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exacerbation of asthma

Heather M Young, Fumin Guo, Rachel L Eddy, Geoffrey Maksym, Grace Parraga
Ventilation heterogeneity is a hallmark finding in obstructive lung disease and may be evaluated using a variety of methods including multiple-breath gas-washout and pulmonary imaging. Such methods provide an opportunity to better understand the relationships between structural and functional abnormalities in the lungs, and their relationships with important clinical outcomes. We measured ventilation heterogeneity and respiratory impedance in 100 subjects (50 asthmatics, 22 ex-smokers and 28 COPD), using oscillometry and hyperpolarized3 He magnetic resonance imaging (MRI) and determined their relationships with quality-of-life scores and disease control/exacerbations...
March 15, 2018: Journal of Applied Physiology
Mei Mei, Haojun Song, Lina Chen, Bin Hu, Ru Bai, Diandou Xu, Ying Liu, Yuliang Zhao, Chunying Chen
BACKGROUND: Epidemiological studies have suggested that elevated levels of air pollution contribute to an increased incidence or severity of asthma. Although late-onset adult asthma seems to be more attributable to environmental risk factors, limited data is available on the impact of early-life exposure to size-fractionated ambient particulate matter (PM) on asthma in adults. We aimed to determine the effect on the development and exacerbation of asthma in the adult after the mice were exposed as juveniles to three size-fractionated ambient particulates collected from Beijing...
March 14, 2018: Particle and Fibre Toxicology
Celeste Porsbjerg, Charlotte Ulrik, Tina Skjold, Vibeke Backer, Birger Laerum, Sverre Lehman, Crister Janson, Thomas Sandstrøm, Leif Bjermer, Barbro Dahlen, Bo Lundbäck, Dora Ludviksdottir, Unnur Björnsdóttir, Alan Altraja, Lauri Lehtimäki, Paula Kauppi, Jussi Karjalainen, Hannu Kankaanranta
Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma ('difficult asthma') should undergo systematic assessment, in order to differentiate between true severe asthma, and 'difficult-to-treat' patients, in whom poor control is related to factors such as poor adherence or co-morbidities...
2018: European Clinical Respiratory Journal
Yrina Rochman, Krista Dienger-Stambaugh, Phoebe K Richgels, Ian P Lewkowich, Andrey V Kartashov, Artem Barski, Gurjit K Khurana Hershey, Warren J Leonard, Harinder Singh
Pathogenic T helper 2 (TH 2) cells, which produce increased amounts of the cytokines interleukin-5 (IL-5) and IL-13, promote allergic disorders, including asthma. Thymic stromal lymphopoietin (TSLP), a cytokine secreted by epithelial and innate immune cells, stimulates such pathogenic TH 2 cell responses. We found that TSLP signaling in mouse CD4+ T cells initiated transcriptional changes associated with TH 2 cell programming. IL-4 signaling amplified and stabilized the genomic response of T cells to TSLP, which increased the frequency of T cells producing IL-4, IL-5, and IL-13...
March 13, 2018: Science Signaling
Giuseppe Brescia, Daniela Parrino, Lorenzo Nicolè, Claudia Zanotti, Cristiano Lanza, Umberto Barion, Filippo Marino, Gino Marioni
PURPOSE: The term aspirin-exacerbated respiratory disease (AERD) refers to a combination of asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), and acute respiratory tract reactions to nonsteroidal anti-inflammatory drugs. AERD has now been included among the CRSwNP endotypes, and is considered one of the most aggressive in terms of disease recurrence. Cortactin is a multi-domain protein with a part in several cellular mechanisms involving actin assembly and cytoskeleton arrangement...
March 5, 2018: American Journal of Otolaryngology
B Xing, J T Lin, H P Tang, L Yang, Y D Yuan, Y H Gu, P Chen, X J Liu, J Zhang, H G Liu, C Z Wang, W Zhou, D J Sun, Y Q Chen, Z C Chen, M Huang, Q C Lin, C P Hu, X H Yang, J M Huo, X W Ye, X Zhou, P Jiang, W Zhang, Y J Huang, L M Dai, R Y Liu, S X Cai, J Y Xu, J Y Zhou
Objective: To study the treatment of patients hospitalized for asthma exacerbation in China. Methods: This was a retrospective study and involved patients hospitalized for asthma exacerbation in 29 hospitals throughout China during Jan 2013 to Dec 2014. Information of the demographic features, the severity of the exacerbation, the medicine prescribed during the hospitalization and the use of mechanical ventilation were collected and analyzed. Results: During the study period, there were 3 240 patients hospitalized for asthma exacerbation, and 1 369(42...
