Journal of Asthma最新文献

Objective: In traditional Chinese medicine, asthma is associated with deficiencies in Lung Qi, Spleen Qi, and Kidney Qi. This study investigated the therapeutic mechanism of point application therapy focusing on the acupoints Feishu (BL13), Pishu (BL20), and Shenshu (BL23) for asthma treatment.

Methods: An asthma model was established in Wistar rats via intraperitoneal ovalbumin injection combined with nebulization. Therapeutic ointments were prepared using white mustard seed, Yanhusuo, Gansui and Asarum sieboldii, which were applied topically to the Feishu (BL13), Pishu (BL20) and Shenshu (BL23) acupoints. To examine the mechanistic basis, the AMPK inhibitor dorsomorphin (compound C, CC) was employed. We subsequently measured inflammatory factor levels in rat serum and bronchoalveolar lavage fluid, quantified AMPK/mTOR pathway-related protein expression, and assessed pulmonary inflammation alongside collagen deposition in airway mucosa.

Results: The point application therapy significantly ameliorated asthma symptoms and reduced levels of inflammatory factors, including interleukin (IL)-6 and IL-1β, in both serum and bronchoalveolar lavage fluid. The treatment additionally decreased expression levels of mTOR, LC3, NF-κB and TGF-β1 while increasing AMPK content. Histological examination revealed reduced inflammatory cell infiltration and diminished collagen deposition in both lung and airway tissues. Crucially, administration of the AMPK inhibitor dorsomorphin substantially attenuated the therapeutic efficacy of point application therapy in asthmatic rats.

Conclusions: Point application therapy targeting Feishu, Pishu and Shenshu acupoints inhibits autophagy in airway and lung tissues in asthma. These therapeutic effects are mediated, at least partially, through the AMPK/mTOR pathway.

Objective: To analyze the reliability, construct and content validity, ceiling and floor effects, acceptability, and feasibility of the Patient-Specific Functional Scale (PSFS) in individuals with asthma.

Methods: This methodological study included individuals with asthma. Sociodemographic and clinical characteristics, lung function (forced expiratory volume in one second - FEV₁), asthma control, and quality of life (Asthma Quality of Life Questionnaire - AQLQ) were assessed, in addition to the administration of the PSFS. Reliability, construct, and content validity, as well as ceiling/floor effects, were analyzed.

Results: One hundred participants were evaluated (88% women, mean age 56 ± 14 years), the mean PSFS score was 4.1 ± 2.3. Regarding reliability, the intraclass correlation coefficient was 0.95 (95% confidence interval (CI): 0.88-0.97, p < .0001). The PSFS showed a fair correlation with the AQLQ activity limitation domain (r = 0.34, p = .001) and a weak correlation with FEV₁ (r = 0.16, p = .19). Lower scores were observed in participants with poorer asthma control (p = .03). Ninety-seven percent of the activities reported in the PSFS were classified under the Activity and Participation domain of the International Classification of Functioning, Disability, and Health (ICF). No ceiling or floor effects were detected.

Conclusions: The PSFS demonstrated strong reliability, adequate validity, and no ceiling or floor effects, supporting its potential as a useful tool for assessing activity limitations in asthma.

Objective: To support policymakers in developing effective health policies, this study analyzed disability-adjusted life years (DALYs) for asthma attributable to Nitrogen dioxide (NO₂) pollution from 1990 to 2021 and predicted future trends.

Methods: Utilizing the Global Burden of Diseases study (GBD) 2021 database, this study analyzed the burden of asthma attributable to NO₂ pollution using DALYs and summary exposure value (SEV), stratified by gender, age, region, country, and socio-demographic index (SDI) level. The asthma risk attributed to NO₂ pollution was estimated using the population attributable fraction (PAF). The Bayesian age-period-cohort model (BAPC) package in R was used to forecast future trends.

Results: The global age-standardized DALYs rate (ASDALYs) decreased from 4.80 [95%UI: -4.29 to 17.75] in 1990 to 2.48 [95%UI: -2.26 to 10.30] in 2021. ASDALYs for males were higher than for females. DALYs were the highest proportion in those aged under 15 years. From 1990 to 2021, SEV and ASDALYs increased in Southeast Asia. In 2021, SEV and ASDALYs in Lebanon were 84.35 [95%UI: 0 to 100] and 19.73 [95%UI: -19.51 to 59.84], respectively. The impact of NO₂ on the asthma burden varies across regions with different SDI levels. The global trend in ASDALYs is projected to decline until 2029, reaching approximately 2.96, before increasing to 7.12 by 2050.

