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1.
Int Arch Allergy Immunol ; 181(1): 71-80, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31722337

RESUMO

BACKGROUND: Few studies have directly compared the immunologic responses to specific subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). OBJECTIVE: We aimed to directly compare clinical efficacy and immunological responses between SLIT and SCIT in allergic rhinitis (AR) sensitized to house dust mites. METHODS: Sixty-seven patients (age 5-55 years) with moderate-severe Dermatophagoides pteronyssinus (Der-p) and Dermatophagoides farinae AR with or without asthma were randomized (2:2:1) into SLIT (n = 27), SCIT (n = 26) and placebo (n = 14) groups. Symptom and medication scores, visual analogue score, serum Der-p specific immunoglobulin G4 (Der-p-sIgG4), CD4+CD25+FoxP3+ regulatory T cells (Tregs) and serum cytokines were measured. RESULTS: After 1-year treatment, a significant improvement of total rhinitis score (TRS), total rhinitis medication score (TRMS) and visual analogue score occurred in both SLIT and SCIT. There were no differences in clinical efficacy except for TRMS (p = 0.026) when SLIT and SCIT were directly compared. CD4+CD25+FoxP3+ Tregs had a trend towards upregulation in the 2 modes and inversely correlated with TRS (p = 0.024) only in SLIT. Der-p-sIgG4 significantly increased in SLIT and SCIT (p < 0.05), and it was 30 times higher in SCIT than SLIT after the treatment (p < 0.05). Serum interferon-γ significantly increased only in SCIT after 1 (p = 0.008), 6 (p = 0.007) and 12 (p = 0.008) months of treatment and inversely correlated with TRS (p = 0.032). CONCLUSION: While SCIT and SLIT have similar rates of clinical improvement, the 2 modes reveal heterogeneous changes of CD4+CD25+Foxp3+ Tregs, sIgG4 and cytokines.


Assuntos
Asma/terapia , Citocinas/sangue , Rinite Alérgica/terapia , Imunoterapia Sublingual/métodos , Linfócitos T Reguladores/imunologia , Adolescente , Adulto , Antígenos de Dermatophagoides/imunologia , Asma/complicações , Asma/imunologia , Antígenos CD4/metabolismo , Criança , Pré-Escolar , Estudos Controlados Antes e Depois , Feminino , Fatores de Transcrição Forkhead/metabolismo , Humanos , Infusões Subcutâneas , Subunidade alfa de Receptor de Interleucina-2/metabolismo , Masculino , Pessoa de Meia-Idade , Rinite Alérgica/complicações , Rinite Alérgica/imunologia , Adulto Jovem
2.
Medicine (Baltimore) ; 98(50): e18335, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852128

RESUMO

BACKGROUND: Many people with cough variant asthma use Traditional Chinese Patent Medicine-Suhuang anti-tussive capsule to help reduce symptoms. However there is no systematic reviews had promising its efficacy and safety for cough variant asthma. METHODS: Four English databases (PubMed, Web of science, EMBASE, and Springer Cochrane Library) and 4 Chinese databases (Wanfang Database, Chinese Scientific Journal Database, China National Knowledge Infrastructure Database, and Chinese Biomedical Literature Database) were researched for the randomized controlled trials of Suhuang anti-tussive capsule for cough variant asthma. The search was limited to human studies, using the search keywords or free-text terms "cough," "cough variant asthma," "Suhuang Zhike capsul,""Suhuang anti-tussive capsul," and "randomized clinical trials." Two reviewers individually extracted data from the included randomized controlled trials (RCTs). Data will be synthesized by either the fixed-effects or random-effects model according to a heterogeneity test. The primary outcomes include the frequency of asthma exacerbations during follow-up, asthmatic symptoms by validated instruments (including symptom scores, Likert scale, visual analogue scale). Lung function, serum immunoglobulin E, blood eosinophil count, phlegm eosinophil count, tumor necrosis factor-a, interleukin-1b, and adverse effects (numbers of participants experiencing each adverse events) will be assessed as the secondary outcome. Meta-analysis will be performed using RevMan5.3.5 software provided by the Cochrane Collaboration. RESULTS: This study will provide high-quality synthesis based on current evidence of Suhuang anti-tussive capsule treatment for cough variant asthma. CONCLUSION: This analysis will provide updated evidence for whether Suhuang anti-tussive capsule is an effective and safe intervention for cough variant asthma. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019139695.


