Journal of Asthma最新文献

Objectives: To evaluate the experiences and opinions of adolescents aged 10-14 years with allergic asthma in Turkiye about the online asthma education they received from their peers.

Methods: Eleven adolescents who had previously received peer education concerning asthma participated in this qualitative phenomenological study. These were asked semi-structured questions to evaluate peer education through a video chat program. Qualitative data were analyzed using N'Vivo (Version 12.5) software.

Results: Four main themes and 12 sub-themes were identified in the light of the data obtained from the interviews. 'The importance of friends' theme (T1) was established for the sharing, listening to their thoughts, caring about their opinions, and taking their suggestions into consideration sub-themes. 'The comfort derived from being with peers' them (T2) was established for the facilitating learning, feeling not alone, feeling understood, and motivation for recovery sub-themes. The reliability of information' theme (T3) was established for the believing in the reliability of the information and applying the information learned sub-themes, and the 'opinions about the educator' theme (T4) for the experiences with peer educators and suggestions for peer educators sub-themes.

Conclusions: The experiences and opinions of the adolescents with allergic asthma in this study were highly favorable regarding the education provided by their peers about the disease in an online environment.

Background: Asthma and other allergic diseases are increasing globally each year, with some patients experiencing the co-occurrence of two or more conditions, significantly impacting their quality of life. While these diseases may share certain immune mechanisms, the independent causal relationships between them and lung function remain unclear.

Objective: This study aims to investigate the independent and interactive effects of allergic asthma, atopic dermatitis, allergic rhinitis, and allergic conjunctivitis on significant declines in lung function. By elucidating the potential causal relationships between these allergic diseases and reduced lung function, we hope to provide valuable scientific evidence for managing asthma patients who are co-morbid with multiple allergic conditions.

Methods: In this study, we conducted Mendelian randomization (MR) analysis using data from the FinnGen database and the UK Biobank. We rigorously selected instrumental variables (IVs) based on established criteria and employed both univariable and multivariable MR approaches to investigate the relationship between various allergic diseases and significant declines in lung function.

Results: In univariable MR analysis, the inverse variance-weighted (IVW) method or the weighted median approach indicated a causal relationship between allergic conjunctivitis, atopic dermatitis, and allergic asthma with significant declines in lung function. However, in multivariable MR analysis, the independent effects of atopic dermatitis and allergic conjunctivitis on lung function were no longer significant. Only allergic asthma continued to show a significant causal relationship with decreased lung function (OR [95%CI]: 1.019 [1.008-1.030], p < .001).

Conclusions: This study suggests that while atopic dermatitis and allergic conjunctivitis may indirectly affect lung function and lead to significant declines, their independent effects are not notable when asthma is well-controlled. Therefore, clinicians should recognize that acute exacerbations of allergic diseases are unlikely to be the primary reason for significant declines in lung function among asthma patients with multiple allergic conditions, provided that their asthma is well-managed.

Objective: Mucosal-associated invariant T cells (MAIT) are the predominant type of innate-like T cells in humans, and they represent a unique subset of microbiota-dependent invariant T cells. This Commentary reviews recent clinical studies and animal model research elucidating the multifaceted roles of MAIT cells in asthma.

Method: A literature search was performed using PubMed and Google Scholar, and covered the period from 1960 to 2024. The search yielded more than 50 articles, and only essential original research articles and selected review articles were evaluated.

Results: Recent studies indicate that MAIT cell-derived effector molecules may play dual roles in asthma and allergic airway inflammation. While MAIT cells can produce the anti-inflammatory enzyme IL4I1 and the Th1 cytokine IFN-γ to repress allergic airway inflammation and airway hyperresponsiveness (AHR), they may also secrete IL-17. Which induces neutrophil infiltration and exacerbates AHR. In addition, some clinical studies from the literature search revealed a negative association between MAIT cell abundance and asthma. Regarding allergic airway inflammation, mouse model studies suggested that MAIT cells may play a protective role.

Conclusion: These findings raise critical questions as to whether MAIT cells are friend or foe in asthma, and whether distinct subsets of MAIT cells play different roles in allergic airway inflammation. Further studies are needed to better understand the implication of MAIT cells in asthma pathogenesis, particularly in patients with severe asthma.

