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https://www.readbyqxmd.com/read/28092287/current-and-future-management-of-the-young-child-with-early-onset-wheezing
#1
Allison J Burbank, Stanley J Szefler
PURPOSE OF REVIEW: In this review, we discuss current thinking in relation to available guidelines for the care of preschool-aged children with recurrent wheezing, while highlighting the gaps in our knowledge and discussing changes that could occur over the next 5 years. RECENT FINDINGS: The Asthma Predictive Index as well as allergen-specific IgE, peripheral eosinophil count and exhaled nitric oxide are perhaps underutilized sources of information that can assist in predicting progression to asthma and response to therapies...
January 13, 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28090045/a-pitfall-in-the-diagnosis-of-eosinophilic-myocarditis-in-a-patient-who-received-steroid-therapy
#2
Yusuke Watanabe, Hiroshi Wada, Kenichi Sakakura, Hideo Fujita, Shin-Ichi Momomura
Eosinophilic myocarditis is a rare form of myocardial inflammation that is characterized by the infiltration of eosinophilic cells into the myocardium. The clinical symptoms of eosinophilic myocarditis are similar to those of acute coronary syndrome, and eosinophilic myocarditis sometimes occurs in combination with bronchial asthma. We herein present a case of eosinophilic myocarditis in which additional time was required to make a definitive diagnosis because the patient received steroid therapy. The diagnosis of eosinophilic myocarditis is challenging, especially when a patient has other inflammatory diseases, such as bronchial asthma...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28089872/identification-of-airway-mucosal-type-2-inflammation-by-clinical-biomarkers-in-asthma
#3
Philip E Silkoff, Michel Laviolette, Dave Singh, J Mark FitzGerald, Steven Kelsen, Vibeke Backer, Celeste M Porsbjerg, Pierre-Olivier Girodet, Patrick Berger, Joel N Kline, Geoffrey Chupp, Vedrana S Susulic, Elliot S Barnathan, Frédéric Baribaud, Matthew J Loza
BACKGROUND AND OBJECTIVE: The Airways Disease Endotyping for Personalized Therapeutics (ADEPT) study profiled mild, moderate and severe asthma, and non-atopic healthy controls. We explored this dataset to define Type-2 inflammation based on airway-mucosal IL-13-driven gene expression and how this related to clinically-accessible biomarkers. METHODS: IL-13-driven gene expression was evaluated in several human cell lines. We then defined Type-2 status in 25 healthy subjects, 28 mild, 29 moderate, and 26 severe asthmatics, based on airway-mucosal expression of 1) CC-motif chemokine ligand (CCL)-26, (the most differentially expressed gene), 2) periostin, or 3) a multi-gene IL-13 in-vitro signature (IVS)...
January 12, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28088474/diagnostic-accuracy-of-fractional-exhaled-nitric-oxide-in-predicting-cough-variant-asthma-and-eosinophilic-bronchitis-in-adult-patients-with-chronic-cough-a-systematic-review-and-meta-analysis
#4
Woo-Jung Song, Hyun Jung Kim, Ji-Su Shim, Ha-Kyeong Won, Sung-Yoon Kang, Kyoung-Hee Sohn, Byung-Keun Kim, Eun-Jung Jo, Min-Hye Kim, Sang-Heon Kim, Heung-Woo Park, Sun-Sin Kim, Yoon-Seok Chang, Alyn H Morice, Byung-Jae Lee, Sang-Heon Cho
BACKGROUND: Individual studies suggested the utility of fractional exhaled nitric oxide (FeNO) in detecting cough variant asthma (CVA) and eosinophilic bronchitis (EB) in chronic cough patients. OBJECTIVE: To obtain summary estimates of diagnostic test accuracy of FeNO in predicting CVA and/or EB in adult patients with chronic cough METHODS: Electronic databases were searched for studies published until January 2016, without language restriction. Cross-sectional studies which reported the diagnostic accuracy of FeNO for detecting CVA or EB were included...
January 11, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28087917/-reasearch-progress-on-the-role-of-neutrophils-in-asthma
#5
Tingting Li, Yuehai Ke, Hongqiang Cheng
Asthma is a phenotypically heterogeneous chronic disease of the airways. Studies have found that neutrophils are crucial to airway inflammation in acute asthma, persistent asthma, particularly in asthma of poor response to glucocorticoid treatment. The role of neutrophils in development of bronchial asthma is complex, as they can release a potent source of cytokines and inflammatory mediators participating in asthma. Differing from eosinophilic inflammatory asthma, neutrophilic inflammatory asthma is not depend on helper T (Th)2 cells, but may be related to Th1 and Th17 cells...