Assuntos
Asma/tratamento farmacológico , Tosse/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Medicamentos sem Prescrição/uso terapêutico , Adulto , Asma/complicações , Cápsulas/uso terapêutico , Tosse/etiologia , Feminino , Humanos , Masculino , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisão Sistemática como Assunto , Resultado do Tratamento
3.
Zhonghua Nei Ke Za Zhi ; 58(11): 826-828, 2019 Nov 01.
Artigo em Chinês | MEDLINE | ID: mdl-31665859

RESUMO

This study aims to explore the diagnostic value of specific immunoglobulin E (sIgE) and specific immunoglobulin G (sIgG) of Aspergillus fumigatus in the diagnosis of allergic broncho-pulmonary aspergillosis (ABPA) and severe asthma with fungal sensitization (SAFS). A total of 17 ABPA patients and 14 SAFS patients were enrolled. The levels of sIgG [2 294.00 (1 527.00, 14 170.00) U/ml vs. 972.60 (650.90, 1 792.00) U/ml] and sIgE [8.77 (1.64, 16.85) kU/L vs. 1.04 (0.70, 2.05) kU/L] in ABPA patients were significantly higher than those in SAFS patients (P<0.05). Aspergillus fumigatus sIgG was strongly correlated with Aspergillus fumigatus sIgE (r(s)=0.797, P<0.001) in ABPA patients. When combined with Aspergillus fumigatus sIgG (>1 000.00 U/mL) and Aspergillus fumigatus sIgE (>1.00 kU/L), the sensitivity was 82.3% and specificity 78.6% for the differential diagnosis of ABPA and SAFS. It demonstrates the diagnostic value of Aspergillus fumigatus sIgG and sIgE.


Assuntos
Aspergilose Broncopulmonar Alérgica/diagnóstico , Aspergillus fumigatus/isolamento & purificação , Asma/complicações , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Anticorpos Antifúngicos/imunologia , Aspergilose Broncopulmonar Alérgica/sangue , Aspergilose Broncopulmonar Alérgica/imunologia , Aspergilose Broncopulmonar Alérgica/microbiologia , Aspergillus fumigatus/imunologia , Asma/sangue , Asma/diagnóstico , Humanos , Imunoglobulina E/imunologia , Imunoglobulina G/imunologia , Índice de Gravidade de Doença
4.
Arerugi ; 68(9): 1132-1140, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31723110

RESUMO

BACKGROUND: Gastroesophageal reflux disease (GERD) is a common comorbidity among patients with asthma. In addition, functional dyspepsia (FD) is characterized by upper abdominal symptoms without organic disease manifestations. However, the prevalence of FD among patients with asthma remains uninvestigated; therefore, herein, we investigated the prevalence of dyspepsia symptoms in these patients. METHODS: We recruited 156 patients with asthma from the outpatient clinic of Teikyo University Hospital and investigated the prevalence of dyspepsia symptoms using the modified Frequency Scale for the Symptoms of GERD. Further, the relationship between dyspepsia symptoms and clinical background of asthma was also investigated. RESULTS: Certain digestive organ symptoms were exhibited by 83% of patients with asthma, dyspepsia symptoms by 44%, and reflux symptoms by 26%. The dyspepsia-dominant group showed significantly higher female ratio and numerically lower %FEV1 than the asymptomatic group. In the group with dyspepsia score >5 points, the ratio of patients undergoing step 4 asthma treatment and the ratio of those using long-acting muscarinic receptor antagonist were higher than those in the group with a score <5 points. Furthermore, endoscopic diagnosis was also made in 84 patients and the prevalence of FD was 21%. CONCLUSION: A considerable proportion of patients with asthma exhibited dyspepsia symptoms, and the asthma severity in patients with dyspepsia was higher than those in asymptomatic patients. Based on the current findings, more attention should be directed to FD, in addition to GERD, as a comorbidity of the digestive system in patients with asthma.


