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NLRP3 Inflammasome Deficiency Alleviates Inflammation and Oxidative Stress by Promoting PINK1/Parkin-Mediated Mitophagy in Allergic Rhinitis Mice and Nasal Epithelial Cells 缺乏 NLRP3 炎症小体可通过促进 PINK1/Parkin 介导的丝裂细胞吞噬缓解过敏性鼻炎小鼠和鼻腔上皮细胞的炎症和氧化应激反应
IF 3.2 3区 医学 Q2 ALLERGY Pub Date : 2024-08-01 DOI: 10.2147/jaa.s467774
Hong Ding, Xiaofan Lu, Huimin Wang, Wenming Chen, Bing Niu
Purpose: Accumulating evidence indicates that oxidative stress and inflammation are the pathological basis of allergic diseases. Inhibition of NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome could ameliorate allergic rhinitis (AR). Here, we explored the effects and mechanisms that underlie NLRP3 inhibition on oxidative stress and inflammation in AR.
Methods: Ovalbumin (OVA)-induced AR murine model was established using wild-type (WT) and NLRP3-deficient mice. HNEpCs were stimulated with interleukin (IL)-13 with MCC950 pretreatment or PTEN-induced putative kinase 1 (PINK1) siRNA. The indicators of oxidative stress, inflammation, apoptosis, and mitophagy were determined both in vivo and in vitro.
Results: NLRP3 knockout (KO) reduced the frequency of nasal rubbing and sneezing, the infiltration of eosinophils, the number of mast cells, and the accumulation of goblet cells in AR mice after OVA stimulation. The NLRP3 KO AR mice exhibited the increased concentrations of OVA-specific immunoglobulin E (OVA-sIgE), IL-1β, IL-4, IL-13, IL-6, TNF-α, and the upregulated level of IFN-γ. NLRP3 KO significantly inhibited oxidative stress, and also markedly decreased apoptosis in the nasal mucosa of AR mice. Moreover, evaluated protein expressions of PINK1, enzyme 3 (E3) ubiquitin ligase PRKN (Parkin), and LC3 II, decreased expression of TOM20, as well as the increased colocalization of LC3 with mitochondria were observed in NLRP3 KO AR mice. In vitro, IL-13 exposure increased the levels of NLRP3 and IL-1β. Inhibition of NLRP3 using MCC950 enhanced PINK1/Parkin-mediated mitophagy but attenuated inflammation, oxidative stress, and apoptosis. However, PINK1 knockdown abrogated mitophagy and also reversed the protective effects of MCC950 on inflammation, oxidative stress, and apoptosis in HNEpCs stimulated with IL-13.
Conclusion: Inhibition of NLRP3 inflammasome exerts the protective effects on AR by facilitating mitophagy regulated by PINK1/Parkin signaling pathway.

Keywords: NLRP3, mitophagy, inflammation, oxidative stress, PINK1/Parkin
目的:越来越多的证据表明,氧化应激和炎症是过敏性疾病的病理基础。抑制 NOD 样受体家族含 pyrin 结构域的 3(NLRP3)炎性体可以改善过敏性鼻炎(AR)。在此,我们探讨了抑制 NLRP3 对 AR 中氧化应激和炎症的影响及其机制:方法:使用野生型(WT)和 NLRP3 缺陷型小鼠建立了卵清蛋白(OVA)诱导的 AR 小鼠模型。用白细胞介素(IL)-13刺激HNEpCs,并使用MCC950预处理或PTEN诱导的推定激酶1(PINK1)siRNA。在体内和体外测定了氧化应激、炎症、细胞凋亡和有丝分裂的指标:结果:NLRP3基因敲除(KO)减少了OVA刺激后AR小鼠揉鼻和打喷嚏的频率、嗜酸性粒细胞的浸润、肥大细胞的数量以及鹅口疮细胞的堆积。NLRP3 KO AR小鼠的OVA特异性免疫球蛋白E(OVA-sIgE)、IL-1β、IL-4、IL-13、IL-6、TNF-α浓度升高,IFN-γ水平上调。NLRP3 KO 能明显抑制氧化应激,还能显著减少 AR 小鼠鼻黏膜的细胞凋亡。此外,在 NLRP3 KO 的 AR 小鼠中还观察到 PINK1、酶 3(E3)泛素连接酶 PRKN(Parkin)和 LC3 II 蛋白表达量的评估、TOM20 表达量的降低以及 LC3 与线粒体共定位的增加。在体外,IL-13 的暴露增加了 NLRP3 和 IL-1β 的水平。使用 MCC950 抑制 NLRP3 可增强 PINK1/Parkin 介导的有丝分裂,但会减轻炎症、氧化应激和细胞凋亡。然而,PINK1基因敲除会减弱有丝分裂,也会逆转MCC950对受到IL-13刺激的HNEpCs的炎症、氧化应激和细胞凋亡的保护作用:结论:抑制NLRP3炎性体通过促进PINK1/Parkin信号通路调控的有丝分裂对AR具有保护作用:NLRP3、有丝分裂、炎症、氧化应激、PINK1/Parkin
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引用次数: 0
Frequency of Severe Asthma and Its Clinical Phenotypes at the Asthma Clinic in One of the Largest Sudanese Tertiary Pediatric Hospitals: A Cross-Sectional Hospital-Outpatient-Based Study 苏丹最大的儿科三级医院之一的哮喘门诊中严重哮喘的发病率及其临床表型:基于医院门诊病人的横断面研究
IF 3.2 3区 医学 Q2 ALLERGY Pub Date : 2024-07-22 DOI: 10.2147/jaa.s450379
Omima Mohammed Ali Omima Mohammed, Omaima Abdel Majeed Mohamed Salih, Islamia Ibrahim Ahmed Omer, Yousra Ibrahim Abdallah Mohammed, Omer A Mohammed, Ammar Elgadi, Lina Hemmeda, Walaa Elnaiem, Malaz Tarig Abdalla Mohamed, Areeba Ahsan, Khabab Abbasher Hussien Mohamed Ahmed
Background: Asthma is one of the most common non-communicable diseases. Childhood asthma has been increasing in Sudan, with a 13– 16% prevalence among Khartoum school children. To achieve and maintain good asthma control, proper diagnosis, assessment of severity, and appropriate medication administration are crucial, with phenotyping being a key factor in determining patients’ specific treatment.
Objective: To study the frequency of severe asthma and the distribution of its different phenotypes and to investigate associations between age and gender and different phenotypes of asthma.
Methodology: This descriptive cross-sectional hospital-based study was conducted in the Asthma Clinic of Mohamed Al-Amin Hamid Pediatrics Hospital. It included 229 patients who were presented to the clinic from September 2021 to April 2022. Data were collected from the patients and/or their caregivers using a modified validated standard questionnaire and were analyzed using SPSS version 26.0. A p-value of 0.05 or less was considered statistically significant.
Results: In this study of 229 participants, 14.4% had severe asthma, with 44.5% and 41% exhibiting mild and moderate asthma, respectively. Most were effectively managed in steps 2 or 3. The cohort, primarily aged 5 or younger (40.2%) with a male majority (62%), showed a mean diagnosis age of 2.9 ± 2.8 years. Impressively, 90% maintained well-controlled asthma. Within severe asthma cases (87% atopic), 39.4% represented a severe allergic asthma phenotype. Elevated eosinophil counts were noted in 45.5% (serum) and 78.8% (sputum cytology), while 57.6% had normal serum IgE levels. The predominant symptom pattern in severe asthma was episodic multi-trigger wheezing (48.5%). Age and gender displayed no significant association with severe asthma phenotype.
Conclusion: This study reveals a concerning rise in childhood asthma prevalence in Sudan, emphasizing the importance of tailored treatment strategies. Severe asthma, characterized by atopic eosinophilic involvement, necessitates targeted interventions in pediatric asthma care for specific phenotypes.