May 25, 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/28087613/systemic-and-mucosal-pre-administration-of-recombinant-helicobacter-pylori-neutrophil-activating-protein-prevents-ovalbumin-induced-allergic-asthma-in-mice
#6
Shuai Zhou, Yanmei Huang, Bingshao Liang, Hui Dong, Shuwen Yao, Yinshuang Chen, Yongqiang Xie, Yan Long, Sitang Gong, Zhenwen Zhou
PURPOSE: Previous epidemiologic studies have demonstrated an inverse association between Helicobacter pylori infection and the frequency of allergic asthma. The neutrophil-activating protein (NAP) of Helicobacter pylori has been identified as a modulator possessing anti-Th2 inflammation activity. Here, we sought to determine whether systemic or mucosal pre-administration of recombinant Helicobacter pylori NAP (rNAP) could prevent ovalbumin-induced allergic asthma in mice. METHODS: Mice were exposed to purified rNAP through intraperitoneal injection or inhalation and then sensitized with ovalbumin...
January 12, 2017: FEMS Microbiology Letters
https://www.readbyqxmd.com/read/28079597/histologic-findings-of-severe-therapy-resistant-asthma-from-video-assisted-thoracoscopic-surgery-biopsies
#7
Humberto E Trejo Bittar, Daniel Doberer, Mitra Mehrad, Diane C Strollo, Joseph K Leader, Sally Wenzel, Samuel A Yousem
The histologic changes occurring in severe/therapy-resistant asthma (SA) as defined by the European Respiratory Society/American Thoracic Society guidelines, particularly at the level of the distal airways are unknown. This study describes the clinical, radiologic, and histologic characteristics of 29 SA patients who underwent video-assisted thoracoscopic surgery lung biopsy. Pathologic observations were correlated with clinical features, especially the presence of autoimmune disease (AID) (15/29, 51.7%). Ten biopsies (10/29, 34...
February 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28079316/clinical-characteristics-and-treatment-response-of-peripheral-neuropathy-in-the-presence-of-eosinophilic-granulomatosis-with-polyangiitis-churg-strauss-syndrome-experience-at-a-single-tertiary-center
#8
Hye Jin Cho, Sehyo Yune, Jin Myoung Seok, Eun Bin Cho, Ju Hong Min, Yeon Lim Seo, Byung Jae Lee, Byoung Joon Kim, Dong Chull Choi
BACKGROUND AND PURPOSE: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic small-vessel vasculitis accompanied by asthma, eosinophilia, and eosinophilic inflammation of various tissues including the peripheral nerves. This study investigated the clinical course and long-term outcomes of peripheral neuropathy in patients with EGPA. METHODS: Seventy-one patients with physician-diagnosed EGPA were identified at Samsung Medical Center between January 1995 and April 2014...
January 2017: Journal of Clinical Neurology
https://www.readbyqxmd.com/read/28072629/the-key-clues-to-reach-the-diagnosis-of-loeffler-endomyocardial-fibrosis-associated-with-eosinophilic-granulomatosis-with-polyangiitis
#9
Enrico Ammirati, Domenico Sirico, Linda Brevetti, Laura Scudiero, Diana Artioli, Patrizia Pedrotti, Maria Frigerio
Loeffler endomyocardial fibrosis is a rare restrictive cardiomyopathy due to chronic eosinophilic exposure (Loeffler endomyocarditis). Loeffler endomyocarditis is associated with different eosinophilic disorders, including eosinophilic granulomatosis with polyangiitis (EGPA). These images recapitulate all typical findings that can be observed in patients presenting with heart failure attributable to this specific cardiomyopathy associated with EGPA, a systemic medical condition that can be easily detectable just putting together different diagnostic elements...
