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Hernández-Colín DD, Bedolla-Barajas M, Morales-Romero J, Robles-Figueroa M, Bedolla-Pulido A, del Rosario Arroyo-Sánchez N. Serum Vitamin D Is Inversely Associated with Blood Eosinophil Count Among Adults with Allergic Asthma. Thorac Res Pract 2023; 24:208-213. [PMID: 37485710 PMCID: PMC10543388 DOI: 10.5152/thoracrespract.2023.22154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 03/15/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE To evaluate the role that serum vitamin D concentration plays in the number of eosinophils in peripheral blood in adults with allergic asthma. MATERIAL AND METHODS A total of 142 patients were categorized based on different cutoff points for eosinophils: ≥200, ≥300, ≥400, and ≥500 cells/mL. The vitamin D concentration was stratified into <20 and ≥20 ng/mL. The association between vitamin D (independent variable) and eosinophils (dependent variable) was explored using multivariate analysis. RESULTS The average number of eosinophils in the included patients was 418 cells/mL, and 33.8% of the included patients had vita- min D concentrations ≥20 ng/mL. Asthmatic patients with vitamin D< 20 ng/mL had a higher mean concentration of eosinophils than did asthmatic patients with vitamin D ≥20 ng/mL (464 ± 377.7 eosinophils/mL vs. 327.8 ± 247.2 eosinophils/mL, P = .025). We also observed that vitamin D was inversely correlated with eosinophil count (rho = 0.244, P = .003). In the multivariate analysis, vitamin D <20 ng/mL showed a significant inverse association with each cutoff value for eosinophilia (odds ratio >1). CONCLUSION Vitamin D concentrations <20 ng/mL are associated with a significant increase in the number of eosinophils in blood. Studies that analyze the use of vitamin D supplements as complementary therapy for the treatment of asthma are needed.
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Affiliation(s)
- Dante Daniel Hernández-Colín
- Department of Allergy and Immunology, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, México
| | - Martín Bedolla-Barajas
- Department of Allergy and Immunology, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, México
| | | | - Martín Robles-Figueroa
- Department of Internal Medicine, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara, México
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Bedolla-Pulido A, Morales-Romero J, Hernández-Colín DD, Bedolla-Pulido TR, Meza-López C, Bedolla-Barajas M. [Prevalence of cow´s milk allergy and lactose intolerance among Mexican late adolescents]. Rev Alerg Mex 2023; 69:105-108. [PMID: 36869009 DOI: 10.29262/ram.v69i3.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/28/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To determine the prevalence of cow´s milk allergy and lactose intolerance in a sample of late adolescents. METHODS Through a population-based study, data corresponding to students with aged 15 to 18 years were analyzed. RESULTS A total of 1992 adolescents was analized. The prevalence of cow´s milk allergy was 1.4% (95% CI: 0.2% to 0.8%) and the prevalence of lactose intolerance was 0.5% (95% CI: 0.2% to 0.8%). Adolescents with cow´s milk allergy had fewer gastrointestinal symptoms (p = 0.036), but more skin (p < 0.001) and respiratory (p = 0.028) ailments than adolescents with lactose intolerance. CONCLUSIONS The manifestations associated with cow's milk consumption in late adolescents seem to correspond mainly to cow´s milk allergy than to lactose intolerance.
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Affiliation(s)
- Angie Bedolla-Pulido
- Universidad de Guadalajara, Centro Universitario en Ciencias de la Salud, Guadalajara, Jalisco.
| | | | - Dante Daniel Hernández-Colín
- División de Medicina Interna, Servicio de Alergia e Inmunología Clínica. Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco.
| | | | - Carlos Meza-López
- Servicio de Pediatría. Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco.
| | - Martín Bedolla-Barajas
- División de Medicina Interna, Servicio de Alergia e Inmunología Clínica. Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco.