背景:哮喘是最常见的非传染性疾病之一:哮喘是最常见的非传染性疾病之一。苏丹儿童哮喘的发病率一直在上升,喀土穆学龄儿童的发病率为 13-16%。要实现并保持对哮喘的良好控制,正确诊断、评估严重程度和适当用药至关重要,而表型分析则是决定患者具体治疗方法的关键因素:研究重症哮喘的发病率及其不同表型的分布情况,并探讨年龄、性别与哮喘不同表型之间的关系:这项描述性横断面医院研究在穆罕默德-阿明-哈米德儿科医院哮喘门诊进行。研究对象包括 2021 年 9 月至 2022 年 4 月期间就诊的 229 名患者。研究人员使用修改过的有效标准问卷向患者和/或其护理人员收集数据,并使用 SPSS 26.0 版进行分析。P值小于或等于0.05为具有统计学意义:在 229 名参与者中,14.4% 患有重度哮喘,44.5% 和 41% 分别为轻度和中度哮喘。大多数人在第二或第三步得到了有效控制。研究对象的年龄主要在 5 岁或以下(40.2%),男性占多数(62%),平均诊断年龄为 2.9±2.8 岁。令人印象深刻的是,90%的哮喘患者都能保持良好的哮喘控制。在重症哮喘病例(87%为特应性)中,39.4%为重度过敏性哮喘表型。45.5%(血清)和78.8%(痰细胞学检查)的患者嗜酸性粒细胞计数升高,而57.6%的患者血清IgE水平正常。重症哮喘的主要症状模式是发作性多诱因喘息(48.5%)。年龄和性别与重症哮喘表型无明显关联:本研究揭示了苏丹儿童哮喘发病率上升的令人担忧的情况,强调了因地制宜的治疗策略的重要性。以特异性嗜酸性粒细胞参与为特征的重症哮喘需要针对特定表型的儿科哮喘护理采取有针对性的干预措施。
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引用次数: 0
Herbacetin Inhibits Asthma Development by Blocking the SGK1/NF-κB Signaling Pathway 草本乙素通过阻断 SGK1/NF-κB 信号通路抑制哮喘的发展
IF 3.2 3区 医学 Q2 ALLERGY Pub Date : 2024-07-22 DOI: 10.2147/jaa.s468689
Xiufeng Chen, Yong hong Jiang, Xiaoqin Fei, Mingjing Wang, Anqi Liu, Xuejun Li, Zhiyan Jiang
Background: Asthma severely interferes with people’s lives through coughing, wheezing and inflammation of the lungs. Herbacetin is a class of natural compounds that inhibit the development of inflammation. However, whether Herbacetin inhibits asthma has not been definitively studied.
Methods: Lipopolysaccharides (LPS)-induced lung epithelial (BASE-2B) cells injury model was established, and then the relief of damaged BASE-2B cells with different concentrations of Herbacetin was examined. The cell counting kit (CCK8) was used to detect the effect of Herbacetin on the proliferation ability in ovalbumin (OVA)-induced asthma mice model, and Western Blot and flow cytometry were used to detect the effect of Herbacetin on the apoptosis in OVA-induced asthma mice model. Additionally, pulmonary pathology was detected by HE and Masson staining, and serum inflammatory factors were detected by alveolar lavage fluid.
Results: Herbacetin reduces BESA-2B cells induced by LPS level of inflammation, and reactive oxygen species (ROS) generation, inhibits cell apoptosis, promotes cell proliferation, OVA-induced mice lung histopathology test HE staining, serum inflammatory factors show the same results. Western Blot shows that Herbacetin regulates the expression of Caspase-3, Bax, and Bcl-2. SGK1 overexpression increased the rate of apoptosis, and Herbacetin reversed this phenomenon. By silencing the expression of SGK1, it was found that Herbacetin was an inhibitor of SGK1, which could inhibit the NF-κB/p-P65 pathway in asthmatic airway inflammation.
Conclusion: Herbacetin reduces pro-inflammatory cytokine levels by inhibiting the SGK1/NF-κB pathway. Our data suggest that Herbacetin has a significant anti-inflammatory effect on asthma and can be used as a potential therapeutic agent.

