13020550] [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: 12/12/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
Epidemiological data indicate the active progression of various forms of diabetes mellitus in patients with bronchial asthma (BA), but little is known about the mechanisms of comorbidity formation. TLR2 and TLR4 are involved in the progression of asthma and type 2 diabetes mellitus (T2DM). These receptors are involved in the inflammatory response to Gram(+) and Gram(-) bacteria, respectively, so changes in their expression may affect the predisposition of patients to bacteremia. The aim of this study was to analyze the expression and functional activity of toll-like receptor 2 and 4 (TLR2 and TLR4) on peripheral blood cells of patients with BA, T2DM, and BA + T2DM. The expression of TLR2 and TLR4 was analyzed by flow cytometry. Whole blood samples were incubated with lipopolysaccharides from E. coli (LPS) and lipoteichoic acid from S. pyogenes (LTA). The concentration of cytokines and soluble blood proteins was determined by ELISA. Patients with comorbid diseases showed a statistically significant increase in TLR2 expression on both monocytes and neutrophils compared with healthy donors and patients with BA. We found increased expression of TLR4 on the surface of blood monocytes from patients compared to donors. The activation of blood cells of patients and donors with LPS or LTA led to an increase in the expression of "fast" pro-inflammatory cytokines (TNF-α, IL-6). In patients with BA, the average production of TNF-α in response to endotoxin was two times higher than in other studied groups. The reactions of blood cells in patients with T2DM and BA + T2DM did not differ significantly. The expression and functional activity of TLR2 and TLR4 on the blood cells of patients with comorbid disease were similar to those only in patients with T2DM. The greatest increase in the synthesis of the pro-inflammatory cytokine TNF-α in response to LPS and LTA was observed in patients with BA, which can lead to an inadequate response to bacteremia.
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Affiliation(s)
- Yaroslav V. Radzyukevich
- Hospital of Pushchino Scientific Center, Russian Academy of Sciences, Pushchino 142290, Russia
- Department of Molecular Biomedicine, Institute of Basic Biological Problems, Federal Research Center “Pushchino Scientific Center for Biological Research of the Russian Academy of Sciences”, Pushchino 142290, Russia
- Correspondence:
| | - Ninel I. Kosyakova
- Hospital of Pushchino Scientific Center, Russian Academy of Sciences, Pushchino 142290, Russia
| | - Isabella R. Prokhorenko
- Department of Molecular Biomedicine, Institute of Basic Biological Problems, Federal Research Center “Pushchino Scientific Center for Biological Research of the Russian Academy of Sciences”, Pushchino 142290, Russia
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20
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Addressing sex and gender to improve asthma management. NPJ Prim Care Respir Med 2022; 32:56. [PMID: 36539451 PMCID: PMC9764319 DOI: 10.1038/s41533-022-00306-7] [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: 05/27/2022] [Accepted: 09/29/2022] [Indexed: 12/24/2022] Open
Abstract
Sex (whether one is 'male' or 'female', based on biological characteristics) and gender (defined by socially constructed roles and behaviors) influence asthma diagnosis and management. For example, women generally report more severe asthma symptoms than men; men and women are exposed to different asthma-causing triggers; men tend to be more physically active than women. Furthermore, implicit, often unintended gender bias by healthcare professionals (HCPs) is widespread, and may result in delayed asthma diagnosis, which can be greater in women than men. The sex and gender of the HCP can also impact asthma management. Pregnancy, menstruation, and menopause can all affect asthma in several ways and may be associated with poor asthma control. This review provides guidance for considering sex- and gender-associated impacts on asthma diagnosis and management and offers possible approaches to support HCPs in providing personalized asthma care for all patients, regardless of their sex or gender.
