scholarly journals Fungal sensitization of patients with asthma in St. Petersburg

2015 ◽  
Vol 12 (5) ◽  
pp. 3-8
Author(s):  
Y I Kozlova ◽  
E V Frolova ◽  
A V Sobolev ◽  
O V Aak ◽  
A E Uchevatkina ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Asthma Severity ◽  
Th2 Cells ◽  
Course Of Disease ◽  
Fungal Allergens ◽  
Asthma Patients ◽  
Serum Total Ige ◽  
Fungal Sensitization

Background. Fungal sensitization is associated with severe uncontrolled asthma. Connections of specific, micromycetes and fungal allergens with disease development and immunopathogenesis of asthma with fungal sensitization are not well understood. Methods. The study included 120 patients with different grades of asthma severity. Results. Fungal sensitization was detected in 48 patients with asthma (40%). Severe course of asthma with fungal sensitization was identified in 7 patients (14,6%). The main fungal allergens in patients with severe asthma were Alternaria spp. and Aspergillus spp., in patients with mild and moderate course of disease - Aspergillus spp. and Penicillium spp. Increasing of serum total IgE and enhancing the ability of blood cells to produce IL2 and IFN-y in patients with bronchial asthma with fungal sensitization were revealed. The obtained results indicated the important role of Th1 along with Th2 cells in the development of immunopathological process in asthma patients withfungal sensitization. Conclusion. Further research is necessary for determination of clinical and immunological criteria of severe asthma with fungal sensitization and study of the effectiveness of antimycotic therapy.

scholarly journals Asthma severity as a contributing factor to cancer incidence: A cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0250430
Author(s):  
Laila Salameh ◽  
Bassam Mahboub ◽  
Amar Khamis ◽  
Mouza Alsharhan ◽  
Syed Hammad Tirmazy ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Incidence ◽  
Asthma Severity ◽  
Asthmatic Patients ◽  
Increased Risk ◽  
Different Types ◽  
Asthma Patients ◽  
Main Factors ◽  
Population Source

Background A putative link between asthma and asthma severity with the occurrence of cancer has been suggested but has not been fully investigated. The objective of this study is to assess the incidence of all types of cancer in a cohort of asthmatic patients. Methods and findings A single center cohort retrospective study was conducted to investigate the role of asthma as a potential risk factor for various cancers. Participants were followed for a period of 9 years from 01/01/2010 to 30/12/2018 and cancer incidence and its determinants were collected in asthmatic patients and controls from the same population source but without any respiratory disease. Overall, 2,027 asthma patients and 1,637 controls were followed up for an average of 9 years. The statistical analysis showed that 2% of asthma patients were diagnosed with various cancers, resulting in an incidence rate of cancer of 383.02 per 100,000 persons per year which is significantly higher than the 139.01 per 100,000 persons per year observed in matched controls (p-value < 0.001). The top four cancers reported among asthmatics were breast, colon, lung and prostate cancer. Lung cancer in asthmatics had the longest diagnosis period with a mean of 36.6 years compared to the shortest with prostate cancer with 16.5 years. Conclusions This study shows that asthma patients are at increased risk of different types of cancers with asthma severity and goiter as the main factors that may increase the risk of developing cancers among asthmatic patients.

scholarly journals Patient and Physician Perspectives on Asthma and Its Therapy in Romania: Results of a Multicenter Survey

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1089
Author(s):  
Dragos Bumbacea ◽  
Carmen Panaitescu ◽  
Roxana Silvia Bumbacea
Keyword(s):  
Maintenance Therapy ◽  
Asthma Control ◽  
Severe Asthma ◽  
Asthma Management ◽  
Asthma Severity ◽  
Treatment Goals ◽  
Cross Sectional ◽  
Multicenter Survey ◽  
Patient Reported ◽  
Asthma Patients