背景:哮喘会引起咳嗽、喘息和肺部炎症,严重影响人们的生活。草本乙炔是一类能抑制炎症发展的天然化合物。然而,草本乙炔是否能抑制哮喘尚未有明确的研究:方法:建立脂多糖(LPS)诱导的肺上皮细胞(BASE-2B)损伤模型,然后检测不同浓度的草本乙素对 BASE-2B 细胞损伤的缓解作用。用细胞计数试剂盒(CCK8)检测草本苷对卵清蛋白(OVA)诱导的哮喘小鼠模型增殖能力的影响,用 Western Blot 和流式细胞术检测草本苷对 OVA 诱导的哮喘小鼠模型细胞凋亡的影响。此外,还通过 HE 和 Masson 染色法检测肺部病理变化,并通过肺泡灌洗液检测血清炎症因子:结果:草本乙炔能降低 LPS 诱导的 BESA-2B 细胞炎症水平和活性氧(ROS)生成,抑制细胞凋亡,促进细胞增殖,OVA 诱导的小鼠肺组织病理学检测 HE 染色、血清炎症因子检测结果相同。Western Blot 显示,草除灵调节 Caspase-3、Bax 和 Bcl-2 的表达。SGK1 过表达会增加细胞凋亡率,而草本乙素能逆转这一现象。通过沉默 SGK1 的表达,发现草本酮是 SGK1 的抑制剂,可以抑制哮喘气道炎症中的 NF-κB/p-P65 通路:结论:草本乙素可通过抑制 SGK1/NF-κB 通路降低促炎细胞因子水平。我们的数据表明,草木犀素对哮喘有显著的抗炎作用,可作为一种潜在的治疗药物。
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引用次数: 0
Healthcare Resource Utilisation of Severe Uncontrolled T2low and Non-T2low Asthma in Finland During 2018-2021 2018-2021年芬兰严重不受控制的T2low和非T2low哮喘的医疗资源利用情况
IF 3.2 3区 医学 Q2 ALLERGY Pub Date : 2024-07-19 DOI: 10.2147/jaa.s455911
Josefine Persson, Juhani Aakko, Saara Kaijala, Mariann I Lassenius, Arja Viinanen, Hannu Kankaanranta, Lauri Lehtimäki
Purpose: Patients with asthma and low levels of type 2 inflammatory biomarkers (T2 low) have limited effective treatment options. Such biomarkers include eg blood eosinophils (b-eos) and fractional exhaled nitric oxide (FeNO). The healthcare resource utilisation (HCRU) of severe uncontrolled T2 low asthma remains unexplored. Thus, this study aimed to estimate the HCRU of T2 low and non-T2 low severe uncontrolled asthma patients using real-world data in Finland.
Patients and Methods: Adult patients with an asthma diagnosis during baseline (2012– 2017) at the pulmonary department of Turku University Hospital were included and followed during 2018– 2021, or until death. Total HCRU costs and respiratory-related HCRU costs were evaluated. The main drivers for the HCRU and costs were assessed with gamma and negative binomial regression models.
Results: Of the severe uncontrolled asthma patients with T2 status available, 40% (N=66) were identified with T2 low and 60% (N=103) with non-T2 low asthma. The average cumulative cost per patient was similar in patients with T2 low compared with non-T2 low, with all-cause costs cumulating in four years of follow-up to 37,524€ (95% CI: 27,160, 47,888) in T2 low compared to 34,712€ (25,484, 43,940) in non-T2 low. The corresponding average cumulative respiratory-related costs were 5178€ (3150, 7205) in T2 low compared to 5209€ (4104, 6313) in non-T2 low. Regression modelling identified no differences between the T2-status groups when assessing all-cause healthcare costs per patient-year (PPY). On the other hand, the regression modelling predicted more inpatient days PPY for severe uncontrolled patients with T2 low status compared to the patients with non-T2 low status.
Conclusion: Patients with uncontrolled severe T2 low asthma use equal healthcare resources as corresponding non-T2 low patients. This study brought new insights into the HCRU of severe uncontrolled asthma patients per T2 status, which has not previously been investigated.

