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Chen X, Chen C, Tu Z, Guo Z, Lu T, Li J, Wen Y, Chen D, Lei W, Wen W, Li H. Intranasal PAMAM-G3 scavenges cell-free DNA attenuating the allergic airway inflammation. Cell Death Discov 2024; 10:213. [PMID: 38698016 PMCID: PMC11065999 DOI: 10.1038/s41420-024-01980-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 04/11/2024] [Accepted: 04/19/2024] [Indexed: 05/05/2024] Open
Abstract
Allergic airway inflammation (AAI), including allergic rhinitis (AR) and allergic asthma, is driven by epithelial barrier dysfunction and type 2 inflammation. However, the underlying mechanism remains uncertain and available treatments are constrained. Consequently, we aim to explore the role of cell-free DNA (cfDNA) in AAI and assess the potential alleviating effects of cationic polymers (CPs) through cfDNA elimination. Levels of cfDNA were evaluated in AR patients, allergen-stimulated human bronchial epithelium (BEAS-2B cells) and primary human nasal epithelium from both AR and healthy control (HC), and AAI murine model. Polyamidoamine dendrimers-generation 3 (PAMAM-G3), a classic type of cationic polymers, were applied to investigate whether the clearance of cfDNA could ameliorate airway epithelial dysfunction and inhibit AAI. The levels of cfDNA in the plasma and nasal secretion from AR were higher than those from HC (P < 0.05). Additionally, cfDNA levels in the exhaled breath condensate (EBC) were positively correlated with Interleukin (IL)-5 levels in EBC (R = 0.4191, P = 0.0001). Plasma cfDNA levels negatively correlated with the duration of allergen immunotherapy treatment (R = -0.4297, P = 0.006). Allergen stimulated cfDNA secretion in vitro (P < 0.001) and in vivo (P < 0.0001), which could be effectively scavenged with PAMAM-G3. The application of PAMAM-G3 inhibited epithelial barrier dysfunction in vitro and attenuated the development of AAI in vivo. This study elucidates that cfDNA, a promising biomarker for monitoring disease severity, aggravates AAI and the application of intranasal PAMAM-G3 could potentially be a novel therapeutic intervention for AAI. Allergen stimulates the secretion of cell-free DNA (cfDNA) in both human and mouse airway. Intranasal polyamidoamine dendrimers-generation 3 (PAMAM-G3) scavenges cfDNA and alleviates allergic airway inflammation.
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Affiliation(s)
- Xiumin Chen
- Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Otorhinolaryngology Hospital, Sun Yat-sen University, Guangzhou, China
| | - Changhui Chen
- Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Otorhinolaryngology Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhaoxu Tu
- Department of Otorhinolaryngology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zeling Guo
- Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Otorhinolaryngology Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tong Lu
- Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Otorhinolaryngology Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jian Li
- Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Otorhinolaryngology Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Otorhinolaryngology, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, Nanning, China
| | - Yihui Wen
- Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Otorhinolaryngology Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dehua Chen
- Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Otorhinolaryngology Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wenbin Lei
- Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
- Otorhinolaryngology Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Weiping Wen
- Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
- Otorhinolaryngology Hospital, Sun Yat-sen University, Guangzhou, China.
- Department of Otorhinolaryngology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
| | - Hang Li
- Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
- Otorhinolaryngology Hospital, Sun Yat-sen University, Guangzhou, China.