Assuntos
Asma/complicações , Dispepsia/complicações , Refluxo Gastroesofágico/complicações , Feminino , Humanos , Masculino , Prevalência
5.
Medicine (Baltimore) ; 98(38): e17203, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567971

RESUMO

The study aimed to expand previous data regarding an association between asthma and appendectomy in children compared with the population of all ages.The Korean Health Insurance Review and Assessment Service-National Sample Cohort from 2002 through 2013 was used. In all, 22,030 participants who underwent appendectomy were matched for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia with 88,120 participants who were included as a control group. In both the appendectomy and control groups, previous history of asthma was investigated. Appendectomy for appendicitis was identified based on a surgical code (International Classification of Disease-10 [ICD-10]: K35). Asthma was classified using an ICD-10 code (J45 and J46) and medication history. The crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of asthma for appendectomy were analyzed using conditional logistic regression analysis. Subgroup analyses were conducted according to age and sex.Approximately 15.2% (3358/22,030) of individuals in the appendectomy group and 13.3% (11,749/88,120) of those in the control group had asthma (P < .001). The appendectomy group demonstrated a higher adjusted odds of asthma than the control group (adjusted OR 1.18, 95% CI 1.13-1.23, P < .001). This result was consistent in the subgroups divided according to age and sex.The odds for asthma were higher in the appendectomy group than in the control group.


Assuntos
Apendicectomia/estatística & dados numéricos , Asma/complicações , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Apendicite/epidemiologia , Apendicite/etiologia , Apendicite/cirurgia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Fatores de Risco , Fatores Sexuais , Adulto Jovem
7.
Praxis (Bern 1994) ; 108(11): 723-727, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31480953

RESUMO

The Mysterious Cough - a Case-Based Proposal of Differential Diagnosis Abstract. Cough is a frequent complaint in the general practice. Avoidance of overdiagnosis and underdiagnosis is essential. In case of acute cough or subacute (<8 week duration), red flags indicate the need for further evaluation, otherwise it is mostly self-limiting. In case of chronic cough (>8 week duration) and normal baseline examination and after cessation of smoking and medication with ACE-I, cough-variant asthma, gastro-esophageal reflux disease and upper airway cough syndrome are the main causes and should be assessed and empirically treated in a systematic manner.


Assuntos
Asma , Tosse , Refluxo Gastroesofágico , Asma/complicações , Asma/diagnóstico , Doença Crônica , Tosse/etiologia , Diagnóstico Diferencial , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/diagnóstico , Humanos
8.
Praxis (Bern 1994) ; 108(11): 729-732, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31480959

RESUMO

Cough, Sputum, Fever: a Frequent Triad, but Not Always Banal Abstract. We report on a 72-year-old patient with known asthma who developed pneumonia after an infection-triggered exacerbation of the asthma. Based on this example we discuss the recommended diagnostic steps as well as the therapeutic decision and importance of follow-up observation.


Assuntos
Asma , Bronquite , Pneumonia , Idoso , Asma/complicações , Asma/diagnóstico , Bronquite/complicações , Bronquite/diagnóstico , Tosse , Humanos , Pneumonia/diagnóstico , Pneumonia/etiologia , Escarro
9.
Praxis (Bern 1994) ; 108(11): 715-721, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31480962

RESUMO

A Difficult-to-Treat Asthma Bronchiale Is Not Necessarily a Severe Asthma Abstract. New biologicals offer the opportunity for treatment of 'difficult-to-treat' asthma. Before prescribing these medications, each 'difficult-to-treat' asthma bronchiale has to be checked for factors aggravating asthma control (e.g. insufficient inhalation technique and adherence, persistent allergen exposure) and asthma-related comorbidities (e.g. rhinosinusitis, gastro-esophageal reflux disease or obstructive sleep apnea) rendering the asthma 'controlled'. Asthma phenotyping s essential for the understanding of different treatment modalities.