Keywords: severe uncontrolled asthma, phenotypes, healthcare resource utilisation, economic burden, real-world evidence
目的:哮喘患者的 2 型炎症生物标志物(T2 低)水平较低,有效的治疗方案有限。此类生物标志物包括血液嗜酸性粒细胞(b-eos)和呼出一氧化氮分数(FeNO)。对于严重失控的 T2 低哮喘患者,其医疗资源利用率(HCRU)仍有待探索。因此,本研究旨在利用芬兰的真实数据估算T2低度和非T2低度严重失控哮喘患者的医疗资源利用率:研究纳入了图尔库大学医院肺科在基线(2012-2017 年)期间确诊为哮喘的成年患者,并在 2018-2021 年期间进行了随访,直至患者死亡。评估了HCRU总成本和与呼吸相关的HCRU成本。采用伽马回归模型和负二项回归模型评估了HCRU和费用的主要驱动因素:在有 T2 状态的严重失控哮喘患者中,40%(66 人)被确定为 T2 低,60%(103 人)被确定为非 T2 低。与非T2低哮喘患者相比,T2低哮喘患者每名患者的平均累计费用相似,在四年的随访中,T2低哮喘患者的全因费用累计为37,524欧元(95% CI:27,160, 47,888),而非T2低哮喘患者的全因费用累计为34,712欧元(25,484, 43,940)。相应的与呼吸相关的平均累计费用为:T2 低度患者 5178 欧元(3150, 7205),非 T2 低度患者 5209 欧元(4104, 6313)。回归模型显示,在评估每位患者每年的全因医疗费用时,T2 状态组之间没有差异。另一方面,与非 T2 低状态患者相比,回归模型预测 T2 低状态严重失控患者的年住院天数更多:结论:未得到控制的严重 T2 低水平哮喘患者与相应的非 T2 低水平患者使用相同的医疗资源。这项研究为重度未控制哮喘患者每 T2 状态的 HCRU 带来了新的见解,而这在以前还没有过研究。 关键词:重度未控制哮喘、表型、医疗资源利用、经济负担、真实世界证据
{"title":"Healthcare Resource Utilisation of Severe Uncontrolled T2low and Non-T2low Asthma in Finland During 2018-2021","authors":"Josefine Persson, Juhani Aakko, Saara Kaijala, Mariann I Lassenius, Arja Viinanen, Hannu Kankaanranta, Lauri Lehtimäki","doi":"10.2147/jaa.s455911","DOIUrl":"https://doi.org/10.2147/jaa.s455911","url":null,"abstract":"<strong>Purpose:</strong> Patients with asthma and low levels of type 2 inflammatory biomarkers (T2 low) have limited effective treatment options. Such biomarkers include eg blood eosinophils (b-eos) and fractional exhaled nitric oxide (FeNO). The healthcare resource utilisation (HCRU) of severe uncontrolled T2 low asthma remains unexplored. Thus, this study aimed to estimate the HCRU of T2 low and non-T2 low severe uncontrolled asthma patients using real-world data in Finland.<br/><strong>Patients and Methods:</strong> Adult patients with an asthma diagnosis during baseline (2012– 2017) at the pulmonary department of Turku University Hospital were included and followed during 2018– 2021, or until death. Total HCRU costs and respiratory-related HCRU costs were evaluated. The main drivers for the HCRU and costs were assessed with gamma and negative binomial regression models.<br/><strong>Results:</strong> Of the severe uncontrolled asthma patients with T2 status available, 40% (N=66) were identified with T2 low and 60% (N=103) with non-T2 low asthma. The average cumulative cost per patient was similar in patients with T2 low compared with non-T2 low, with all-cause costs cumulating in four years of follow-up to 37,524€ (95% CI: 27,160, 47,888) in T2 low compared to 34,712€ (25,484, 43,940) in non-T2 low. The corresponding average cumulative respiratory-related costs were 5178€ (3150, 7205) in T2 low compared to 5209€ (4104, 6313) in non-T2 low. Regression modelling identified no differences between the T2-status groups when assessing all-cause healthcare costs per patient-year (PPY). On the other hand, the regression modelling predicted more inpatient days PPY for severe uncontrolled patients with T2 low status compared to the patients with non-T2 low status.<br/><strong>Conclusion:</strong> Patients with uncontrolled severe T2 low asthma use equal healthcare resources as corresponding non-T2 low patients. This study brought new insights into the HCRU of severe uncontrolled asthma patients per T2 status, which has not previously been investigated.<br/><br/><strong>Keywords:</strong> severe uncontrolled asthma, phenotypes, healthcare resource utilisation, economic burden, real-world evidence<br/>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"64 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141744685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Use of Azelastine Hydrochloride/Fluticasone Propionate in the Management of Allergic Rhinitis in Asia: A Review 盐酸阿折拉斯汀/丙酸氟替卡松在亚洲过敏性鼻炎治疗中的应用:综述
IF 3.2 3区 医学 Q2 ALLERGY Pub Date : 2024-07-12 DOI: 10.2147/jaa.s451733
Pongsakorn Tantilipikorn, Virat Kirtsreesakul, Chaweewan Bunnag, Mukda Vangveeravong, Sanguansak Thanaviratananich, Supinda Chusakul
Abstract: The incidence of allergic rhinitis (AR) in Asia and the world is steadily rising. Patients experience incomplete symptom relief despite existing treatment options, which warrants the need for new therapeutic regimes. Azelastine hydrochloride/fluticasone propionate (MP-AzeFlu), a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate has been indicated in the treatment of AR. The current review discusses the effects of MP-AzeFlu versus conventional therapies in achieving superior clinical improvement with a very rapid onset of action (5 minutes). The superiority of MP-AzeFlu in offering complete symptom control with sustained relief in patients with AR compared to the existing therapeutic options is also discussed. MP-AzeFlu has been shown to improve the quality of life for patients with AR, thereby enhancing patient adherence to therapy and establishing its preference for the treatment of AR. Currently, the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines recommend the use of a combination of intranasal corticosteroids and intranasal antihistamines as first-line treatment in patients with persistent AR with visual analog scores ≥ 5 or when prior treatment with single agents has been ineffective. Widely published data on the efficacy and safety of its prolonged use in adults and children have validated that effective treatment of AR can be achieved with MP-AzeFlu.

