Adult Asthma Research Articles

Use of Disinfectants and Cleaning Products Associated with Respiratory Disease: A Scoping Review

Introduction: there is extensive evidence on the harmful respiratory effects of exposure to disinfectants and cleaning products. Methodology: an exploratory systematic review was carried out in five databases: LILACS, PubMed, MEDLINE and BIREME. Twenty articles from 2013 to 2024 were selected for the present review. Results: chemical compounds present in some disinfectants and cleaning products such as Polyhexamethylene guanidine (PHMG) and Chloromethylisothiazolinone/Methylisothiazolinone (CMIT/MIT) influence the development of Humidifier Respiratory Distress Syndrome (HDRS) and increased incidence of asthma and Chronic Obstructive Pulmonary Disease (COPD) in adults. Conclusions: There is a relationship between exposure to chemical compounds in certain disinfectants and lung health impairment. It is imperative to increase the general population’s awareness of the effects of these substances will lead to improved self-care in those who are in daily contact with these elements.

Asthma and cognitive dysfunction in older adults: the mediating role of systemic immune-inflammation index

Asthma and cognitive dysfunction represent significant public health challenges. Our study aimed to investigate the relationship between asthma and cognitive dysfunction in adults aged ≥ 60 years, and explore the role of systemic immune inflammation index (SII) in asthma - cognitive dysfunction link. The retrospective cross-sectional study included 2,579 participants aged ≥ 60 years from the 2011–2014 National Health and Nutrition Examination Survey (NHANES) cycles. Asthma diagnosis was confirmed using the MCQ010 questionnaire, cognitive function assessed through the Digit Symbol Substitution Test (DSST). SII was calculated using the formula: (platelet count × neutrophil count)/lymphocyte count. Controlling for demographic variables including sex, age, race and/ethnicity, poverty-to-income ratio (PIR) and education level, a negative association was found between asthma and DSST scores (β = -1.75, 95% CI: -3.38, -0.120, P = 0.037). This association persisted even after further adjustments for body mass index (BMI) and diabetes (β = -1.72, 95% CI: -3.38, -0.057, P = 0.043). Moreover, subgroup analysis showed no significant association of sex, age, race/ethnicity, BMI or diabetes with the relationship between asthma and cognitive function. Mediation analysis indicated SII was a mediator of asthma-induced cognitive impairment, a notable Average Causal Mediated Effect (ACME) (P = 0.004) between SII and cognitive dysfunction. Our investigation indicated that elderly asthma (aged ≥ 60 years) was predisposed to cognitive dysfunction, independent of sex, age, race/ethnicity, BMI and diabetes. Furthermore, mediation analysis suggested that asthma might contribute to cognitive dysfunction through the involvement of SII.

Long-Term Ozone Exposure, COPD, and Asthma Mortality: A Retrospective Cohort Study in the Republic of Korea

Ozone concentrations have increased in recent decades, and several studies have reported that long-term exposure to ozone increases the mortality risk induced by respiratory conditions. However, research on cause-specific mortality related to ozone exposure and respiratory diseases remains scarce. We constructed a retrospective cohort of 5,360,032 adults aged ≥ 65 years from the National Health Insurance Service of Republic of Korea, and death certificates were obtained from Statistics Republic of Korea to determine the cause of death between 2010 and 2019. The daily maximum 8 h average levels of ozone during the warm season annually (May–September) and other air pollutants were determined for the residential district. We analyzed the data using a time-varying Cox proportional hazards model with individual- and district-level covariates, incorporating a competing risk framework to address deaths from causes other than chronic obstructive pulmonary disease (COPD) and asthma. In our single-pollutant model with a 3-year moving average, a 1 ppb increase in ozone exposure was associated with a hazard ratio (HR) of 1.011 (95% confidence interval [CI]: 1.008–1.013) for COPD mortality and an HR of 1.016 (95% CI: 1.011–1.022) for asthma mortality. In our model adjusted for the presence of underlying diseases and district-level variables, the HRs were 1.009 (95% CI: 1.008–1.014) for COPD and 1.017 (95% CI: 1.011–1.023) for asthma, respectively. These associations remained robust in our two-pollutant model, except for NO2 and COPD. A linear concentration–response relationship was identified between ozone concentration, COPD, and asthma mortality. In this large nationwide cohort study, long-term exposure to ozone was associated with an increased risk of death from COPD and asthma in older Korean adults.

Patient-centred composite scores as tools for assesment of response to biological therapy for paediatric and adult severe asthma.