Assuntos
Asma , Refluxo Gastroesofágico , Apneia Obstrutiva do Sono , Asma/complicações , Asma/terapia , Refluxo Gastroesofágico/complicações , Humanos , Fatores de Risco , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/complicações
11.
Eur. respir. j ; 54(3): 1900588, Sept. 2019.
Artigo em Inglês | BIGG | ID: biblio-1026251

RESUMO

This document provides clinical recommendations for the management of severe asthma. Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of asthma experts, who made specific recommendations on 6 specific questions. After considering the balance of desirable and undesirable consequences, quality of evidence, feasibility, and acceptability of various interventions, the Task Force made the following recommendations: 1) Suggest using anti-IL5 and anti IL-5Rα for severe uncontrolled adult eosinophilic asthma phenotypes; 2) suggest using blood eosinophil cut-point of ≥150/µL to guide anti-IL5 initiation in adult patients with severe asthma; and 3) Suggest considering specific eosinophil (≥260/µL) and FeNO (≥19.5 ppb) cutoffs to identify adolescents or adults with the greatest likelihood or response to anti-IgE therapy; 4) Suggest using inhaled tiotropium for adolescents and adults with severe uncontrolled asthma despite GINA step 4-5 or NAEPP step 5 therapies; 5) Suggest a trial of chronic macrolide therapy to reduce asthma exacerbations in persistently symptomatic or uncontrolled patients on GINA step 5 or NAEPP step 5 therapies, irrespective of asthma phenotype; 6) Suggest using anti-IL4/13 for adult patients with severe eosinophilic asthma, and for those with severe corticosteroid-dependent asthma regardless of blood eosinophil levels. These recommendations should be reconsidered as new evidence becomes available.


Assuntos
Humanos , Asma/complicações , Asma/diagnóstico , Asma/prevenção & controle , Estado Asmático/prevenção & controle
12.
West Afr J Med ; 36(2): 158-164, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385602

RESUMO

OBJECTIVE: Previous reports has shown that asthmatic patients with poor asthma control exhibited cognitive dysfunction. However, there is paucity of information on the cognitive functions of patients with clinically stable asthma particularly in sub-Saharan Africa. Subjects, study setting, materials and methods: This was a cross-sectional study conducted at the Federal Medical Centre, Owo, South West Nigeria from 2014-2016. Forty patients with mild to moderate asthma and forty matched (age, sex and educational status) non-asthmatic control subjects were included. Spirometry was done for all participants. Cognitive performance on domains of psychomotor speed, attention/concentration, memory and vigilance were assessed in all the participants using the Fepsy neuropsychological test battery Results: The mean age of the patients with asthma in years was 38.65±16.67 while that of the control subjects was 39.18±11.64 years. The patients with asthma had prolonged visual and binary choice reaction time relative to controls. Older asthmatic patients had prolonged visual and binary choice reaction time when compared to controls (p<0.05) while other socio-demographic clinical characteristics of the patients did not have impact on their cognitive performance (p>0.05). CONCLUSION: Cognitive performance was similar between the patients with mild to moderate asthma and non-asthmatic controls. Older asthmatic patients have impaired psychomotor speed relative to younger asthmatic patients.


Assuntos
Asma/diagnóstico , Transtornos Cognitivos/etiologia , Cognição/fisiologia , Desempenho Psicomotor/fisiologia , Adolescente , Adulto , Fatores Etários , Asma/complicações , Estudos de Casos e Controles , Transtornos Cognitivos/diagnóstico , Estudos Transversais , Humanos , Memória , Pessoa de Meia-Idade , Testes Neuropsicológicos , Nigéria
13.
Life Sci ; 234: 116780, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31430453