Keywords: fixed-dose combination, intranasal, MP-AzeFlu, corticosteroids, antihistamines
摘要:过敏性鼻炎(AR)在亚洲和全球的发病率正在稳步上升。尽管有现有的治疗方案,但患者的症状缓解不彻底,因此需要新的治疗方案。盐酸氮卓斯汀/丙酸氟替卡松(MP-AzeFlu)是盐酸氮卓斯汀和丙酸氟替卡松的新型鼻内制剂,已被用于治疗鼻炎。本综述讨论了 MP-AzeFlu 与传统疗法相比,在快速起效(5 分钟)改善临床症状方面的效果。此外,还讨论了 MP-AzeFlu 与现有治疗方案相比,在完全控制 AR 患者症状并持续缓解症状方面的优越性。事实证明,MP-AzeFlu 可改善 AR 患者的生活质量,从而提高患者对治疗的依从性,并确立其在 AR 治疗中的优先地位。目前,过敏性鼻炎及其对哮喘的影响(ARIA)指南建议将鼻内皮质类固醇激素和鼻内抗组胺药物联合使用,作为视觉模拟评分≥5 分或之前单药治疗无效的持续性 AR 患者的一线治疗方法。在成人和儿童中长期使用MP-AzeFlu的疗效和安全性的广泛数据已经证实,MP-AzeFlu可以有效治疗AR。 关键词:固定剂量复方制剂;鼻内用药;MP-AzeFlu;皮质类固醇;抗组胺药
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引用次数: 0
iPREDICT: Characterization of Asthma Triggers and Selection of Digital Technology to Predict Changes in Disease Control iPREDICT:确定哮喘触发因素的特征并选择数字技术来预测疾病控制的变化
IF 3.2 3区 医学 Q2 ALLERGY Pub Date : 2024-07-10 DOI: 10.2147/jaa.s458618
Mario Castro, Merrill Zavod, Annika Rutgersson, Magnus Jörntén-Karlsson, Bhaskar Dutta, Lynn Hagger
Purpose: The iPREDICT program aimed to develop an integrated digital health solution capable of continuous data streaming, predicting changes in asthma control, and enabling early intervention.
Patients and Methods: As part of the iPREDICT program, asthma triggers were characterized by surveying 221 patients (aged ≥ 18 years) with self-reported asthma for a risk–benefit analysis of parameters predictive of changes in disease control. Seventeen healthy volunteers (age 25– 65 years) tested 13 devices to measure these parameters and assessed their usability attributes.
Results: Patients identified irritants such as chemicals, allergens, weather changes, and physical activity as triggers that were the most relevant to deteriorating asthma control. Device testing in healthy volunteers revealed variable data formats/units and quality issues, such as missing data and low signal-to-noise ratio. Based on user preference and data capture validity, a spirometer, vital sign monitor, and sleep monitor formed the iPREDICT integrated system for continuous data streaming to develop a personalized/predictive algorithm for asthma control.
Conclusion: These findings emphasize the need to systematically compare devices based on several parameters, including usability and data quality, to develop integrated digital technology programs for asthma care.

