Applied Sciences

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8 pages, 243 KiB

Open AccessCommunication

Allergic Rhinitis and Asthma: Relationship with Transverse Maxillary Contraction and Transverse Expansion Stability in Children

by Giancarlo Ottaviano, Lorenzo Favero, Silva Hajrulla, Andrea Volpato, Sally Paganin, Guido Bissolotti, Bruno Scarpa and Riccardo Favero

Appl. Sci. 2023, 13(5), 3200; https://doi.org/10.3390/app13053200 - 2 Mar 2023

Viewed by 1708

Abstract

Background: Allergic rhinitis is a frequent cause of nasal obstruction in the pediatric population. The effect of prolonged mouth breathing on craniofacial growth continues to be a controversial topic in the orthodontic literature. This study investigates both the role of allergic rhinitis/asthma in [...] Read more.

Background: Allergic rhinitis is a frequent cause of nasal obstruction in the pediatric population. The effect of prolonged mouth breathing on craniofacial growth continues to be a controversial topic in the orthodontic literature. This study investigates both the role of allergic rhinitis/asthma in the etiology of posterior crossbite and ogival palate and the influence of allergic rhinitis/asthma on the long-term stability produced by transverse expansion treatment. Methods: A retrospective analysis of the clinical records of 319 subjects between 5 and 12 years, presenting for an orthodontic evaluation was performed. The sample was divided into study and control groups depending on the presence/absence of posterior crossbite and/or ogival palate. Data regarding the subjects’ breathing patterns and allergic respiratory diseases were collected. The relapse rate of transverse expansion treatment was evaluated. Results: An association (p = 0.05) was found between posterior crossbite/ogival palate and the presence of allergies. Multivariate analyses uncovered that both allergic rhinitis and younger ages were associated with posterior crossbite/ogival palate (p = 0.029890; p = 0.000283, respectively). No association was found between allergies and/or asthma and relapse following orthodontic treatment. Conclusions: Although data analysis suggests that allergies can induce transverse maxillary contraction in children, their presence did not seem to affect the outcome of orthodontic expansion treatment. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

13 pages, 1040 KiB

Open AccessArticle

A Preliminary Investigation of Mobile Respiratory Function Testing in Western Australian Communities

by Petra Czarniak, Kim Watkins, Finbarr Foy, Richard Parsons, Graham L. Hall and Bruce Sunderland

Appl. Sci. 2023, 13(3), 1855; https://doi.org/10.3390/app13031855 - 31 Jan 2023

Viewed by 944

Abstract

Although underutilized, spirometry is essential in the diagnosis and management of chronic obstructive pulmonary disease (COPD) and asthma. This study aimed to investigate a mobile (i.e., transportable) lung function testing (LFT) services in two metropolitan and two rural clinics in Western Australia. Individuals [...] Read more.

Although underutilized, spirometry is essential in the diagnosis and management of chronic obstructive pulmonary disease (COPD) and asthma. This study aimed to investigate a mobile (i.e., transportable) lung function testing (LFT) services in two metropolitan and two rural clinics in Western Australia. Individuals attending a mobile LFT clinic in 2021 were invited to complete questionnaires at baseline and after 6–8 weeks. Questionnaires were completed by 59/74 (79.7%) respondents (mean age 62.5 ± 14.2 years); most were female (35/59; 59.3%). A history of asthma was reported in 50.9% (30/59) and COPD in 18.6% (11/59) of respondents [13.6% (8/59) reported both]. At baseline, most (22/30; 73.3%) had asthma control test scores ≤19 (mean 16.6; range 8.0–25.0); at follow-up, 16/31 (51.6%) had scores ≤19 (mean score 18.0; range 6.0–25.0). Of the 11 diagnosed with COPD at baseline, the mean Clinical COPD Questionnaire and COPD assessment test scores were greater at follow-up (1.9 vs. 2.3; and: 10.3 vs. 14.7 respectively), reflecting worsening disease. Most participants (57/59; 96.6%) were satisfied with the LFT experience. The role of mobile LFT services to optimize the diagnosis and management of chronic lung disease and to minimize patient burden requires further investigation to improve short term patient outcomes. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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10 pages, 547 KiB