We have previously developed Core Outcome Measures sets for Severe Asthma (COMSA) by multi-stakeholder consensus. There are no patient-centred tools to quantify response to biologics for severe asthma. We aimed to develop paediatric and adult CompOsite iNdexes For Response in asthMa (CONFiRM) incorporating clinical parameters and patient-reported quality of life (QoL). International expert healthcare professionals (HCPs) and patients with severe asthma were invited to: 1) develop consensus levels of clinically relevant changes for each outcome measure within COMSA; 2) use multicriteria decision analysis to develop the CONFiRM scores and 3) assess their internal validity. A separate group of HCPs evaluated CONFiRM's external validity. Five levels of change for each COMSA outcome were agreed. Severe exacerbations and maintenance oral corticosteroids use were rated as most important in determining both paediatric and adult CONFiRM scores. There was strong agreement between HCPs and patients, although patients assigned greater importance to QoL. The CONFiRM score quantified response to a biological from -31 (deterioration) to 69 (best possible response). Paediatric and adult CONFiRMs had good discriminative ability for a sufficient (AUC≥0.92) and a substantial (AUC≥0.95) response to biologics. Both CONFiRMs demonstrated excellent external validity (Spearman correlation coefficients 0.9 and 0.8 for paediatric and adult respectively (p<0.0001)). We have developed novel patient-centred paediatric and adult CONFiRMs which include QoL measures. CONFiRMs should allow a more holistic understanding of response for the patient and a standardised assessment of the effectiveness of biologics between studies. Further research is needed to prospectively validate CONFiRM scores.

Circulating microRNAs associated with bronchodilator response in childhood asthma

BackgroundBronchodilator response (BDR) is a measure of improvement in airway smooth muscle tone, inhibition of liquid accumulation and mucus section into the lumen in response to short-acting beta-2 agonists that varies among asthmatic patients. MicroRNAs (miRNAs) are well-known post-translational regulators. Identifying miRNAs associated with BDR could lead to a better understanding of the underlying complex pathophysiology.ObjectiveThe purpose of this study is to identify circulating miRNAs associated with bronchodilator response in asthma and decipher possible mechanism of bronchodilator response variation.MethodsWe used available small RNA sequencing on blood serum from 1,134 asthmatic children aged 6 to 14 years who participated in the Genetics of Asthma in Costa Rica Study (GACRS). We filtered the participants into the highest and lowest bronchodilator response (BDR) quartiles and used DeSeq2 to identify miRNAs with differential expression (DE) in high (N = 277) vs. low (N = 278) BDR group. Replication was carried out in the Leukotriene modifier Or Corticosteroids or Corticosteroid-Salmeterol trial (LOCCS), an adult asthma cohort. The putative target genes of DE miRNAs were identified, and pathway enrichment analysis was performed.ResultsWe identified 10 down-regulated miRNAs having odds ratios (OR) between 0.37 and 0.76 for a doubling of miRNA counts and one up-regulated miRNA (OR = 2.26) between high and low BDR group. These were assessed for replication in the LOCCS cohort, where two miRNAs (miR-200b-3p and miR-1246) were associated. Further, functional annotation of 11 DE miRNAs were performed as well as of two replicated miRs. Target genes of these miRs were enriched in regulation of cholesterol biosynthesis by SREBPs, ESR-mediated signaling, G1/S transition, RHO GTPase cycle, and signaling by TGFB family pathways.ConclusionMiRNAs miR-1246 and miR-200b-3p are associated with both childhood and adult asthma BDR. Our findings add to the growing body of evidence that miRNAs play a significant role in the difference of asthma treatment response among patients as it points to genomic regulatory machinery underlying difference in bronchodilator response among patients.Trial registrationLOCCS cohort [ClinicalTrials.gov number NCT00156819, Registration date 20050912], GACRS cohort [ClinicalTrials.gov number NCT00021840].

