Immunometabolism in the pathogenesis of asthma

Bibliometric Perspectives on Inflammatory and Immunological Research in Pediatric Asthma

OBJECTIVE

Pediatric bronchial asthma, a prevalent chronic inflammatory respiratory disease, significantly affects children globally. However, bibliometric analyses focused on its inflammatory and immunological aspects are limited. This study aims to provide an overview of the field, identify key focus areas, and predict emerging trends.

METHODS

We collected and analyzed relevant literature published from January 1, 2000, to May 31, 2024, from the Web of Science Core Collection. Collaborative network analysis was conducted using CiteSpace 5.8.R3, VOSviewer 1.6.20, and Bibliometrix.

RESULTS

A total of 911 papers were retrieved, showing growth in research output since 2006, with the United States leading in publications. The University of Western Australia ranks first in publication count, while the University of Wisconsin-Madison has the highest average citations per paper. Among 5,059 authors, 146 core authors contributed to 592 articles, accounting for 64.98% of total publications, with Anne M. Fitzpatrick as the leading author. The journal "Allergy, Asthma & Immunology Reviews" is the most influential, and "asthma" is the most cited keyword. Co-citation analysis reveals 20 keyword clusters, with hotspots including "efficacy" and "allergic rhinitis." The most cited paper is by D. P. Strachan in the "British Medical Journal."

CONCLUSION

This study reveals a significant increase in pediatric asthma research from 2000 to 2024, with the U.S. leading in scholarly contributions. Key findings highlight allergic airway inflammation and type 2 inflammation as primary mechanisms underlying the disease. Inhaled corticosteroids and biologics are identified as effective treatments. These insights emphasize the importance of global collaboration and ongoing research efforts to advance understanding of pathogenic mechanisms and clinical management in pediatric asthma patients.

Breviscapine Attenuates Lipopolysaccharide-Induced Airway Dysfunction in Normal Human Bronchial Epithelial Cells by Suppressing the TLR4/MyD88 Signaling Pathway

Pediatric asthma is a common chronic respiratory disorder characterized by airway inflammation and hyperresponsiveness. Breviscapine (Bre) is a natural flavonoid with a broad spectrum of pharmacological activities. Previous studies have found that Bre exerts a protective effect on inflammation in airway and lung tissues. However, the effect of Bre on asthma has not yet been reported. The effects of Bre on asthmatic airway dysfunction were investigated in lipopolysaccharide (LPS)-induced normal human bronchial epithelial cells (NHBEs). Cell viability was determined by CCK-8 assay. Secretion levels of cytokines (IL-1β and IL-6) and chemokine (MCP-1) in the supernatant of NHBEs were measured by using ELISA. Whether Bre could influence LPS-caused oxidative stress in NHBEs was evaluated by detecting malondialdehyde (MDA) production and activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px). RT-PCR was applied to determine the mRNA levels of mucin 5 AC (MUC5AC), collagen I (Col-I), and fibronectin (FN). Western blotting was performed to assess the expression levels of toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), and TNF receptor associated factor 6 (TRAF6). To further confirm the role of TLR4/MyD88 signaling pathway, TLR4-overexpressing cells were constructed. Results showed that Bre attenuated LPS-induced inflammatory responses with decreased release of IL-1β, IL-6, and MCP-1 in NHBEs. The oxidative status in LPS-stimulated NHBEs was suppressed by Bre treatment, as shown by reduced MDA production and increased activities of SOD and GSH-Px. Bre also attenuated LPS-induced expression of MUC5AC, Col-I, and FN. LPS induced the activation of the TLR4/MyD88 signaling pathway in NHBEs, which could be reversed by Bre treatment. Additionally, overexpression of TLR4 lessened the protective effects of Bre on LPS-stimulated NHBEs. Overall, the foregoing results suggested that the TLR4/MyD88 signaling pathway mediated a critical protective effect of Bre on LPS-induced asthmatic airway dysfunction, which provided evidence for the potential usage of Bre for the treatment of asthma.