Open AccessArticle

Prevalence and Outcome of Asthma in Adult Patients Admitted to the Emergency Department for COVID-19: A Case-Control Study

by Maurizio Gabrielli, Marcello Candelli, Giulia Pignataro, Veronica Ojetti, Marta Sacco Fernandez, Federico Rosa, Antonio Gasbarrini, Francesco Franceschi and on behalf of GEMELLI AGAINST COVID 2019

Appl. Sci. 2023, 13(1), 44; https://doi.org/10.3390/app13010044 - 21 Dec 2022

Viewed by 1482

Abstract

(1) Background: Viral respiratory infections are common triggers for asthma exacerbation, often leading patients to the emergency department (ED). COVID-19, the disease caused by the SARS-CoV-2 virus, typically presents with respiratory symptoms, from minor symptoms, up to and including severe acute respiratory failure. [...] Read more.

(1) Background: Viral respiratory infections are common triggers for asthma exacerbation, often leading patients to the emergency department (ED). COVID-19, the disease caused by the SARS-CoV-2 virus, typically presents with respiratory symptoms, from minor symptoms, up to and including severe acute respiratory failure. Data on the association between asthma and COVID-19 are conflicting, and those from an ED setting are scarce. Our aims were to assess the prevalence and outcome of patients with asthma admitted to the ED for COVID-19. (2) Methods: We performed a case-control study, extracting data from a registry of adult patients with confirmed COVID-19 consecutively admitted to the ED of our hospital between March 2020 and January 2021. (3) Results: We identified 83 patients with asthma out of 935 individuals (prevalence 8.9%). There were no significant differences between cases and controls regarding both the proportion of hospital admissions and patients with critical COVID-19. (OR 1.37; 95% CI 0.52–3.56; and (OR 0.74; 95% CI 0.31–1.78 respectively). (4) Conclusions: In patients admitted to the ED for COVID-19, the prevalence of asthma was not higher than expected, and asthma was not associated with a worse outcome, in terms of the rate of hospitalization and critical COVID-19 disease. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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10 pages, 830 KiB

Open AccessArticle

The Efficacy, Tolerance and Acceptance of a New Fixed-Dose Salmeterol and Fluticasone Propionate Dry-Powder Inhaler—Salflumix Easyhaler^® in COPD Patients in the Daily Clinical Practice

by Zbigniew Doniec, Magdalena Olszanecka-Glinianowicz, Piotr Hantulik, Agnieszka Almgren-Rachtan and Jerzy Chudek

Appl. Sci. 2022, 12(23), 12142; https://doi.org/10.3390/app122312142 - 27 Nov 2022

Viewed by 1464

Abstract

The efficacy of the fix-dose salmeterol/fluticasone propionate combination in chronic obstructive pulmonary disease (COPD) was only shown for the original product. This investigator-initiated study aimed to prove the efficacy and safety of Salflumix Easyhaler^®, a second-entry product (dry-powder inhaler) in a [...] Read more.

The efficacy of the fix-dose salmeterol/fluticasone propionate combination in chronic obstructive pulmonary disease (COPD) was only shown for the original product. This investigator-initiated study aimed to prove the efficacy and safety of Salflumix Easyhaler^®, a second-entry product (dry-powder inhaler) in a real-life setting. The efficacy of the therapy was assessed in 440 COPD outpatients (36.1% classified as C&D groups according to GOLD) using the COPD assessment test (CAT) and the modified Medical Research Council (mMRC). During 86 ± 30 days, the frequency of COPD with a big and very big impact on life (CAT > 20 pts); and high scores of dyspnea (mMRC ≥ 2) decreased from 60.7% and 57.5% at I visit to 15.2% and 22.6% at III visits, respectively (p < 0.001). There was a greater improvement in newly diagnosed patients than those who switched from other devices due to insufficient disease control or patient dissatisfaction with the used inhaler. Patients’ satisfaction was scored 3.2–3.5 in a 4 pts scale. Physicians scored the burden related to the use of Salflumix Easyhaler^® as very low. Adherence exceeded 90%. This study supports effectiveness, satisfaction, and convenience with the use of this new product in COPD, and shows that ICS-containing DPI therapy is still improperly prescribed for patients with a low risk of COPD exacerbation in real-life settings. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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15 pages, 3285 KiB