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Bedolla-Barajas M, Morales-Romero J, Hernández-Colín DD, Larenas-Linnemann D, Mariscal-Castro J, Flores-Razo MM, Bedolla-Pulido A. Beyond eosinophilia: inflammatory patterns in patients with asthma. J Asthma 2020; 59:255-263. [PMID: 33203290 DOI: 10.1080/02770903.2020.1852413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Recently, inflammatory cell ratios have gained importance as useful indicators in the categorization of asthma.Objective: We compared the concentration of white blood cells in peripheral blood, as well as their respective inflammatory cell ratios, between patients with asthma and a healthy control group.Methods: We performed cross-sectional analyses of the data obtained from 53 adult patients with asthma and 109 adult controls. In our study, we estimated and compared the following inflammatory cell ratios: Neutrophil-Lymphocyte Ratio (NLR), Eosinophil-Lymphocyte Ratio (ELR), Eosinophil-Neutrophil Ratio (ENR), Eosinophil-Monocyte Ratio (EMR), and Platelet-Lymphocyte Ratio (PLR). The magnitude of association was quantified with the odds ratio.Results: In both groups, the average age was 33 years. In asthmatic patients, we obtained the following results: eosinophils ≥ 400 cells/µl, accounted for 37.7%; basophils ≥ 110 cells/µl, comprised 37.7%; and monocytes < 320 cells/µl, reached 11.3%. In the control group, the results were as follows: 4.6%, 9.2% and 0.9%, respectively. When compared to the control group, asthmatic patients had higher odds of eosinophils ≥ 400 cells/µl (OR = 12.61, p < 0.0001); higher odds of basophils ≥ 110 cells/µl (OR = 6.00, p < 0.0001); and increased odds of monocytes < 320 cells/µl (OR = 13.79, p = 0.017). NLR did not differ between our two groups; however, ELR, ENR, EMR and PLR were significantly higher in the asthma group.Conclusions: Overall, patients with asthma have a higher concentration of eosinophils and basophils, fewer monocytes in their blood, and higher ratios of increased chronic inflammation.
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Affiliation(s)
- Martín Bedolla-Barajas
- Department of Allergy and Clinical Immunology, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | | | - Dante Daniel Hernández-Colín
- Department of Allergy and Clinical Immunology, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | | | - Juan Mariscal-Castro
- Department of Allergy and Clinical Immunology, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | - Miriam Montzerrat Flores-Razo
- Department of Allergy and Clinical Immunology, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Jalisco, Mexico
| | - Angie Bedolla-Pulido
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
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Larenas-Linnemann D, Gochicoa-Rangel L, Macías-Weinmann A, Soto-Ramos M, Luna-Pech JA, Elizondo-Ríos A, Del Río-Navarro BE, Hernández-Colín DD, García-Maldonado S, Zepeda B, Martínez-Infante EA, Vázquez JC. [Mexican consensus on fractional exhaled nitric oxide (FeNO) in asthma 2020]. ACTA ACUST UNITED AC 2020; 67 Suppl 2:S1-S25. [PMID: 33017878 DOI: 10.29262/ram.v67i0.760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The fractional exhaled nitric oxide (FeNO) is related to the level of eosinophilic inflammation in the airways and the levels of interleukin-13, as such it could be a diagnostic and monitoring tool in asthma. A working group was convened between pulmonologists, respiratory physiology experts, and allergists to establish criteria for the use of FeNO in asthma in Mexico. Through a simplified Delphi method and group discussion, seven key points regarding the use of FeNO were agreed upon. We agree that the measurement of FeNO serves for the diagnosis of asthma in specialized clinics, both in children and adults, as well as to determine the level of corticosteroid treatment. In severe asthma, we recommend FeNO for endotyping, for detecting poor therapeutic adherence, undertreatment, and the risk of crisis. We suggest FeNO can be used to determine the level of corticosteroid treatment and to identify patients at risk of loss of lung function. We also recommend it in adults to improve the selection of biological therapy and, in this context, we only suggest it in selected cases for children.