Glycolysis in asthma: Its role and potential as a diagnostic or therapeutic target

Asthma is a heterogeneous disease characterized by chronic airway inflammation and hyperresponsiveness. A number of immune cells are involved in asthma pathogenesis, such as eosinophils, mast cells, T lymphocytes and neutrophils, as well as airway epithelial cells. Glycolysis plays a crucial role in glucose metabolism, and serves as a bridge between metabolic and inflammatory dysfunction. Research has found that abnormal glycolytic metabolism in various immune cells may contribute to the pathogenesis of asthma by inducing dysregulation in congenital and adaptive immune responses. Therefore, the inhibition of glycolysis can be a viable approach to prevent airway inflammation in asthma. The present study reviews the relationship between glycolysis and inflammatory cells in different asthma subtypes, and its potential therapeutic significance.

Jingfang Granules alleviates OVA-induced allergic rhinitis through regulating endoplasmic reticulum stress signaling pathway

ETHNOPHARMACOLOGICAL RELEVANCE

Jingfang Granules (JF) is a modified herbal compound preparation that is empirically used in clinical practice for the treatment of allergic diseases. Nevertheless, the role of JF in allergic rhinitis (AR) has yet to be demonstrated, and its potential mechanisms of action remain to be fully evaluated.

AIM OF STUDY

The objective of this research is to examine the underlying mechanisms by which JF can be used to treat AR. This will be achieved through the use of an ovalbumin (OVA)/aluminum hydroxide AR model in mice.

MATERIALS AND METHODS

ICR mice were administered an intraperitoneal (i.p.) injection of OVA/aluminium hydroxide in order to permit the establishment of an AR model. Following the intragastric administration of JF to the mice, testing nose scratching and sneezing behavior in mice to determine modeling status, and stained transverse sections of the mouse nose using the Hematoxylin and Eosin (H&E) method were in vitro evaluated to assess the histological effects of JF on mice with AR. The regulatory network was subjected to proteomic and metabolomic investigation. The expression of serum cytokines as well as histamine (HIS) was detected using ELISA kits. Protein expression in nasal mucosal tissues was identified through the use of a Western blot.

RESULTS

JF demonstrated a notable reduction in nose-scratching and sneezing in AR mice. Concurrently, JF markedly reduced IgE, IL-4, IL-6, IL-13, TNF-α and HIS levels while elevating IFN-γ levels in the serum of AR mice. This was achieved by inhibiting the endoplasmic reticulum (ER) stress-related protein associated proteins including GADD and ATF4, p-eIF2α, p-IRE1α, XBP1s and p-PERK. Proteomics, metabolomics, Western blotting and Quantitative Real-time polymerase chain reaction (qPCR) results confirmed that JF inhibits the glycolysis/arginine biosynthesis pathway by suppressing the ER stress (ERs) signaling pathway, which in turn inhibits the inflammatory response.

CONCLUSION

Findings from the present study indicate that JF is an efficacious treatment for OVA/aluminum hydroxide-induced nasal mucosal injury and inflammation in mice. Furthermore, the study demonstrated that JF exhibited anti-AR clinic pharmacological effects by modulating the ERs signaling pathway and inhibiting glycolysis as well as arginine biosynthesis.

Neochlorogenic acid ameliorates allergic airway inflammation by suppressing type 2 immunity and upregulating HO-1 expression

Neochlorogenic acid is a natural compound isolated from various fruits and vegetables that has anti-inflammation and anti-oxidative effects in macrophages. Inflammatory immune cells and tracheal epithelial cells can stimulate airway hyperresponsiveness, inflammation, and reactive oxygen species. In this study, we investigated the effect of neochlorogenic acid in ameliorating inflammatory and oxidative responses in asthmatic mice. We used an ovalbumin (OVA)-induced mouse model, treating mice with neochlorogenic acid by intraperitoneal injection. We also treated inflammatory human tracheal epithelial (BEAS-2B) cells with neochlorogenic acid to evaluate inflammatory cytokine levels and oxidative responses. The results demonstrate that neochlorogenic acid attenuated airway hyperresponsiveness, eosinophil infiltration, and goblet cell hyperplasia in the lungs of asthmatic mice. Neochlorogenic acid also reduced type 2 cytokine expression in bronchoalveolar lavage fluid and improved oxidative stress in the lung. Neochlorogenic acid effectively blocked monocyte attachment to adherent BEAS-2B cells, and reduced pro-inflammatory cytokine and reactive oxygen species production in inflammatory BEAS-2B cells. These findings suggest that neochlorogenic acid is a potential immunomodulator that can ameliorate airway hyperresponsiveness and airway inflammation in asthmatic mice.