Open AccessArticle

State of Asthma-Related Hospital Admissions in New Zealand and Predicting Length of Stay Using Machine Learning

by Widana Kankanamge Darsha Jayamini, Farhaan Mirza, M. Asif Naeem and Amy Hai Yan Chan

Appl. Sci. 2022, 12(19), 9890; https://doi.org/10.3390/app12199890 - 1 Oct 2022

Cited by 2 | Viewed by 2489

Abstract

Length of stay (LOS) is a key indicator of healthcare quality and reflects the burden on the healthcare system. However, limited studies have used machine learning to predict LOS in asthma. This study aimed to explore the characteristics and associations between asthma-related admission [...] Read more.

Length of stay (LOS) is a key indicator of healthcare quality and reflects the burden on the healthcare system. However, limited studies have used machine learning to predict LOS in asthma. This study aimed to explore the characteristics and associations between asthma-related admission data variables with LOS and to use those factors to predict LOS. A dataset of asthma-related admissions in the Auckland region was analysed using different statistical techniques. Using those predictors, machine learning models were built to predict LOS. Demographic, diagnostic, and temporal factors were associated with LOS. Māori females had the highest average LOS among all the admissions at 2.8 days. The random forest algorithm performed well, with an RMSE of 2.48, MAE of 1.67, and MSE of 6.15. The mean predicted LOS by random forest was 2.6 days with a standard deviation of 1.0. The other three algorithms were also acceptable in predicting LOS. Implementing more robust machine learning classifiers, such as artificial neural networks, could outperform the models used in this study. Future work to further develop these models with other regions and to identify the reasons behind the shorter and longer stays for asthma patients is warranted. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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14 pages, 3140 KiB

Open AccessArticle

Anti-Inflammatory and Anti-Airway Remodeling Activities of Jakyakgamcho-Tang in a Mouse Model of COPD

by Jee Hyun Kang, Yu-Jin Kim, Eun Bok Baek, Eun-Ju Hong, Mee-Young Lee and Hyo-Jung Kwun

Appl. Sci. 2022, 12(17), 8646; https://doi.org/10.3390/app12178646 - 29 Aug 2022

Cited by 1 | Viewed by 1623

Abstract

Jakyakgamcho-tang (JGT) is used in oriental medicine to treat inflammation and allergy. Chronic obstructive pulmonary disease (COPD) causes respiratory inflammation, airway remodeling, and pulmonary emphysema. We examine the influence of JGT on COPD by using a mouse model. COPD was induced by inhalation [...] Read more.

Jakyakgamcho-tang (JGT) is used in oriental medicine to treat inflammation and allergy. Chronic obstructive pulmonary disease (COPD) causes respiratory inflammation, airway remodeling, and pulmonary emphysema. We examine the influence of JGT on COPD by using a mouse model. COPD was induced by inhalation of cigarette smoke (CS) and nasal administration of lipopolysaccharide (LPS). In comparison to COPD mice induced by CS and LPS, mice administered with JGT exhibited significantly lower amounts of inflammatory cells and reduced expression levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1β, and monocyte chemoattractant protein-1 (MCP-1) in bronchoalveolar lavage fluid (BALF) and lung tissue. The elevated concentrations of transforming growth factor-β (TGF-β), α-smooth muscle actin (α-SMA), and matrix metallopeptidase-9 (MMP-9) induced by CS and LPS were also inhibited by JGT treatment. Moreover, JGT suppressed CS and LPS-induced phosphorylation of nuclear factor kappa B (NF-κB), extracellular signal-regulated kinase1/2 (ERK1/2) and mitogen-activated protein kinases (p38 MAPKs). In a COPD mouse model, our results demonstrated that JGT prevented CS and LPS induced airway inflammation and remodeling. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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17 pages, 2388 KiB