Keywords: asthma, devices, digital, predictive algorithm, sensors
目的:iPREDICT 计划旨在开发一种能够连续传输数据、预测哮喘控制变化并实现早期干预的综合数字健康解决方案:作为 iPREDICT 计划的一部分,通过对 221 名自述患有哮喘的患者(年龄≥ 18 岁)进行调查,对预测疾病控制变化的参数进行风险效益分析,从而确定哮喘诱发因素的特征。17 名健康志愿者(25-65 岁)测试了 13 种测量这些参数的设备,并评估了其可用性属性:结果:患者认为化学物质、过敏原、天气变化和体力活动等刺激因素是与哮喘控制恶化最相关的诱因。对健康志愿者进行的设备测试表明,数据格式/单位不一,存在数据缺失和信噪比低等质量问题。根据用户偏好和数据采集的有效性,肺活量计、生命体征监测仪和睡眠监测仪组成了 iPREDICT 集成系统,用于连续数据流,以开发个性化/预测性哮喘控制算法:这些发现强调了根据几个参数(包括可用性和数据质量)对设备进行系统比较的必要性,以便为哮喘护理开发集成数字技术程序。 关键词:哮喘、设备、数字、预测算法、传感器
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引用次数: 0
Risk Factors Associated with Asthma Control and Quality of Life in Patients with Mild Asthma Without Preventer Treatment, a Cross-Sectional Study 一项横断面研究:与未接受预防治疗的轻度哮喘患者的哮喘控制和生活质量相关的风险因素
IF 3.2 3区 医学 Q2 ALLERGY Pub Date : 2024-07-09 DOI: 10.2147/jaa.s460051
Sofia Eriksson, Maaike Giezeman, Mikael Hasselgren, Christer Janson, Marta A Kisiel, Scott Montgomery, Anna Nager, Hanna Sandelowsky, Björn Ställberg, Josefin Sundh, Karin Lisspers
<strong>Purpose:</strong> To study risk factors for uncontrolled asthma and insufficient quality of life (QoL) in patients with mild asthma, ie those without preventer treatment.<br/><strong>Patients and Methods:</strong> Patients aged 18– 75 years with a doctor’s diagnosis of asthma randomly selected from primary and secondary care in Sweden. Mild asthma was defined as self-reported current asthma and no preventer treatment. Data were collected from self-completed questionnaires in 2012 and 2015. Well-controlled asthma was defined as Asthma Control Test (ACT) ≥ 20 points and no exacerbation and uncontrolled asthma as ACT< 20 points and/or at least one exacerbation in the previous six months. QoL was measured by the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ), where a total mean score of ≥ 6 indicated sufficient and < 6 insufficient QoL. Multivariate logistic regression analyses were performed using asthma control and Mini-AQLQ as dependent variables. Asthma control was dichotomized as controlled and uncontrolled asthma and the Mini-AQLQ as sufficient QoL (mean score ≥ 6) and insufficient QoL (mean score < 6).<br/><strong>Results:</strong> Among 298 patients, 26% had uncontrolled asthma, 40% insufficient QoL and 20% both uncontrolled asthma and insufficient QoL. Age ≥ 60 years, obesity, daily smoking, rhinitis and inadequate knowledge of asthma self-management were independently associated with poor asthma control. Factors independently associated with insufficient QoL were age ≥ 60 years, overweight, obesity, rhinitis, sinusitis and inadequate knowledge of asthma self-management. Age ≥ 60 years, obesity, rhinitis and inadequate knowledge of asthma self-management were independently associated with both uncontrolled asthma and insufficient QoL.<br/><strong>Conclusion:</strong> Among asthma patients without preventer medication, 26% had uncontrolled asthma and 40% had insufficient asthma-related QoL. Older age, obesity, and rhinitis were risk factors for both poor asthma control and a reduced QoL, but having good knowledge of asthma self-management reduced this risk. Our findings suggest that this group of patients requires further attention and follow-up.<br/><br/><strong>Plain Language Summary:</strong> Many patients with little symptoms of asthma do not take asthma-preventer medication as their asthma is recognized as mild. Still, it is well-known that in this group there are patients with frequent and severe symptoms and acute attacks of asthma, defined as uncontrolled asthma. Quality of life (QoL) is less studied in these patients. Our aim was to study patient characteristics and factors with a higher risk for uncontrolled asthma and insufficient QoL in patients with mild asthma.<br/>We studied patients with asthma diagnosis 18– 75 of age in Sweden who reported asthma and no asthma preventer medication. They answered questionnaires about characteristics, knowledge of asthma, asthma symptoms, acute asthma attacks and QoL. A
目的:研究轻度哮喘患者(即未接受预防性治疗的患者)哮喘失控和生活质量(QoL)不足的风险因素:从瑞典的初级和中级医疗机构随机抽取 18-75 岁经医生诊断患有哮喘的患者。轻度哮喘的定义是自述目前患有哮喘且未接受预防性治疗的患者。数据来自 2012 年和 2015 年的自填问卷。哮喘控制测试(ACT)≥20 分且无恶化者为哮喘控制良好,ACT< 20 分和/或在过去六个月中至少有一次恶化者为哮喘失控。QoL 采用迷你哮喘生活质量问卷(Mini-AQLQ)进行测量,总平均分≥ 6 分表示 QoL 足够,< 6 分表示 QoL 不足。以哮喘控制和迷你哮喘生活质量问卷为因变量进行了多变量逻辑回归分析。哮喘控制被二分为哮喘控制和未控制,迷你AQLQ被二分为QoL足够(平均分≥6)和QoL不足(平均分< 6):在 298 名患者中,26% 的患者哮喘未得到控制,40% 的患者 QoL 不足,20% 的患者哮喘未得到控制且 QoL 不足。年龄≥60 岁、肥胖、每天吸烟、鼻炎和哮喘自我管理知识不足是哮喘控制不佳的独立相关因素。年龄≥60 岁、超重、肥胖、鼻炎、鼻窦炎和哮喘自我管理知识不足是与 QoL 不足独立相关的因素。年龄≥60 岁、肥胖、鼻炎和哮喘自我管理知识不足与哮喘未得到控制和 QoL 不足均有独立关联:结论:在未服用预防药物的哮喘患者中,26%的人哮喘未得到控制,40%的人与哮喘相关的生活质量不足。高龄、肥胖和鼻炎是导致哮喘控制不佳和生活质量下降的风险因素,但掌握良好的哮喘自我管理知识可降低这一风险。我们的研究结果表明,这部分患者需要进一步关注和随访。白话摘要:许多哮喘症状轻微的患者并没有服用预防哮喘的药物,因为他们的哮喘被认为是轻微的。然而,众所周知,在这一群体中,也有一些症状频繁且严重的患者,他们的哮喘会急性发作,被定义为不受控制的哮喘。对这些患者的生活质量(QoL)研究较少。我们的目的是研究轻度哮喘患者的特征以及哮喘失控和生活质量不高的风险较高的因素。我们的研究对象是瑞典 18-75 岁确诊为哮喘且未服用哮喘预防药物的患者。他们回答了有关特征、哮喘知识、哮喘症状、哮喘急性发作和 QoL 的问卷。他们还回答了一项哮喘症状控制测试,即哮喘控制测试(ACT),20 分或以上表示哮喘症状控制良好。如果患者在过去 6 个月中哮喘症状低于 20 分和/或至少有一次急性哮喘发作,则被视为哮喘未得到控制。生活质量通过迷你哮喘生活质量问卷进行测量。在 298 名患者中,26% 的患者哮喘未得到控制,40% 的患者生活质量不足,20% 的患者两者兼有。同时存在哮喘失控和生活质量不足风险的患者年龄在 60 岁及以上,患有肥胖症、鼻炎以及对如何应对哮喘认识不足的患者。我们的研究结果表明,轻度哮喘患者需要更多的关注、更好的管理和随访。
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引用次数: 0
Association Between Gut and Nasal Microbiota and Allergic Rhinitis: A Systematic Review 肠道和鼻腔微生物群与过敏性鼻炎的关系:系统性综述
IF 3.2 3区 医学 Q2 ALLERGY Pub Date : 2024-07-09 DOI: 10.2147/jaa.s472632
Yucheng Hu, Rong Zhang, Junjie Li, Huan Wang, Meiya Wang, Qiuyi Ren, Yueqi Fang, Li Tian
Abstract: Allergic rhinitis is a chronic non-infectious inflammation of the nasal mucosa mediated by specific IgE. Recently, the human microbiome has drawn broad interest as a potential new target for treating this condition. This paper succinctly summarizes the main findings of 17 eligible studies published by February 2024, involving 1044 allergic rhinitis patients and 954 healthy controls from 5 countries. These studies examine differences in the human microbiome across important mucosal interfaces, including the nasal and intestinal areas, between patients and controls. Overall, findings suggest variations in the gut microbiota between allergic rhinitis patients and healthy individuals, although the specific bacterial taxa that significantly changed were not always consistent across studies. Due to the limited scope of existing research and patient coverage, the relationship between the nasal microbiome and allergic rhinitis remains inconclusive. The article discusses the potential immune-regulating role of the gut microbiome in allergic rhinitis. Further well-designed clinical trials with large-scale recruitment of allergic rhinitis patients are encouraged.