Epithelial and immune transcriptomic characteristics and possible regulatory mechanisms in asthma exacerbation: insights from integrated studies

Background

Asthma exacerbation significantly contribute to disease mortality and result in heightened health care expenditures. This study was aimed at gaining important new insights into the heterogeneity of epithelial and immune cells and elucidating key regulatory genes involved in the pathogenesis of asthma exacerbation.

Methods

Functional enrichment, pseudotime, metabolism and cell-cell communication analyses of epithelial cells and immune cells in single-cell RNA sequencing (scRNA-seq) dataset were applied. Immune infiltration analysis was performed in bulk RNA sequencing (bulk RNA-seq) dataset. Key regulatory genes were obtained by taking the intersection of the differentially expressed genes (DEGs) between control and asthma group in epithelial cells, immune cells and bulk RNA-seq data. Asthma animal and in vitro cell line models were established to verify the key regulatory genes expression by employing quantitative reverse transcription polymerase chain reaction (qRT-PCR).

Results

ScRNA-seq analysis identified 7 epithelial subpopulations and 14 distinct immune cell types based on gene expression profiles. Further analysis demonstrated that these cells manifested high heterogeneity at the levels of functional variations, dynamics, communication patterns and metabolic changes. Notably, TMPRSS11A, TUBA1A, SCEL, ICAM4, TMPRSS11B, IGFBP2, CLC, NFAM1 and F13A1 were identified as key regulatory genes of asthma. The results of the qRT-PCR demonstrated that the 9 key regulatory genes were involved in asthma.

Conclusions

We systematically explored epithelial and immune characteristics in asthma exacerbation and identified 9 key regulatory genes underlying asthma occurrence and progression, which may be valuable for providing new insights into the cellular and molecular mechanisms driving asthma exacerbations.

First-in-human study on tolerability, pharmacokinetics and pharmacodynamics of single and multiple escalating doses of XKH001, a recombinant humanized monoclonal antibody against IL-25 in healthy Chinese volunteers

BACKGROUND

XKH001 is a recombinant humanized IgG1 monoclonal antibody against IL-25 for the treatment of type 2 inflammatory diseases. This study aimed to evaluate the tolerability, pharmacokinetics, and pharmacodynamics of XKH001 in humans for the first time.

RESEARCH DESIGN AND METHODS

This clinical investigation adopted a randomized, double-blind, and placebo-controlled single ascending dose (SAD) and multiple ascending dose (MAD) design.

RESULTS

XKH001 was well tolerated in healthy Chinese subjects. Following repeated administration, XKH001 showed a slow absorption with a median Tmax of 4-7 days and a mean half-life (t1/2) of 22-25 days. The accumulation ratio ranged from 1.34 to 1.99. The exposure was mostly dose proportional, with a mean slope of 0.85-1.06. All subjects tested negative for ADA (except three subjects tested positive). The subjects who received 600 mg XKH001 in the MAD study showed a 78.2 ng/mL decrease in the total immunoglobulin E (IgE) level 85 days after the first administration, while the subjects who received matched placebo exhibited only an 8.6 ng/mL decrease.

CONCLUSIONS

XKH001 showed favorable safety and pharmacokinetics profiles and a low immunogenicity in its first-in-human study. The data support its further clinical evaluation in patients with type 2 inflammatory diseases.

TRIAL REGISTRATION

The study was registered in ClinicalTrials.gov (NCT05991661).