Open AccessArticle

Influence of Home Indoor Dampness Exposure on Volatile Organic Compounds in Exhaled Breath of Mothers and Their Infants: The NELA Birth Cohort

by Rosa A. Sola-Martínez, Gema Lozano Terol, Julia Gallego-Jara, Eva Morales, Luis García-Marcos, José Antonio Noguera-Velasco, Manuel Cánovas Díaz and Teresa de Diego Puente

Appl. Sci. 2022, 12(14), 6864; https://doi.org/10.3390/app12146864 - 7 Jul 2022

Cited by 1 | Viewed by 1527

Abstract

Currently, the effect of exposure to indoor air contaminants and the presence of dampness at home on respiratory/atopic health is of particular concern to physicians. The measurement of volatile organic compounds (VOCs) in exhaled breath is a useful approach for monitoring environmental exposures. [...] Read more.

Currently, the effect of exposure to indoor air contaminants and the presence of dampness at home on respiratory/atopic health is of particular concern to physicians. The measurement of volatile organic compounds (VOCs) in exhaled breath is a useful approach for monitoring environmental exposures. A great advantage of this strategy is that it allows the study of the impact of pollutants on the metabolism through a non-invasive method. In this paper, the levels of nine VOCs (acetone, isoprene, toluene, p/m-xylene, o-xylene, styrene, benzaldehyde, naphthalene, and 2-ethyl-1-hexanol) in the exhaled breath of subjects exposed and not exposed to home dampness were assessed. Exhaled breath samples were collected from 337 mother–child pairs of a birth cohort and analysed by gas-chromatography–mass-spectrometry. It was observed that the levels of 2-ethyl-1-hexanol in the exhaled breath of the mothers were significantly influenced by exposure to household humidity. In the case of the infants, differences in some of the VOC levels related to home dampness exposure; however, they did not reach statistical significance. In addition, it was also found that the eosinophil counts of the mothers exposed to home dampness were significantly elevated compared to those of the non-exposed mothers. To our knowledge, these findings show, for the first time, that exposure to home dampness may influence VOC patterns in exhaled breath. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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14 pages, 9519 KiB

Open AccessArticle

Prostaglandin D₂ Attenuates Lipopolysaccharide-Induced Acute Lung Injury through the Modulation of Inflammation and Macrophage Polarization

by Ahmad Almatroudi, Mohammed A. Alsahli, Mansoor Ali Syed, Amjad Ali Khan and Arshad Husain Rahmani

Appl. Sci. 2022, 12(12), 6076; https://doi.org/10.3390/app12126076 - 15 Jun 2022

Cited by 1 | Viewed by 1518

Abstract

Acute lung injury (ALI) is a well-known respiratory disease and a leading cause of death worldwide. Despite advancements in the medical field, developing complete treatment strategies against this disease is still a challenge. In the current study, the therapeutic role of prostaglandin D [...] Read more.