Conclusions: From 1990 to 2021, the global DALYs for asthma attributed to NO₂ pollution have generally decreased. However, there may be a future rising tendency. Additionally, it is still quite significant for children under the age of 15 and in some underdeveloped regions.

Introduction: This study examines the link between social determinants of health (SDoH) and asthma, utilizing data from the National Health and Nutrition Examination Survey (NHANES).

Methods: We analyzed 39,340 participants, including 5,645 with asthma and 33,695 without. Multivariable logistic regression assessed the SDoH-asthma relationship, with subgroup analyses for effect modifiers. Machine learning models combining demographic, clinical, and SDoH variables were evaluated using area under the curve (AUC).

Results: Asthma was more prevalent among younger individuals (mean age: 45.11 years), females (58%), and those with significant differences in BMI, education, marital status, and race (all p < 0.001). Unadjusted models showed a 5.5% increased asthma risk per SDoH index unit (OR = 1.055, p < 0.001), remaining significant after demographic and clinical adjustments (Model 2: OR = 1.045, Model 3: OR = 1.039). Stronger SDoH-asthma associations were found among smokers (OR = 1.08) and diabetics (OR = 1.12), but not in participants with higher education (OR = 1.00). Model 3, including SDoH variables, demonstrated superior predictive performance (training AUC = 0.779) with minimal generalizability loss (ΔAUC = 0.206).

Conclusion: SDoH is an independent risk factor for asthma, particularly among smokers, diabetics, and individuals with less education. Incorporating SDoH into predictive models enhances performance and offers insights for clinical and policy interventions.

Background: This study investigated the feasibility of performing spirometry without technical errors in preschool children. It also evaluated the effect of an educational intervention on the success rates and duration of spirometry in this age group.

Methods: This randomized controlled study was conducted in Greece during two separate time periods due to the COVID-19 pandemic. The study included 132 children aged 3-6 years who had not previously undergone spirometry. Children who were born prematurely, had neurological disorders and/or developmental delays, or refused to attempt an FVC maneuver were excluded from the study. Participants were randomly allocated to the intervention (n = 65) and control (n = 67) groups. The mean (SD) ages were 4.5 ± 0.88 and 4.6 ± 0.92 years, respectively. The control group received standard verbal instructions, whereas the intervention group watched a short educational video. All spirometry tests were performed by the same operator.

Results: The overall success rate of spirometry was 74.2%. Success rates were significantly higher in the intervention group compared with the control group (84.6% vs. 65.7%, p = 0.015). The educational intervention increased the likelihood of achieving successful spirometry by 3.85-fold (OR 3.85, 95% CI 1.5-107, p = 0.05). It also increased the number of acceptable FVC maneuvers and reduced the total time required to complete the test (11.7 ± 6.5 min in the intervention group vs. 16.2 ± 8.6 min in the control group; p = 0.002). The median number of attempts did not differ significantly between the groups.

Conclusions: Spirometry is generally feasible in preschool children; however, a brief educational video can substantially improve the likelihood of successful performance and reduce the time needed to complete the test.

Background: Asthma is a chronic disease impacting millions globally, with rising prevalence linked to obesity. Body roundness index(BRI) is a novel measure of visceral fat distribution, but its association with asthma remains unexplored.

Objective: This study aimed to assess the relationship between body roundness index (BRI) and the prevalence of asthma using NHANES data from 2001 to 2018.

Date sources: www.cdc.gov/nchs/nhanes/.

Study selections: The association between BRI and asthma prevalence, as well as age at first asthma, was examined using NHANES data from 2001 to 2018. Subgroup analysis was conducted to evaluate sensitive populations. Nonlinear relationships between BRI and asthma prevalence and age at first asthma were assessed through smooth curve fitting and threshold effect analysis.

Results: Among the 44,426 participants, 6,057 self-reported having asthma. After adjusting for confounders, a positive association was observed between BRI and asthma prevalence (OR = 1.09, 95% CI: 1.08, 1.11). This association grew stronger as BRI increased (P for trend <.01). Smooth curve fitting analysis indicated a linear relationship between BRI and asthma prevalence. Subgroup analysis revealed a positive association between BRI and all groups. Furthermore, there was a nonlinear positive relationship between BRI and age at first asthma (β = 0.46, 95% CI: 0.24, 0.68), with the saturation effect analysis indicating an important inflection point at 5.24.

Conclusions: Increased BRI showed a linearly positive association with higher asthma incidence, although causality cannot be determined. Greater caution is advised when considering higher BRI, particularly regarding the development of late-onset asthma.

Objective: Asthma is a chronic inflammatory disease of the airways with a significant global disease burden. The relationship between Relative Fat Mass (RFM) - a novel obesity metric - and asthma exacerbation remains poorly characterized. This study aimed to determine whether RFM independently associates with exacerbation risk in asthma patients.