Background and Objectives: Patient’s behaviours, attitudes and beliefs related to asthma and its treatment were shown to influence the adherence to therapy and the level of asthma control. This survey aimed to assess the level of asthma control and patient-reported behaviours, attitudes and expectations related to their disease in Romanian patients. Materials and Methods: This cross-sectional quantitative survey was performed in February-March 2019 and enrolled 70 specialist physicians experienced in asthma management and 433 asthma patients under their care. Results: Of the 433 patients enrolled, 19.4% had mild asthma, 60.5% moderate asthma and 20.1% severe asthma. For the previous 12 months, asthma symptoms, exacerbations and emergency room visits were common in the sample analysed, with significantly higher figures in severe asthma patients (p < 0.001). The most important treatment goal for asthma patients was participation in all activities of daily living, while for physicians this was preventing asthma exacerbations. The valuation of the treatment goals was different between patients with severe asthma and those with mild and moderate forms. Based on the patients’ responses, 3 attitude clusters were identified: empowered savvy (36.5% of the patients), pessimistic non-compliers (43.2%), and anxious strugglers (20.3%). “Empowered savvy” had the lowest frequency of severe asthma, the highest adherence to maintenance therapy and the highest level of confidence in the effectiveness of asthma medication. The opposite of this attitude cluster is the “anxious strugglers”, containing more patients with severe asthma, a higher score for worries about asthma therapy and better self-reported knowledge of their treatment, contrasting with a proportion of 25% taking maintenance therapy only when having breathing difficulties. Conclusion: Asthma control in Romania remains poor, with frequent exacerbations and hospitalizations. The differences in treatment goals found between patients and physicians and between different asthma severity groups suggest the need for more patient-centred approaches.

scholarly journals The Genomics and Metagenomics of Asthma Severity (GEMAS) Study: Rationale and Design

2020 ◽  
Vol 10 (3) ◽  
pp. 123
Author(s):  
Javier Perez-Garcia ◽  
José M. Hernández-Pérez ◽  
Ruperto González-Pérez ◽  
Olaia Sardón ◽  
Elena Martin-Gonzalez ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Basque Country ◽  
Severe Disease ◽  
Predictive Biomarkers ◽  
Asthma Severity ◽  
Pulmonary Medicine ◽  
Clinical Variables ◽  
Phenotype Definition ◽  
Asthma Exacerbations ◽  
Asthma Patients

Asthma exacerbations are a major contributor to the global disease burden, but no significant predictive biomarkers are known. The Genomics and Metagenomics of Asthma Severity (GEMAS) study aims to assess the role of genomics and the microbiome in severe asthma exacerbations. Here, we present the design of GEMAS and the characteristics of patients recruited from March 2018 to March 2020. Different biological samples and demographic and clinical variables were collected from asthma patients recruited by allergy and pulmonary medicine units in several hospitals from Spain. Cases and controls were defined by the presence/absence of severe asthma exacerbations in the past year (oral corticosteroid use, emergency room visits, and/or asthma-related hospitalizations). A total of 137 cases and 120 controls were recruited. After stratifying by recruitment location (i.e., Canary Islands and Basque Country), cases and controls did not differ for most demographic and clinical variables (p > 0.05). However, cases showed a higher proportion of characteristics inherent to asthma exacerbations (impaired lung function, severe disease, uncontrolled asthma, gastroesophageal reflux, and use of asthma medications) compared to controls (p < 0.05). Similar results were found after stratification by recruitment unit. Thereby, asthma patients enrolled in GEMAS are balanced for potential confounders and have clinical characteristics that support the phenotype definition. GEMAS will improve the knowledge of potential biomarkers of asthma exacerbations.

scholarly journals Initiation and Pathogenesis of Severe Asthma with Fungal Sensitization

Cells ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 913
Author(s):  
Meenakshi Tiwary ◽  
Amali E. Samarasinghe
Keyword(s):  
Allergic Asthma ◽  
Mouse Models ◽  
Severe Asthma ◽  
Human Disease ◽  
Fungal Allergens ◽  
Immunologic Parameters ◽  
Fungal Sensitization

Fungi represent one of the most diverse and abundant eukaryotes on earth, and their ubiquity and small proteolytically active products make them pervasive allergens that affect humans and other mammals. The immunologic parameters surrounding fungal allergies are still not fully elucidated despite their importance given that a large proportion of severe asthmatics are sensitized to fungal allergens. Herein, we explore fungal allergic asthma with emphasis on mouse models that recapitulate the characteristics of human disease, and the main leukocyte players in the pathogenesis of fungal allergies. The endogenous mycobiome may also contribute to fungal asthma, a phenomenon that we discuss only superficially, as much remains to be discovered.

scholarly journals Airwayβ-Defensin-1 Protein Is Elevated in COPD and Severe Asthma

