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Asthma exacerbations

Keitaro Nakamoto, Masato Watanabe, Mitsuru Sada, Toshiya Inui, Masuo Nakamura, Kojiro Honda, Hiroo Wada, Yu Mikami, Hirotaka Matsuzaki, Masafumi Horie, Satoshi Noguchi, Yasuhiro Yamauchi, Hikari Koyama, Toshiyuki Kogane, Tadashi Kohyama, Hajime Takizawa
BACKGROUND AND PURPOSE: Bronchial asthma (BA) is a chronic airway disease characterized by airway hyperresponsiveness and remodeling, which are intimately linked to chronic airway inflammation. Reactive oxygen species (ROS) such as hydrogen peroxide are generated by inflammatory cells that are involved in the pathogenesis of BA. However, the role of ROS in the management of BA patients is not yet clear. We attempted to determine the role of ROS as a biomarker in the clinical setting of BA...
2016: PloS One
Stefano R Del Giacco, Arzu Bakirtas, Elizabeth Bel, Adnan Custovic, Zuzana Diamant, Eckard Hamelmann, Enrico Heffler, Ömer Kalayci, Sejal Saglani, Svetlana Sergejeva, Sven Seys, Angela Simpson, Leif Bjermer
It is well recognized that atopic sensitisation is an important risk factor for asthma, both in adults and in children. However, the role of allergy in severe asthma is still under debate. The term "Severe Asthma" encompasses a highly heterogeneous group of patients who require treatment on steps 4-5 of GINA guidelines to prevent their asthma from becoming "uncontrolled", or whose disease remains "uncontrolled" despite this therapy. Epidemiological studies on emergency room visits and hospital admissions for asthma suggest the important role of allergy in asthma exacerbations...
October 24, 2016: Allergy
Diane Lefaudeux, Bertrand De Meulder, Matthew J Loza, Nancy Peffer, Anthony Rowe, Frédéric Baribaud, Aruna T Bansal, Rene Lutter, Ana R Sousa, Julie Corfield, Ioannis Pandis, Per S Bakke, Massimo Caruso, Pascal Chanez, Sven-Erik Dahlén, Louise J Fleming, Stephen J Fowler, Ildiko Horvath, Norbert Krug, Paolo Montuschi, Marek Sanak, Thomas Sandstrom, Dominic E Shaw, Florian Singer, Peter J Sterk, Graham Roberts, Ian M Adcock, Ratko Djukanovic, Charles Auffray, Kian F Chung
BACKGROUND: Asthma is a heterogeneous disease in which there is a differential response to asthma treatments. This heterogeneity needs to be evaluated so that a personalised management approach can be provided. OBJECTIVES: We stratified patients with moderate-to-severe asthma based on clinico-physiological parameters and performed an -omics analysis of sputum. METHODS: Partition-around-medoid clustering was applied to a training set of 266 asthma participants from the European U-BIOPRED adult cohort using 8 pre-specified clinic-physiological variables...
October 20, 2016: Journal of Allergy and Clinical Immunology
John Nixon, Paul Newbold, Tomas Mustelin, Gary P Anderson, Roland Kolbeck
Eosinophils have been linked with asthma for more than a century, but their role has been unclear. This review discusses the roles of eosinophils in asthma and chronic obstructive pulmonary disease (COPD) and describes therapeutic antibodies that affect eosinophilia. The aims of pharmacologic treatments for pulmonary conditions are to reduce symptoms, slow decline or improve lung function, and reduce the frequency and severity of exacerbations. Inhaled corticosteroids (ICS) are important in managing symptoms and exacerbations in asthma and COPD...
October 20, 2016: Pharmacology & Therapeutics
Kaori Sadakane, Takamichi Ichinose, Masataka Nishikawa, Hirohisa Takano, Takayuki Shibamoto
BACKGROUND: Epidemiological studies have implicated Asian sand dust (ASD) in the increased prevalence of respiratory disorders, including asthma. It has been observed that fungal elements such as β-glucan can be adsorbed onto ASD. In the present study, the exacerbating effect of the combined exposure to zymosan A (ZymA) containing yeast β-glucan and heat-inactivated ASD on ovalbumin (OVA)-induced murine lung eosinophilia was investigated. METHODS: BALB/c mice were repeatedly instilled intratracheally with one of eight immunogenic formulations consisting of various combinations of (1) ZymA, (2) ASD that was briefly heated to remove organic substances (H-ASD), and (3) OVA in normal saline, or each of the above alone...
2016: Allergy, Asthma, and Clinical Immunology
A Vora, Amit Bhargava
INTRODUCTION: Cough is significant health problem with greater implication for impaired quality of life. Acute and chronic cough due to infective (viral/bacterial), allergic conditions or bronchial asthma including cough variant asthma are often treated with combination of mucolytics, expectorants and bronchodilators. Bronchodilators reduces cough sensitivity, promotes clearance of cough secretions while reducing protrusive inflammatory mediator release. AIMS AND OBJECTIVES: To further understand the clinical utility and safety of Bronchodilatory cough formulations (BCF) containing Levosalbutamol in real world settings...
