Journal of Asthma最新文献

Objective: Asthma is a respiratory condition that causes lung dysfunction and inflammatory cell infiltration. Methylene blue (MB), a phenothiazinium, is an antioxidant and anti-inflammatory. It has been proposed as a treatment for numerous illnesses, but its asthma treatment efficacy remains untested. The study examined the protective and anti-inflammatory effects of MB on asthma.

Methods: A total of 32 female BALB/c mice aged 6-8 weeks were randomly assigned to four equal groups: control, OVA (model), MB (10 mg/kg), and MB (20 mg/kg). Mice received 25 µg OVA and 2 mg Al(OH)₃ gel intraperitoneally to develop asthma on days 0 and 7. After receiving the medication, all mouse groups except the control inhaled 5% OVA vaporized in phosphate buffer saline (PBS) for 60 min on days 14-16. From days 11 to 16, the treatment groups received intraperitoneal MB at 10 and 20 mg/kg. On day 17, mice were anesthetized, and bronchoalveolar lavage fluid (BALF) and blood samples were collected to assess leukocyte infiltration, histological alterations, oxidative stress, and T helper type 2 (Th2)-associated cytokines like IL-4, IL-13, and immunoglobulin E.

Results: MB significantly reduced histopathological alterations, oxidative stress biomarkers, and antioxidant levels by lowering malondialdehyde (MDA) and increasing glutathione (GSH) and glutathione peroxidase (GPx). The dose-dependent reduction in inflammatory cell infiltration and OVA-specific IgE was considerable. This study represents the inaugural examination of MB's immunomodulatory effects on allergic asthma in murine models.

Conclusion: These findings suggest that MB may serve as an anti-asthmatic agent by modulating oxidative stress and inflammation, representing a promising therapeutic approach for allergic asthma.

Background: Asthma remains a major global health burden, particularly in adults aged ≥45 years. The relationship between the composite triglyceride-glucose-body-mass-index (TYG-BMI) and asthma risk in this age group has not been defined.

Methods: This cross-sectional study integrated data from the Global Burden of Disease (GBD) 2021 study, the China Health and Retirement Longitudinal Study (CHARLS), and the National Health and Nutrition Examination Survey (NHANES). After exclusions, 9,432 participants from CHARLS and 1340 from NHANES were included. The TYG-BMI index was calculated and participants were divided into quartiles. Restricted cubic spline (RCS) and segmented regression models were used to analyze the relationship between TYG-BMI and asthma risk.

Results: The GBD 2021 data shows high BMI is the top risk factor for asthma-related DALYs globally. CHARLS and NHANES studies both find a nonlinear relationship between TYG-BMI and asthma risk, with critical points at 199.51 and 246.905, respectively. Below the threshold, asthma risk decreases (OR = 0.985, 95% CI: 0.978-0.991 in CHARLS); above it, risk increases (OR = 1.0003, 95% CI: 1.0000-1.0005 in CHARLS; OR = 1.004, 95% CI: 1.001-1.009 in NHANES). A 10-unit increase above the threshold raises asthma risk by 0.3-4%, while a 10-unit decrease reduces it by 14%. This underscores the preventive value of optimizing metabolic status.

Conclusion: This study provides the large-scale evidence of a nonlinear relationship between the TYG-BMI index and asthma risk in individuals aged 45 and older.

Objectives: This study aimed to examine the effectiveness of motivational interviewing (MI) in enhancing asthma self-efficacy among adults in a primary care setting in Northern Jordan.

Methods: A quality improvement project employing a quasi-experimental pre-post design was conducted using a convenience sample of adults diagnosed with asthma. The Asthma Self-Efficacy Scale (ASES) was administered at baseline and again eight weeks after implementation of the MI intervention. The sessions were guided by Bandura's self-efficacy framework, focusing on mastery experiences, social persuasion, and emotional regulation. Data were analyzed using paired t-tests at a significance level of 0.05.