RESUMO

Bronchial asthma and obesity are common health problems. Obesity is already responsible for 300,000 deaths per year. AIMS: The aim of the present study was to assess whether apocynin, alpha lipoic acid and probiotic administration in combination with low-fat diet supplementation influences the levels of antioxidant enzymes in the pulmonary tissues of obese asthmatic mice. MAIN METHODS: The study was performed on male C57/BL6 mice divided into 10 groups: (I) control; (II) asthma; (III) obesity; (IV) asthma + obesity; (V) asthma + obesity + apocynin p.o. 15 mg/kg/day for 12 weeks; (VI) asthma + obesity + low-fat diet for 12 weeks; (VII) asthma + obesity + low-fat diet for 12 weeks with apocynin p.o. 15 mg/kg/day; (VIII) asthma + obesity + low-fat diet with probiotics for 12 weeks; (IX) asthma + obesity + low-fat diet for 12 weeks with lipoic acid p.o. 100 mg/kg/day for 12 weeks; (X) asthma + obesity + standard diet with probiotics for 12 weeks. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and glutathione reductase (GR) activity were examined. The administration of apocynin alone and apocynin in combination with a low-fat diet resulted in a significant increase in SOD values (respectively p < 0.001; p = 0.010). Application of probiotics resulted in a decrease in CAT activity (p = 0.037) and an increase in GPx activity (p < 0.001) compared to obese asthmatic mice. The administration of lipoic acid resulted in an increase in GR activity (p = 0.024 vs. control). KEY FINDINGS: Supplementation containing apocynin, lipoic acid and probiotics has a positive influence on the antioxidant capacity of the pulmonary tissues of obese asthmatic mice. SIGNIFICANCE: These results may contribute to the development of new therapeutic approaches.


Assuntos
Acetofenonas/uso terapêutico , Antioxidantes/uso terapêutico , Asma/tratamento farmacológico , Obesidade/tratamento farmacológico , Probióticos/uso terapêutico , Ácido Tióctico/uso terapêutico , Animais , Asma/complicações , Asma/metabolismo , Catalase/análise , Catalase/metabolismo , Glutationa Peroxidase/análise , Glutationa Peroxidase/metabolismo , Pulmão/efeitos dos fármacos , Pulmão/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Camundongos Obesos , Obesidade/complicações , Obesidade/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Superóxido Dismutase/análise , Superóxido Dismutase/metabolismo
14.
Internist (Berl) ; 60(11): 1151-1154, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31463521

RESUMO

Human rhinoviruses (RV) belong to the Picornaviridae and are divided into three species: rhinovirus A, B and C. As causative viruses of upper airway infections (common cold), they possess enormous epidemiological and clinical importance. Furthermore, rhinoviruses are significant pathogens of acute exacerbations of chronic airway diseases such as asthma and chronic obstructive pulmonary disease. Their role as a cofactor in the development of pneumonia and their relevance in critically ill patients is still unclear and the focus of current research. Due to the unspecific clinical symptoms, diagnosis is difficult. Laboratory detection is sophisticated and a distinction between clinically relevant infection and contamination not always possible. Specific therapeutic antiviral strategies against rhinovirus infection do not exist as yet and, due to the large variety of subtypes, the development of vaccines remains a considerable challenge.


Assuntos
Asma/complicações , Infecções por Picornaviridae/complicações , Pneumonia/complicações , Doença Pulmonar Obstrutiva Crônica/complicações , Rinite/complicações , Rhinovirus/isolamento & purificação , Antivirais , Asma/diagnóstico , Asma/virologia , Progressão da Doença , Humanos , Infecções por Picornaviridae/diagnóstico , Infecções por Picornaviridae/virologia , Pneumonia/diagnóstico , Pneumonia/virologia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/virologia , Infecções Respiratórias , Rinite/diagnóstico , Rinite/virologia
15.
BMJ Case Rep ; 12(7)2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31296634

RESUMO

Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystemic small-vessel vasculitic disease that can present with positive MPO-P-ANCA (myeloperoxidase-perinuclear-anti-neutrophil cytoplasmic antibody). It is a rare condition that is difficult to diagnose. We present the case of a 64-year-old man with late-onset adult asthma and treated nasopharyngeal carcinoma who initially presented to us with proximal myopathy. Thereafter, he developed a constellation of fleeting symptoms which included rhinosinusitis, mononeuritis multiplex, skin vasculitis and arthritis. Blood investigations showed that he had eosinophilia, and skin biopsy demonstrated dermal vasculitis with eosinophils. He was found to be MPO-C-ANCA positive, and although initially thought to have granulomatosis with polyangiitis, the diagnosis was later revised to EGPA. This case highlights the diagnostic challenges with atypical presentations of EGPA and also presents a rare case of positive MPO-C-ANCA that has never been described in EGPA before.