Asthma prescribing trends, inhaler adherence and outcomes: a Real-World Data analysis of a multi-ethnic Asian Asthma population

Inhaled corticosteroid (ICS) is the mainstay therapy for asthma, but general adherence is low. There is a paucity of real-world inhaler prescribing and adherence data from Asia and at the population level. To address these gaps, we performed a real-world data analysis of inhaler prescribing pattern and adherence in a multi-ethnic Asian asthma cohort and evaluated the association with asthma outcomes. We performed a retrospective analysis of adult asthma patients (aged ≥18 years) treated in the primary and specialist care settings in Singapore between 2015 to 2019. Medication adherence was measured using the medication possession ratio (MPR), and categorised into good adherence (MPR 0.75-1.2), poor adherence (MPR 0.75) or medication oversupply (MPR > 1.2). All statistical analyses were performed using R Studio. 8023 patients, mean age 57 years, were evaluated between 2015 and 2019. Most patients were receiving primary care (70.4%) and on GINA step 1–3 therapies (78.2%). ICS-long-acting beta-2 agonist (ICS-LABA) users increased over the years especially in the primary care, from 33% to 52%. Correspondingly, inpatient admission and ED visit rates decreased over the years. Between 2015 and 2019, the proportion of patients with poor adherence decreased from 12.8% to 10.5% (for ICS) and from 30.0% to 26.8% (for ICS-LABA) respectively. Factors associated with poor adherence included minority ethnic groups (Odds ratio of MPR 0.75–1.2: 0.73–0.93; compared to Chinese), presence of COPD (OR 0.75, 95% CI 0.59–0.96) and GINA step 4 treatment ladder (OR 0.71, 95% CI 0.61–0.85). Factors associated with good adherence were male gender (OR 1.14, 95% CI 1.01–1.28), single site of care (OR 1.22 for primary care and OR 1.76 for specialist care), GINA step 2 treatment ladder (OR 1.28, 95% CI 1.08–1.50). Good adherence was also associated with less frequent inpatient admission (OR 0.91, 95% CI 0.84–0.98), greater SABA overdispensing (OR 1.66, 95% CI 1.47–1.87) and oral corticosteroids use (OR 1.10, 95% CI 1.05–1.14). Inhaled corticosteroid (ICS) adherence has improved generally, however, poor adherence was observed for patients receiving asthma care in both primary and specialist care, and those from the minority ethnicities.

Validation of the adult asthma epidemiological score: a secondary analysis of the EPI-ASTHMA population-based study.

The A2 score is an eight-question patient-reported outcome measure that has been validated for ruling in (score ≥4) and ruling out (score 0-1) asthma. However, this screening tool has been validated in a cohort similar to the derivation cohort used. This study aims to validate the predictive accuracy of the A2 score in a primary care population against general practitioner (GP) clinical assessment and to determine whether the proposed cut-offs are the most appropriate. This accuracy study is a secondary analysis of the EPI-ASTHMA population-based study. Primary care centres in Portugal. Random adult participants answered the A2 score by phone interview. Those with an A2 score ≥1 (plus 5% with an A2 score of 0) were invited to a diagnostic visit carried out by a GP to confirm or not a diagnosis of asthma. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curves. A total of 1283 participants (median 54 (p25-p75 43-66) years; 60% women) were analysed. The A2 score showed high discriminatory power in identifying asthma, with an area under the ROC curve of 82.9% (95% CI 80.4% to 85.4%). The proposed cut-off ≥4 was the most appropriate to rule in asthma (specificity 83.1%, positive predictive value 62.4%, accuracy 78%). Similarly, the proposed cut-off<2 was the most suitable for excluding asthma (sensitivity 92.7%, negative predictive value 93.7%, accuracy 60.5%). The A2 score is a useful tool to identify patients with asthma in a primary care population. NCT0516961.

Subtype prevalence and treatment implication in adolescents and adults with mild-to-moderate asthma: A systematic review and meta-analysis

BackgroundInhaled corticosteroid (ICS) containing regimens are the mainstay for treating asthma despite usually being ineffective in non-eosinophilic asthma (NEA). Data on the prevalence of NEA versus eosinophilic asthma (EA) in mild-to-moderate asthmatics is limited. ObjectiveTo systematically review the subtype prevalence of mild-to-moderate asthma in adolescents and adults using sputum inflammatory cell analysis and their responses to ICS. MethodsWe searched electronic databases (PubMed, Scopus, EMBASE, Cochrane) for studies in adolescents and adults with mild-to-moderate asthma. The primary outcome was the prevalence of asthma subtypes based on sputum inflammatory cell analysis, categorized into EA and NEA. The secondary outcome involved comparing asthma outcomes between different subtypes following ICS therapy. Certainty of evidence was reported for each pooled analysis. ResultsEighteen studies involving 3,533 adolescents and adults with mild-to-moderate asthmatics were reviewed. The pooled prevalence (95% confidence interval, CI) of NEA was estimated at 40.39% (27.54, 53.93) in patients with ICS naïve with very low certainty of evidence. Upon reevaluating sputum cytology, approximately 20% to 30% of patients initially classified as having NEA transitioned to the EA subtype. EA patients showed significant improvements in asthma symptoms, FEV1 [standardized mean difference (95% CI): 0.79 (0.30, 1.27)], and airway hyperresponsiveness [1.34 (0.29, 2.40)] following ICS therapy, while NEA patients exhibited limited response. ConclusionA high proportion of adolescents and adults with mild-to-moderate asthma were identified as having the NEA subtype, which exhibited a poor response to ICS. A thorough diagnostic evaluation before initiating treatment should be integrated into clinical practice.