Keywords: allergic rhinitis, microbiota dysbiosis, nasal microbiome, short-chain fatty acids, immunomodulation
摘要:过敏性鼻炎是由特异性 IgE 介导的鼻粘膜慢性非感染性炎症。最近,人类微生物组作为治疗这种疾病的潜在新靶点引起了广泛关注。本文简明扼要地总结了截至 2024 年 2 月发表的 17 项合格研究的主要发现,这些研究涉及来自 5 个国家的 1044 名过敏性鼻炎患者和 954 名健康对照者。这些研究考察了患者和对照组在鼻腔和肠道等重要粘膜界面上的人体微生物组差异。总体而言,研究结果表明,过敏性鼻炎患者和健康人的肠道微生物群存在差异,但不同研究中发生显著变化的具体细菌类群并不总是一致的。由于现有的研究范围和患者覆盖面有限,鼻腔微生物群与过敏性鼻炎之间的关系仍无定论。文章讨论了肠道微生物组在过敏性鼻炎中的潜在免疫调节作用。关键词:过敏性鼻炎;微生物群失调;鼻腔微生物群;短链脂肪酸;免疫调节
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引用次数: 0
Asthma Control and Associated Factors Among Children with Current Asthma - Findings from the 2019 Child Behavioral Risk Factor Surveillance System - Asthma Call-Back Survey. 当前哮喘儿童的哮喘控制情况及相关因素--2019 年儿童行为风险因素监测系统--哮喘回访调查的结果。
IF 3.7 3区 医学 Q2 ALLERGY Pub Date : 2024-06-27 eCollection Date: 2024-01-01 DOI: 10.2147/JAA.S465550
Bruck Messele Habte, Kebede A Beyene, Shivani A Patel, Teferi Gedif Fenta, Anne M Fitzpatrick

Purpose: This study aimed to determine the prevalence and correlates of uncontrolled asthma among children with current asthma in four US states. We also determined the rates and correlates of asthma-related hospitalization, urgent care center (UCC), or emergency department (ED) visits.

Participants and methods: We analyzed the 2019 Behavioral Risk Factor Surveillance Survey (BRFSS) Asthma Call-back Survey (ACBS) datasets. Asthma control status was classified as well-controlled or uncontrolled asthma based on day- and night-time asthma symptoms, activity limitation or use of rescue medications. Multivariable logistic regression models were used to identify the correlates of uncontrolled asthma and asthma-related hospitalization or UCC/ED visits.

Results: Among 249 children with current asthma, 55.1% had uncontrolled asthma while 40% reported asthma-related hospitalization or UCC/ED visits in the past year. Non-Hispanic ethnicity, ages of 0-9 and 15-17 years, household income <$25,000, and not having a flu vaccination had higher odds of uncontrolled asthma. Conversely, asthma self-management education and households with two children compared to one were positively associated with uncontrolled asthma. For healthcare utilization, male and non-Hispanic children, along with those from households earning <$25,000 exhibited higher odds of asthma-related hospitalization and UCC/ED visits.

