Clinical characterization and predictors of IOS-defined small airway dysfunction in asthma.

Publication date: Available online 11 November 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Marcello Cottini, Anita Licini, Carlo Lombardi, Alvise BertiAbstractBackgroundThe involvement of small airways has recently gained greater recognition in asthma. Impulse oscillometry (IOS) is a simple and noninvasive method based on the forced oscillation technique, for the detection of small airway dysfunction (SAD).ObjectiveWe aimed to identify the predictors of SAD in an unselected sample of 400 patients with physician-diagnosed asthma.MethodsAll patients underwent standard spirometry and IOS at the first visit, and were stratified by the presence of SAD defined by IOS (fall in resistance from 5 to 20 Hz [R5–R20]>0.07kPa×s×L–1). Univariable and multivariable analyses and classification-tree method were used to analyze cross-sectional relationships between clinical variables and outcome (SAD).ResultsSAD was present in 62% of the cohort. Subjects with SAD showed a less well-controlled asthma, according to the Global Initiative for Asthma (GINA) definition, and a higher mean inhaled corticosteroid (ICS) dosage use compared to subjects without SAD (both p
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research

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Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Source Type: research
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Research Objective: Assessment of the level of adipokines and their receptors in blood at young patients with bronchial asthma (BA) depending on the obesity phenotype.Material and Methods: 164 patients with BA were divided into 3 groups: BMI 30-34.9 kg/m2 + thickness of epicardial fatty tissue (EFT) ≥7 mm (1st gr.), BMI 30-34.9 kg/m2 + EFT
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
Conclusions: Our study highlights an unrecognised role for HFD-induced, obesity-associated, NLRP3 inflammasome responses in steroid-resistant AHR. Furthermore, we identify a novel role for IL-5 and IL-13 responses upstream of the NLRP3 inflammasome in the development of obesity-associated, SSR asthma.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
Background: Obese-related asthma (OBA) is an asthma sub-phenotype that often is severe. Inflamed adipose tissue may release pro (leptin) and anti-inflammatory (adiponectin) adipokines implicated in OBA. The effects of treatment with oral corticosteroids (OCS) on systemic levels of adipokines remains unknown.Subjects and Methods: Patients with mild to moderate asthma (MMA, n=55), severe asthma (SA= 72) and COPD (n=41) were from BIOAIR, a European multicenter study. After recruitment (visit 1), patients were optimized with medium doses of inhaled glucocorticosteroids (ICS) and LABA for four weeks (visit 2), then included in ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
Background: There is little information on the state of asthma, particularly severe asthma, in China.Objectives: To determine the characteristics of severe asthma patients in China and their stability.Methods: We recruited adults with severe asthma (n=349 non-smokers, NSA, &n=114 smokers and ex-smokers, SSA), mild/moderate asthma (MMA; n=97) and healthy controls (HS, n=100) from 33 university hospitals in 15 provinces. Severe asthma was defined by 2014 ERS/ATS guidelines.Results: NSA was mostly female (70%) but SSA exclusively (96.5%), with both groups having most obese subjects (BMI>28) (NSA: 14.6% and SSA: 17.5% v...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
In French Polynesia, remote South Pacific tropical islands, asthma prevalence is estimated to 11%.Between 2016 and 2018, 498 patients consulting for asthma and/or chronic rhinitis in a respiratory medical center, were included to investigate risk factors associated with asthma control and exacerbations, on the basis of clinical, functionnal, biological and social findings.From them, 398 (80%) were Maohi people, 226 (45%) were adults, and 80% of these adults were obese. Among 464 (93%) patients living with asthma, 54 uncontroled patients yielded to more than 45% of 706 exacerbations, and 86 to 143 hospitalizations. The FEV1...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
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Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
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Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
Introduction: Compared to lean patients, obese asthmatic patients suffer from severe symptoms, frequent exacerbations, poor quality of life and poor response to corticosteroids. Very little is known about the mechanisms by which obesity affects asthma pathogenesis.Aims: We here investigated whether obesity augments allergen-induced lung inflammation via changes in immune cell function.Methods: C57BL/6 mice fed with either low-fat (lean, n=8) or high-fat (obese, n=6) diets were sensitized and challenged with ovalbumin (or saline as control). Inflammatory cytokines levels were examined in bronchoalveolar lavage fluids. Score...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
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