Journal of Asthma and Allergy最新文献

Aim: This study aimed to systematically analyze the neuro-regulation mechanisms of airway hyperreactivity disease using bibliometrics, focusing on the research status and progress of two key regulatory networks: the "lung-brain axis" and the "nasal-brain axis", to further characterize the "nasal-brain axis".

Methods: A bibliometric analysis of 626 articles published between 1991 and 2024 was conducted to assess the growing interest in the impact of neuro-immune mechanisms and psychological stress on airway diseases, including asthma and allergic rhinitis (AR).

Results: The study findings revealed that interactions between neuro-immune signaling pathways and the central nervous system are crucial for understanding airway hyperreactivity, with the United States leading research contributions. Key themes identified in this study include allergic asthma, neuroinflammation, and the lung-brain axis, revealing bidirectional communication pathways between peripheral and central immune responses.

Conclusion: Based on studies of asthma and the lung-brain axis, we anticipate that AR and the nasal-brain axis likely involve similar neuro-immune mechanisms and peripheral-central response circuits. The nasal-brain axis theory was further supported by its integration with the unified airway hypothesis, solidifying its role as a crucial regulatory mechanism in airway inflammation research.

Objective: Airborne pollen is a major contributor to allergic diseases. This study investigates the correlation between airborne pollen dynamics and allergic rhinitis (AR) incidence in Xi'an (2020-2023) and compared with 1984 data for informing evidence-based prevention strategies.

Methods: The species and concentration of daily pollen in Xi'an were monitored for 4 consecutive years (2020-2023). Daily pollen concentrations were analyzed alongside clinical AR records from the Second Affiliated Hospital of Xi'an Jiaotong University and public health awareness metrics (Baidu search indices for "allergic rhinitis", "pollen allergy", and "loratadine").

Results: The pollen season in Xi'an occurred from March to May and from August to October, with higher concentrations in spring. Compared to the 1984 data, pollen counts increased significantly (+121.9%, P>0.05). Correlation analysis revealed a positive relationship between pollen concentration and the number of AR patients during the autumn pollen season from 2020 to 2022 (r=0.307~0.636, P<0.05). "Pollen allergy" search index correlated positively lwith pollen concentration over the four-year autumn period (r=0.512~0.750, P<0.001), while trends for "allergic rhinitis" and "loratadine" search indices were less consistent, showing positive correlation only in the autumn pollen season. The public perception of sensitized pollen species in Xi'an did not match the actual AR-related pollen species.

Conclusion: Pollen counts increased significantly in Xi'an, whereas pollen species diversity decreased in the last 40 years. Our results showed the 40-year characteristics comparison of pollen concentration in Xi'an can serve as a basis for developing effective preventive and management measures for patients with pollen-related allergies, including environmental control, timely pollen monitoring, desensitization therapy, and patient health education, to guide the scientific control and prevention of pollen-induced allergic diseases. This study underscores the need for integrated environmental and public health strategies to mitigate pollen-induced AR in rapidly urbanizing regions.

Background: Increasing physical activity is recommended as a non-pharmacological approach for improving the symptoms, quality of life, and overall health in patients with asthma. However, the systemic effect of physical activity, especially sedentary behavior, in patients with asthma remains unclear.

Objective: The aim of this study was to investigate the association of objectively measured physical activity, including sedentary time, with body composition data and clinical characteristics in patients with asthma.

Methods: The study included 85 patients with asthma and 38 healthy controls. Physical activity indices were assessed for 2 weeks using accelerometers. We investigated the relationship between physical activity levels and clinical characteristics, along with its association with body composition data assessed using dual-energy X-ray absorptiometry and computed tomography in patients with asthma.

Results: In patients with asthma, high blood eosinophil counts and poor asthma control, as assessed by the Asthma Control Questionnaire score, were associated with prolonged sedentary time and reduced step count. Moreover, reduced step count was independently associated with an elevated fat mass index, whereas a prolonged sedentary time and high oral corticosteroid doses were independently associated with a low lean mass index in patients with asthma. Prolonged sedentary time demonstrated a negative correlation with erector spinae muscle area after adjusting for background factors.

Conclusion: Sedentary behavior and physical inactivity are associated with body composition in patients with asthma, suggesting the need for interventions targeting these behaviors to improve health outcomes.