Conclusion: Uncontrolled asthma and asthma-related visits to UCC/ED and hospitalization are common among children with current asthma. These outcomes are influenced by low household income and male sex, among other factors which call for multi-faceted interventions by healthcare providers and policymakers. Targeted strategies to effectively manage asthma and reduce the need for emergency healthcare services are recommended.

目的:本研究旨在确定美国四个州目前患有哮喘的儿童中哮喘未得到控制的患病率及其相关因素。我们还确定了与哮喘相关的住院、紧急护理中心(UCC)或急诊科(ED)就诊率及其相关性:我们分析了 2019 年行为风险因素监测调查(BRFSS)哮喘回访调查(ACBS)数据集。根据白天和夜间哮喘症状、活动受限或使用抢救药物的情况,将哮喘控制状况分为控制良好和控制不良。多变量逻辑回归模型用于确定未控制哮喘与哮喘相关住院或 UCC/ED 就诊的相关性:结果:在 249 名患有哮喘的儿童中,55.1% 的儿童哮喘未得到控制,40% 的儿童在过去一年中接受过与哮喘相关的住院治疗或 UCC/ED 就诊。非西班牙裔、年龄在 0-9 岁和 15-17 岁之间、家庭收入 结论:哮喘是一种常见的慢性疾病:在目前患有哮喘的儿童中,哮喘得不到控制以及与哮喘相关的 UCC/ED 就诊和住院治疗很常见。除其他因素外,这些结果还受到低收入家庭和男性性别的影响,因此需要医疗服务提供者和政策制定者采取多方面的干预措施。建议采取有针对性的策略,有效管理哮喘并减少对急诊医疗服务的需求。
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引用次数: 0
High Serum Allergen-Specific IgE of House Dust Mite in Predicting the Risk of Comorbidity in Children with Allergic Conjunctivitis. 预测过敏性结膜炎患儿合并症风险的高血清屋尘螨过敏原特异性 IgE
IF 3.7 3区 医学 Q2 ALLERGY Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI: 10.2147/JAA.S467671
Xiao-Jiao Tang, Jia-Tong He, Qing Liu, Enmei Liu, Lin Chen

Purpose: To investigate the patterns of allergens in allergic conjunctivitis (AC) and the association with allergic comorbidity.

Methods: This retrospective cross-sectional study enrolled 2972 children with AC. Clinical data, including sex, age, allergic comorbidities (allergic asthma, allergic rhinitis, and atopic dermatitis), and serum allergen-specific immunoglobulin E (sIgE), were collected from the electronic medical record (EMR). The categorical variables were compared with the chi-square test. The characteristics of allergens in children of different ages and comorbidities were analyzed by trend chi-square. The sensitivity level of HDM associated with AC and comorbidities was assessed by odds ratios (ORs) with 95% confidence intervals of logistic regression analysis.

Results: A total of 2972 children (2015 boys and 957 girls) with AC were included in the study. The mean age was 3.78 (0.5~12) years. The most common allergen was house dust mite(HDM) (43.41%). With age, the positive rate for inhaled allergens gradually increased, and the positive rate for ingested allergens decreased. With the number of comorbidities increasing, the positive rates of sensitization were 38.33%, 74.51%, 80.72%, and 89.05%, and the incidence of polysensitization was 44.66%, 56.48%, 59.54%, and 74.59%, respectively. With the increase of HDM-sIgE level, the number of comorbidities and the risk increased gradually.

Conclusion: HDM is the most common allergen in AC children of different ages. High levels of HDM-sIgE may be a predictor for allergic comorbidities. Children with polysensitization and high levels of HDM sIgE will be an important target population for future intervention in other allergy-related disease prevention.

目的:研究过敏性结膜炎(AC)的过敏原模式以及与过敏性合并症的关系:这项回顾性横断面研究共纳入 2972 名过敏性结膜炎患儿。从电子病历(EMR)中收集了临床数据,包括性别、年龄、过敏性合并症(过敏性哮喘、过敏性鼻炎和特应性皮炎)以及血清过敏原特异性免疫球蛋白 E(sIgE)。分类变量采用卡方检验进行比较。对不同年龄和合并症儿童的过敏原特征进行了趋势卡方分析。通过几率比(ORs)和95%置信区间的逻辑回归分析,评估了与AC和合并症相关的HDM的敏感性水平:共有 2972 名儿童(2015 名男孩和 957 名女孩)患有先天性心脏病。平均年龄为 3.78(0.5~12)岁。最常见的过敏原是屋尘螨(HDM)(43.41%)。随着年龄的增长,吸入过敏原的阳性率逐渐升高,摄入过敏原的阳性率逐渐降低。随着合并症数量的增加,过敏阳性率分别为 38.33%、74.51%、80.72% 和 89.05%,多过敏发生率分别为 44.66%、56.48%、59.54% 和 74.59%。随着 HDM-sIgE 水平的升高,合并症的数量和风险也逐渐增加:结论:HDM是不同年龄段AC儿童最常见的过敏原。结论:HDM 是不同年龄 AC 儿童最常见的过敏原,高水平的 HDM-sIgE 可预测过敏性合并症。多敏性和高水平 HDM sIgE 的儿童将成为未来干预其他过敏相关疾病预防的重要目标人群。
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Journal of Asthma and Allergy
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