Clinical, functional and inflammatory evaluation in asthmatic patients after a simple short-term educational program: a randomized trial

Soraia Nogueira Felix,Milton De Arruda De Martins,Pedro Giavina-Bianchi,Julia Caroline Cezario,Thais Santos Amorim,Marcelo Vivolo Aun,Beatriz Mangueira Saraiva Romanholo,Rosana Câmara Agondi,Clarice Rosa Olivo,Francine Maria De Almeida,Iolanda De Fátima Lopes Calvo Tiberio

doi:10.1038/s41598-021-97846-8

Abstract

This study aimed to evaluate the clinical evolution, functional parameters and inflammatory activity of asthma in patients who submitted to an educational intervention. 58 adult patients over 18 years of age with partly controlled and uncontrolled asthma were randomized into an intervention group (IG) (N = 32) and a control group (CG) (N = 26) and evaluated for 12 weeks. The Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), Asthma Quality Life Questionnaire (AQLQ) and Beck Depression Inventory (BDI) questionnaires were applied. Spirometry, exhaled nitric oxide (NO), exhaled breath condensate (EBC) and induced sputum (IS), measurement of the peak flow and symptoms were performed. The IG patients received an educational activity for 30 min applied by a nurse. Statistical analysis: analysis of variance with repeated intragroup measures. IG presented a decreased number of eosinophils in IS and IL-17A in EBC, an increase in the percentage of FEV1 before and after bronchodilator and an improvement in quality of life compared to the CG. There was an improvement in depression levels and a decrease in IL-4 and IL-5 in the IS and in the EBC in both groups. Our results suggest that an educational intervention can bring benefits concerning the control of inflammation, lung function alterations, quality of life and levels of depression in asthmatic patients. Registration: ClinicalTrials.gov; NCT03655392.

Highlights

Soraia Nogueira Felix 1*, Rosana Câmara Agondi 2, Marcelo Vivolo Aun 2, Clarice Rosa Olivo[1,3,4], Francine Maria de Almeida 4, Thais Santos Amorim[3], Julia Caroline Cezario[3], Pedro Giavina‐Bianchi 2, Iolanda de Fátima Lopes Calvo Tiberio 4, Milton de Arruda de Martins4 & Beatriz Mangueira Saraiva Romanholo 1,3,4*
The claimed reasons for that were: lack of time to participate, other health treatments not related to this study, difficulties to get into hospital, change of address or employment, difficulty in missing work for treatment, among other reasons
We found that asthmatic patients with the disease partly controlled and uncontrolled who underwent an educational intervention showed improved clinical control of asthma, pulmonary function, markers of airway inflammation, and quality of life and decreased levels of depression

Summary

Introduction

Soraia Nogueira Felix 1*, Rosana Câmara Agondi 2, Marcelo Vivolo Aun 2, Clarice Rosa Olivo[1,3,4], Francine Maria de Almeida 4, Thais Santos Amorim[3], Julia Caroline Cezario[3], Pedro Giavina‐Bianchi 2, Iolanda de Fátima Lopes Calvo Tiberio 4, Milton de Arruda de Martins4 & Beatriz Mangueira Saraiva Romanholo 1,3,4*. Chronic inflammation in asthma is a consequence of the participation of several mediators that lead to influx of inflammatory cells and airway remodeling as a consequence of goblet cell metaplasia, excessive subepithelial collagen deposition, airway smooth muscle hyperplasia, and increased vascularity. These characteristic features are orchestrated mainly by Type 2 (Th2) cells and cytokines[3,4,5]. Inhaled corticosteroids are the basis of treatment for most cases of asthma Their constant use is associated with an improvement of symptoms and a reduction of morbidity and mortality related to d isease[2,10,11]

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