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Journal of Asthma and Allergy

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https://www.readbyqxmd.com/read/29445292/late-onset-asthma-current-perspectives
#1
REVIEW
Tsunahiko Hirano, Kazuto Matsunaga
Because the pathophysiology of asthma has diverse characteristics, to manage the disease effectively, it is important for clinicians to distinguish among the clinical phenotypes. Among them, adult-onset asthma, that is, late-onset asthma (LOA), is increasing because of the aging of the population. The phenotype of LOA is largely divided into two types according to the presence or absence of eosinophilic inflammation, T-helper (Th)2- and non-Th2-associated LOA. Especially in Th2 LOA related to rhinosinusitis, as pulmonary function at onset is poor and asthma exacerbations occur frequently, it is important to detect this phenotype in the early phase by using a biomarker of Th2-type inflammation such as fractional exhaled nitric oxide (FE NO )...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29398922/severe-bronchial-asthma-in-children-a-review-of-novel-biomarkers-used-as-predictors-of-the-disease
#2
REVIEW
Samuel N Uwaezuoke, Adaeze C Ayuk, Joy N Eze
Severe asthma or therapy-resistant asthma in children is a heterogeneous disease that affects all age-groups. Given its heterogeneity, precision in diagnosis and treatment has become imperative, in order to achieve better outcomes. If one is thus able to identify specific patient phenotypes and endotypes using the appropriate biomarkers, it will assist in providing the patient with more personalized and appropriate treatment. However, there appears to be a huge diagnostic gap in severe asthma, as there is no single test yet that accurately determines disease phenotype...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29296089/elevated-fractional-exhaled-nitric-oxide-and-blood-eosinophil-counts-are-associated-with-a-17q21-asthma-risk-allele-in-adult-subjects
#3
Elizabeth A Schwantes, Michael D Evans, Alex Cuskey, Alex Burford, Judith A Smith, Robert F Lemanske, Nizar N Jarjour, Sameer K Mathur
Background and objectives: Genome-wide association studies identified single-nucleotide polymorphisms (SNPs) at the 17q21 locus conferring increased risk for childhood-onset asthma. Little is known about how these SNPs impact adult asthma patients. We sought to examine an adult population for associations between rs7216389 (17q21-associated SNP) and features of asthma including fractional exhaled nitric oxide (FeNO), eosinophil counts, and age of asthma onset. Methods: Subjects were genotyped at SNP rs7216389...
2018: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29290688/recovery-of-hypothalamo-pituitary-adrenal-axis-suppression-during-treatment-with-inhaled-corticosteroids-for-childhood-asthma
#4
Arundoss Gangadharan, Paul McCoy, Aye Phyo, Michael P McGuigan, Poonam Dharmaraj, Renuka Ramakrishnan, Paul S McNamara, Joanne Blair
Objective: To describe recovery of adrenal insufficiency in asthmatic children treated with inhaled corticosteroids (ICS) and cortisol replacement therapy. Design: Retrospective, observational study. Patients: A total of 113 patients, 74 male; age 10.4 (3.3-16.5) years; beclomethasone-equivalent ICS dose, 800 μg, (100-1,000), tested by low dose short Synacthen (tetracosactide) test (LDSST), were studied. Test results were classified by basal and peak cortisol concentration: "normal" (basal >100 nmol/L, peak >500 nmol/L), "suboptimal" (basal >100 nmol/L, peak 350-499 nmol/L), "abnormal" (basal <100 nmol/L and/or peak <350 nmol/L)...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29238209/transplant-acquired-food-allergy-current-perspectives
#5
REVIEW
Shweta S Hosakoppal, Paul J Bryce
Mechanisms that regulate the tolerance to dietary proteins or the loss of this and subsequent development of disease are poorly understood. In food allergy, there is growing awareness of the urgency in understanding these events to aid in the development of next-generation therapies and interventions. This review focuses on the accumulating evidence related to food allergy that develops after transplantation. This intriguing immunological phenomenon has been described in several different types of transplant settings and to variety of different foods...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29238208/is-it-severe-asthma-or-asthma-with-severe-comorbidities
#6
Luisa Brussino, Paolo Solidoro, Giovanni Rolla
Severe asthma is defined as asthma that requires treatment with high-dose inhaled corticosteroids (ICSs) plus a second controller and/or systemic corticosteroids to prevent it from becoming uncontrolled or that remains uncontrolled despite this therapy. This definition has limitations: 1) it does not define any biological characteristic that distinguishes severe asthma from asthma in general and 2) it relies on the clinical interpretation of asthma symptoms that are not specific. Actually, wheezing, dyspnea, cough and chest tightness may be caused by the comorbidities (such as rhinosinusitis, obesity and vocal cord dysfunction [VCD]) which are associated with asthma...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29158683/animal-models-of-asthma-utility-and-limitations
#7
REVIEW
Marcelo Vivolo Aun, Rafael Bonamichi-Santos, Fernanda Magalhães Arantes-Costa, Jorge Kalil, Pedro Giavina-Bianchi