January 7, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28070196/airway-autoimmune-responses-in-severe-eosinophilic-asthma-following-low-dose-mepolizumab-therapy
#10
Manali Mukherjee, Hui Fang Lim, Sruthi Thomas, Douglas Miller, Melanie Kjarsgaard, Bruce Tan, Roma Sehmi, Nader Khalidi, Parameswaran Nair
BACKGROUND: Anti-interleukin (IL)-5 monoclonal antibodies as an eosinophil-depleting strategy is well established, with Mepolizumab being the first biologic approved as an adjunct treatment for severe eosinophilic asthma. CASE PRESENTATION: A 62-year old woman diagnosed with severe eosinophilic asthma showed poor response to Mepolizumab therapy (100 mg subcutaneous dose/monthly) and subsequent worsening of symptoms. The treatment response to Mepolizumab was monitored using both blood and sputum eosinophil counts...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28069425/an-epigenome-wide-association-study-of-total-serum-immunoglobulin-e-in-hispanic-children
#11
Wei Chen, Ting Wang, Maria Pino-Yanes, Erick Forno, Liming Liang, Qi Yan, Donglei Hu, Daniel E Weeks, Andrea Baccarelli, Edna Acosta-Perez, Celeste Eng, Yueh-Ying Han, Nadia Boutaoui, Catherine Laprise, Gwyneth A Davies, Julian M Hopkin, Miriam F Moffatt, William O C M Cookson, Glorisa Canino, Esteban G Burchard, Juan C Celedón
BACKGROUND: Total immunoglobulin E (IgE) is a therapeutic target in allergic diseases. DNA methylation in white blood cells (WBCs) was associated with total IgE in an epigenome-wide association study (EWAS) of Caucasians. Whether DNA methylation of eosinophils explains those findings is insufficiently understood. METHODS: We tested for association between genome-wide DNA methylation in WBCs and total IgE in two studies of Hispanic children: the Puerto Rico Genetics of Asthma and Lifestyle Study (PR-GOAL, n = 306) and the Genes-environments and Admixture in Latino Americans (GALA II, n = 573)...
January 6, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28069248/race-is-associated-with-differences-in-airway-inflammation-in-patients-with-asthma
#12
Sharmilee M Nyenhuis, Jerry A Krishnan, Alalia Berry, William J Calhoun, Vernon M Chinchilli, Linda Engle, Nicole Grossman, Fernando Holguin, Elliot Israel, Rick A Kittles, Monica Kraft, Stephen C Lazarus, Erik B Lehman, David T Mauger, James N Moy, Stephen P Peters, Wanda Phipatanakul, Lewis J Smith, Kaharu Sumino, Stanley J Szefler, Michael E Wechsler, Sally Wenzel, Steven R White, Steven J Ackerman
BACKGROUND: African American subjects have a greater burden from asthma compared with white subjects. Whether the pattern of airway inflammation differs between African American and white subjects is unclear. OBJECTIVE: We sought to compare sputum airway inflammatory phenotypes of African American and white subjects treated or not with inhaled corticosteroids (ICSs; ICS+ and ICS-, respectively). METHODS: We performed a secondary analysis of self-identified African American and white subjects with asthma enrolled in clinical trials conducted by the National Heart, Lung, and Blood Institute-sponsored Asthma Clinical Research Network and AsthmaNet...
December 31, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28068894/strain-differences-in-a-murine-model-of-air-pollutant-induced-nonatopic-asthma-and-rhinitis
#13
Jack R Harkema, Lucas A Hotchkiss, Nicholas A Vetter, Daven N Jackson-Humbles, Ryan P Lewandowski, James G Wagner
Ozone is an irritating gas found in photochemical smog. Epidemiological associations have been made between the onset of asthma and childhood exposures to increasing levels of ambient ozone (i.e., air pollutant-induced nonatopic asthma). Individuals, however, vary in their susceptibility to this outdoor air pollutant, which may be due, in part, to their genetic makeup. The present study was designed to test the hypothesis that there are murine strain-dependent differences in pulmonary and nasal pathologic responses to repeated ozone exposures...
January 2017: Toxicologic Pathology
https://www.readbyqxmd.com/read/28065613/anca-negative-churg-strauss-syndrome-presenting-as-acute-multiple-cerebral-infarcts-a-case-report
#14
Klearchos Psychogios, Ilias Evmorfiadis, Spyros Dragomanovits, Athanasios Stavridis, Konstantinos Takis, Loukas Kaklamanis, Stathis Pantelis
Eosinophilic granulomatosis with polyangiitis (EGPA, previously named Churg-Strauss syndrome) is a form of necrotizing vasculitis occurring in patients with asthma and eosinophilia. Ischemic stroke is a relatively rare complication of the disease. We report a case of a 63-year-old woman with multiple embolic infarcts, hypereosinophilia (for >7 years), and skin rash. Elevated cardiac enzymes and cardiac magnetic resonance imaging were consistent with endomyocarditis. The simultaneous presence of history of asthma, sinusitis, hypereosinophilia, and vasculitis led to the diagnosis of EGPA...