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Ferrante G, Cogo AL, Sandri M, Piazza M, Costella S, Appodia M, Aralla R, Tenero L, Zaffanello M, Piacentini G. Association between individual sensor behavior of an electronic nose and airways inflammation in children with asthma: a pilot study at alpine altitude climate. Pediatr Pulmonol 2024; 59:1339-1345. [PMID: 38376005 DOI: 10.1002/ppul.26911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/22/2023] [Accepted: 01/31/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Markers of airway inflammation can be helpful in the management of childhood asthma. Residential activities, such as intensive asthma camps at alpine altitude climate (AAC), can help reduce bronchial inflammation in patients who fail to achieve optimal control of the disease. Analysis of volatile organic compounds (VOCs) can be obtained using electronic devices such as e-Noses. We aimed to identify alterations in urinary e-Nose sensors among children with asthma participating in an intensive camp at AAC and to investigate associations between urinary e-Nose analysis and airway inflammation. METHODS We analyzed data collected in children with asthma recruited between July and September 2020. All children were born and resided at altitudes below 600 m asl. Urinary VOCs (measured using the Cyranose 320® VOC analyzer), Fractional exhaled Nitric Oxide (FeNO) and spirometry were evaluated upon children's arrival at the Istituto Pio XII, Misurina (BL), Italy, at 1756 m asl (T0), and after 7 (T1) and 15 days (T2) of stay. RESULTS Twenty-two patients (68.2% males; median age: 14.5 years) were enrolled. From T0 to T1 and T2, the negative trend for FeNO was significant (p < .001). Significant associations were observed between e-Nose sensors S7 (p = .002), S12 (p = .013), S16 (p = .027), S17 (p = .017), S22 (p = .029), S29 (p = .021), S31 (p = .009) and ΔFeNO at T0-T1. ΔFeNO at T0-T2 was significantly associated with S17 (p = .015), S19 (p = .004), S21 (p = .020), S24 (p = .012), S25 (p = .018), S26 (p = .008), S27 (p = .002), S29 (p = .007), S30 (p = .013). CONCLUSIONS We showed that a decrease in FeNO levels after a short sojourn at AAC is associated with behaviors of individual urinary e-Nose sensors in children with asthma.
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Affiliation(s)
- Giuliana Ferrante
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy
| | - Anna Luisa Cogo
- Altitude Pediatric Asthma Centre in Misurina, Pio XII Institute, Belluno, Italy
| | - Marco Sandri
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy
| | - Michele Piazza
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy
| | - Silvia Costella
- Altitude Pediatric Asthma Centre in Misurina, Pio XII Institute, Belluno, Italy
| | | | - Raffaele Aralla
- Altitude Pediatric Asthma Centre in Misurina, Pio XII Institute, Belluno, Italy
| | - Laura Tenero
- Department of Women and Children's Health, Pediatric Division C, Azienda Ospedaliera Universitaria Integrata Verona, AOUI Verona, Verona, Italy
| | - Marco Zaffanello
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy
| | - Giorgio Piacentini
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy
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Lopes Vieira J, Miskovic A, Abel F. Interpretation of pulmonary function tests in children. BJA Educ 2023; 23:425-431. [PMID: 37876760 PMCID: PMC10591135 DOI: 10.1016/j.bjae.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 07/05/2023] [Accepted: 07/20/2023] [Indexed: 10/26/2023] Open
Affiliation(s)
- J.F. Lopes Vieira
- Chelsea and Westminster Hospital, London, UK
- Greate Ormond Stree Hospital, London, UK
| | | | - F. Abel
- Greate Ormond Stree Hospital, London, UK
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Rodrigues M, de Castro Mendes F, Padrão P, Delgado L, Paciência I, Barros R, Rufo JC, Silva D, Moreira A, Moreira P. Mediterranean Diet and Airway Inflammation in School-Aged Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1305. [PMID: 37628304 PMCID: PMC10453938 DOI: 10.3390/children10081305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023]
Abstract
There seems to exist an intricate relationship between airway inflammation, body mass index (BMI), and diet. The intake of specific foods or food groups has been suggested to suppress the oxidative stress and inflammatory processes that characterize airway inflammation, but little is known about dietary patterns and their complex interplay with BMI and airway inflammation. Therefore, this cross-sectional study aimed to explore the association between adherence to the Mediterranean diet (MD), a characteristic European diet, and levels of airway inflammation in school-aged children, taking into account their BMI. This cross-sectional analysis comprised 660 children: 49.1% females, 7-12 years old. Adherence to the MD was assessed through the alternate Mediterranean score (aMED). Higher scores represent a healthier diet (0-8). Airway inflammation was assessed measuring exhaled fractional nitric oxide (eNO). Two categories of BMI were considered: non-overweight/non-obese (p < 85th) and overweight/obese (p ≥ 85th). The associations between diet and airway inflammation were estimated using logistic regression models. Higher scores of the aMED were associated with decreased odds of having eNO ≥ 35 ppb, but only in non-overweight/non-obese children (OR = 0.77; 95% CI, 0.61-0.97). For overweight/obese children, the previous association was not significant (OR = 1.57, 95% CI, 0.88-2.79). Our findings suggest that adherence to the MD is associated with lower levels of airway inflammation among non-overweight/non-obese children.