A Long-Term Follow-Up Study of Serum NFATc3 Levels in Pediatric Patients with Bronchial Asthma: A Prospective Observational Case-Control Investigation

The early and precise diagnosis of asthma significantly impacts the long-term health outcomes of pediatric patients. The sensitivity and specificity of current biomarkers, however, are frequently limited. Our study aimed to evaluate the clinical significance of nuclear factor of activated T cells, cytoplasmic 3 (NFATc3), in pediatric bronchial asthma, focusing on its diagnostic and prognostic value for disease severity and recurrence. This observational, prospective case-control study involved 200 pediatric patients with bronchial asthma and 200 age- and sex-matched healthy controls, from January 2020 to January 2023. Follow-up varied from 1 to 3 years. We measured levels of NFATc3 and inflammatory cytokines interleukin-1β (IL-1β), IL-6, and TNF-α via enzyme-linked immunosorbent assay. NFATc3 and IL-1β levels at enrollment were markedly higher in patients with acute exacerbations and those classified as severe, compared with their less severe counterparts. Throughout the study, NFATc3, IL-1β, and IL-6 levels significantly increased in severe or acutely exacerbating cases. The diagnostic value of NFATc3 was assessed through receiver operating characteristic curve analysis, which showed its potential in diagnosing bronchial asthma and identifying severe cases. Spearman's analysis confirmed positive associations between peak NFATc3 and cytokine levels. Importantly, disease type, NFATc3 values at enrollment, as well as peak IL-6 levels were identified as independent risk factors for severe bronchial asthma. Elevated NFATc3 is linked with the severity of pediatric bronchial asthma and serves as a potential biomarker for diagnosis and severity prediction, emphasizing its role in guiding treatment strategies.

DMRT3-mediated lncRNA OIP5-AS1 promotes the pyroptosis of bronchial epithelial cells by binding with EIF4A3 to enhance YAP mRNA stability

Asthma is featured by persistent airway inflammation. Long noncoding RNAs (lncRNAs) are reported to play critical roles in asthma. However, the function of Opa interacting protein 5-antisense 1 (OIP5-AS1) in pyroptosis during the development of asthma remains unexplored. The blood samples of asthma patients (n = 32) as well as the baseline characteristics of asthma patients or healthy people were collected. An in vivo model of asthma was established using house dust mites (HDM). To mimic asthma in vitro, BEAS-2B cells were treated with HDM. Cell pyroptosis and apoptosis were examined by flow cytometry. The levels of interleukin-1 beta (IL-1β) and interleukin-18 (IL-18) were detected by enzyme-linked immunosorbent assay (ELISA). The binding among messenger RNAs (mRNAs) was assessed by chromatin immunoprecipitation (ChIP), dual luciferase report assay, RNA immunoprecipitation (RIP), co-immunoprecipitation (Co-IP), and RNA pull-down assay, respectively. The cellular localization was observed by fluorescence in situ hybridization (FISH) staining. The level of OIP5-AS1 was upregulated in asthma patients. HDM induced pyroptosis and increased the levels of IL-18, IL-1β, and lactate dehydrogenase (LDH) in BEAS-2B cells, which was obviously reversed by OIP5-AS1 knockdown. Consistently, the expressions of NOD-like receptor protein 3 (NLRP3), apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), c-caspase 1, and pyroptosis-related gasdermin D-1 (GSDMD-1) in BEAS-2B cells were upregulated by HDM treatment, while these phenomena were partially abolished by silencing of OIP5-AS1. Moreover, HDM promoted the progression of asthma in vivo, which was rescued by the downregulation of OIP5-AS1. OIP5-AS1 silencing decreased HDM-induced cell pyroptosis by inactivation of NLRP3. More importantly, OIP5-AS1 promoted the mRNA stability of yes-associated protein (YAP) via binding with eukaryotic translation initiation factor 4A3 (EIF4A3), and OIP5-AS1 was transcriptionally upregulated by doublesex and mab-3 related transcription factor 3 (DMRT3). DMRT3-mediated OIP5-AS1 aggravated the progression of asthma by mediation of the EIF4A3/YAP axis, which might provide a new therapeutic strategy against asthma.

