Different expression levels of interleukin-36 in asthma phenotypes

Interleukin (IL)-36 family is closely associated with inflammation and consists of IL-36α, IL-36β, IL-36γ, and IL-36Ra. The role of IL-36 in the context of asthma and asthmatic phenotypes is not well characterized. We examined the sputum IL-36 levels in patients with different asthma phenotypes in order to unravel the mechanism of IL-36 in different asthma phenotypes. Our objective was to investigate the induced sputum IL-36α, IL-36β, IL-36γ, and IL-36Ra concentrations in patients with mild asthma, and to analyze the relationship of these markers with lung function and other cytokines in patients with different asthma phenotypes. Induced sputum samples were collected from patients with mild controlled asthma (n = 62, 27 males, age 54.77 ± 15.49) and healthy non-asthmatic controls (n = 16, 10 males, age 54.25 ± 14.60). Inflammatory cell counts in sputum were determined. The concentrations of IL-36 and other cytokines in the sputum supernatant were measured by ELISA and Cytometric Bead Array. This is the first study to report the differential expression of different isoforms of IL-36 in different asthma phenotypes. IL-36α and IL-36β concentrations were significantly higher in the asthma group (P = 0.003 and 0.031), while IL-36Ra concentrations were significantly lower (P < 0.001) compared to healthy non-asthmatic controls. Sputum IL-36α and IL-36β concentrations in the neutrophilic asthma group were significantly higher than those in paucigranulocytic asthma (n = 24) and eosinophilic asthma groups (n = 23). IL-36α and IL-36β showed positive correlation with sputum neutrophils and total cell count (R = 0.689, P < 0.01; R = 0.304, P = 0.008; R = 0.689, P < 0.042; R = 0.253, P = 0.026). In conclusion, IL-36α and IL-36β may contribute to asthma airway inflammation by promoting neutrophil recruitment in airways. Our study provides insights into the inflammatory pathways of neutrophilic asthma and identifies potential therapeutic target.

Psychological distress and associated factors among asthmatic patients in Southern, Ethiopia, 2021

BACKGROUND

There is an increased prevalence of psychological distress in adults with asthma. Psychological distress describes unpleasant feelings or emotions that impact the level of functioning. It is a significant exacerbating factor in asthma control. Addressing factors that contribute to psychological distress in those asthma patients improves asthma outcomes. So, this study aimed to assess the prevalence of psychological distress and associated factors among asthmatic patients at Hawassa public hospitals, Ethiopia, 2021.

METHODS

Institution-based cross-sectional study design was used to select 394 asthma patients. Proportional allocation and systematic sampling techniques were used to select study participants. A logistic regression model was used to assess the predictors and psychological distress of the asthmatic patient. The association was interpreted using the odds ratio and 95% confidence interval.

RESULT

A total of 394 asthma patients participated in the study, giving a response rate of 93.4%. The prevalence of psychological distress among asthmatic patients was 51% [95%CI: 46%-56%]. Participants who had comorbid medical illness [AOR: 6.049, 95% CI (3.131-11.684)], experienced stigma [AOR: 3.587, 95%CI (1.914-6.723)], chewed khat [AOR: 7.268, 95%CI (3.468-15.231)], had poor social support and had uncontrolled asthma were significantly associated with psychological distress in asthmatic patients.

CONCLUSION

This study demonstrated that the prevalence of psychological distress was found to be high among asthmatic patients. Social support, stigma, chewing khat, comorbid medical illness, and poor asthmatic control had significantly associated with psychological distress in asthmatic patients.

Particulate matter (PM2.5) and diseases: an autoregressive distributed lag (ARDL) technique

Air pollution can be attributed to the reduction in visibility, less agricultural activity, more health issues, and long-term destruction to infrastructure. This paper aimed to examine the validity of association among the Particulate matter (PM_2.5) and number of acute upper respiratory infection (ARI) and Asthma (AS) patients using an autoregressive distributed lag (ARDL) approach. This ARDL model study was conducted in Lahore, Pakistan. We used monthly data of ARI and AS patients acquired from Directorate General Health Services Punjab and PM_2.5 from Air Visual-IQAir during the period January 2018-August 2019. ARDL bound testing technique was used to investigate the association between number of AS, ARI patients and PM_2.5. In the short run, the PM_2.5 has substantial positive impact on number of AS patients in Lahore. The values of short-run coefficient depicts that the association between PM_2.5 and ARI patients is stronger than AS. The effect of PM_2.5 on number of patients in short term is more than that in the long-term. For both AS and ARI, in the long run, PM_2.5 has negative impact on number of patients.