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Affiliation(s)
- Mónica Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (M.R.); (R.B.); (A.M.); (P.M.)
| | - Francisca de Castro Mendes
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (F.d.C.M.); (L.D.); (D.S.)
- Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
| | - Patrícia Padrão
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (M.R.); (R.B.); (A.M.); (P.M.)
- Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
| | - Luís Delgado
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (F.d.C.M.); (L.D.); (D.S.)
- Immuno-Allergology Department, Centro Hospitalar São João, 4200-319 Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS@RISE) , Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Inês Paciência
- Center for Environmental and Respiratory Health Research (CERH), Population Health, University of Oulu, 90014 Oulu, Finland;
- Biocenter Oulu, University of Oulu, 90014 Oulu, Finland
| | - Renata Barros
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (M.R.); (R.B.); (A.M.); (P.M.)
- Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
| | - João Cavaleiro Rufo
- Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
| | - Diana Silva
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (F.d.C.M.); (L.D.); (D.S.)
- Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
| | - André Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (M.R.); (R.B.); (A.M.); (P.M.)
- Basic and Clinical Immunology, Department of Pathology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (F.d.C.M.); (L.D.); (D.S.)
- Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
- Immuno-Allergology Department, Centro Hospitalar São João, 4200-319 Porto, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Sciences, University of Porto, 4150-180 Porto, Portugal; (M.R.); (R.B.); (A.M.); (P.M.)
- Epidemiology Research Unit, Laboratory for Integrative and Translational Research in Population Health, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal;
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Hu J, Sang J, Hao F, Liu L. Association between vitamin A and asthma: A meta-analysis with trial sequential analysis. Front Pharmacol 2023; 14:1100002. [PMID: 36794278 PMCID: PMC9922757 DOI: 10.3389/fphar.2023.1100002] [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: 11/18/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023] Open
Abstract
Objective: To explore the association between vitamin A (vit A) status and risk of asthma. Methods: PubMed, Web of Science, Embase and the Cochrane Library were electronically searched to identify related studies that reported the association between vit A status and asthma. All databases were searched from inception to November 2022. Two reviewers independently screened literature, extracted data, and assessed risk bias of included studies. Meta-analysis was performed on R software Version 4.1.2 and STATA Version 12.0. Results: A total of 19 observational studies were included. A pooled analysis showed that the serum vit A concentrations in patients with asthma was lower than that in healthy controls (standard mean difference (SMD)= -2.479, 95% confidence interval (CI): -3.719, -.239, 95% prediction interval (PI): -7.510, 2.552), and relatively higher vit A intake in pregnancy was associated with an increased risk of asthma at age 7 years (risk ratio (RR)= 1.181, 95% CI: 1.048, 1.331). No significant correlation was observed between serum vit A levels or vit A intake and the risk of asthma. Conclusion: Our meta-analysis confirms that serum vit A levels are lower in patients with asthma than in healthy controls. Relatively higher vit A intake during pregnancy is associated with an increased risk of asthma at age 7 years. There is no significant correlation between vit A intake and asthma risk in children, nor between serum vit A levels and asthma risk. The effect of vit A may depend on age or developmental stage, diet and genetics. Therefore, further studies are needed to explore the association of vit A and asthma. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/CRD42022358930, identifier CRD42022358930.