Visualization of the relationship between metabolism and lung diseases from the perspective of bibliometric analysis: research trends and future prospects

Background

Extensive research has examined the role of metabolism in lung disease development, yet a comprehensive literature review remains absent despite numerous publications.

Objective

This study aims to visualize and assess the advancements in research on metabolism and its role in lung diseases.

Methods

Publications from January 1, 1991, to April 30, 2024, related to lung diseases and metabolism were sourced from the Web of Science Core Collection and analyzed using CiteSpace 6.2.R4, VOSviewer 1.6.19, Bibliometrix, R Studio, and various online tools.

Results

A total of 1,542 studies were collected and processed through these platforms for literature analysis and data visualization. The analysis revealed a sharp increase in annual publications on metabolism and lung diseases, with the United States and China emerging as leading contributors. Current research trends highlight a shift toward investigating metabolic reprogramming of immune cells in the context of lung diseases. Moreover, genes such as TNF, DIF, AKT1, INS, IL-6, CXCL8, IL-1β, TP53, NF-κB1, MTOR, IFNG, TGF-β1, HIF1α, VEGFA, IL-10, NFE2L2, PPARG, AKT, CRP, STAT3, and CD4 have received significant attention in this research domain. Employing a bibliometric approach, this study offers a comprehensive and objective examination of the knowledge landscape, shedding light on the evolving trends in this field. The findings serve as a valuable resource for researchers, offering a clearer perspective on the advancements in metabolism-related lung disease studies.

Bioinformatics Analysis and Experimental Validation to Identify Key Glycosylation-Related Genes in Asthma

Purpose

Asthma is a chronic inflammatory disease influenced by complex genetic and environmental factors. Despite extensive research, the intricate pathophysiology of asthma remains incompletely understood. Furthermore, the effects of glycosylation on asthma remain unclear. Considering that glycosylation-related genes have not been reported in patients with asthma, we aimed in this study to identify key glycosylation-related genes involved in asthma and their potential as therapeutic targets.

Material and Methods

In the GSE63142 microarray dataset, we performed weighted gene co-expression network, protein-protein interaction network, Gene Ontology, Kyoto Encyclopedia of Genes and Genomes pathway enrichment, and CIBERSORT analyses to identify glycosylation-related genes associated with asthma. Subsequently, these key genes were validated in the GSE67472 microarray dataset and BEAS-2B cells. Correlation analysis of key gene expression and clinical characteristics of asthma patients were performed using Spearman correlation analysis.

Results

Six key glycosylation-related genes related to asthma were identified: FUT5, FUT3, HCRT, B3GNT6, KDELR3, and SCGB1A1. Expression of FUT5, FUT3, B3GNT6, and KDELR3 was significantly upregulated and that of HCRT and SCGB1A1 significantly downregulated in BEAS-2B cells stimulated with IL-13/IL-4. Moreover, expression of key glycosylation-related genes in the peripheral blood of asthma patients correlated strongly with lung function and eosinophils.

Conclusion

Our findings have implications for identifying potential therapeutic targets and prognostic markers for asthma.

Outpatient inhaled corticosteroid use in bronchopulmonary dysplasia

RATIONALE

In the outpatient setting, inhaled corticosteroids (ICS) are frequently given to children with bronchopulmonary dysplasia (BPD) for treatment of respiratory and asthma-associated symptoms. In this study we sought to determine if correlations existed between ICS use and ICS initiation and patient characteristics and outpatient respiratory outcomes.

METHODS

This study included children with the diagnosis of BPD (n = 661) who were seen in outpatient pulmonary clinics at the Children's Hospital of Philadelphia between 2016 and 2021. Chart review was used to determine patient demographics, use and timing of ICS initiation, asthma diagnosis, and acute care usage following initial hospital discharge.