Acute lung injury (ALI) is a well-known respiratory disease and a leading cause of death worldwide. Despite advancements in the medical field, developing complete treatment strategies against this disease is still a challenge. In the current study, the therapeutic role of prostaglandin D₂ (PGD₂) was investigated on lipopolysaccharide (LPS)-induced lung injury in mice models and RAW264.7 macrophages through anti-inflammatory, histopathology, immunohistochemistry, and TUNEL staining. The overproduction of cytokines by RAW264.7 macrophages was observed after stimulation with LPS. However, pretreatment with PGD₂ decreased the production of cytokines. The level of inflammatory markers was significantly restored in the PGD₂ treatment group (TNF-α = 58.6 vs. 78.5 pg/mL; IL-1β = 29.3 vs. 36.6 pg/mL; IL-6 = 75.4 vs. 98.2 pg/mL; and CRP = 0.84 vs. 1.14 ng/mL). The wet/dry weight ratio of the lungs was quite significant in the disease control (LPS-only treatment) group. Moreover, the histological changes as determined by haematoxylin and eosin (H&E) staining clearly showed that PGD₂ treatment maintains the lung tissue architecture. The iNOS expression pattern was increased in lung tissues of LPS-treated animals, whereas, in mice treated with PGD₂, the expression of iNOS protein decreased. Flow cytometry data demonstrated that LPS intoxication enhanced apoptosis, which significantly decreased with PGD₂ treatment. In conclusion, all these observations indicate that PGD₂ provides an anti-inflammatory response in RAW264.7 macrophages and in ALI, and they suggest a therapeutic potential in lung pathogenesis. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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9 pages, 652 KiB

Open AccessArticle

Soluble Receptor of Advanced Glycation End-Products (sRAGE) in Pediatric Asthma: A Prospective Study in 68 Children Aged 7 Years

by Julie Magnier, Valérie Julian, Vincent Sapin, Aurélien Mulliez, Alexandra Usclade, Emmanuelle Rochette, Bertrand Evrard, André Labbe, Karen Coste and Carole Egron

Appl. Sci. 2022, 12(12), 5926; https://doi.org/10.3390/app12125926 - 10 Jun 2022

Cited by 1 | Viewed by 1359

Abstract

Background: Asthma is a chronic inflammatory disease of the airways common in children. Soluble advanced glycation end-product receptor (sRAGE) is a blood biomarker of lung damage and inflammation. We sought to determine whether it could also be a biomarker in childhood asthma. Methods [...] Read more.

Background: Asthma is a chronic inflammatory disease of the airways common in children. Soluble advanced glycation end-product receptor (sRAGE) is a blood biomarker of lung damage and inflammation. We sought to determine whether it could also be a biomarker in childhood asthma. Methods: We conducted a prospective, observational, analytical study at Clermont-Ferrand University Hospital. We measured plasma sRAGE levels in asthmatic and healthy children aged 7 years. Results: Of the 68 children assessed, 15 (22.05%) presented asthma. All presented normal respiratory function. The mean plasma sRAGE level was 1875 pg/mL in the children with asthma and 1794 pg/mL in the healthy children (p = 0.525). The mean plasma sRAGE level was significantly decreased with tobacco exposure during pregnancy: 1478 pg/mL versus 1870 pg/mL without (p = 0.007). Lower levels were observed in children living in apartments (1557 pg/mL) than in those living in houses (1863 pg/mL) (p = 0.031). Conclusions: No difference was observed in plasma sRAGE levels in children with asthma in our well-treated and controlled population. Environmental exposure may affect these levels. Further studies are required to better characterize the role of sRAGE. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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9 pages, 263 KiB

Open AccessArticle

The Influence of Peripheral Blood Eosinophil Counts in Asthma Comorbidities in Adults: A Real Life Study

by Ignacio Esteban-Gorgojo, Manuel Jorge Rial and Joaquín Sastre

Appl. Sci. 2022, 12(9), 4271; https://doi.org/10.3390/app12094271 - 23 Apr 2022

Cited by 1 | Viewed by 1314

Abstract

Asthma and eosinophilia are two closely related pathologies whose interaction is key in the era of precision medicine. However, this relationship is rarely taken into account without the influence of therapeutic prescriptions. In this study involving 1296 subjects, the relationship between eosinophilia and [...] Read more.