Results: Participants demonstrated a significant improvement in asthma self-efficacy scores and symptom control following the intervention. The paired t-test indicated a statistically significant increase in self-efficacy (p < 0.001), confirming the intervention's effectiveness. Additionally, participants reported lower perceived stress and a 56% reduction in asthma symptom flare-ups.

Conclusions: Motivational interviewing proved effective in strengthening asthma self-management by enhancing patients' confidence and promoting behavioral change. The integration of MI into routine primary care is recommended to foster patient empowerment and improve clinical outcomes.

Background: Asthma is a complex chronic inflammatory airway disease and one of the major health threats to children. Vitamin D (Vit D), an essential micronutrient, has been closely linked to the development and progression of asthma. However, there is still a lack of bibliometric analyses focusing on the relationship between Vit D and childhood asthma.

Objective: This study aims to systematically review the current research status, hotspots, and future trends in this field using bibliometric methods, providing a more comprehensive knowledge network and reference for related research.

Methods: A retrospective search was conducted in the Web of Science Core Collection (WoSCC) database for studies related to Vit D and childhood asthma published from January 2003 to December 2023. CiteSpace and VOSviewer were used to extract and analyze the data and to generate visual knowledge maps.

Results: A total of 656 articles were included. The United States ranked first in publication volume, followed by China and the United Kingdom. The Journal of Allergy and Clinical Immunology had the highest number of publications. Core research keywords included T cells, inflammation, in utero exposure and prenatal factors, as well as asthma-related comorbidities.

Conclusions: Research on the relationship between Vit D and childhood asthma remains in a developmental stage, with no established consensus regarding its underlying mechanisms, contributing factors, or associated comorbidities. Regional disparities remain significant. Strengthening cross-regional collaboration and conducting high-quality clinical and basic research is essential to advance understanding and improve prevention and treatment strategies.

Objective: The Severe Asthma Questionnaire (SAQ) is a validated tool used to assess health-related quality of life (HRQoL) in patients with severe asthma. This study aimed to evaluate the Turkish language validity, reliability, and concurrent validity of the SAQ in comparison with other validated tools in Turkish.

Methods: This was a multi-centre, real-life, prospective observational study. Patients with severe asthma who had been receiving biologic therapy for at least six months were enrolled. After translation with cultural adaptation, the Turkish version of the SAQ (TR-SAQ), the Asthma Control Test (ACT), and the Asthma Quality of Life Questionnaire (AQLQ) were administered alongside pulmonary function tests on the same day. The TR-SAQ was repeated on day 14 ± 2. The validity and reliability were assessed based on the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria.

Results: Among the 197 severe asthma patients included, 73.4% (n:144) were female, with a mean age of 53.6 ± 13 years. The mean total score of the SAQ (16-item) was 5.09 ± 1.41 (out of 7), and the global SAQ score was 68.24 ± 21.23. The TR-SAQ demonstrated high internal consistency (Cronbach's alpha = 0.955). Test-retest reliability was r = 0.785 (p < 0.001). The Kaiser-Meyer-Olkin value was 0.93, and Bartlett's test p-value was <0.001, supporting factorability. SAQ total scores correlated significantly with ACT (r = 0.597, p < 0.001) and AQLQ (r = 0.727, p < 0.001). No significant differences in SAQ scores were observed across gender, BMI, or comorbidities (p > 0.05).

Conclusion: Turkish physicians can use TR-SAQ, a valid, reliable HRQoL assessment tool, for severe asthma patients.

Objective: This study evaluates the associations and interaction effects between jogging and pet ownership on asthma-related emergency department (ED) visits.

Methods: This cross-sectional study utilized data from the Third National Health and Nutrition Examination Survey (NHANES III). The outcome was defined as ≥1 asthma-related ED visit in the past year. Complex sampling-weighted logistic regression was used to assess the association between jogging habits (none, low, high) and ED visit risk, calculating odds ratios (ORs) and 95% confidence intervals (CIs). Trend tests and natural splines were employed to analyze jogging frequency. Interaction models assessed the moderating effect of pet ownership (cats/dogs), reporting multiplicative interaction ORs and the Relative Excess Risk due to Interaction (RERI).