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Katherine J. Baines ◽  
Thomas K. Wright ◽  
Jodie L. Simpson ◽  
Vanessa M. McDonald ◽  
Lisa G. Wood ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Chronic Obstructive ◽  
Healthy Controls ◽  
Obstructive Pulmonary Disease ◽  
Bronchial Epithelial ◽  
Receiver Operating Characteristic Curves ◽  
Asthma Patients ◽  
Inflammatory Phenotype ◽  
Primary Bronchial Epithelial Cells

Background. Innate immune antimicrobial peptides, includingβ-defensin-1, promote the chemotaxis and activation of several immune cells. The role ofβ-defensin-1 in asthma and chronic obstructive pulmonary disease (COPD) remains unclear.Methods. Induced sputum was collected from healthy controls and individuals with asthma or COPD.β-defensin-1 protein in sputum supernatant was quantified by ELISA. Biomarker potential was examined using receiver operating characteristic curves.β-defensin-1 release from primary bronchial epithelial cells (pBECs) was investigated in culture with and without cigarette smoke extract (CSE).Results. Airwayβ-defensin-1 protein was elevated in COPD participants compared to asthma participants and healthy controls. Inflammatory phenotype had no effect onβ-defensin-1 levels in asthma or COPD.β-defensin-1 protein was significantly higher in severe asthma compared to controlled and uncontrolled asthma.β-defensin-1 protein could predict the presence of COPD from both healthy controls and asthma patients. Exposure of pBECs to CSE decreasedβ-defensin-1 production in healthy controls; however in pBECs from COPD participants the level ofβ-defensin-1 remanied unchanged.Conclusions. Elevatedβ-defensin-1 protein is a feature of COPD and severe asthma regardless of inflammatory phenotype.β-defensin-1 production is dysregulated in the epithelium of patients with COPD and may be an effective biomarker and potential therapeutic target.

scholarly journals Allergic bronchopulmonary aspergillosis in patients with asthma: Results of a prospective study

2017 ◽  
Vol 89 (8) ◽  
pp. 13-16 ◽  
Author(s):  
Ya I Kozlova ◽  
E V Frolova ◽  
L V Filippova ◽  
A E Uchevatkina ◽  
O V Aak ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Specific Ige ◽  
Skin Tests ◽  
Asthmatic Patients ◽  
Fungal Allergens ◽  
Allergenic Fungi ◽  
Fungal Allergen ◽  
A Prospective Study ◽  
Fungal Sensitization

Aim. To estimate the frequency of fungal sensitization and the incidence of allergic bronchopulmonary aspergillosis (ABPA) in asthmatic patients. Subjects and methods. A total of 140 asthmatic patients were examined. They underwent allergologic (skin tests for fungal allergens, estimation of total and fungal allergen-specific IgE levels) and mycological (microscopy and inoculation of respiratory biosubstrates) examinations. Chest computed tomography, when indicated, was done. A group of patients with ABPA and that of patients with severe asthma and fungal sensitization were identified. Results. The frequency of fungal sensitization in asthmatic patients was 36%; the main allergenic fungi were Aspergillus and Alternaria. The incidence of ABPA was as high as 4% in the patients with asthma and 11% in those with severe asthma and fungal sensitization. Conclusion. The given current diagnostic criteria will assist practitioners to identify ABPA, to prevent its progression, and to initiate specific anti-inflammatory and antifungal therapy in due time.

scholarly journals Newly Diagnosed Asthma in China: Initial Severity and Changes Over 1-year Management

2021 ◽  
Author(s):  
Zhizhen Hu ◽  
Jianwei Xuan ◽  
Haijin Zhao ◽  
Hangming Dong ◽  
Changhui Yu ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Asthma Severity ◽  
Initial Diagnosis ◽  
Mild Asthma ◽  
First Year ◽  
Newly Diagnosed ◽  
Medical Database ◽  
Asthma Patients ◽  
First Diagnosis