February 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Jisoo Park, Eun Kyung Kim, Mi Ae Kim, Tae Hyung Kim, Jung Hyun Chang, Yon Ju Ryu, Sei Won Lee, Yeon Mok Oh, Suk Joong Yong, Won Il Choi, Kwang Ha Yoo, Ji Hyun Lee
BACKGROUND: Obstructive airway disease patients with increased variability of airflow and incompletely reversible airflow obstruction are often categorized as having asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS). ACOS is heterogeneous with two sub-phenotypes: asthma-ACOS and COPD-ACOS. The objective of this study was to determine the difference in risk of exacerbation between the two sub-phenotypes of ACOS. METHODS: A total of 223 patients exhibiting incompletely reversible airflow obstruction with increased variability (spirometrically defined ACOS) were enrolled...
March 7, 2018: Tuberculosis and Respiratory Diseases
Matthew Morten, Adam Collison, Vanessa E Murphy, Daniel Barker, Christopher Oldmeadow, John Attia, Joseph Meredith, Heather Powell, Paul D Robinson, Peter D Sly, Peter G Gibson, Joerg Mattes
BACKGROUND: The single-centre double-blind, randomised controlled Managing Asthma in Pregnancy (MAP) trial in Newcastle, Australia, compared a treatment algorithm using the fraction of exhaled nitric oxide (FeNO) in combination with asthma symptoms (FeNO group) against a treatment algorithm using clinical symptoms only (clinical group) in pregnant asthmatic women (ANZ Clinical Trials Registry, number 12607000561482). The primary outcome was a 50% reduction in asthma exacerbations during pregnancy in the FeNO group...
March 7, 2018: Journal of Allergy and Clinical Immunology
Umakanth Katwa, Estefania Rivera
Asthma is the most common chronic pediatric condition. Effective asthma management requires a proactive and inclusive approach that controls the patient's symptoms and prevents recurrence of exacerbations. Clinicians should encourage patients to become involved in their management since self-management approaches have proven to be an effective means for chronic illness treatment. Novel forms of self-monitoring and management are technological interventions. In the last decade, novel technology has been developed and used to improve asthma control since it is a powerful agent that addresses a variety of challenges in chronic disease management such as education, communication and adherence...
March 10, 2018: Indian Journal of Pediatrics
Samuel C Cerps, Mandy Menzel, Irma Mahmutovic Persson, Leif Bjermer, Hamid Akbarshahi, Lena Uller
Defective production of antiviral interferon (IFN)-β is thought to contribute to rhinovirus-induced asthma exacerbations. These exacerbations are associated with elevated lung levels of lactate dehydrogenase (LDH), indicating occurrence of cell necrosis. We thus hypothesized that reduced lung IFN-β could contribute to necrotic cell death in a model of asthma exacerbations. Wild-type and IFN-β-/- mice were given saline or house dust mite (HDM) intranasally for 3 weeks to induce inflammation. Double-stranded RNA (dsRNA) was then given for additional 3 days to induce exacerbation...
March 9, 2018: Scientific Reports
Christina Li-Ping Thio, Po-Yu Chi, Alan Chuan-Ying Lai, Ya-Jen Chang
BACKGROUND: Allergic asthma is characterized airway hyperreactivity (AHR) and inflammation driven by aberrant TH 2 response. Type 2 innate lymphoid cells (ILC2s) are a critical source of TH 2 cytokines IL-5 and IL-13 which promote acute asthma exacerbation. Short chain fatty acids (SCFAs) have been shown to attenuate T cell-mediated allergic airway inflammation. Their role in the regulation of ILC2-driven AHR and lung inflammation, however, remains unknown. OBJECTIVE: We investigated the immunomodulatory role of SCFAs in the regulation of ILC2-induced AHR and airway inflammation and delineated the mechanism involved...
March 6, 2018: Journal of Allergy and Clinical Immunology
Charu Rajput, Megan P Walsh, Breanna N Eder, Ediri E Metitiri, Antonia P Popova, Marc B Hershenson
Infections with rhinovirus (RV) cause asthma exacerbations. Recent studies suggest that macrophages play a role in asthmatic airway inflammation and the innate immune response to RV infection. Macrophages exhibit discrete phenotypes based on surface markers and gene expression. We hypothesized that macrophage polarization state alters gene expression in response to RV infection. Cells were derived from human peripheral blood derived monocytes. M1 and M2 polarization was carried out using IFN-y and IL-4, respectively, and RNA was extracted for Affymetrix Human Gene ST2...
March 9, 2018: Physiological Genomics
Nicholas Arrotta, Jesse Hill, Cristina Villa-Roel, Elizabeth Dennett, Molly Harries, Brian H Rowe
OBJECTIVES: A variable proportion of patients presenting to the emergency department (ED) with acute asthma require admission to hospital. Previous studies have identified select factors associated with admission following ED presentation; however, no review has synthesized the evidence in this regard. This systematic review summarizes the evidence regarding factors associated with hospital admission following ED presentation. METHODS: Searches were conducted in seven electronic databases and common sources of grey literature...