Results: The study included 2,680 participants. Analysis revealed that participants with high jogging habits had a significantly lower risk of asthma-related ED visits compared to non-joggers (OR = 0.46, 95% CI: 0.27-0.80). Cat ownership and jogging habits exhibited a significant positive multiplicative interaction (OR = 9.08, 95% CI: 1.71-48.28), indicating that the protective association of jogging was attenuated among cat owners. No significant additive interaction or effect modification by dog ownership was observed. The findings suggest a threshold effect in the association between jogging habits and ED visit risk.

Conclusion: Jogging was associated with a reduced risk of asthma-related ED visits. However, cat ownership significantly attenuated this protective effect, suggesting it may weaken the beneficial association of jogging.

Objective: Macrolides are used in patients with chronic respiratory conditions to prevent exacerbations. However, due to their QT interval prolonging effect, an electrocardiogram (ECG) assessment prior to long-term treatment is recommended. The objective was to evaluate the incidence of macrolides use (azithromycin, clarithromycin, erythromycin) in individuals with asthma, chronic obstructive pulmonary disease (COPD), asthma-COPD overlap (ACO), and to assess the frequency of ECGs performed prior to long-term macrolide prescribing.

Methods: We utilized data from the Dutch Integrated Primary Care Information (IPCI) database and Spanish Information System for Research in Primary Care (SIDIAP), between 2006 and 2022. The study population consisted of individuals diagnosed with asthma, COPD, and ACO with ≥365 days follow-up after diagnosis. Incidence was analyzed by type of macrolide, database, year, and prescribing-duration (short-, medium-, long-term [<30, 30-179, ≥180 days]).

Results: SIDIAP included 224,783 individuals with asthma, 167,524 with COPD, and 34,475 with ACO, while IPCI included 66,383 with asthma, 26,805 with COPD, and 7250 with ACO. The incidence of short-term use per 100,000 person-years (PYs) was 3500-6700 for azithromycin, 1300-2100 for clarithromycin and 200-300 for erythromycin. The incidence of medium- and long-term use was less than <1100/100,000 PYs. Incidence rates were higher in SIDIAP, females, and 60-79 year-olds. Medium- and long-term use was 2- to 4-fold higher in COPD and ACO than asthma, and increased over time. Database-registered ECGs were found in less than 1% of long-term macrolide users.

Conclusions: Long-term macrolide users were on the rise among COPD- and ACO individuals; however, ECG monitoring was rare, raising concerns given guideline recommendations.

Background: Asthma is a chronic disease whose control varies depending on multiple clinico-epidemiological factors. In Morocco, few studies have analyzed these determinants in specific regional contexts, such as Agadir.

Objective: This study aimed to assess asthma control and identify associated factors among adult and adolescent patients followed in allergy consultations in the Agadir region.

Methods: A retrospective analysis was conducted on 58 patients aged 12 years and older, diagnosed with persistent asthma and followed between March 2022 and December 2024. Asthma control was assessed using the Asthma Control Test (ACT), classifying patients into two groups: controlled (ACT score 20-25) and uncontrolled (score ≤19). The variables studied included demographic, socioeconomic, clinical, therapeutic, and environmental factors. Descriptive and inferential statistical analyses (Fisher's tests, logistic and linear regressions) were performed.

Results: Among participants, 77.6% (n = 45) had controlled asthma, while 22.4% (n = 13) had uncontrolled asthma. No significant association was found with sex (p = 0.448) or ICS + LABA treatment (p = 0.283). Patients hospitalized for asthma had poorer control (64.7% vs. 82.9%, p = 0.123). Age influenced control, with 100% of 12-19-year-olds achieving control compared to 60% of those ≥60 years (p = 0.045). A secondary education level was associated with better control (AOR = 4.02, p = 0.070), while cold exposure significantly increased hospitalization risk (OR = 19.156, p = 0.019).