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Larenas-Linnemann D, Rodríguez-Pérez N, Luna-Pech JA, Rodríguez-González M, Blandón-Vijil MV, Del-Río-Navarro BE, Costa-Domínguez MDC, Navarrete-Rodríguez EM, Macouzet-Sánchez C, Ortega-Martell JA, Pozo-Beltrán CF, Estrada-Cardona A, Arias-Cruz A, Rodríguez Galván KG, Brito-Díaz H, Canseco-Raymundo MDR, Castelán-Chávez EE, Escalante-Domínguez AJ, Gálvez-Romero JL, Gómez-Vera J, González-Díaz SN, Guerrero-Núñez MGB, Hernández-Colín DD, Macías-Weinmann A, Mendoza-Hernández DA, Meneses-Sánchez NA, Mogica-Martínez MD, Moncayo-Coello CV, Montiel-Herrera JM, O'Farril-Romanillos PM, Onuma-Takane E, Ortega-Cisneros M, Rangel-Garza L, Stone-Aguilar H, Torres-Lozano C, Venegas-Montoya E, Wakida-Kusunoki G, Partida-Gaytán A, López-García AI, Macías-Robles AP, Ambriz-Moreno MDJ, Azamar-Jácome AA, Beltrán-De Paz CY, Caballero-López C, Fernández de Córdova-Aguirre JC, Fernández-Soto JR, Lozano-Sáenz JS, Oyoqui-Flores JJ, Osorio-Escamilla RE, Ramírez-Jiménez F, Rivero-Yeverino D, Martínez Infante E, Medina-Ávalos MA. Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines. World Allergy Organ J 2020; 13:100444. [PMID: 32884611 PMCID: PMC7451623 DOI: 10.1016/j.waojou.2020.100444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/15/2020] [Accepted: 06/23/2020] [Indexed: 11/16/2022] Open
Abstract
Background Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, Supplementary data) concluded the following. Results Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50-200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions Countries where European and American AIT extracts are available should adjust AIT according to which school is followed.
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Key Words
- AGREE-II, Appraisal of Guidelines for Research & Evaluation Instrument
- AIT, Allergen immunotherapy
- Allergen extract
- Allergen immunotherapy
- Asthma and Immunology, DBPC
- CMICA, Colegio Mexicano de Inmunología Clínica y Alergia
- COMPEDIA, Colegio Mexicano de Pediatras Especialistas in Inmunología Clínica y Alergia
- EAACI, European Academy of Allergy
- FASIT, Future of the Allergists and Specific Immunotherapy
- GIN, Guidelines International Network
- GINA, Global Initiative for Asthma
- GP, grass pollen
- GRADE, grading of recommendations assessment development and evaluation
- GUIMIT, by its Spanish initials of Guía Mexicana de Inmunoterapia
- Guideline
- HDM, house dust mite
- Ig, immunoglobulin
- MRG, main reference guidelines
- PICO, Patient-Intervention-Comparator-Outcome
- SCIT, subcutaneous allergen immunotherapy
- SLIT, sublingual allergen immunotherapy
- Subcutaneous immunotherapy
- Sublingual immunotherapy
- US, United States of North America
- double-blind, placebo controlled
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Affiliation(s)
- Désirée Larenas-Linnemann
- Médica Sur, Clinical Foundation and Hospital, Mexico City, Mexico
- Corresponding author. Médica Sur, Fundación clínica y hospital, Puente de piedra 150, T2Toriello Guerra, Tlalpan, 14050, Ciudad de México, Mexico
| | | | - Jorge A. Luna-Pech
- Departamento de Disciplinas Filosóficas, Metodológicas e Instrumentales (CUCS), Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | | | | | | | | | | | - Carlos Macouzet-Sánchez
- State University of Nuevo León, School of Medicine and University Hospital “Dr. José Eleuterio González”, Monterrey, Nuevo León, Mexico
| | | | | | | | - Alfredo Arias-Cruz
- State University of Nuevo León, School of Medicine and University Hospital “Dr. José Eleuterio González”, Monterrey, Nuevo León, Mexico
| | | | | | | | | | | | | | - Javier Gómez-Vera
- Institute of Security and Social Services of State Workers, López Mateos Regional Hospital, Mexico City, Mexico
| | - Sandra Nora González-Díaz
- State University of Nuevo León, School of Medicine and University Hospital “Dr. José Eleuterio González”, Monterrey, Nuevo León, Mexico
| | | | | | - Alejandra Macías-Weinmann
- State University of Nuevo León, School of Medicine and University Hospital “Dr. José Eleuterio González”, Monterrey, Nuevo León, Mexico
| | | | - Néstor Alejandro Meneses-Sánchez
- Centro Médico Nacional Siglo Xxi. Unidad Médica De Alta Especialidad. Hospital De Pediatria Dr. Silvestre Frenk Freund., Mexico City, Mexico
| | | | | | | | | | | | | | | | | | | | - Edna Venegas-Montoya
- Mexican Social Security Institute, High Specialty Medical Unit 25, Department of Clinical Immunology and Allergy, Monterrey, Nuevo León, Mexico