Abstract Background: The prevalence of adult asthma is increasing in China. However, there are no large sample, epidemiological data describing asthma severity at the time of new diagnosis and changes during follow-up management. Thus, the purpose of this study was to use a large health care database to examine asthma severity at initial diagnosis, and changes in severity over the first year of management.Methods: Data of patients with a first diagnosis of asthma were extracted from the SuValue electronic medical database. Inclusion criteria were: 1) At least 14 years old at the time of first diagnosis; 2) Initial diagnosis from 2001 to March 2019; 3) Followed-up for at least 12 months; 4) Had a follow-up visit every 3 months. Disease severity at diagnosis and at each follow-up visit, medications prescribed, and symptoms were collected and analysed.Results: A total of 7,654 adult patients with newly diagnosed asthma from tertiary hospitals (26.38%) and secondary hospitals (73.62%) who were followed-up for at least 12 months were included. Approximately 54% were females, and the proportion of patients over 60 years old was the highest (38%). Of all patients, 53.91% were not prescribed medications to control asthma, suggesting that these patients were mild asthma. Approximately 16% of patients were prescribed oral corticosteroid and/or inhaled corticosteroid and long-acting β2-agonist combination, suggesting moderate to severe asthma. The proportions of patients with moderate and severe decreased during the first 6 months, and then the proportions remained stable. The proportion of patients with severe asthma remained stable from the 6th month onward. At the end of the year 2.7% of patients had severe asthma. Patients with mild asthma tended to continue to have mild asthma in the following 3 months (> 76.19%). However, of the patients with mild and moderate asthma at 3 months, 92.85% and 75.1%, respectively, had a reduction in severity and had mild asthma at 12 months. On the other hand, 1.26% and 3.15%, respectively, progressed to severe asthma by 12 months.Conclusion: During the first year after an initial diagnosis of asthma patients diagnosed with mild asthma tended to not progress and remained stable with mild asthma over the year. The proportions of patients diagnosed with moderate and severe asthma remained stable over the year. Further study is needed to examine the clinical features of newly diagnosed patients with severe asthma who do not experience a reduction in severity in order to target these patients for more intensive treatment and reduce the disease burden.

scholarly journals Profiles of sensitization and comorbidity in asthma patients with markedly increased serum total immunoglobulin E level (>1000 kUA/L)

2021 ◽  
Author(s):  
Ge Wu ◽  
Teng Zhang ◽  
Xiaohua Douglas Zhang ◽  
Baoqing Sun
Keyword(s):  
Immunoglobulin E ◽  
Asthma Severity ◽  
Specific Ige ◽  
Blood Eosinophil ◽  
Scaling Analysis ◽  
Peripheral Blood Eosinophil ◽  
Total Ige ◽  
Airway Infections ◽  
Asthma Patients ◽  
Serum Total Ige

Abstract BackgroundImmunoglobulin E (IgE) plays an important role in asthma, but a few cases exhibited extremely high levels of serum total IgE. This study aimed to investigate the profiles of complications, severity, and sensitizations in asthma patients with serum total IgE level >1000 kUA/L.MethodsWe retrospectively analyzed 170 asthma patients with serum total IgE levels >1000 kUA/L from the in-patient database of First Affiliated Hospital of Guangzhou Medical University from January 2014 to June 2019. Available information including age, gender, body mass index (BMI), diagnosis, results of blood routine, pulmonary function, fractional exhaled nitric oxide (FeNO), induced sputum (if any), IgE (both total and specific) and medication records were analyzed. ResultsAbout 15% patients had at least one complication, and 78.82% patients were positive for at least one allergen. The top two complications were airway infections (44.71%) and rhinosinusitis (41.18%), followed by hypertension and/or cardiovascular diseases (20.59%) and COPD (12.94%). And in patients without sensitization, rhinosinusitis accounted for the highest proportion over all complications (45.83%). Serum total IgE levels did not differ among patients with different complications. Overall, mites had the highest positive rate (59.4%). In minors, the positive rates of mites (81.25% vs. 54.35%, P <0.01) and food (68.75% vs. 39.86%, P <0.01) were significantly higher than those in adults. Serum total IgE levels were positively correlated to house dust mite specific IgE levels (r=0.23, P <0.05), peripheral blood eosinophil counts (r=0.21, P <0.01) and number of confirmed sIgE positivity (r=0.19, P <0.01) and optimal scaling analysis showed that asthma severity was associated with A. fumigatus specific IgE levels. ConclusionsIn asthma patients with markedly increased serum total IgE levels (>1000 kUA/L), the most common two complications were airway infections and rhinosinusitis despite of sensitization. A. fumigatus specific IgE levels were closely associated with total IgE levels and asthma severity.

Sign in / Sign up

Export Citation Format

Share Document