Assuntos
Anticorpos Anticitoplasma de Neutrófilos/sangue , Asma/complicações , Síndrome de Churg-Strauss/complicações , Síndrome de Churg-Strauss/diagnóstico , Granulomatose com Poliangiite , Peroxidase/sangue , Síndrome de Churg-Strauss/sangue , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade
16.
Biomed Res Int ; 2019: 8919230, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31317041

RESUMO

Several previous studies demonstrated the risk of stroke in asthma patients. The aim of this study was to evaluate the risk of hemorrhagic and ischemic stroke in asthma patients, independent of age, sex, income, region of residence, and past medical histories. The Korean Health Insurance Review and Assessment Service-National Sample Cohort from 2002 through 2013 was used. Overall, 111,364 asthma patients ≥ 20 years old were matched to 111,364 control participants for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia. Asthma was classified using ICD-10 codes (J45 and J46) and medication history. The admission histories were investigated for hemorrhagic stroke (I60-I62) and ischemic stroke (I63) using ICD-10 codes. The crude and adjusted (age, sex, income, region of residence, hypertension, diabetes, dyslipidemia, ischemic heart disease, and depression) hazard ratios (HRs) for hemorrhagic and ischemic stroke in asthma patients were analyzed using a Cox proportional hazards model. Subgroup analyses were conducted according to age and sex. Hemorrhagic and ischemic stroke were found in 0.7% (795/117,364) and 2.4% (922/117,364) of the asthma group and in 0.8% (922/117,364) and 2.6% (93,079/117,364) of the control group, respectively. The asthma group demonstrated adjusted HRs of 0.86 (95% confidence interval [CI] = 0.78-0.94, p = 0.002) for hemorrhagic stroke and 0.91 (95% CI = 0.86-0.95, p = 0.002) for ischemic stroke. None of the subgroups of asthma patients showed higher HRs for stroke. Asthma did not elevate the risk of either hemorrhagic or ischemic stroke.


Assuntos
Asma/epidemiologia , Hemorragia/epidemiologia , Isquemia/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Asma/complicações , Asma/fisiopatologia , Feminino , Seguimentos , Hemorragia/etiologia , Hemorragia/fisiopatologia , Humanos , Isquemia/etiologia , Isquemia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , República da Coreia , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/fisiopatologia , Adulto Jovem
17.
Rhinology ; 57(5): 392-399, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31322142

RESUMO

Over the past 20 years, ARIA (Allergic Rhinitis and its Impact on Asthma) has developed various guidelines for the treatment of allergic rhinitis (AR) and asthma multimorbidity. Over time, the ARIA initiative has evolved to ensure the highest level of bestpractices adoption in real life settings. It has evolved towards Integrated Care Pathways (ICPs) using mobile technology, and has now entered a new phase in which change management is key to provide an active and healthy life to all AR patients. With that in mind, the first ARIA masterclass was held on 12th September 2018 in Brussels, Belgium. The masterclass aimed at informing clinicians about the principles of change management, providing unbiased education on diagnosis and treatments, sharing the most recent research data on AR and multimorbidities, and creating a snowball effect to increase the adoption of best practices around the globe. This report provides an overview of the ARIA masterclass concept, summarizes the key lectures and discussions, and gives an outline of the future key development.


Assuntos
Asma , Rinite Alérgica , Asma/complicações , Asma/terapia , Bélgica , Competência Clínica , Humanos , Rinite Alérgica/complicações , Rinite Alérgica/terapia
18.
Mol Med Rep ; 20(3): 2381-2388, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31322198

RESUMO

The phagocytosis of apoptotic cells by alveolar epithelial cells helps to eliminate airway inflammation. Insulin­like growth factor 1 (IGF­1) regulates cell metabolism and proliferation, and promotes cell survival, while it may also promote the proliferation and differentiation of alveolar epithelial cells during the repair of lung injury. The present study investigated the effect of IGF­1 on the phagocytic activity of alveolar epithelial cells, a nonprofessional phagocyte. IGF­1 was elevated in lung tissue and bronchoalveolar lavage fluid obtained from mice with ovalbumin­induced asthma. IGF­1 was reduced by 50% in the lung tissue and by nearly 100% in the bronchoalveolar lavage fluid in asthmatic mice established by depletion of alveolar macrophages using 2­chloroadenosine. In addition, interleukin­33 induced IGF­1 production in primary alveolar macrophages. It was also observed that IGF­1 inhibited the phagocytosis of fluorescent microspheres and apoptotic cells by MLE­12 alveolar epithelial cells. Antibody blocking of IGF­1 enhanced the phagocytosis of fluorescent microspheres and apoptotic cells, and significantly reduced inflammatory cell infiltration in airway and perivascular tissues. The elevated IGF­1 level in the lungs of asthma model mice was mainly produced in alveolar macrophages. Taken together, the current study demonstrated that IGF­1 inhibited phagocytosis by alveolar epithelial cells, and that IGF­1 blockade enhanced the phagocytic activity and alleviated airway inflammation. These results support the potential use of IGF­1 as a target in the treatment of asthma.