| | | | | | | | - Ana Paola Macías-Robles
- Instituto Mexicano del Seguro Social, Centro Medico Nacional de Occidente Unidad de Alta Especialidad Hospital de Pediatria, Guadalajara, Jalisco, Mexico
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Bedolla-Barajas M, Morales-Romero J, Fonseca-López JC, Pulido-Guillén NA, Larenas-Linnemann D, Hernández-Colín DD. Anxiety and depression in adult patients with asthma: the role of asthma control, obesity and allergic sensitization. J Asthma 2020; 58:1058-1066. [PMID: 32312136 DOI: 10.1080/02770903.2020.1759087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine the frequency of anxiety and depression in adult patients with asthma and to identify factors associated with them. METHODS This cross-sectional study included 164 consecutively recruited patients with asthma aged ≥ 18 years. Participants were clinically assessed and the mental state was analyzed through of the Beck Anxiety Inventory (BAI), the Beck Depression Inventory II (BDI-II); the Asthma Control Test (ACT) was measured, and allergic sensitization and respiratory function were also evaluated. Binary logistic regression models to identify the factors related to anxiety or depression were carried out. Complementary, 95% confidence intervals (CI) were estimated. RESULTS Anxiety was present in 54.3% of patients (95% CI: 46.6%-61.7%) while depression was found in 50.6% (95% CI: 43.0%-58.2%). Depression increased the odds of anxiety in patients with asthma (OR: 26.00, p < 0.0001), whereas an ACT score ≥ 20 points and allergic asthma were associated with a lower odds than the reference group (OR: 0.29; p = 0.007 and OR: 0.29; p = 0.024, respectively). Depression was associated with anxiety and obesity (OR: 25.33, p < 0.0001 and OR: 3.66; p = 0.014, respectively). CONCLUSIONS Overall, more than half of all asthmatic patients suffer from anxiety and depression. Well-controlled asthma and allergic sensitization decreased the likelihood of anxiety, while depression was associated with both obesity and anxiety.
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Affiliation(s)
- Martín Bedolla-Barajas
- Servicio de Alergia e Inmunología Clínica, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Jalisco, México
| | | | - Juan Carlos Fonseca-López
- Servicio de Urgencias Adultos, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Jalisco, México
| | - Norma Angélica Pulido-Guillén
- Centro Universitario de Ciencias de la Salud, Maestría en Ciencias de la Salud de la Adolescencia y la Juventud, Universidad de Guadalajara, Guadalajara, Mexico
| | | | - Dante Daniel Hernández-Colín
- Servicio de Alergia e Inmunología Clínica, Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Jalisco, México
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Hernández-Colín DD, Fregoso-Zúñiga E, Morales-Romero J, Bedolla-Pulido TI, Barajas-Serrano AC, Bedolla-Pulido A, Bedolla-Barajas M. Peanut allergy among Mexican adults with allergic respiratory diseases: prevalence and clinical manifestations. ACTA ACUST UNITED AC 2020; 66:314-321. [PMID: 31606015 DOI: 10.29262/ram.v66i3.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Peanut allergy among adults with respiratory diseases has seldom been studied within Mexico. OBJECTIVE To establish the prevalence of peanut allergy among adults that have been diagnosed with either asthma or allergic rhinitis; we will also be describing the symptoms that are associated with peanut allergy. METHODS We carried out a cross-sectional study through which we analyzed the corresponding data of 257 patients with allergic respiratory diseases, asthma or allergic rhinitis, all participants were 16 years of age or older, and were recruited in a consecutive manner. Peanut allergy was established by testing positive to a peanut skin-prick test; we also conducted a standard interview with each patient. RESULTS From our sample of 257 patients, 18 tested positive to peanut sensitization, (7.0%; 95% CI = 3.9% to 10.1%); among these 18 participants, 7 were considered to be allergic to peanuts (2.7%; 95% IC: 0.7% to 4.7%). Predominant symptoms were oral, primarily affecting the pharynx and the palate, followed by swelling of the lips. When it came to respiratory discomfort, sneezing and rhinorrhea stood out, and lastly there were cutaneous symptoms. We did not detect any systemic reactions to the peanut. CONCLUSION In our study, peanut allergy among adults with allergic respiratory diseases is not an uncommon occurrence.