Asthma and eosinophilia are two closely related pathologies whose interaction is key in the era of precision medicine. However, this relationship is rarely taken into account without the influence of therapeutic prescriptions. In this study involving 1296 subjects, the relationship between eosinophilia and asthma was analyzed without taking into account other biases. We observed that rhinitis only appears in non-asthmatic patients with elevated blood eosinophil levels, while atopy was elevated in parallel to eosinophilia regardless of whether the patients were asthmatic or not. In terms of lung function, a decrease was observed for higher blood eosinophil levels, which is especially relevant in the FEV1/FVC ratio. FENO is elevated in relation to higher eosinophilia, but total IgE is only elevated in patients with high peripheral blood eosinophil levels and asthma. Finally, the only feature of asthma that is altered by increased peripheral eosinophilia is persistent asthma, with all other features remaining unchanged. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

Review

Jump to: Research

15 pages, 704 KiB

Open AccessReview

Pediatric Asthma: Where Has Montelukast Gone?

by Marco Maglione, Antonietta Giannattasio, Antonia Pascarella and Vincenzo Tipo

Appl. Sci. 2023, 13(7), 4146; https://doi.org/10.3390/app13074146 - 24 Mar 2023

Viewed by 3853

Abstract

At its introduction in the management of pediatric asthma, montelukast was regarded as a potentially revolutionary drug due to its mechanism of action and easy clinical applicability. Nevertheless, its use in daily practice and evidence from clinical trials have shown that, rather than [...] Read more.

At its introduction in the management of pediatric asthma, montelukast was regarded as a potentially revolutionary drug due to its mechanism of action and easy clinical applicability. Nevertheless, its use in daily practice and evidence from clinical trials have shown that, rather than a radical change in the approach to asthmatic children, montelukast more likely represents a second-line medication that is useful when inhaled steroids alone fail in providing adequate symptom control. Furthermore, increasingly reported side effects have raised concerns regarding its safety. In the last decade, several studies have tried to better define the strengths and drawbacks of montelukast both in preschool wheezing and school-age asthma. The present review summarizes the literature published on this topic since 2010, highlighting the often-controversial results and the unanswered questions regarding the role of montelukast in pediatric asthma. Moreover, advances in the understanding of the mechanisms of action of montelukast are reported. The main finding emerging from the present analysis is that montelukast application is likely to be useful in a subset of asthmatic children rather than in large groups of patients. Future studies should focus on the identification of biomarkers able to predict which patients will benefit from montelukast to achieve a more tailored prescription. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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25 pages, 1032 KiB

Open AccessReview

Sex-Based Differences in Bronchial Asthma: What Are the Mechanisms behind Them?

by Daniela Mokra, Romana Barosova and Juraj Mokry

Appl. Sci. 2023, 13(4), 2694; https://doi.org/10.3390/app13042694 - 19 Feb 2023

Cited by 3 | Viewed by 2723

Abstract

Sex-based differences in bronchial asthma can already be observed in childhood, at which time allergic atopic asthma is more frequently found in boys than in girls. In adulthood, higher prevalence of asthma is reported in women, especially for the more severe neutrophilic subtype [...] Read more.

Sex-based differences in bronchial asthma can already be observed in childhood, at which time allergic atopic asthma is more frequently found in boys than in girls. In adulthood, higher prevalence of asthma is reported in women, especially for the more severe neutrophilic subtype associated with obesity, which responds poorly to corticosteroids. Sex-based differences seem to be attributable to changing levels of estrogens, progesterone, and testosterone, which may exert mainly pro-inflammatory (estrogens, progesterone) or anti-inflammatory effects (testosterone). Sex steroids differentially influence lung immune responses, airway reactivity, and pulmonary circulation and may thereby contribute to the higher susceptibility of females to more serious complications resulting from inflammatory lung diseases compared to males. However, other factors, such as anatomical and physiological differences in the lungs, differences in genetically conditioned factors, obesity and lifestyle, smoking, exposure to environmental and occupational factors, chronic stress, etc., may also contribute to the sex-based differences in asthma. Elucidation of the mechanisms behind these differences may contribute to more appropriate personalized therapy for asthma. For the review, articles in the English language from the PubMed database were used. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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26 pages, 2072 KiB