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Affiliation(s)
- Jun Hu
- College of Acupuncture-Moxibustion and Tuina, College of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jiajia Sang
- Department of Tuina, Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Feng Hao
- College of Acupuncture-Moxibustion and Tuina, College of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, Nanjing, China,*Correspondence: Feng Hao, ; Li Liu,
| | - Li Liu
- Central Laboratory, Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Province Hospital of Chinese Medicine, Nanjing, China,*Correspondence: Feng Hao, ; Li Liu,
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Ghelli F, Panizzolo M, Garzaro G, Squillacioti G, Bellisario V, Colombi N, Bergamaschi E, Guseva Canu I, Bono R. Inflammatory Biomarkers in Exhaled Breath Condensate: A Systematic Review. Int J Mol Sci 2022; 23:ijms23179820. [PMID: 36077213 PMCID: PMC9456215 DOI: 10.3390/ijms23179820] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 01/08/2023] Open
Abstract
Inflammation is a comprehensive set of physiological processes that an organism undertakes in response to a wide variety of foreign stimuli, such as viruses, bacteria, and inorganic particles. A key role is played by cytokines, protein-based chemical mediators produced by a broad range of cells, including the immune cells recruited in the inflammation site. The aim of this systematic review is to compare baseline values of pro/anti-inflammatory biomarkers measured in Exhaled Breath Condensate (EBC) in healthy, non-smoking adults to provide a summary of the concentrations reported in the literature. We focused on: interleukin (IL)-1β, IL-4, IL-6, IL-8, IL-10, tumour necrosis factor-alpha (TNF-α), and C reactive protein (CRP). Eligible articles were identified in PubMed, Embase, and Cochrane CENTRAL. Due to the wide differences in methodologies employed in the included articles concerning EBC sampling, storage, and analyses, research protocols were assessed specifically to test their adherence to the ATS/ERS Task Force guidelines on EBC. The development of reference intervals for these biomarkers can result in their introduction and use in both research and clinical settings, not only for monitoring purposes but also, in the perspective of future longitudinal studies, as predictive parameters for the onset and development of chronic diseases with inflammatory aetiology.
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Affiliation(s)
- Federica Ghelli
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Marco Panizzolo
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Giacomo Garzaro
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Giulia Squillacioti
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Valeria Bellisario
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - Nicoletta Colombi
- Federated Library of Medicine “F. Rossi”, University of Turin, 10126 Turin, Italy
| | - Enrico Bergamaschi
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
- Correspondence:
| | - Irina Guseva Canu
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1066 Lausanne, Switzerland
| | - Roberto Bono
- Department of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
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7
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Babadi RS, Riederer AM, Sampson PD, Sathyanarayana S, Kavanagh TJ, Krenz JE, Andra SS, Kim-Schulze S, Jansen KL, Torres E, Perez A, Younglove LR, Tchong-French MI, Karr CJ. Longitudinal measures of phthalate exposure and asthma exacerbation in a rural agricultural cohort of Latino children in Yakima Valley, Washington. Int J Hyg Environ Health 2022; 243:113954. [PMID: 35588565 DOI: 10.1016/j.ijheh.2022.113954] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/02/2022] [Accepted: 03/08/2022] [Indexed: 12/15/2022]
Abstract
Phthalates are a class of widely used synthetic chemicals found in commonly used materials and products. Epidemiological studies suggest phthalate exposure is associated with asthma outcomes, though most studies have not investigated phthalates as triggers of exacerbations in children diagnosed with asthma. This study used data from the Home Air in Agriculture Pediatric Intervention Trial (HAPI) to examine relationships between phthalate exposure and outcomes related to childhood asthma exacerbation. We used measures of phthalate metabolites and respiratory health measures including fractional exhaled nitric oxide (FENO), the Asthma Control Test (ACT), caregiver report of symptoms, and urinary leukotriene E4 (uLTE4) to estimate longitudinal associations using mixed effects models, adjusted for covariates. For 100% (i.e., doubling) increases in mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-2-ethylhexyl phthalate (MEHP), and mono-ethyl phthalate (MEP), concentrations of FENO increased by 8.7% (95% CI: 0.7-17.3), 7.2% (95% CI: 0.0-14.9), and 6.4% (95% CI: 0.0-13.3), respectively. All phthalate metabolites demonstrated associations with uLTE4, effect sizes ranging from an 8.7% increase in uLTE4 (95% CI: 4.3-12.5) for a 100% increase in MEHP to an 18.1% increase in uLTE4 (95% CI: 13.3-23.1) for a 100% increase in MNBP. In models of caregiver report of symptoms, no phthalate metabolites were significantly associated in primary models. No phthalate metabolites were associated with standardized ACT score. Our results suggest urinary phthalate metabolites are significant predictors of inflammatory biomarkers related to asthma exacerbation in children but not child and caregiver report of airway symptomatology.