Clinical studies in asthma are not able to clear up all aspects of disease pathophysiology. Animal models have been developed to better understand these mechanisms and to evaluate both safety and efficacy of therapies before starting clinical trials. Several species of animals have been used in experimental models of asthma, such as Drosophila, rats, guinea pigs, cats, dogs, pigs, primates and equines. However, the most common species studied in the last two decades is mice, particularly BALB/c. Animal models of asthma try to mimic the pathophysiology of human disease...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29066920/study-of-the-clinical-and-functional-characteristics-of-asthmatic-children-with-obstructive-sleep-apnea
#8
Yen Nguyen-Hoang, Thuy Nguyen-Thi-Dieu, Sy Duong-Quy
BACKGROUND AND OBJECTIVE: The obstructive sleep apnea (OSA) is a common respiratory disorder in children, especially those at preschool and school ages. This study aimed to describe the characteristics of asthmatic children with OSA and the symptoms for a high risk of OSA. SUBJECTS AND METHODS: It was a prospective and descriptive study. The data of asthmatic children including medical history, clinical examination, blood tests, spirometry, exhaled nitric oxide (NO), and respiratory polygraphy were registered for analyses...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29066919/differentiating-vocal-cord-dysfunction-from-asthma
#9
REVIEW
Andrew Fretzayas, Maria Moustaki, Ioanna Loukou, Konstantinos Douros
Vocal cord dysfunction (VCD)-associated symptoms are not rare in pediatric patients. Dyspnea, wheezing, stridor, chest pain or tightness and throat discomfort are the most commonly encountered symptoms. They may occur either at rest or more commonly during exercise in patients with VCD, as well as in asthmatic subjects. The phase of respiration (inspiration rather than expiration), the location of the wheezing origin, the rapid resolution of symptoms, and the timing occurring in relation to exercise, when VCD is exercise induced, raise the suspicion of VCD in patients who may have been characterized as merely asthmatics and, most importantly, had not responded to the appropriate treatment...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29066918/asthma-with-bronchial-hypersecretion-expression-of-mucins-and-toll-like-receptors-in-sputum-and-blood
#10
Astrid Crespo-Lessmann, Eder Mateus, Montserrat Torrejón, Alicia Belda, Jordi Giner, Silvia Vidal, Oriol Sibila, Vicente Plaza
Asthma with bronchial hypersecretion is a type of asthma that is poorly studied. Its pathogenesis is not well understood, but is probably related to innate impaired immunity, particularly with toll-like receptors (TLRs) and secretory mucins (MUC). OBJECTIVES: 1) Define the clinical and inflammatory phenotype of asthma with bronchial hypersecretion of mucus. 2) Compare the type of mucin present in induced sputum (IS) of patients with and without bronchial hypersecretion. 3) Determine the expression of TLRs in IS and blood of asthmatics with and without bronchial hypersecretion...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29042800/postpartum-airway-responsiveness-and-exacerbation-of-asthma-during-pregnancy-a-pilot-study
#11
Zarqa Ali, Lisbeth Nilas, Charlotte Suppli Ulrik
BACKGROUND: Airway responsiveness and inflammation are associated with the clinical manifestations of asthma and the response to pharmacological therapy. OBJECTIVE: To investigate if airway responsiveness and inflammatory characteristics are related to asthma exacerbations during pregnancy. MATERIALS AND METHODS: In women with asthma who were prescribed controller medication and monitored closely during pregnancy, the risk of exacerbations was analyzed in relation to postpartum measures of fractional exhaled nitric oxide (FENO), skin prick test reactivity, static and dynamic lung volumes, diffusing capacity for carbon monoxide, bronchial responsiveness to inhaled mannitol, and inflammatory characteristics in induced sputum...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/29042799/asthma-symptoms-mannitol-reactivity-and-exercise-induced-bronchoconstriction-in-adolescent-swimmers-versus-tennis-players
#12
Kerstin Romberg, Ellen Tufvesson, Leif Bjermer
BACKGROUND: Strenuous physical activity at an elite level is associated with an increased risk for asthma and, in some sports, also prevalence of allergies. The aim of this study was to investigate the prevalence of asthma and allergy among elite swimmers and tennis players and compare airway hyperreactivity to mannitol and exercise. MATERIALS AND METHODS: One hundred and one adolescent swimmers and 86 tennis players answered a questionnaire about respiratory symptoms and allergy and performed mannitol challenge and sport-specific exercise challenge...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28919788/innovative-treatments-for-severe-refractory-asthma-how-to-choose-the-right-option-for-the-right-patient
#13
REVIEW
Francesco Menzella, Carla Galeone, Francesca Bertolini, Claudia Castagnetti, Nicola Facciolongo
The increasing understanding of the molecular biology and the etiopathogenetic mechanisms of asthma helps in identification of numerous phenotypes and endotypes, particularly for severe refractory asthma. For a decade, the only available biologic therapy that met the unmet needs of a specific group of patients with severe uncontrolled allergic asthma has been omalizumab. Recently, new biologic therapies with different mechanisms of action and targets have been approved for marketing, such as mepolizumab. Other promising drugs will be available in the coming years, such as reslizumab, benralizumab, dupilumab and lebrikizumab...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28860828/the-evolving-role-of-tiotropium-in-asthma
#14
REVIEW
Emma R McIvor, R Andrew McIvor