RESULTS

At the first pulmonary visit, 9.2% of children had been prescribed an ICS at NICU discharge, 13.9% had been prescribed an ICS after NICU discharge but before their first pulmonary appointment, and 6.9% were prescribed an ICS at the completion of initial pulmonary visit. Children started on an ICS as outpatients had a higher likelihood of ER visits (adjusted odds ratio: 2.68 ± 0.7), hospitalizations (4.81 ± 1.16), and a diagnosis of asthma (3.58 ± 0.84), compared to children never on an ICS. Of those diagnosed with asthma, children prescribed an ICS in the outpatient setting received the diagnosis at an earlier age. No associations between NICU BPD severity scores and ICS use were found.

CONCLUSIONS

This study identifies an outpatient BPD phenotype associated with ICS use and ICS initiation independent of NICU severity score. Additionally, outpatient ICS initiation correlates with a subsequent diagnosis of asthma and acute care usage in children with BPD.

The Effects of Turmeric and Mangosteen Pericarp Ethanol Extract on Eosinophil Count, TNF-α and TGF-β1 Gene Expression in Asthmatic Rat Model

Background

Asthma is a chronic respiratory disease that is characterized by inflammation, bronchial hyperreactivity, and airway remodeling. The long-term use of corticosteroids at high doses causes various side effects. Traditional herbal medicine has been suggested as an alternative therapy that is safe and effective in dealing with asthma. Natural plants such as turmeric and mangosteen are known to treat asthma and reduce inflammation.

Objective

The purpose of this study was to investigate the effects of turmeric and mangosteen pericarp ethanol extracts on the eosinophil counts, TNF-α and TGF-β1 gene expression, and inflammatory cell counts in the histopathology of an asthmatic rat model.

Methods

The preliminary study used 30 rats, which were divided into a normal group, negative control group (OVA-sensitized), turmeric normal group, mangosteen group, and positive control group. Blood samples were collected after the sensitization period to determine eosinophil counts. TNF-α and TGF-β1 gene expression, and histopathology were observed in the rat's lungs. The follow-up study used 30 rats divided into a normal group, negative control group (OVA-sensitized), combination of turmeric and mangosteen group (54m/200gr rats, 36mg/200gr rats, and 36mg/200gr rats), and positive control group. The examination procedures were the same as in the preliminary study.

Results

The administration of single ethanol extracts of turmeric and mangosteen significantly decreased eosinophils and improved the histopathological features of the lungs (inflammatory cell counts, bronchial inflammatory score, and bronchial smooth muscle thickness) (p<0.05). The combination of turmeric and mangosteen extracts at all doses significantly decreased eosinophils and improved the histopathological features of the lungs (inflammatory cell counts, bronchial inflammatory score, and bronchial smooth muscle thickness) (p<0.05). Both the single and combined administration of turmeric and mangosteen ethanol extracts did not cause significant changes in TNF-alpha and TGF-beta (p>0.05).

Conclusion

Turmeric ethanol extract and mangosteen pericarp ethanol extract have a reductional effect on the parameters of asthma based on the eosinophil counts, the inflammatory cell counts and score, and bronchial smooth muscle thickness.

Novel insights into the heterogeneity of FOXP3 + Treg cells in drug-induced allergic reactions through single-cell transcriptomics