IntroductionSevere asthma impacts work capacity, but little is known about the effects of biologic therapy on patients' ability to work. We aimed to assess the impact of biologic therapy for severe asthma on work capacity and workforce attachment.MethodsThis cohort study used the Danish Severe Asthma Register, comprising all Danish patients with severe asthma initiating biologic therapy. Earned income, hours worked, and workforce attachment tracked in national databases from one year prior to biologic therapy as well as during two years of biologic therapy. Outcomes were compared to age-, sex-, cohabitation- and residence-matched controls from the general population.ResultsOverall, 381 patients aged 20-62 years (52% females) were included. Annual weeks worked were lower among patients with severe asthma (adjusted incidence rate ratio (aIRR) 0.82 (0.80-0.84)), driven by increases in sick-leave (aIRR 2.77 (2.58-2.98)), unemployment (aIRR 1.38 (1.30-1.46)) and disability pension (aIRR 1.85 (1.76-1.94)).After initiating biologic therapy, patients saw modest increases in annual hours worked during the second year of treatment (aIRR 1.03 (1.03-1.04)). However, patients remained at risk for temporary (OR 1.83 (1.15-2.93)) and permanent (OR 2.67 (1.16-6.16)) workforce withdrawal.Patients achieving on-treatment remission worked significantly more hours compared to non- and clinical responders and had lower unemployment-, sick-leave and disability pension rates both at baseline and after two years.ConclusionBiologic therapy resulted in a modest increase in hours worked, yet patients remain at significant risk of early workforce withdrawal. Patients achieving remission had a stronger attachment to the workforce, also prior to biologic therapy.

Objective: The benefits of incorporating breathing exercises as an adjunct to medical treatment in the management of asthma are well established. Video game-based interventions are notable for the additional advantages they offer to children with chronic respiratory diseases; however, research specifically focusing on children with asthma remains limited. This study aimed to compare the effects of video game-based breathing exercises and conventional breathing exercises on pulmonary and extrapulmonary features in children with asthma.

Methods: Thirty-four children with asthma aged 8-18 years were randomly divided into gamification group (GG) and control group (CG). The GG performed video game-based breathing exercises and the CG performed conventional breathing exercises 5 days a week for 8 weeks. Pulmonary function, respiratory and peripheral muscle strength, functional capacity, dyspnea, fatigue, asthma control, and quality of life were assessed at baseline and after 8 weeks of training.

Results: Pulmonary function, respiratory and peripheral muscle strength, functional capacity, and total and physical dimensions of both fatigue and quality of life improved in both GG and CG; however, the improvement in the GG was greater. Significant change in inspiratory capacity and improvement in dynamic hyperinflation were found only in the GG. Both methods were insufficient in improving dyspnea and asthma control.

Conclusion: While breathing exercises are beneficial for children with asthma in improving pulmonary and extrapulmonary features, the video game-based method may provide further improvements. More importantly, the video game-based method is superior to the conventional method as it is also successful in improving dynamic hyperinflation.

Introduction: Asthma and obstructive sleep apnea (OSA) are two of the most prevalent respiratory diseases in the world. Their high prevalence increases the probability of the two diseases coexisting by chance in a single individual, but in recent years various studies have also shown a real one-to-one association between them.

Data sources: Source: PubMed. Keywords: asthma (title) and OSA (title) and apnea (title) and positive airway pressure and CPAP (title).

Studies selection: All manuscript related to the relationship between asthma an OSA as well as its treatments in terms of pathophysiological, diagnostic, etiological, epidemiological and treatment points.

Results: 50% of asthmatic patients suffer from OSA and that the adjusted risk of developing OSA in asthmatics is 2.5 times higher than in non-asthmatic individuals, especially in poorly controlled, more severe or longer-standing asthmatics. Several mechanisms have been postulated to explain this increase in OSA in asthmatics: obesity, gastro-esophageal reflux, rhinitis, nasal polyps, increased pharyngeal collapsibility due to mechanical, inflammatory or dynamic causes and, finally, the upper airway deposition of inhaled corticosteroids (IC) generating myopathy in the pharyngeal muscles (as occurs in the vocal cord muscles, resulting in dysphonia).

Conclusions: Although both asthma and OSA are common diseases that can coexist in the same individual, a one-to-one association between the two diseases has been observed. The presence of asthma could generate or exacerbate a pre-existing OSA. Caution is recommended in IC inhalation techniques in patients with OSA. The use of ultrafine particles with less pharyngeal deposition is recommended.

Purpose: Obesity-related asthma poses serious health problems. Blood metabolite concentrations play crucial roles in its development, but the association with obesity-related asthma risk is unclear. This study aimed to explore the causal effect of blood metabolite levels on this risk.

Patients and methods: Using data from the 2023 FinnGen study, which included 345,200 subjects, with 10,306 patients having obesity-associated asthma, we conducted a two-sample Mendelian randomization (MR) analysis. We assessed the causal relationship between 1400 blood metabolites and the risk of developing obesity-associated asthma. The inverse-variance weighting (IVW) method was used to estimate the causal link, with additional tests for heterogeneity and pleiotropy to ensure robustness.

Results: The forward MR results showed that 71 metabolites were associated with the risk of developing obesity-related asthma; 57 were previously identified, and 14 were new. Among the known metabolites, 29 were linked to an increased risk, and 28 to a decreased risk. Reverse-MR results identified four metabolites related to the risk of obesity-related asthma.