March 9, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Vinh Nhu Nguyen, Thuong Thi Hoai Huynh, Niels H Chavannes
Background: Most asthma patients in Vietnam have poorly controlled asthma. Besides reasons related to the health care system and health care providers, knowledge on the self-management of patients has also contributed to this situation. Purpose: To assess knowledge on asthma self-management among adult asthma patients in Ho Chi Minh City. Patients and methods: A cross-sectional study with convenience sampling was conducted among 322 ambulatory patients using questionnaires filled in via a face-to-face interview...
2018: International Journal of General Medicine
Teresa To, Laura Y Feldman, Jingqin Zhu, Andrea S Gershon
During pregnancy, women with asthma may be at higher risk of exacerbation. The objective of this study was to determine whether women with asthma in Ontario, Canada have increased health services utilization (HSU) during pregnancy.Rates of asthma-specific, asthma-related and non-pregnancy-related HSU were calculated in a population-based cohort of pregnant women with asthma. Poisson regression with repeated measures was used to determine adjusted rate ratios and 95% confidence intervals of HSU during and one year after pregnancy, compared to the year before pregnancy...
March 8, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Lorenzo Cecchi, Gennaro D'Amato, Isabella Annesi-Maesano
Allergies are complex diseases that result from interactions between multiple genetic and environmental factors. However, the increase in allergies observed in the past decades is explained exclusively by environmental changes occurring in the same period. Presently, the exposome, the totality of specific and nonspecific external environmental exposures (external exposome) to which a subject is exposed from preconception onward and their consequences at the organ and cell levels (internal exposome), is being considered to explain the inception, development, and exacerbations of allergic diseases...
March 2018: Journal of Allergy and Clinical Immunology
S A van Nederveen-Bendien, S R J van Oord-Bosselaar, A H Feitsma, J H Kappen
- Asthma during pregnancy is associated with an increased risk of preterm delivery, low birth weight and pre-eclampsia.- This condition may be undertreated due to insufficient knowledge and, in particular, concerns about teratogenic effects of asthma medication among treating healthcare professionals and pregnant women.- The risk of teratogenic effects of inhaled medications (ICS, SABA and LABA) is small. These agents have been used by large groups of patients for many years.- Well-controlled asthma with pharmacological therapy during pregnancy is safer and leads to fewer complications then accepting asthma symptoms and exacerbations...
2018: Nederlands Tijdschrift Voor Geneeskunde
Nikolaos Lazarinis, Johan Bood, Cristina Gomez, Johan Kolmert, Ann-Sofie Lantz, Pär Gyllfors, Andy Davis, Craig E Wheelock, Sven-Erik Dahlén, Barbro Dahlén
BACKGROUND: Leukotriene E4 (LTE4 ) is the final active metabolite among the cysteinyl leukotrienes (CysLTs). Animal studies have identified a distinct LTE4 receptor, suggesting that current CysLT1 receptor antagonists may provide incomplete inhibition of CysLT responses. OBJECTIVE: We tested this hypothesis by assessing the influence of the CysLT1 antagonist montelukast on responses induced by inhalation of LTE4 in asthmatic subjects. METHODS: Fourteen subjects with mild intermittent asthma and two subjects with aspirin exacerbated respiratory disease (AERD) received montelukast 20 mg bid and placebo for 5-7 days in a randomized, double blind, crossover study (NCT01841164)...
March 5, 2018: Journal of Allergy and Clinical Immunology
Mina Fazlollahi, Tricia D Lee, Jade Andrade, Kasopefoluwa Oguntuyo, Yoojin Chun, Galina Grishina, Alexander Grishin, Supinda Bunyavanich
BACKGROUND: Nasal microbiota may influence asthma pathobiology. OBJECTIVE: We sought to characterize the nasal microbiome of subjects with exacerbated asthma, non-exacerbated asthma, and healthy controls to identify nasal microbiota associated with asthma activity. METHODS: 16S rRNA sequencing was performed on nasal swabs obtained from 72 primarily adult subjects with exacerbated asthma (n=20), non-exacerbated asthma (n=31), and healthy controls (n=21)...
March 5, 2018: Journal of Allergy and Clinical Immunology
Claudia R Morris, David T Mauger, Jung H Suh, Wanda Phipatanakul, William J Sheehan, James N Moy, Ian M Paul, Stanley J Szefler, Daniel J Jackson, Anne M Fitzpatrick
Retrospective studies have demonstrated associations between acetaminophen and exacerbations in asthma, purportedly due to reductions in the antioxidant, glutathione. In this study of young children with mild asthma treated with acetaminophen, baseline levels of glutathione were not associated with future exacerbations.
March 5, 2018: Journal of Allergy and Clinical Immunology
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