Effects of medication adherence on healthcare services use among asthma patients

INTRODUCTION AND OBJECTIVES

Medication adherence is an important indicator of quality in healthcare, and non-adherence is associated with increased healthcare costs, hospital admissions, re-admissions, and decline in health outcomes. Despite the availability of medication to control and avoid adverse health outcomes, adherence to medications among asthma patients varies between 40% and 60%. The objective of this study is to evaluate the effects of asthma medication adherence on healthcare services.

MATERIAL AND METHODS

This cross-sectional study is based on insurance claims data for Medicaid patients primarily diagnosed with asthma during 2015-2016. A regression analysis was performed to examine the relationship between control and rescue medication adherence with healthcare use (hospital admissions and re-admissions, clinic visits, and emergency department visits), as well as patient demographics (age, gender, and estimated income).

RESULTS

This study found a control medication adherence of 82%. Patients with high rescue medication adherence had fewer emergency department visits (p=.0004) and inpatient admissions (p=.0303). Patients with more than 4 clinic visits had higher rescue medication adherence. Older and low-income patients had higher 30-day re-admissions. Males and low-income patients had more emergency visits.

CONCLUSIONS

These results provide evidence that certain populations (older, low-income, and male) may benefit from additional education on monitoring and controlling asthma. This may reduce costlier healthcare services use in favor of less expensive physician visits and education programs.

Relationship between neuroticism and sleep quality among asthma patients: the mediation effect of mindfulness

OBJECTIVE

The aims of this study were to investigate the prevalence of sleep disturbance; to validate the associations between neuroticism, mindfulness, and sleep quality; and to further examine whether mindfulness mediates the relationship between neuroticism and sleep quality among asthma patients.

METHODS

This study was conducted with 193 asthma patients from outpatient clinics. They completed questionnaires including the neuroticism subscale of the Big Five Inventory (BFI), the Pittsburgh Sleep Quality Index (PSQI), and the Mindful Attention Awareness Scale (MAAS). Structural equation model was used to analyze the relationships among neuroticism, mindfulness, and sleep quality, with mindfulness as a mediator.

RESULTS

The mean global PSQI score was 7.57 (SD = 3.25), and 69.9% of asthma patients reported poor sleep quality (cutoff score > 5). Structural equation model analysis showed that neuroticism was significantly associated with global PSQI scores (β = 0.198, P = 0.006), and mindfulness (β = - 0.408, P < 0.001), respectively; mindfulness was associated with global PSQI scores (β = - 0.250, P = 0.006). Furthermore, mindfulness mediated the relationship between neuroticism and global PSQI scores, in which the mediation effect was 0.102 (- 0.408 × - 0.250), and the bootstrapped 95% CI did not include zero (0.032, 0.208, P = 0.021).

CONCLUSIONS

Sleep disturbance is a serious health concern among asthma patients. This study illuminated the latent mediating mechanism of mindfulness on neuroticism and sleep quality, and implied that intervention and prevention programs on mindfulness might be beneficial in improving sleep quality in asthma patients.

The Correlation between Adherence and Asthma Patients Quality of Life in Medan, Indonesia

BACKGROUND:

Asthma is a chronic airway disease that is based on an inflammatory process and a serious health problem around the world. Asthma is often associated with treatment management factor. Adherence is the patient’s compliance towards their doctor’s advice, which is accompanied by their understanding and follows the doctors’ advice consistently.

AIM:

This study aimed to get a valid and reliable adherence measure in asthma patients especially in Medan.

METHODS:

This research used the method of quantitative done by the cross-sectional approach. The sample (200 adult asthma patients) used standard asthma medication, stable asthma patients and did not suffer from severe asthma or other accompanying diseases. Data were analysed using univariate, bivariate and multivariate analysis, which is SEM (Structural Equation Modeling) analysis.

RESULTS:

The best dimension of medication adherence was the dimension of beliefs in medication 64%. The highest education adherence is at college education level which is 67.6%. Employment status with highest adherence value is medication on civil servant/military/police with the value of 67.7.

CONCLUSIONS:

There is a correlation between adherence and asthma patient’s quality of life in Medan.