Open AccessReview

Diagnosis and Treatment in Asthma and Allergic Rhinitis: Past, Present, and Future

by Marta Espada-Sánchez, Rocío Sáenz de Santa María, María del Carmen Martín-Astorga, Clara Lebrón-Martín, María Jesús Delgado, Ibón Eguiluz-Gracia, Carmen Rondón, Cristobalina Mayorga, María José Torres, Carlos José Aranda and José Antonio Cañas

Appl. Sci. 2023, 13(3), 1273; https://doi.org/10.3390/app13031273 - 18 Jan 2023

Cited by 1 | Viewed by 5271

Abstract

Respiratory diseases are pathological conditions that affect airways, hampering breathing and causing high mortality. In particular, asthma and allergic rhinitis (AR) are two of the most common airway diseases that affect millions of people and have a high prevalence in childhood and adulthood. [...] Read more.

Respiratory diseases are pathological conditions that affect airways, hampering breathing and causing high mortality. In particular, asthma and allergic rhinitis (AR) are two of the most common airway diseases that affect millions of people and have a high prevalence in childhood and adulthood. Asthma is a heterogeneous chronic inflammatory disease characterized by wheezing, chest tightness, shortness of breath, and cough. AR occurs with rhinorrhea, nasal congestion, and sneezing. Indeed, these pathologies share common physiopathological mechanisms such as airway hyperresponsiveness and similar immunopathology such as tissue eosinophilia and T-helper type 2 inflammation. Moreover, AR can be an important risk factor for suffering asthma. Thus, early diagnosis and effective treatment are crucial to improving the health and quality of life of these patients. Classical drugs such as corticosteroids have been used; however, in the last decades, efforts to improve treatments have increased, focusing on biological agents and specific allergen immunotherapy development. Moreover, more precise diagnostic tools have been elaborated, besides classical methods (medical history, physical examination, and pulmonary function tests), such as basophil activation test, and specific cellular and molecular biomarkers (microRNAs, sputum/blood eosinophils, IgE serum, and periostin levels). Therefore, in this review, we compile all these important issues for managing asthma and AR. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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13 pages, 1407 KiB

Open AccessReview

Management of Severe Asthma in Eosinophilic Granulomatosis with Polyangiitis with Interleukin-5-Targeted Therapies: Current Status and Report of Two Cases

by Ciro Romano, Domenico Cozzolino, Ausilia Sellitto and Luca Rinaldi

Appl. Sci. 2022, 12(22), 11535; https://doi.org/10.3390/app122211535 - 14 Nov 2022

Cited by 1 | Viewed by 2255

Abstract

Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic disorder characterized by peripheral eosinophilia, severe eosinophilic asthma, sinusitis, transient pulmonary infiltrates, and features of medium/small-vessel vasculitis. EGPA belongs to the group of anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitides, although only 30 to 40% of patients [...] Read more.

Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic disorder characterized by peripheral eosinophilia, severe eosinophilic asthma, sinusitis, transient pulmonary infiltrates, and features of medium/small-vessel vasculitis. EGPA belongs to the group of anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitides, although only 30 to 40% of patients display ANCA positivity, which is mainly of myeloperoxidase (MPO) specificity. Particularly, ANCA-positive patients typically show vasculitic features. Interleukin (IL)-5 has been demonstrated to play a crucial role in determining eosinophilic airway inflammation in EGPA patients. Specifically, maturation, activation, and survival of eosinophils especially depend on IL-5 availability. Therefore, blocking IL-5 biological activity may be a rewarding strategy for control of eosinophilic inflammation. Several monoclonal antibodies with the ability to interfere with the biological activity of IL-5 have been developed, namely, mepolizumab, reslizumab, and benralizumab. Here, we discuss the role of these drugs in the management of severe eosinophilic asthma in the context of EGPA and report the outcome of two EGPA patients with severe eosinophilic asthma treated at our outpatient clinic. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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11 pages, 554 KiB