Conclusion: The ratio of proline to trans-4-hydroxyproline and branched chain 14:0 dicarboxylic acid are negatively associated with the risk, while serum concentrations of X-25810 and N-acetyl-L-alanine are positively associated with the risk.

Background: Long non-coding RNAs (lncRNAs) are emerging regulators of pathophysiological processes in a variety of diseases including asthma. In this study, we reported the identification of lncRNA-AK007111 as an essential modulator of mast cell apoptosis and investigated its potential mechanism.

Methods: RNA-seq profiling and transcriptome sequencing technology were adopted to screen for differentially expressed genes. Transfection was done by small interfering RNAs (siRNAs) to down-regulate lncRNA-AK007111 and Modulator of apoptosis 1 (MOAP1). Starvation was used to induce apoptosis. The apoptotic rate was measured by flow cytometry. Western Blot was conducted to detect the expression of apoptosis-related proteins.

Results: LncRNA-AK007111 was highly expressed in IgE/Ag-mediated activation of mast cells. Down-regulation of LncRNA-AK007111 promoted apoptosis of mast cells. Down-regulation of MOAP1 attenuated apoptosis in mast cells induced by the down-regulation of lncRNA-AK007111.

Conclusion: LncRNA-AK007111 may be a potential regulator of mast cell apoptosis by interaction with MOAP1.

Objective: A subset of asthmatics suffers from frequent exacerbations. Various features of airway remodeling and the resultant elastic property of airway walls may play pathophysiological roles in these exacerbations. The aim of the study was to examine the collapsibility of airways and sputum biomarkers associated with airway remodeling with different frequencies of exacerbations.

Methods: We studied 29 moderate-to-severe asthmatics classified by the number of exacerbations in the previous year as, ≤1: stable, n = 18; ≥2: difficult, n = 11, and 11 healthy controls (HC). Absolute wall area (Awa) and luminal area (Ai) of a segmental bronchus were measured by computed tomography at full-inspiration (FI) and full-expiration (FE). We examined the %change of Ai (a measure of airway collapsibility) and Awa (a possible measure of vascular/water contents in the airway wall) from FI to FE. Sputum biomarkers associated with fibrosis [TGF-β₁ and matrix metalloproteinase (MMP)-9 / tissue inhibitors of metalloproteinase (TIMP)-1 molar ratio] and those associated with angiogenesis/edema [vascular endothelial growth factor (VEGF) and vascular permeability index (sputum/serum ratio of albumin levels)] were examined.

Results: Airway collapsibility was greater in difficult asthmatics than in stable asthmatics and HC. Sputum TGF-β₁ levels were higher and MMP-9/TIMP-1 molar ratios were lower in stable asthmatics than in HC. Sputum VEGF levels and vascular permeability index were higher in difficult asthmatics than in HC.

Conclusions: Collapsibility of thickened airway walls may determine their susceptibility to exacerbations. This may depend on the balance between fibrosis and angiogenesis/edema in the airways.

Objective: Previous clinical studies have demonstrated that Wumei Pill (WP), a traditional Chinese medicine formula, can effectively alleviate nocturnal asthma-related anxiety and improve nighttime symptoms. The therapeutic mechanism of WP may involve regulation of inflammatory chemokines in peripheral blood. This mechanism is potentially linked to modulation of the circadian clock gene ARNT-like protein-1 (Bmal1), but precise pathways underlying this interaction remain unclear, requiring further investigation.

Methods: Bmal1 knockout and wild-type mice were utilized to establish asthma models. Techniques such as flow cytometry, RT-PCR, and ELISA were employed to measure the levels of serum inflammatory mediators, specifically IFN-γ, CXCL16, I-TAC, and PARC. Furthermore, the pathological alterations in airway thickness were assessed. Additionally, we investigated the regulation of the Bmal1 gene and its influence on the circadian rhythm-related recruitment of leukocytes, as well as the expression patterns of downstream mediators.

Results: Compared to the wild-type (WT) group, the model group showed significantly higher levels of CXCL16, I-TAC, and PARC (p < 0.05), as well as a notable decrease in IFN-γ expression. WP treatment effectively normalized the levels of these inflammatory factors in the model group, indicating a regulatory effect of WP on inflammatory chemokines.

Conclusion: The knockout of the Bmal1 gene, a crucial regulator of circadian rhythms, disrupts the circadian expression of inflammatory chemokines. Treatment with WP modulated Bmal1 expression, influencing the release of these mediators, offering a promising strategy for managing nocturnal asthma. Notably, wild-type nocturnal asthma mice exhibited significantly better control of airway inflammation compared to their Bmal1-deficient counterparts, highlighting the importance of circadian regulation in the pathophysiology of asthma.