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Affiliation(s)
- Ryan S Babadi
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, 98195, USA.
| | - Anne M Riederer
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, 98195, USA
| | - Paul D Sampson
- Department of Statistics, University of Washington, Seattle, WA, 98195, USA
| | - Sheela Sathyanarayana
- Seattle Children's Research Institute, Seattle, WA, 98145, USA; Department of Pediatrics, University of Washington, Seattle, WA, 98195, USA
| | - Terrance J Kavanagh
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, 98195, USA
| | - Jennifer E Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, 98195, USA
| | - Syam S Andra
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Seunghee Kim-Schulze
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Karen L Jansen
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, 98195, USA
| | - Elizabeth Torres
- Northwest Communities Education Center, Radio KDNA, Granger, WA, 98932, USA
| | - Adriana Perez
- Yakima Valley Farm Workers Clinic, Toppenish, WA, 98901, USA
| | - Lisa R Younglove
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, 98195, USA
| | - Maria I Tchong-French
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, 98195, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, 98195, USA; Department of Pediatrics, University of Washington, Seattle, WA, 98195, USA
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8
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Sola-Martínez RA, Sanchez-Solis M, Lozano-Terol G, Gallego-Jara J, García-Marcos L, Cánovas Díaz M, de Diego Puente T. Relationship between lung function and exhaled volatile organic compounds in healthy infants. Pediatr Pulmonol 2022; 57:1282-1292. [PMID: 35092361 PMCID: PMC9304127 DOI: 10.1002/ppul.25849] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study is to assess, for the first time, the relationship between the volatilome and lung function in healthy infants, which may be of help for the early detection of certain respiratory diseases. Lung function tests are crucial in chronic respiratory diseases diagnosis. Moreover, volatile organic compounds (VOCs) analysis in exhaled breath is a noninvasive technique that enables the monitorization of oxidative stress, typical of some forms of airway inflammation. METHODS Lung function was studied in 50 healthy infants of 3-8 months of age and the following parameters were obtained: forced vital capacity (FVC), forced expiratory volume at 0.5 s (FEV0.5 ), forced expiratory flow at 75% of FVC (FEF75 ), forced expiratory flow at 25%-75% of FVC (FEF25-75 ), and FEV0.5 /FVC. Lung function was measured according to the raised volume rapid thoracoabdominal compression technique. In addition, a targeted analysis of six endogenous VOCs (acetone, isoprene, decane, undecane, tetradecane, and pentadecane) in the exhaled breath of the children was carried out by means of thermal desorption coupled gas chromatography-single quadrupole mass spectrometry system. RESULTS A negatively significant relationship has been observed between levels of acetone, tetradecane, and pentadecane in exhaled breath and several of the lung function parameters. Levels of acetone (feature m/z = 58) were significantly negatively associated with FVC and FVE0.5 , levels of tetradecane (feature m/z = 71) with FEV0.5, and levels of pentadecane (feature m/z = 71) with FEV0.5 and FEF25-75 . CONCLUSION The findings of this study highlight a significant association between VOCs related to oxidative stress and lung function in healthy infants.