January 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28065396/inhaled-corticosteroid-dose-response-in-asthma-should-we-measure-inflammation
#15
William J Anderson, Philip M Short, Sunny Jabbal, Brian J Lipworth
BACKGROUND: Inhaled corticosteroid (ICS) titration in asthma is primarily based on symptoms and pulmonary function. ICSs may not be increased on this basis despite residual airway inflammation. OBJECTIVE: To compare the dose-response relationships of ICSs on measures of pulmonary function, symptoms, and inflammation in patients with persistent asthma. METHODS: We performed a pooled post hoc analysis of 121 patients with mild to moderate asthma from 4 randomized clinical trials that incorporated an ICS dose ramp...
January 3, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28063044/characterization-of-group-2-innate-lymphoid-cells-in-allergic-airway-inflammation-models-in-the-mouse
#16
Bobby W S Li, Dior M J M Beerens, Maarten D Brem, Rudi W Hendriks
Allergic asthma is a chronic inflammatory lung disease mediated by type 2 cytokines produced by T helper 2 (Th2) cells as well as the recently discovered group 2 innate lymphoid cells (ILC2). Due to a lack of unique markers, the accurate phenotypic characterization and quantification of ILC2 requires a comprehensive panel of fluorescently labeled antibodies. The markers that are currently used to characterize ILC2 have not been standardized and often vary between research groups, which poses significant challenges when comparing data...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28063043/subcutaneous-and-sublingual-immunotherapy-in-a-mouse-model-of-allergic-asthma
#17
Laura Hesse, Martijn C Nawijn
Allergic asthma, caused by inhaled allergens such as house dust mite or grass pollen, is characterized by reversible airway obstruction, associated with an eosinophilic inflammation of the airways, as well as airway hyper responsiveness and remodeling. The inhaled allergens trigger a type-2 inflammatory response with involvement of innate lymphoid cells (ILC2) and Th2 cells, resulting in high production of immunoglobulin E (IgE) antibodies. Consequently, renewed allergen exposure results in a classic allergic response with a distinct early and late phase, both resulting in bronchoconstriction and shortness of breath...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28063042/murine-models-of-allergic-asthma
#18
Eline Haspeslagh, Nincy Debeuf, Hamida Hammad, Bart N Lambrecht
Allergic asthma is a heterogeneous inflammatory lung disease affecting millions of people worldwide and with a steadily increasing incidence. Mouse models have been of utmost importance in uncovering key inflammatory cell types, cytokines, and pathways in the development and maintenance of allergic asthma. Historically, the mainstay in experimental asthma research was sensitizing rodents to the model protein antigen ovalbumin (OVA) with the pro-Th2 adjuvant aluminum hydroxide, followed by repetitive OVA exposures to the airways to initiate a Th2-skewed adaptive immune response leading to eosinophilic airway inflammation and airway hyperreactivity (AHR)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28056550/co-inhalation-of-roflumilast-rather-than-formoterol-with-fluticasone-more-effectively-improves-asthma-in-asthmatic-mice
#19
Hussam A Murad, Hamed S Habib, Misbahuddin M Rafeeq, Mansour I Sulaiman, Amer S Abdulrahman, Mohamad Nidal Khabaz
Roflumilast is approved as an add-on therapy for chronic obstructive pulmonary disease. The inflammation in chronic obstructive pulmonary disease is mainly neutrophilic, while in asthma it is mainly eosinophilic, studies addressing role of roflumilast in eosinophilic inflammation are recommended. Also in severe asthma, the dominant inflammatory cells are neutrophils. Thus, roflumilast has a potential off-label use in the treatment of asthma. This study was designed to evaluate the effects of co-inhalation of roflumilast and fluticasone compared to that of formoterol and fluticasone in ovalbumin-sensitized and-challenged BALB/c mice...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28049209/diagnostic-value-of-serum-baseline-tryptase-levels-in-childhood-asthma-and-its-correlation-with-disease-severity
#20
Siju Gao, Jingang Fan, Zhaoan Wang
BACKGROUND: The aim of this study was to explore whether serum baseline tryptase (sBT) levels might be a useful marker not only for the accurate diagnosis of childhood asthma, but also for the prediction of disease severity. METHODS: A total of 114 asthmatic children were enrolled in this study, 36 of whom had mild intermittent asthma, 38 had mild persistent asthma, and 40 had moderate to severe persistent asthma. Additionally, 34 age-matched healthy children were enrolled as controls...
January 4, 2017: International Archives of Allergy and Immunology
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