September 2016: Journal of the Association of Physicians of India
George M Slavich
Life stress is a central construct in many models of human health and disease. The present article reviews research on stress and health, with a focus on (a) how life stress has been conceptualized and measured over time, (b) recent evidence linking stress and disease, and (c) mechanisms that might underlie these effects. Emerging from this body of work is evidence that stress is involved in the development, maintenance, or exacerbation of several mental and physical health conditions, including asthma, rheumatoid arthritis, anxiety disorders, depression, cardiovascular disease, chronic pain, human immunodeficiency virus/AIDS, stroke, and certain types of cancer...
October 2016: Teaching of Psychology
J Quiralte-Castillo, M Del Robledo Ávila-Castellano, S Cimbollek, P Benaixa, S Leguisamo, K Baynova, M Labella, J Quiralte
BACKGROUND: Safer and less time consuming alternatives to single-blind placebo-controlled oral challenge (SBPCOC) in order to diagnose aspirin-exacerbated respiratory disease (AERD) have been searched for. Nasal challenges with different non-steroidal anti-inflammatory drugs and assessment methods have been developed. OBJECTIVE: Our objective was to evaluate the utility and safety of nasal ketorolac challenge (NKC) using an acoustic rhinomether in patients with suspected AERD Methods: Thirty-six patients with suspected AERD were included in the study...
October 19, 2016: Journal of Investigational Allergology & Clinical Immunology
Kelly W Reeves, Yhenneko Taylor, Hazel Tapp, Thomas Ludden, Lindsay E Shade, Beth Burton, Cheryl Courtlandt, Michael Dulin
OBJECTIVE: Asthma is a common childhood chronic lung disease affecting greater than 10% of children in the United States. School nurses are in a unique position to close gaps in care. Indeed, effective asthma management is more likely to result when providers, family, and schools work together to optimize the patient's treatment plan. Currently, effective communication between schools and healthcare systems through electronic medical record (EMR) systems remains a challenge. The goal of this feasibility pilot was to link the school-based care team with primary care providers in the healthcare system network via electronic communication through the EMR, on behalf of pediatric asthma patients who had been hospitalized for an asthma exacerbation...
October 19, 2016: Applied Clinical Informatics
Kathryn V Blake
PURPOSE OF REVIEW: Poor adherence to asthma controller medications, particularly inhaled corticosteroids, has been well known for decades and is a major cause of uncontrolled asthma and increased healthcare utilization. This review presents recent evidence on factors leading to nonadherence in specific age groups, parents of young children, adolescents and young adults, adults, and the elderly. Novel management strategies including electronic sensors with associated smart phone applications for adherence improvement are discussed...
October 15, 2016: Current Opinion in Pulmonary Medicine
Maxime Luu, Marc Bardou, Philippe Bonniaud, Françoise Goirand
Omalizumab is a subcutaneously administrated monoclonal anti-IgE antibody indicated in adults, adolescents and children 6 years of age and older with moderate to severe allergic asthma uncontrolled by conventional pharmacological treatments and sensitization to at least one perennial allergen. Area covered: This drug evaluation summarizes published data on pharmacokinetic and pharmacodynamic properties of omalizumab, on clinical efficacy and safety, including real-world evidence, and provides a medico-economic evaluation of the drug...
October 17, 2016: Expert Opinion on Drug Metabolism & Toxicology
Ritesh Agarwal, Inderpaul S Sehgal, Sahajal Dhooria, Ashutosh N Aggarwal
Allergic bronchopulmonary aspergillosis (ABPA) is a complex pulmonary disorder characterized by recurrent episodes of wheezing, fleeting pulmonary opacities and bronchiectasis. It is the most prevalent of the Aspergillus disorders with an estimated five million cases worldwide. Despite six decades of research, the pathogenesis, diagnosis and treatment of this condition remains controversial. The International Society for Human and Animal Mycology has formed a working group to resolve the controversies around this entity...
October 17, 2016: Expert Review of Respiratory Medicine
Yury A Bochkov, Kelly Watters, Sarmila Basnet, Shakher Sijapati, Marchel Hill, Ann C Palmenberg, James E Gern
Viruses in the rhinovirus C species (RV-C) can cause severe respiratory illnesses in children including pneumonia and asthma exacerbations. A transduced cell line (HeLa-E8) stably expressing the CDHR3-Y529 receptor variant, supports propagation of RV-C after infection. C15 clinical or recombinant isolates replicate in HeLa-E8, however progeny yields are lower than those of related strains of RV-A and RV-B. Serial passaging of C15 in HeLa-E8 resulted in stronger cytopathic effects and increased (≥10-fold) virus binding to cells and progeny yields...