This study uncovers the novel heterogeneity of FOXP3 + regulatory T (Treg) cells and their pivotal role in modulating immune responses during drug-induced allergic reactions, employing cutting-edge single-cell transcriptomics. We established a mouse model for drug-induced allergic reactions and utilized single-cell RNA sequencing (scRNA-seq) to analyze the transcriptomic landscapes of FOXP3 + Treg cells isolated from affected tissues. The study involved both in vitro and in vivo approaches to evaluate the impact of FOXP3 expression levels on the immunoregulatory functions of Treg cells during allergic responses. Techniques included flow cytometry, cluster analysis, principal component analysis (PCA), CCK8 and CSFE assays for cell proliferation, LDH release assays for toxicity, ELISA for cytokine profiling, and CRISPR/Cas9 technology for gene editing. Our findings revealed significant transcriptomic heterogeneity among FOXP3 + Treg cells in the context of drug-induced allergic reactions, with distinct subpopulations exhibiting unique gene expression profiles. This heterogeneity suggests specialized roles in immune regulation. We observed a decrease in the proliferative capacity and cytokine secretion of FOXP3 + Treg cells following allergic stimulation, alongside an increase in reaction toxicity. Manipulating FOXP3 expression levels directly influenced these outcomes, where FOXP3 deletion exacerbated allergic responses, whereas its overexpression mitigated them. Notably, in vivo experiments demonstrated that FOXP3 overexpression significantly reduced the severity of allergic skin reactions in mice. Our study presents novel insights into the heterogeneity and crucial immunoregulatory role of FOXP3 + Treg cells during drug-induced allergic reactions. Overexpression of FOXP3 emerges as a potential therapeutic strategy to alleviate such allergic responses. These findings contribute significantly to our understanding of immune regulation and the development of targeted treatments for drug-induced allergies.

Targeting reprogrammed metabolism as a therapeutic approach for respiratory diseases

Metabolic reprogramming underlies the etiology and pathophysiology of respiratory diseases such as asthma, idiopathic pulmonary fibrosis (IPF), and chronic obstructive pulmonary disease (COPD). The dysregulated cellular activities driving airway inflammation and remodelling in these diseases have reportedly been linked to aberrant shifts in energy-producing metabolic pathways: glycolysis and oxidative phosphorylation (OXPHOS). The rewiring of glycolysis and OXPHOS accompanying the therapeutic effects of many clinical compounds and natural products in asthma, IPF, and COPD, supports targeting metabolism as a therapeutic approach for respiratory diseases. Correspondingly, inhibiting glycolysis has largely attested effective against experimental asthma, IPF, and COPD. However, modulating OXPHOS and its supporting catabolic pathways like mitochondrial pyruvate catabolism, fatty acid β-oxidation (FAO), and glutaminolysis for these respiratory diseases remain inconclusive. An emerging repertoire of metabolic enzymes are also interconnected to these canonical metabolic pathways that similarly possess therapeutic potential for respiratory diseases. Taken together, this review highlights the urgent demand for future studies to ascertain the role of OXPHOS in different respiratory diseases, under different stimulatory conditions, and in different cell types. While this review provides strong experimental evidence in support of the inhibition of glycolysis for asthma, IPF, and COPD, further verification by clinical trials is definitely required.

Assessing post-COVID-19 respiratory dynamics: a comprehensive analysis of pulmonary function, bronchial hyperresponsiveness and bronchodilator response

Background

Coronavirus disease 2019 (COVID-19) has a considerable impact on the global healthcare system. Individuals who have recovered from COVID often experience chronic respiratory symptoms that affect their daily lives. This study aimed to assess respiratory dynamics such as airway hyperresponsiveness (AHR) and bronchodilator response in post-COVID patients.

Methods

This study included 282 adults with respiratory symptoms who underwent provocation tests. The demographic details, clinical symptoms and medical histories were recorded. Baseline spirometry, methacholine challenge tests (MCT) and post-bronchodilator spirometry were performed. Patients were divided into the following four groups: Group 1: non-COVID-19 and negative MCT; Group 2: post-COVID-19 and negative MCT; Group 3: non-COVID-19 and positive MCT; and Group 4: post-COVID-19 and positive MCT.

Results

Most post-COVID-19 patients (43.7%) experienced AHR, and wheezing was more common. Patients in Group 4 exhibited increased intensities of dyspnoea, cough and wheezing with the lowest pulmonary function test (PFT) parameters at baseline. Moreover, significant decreases in PFT parameters after the MCT were observed in these patients. Although the prevalence of a low forced expiratory volume in 1 s to forced vital capacity ratio (<70%) was initially 2% in Group 4, it increased to 29% after MCT. No significant differences in allergic history or underlying diseases were observed between the groups.