Conclusions: Asthma control in this population was mostly good but influenced by age, education, and cold exposure. These findings highlight the importance of targeting modifiable factors, such as therapeutic education and protection against environmental triggers, to improve management.

Background: Severe asthma is a clinically heterogeneous and often treatment-refractory condition, in which steroid resistance and persistent neutrophilic airway inflammation are frequently driven by the IL-17 signaling axis. However, upstream regulatory mechanisms and effective therapeutic interventions targeting this pathway remain poorly defined. This study aimed to investigate the immunomodulatory effects of OM-85, a bacterial lysate-based agent, and its regulatory role on IL-17-associated signaling in a murine model of allergic asthma.

Methods: An ovalbumin (OVA)-induced mouse model of asthma was used to evaluate the effects of OM-85. Airway hyperresponsiveness (AHR), histopathological changes, and cytokine profiles were assessed. Quantitative real-time PCR and western blotting were performed to evaluate inflammatory gene and protein expression. Transcriptomic enrichment and immunofluorescence co-localization analyses were conducted to validate OM-85's impact on the IL-17A/TRAF5/NF-κB signaling pathway.

Results: OM-85 administration significantly reduced AHR, goblet cell hyperplasia, and peribronchial collagen deposition in asthmatic mice. Expression of Th2 cytokines (IL-4, IL-5, and IL-13) was markedly suppressed, while IFN-γ levels were restored, indicating a rebalancing of Th1/Th2 responses. Bioinformatics analysis and experimental validation revealed that OM-85 downregulated the IL-17A/TRAF5/NF-κB axis. Immunofluorescence staining confirmed a reduction in IL-17A-Ly6G and IL-17A-TRAF5co-localization, suggesting disruption of IL-TRAF-mediated inflammatory circuits.

Conclusions: OM-85 exerts multi-dimensional immunoregulatory effects in allergic asthma by suppressing IL-17A-mediated signaling and restoring immune homeostasis. These findings suggest that OM-85 may represent a promising immunotherapeutic approach for managing steroid-resistant asthma phenotypes associated with IL-17-driven inflammation.

Objective: The long-term effects of childhood asthma on cardiac functions remain unclear. This study evaluates the relationship between asthma severity and cardiac function in pediatric asthma patients.

Methods: Children aged 10-18 years with at least five years of asthma follow-up and no known cardiac disease were included. A control group of healthy children with no chronic diseases participated. Both groups underwent electrocardiography, conventional echocardiography, tissue Doppler examination (TDI), and 2D speckle tracking echocardiography (2D-STE).

Results: A total of 113 asthma patients (59 mild, 54 moderate-severe) and 59 controls were assessed. Compared to controls, the asthma group had increased right ventricular area (RVA) (p = 0.04), while interventricular septal and left ventricular S' velocity (IVSS', LVS') and right ventricular late diastolic velocity (RVA') were lower (p = 0.04, p = 0.04, p = 0.02, respectively). Conventional and TDI parameters showed no other significant differences. In 2D-STE measurements, left ventricular global longitudinal and circumferential strain (LVGLS, LVGCS), right ventricular global longitudinal strain (RVGLS), and right atrial reservoir strain (RARS) were lower (p = 0.01, p = 0.03, p = 0.01, p = 0.01, respectively), while left ventricular global longitudinal and circumferential strain rate (LVGLSR, LVGCSR), right ventricular global longitudinal strain rate (RVGLSR), and right atrial reservoir strain rate (RARSR) were higher (p = 0.04, p = 0.04, p = 0.03, p = 0.04, respectively) in the asthma group, with more pronounced differences in the moderate-severe asthma group.

Conclusion: Our study shows a decrease in both systolic and diastolic functions in both ventricles and right atrium in relation to the severity of childhood asthma, and 2D-STE can be useful in identifying early changes.