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Affiliation(s)
- Dante Daniel Hernández-Colín
- Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Servicio de Alergia e Inmunología Clínica, Guadalajara, Jalisco, México.
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Bedolla-Barajas M, Delgado-Figueroa N, Pérez-Molina JJ, Orozco-Alatorre LG, Bedolla-Pulido TI, Morales-Romero J, Hernández-Colín DD. Self-Reported Drug Hypersensitivity Amongst Late Adolescents in Mexico: A Population Based Study. J Investig Allergol Clin Immunol 2019; 28:281-282. [PMID: 30073969 DOI: 10.18176/jiaci.0268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M Bedolla-Barajas
- Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", México
| | - N Delgado-Figueroa
- División de Pediatría, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", México
| | - J J Pérez-Molina
- División de Pediatría, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", México
| | - L G Orozco-Alatorre
- División de Pediatría, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", México
| | - T I Bedolla-Pulido
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, México
| | | | - D D Hernández-Colín
- Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", México
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Bedolla-Barajas M, Raúl Ortiz-Peregrina J, Daniel Hernández-Colín D, Morales-Romero J, Ramses Bedolla-Pulido T, Larenas-Linnemann D. The characterization of asthma with blood eosinophilia in adults in Latin America. J Asthma 2018; 56:1138-1146. [PMID: 30395744 DOI: 10.1080/02770903.2018.1520863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: To identify and characterize asthma with blood eosinophilia in adults. Methods: This cross-sectional study consisted of 164 asthma patients, aged 18 years or older. Multivariate analyses by logistic regression were performed to identify clinical characteristics and biomarkers associated with asthma with blood eosinophilia (defined as asthma and a peripheral blood eosinophil count ≥400 cells/mm3). To evaluate the diagnostic accuracy of these biomarkers, the sensitivity, specificity and predictive values were calculated. Additionally, the area under the receiver operating characteristic (ROC) curve (AUC) was estimated for each biomarker. Results: Overall, 37.8% (95%CI: 30.7-45.4%) of asthma patients had blood eosinophilia. The following factors were associated with this characteristic: patient age <50 years (OR 3.25; 95% CI: 1.33-7.94), a serum level of IgE ≥300 UI/mL (OR 2.32; 95%CI: 1.14-4.75), and an Asthma Control Test (ACT) score <20 points (OR 3.10; 95%CI: 1.35-4.75); asthma with blood eosinophilia was also associated with a baseline FEV1/FVC <70% (OR 2.68; 95%CI: 1.28-5.59). On the other hand, age <50 years and ACT score <20 showed the highest sensitivity (above 80% each). Serum IgE level ≥300 UI/mL had the highest specificity (almost 68%). Finally, those with an ACT score <20 had the highest AUC (68%). Conclusions: In our study population, one-third of asthmatic adults had asthma with blood eosinophilia. Furthermore, the prevalence was greater in those ≤50 years of age; these patients experienced more severe, more poorly controlled asthma and had higher total serum IgE levels.
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Affiliation(s)
- Martín Bedolla-Barajas
- Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca ," Salvador de Quevedo y Zubieta No. 750, Colonia La Perla , Guadalajara , Jalisco , CP. 44340 , México
| | - José Raúl Ortiz-Peregrina
- Servicio de Neumología, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" , Salvador de Quevedo y Zubieta No. 750, Colonia La Perla , CP. 44340 , Guadalajara , Jalisco , México
| | - Dante Daniel Hernández-Colín
- Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca ," Salvador de Quevedo y Zubieta No. 750, Colonia La Perla , Guadalajara , Jalisco , CP. 44340 , México
| | - Jaime Morales-Romero
- Instituto de Salud Pública, Universidad Veracruzana. , Av. Luis Castelazo Ayala s/n. Col. Industrial Ánimas , Xalapa , Veracruz , CP. 91190 , México
| | - Tonatiuh Ramses Bedolla-Pulido
- Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca ," Salvador de Quevedo y Zubieta No. 750, Colonia La Perla , Guadalajara , Jalisco , CP. 44340 , México
| | - Désirée Larenas-Linnemann
- Unidad de Investigación, Hospital Médica Sur , Puente de Piedra 150, Colonia Toriello Guerra , Ciudad de México , CP. 14050 , México
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