Methods: We conducted a cross-sectional study involving 1,770 adult participants from the National Health and Nutrition Examination Survey (NHANES). Participants were stratified by RFM tertiles (T1-T3). We used logistic regression models to assess the association between RFM and asthma exacerbation. Analyses were performed using both continuous and categorical RFM definitions, with progressive covariate adjustment across four models.

Results: Significant differences were observed between stable asthma and asthma exacerbation groups in terms of sex, education level and family history of asthma. After full covariate adjustment, RFM remained significantly associated with asthma exacerbation, confirming RFM as an independent predictor of asthma exacerbation (OR = 1.03, 95%CI: 1.01 ∼ 1.05, p = 0.001), with higher RFM tertiles (T3:OR = 1.59, 95%CI: 1.09 ∼ 2.31, p = 0.016) showing increased risk. Curve fitting confirmed a linear dose-response relationship (p = 0.003).

Conclusion: This study revealed an independent positive association between RFM and asthma exacerbation risk, suggesting its potential utility for risk stratification.

Objective: Asthma and other allergic diseases, driven by immune dysregulation, pose a significant global health burden. While observational and experimental studies suggest a link between metabolites and allergies, causality remains unclear. This study aimed to investigate the causal effects of circulating metabolites on asthma and other common allergic diseases.

Methods: Genome-wide association study (GWAS) data for childhood allergies (CA; ncase = 6110, controls = 406,07) and typical allergic conditions included asthma, hay fever and eczema (ncase = 180,129, controls = 180,709) were used. Data on exposures were extracted from 136,016 Europeans for 233 circulating biomarkers and from 8,000 participants for 1400 plasma metabolites. The primary universal Mendelian randomization (UVMR) analysis used inverse variance weighting (IVW) and three supplementary methods for causal assessment. Sensitivity analyses included Cochran's Q test, MR-Egger intercept and MR-PRESSO to ensure robustness. Leave-one-out (LOO) analysis evaluated bias by sequentially removing SNPs. Bonferroni correction was applied, and significant metabolites underwent pathway enrichment analysis.

Results: We identified 24 metabolic pathways potentially involved in the biological mechanisms of typical allergic diseases and CA. MR analysis revealed 3 circulating biomarkers and 57 metabiotic traits potentially linked to CA, while 2 biomarkers and 56 metabolites were causally related to typical allergic diseases. After genetic correction, the ratio of omega-6 fatty acids to total fatty acids (IVW: p = 0.015, OR: 0.816, 95% CI: 0.693-0.961) and bilirubin (E, E) level (IVW: p = 8.23 × 10^-4, OR: 1.097, 95% CI: 1.039-1.578) remained significantly associated with CA. The significant roles of valine, leucine and isoleucine biosynthesis (p = 1.7 × 10^-3) and degradation (p = 0.041) in allergic diseases were also identified.

Conclusions: This study identified genetically determined metabolites and pathways significantly associated with asthma and other allergic diseases, offering novel insights into their pathogenesis.

Objective: This systematic review and meta-analysis evaluated the efficacy of yoga-based lifestyle interventions as an adjunct to standard pharmacotherapy in pediatric asthma on pulmonary function, asthma control, and quality of life.

Data sources: PubMed, Embase, and Cochrane electronic databases were searched from inception to May 5, 2025.

Study selection: Randomized controlled trials (RCTs) assessing pulmonary functions, asthma symptom control, and/or quality of life were included. Pooled mean differences (MD) and standardized MD with 95% confidence intervals (CI) were calculated for outcomes at 6 and 12 wk using Stata 16. Study quality was assessed with the Cochrane Risk of Bias 2 tool, publication bias with the Egger test, heterogeneity with Q and I² tests, and evidence certainty with GRADEpro.

Results: Six RCTs were included in the systematic review, and five of them (480 children, 8-16 years) were pooled in the meta-analysis. At 6 wk, three RCTs (n = 347) showed that yoga, compared with control, significantly improved FVC % predicted (MD = 2.71, 95% CI 0.15-5.27), FEV₁/FVC % predicted (MD = 1.30, 95% CI 0.36-2.24), and PEFR % predicted (MD = 4.87, 95% CI 1.51-8.24). Four RCTs (n = 377) also showed improved FEV₁ % predicted (MD = 2.94, 95% CI 0.33-5.55) at 6 wk, and two RCTs (n = 208) demonstrated improved FVC % predicted (MD = 3.59, 95% CI 0.79-6.38) at 12 wk. Asthma control and quality of life were not significant.

Conclusion: Yoga as a complementary therapy significantly improves pulmonary function in asthmatic children at 6 and 12 wk.