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Raherison C, Hamzaoui A, Nocent-Ejnaini C, Essari LA, Ouksel H, Zysman M, Prudhomme A. [Woman's asthma throughout life: Towards a personalized management?]. Rev Mal Respir 2020; 37:144-160. [PMID: 32057504 DOI: 10.1016/j.rmr.2019.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/18/2019] [Indexed: 11/30/2022]
Abstract
In a woman's life, asthma can affect her in a variety of ways, with the onset of premenstrual asthma currently under-diagnosed. It is estimated that about 20% of women with asthma have premenstrual asthma, which is more common in patients with severe asthma. Women with asthma are at high risk of exacerbations and of severe asthma. Asthma is the most common chronic disease during pregnancy with potential maternal and foetal complications. Asthma medications are safe for the foetus and it is essential to continue pre-existing treatment and adapt it to the progress of asthma during the pregnancy. Sex steroids modulate the structure and function of bronchial and immune cells. Understanding their role in asthma pathogenesis is complicated by the ambivalent effects of bronchodilating and pro-inflammatory oestrogens as well as the diversity of response to their association with progesterone. Menopausal asthma is a clinical entity and is part of one of the phenotypes of severe non-allergic and low steroid-sensitive asthma. Targeted assessment of the domestic and professional environment allows optimization of asthma management.
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Affiliation(s)
- C Raherison
- Service des maladies respiratoires, pôle cardiothoracique, INSERM U1219, université de Bordeaux, CHU Bordeaux, 146, rue Léo-Saignat, 33604 Bordeaux, France.
| | - A Hamzaoui
- Pavillon B, unité de recherche UR12 SP15, hôpital Abderrahmen Mami, faculté de médecine, université de Tunis El Manar, Ariana, Tunisie
| | | | - L-A Essari
- Département de pneumologie, CHRU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - H Ouksel
- Département de pneumologie, CHU d'Angers, Angers, France
| | - M Zysman
- UMR_S955, université Paris-Est Créteil (UPEC), 94000 Créteil, France; Inserm, U955, Team 4, 94000 Créteil, France
| | - A Prudhomme
- Service de pneumologie, CHG Tarbes, Tarbes, France
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Hallit S, Assi TB, Hallit R, Salameh P. Allergic diseases, smoking, and environmental exposure among university students in Lebanon. J Asthma 2017; 55:35-42. [PMID: 28296532 DOI: 10.1080/02770903.2017.1306075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Smoking habits among university students in Lebanon are not clearly identified, and studies correlating these habits to asthma and allergic diseases are lacking. The primary objective of this study is to assess asthma and allergic diseases' predictors, particularly cigarette and/or waterpipe smoking and other environmental exposures, among university students. A second objective is to evaluate the potential role of these predictors as correlates of health-related self-assessment. METHODS A cross-sectional study, using a proportionate cluster sample of 3000 Lebanese students in both public and private universities, was conducted between January 2015 and December 2015. RESULTS The number of smokers at home, living close to an electricity generator and exposure to sand and dust significantly increased the odds of having asthma or allergic diseases (p = 0.015; OR = 1.183; p = 0.01; OR = 2.062; p = 0.001; OR = 3.558 respectively). Having tried cigarette smoking and having an air conditioner inside the means of transportation would decrease the odds of having asthma or allergic diseases by around 68% and 56.1% respectively (p = 0.009; ORa = 0.320; p = 0.01; ORa = 0.439 respectively). CONCLUSION Although students with asthma or allergic diseases tended to avoid all identifiable atopic risk factors, lesser known environmental factors such as living close to an electricity generator, exposure to sand and dust, and exposure to car exhaust fumes were associated with a higher risk of asthma and a decrease in health related self-assessment. Students with asthma and allergic diseases smoked cigarettes and waterpipe at similar percentages, but cigarette smokers had a lower health related self-assessment.