Assuntos
Células Epiteliais Alveolares/imunologia , Asma/imunologia , Fator de Crescimento Insulin-Like I/imunologia , Fagocitose , Células Epiteliais Alveolares/patologia , Animais , Apoptose , Asma/complicações , Asma/patologia , Células Cultivadas , Feminino , Inflamação/complicações , Inflamação/imunologia , Inflamação/patologia , Fator de Crescimento Insulin-Like I/análise , Pulmão/imunologia , Pulmão/patologia , Camundongos , Camundongos Endogâmicos BALB C
19.
Arerugi ; 68(6): 696-700, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31308336

RESUMO

Atopic dermatitis and bronchial asthma are common diseases in children. We report the development of eosinophilic polyangiitis granulomatosis (EGPA) in a young girl being treated for both atopic dermatitis, diagnosed at 1 year of age, and bronchial asthma, diagnosed at 4 years of age. Her eruption did not result in lichenification and was not fully responsive to corticosteroid ointment. Asthma lightened by treatment of inhalational steroids. Hypereosinophilia was detected at 5 years of age, at least 20% of white blood cells, and 44% at 8 years of age. At 10 years of age, she was diagnosed with anti-neutrophil cytoplasmic antibody-negative EGPA. The diagnosis was based on findings of eosinophil-infiltrating granulomatous vasculitis of the skin accompanied by notable peripheral blood eosinophilia, sinusitis, and pulmonary nodules on radiographic evaluation. Asymptomatic myocardial involvement was also detected utilizing dual perfusion and metabolic scintigraphy with 201Tl/123I-BMIPP, which was relieved by 1-year treatment of glucocorticoid combined with immunosuppressive drugs. EGPA is an extremely rare vasculitis that develops several years after preceding allergic disorders. Pediatric-onset EGPA has a poorer prognosis than adult-onset EGPA, which can be attributed to a high prevalence of cardiac involvement. Therefore, accurate diagnosis is critical for improving prognosis. EGPA should be considered when atypical findings are noted in management of atopic dermatitis and bronchial asthma.


Assuntos
Asma/complicações , Síndrome de Churg-Strauss/diagnóstico , Dermatite Atópica/complicações , Eczema/complicações , Corticosteroides/uso terapêutico , Asma/diagnóstico , Criança , Pré-Escolar , Síndrome de Churg-Strauss/complicações , Dermatite Atópica/diagnóstico , Eczema/diagnóstico , Feminino , Humanos
20.
Medicina (Kaunas) ; 55(7)2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31277327

RESUMO

A 56-year-old man with severe asthma underwent bronchial thermoplasty (BT). However, his asthma exacerbated and hypereosinophilia developed 2 months later, thus necessitating oral corticosteroid (OCS) therapy. Six months after BT, a diagnosis of severe asthma with eosinophilic chronic rhinosinusitis (ECRS) was made and benralizumab treatment was initiated; the blood eosinophil count subsequently decreased and lung function improved, thereby permitting OCS dose tapering. Surprisingly, benralizumab both reduced nasal polyps and ameliorated ECRS. Thus, benralizumab may be a useful drug for the rapid treatment of severe asthma with ECRS, especially in patients with hypereosinophilia.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Asma/tratamento farmacológico , Eosinofilia/tratamento farmacológico , Sinusite/tratamento farmacológico , Anticorpos Monoclonais Humanizados/farmacologia , Asma/complicações , Termoplastia Brônquica/métodos , Progressão da Doença , Eosinofilia/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Sinusite/complicações
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