Objective: To assess the efficacy and safety of the combination of N-acetylcysteine and acebrophylline (Combination named Abiways), in patients with moderate to severe COPD and Asthma.

Materials and methods: In this non-randomized, interventional, prospective, single-arm, post-marketing surveillance study, participants were administered Abiways as an add-on therapy for 90 days. The primary endpoint was Quality of Life, evaluated using the COPD Assessment Test (CAT) and Asthma Control Test (ACT) questionnaires. Secondary endpoints included mean FEV1 and FVC changes. Adverse events were recorded throughout the study.

Results: 97 (of 102 subjects enrolled) completed the study (76 COPD and 21 Asthma patients, respectively; mean age 57.9 ± 8.1 years; 33 females, 64 males). Overall, FEV1 improved significantly from 1.287L to 1.484L (p < 0.001) with similar statistical improvements in COPD (1.237 L to 1.414 L; p = 001) and asthma (1.477 L to 1.747 L; p = 0.004) subpopulations. COPD patients showed statistically significant improvements in CAT scores (17.2 ± 1.0 to 10.6 ± 0.9, p = 0.0001); however, such significance was not observed in the ACT scores for asthma patients. FVC remained unchanged in all subgroups. No severe adverse events were reported.

Conclusion: The combination of N-acetylcysteine and acebrophylline improves QoL in moderate to severe COPD patients and FEV1 in both COPD and asthma patients with a favorable safety and tolerability profile. The combination appears safe and effective for managing obstructive airway disease.

Background: Benralizumab, targeting the IL-5 receptor, reduces exacerbations and improves lung function in severe eosinophilic asthma. Data on its effect on fractional exhaled nitric oxide (FeNO), particularly in patients with and without chronic rhinosinusitis with nasal polyps (CRSwNP), are limited.

Objective: This study evaluates benralizumab's impact on FeNO levels in severe eosinophilic asthma, focusing on the presence of CRSwNP.

Methods: We retrospectively analyzed 43 patients with severe eosinophilic asthma treated with benralizumab. Patients were divided into CRSwNP (N=13) and non-CRSwNP (N=30) groups. Baseline characteristics, FeNO levels, FEV1, FVC, ACT scores, exacerbations, and oral corticosteroid (OCS) use were recorded at baseline, 3, 6, and 12 months.

Results: At baseline, FeNO levels were higher in CRSwNP patients than in non-CRSwNP (82.80 ppb vs 41.86 ppb, P = 0.019). Over 12 months, FeNO significantly decreased in CRSwNP patients (-29.69 ppb, P = 0.036) and remained stable in non-CRSwNP patients (+3.55 ppb, P = 0.036). Significant improvements were observed in FEV1 (0.59L vs 0.38L, P = 0.017) and ACT scores (6.46 vs 4.01, P < 0.001) in CRSwNP patients. Both groups showed a notable reduction in exacerbations, which was more pronounced in CRSwNP patients (-3.12 vs -3.60, P < 0.001). OCS withdrawal was achieved in 53.8% of CRSwNP patients and 43.3% of non-CRSwNP patients.

Conclusion: Benralizumab reduces FeNO levels and improves clinical outcomes in severe eosinophilic asthma, especially in patients with CRSwNP. Monitoring FeNO levels provides additional insights into treatment response, highlighting its potential role as a marker in specific patient subgroups.

Patients with asthma frequently experience recurrent symptoms including coughing, wheezing, shortness of breath, and chest tightness. Asthma is a common public health concern. It is characterized by chronic airway inflammation. However, The pathogenesis of asthma is complex. Inflammasomes are signaling platforms that regulate the inflammatory response. There is a correlation between inflammasomes and asthma. Pattern recognition receptors recognize danger signals and participate in inflammasome activation. Nucleotide-binding and oligomerization domain-containing 2 (NOD2), a pattern recognition receptor, senses microbial components and triggers immune responses. There have been studies showing a correlation between NOD2 and asthma. The nucleotide-binding oligomerization domain-like receptor containing pyrin domain 3 (NLRP3) participates in the formation of inflammasomes. NLRP3 are involved in asthma pathogenesis. In this review, we discuss the roles of NOD2 and NLRP3 in the pathogenesis of asthma.