Conclusions

These findings provide comprehensive insights into the AHR and respiratory symptoms of post-COVID-19 individuals, highlighting the characteristics and potential exacerbations in patients with positive MCT results. This emphasises the need of MCT to address respiratory dynamics in post-COVID-19 individuals.

Can probiotics be used in the prevention and treatment of bronchial asthma?

Asthma is a lifelong condition with varying degrees of severity and susceptibility to symptom control. Recent studies have examined the effects of individual genus, species, and strains of probiotic microorganisms on the course of asthma. The present review aims to provide an overview of current knowledge on the use of probiotic microorganisms, mainly bacteria of the genus Lactobacillus and Bifidobacterium, in asthma prevention and treatment. Recent data from clinical trials and mouse models of allergic asthma indicate that probiotics have therapeutic potential in this condition. Animal studies indicate that probiotic microorganisms demonstrate anti-inflammatory activity, attenuate airway hyperresponsiveness (AHR), and reduce airway mucus secretion. A randomized, double-blind, placebo-controlled human trials found that combining multi-strain probiotics with prebiotics yielded promising outcomes in the treatment of clinical manifestations of asthma. It appears that probiotic supplementation is safe and significantly reduces the frequency of asthma exacerbations, as well as improved forced expiratory volume and peak expiratory flow parameters, and greater attenuation of inflammation. Due to the small number of available clinical trials, and the use of a wide range of probiotic microorganisms and assessment methods, it is not possible to draw clear conclusions regarding the use of probiotics as asthma treatments.

Severe Allergy as a Chronic Inflammatory Condition From a Systems Biology Perspective

Persistent and unresolved inflammation is a common underlying factor observed in several and seemingly unrelated human diseases, including cardiovascular and neurodegenerative diseases. Particularly, in atopic conditions, acute inflammatory responses such as those triggered by insect venom, food or drug allergies possess also a life-threatening potential. However, respiratory allergies predominantly exhibit late immune responses associated with chronic inflammation, that can eventually progress into a severe phenotype displaying similar features as those observed in other chronic inflammatory diseases, as is the case of uncontrolled severe asthma. This review aims to explore the different facets and systems involved in chronic allergic inflammation, including processes such as tissue remodelling and immune cell dysregulation, as well as genetic, metabolic and microbiota alterations, which are common to other inflammatory conditions. Our goal here was to deepen on the understanding of an entangled disease as is chronic allergic inflammation and expose potential avenues for the development of better diagnostic and intervention strategies.

Deciphering the Interplay between the Epithelial Barrier, Immune Cells, and Metabolic Mediators in Allergic Disease

Chronic exposure to harmful pollutants, chemicals, and pathogens from the environment can lead to pathological changes in the epithelial barrier, which increase the risk of developing an allergy. During allergic inflammation, epithelial cells send proinflammatory signals to group 2 innate lymphoid cell (ILC2s) and eosinophils, which require energy and resources to mediate their activation, cytokine/chemokine secretion, and mobilization of other cells. This review aims to provide an overview of the metabolic regulation in allergic asthma, atopic dermatitis (AD), and allergic rhinitis (AR), highlighting its underlying mechanisms and phenotypes, and the potential metabolic regulatory roles of eosinophils and ILC2s. Eosinophils and ILC2s regulate allergic inflammation through lipid mediators, particularly cysteinyl leukotrienes (CysLTs) and prostaglandins (PGs). Arachidonic acid (AA)-derived metabolites and Sphinosine-1-phosphate (S1P) are significant metabolic markers that indicate immune dysfunction and epithelial barrier dysfunction in allergy. Notably, eosinophils are promoters of allergic symptoms and exhibit greater metabolic plasticity compared to ILC2s, directly involved in promoting allergic symptoms. Our findings suggest that metabolomic analysis provides insights into the complex interactions between immune cells, epithelial cells, and environmental factors. Potential therapeutic targets have been highlighted to further understand the metabolic regulation of eosinophils and ILC2s in allergy. Future research in metabolomics can facilitate the development of novel diagnostics and therapeutics for future application.