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Affiliation(s)
- Souheil Hallit
- a Faculty of Pharmacy , Lebanese University , Hadath , Lebanon.,b School of Pharmacy , Saint Joseph University , Beirut , Lebanon.,c Faculty of Medicine , Universite Saint Esprit Kaslik , Kaslik , Lebanon.,d Psychiatric Hospital of the Cross , Jal Eddib , Lebanon.,e Occupational Health Environment Research Team , U1219 BPH Bordeaux Population Health Research Center Inserm-Université de Bordeaux
| | - Tarek Bou Assi
- d Psychiatric Hospital of the Cross , Jal Eddib , Lebanon
| | - Rabih Hallit
- c Faculty of Medicine , Universite Saint Esprit Kaslik , Kaslik , Lebanon
| | - Pascale Salameh
- a Faculty of Pharmacy , Lebanese University , Hadath , Lebanon.,f Faculty of Medicine , Lebanese University , Beirut , Lebanon
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Heck S, Al-Shobash S, Rapp D, Le DD, Omlor A, Bekhit A, Flaig M, Al-Kadah B, Herian W, Bals R, Wagenpfeil S, Dinh QT. High probability of comorbidities in bronchial asthma in Germany. NPJ Prim Care Respir Med 2017; 27:28. [PMID: 28432297 PMCID: PMC5435094 DOI: 10.1038/s41533-017-0026-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 03/02/2017] [Accepted: 03/21/2017] [Indexed: 12/19/2022] Open
Abstract
UNLABELLED Clinical experience has shown that allergic and non-allergic respiratory, metabolic, mental, and cardiovascular disorders sometimes coexist with bronchial asthma. However, no study has been carried out that calculates the chance of manifestation of these disorders with bronchial asthma in Saarland and Rhineland-Palatinate, Germany. Using ICD10 diagnoses from health care institutions, the present study systematically analyzed the co-prevalence and odds ratios of comorbidities in the asthma population in Germany. The odds ratios were adjusted for age and sex for all comorbidities for patients with asthma vs. without asthma. Bronchial asthma was strongly associated with allergic and with a lesser extent to non-allergic comorbidities: OR 7.02 (95%CI:6.83-7.22) for allergic rhinitis; OR 4.98 (95%CI:4.67-5.32) allergic conjunctivitis; OR 2.41 (95%CI:2.33-2.52) atopic dermatitis; OR 2.47 (95%CI:2.16-2.82) food allergy, and OR 1.69 (95%CI:1.61-1.78) drug allergy. Interestingly, increased ORs were found for respiratory diseases: 2.06 (95%CI:1.64-2.58) vocal dysfunction; 1.83 (95%CI:1.74-1.92) pneumonia; 1.78 (95%CI:1.73-1.84) sinusitis; 1.71 (95%CI:1.65-1.78) rhinopharyngitis; 2.55 (95%CI:2.03-3.19) obstructive sleep apnea; 1.42 (95%CI:1.25-1.61) pulmonary embolism, and 3.75 (95%CI:1.64-8.53) bronchopulmonary aspergillosis. Asthmatics also suffer from psychiatric, metabolic, cardiac or other comorbidities. Myocardial infarction (OR 0.86, 95%CI:0.79-0.94) did not coexist with asthma. Based on the calculated chances of manifestation for these comorbidities, especially allergic and respiratory, to a lesser extent also metabolic, cardiovascular, and mental disorders should be taken into consideration in the diagnostic and treatment strategy of bronchial asthma. BRONCHIAL ASTHMA PREVALENCE OF CO-EXISTING DISEASES IN GERMANY: Patients in Germany with bronchial asthma are highly likely to suffer from co-existing diseases and their treatments should reflect this. Quoc Thai Dinh at Saarland University Hospital in Homburg, Germany, and co-workers conducted a large-scale study of patients presenting with bronchial asthma in the Saarland region between 2009 and 2012. Patients with asthma made up 5.4% of the region's total population, with a higher prevalence occurring in females. They found that bronchial asthma was strongly associated with allergic comorbidities such as rhinitis. Indeed, asthmatic patients had a seven times higher chance to suffer from allergic rhinitis than the rest of the population, and were at higher risk of respiratory diseases like pneumonia and obstructive sleep apnea syndrome. Further associations included cardiovascular, metabolic and mental disorders. Dinh's team call for asthma treatments to take such comorbidities into account.
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Affiliation(s)
- S Heck
- Department of Experimental Pneumology and Allergology, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - S Al-Shobash
- Department of Experimental Pneumology and Allergology, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - D Rapp
- Department of Biometry, Epidemiology and Clinical informatics, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - D D Le
- Department of Experimental Pneumology and Allergology, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - A Omlor
- Department of Experimental Pneumology and Allergology, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - A Bekhit
- Department of Biometry, Epidemiology and Clinical informatics, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - M Flaig
- Department of Internal Medicine V, Pneumology, Allergology and Respiratory Critical Care Medicine, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - B Al-Kadah
- Department of Otorhinolaryngology, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - W Herian
- Head of the Regulatory Management Division, Association of Statutory Health Insurance Physicians Saarland, Saarbrucken, Germany
| | - R Bals
- Department of Internal Medicine V, Pneumology, Allergology and Respiratory Critical Care Medicine, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - S Wagenpfeil
- Department of Biometry, Epidemiology and Clinical informatics, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - Q T Dinh
- Department of Experimental Pneumology and Allergology, Saarland University Faculty of Medicine, Homburg/Saar, Germany.
- Department of Internal Medicine V, Pneumology, Allergology and Respiratory Critical Care Medicine, Saarland University Faculty of Medicine, Homburg/Saar, Germany.
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Leynaert B. [The increasing burden of chronic respiratory diseases in women. An expanding area of research]. Rev Mal Respir 2014; 31:463-7. [PMID: 25012032 DOI: 10.1016/j.rmr.2014.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 05/17/2014] [Indexed: 10/25/2022]
Affiliation(s)
- B Leynaert
- Inserm UMR1152 - Épidémiologie, université Paris-Diderot Paris 7, Paris, France.
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