October 13, 2016: Virology
Jillian M Cavallari, Tara S Jawaro, Nadia I Awad, Patrick J Bridgeman
Glucagon, a hormone secreted by pancreatic alpha cells, causes bronchial smooth muscle relaxation by activating the synthesis of cyclic adenosine monophosphate. It was studied in the 1980s and 1990s as a treatment option for the management of asthma but has since not been evaluated. Data to support its use are limited, but it may serve as a last-line agent for refractory asthma exacerbation. Here we describe 4 cases in which intravenous glucagon was used to manage severe, refractory asthma exacerbation in the emergency department...
September 30, 2016: American Journal of Emergency Medicine
Steven Maltby, Peter G Gibson, Heather Powell, Vanessa M McDonald
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) are common airway diseases. Individuals with overlapping asthma and COPD experience increased health impairment and severe disease exacerbations. Efficacious treatment options are required for this population. Omalizumab (anti-IgE) therapy is effective in patients with severe, persistent asthma, but limited data are available on efficacy in populations with overlapping asthma and COPD. METHODS: Data from the Australian Xolair Registry (AXR) was used to compare treatment responses in individuals with asthma-COPD overlap to severe asthma alone...
October 11, 2016: Chest
Michele Miraglia Del Giudice, Annalisa Allegorico
The role of vitamin D in calcium and phosphate homeostasis is well known; however, in addition to traditional functions, vitamin D modulates a variety of processes, and evidence shows that it has an important role in different allergic diseases such as asthma, atopic dermatitis, and food allergy. Vitamin D acts by binding to the vitamin D receptor, which is present in a variety of tissues; for this reason it is considered a hormone. One of the most important functions is to modulate the immune system response, both innate and adaptive, by suppressing Th2-type response and increasing natural killer cells...
November 2016: Journal of Clinical Gastroenterology
Pei-Chia Lo, Yueh-Ting Tsai, Shun-Ku Lin, Jung-Nien Lai
Patients allergic to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) who develop respiratory reactions such as bronchospasm or asthma exacerbation have aspirin-induced asthma or NSAIDs-exacerbated respiratory disease. However, large-scale studies have not been conducted to investigate the risk of aspirin/NSAIDs exposure in children with asthma. Therefore, this study evaluated the relationship between aspirin/NSAIDs and the risk of asthma exacerbation in children with asthma.This retrospective cohort study was conducted using the data of 1 million random beneficiaries of the Taiwan National Health Insurance program between 1997 and 2012...
October 2016: Medicine (Baltimore)
Andrew Skeggs, Tricia McKeever, Lelia Duley, Eleanor Mitchell, Lucy Bradshaw, Kevin Mortimer, Samantha Walker, Steve Parrott, Andrew Wilson, Ian Pavord, Chris Brightling, Mike Thomas, David Price, Graham Devereux, Bernard Higgins, Tim Harrison, Rebecca Haydock
BACKGROUND: Asthma is one of the commonest chronic diseases in the UK. Acute exacerbations of asthma are unpredictable, disruptive and frightening. They cause considerable morbidity and account for a large component of the health service costs of asthma. The widespread use of an asthma self-management plan, designed to encourage disease monitoring and timely intervention, can reduce exacerbations and is, therefore, recommended for all patients with asthma. Unfortunately, the majority of patients are not provided with such a plan...
October 13, 2016: Trials
Thomas Westergren, Sveinung Berntsen, Karin C Lødrup Carlsen, Petter Mowinckel, Geir Håland, Liv Fegran, Kai-Håkon Carlsen
BACKGROUND: Children with asthma may be less physically active than their healthy peers. We aimed to investigate if perceived exercise limitation (EL) was associated with lung function or bronchial hyperresponsiveness (BHR), socio-economic factors, prenatal smoking, overweight, allergic disease, asthma severity or physical activity (PA). METHODS: The 302 children with asthma from the 10-year examination of the Environment and Childhood Asthma birth cohort study underwent a clinical examination including perceived EL (structured interview of child and parent(s)), measure of overweight (body mass index by sex and age passing through 25kg/m(2) or above at18 years), exercise-induced bronchoconstriction (forced expiratory volume in one second (FEV1 ) pre- and post-exercise), methacholine bronchial challenge (severe BHR; provocative dose causing ≥20% decrease in FEV1≤1μmol) and asthma severity score (dose of controller medication and exacerbations last 12 months)...
October 13, 2016: Pediatric Allergy and Immunology
Yang Quan-Jun, Zhang Jian-Ping, Zhang Jian-Hua, Han Yong-Long, Xin Bo, Zhang Jing-Xian, Dai Bona, Zhang Yuan, Guo Cheng
Inhaled budesonide and salbutamol represent the most important and frequently used drugs in asthmatic children during acute exacerbation. However, there is still no consensus about their resulting metabolic derangements; thus, the present study was conducted to determine the distinct metabolic profiles of these two drugs. A total of 69 children with asthma during acute exacerbation were included, and their serum and urine were investigated using high-resolution nuclear magnetic resonance (NMR). A metabolomics analysis was performed using a principal component analysis and orthogonal signal correction-partial least squares using SIMCA-P...
October 12, 2016: Basic & Clinical Pharmacology & Toxicology
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