Effect of overweight/obesity on relationship between fractional exhaled nitric oxide and airway hyperresponsiveness in Chinese elderly patients with asthma.

Purpose: This retrospective study investigates the influence of overweight and obesity status on pulmonary function, airway inflammatory markers, and airway responsiveness in elderly asthma patients. Methods: Patients with asthma older than 65 years old who completed a bronchial provocation test (BPT) or bronchial dilation test (BDT) and a fractional exhaled nitric oxide (FeNO) test between December 2015 and June 2020 were identified retrospectively for this study. All of the patients were categorized into overweight/obesity and non-obesity groups based on their BMI. Pulmonary function test (PFT) and FeNO measurements were accomplished according to the 2014 recommendations of the Chinese National Guidelines of Pulmonary Function Test and American Thoracic Society/European Respiratory Society recommendations, respectively. Results: A total of 136 patients with an average age of 71.2 ± 5.40 years were identified. The average BMI was 23.8 ± 3.63, while the value of FeNO was 42.3 ± 38.4 parts per billion (ppb). In contrast to the non-obesity group, which had a value of 48.8 ± 43.1 ppb for FeNO, the overweight/obesity group had a significant lower value of 35.4 ± 31.4 ppb. There was no significant difference in the proportion of individuals with high airway hyperresponsiveness between the overweight/obesity and non-obesity groups (96 patients in total). Multiple linear regression analysis established an inverse correlation between FeNO and Provocation concentration causing a 20% fall in FEV1(PC20) but excluded significant relationships with age and BMI. The model's R is 0.289, and its p value is 0.045. Conclusion: The elderly Chinese Han asthmatics with overweight/obesity had lower FeNO levels than those with non-obese according to our findings. In addition, the FeNO level was inversely correlated between FeNO levels and PC20 in elderly asthmatics.

Airway hyperresponsiveness in asthma: The role of the epithelium.

Airway hyperresponsiveness (AHR) is a key clinical feature of asthma. The presence of AHR in people with asthma provides the substrate for bronchoconstriction in response to numerous diverse stimuli, contributing to airflow limitation and symptoms including breathlessness, wheeze, and chest tightness. Dysfunctional airway smooth muscle significantly contributes to AHR and is displayed as increased sensitivity to direct pharmacologic bronchoconstrictor stimuli, such as inhaled histamine and methacholine (direct AHR), or to endogenous mediators released by activated airway cells such as mast cells (indirect AHR). Research in in vivo human models has shown that the disrupted airway epithelium plays an important role in driving inflammation that mediates indirect AHR in asthma through the release of cytokines such as thymic stromal lymphopoietin and IL-33. These cytokines upregulate type 2 cytokines promoting airway eosinophilia and induce the release of bronchoconstrictor mediators from mast cells such as histamine, prostaglandin D2, and cysteinyl leukotrienes. While bronchoconstriction is largely due to airway smooth muscle contraction, airway structural changes known as remodeling, likely mediated in part by epithelial-derived mediators, also lead to airflow obstruction and may enhance AHR. In this review, we outline the current knowledge of the role of the airway epithelium in AHR in asthma and its implications on the wider disease. Increased understanding of airway epithelial biology may contribute to better treatment options, particularly in precision medicine.

Efeito da pré-exposição de vias aéreas de ratos com enterotoxina estafilocócica do tipo B (SEB) sobre a inflamação alérgica pulmonar / Effect of the pre-exposition of rats airways with staphylococci enteroxin type B (SEB) on pulmonary allergic inflammation

As enterotoxinas estafilocócicas (SEs) são produzidas e excretadas por algumas cepas da bactéria Staphylococcus aureus. A asma é uma doença caracterizada por resposta inflamatória crônica das vias aéreas. A admnistrração sistêmica de SEB em coelhos...

The staphylococci enterotoxin (SEs) are produced and secreted by some kind of Staphylococcus aureus. The asthma is a disease characterized by a chronic inflammatory response of the airways. the systemic administration of SEB in rabbits causes a pulmonary inflammation characterized...

Perfil clínico e laboratorial de crianças com alergia respiratória atendidas em ambulatório geral de pediatria / Clinical and laboratory profile of children affected by respiratory allergy at a pediatric clinic

Foi realizado um estudo retrospectivo com 53 crianças portadoras de alergia respiratória (asma e rinite alérgica) aconpanhadas em ambulatório. Avaliando o perfil clínico e laboratorial desse grupo verificamos que sexo masculino e a presença de familiares diretos atópicos (especialmente a mãe) constituiram fatores de risco para o aparecimento da doença alérgica. O ambiente físico teve influência determinante na fisiopatologia da asma e da rinite na maior parte dos casos. Verificou-se o aumento do nível sérico da IgE na totalidade do grupo e eosinofilia em 66 (per cent) dos caos. Entre as crianças com teste cutâneo positivo, os alérgenos predominantes foram o "Dermatophagoides pteronyssinus" e o "Dermatophagoides farinae". A história clínica e o exame físico dos pacientes permitiu o diagnóstico e o estabelecimento do plano terapêutico, ficando reservado um papel secundário aos testes laboratoriais. Os autores puderam observar também nesta casuística que o acompanhamento dos pacientes alérgicos deve priorizar medidas preventivas dirigidas à higiene do ambiente físico para exclusào dos fatores desencadeantes reconhecidos (au)

Aeroalargenos y alergia respiratoria en el estado de Oaxaca, México / Aeroallergens and respiratory allergy in the state of Oaxaca, Mexico

Se estudiaron 108 pacientes del estado de Oaxaca, M[exico., 75 hombres, 62 mujeres, con promedio de edad de 29 a;os, con diagnosticos de asma, rinitis y sinusitis, para determinar la frecuencia de aeroalargenos comprometidos. Se efectuaron pruebas de escarificacion con alergenos glicerinados 1:20 p/v Hollister S. Los resultados muestran al Dermaphagoides como principal alergeno, seguido de polvo casero y los polenes de capriola y lolium.

Inflamación y asma bronquial / Inflammation and bronchial asthma

En la reacción asmática inmediata, la liberación de mediadores del mastocito, produce una alteración tisular limitada de corta duración (2 horas), controlable con Beta2 adrenérgicos o Teofilina y prevenible con cromoglicato o similares. Más de la mitad de los asmáticos tienen una respuesta tardía al factor provocador de la reacción, que alcanza su máxima intensidad unas ocho horas después y puede mantenerse durante varios días. A nivel de los tejidos se ha producido una infiltración celular, de neutrófilos y eosinófilos primero y células mononucleares luego. Este proceso se produce por acción de alergenos, infección viral o sustancias químicas y determina manifiesta hiperirritabilidad bronquial, siendo más afectada la pequeña vía aérea. Están involucrados en la inflamación del bronquio, mastocitos, basófilos, neutrófilos, eosinófilos, linfocitos, plaquetas y macrófagos-monocitos. Se liberan mediadores de origen celular, plasmático o neurógeno que provocan edema, contracción del músculo bronquial, hipersecreción mucosa con discrinia y quimiotaxis. PAF parece ocupar un lugar central entre los mediadores, su efecto es potente y prolongado y recluta plaquetas, neurotrófilos y eosinófilos en el pulmón. Todo esto contribuye al daño epitelial con pérdida de colgajos. Fibras nerviosas aferentes liberan SP y otros neuropéptidos localmente, contribuyen a la inflamación e interactúan con los otros mediadores. La terapéutica implica evitar la exposición a alergenos, inmunoterapia, esteroides, teofilina y cromoglicato o similares