Tiotropium is a long-acting muscarinic antagonist (LAMA) that exerts its bronchodilatory effect by blocking endogenous acetylcholine receptors in the airways. Its safety and efficacy are well established for the treatment of COPD, and it is now being recognized for its role in improving lung function and control in asthma. This review discusses the evolving role of tiotropium delivered by the Respimat® in patients across the range of asthma severities and ages, and provides an overview of safety and efficacy data...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28794646/bronchial-thermoplasty-implementing-best-practice-in-the-era-of-cost-containment
#15
Laren D Tan, Nicholas Kenyon, Ken Y Yoneda, Samuel Louie
Increasing dependence on advanced technologies in the 21st century has created a dilemma between the practice and business of medicine. From information technology to robotic surgery, new technologies have expanded treatment possibilities and have potentially improved patient outcomes and safety. Simultaneously, their escalating costs limit access for certain patients and health care facilities. Nevertheless, medical decisions should not simply be based on cost. Input from physicians and other health care specialists as well as adherence to best practice position statements, are vital to implementing truly cost-effective strategies in medicine...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28794645/asthma-referrals-a-key-component-of-asthma-management-that-needs-to-be-addressed
#16
REVIEW
David Price, Leif Bjermer, David A Bergin, Rafael Martinez
Heterogeneity of asthma and difficulty in achieving optimal control are the major challenges in the management of asthma. To help attain the best possible clinical outcomes in patients with asthma, several guidelines provide recommendations for patients who will require a referral to a specialist. Such referrals can help in clearing the uncertainty from the initial diagnosis, provide tailored treatment options to patients with persistent symptoms and offer the patients access to health care providers with expertise in the management of the asthma; thus, specialist referrals have a substantial impact on disease prognosis and the patient's health status...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28721077/food-protein-induced-enterocolitis-syndrome-a-review-of-the-literature-with-focus-on-clinical-management
#17
REVIEW
Marine Michelet, Dominique Schluckebier, Laetitia-Marie Petit, Jean-Christoph Caubet
Food protein-induced enterocolitis syndrome (FPIES) is a potentially severe presentation of non-IgE-mediated gastrointestinal food allergy (non-IgE-GI-FA) with heterogeneous clinical manifestations. Acute FPIES is typically characterized by profuse vomiting and lethargy, occurring classically 1-4 hours after ingestion of the offending food. When continuously exposed to the incriminated food, a chronic form has been described with persistent vomiting, diarrhea, and/or failure to thrive. Although affecting mainly infants, FPIES has also been described in adults...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28670135/evaluating-asthma-websites-using-the-brief-discern-instrument
#18
Nancy Cantey Banasiak, Mikki Meadows-Oliver
PURPOSE: The primary purpose of this study was to examine the quality of sponsored and unsponsored asthma websites using the Brief DISCERN instrument and to evaluate whether the Health On the Net Code of Conduct (HONcode) logo was present, thereby indicating that the site met the criteria. The Internet is an important source of health information for patients and their families. The primary purpose of this study was to examine the quality of sponsored and unsupported asthma websites. A secondary aim was to determine the readability and reading ease of the materials for each website along with the grade level...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28572736/asthma-like-airway-inflammation-and-responses-in-a-rat-model-of-atopic-dermatitis-induced-by-neonatal-capsaicin-treatment
#19
Rafael Taeho Han, Sewon Kim, Kyungmin Choi, Hyeonseok Jwa, JaeHee Lee, Hye Young Kim, Hee Jin Kim, Hang-Rae Kim, Seung Keun Back, Heung Sik Na
Recent studies have shown that approximately 70% of patients with severe atopic dermatitis (AD) develop asthma. Development of AD in infancy and subsequent other atopic diseases such as asthma in childhood is referred to as atopic march. However, a causal link between the diseases of atopic march has remained largely unaddressed, possibly due to lack of a proper animal model. Recently, we developed an AD rat model showing chronically relapsing dermatitis and scratching behaviors induced by neonatal capsaicin treatment...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28553127/real-world-health-care-utilization-in-asthma-patients-using-albuterol-sulfate-inhalation-aerosol-proair-%C3%A2-hfa-with-and-without-integrated-dose-counters
#20
Edward M Kerwin, Thomas J Ferro, Rinat Ariely, Debra E Irwin, Ruchir Parikh
BACKGROUND: Accurate tracking of the administered dose of asthma rescue inhalers is critical for optimal disease management and is related to reductions in rates of unscheduled health care utilization in asthma patients. There are few published data on the real-world impact of rescue inhalers with integrated dose counters (IDCs) on health care resource utilization (HRU) for asthma patients. This study evaluates HRU among users of ProAir(®) hydrofluoroalkane (HFA) (albuterol sulfate inhalation aerosol), with IDC versus without IDC, in asthma patients...
2017: Journal of Asthma and Allergy
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