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Affiliation(s)
- Rosa A Sola-Martínez
- Department of Biochemistry and Molecular Biology B and Immunology, University of Murcia, Murcia, Spain.,Group of Molecular Systems Biology, Biomedical Research Institute of Murcia, IMIB-Arrixaca, Murcia, Spain
| | - Manuel Sanchez-Solis
- Group of Pediatric Research, Biomedical Research Institute of Murcia, IMIB-Arrixaca, Murcia, Spain.,Respiratory and Allergy Units, Arrixaca Children's University Hospital, University of Murcia, Murcia, Spain.,Network of Asthma and Adverse and Allergy Reactions (ARADyAL), Health Institute Carlos III, Madrid, Spain
| | - Gema Lozano-Terol
- Department of Biochemistry and Molecular Biology B and Immunology, University of Murcia, Murcia, Spain.,Group of Molecular Systems Biology, Biomedical Research Institute of Murcia, IMIB-Arrixaca, Murcia, Spain
| | - Julia Gallego-Jara
- Department of Biochemistry and Molecular Biology B and Immunology, University of Murcia, Murcia, Spain.,Group of Molecular Systems Biology, Biomedical Research Institute of Murcia, IMIB-Arrixaca, Murcia, Spain
| | - Luis García-Marcos
- Group of Pediatric Research, Biomedical Research Institute of Murcia, IMIB-Arrixaca, Murcia, Spain.,Respiratory and Allergy Units, Arrixaca Children's University Hospital, University of Murcia, Murcia, Spain.,Network of Asthma and Adverse and Allergy Reactions (ARADyAL), Health Institute Carlos III, Madrid, Spain
| | - Manuel Cánovas Díaz
- Department of Biochemistry and Molecular Biology B and Immunology, University of Murcia, Murcia, Spain.,Group of Molecular Systems Biology, Biomedical Research Institute of Murcia, IMIB-Arrixaca, Murcia, Spain
| | - Teresa de Diego Puente
- Department of Biochemistry and Molecular Biology B and Immunology, University of Murcia, Murcia, Spain.,Group of Molecular Systems Biology, Biomedical Research Institute of Murcia, IMIB-Arrixaca, Murcia, Spain
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Loewenthal L, Menzies-Gow A. FeNO in Asthma. Semin Respir Crit Care Med 2022; 43:635-645. [DOI: 10.1055/s-0042-1743290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractAsthma is a common disease affecting 350 million people worldwide, which is characterized by airways inflammation and hyperreactivity. Historically diagnosis and treatment have been mainly based on symptoms, which have the potential to result in misdiagnosis and inappropriate treatment. Nitric oxide (NO) is exhaled in human breath and is a marker of airways inflammation. Levels of NO are increased in the exhaled breath of patients with type 2 asthma and fractional exhaled nitric oxide (FeNO) provides an objective biomarker of airway inflammation. FeNO testing is an accessible, noninvasive, and easy-to-use test. Cut-off values have been established by the American Thoracic Society (ATS), the Global Initiative for Asthma (GINA), and the National Institute for Health and Care Excellence (NICE) but vary between guidance. FeNO levels have been shown to be predictive of blood and sputum eosinophil levels but should not be used in isolation and current guidance emphasizes the importance of incorporating clinical symptoms and testing when utilizing FeNO results. The inclusion of FeNO testing can increase diagnostic accuracy of asthma, while high levels in asthmatic patients can help predict response to inhaled corticosteroids (ICS) and suppression of levels with ICS to monitor adherence. FeNO levels are also a predictor of asthma risk with increased exacerbation rates and accelerated decline in lung function associated with high levels as well as having an emerging role in predicting response to some biologic therapies in severe asthma. FeNO testing is cost-effective and has been shown, when combined with clinical assessment, to improve asthma management.