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21
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Importance of β 2-receptor function in premenstrual asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2776. [PMID: 36216465 DOI: 10.1016/j.jaip.2022.07.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/29/2022] [Indexed: 01/03/2023]
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22
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Jenkins CR, Boulet LP, Lavoie KL, Raherison-Semjen C, Singh D. Reply to “Importance of β2-receptor function in premenstrual asthma”. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY: IN PRACTICE 2022; 10:2776-2777. [DOI: 10.1016/j.jaip.2022.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/06/2022]
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23
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Rogliani P, Cavalli F, Ritondo BL, Cazzola M, Calzetta L. Sex differences in adult asthma and COPD therapy: a systematic review. Respir Res 2022; 23:222. [PMID: 36038873 PMCID: PMC9426004 DOI: 10.1186/s12931-022-02140-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/04/2022] [Indexed: 11/18/2022] Open
Abstract
Background Although asthma is more prevalent in women and the prevalence of COPD is increasing in women, the current international recommendations for the management and prevention of asthma and COPD provide no sex-related indication for the treatment of these diseases. Therefore, we systematically reviewed the evidence across literature on the sex-related effectiveness of asthma and COPD therapy. Methods This systematic review has been registered in PROSPERO and performed according to PRISMA-P. The PICO framework was applied for the literature search strategy: "patient problem” included adult patients suffering from asthma or COPD, “Intervention” regarded the pharmacological treatments for asthma or COPD, “Comparison” was vs. baseline, active controls, or placebo, “Outcome” was any difference sex-related in the effectiveness of interventions. Results In asthma 44% of the evidence reported that men responded better than women to the therapy, whereas this percentage was 28% in COPD. ICS was generally less effective in women than in men to treat asthma, and consistent evidence suggests that in asthmatic patients ICS/LABA/LAMA combination may be equally effective in both men and women. Due to the inconsistent available evidence, it is not possible to identify specific treatments whose effectiveness is related to sex difference in COPD patients. Conclusions There is a strong need of investigating the sex-related impact of asthma and COPD treatments. Pre-specified analyses in men and women should be planned in future trial protocols, a necessary condition that should be requested also by the regulatory agencies to overcome the anachronistic “one-size-fits-all” approach to therapeutics associated with suboptimal outcomes for patients.
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Affiliation(s)
- Paola Rogliani
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Via Montpellier, 1 - 00133, Rome, Italy. .,Respiratory Medicine, University Hospital Policlinico Tor Vergata, Rome, Italy.
| | - Francesco Cavalli
- Respiratory Medicine, University Hospital Policlinico Tor Vergata, Rome, Italy
| | - Beatrice Ludovica Ritondo
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Via Montpellier, 1 - 00133, Rome, Italy
| | - Mario Cazzola
- Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata", Via Montpellier, 1 - 00133, Rome, Italy
| | - Luigino Calzetta
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
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24
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Ahmed S, Pinnock H, Dowrick A, Steed L. Generational perspective on asthma self-management in the Bangladeshi and Pakistani community in the United Kingdom: A qualitative study. Health Expect 2022; 25:2534-2547. [PMID: 35999685 PMCID: PMC9615058 DOI: 10.1111/hex.13579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/05/2022] [Accepted: 07/22/2022] [Indexed: 11/27/2022] Open
Abstract
Background Self‐management strategies improve asthma outcomes, although interventions for South Asian populations have been less effective than in White populations. Both self‐management and culture are dynamic, and factors such as acculturation and generation have not always been adequately reflected in existing cultural interventions. We aimed to explore the perspectives of Bangladeshi and Pakistani people in the United Kingdom, across multiple generations (first, second and third/fourth), on how they self‐manage their asthma, with a view to suggesting recommendations for cultural interventions. Methods We purposively recruited Bangladeshi and Pakistani participants, with an active diagnosis of asthma from healthcare settings. Semi‐structured interviews in the participants' choice of language (English, Sylheti, Standard Bengali or Urdu) were conducted, and data were analysed thematically. Results Twenty‐seven participants (13 Bangladeshi and 14 Pakistani) were interviewed. There were generational differences in self‐management, influenced by complex cultural processes experienced by South Asians as part of being an ethnic minority group. Individuals from the first generation used self‐management strategies congruent to traditional beliefs such as ‘sweating’ and often chose to travel to South Asian countries. Generations born and raised in the United Kingdom learnt and experimented with self‐management based on their fused identities and modified their approach depending on whether they were in familial or peer settings. Acculturative stress, which was typically higher in first generations who had migration‐related stressors, influenced the priority given to asthma self‐management throughout generations. The amount and type of available asthma information as well as social discussions within the community and with healthcare professionals also shaped asthma self‐management. Conclusions Recognizing cultural diversity and its influence of asthma self‐management can help develop effective interventions tailored to the lives of South Asian people. Patient or Public Contribution Patient and Public Involvement colleagues were consulted throughout to ensure that the study and its materials were fit for purpose.
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Affiliation(s)
- Salina Ahmed
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.,School of Health Sciences, University of Greenwich, London, UK
| | - Hilary Pinnock
- Usher Institute, College of Medicine and Veterinary Science, The University of Edinburgh, Edinburgh, UK
| | - Anna Dowrick
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.,Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Liz Steed
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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