The incidence of allergic diseases has been increasing annually, severely affecting the quality of life of patients. With the growing recognition of traditional medicine, acupuncture, an ancient Chinese therapeutic method, has gradually gained attention for its potential in immune modulation. Studies have shown that macrophages play a crucial role in the development of allergic diseases, and acupuncture may influence allergic reactions by modulating the function of macrophages. This article aims to systematically evaluate the regulatory effects of acupuncture on macrophages in allergic diseases and the corresponding mechanisms. It analyzes existing research findings and explores the clinical application prospects of acupuncture in this context. By understanding how acupuncture affects the activation, secretion, and role of macrophages in immune responses, we hope to provide new insights and directions for the treatment of allergic diseases.

This study aims to demonstrate the bibliometric characteristics of articles on biologics for asthma treatment over the past two decades. There were 3395 articles published in 653 journals from 91 countries/regions from January 1, 2000 to September 30, 2023. The results showed biologics changes the course of asthma has attracted the interest of researchers and asthma remission has recently been proposed by researchers. Therefore, the goal of T2-high asthma management was shifted from controlling to complete remission. There was also growing interest among researchers in alleviating symptoms in T2-low asthma. New biological targets also need to be discovered when patients do not achieve satisfactory therapeutic outcomes with biologic agent, and one of the potential future direction for a treatment breakthrough lies in the combination of two biologics or the utilization of novel biologics that target dual sites. The development of biologics has progressed rapidly and has demonstrated their effectiveness in clinic, however, biologics still face multifaceted challenges and require further research to identify additional targets or enhance efficacy.

Biologic therapies have revolutionized the management of severe asthma (SA), offering significant symptom control and reduced exacerbations for many patients. However, up to 25% of individuals do not show satisfactory responses to these treatments and are categorized as non-responders. Definitions of response and primary non-response to biologics in SA are well-established. In secondary nonresponse, patients show initial response to biological treatment in the first 6-12 months but later lose asthma control, and in SA this phenomenon remains undefined and unstudied in literature. We present 4 cases of severe asthma treated with different biologic agents. All patients demonstrated significant clinical improvement during the first 12 months of therapy but followed by a gradual loss of asthma control, indicative of secondary nonresponse. We discuss the clinical features, potential mechanisms, and implications of secondary nonresponse to biologics in severe asthma, highlighting an unmet need for further research to define this phenomenon and guide future therapeutic strategies.

Background: Eosinophilic gastrointestinal disorders (EGIDs) are chronic immune-mediated conditions characterized by pathological eosinophilic infiltration. The clinical features and therapies for eosinophilic esophagitis (EoE) vary between children and adults. However, there is limited comparison of non-EoE EGIDs across different ages of disease onset.

Methods: We retrospectively analyzed data that included 94 patients (12 juveniles, 57 young adults, and 23 older adults) with a history of non-EoE EGIDs managed in a tertiary hospital.

Results: The study included patients with a mean onset age of 36.6 years, 52.1% of whom had allergic comorbidities. Diarrhea was more common in young adults (18-49 years), while nausea and vomiting were predominant in juveniles (0-17 years) compared to older adults (≥50 years). Reduced flatulence and/or defecation were less common in young adults. Ascites were less frequent in older adults. Notably, patients with the same affected gastrointestinal site also exhibited varying manifestations across age groups: young adults with gastric or ileal involvement had higher diarrhea rates (64% and 68.4%, respectively, p < 0.05), while juveniles with gastric/duodenal involvement exhibited higher nausea, vomiting, and ascites, and those with ileal involvement showed higher ascites (p =0.031). Young adults with colonic involvement had reduced flatulence/defecation less frequently (p = 0.005). Juveniles had significantly higher peripheral eosinophil counts (p = 0.040), and higher total serum IgE levels (p =0.002) compared to older adults. Serum albumin levels were significantly higher, and erythrocyte sedimentation rate (ESR) was significantly lower in the juvenile group compared to the young adult group (p = 0.004, p = 0.045) and the older adult group (p = 0.002, p = 0.002).

Conclusion: Clinical phenotypes of patients with non-EoE EGIDs vary by age of onset. A comprehensive understanding of the features in symptoms and therapies across different age groups can help accelerate diagnosis and enhance patient care.