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Affiliation(s)
- Lola Loewenthal
- Department of Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, United Kingdom
- National Heart and Lung Institute, Imperial College London, United Kingdom
| | - Andrew Menzies-Gow
- Department of Respiratory Medicine, Royal Brompton and Harefield Hospitals, London, United Kingdom
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10
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Wei B, Dang YH, Liu XP, Li M. Protective effect of inhaled corticosteroid on children with asthma with Mycoplasma pneumoniae pneumonia. Front Pediatr 2022; 10:908857. [PMID: 36090550 PMCID: PMC9452955 DOI: 10.3389/fped.2022.908857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the differences in the characteristics of Mycoplasma pneumoniae pneumonia (MPP) in children with and without asthma and in children with asthma with and without inhaled corticosteroid (ICS) therapy in order to determine the risk factors for asthma exacerbation and the effect of regular ICS therapy on children with asthma with MPP. MATERIALS AND METHODS Children with MPP were divided into two groups according to whether they had a history of asthma. Children with asthma were further divided into an ICS therapy group and a group without ICS therapy. The clinical characteristics, laboratory test results, and pulmonary images were compared between the children with and without asthma. Differences in the severity of acute exacerbation were compared between the children with asthma in the ICS therapy and without ICS therapy groups. Multivariable logistic regression was used to determine the risk factors for exacerbation of MPP in children with asthma. RESULTS In children with MPP, the differences in the eosinophil counts; total immunoglobulin E (IgE), C-reactive protein, procalcitonin (PCT), and lactate dehydrogenase (LDH) levels; and fever duration, wheezing, extrapulmonary complications, oxygen saturation < 92%, severe pneumonia, pleural effusion, co-infection with other pathogens, and lobar pneumonia between children with and without asthma were statistically significant. Among children with asthma with MPP, those in the ICS therapy group were less likely to experience an exacerbation, and exacerbations were less severe than those in the without ICS therapy group. The multivariable logistic regression analysis showed that the ICS therapy was an independent protective factor against exacerbation. CONCLUSION Among children with MPP, the chance of wheezing was higher in children with asthma than in children without asthma. The ICS therapy was a protective factor against exacerbation in children with asthma with MPP.
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Affiliation(s)
- Bing Wei
- Department of Neonatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Yan-Hong Dang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiang-Ping Liu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Miao Li
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
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11
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Exhaled volatilome analysis as a useful tool to discriminate asthma with other coexisting atopic diseases in women of childbearing age. Sci Rep 2021; 11:13823. [PMID: 34226570 PMCID: PMC8257728 DOI: 10.1038/s41598-021-92933-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/14/2021] [Indexed: 02/06/2023] Open
Abstract
The prevalence of asthma is considerably high among women of childbearing age. Most asthmatic women also often have other atopic disorders. Therefore, the differentiation between patients with atopic diseases without asthma and asthmatics with coexisting diseases is essential to avoid underdiagnosis of asthma and to design strategies to reduce symptom severity and improve quality of life of patients. Hence, we aimed for the first time to conduct an analysis of volatile organic compounds in exhaled breath of women of childbearing age as a new approach to discriminate between asthmatics with other coexisting atopic diseases and non-asthmatics (with or without atopic diseases), which could be a helpful tool for more accurate asthma detection and monitoring using a noninvasive technique in the near future. In this study, exhaled air samples of 336 women (training set (n = 211) and validation set (n = 125)) were collected and analyzed by thermal desorption coupled with gas chromatography-mass spectrometry. ASCA (ANOVA (analysis of variance) simultaneous component analysis) and LASSO + LS (least absolute shrinkage and selection operator + logistic regression) were employed for data analysis. Fifteen statistically significant models (p-value < 0.05 in permutation tests) that discriminated asthma with other coexisting atopic diseases in women of childbearing age were generated. Acetone, 2-ethyl-1-hexanol and a tetrahydroisoquinoline derivative were selected as discriminants of asthma with other coexisting atopic diseases. In addition, carbon disulfide, a tetrahydroisoquinoline derivative, 2-ethyl-1-hexanol and decane discriminated asthma disease among patients with other atopic disorders. Results of this study indicate that refined metabolomic analysis of exhaled breath allows asthma with other coexisting atopic diseases discrimination in women of reproductive age.