Open AccessReview

Local Allergic Rhinitis: A Different Rhinitis Endotype? Literature Overview

by Elena Cantone, Aikaterini Detoraki and Eugenio De Corso

Appl. Sci. 2022, 12(21), 11141; https://doi.org/10.3390/app122111141 - 3 Nov 2022

Cited by 1 | Viewed by 2064

Abstract

Chronic rhinitis (CR) is commonly divided into allergic rhinitis (AR) and nonallergic rhinitis (NAR). AR is triggered by the immunoglobulin E (IgE)-mediated response to allergens, whereas NAR is characterized by the absence of allergic sensitization. Previous studies have demonstrated the presence of local [...] Read more.

Chronic rhinitis (CR) is commonly divided into allergic rhinitis (AR) and nonallergic rhinitis (NAR). AR is triggered by the immunoglobulin E (IgE)-mediated response to allergens, whereas NAR is characterized by the absence of allergic sensitization. Previous studies have demonstrated the presence of local IgE in the nasal mucosa of patients suffering from typical allergic rhinitis (AR) symptoms but without a history of atopy and a positive response to a nasal allergen challenge (NAC). This condition was recently defined as local allergic rhinitis (LAR), which is supposed to be a different CR characterized by a type 2 (T2) inflammation response with the release of typical T2 mediators. LAR is defined as a phenotype of AR characterized by a localized nasal allergic response that is negative skin prick testing to allergens in the absence of serum-specific IgE. Diagnosis is based on a positive response to NAC. This review is an update of LAR literature, focusing on the definition of LAR as an independent endotype. LAR, AR, and NAR are characterized by the same clinical symptoms, although there are some differences between these three subtypes. However, the literature data are not yet univocal in defining LAR as an independent endotype. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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15 pages, 1035 KiB

Open AccessReview

Adult Asthma Management in the Emergency Department during COVID-19 Pandemic: An Expert Opinion Survey

by Maurizio Gabrielli, Angela Saviano, Matteo Bonini, Cristina Boccabella, Cristiano Caruso, Maria Pia Ruggieri, Simone Bianconi, Leonello Fuso, Pietro Capuzi, Francesca De Marco, Laura Franza and Francesco Franceschi

Appl. Sci. 2022, 12(19), 9460; https://doi.org/10.3390/app12199460 - 21 Sep 2022

Viewed by 5240

Abstract

Adult patients with asthma often access the emergency department (ED) for the management of exacerbations or uncontrolled symptoms. Sometimes the first diagnosis of asthma occurs right in the ED. In the last couple of years, the COVID-19 pandemic spread around the world, causing [...] Read more.

Adult patients with asthma often access the emergency department (ED) for the management of exacerbations or uncontrolled symptoms. Sometimes the first diagnosis of asthma occurs right in the ED. In the last couple of years, the COVID-19 pandemic spread around the world, causing an acute respiratory syndrome named SARS-CoV-2, characterized mainly by respiratory symptoms, such as cough and shortness of breath, in addition to fever. This clinical pattern partially overlaps with that caused by asthma, thus generating confusion in terms of diagnosis and management. It is also unclear whether asthma may be associated with a worse prognosis in COVID-19 infection. This expert opinion paper provides specific recommendations to ease the challenges related to adult patients with asthma admitted to the ED during the COVID-19 pandemic, with particular reference to diagnosis and treatment. Moreover, it provides well-defined indications to guide decisions on discharge, hospital admission, as well as follow-up. A panel of experts composed of emergency medicine physicians, pulmonologists and allergologists discussed, voted and approved all the recommendations. Full article

(This article belongs to the Special Issue Asthma and Respiratory Disease: Prediction, Diagnosis and Treatment)

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