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Licari A, Castagnoli R, Manca E, Votto M, Michev A, Marseglia GL. Towards Precision Medicine in Pediatric Severe Asthma: An Update on Current and Emerging Biomarkers. CURRENT RESPIRATORY MEDICINE REVIEWS 2020. [DOI: 10.2174/1573398x15666190423150227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Pediatric severe asthma is actually considered a rare disease with a heterogeneous nature.
Recent cohort studies focusing on children with severe asthma identified different clinical
presentations (phenotypes) and underlying pathophysiological mechanisms (endotypes). Phenotyping
and endotyping asthma represent the current approach to patients with severe asthma and consist in
characterizing objectively measurable and non-invasive indicators (biomarkers) capable of orienting
diagnosis, management and personalized treatment, as advocated by the Precision Medicine
approach. The aim of this review is to provide a practical overview of current and emerging
biomarkers in pediatric severe asthma.
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Affiliation(s)
- Amelia Licari
- Department of Pediatrics, University of Pavia, Pavia, Italy
| | | | - Enrica Manca
- Department of Pediatrics, “Casa del Sollievo e della Sofferenza” Scientific Institute, University of Foggia, Foggia, Italy
| | - Martina Votto
- Department of Pediatrics, University of Pavia, Pavia, Italy
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13
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Costagliola G, Marco SD, Comberiati P, D'Elios S, Petashvili N, Di Cicco ME, Peroni D. Practical Approach to Children Presenting with Eosinophila and Hypereosinophilia. Curr Pediatr Rev 2020; 16:81-88. [PMID: 31729944 DOI: 10.2174/1573396315666191114150438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/08/2019] [Accepted: 10/08/2019] [Indexed: 11/22/2022]
Abstract
Eosinophilia is not a rare finding in clinical practice, and often poses problems in terms of etiologic research and differential diagnosis. Peripheral eosinophilia is defined by a blood eosinophil count > 500 cells/μL. It is classified into mild (500-1500 cells/μl), moderate (1500-5000 cells/μl) and severe for an eosinophil count > 5000 cells /μl. The term "hypereosinophilia" defines a condition characterized by a blood eosinophil count >1500 cells/μl in at least two consecutive tests made with a minimum of a 4-week interval. The causes of eosinophilia are various, and can be summarized by the acronym "APLV" which refers to Allergic disorders, Parasitic infections, Leukemia/ Lymphomas (and solid tumors) and Vasculitis-Immunodeficiency diseases, with allergic disorders and parasitic infections representing the most commonly identified causes. Allergic disorders are usually associated with mild eosinophilia, whereas values >20.000 cell/μl are highly suggestive for myeloproliferative disorders. Eosinophils may also be directly responsible for organ damage, mainly at cardiac, pulmonary and cutaneous level, deriving from the release of the granule products, of lipidic mediators and cytokines. Therefore, in the physician's approach to a patient with persistent hypereosinophilia, it is also important to investigate the presence of organ involvement. In this review, we propose a diagnostic algorithm for children presenting with either blood eosinophilia or hypereosinophilia. This algorithm focuses on the patient's history and clinical manifestations as the first step and the level and persistence of blood eosinophilia as the second, and this can help the physician to identify patients presenting with an elevated blood eosinophil count that need further laboratory or instrumental investigations.
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Affiliation(s)
- Giorgio Costagliola
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Serena Di Marco
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Pasquale Comberiati
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Sofia D'Elios
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | | | - Maria Elisa Di Cicco
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Diego Peroni
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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14
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Abumossalam A, El-Halaby HS. Key notes around fraction of exhaled nitric oxide marker in pneumonia. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2020. [DOI: 10.4103/ejcdt.ejcdt_71_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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