Prevalence of Obesity and Its Associated Comorbidities in Adults with Asthma: A Single-Center Study in Saudi Arabia

Background and Objectives: Asthma is associated with several comorbidities, one of which is obesity. The worldwide increase in obesity has been accompanied by a parallel rise in asthma prevalence, with obesity recognized as a significant risk factor for both the development and severity of asthma. Obesity is often linked to various comorbidities, which can complicate asthma management and lead to poorer clinical outcomes. This study aims to investigate the prevalence of obesity and its comorbidities in adults with asthma in a single center in Saudi Arabia, providing an overview of the associated health implications. Materials and Methods: This single-center, retrospective study aimed to assess the prevalence of obesity and other comorbidities in asthma patients. Data were collected from King Khalid University Hospital in Saudi Arabia between July 2023 and December 2023. Results: This study revealed that 72.1% of asthma patients were either obese or overweight. Female patients had significantly higher BMI values compared to males. Our study revealed that 38.21% of female asthma patients (mean age = 57 ± 13.85 years) had comorbidities compared to 24.14% of male asthma patients (mean age = 59 ± 14.02 years). Furthermore, the proportion of obese asthmatic patients with comorbidities was significantly greater than those without comorbidities. Conclusions: This study investigates obesity prevalence and associated comorbidities in adult asthmatics in a single center in Saudi Arabia. The findings reveal a 72.1% rate of obesity and overweight among asthmatic patients, with higher BMI and comorbidity prevalence in females. These results underscore the need for targeted interventions addressing obesity and comorbidities, especially in female asthmatics.

Gender-specific association between a lipid composite index and asthma among US adults: insights from a population-based study

BackgroundAbnormalities in lipid metabolism are common among adult asthmatics. However, the precise directionality linking asthma to blood lipid levels remains controversial. Our study aimed to evaluate the association between the Non-HDL to HDL Ratio (NHHR), a lipid composite index, and asthma prevalence among the adult population in the United States.MethodsUtilizing adult participants’ data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2009 to 2018, the study employed a multivariable logistic regression model, adjusting for covariables, to establish the relationship between NHHR levels and the prevalence of asthma. Furthermore, smoothing curve fitting and subgroup analyses were conducted to investigate the robustness of this association.ResultsThis study included 26,023 adult individuals (mean age = 49.63 ± 17.66). In the fully adjusted model, a significant inverse association was observed between log-transformed NHHR values and asthma prevalence (OR = 0.85, 95% CI: 0.79–0.93). Subgroup analysis revealed that gender served as a modulator, altering the association between NHHR levels and asthma prevalence. A more pronounced negative association between lnNHHR and asthma prevalence was noted among male participants [(Male: OR = 0.78, 95% CI: 0.69–0.88) vs. (Female: OR = 0.92, 95% CI: 0.83–1.03), P for interaction = 0.0313].ConclusionsOur study revealed an inverse association between NHHR levels and the prevalence of asthma in the US adult population, which is influenced by gender. NHHR measurement may be a potential tool for early identification and prediction of adult asthmatics in specific populations.

Radiomultiomics: quantitative CT clusters of severe asthma associated with multi-omics.

Lung quantitative computed tomographic (qCT) severe asthma clusters have been reported, but their replication and underlying disease mechanisms are unknown. We identified and replicated qCT clusters of severe asthma in two independent asthma cohorts and determined their association with molecular pathways. We used consensus clustering on qCT measurements of airway and lung CT scans, performed in 105 severe asthmatic adults from the U-BIOPRED cohort. The same qCT measurements were used to replicate qCT clusters in a subsample of the ATLANTIS asthma cohort (n=97). We performed integrated enrichment analysis using blood, sputum, bronchial biopsies, bronchial brushings and nasal brushings transcriptomics and blood and sputum proteomics to characterize radiomultiomic-associated clusters (RACs). qCT clusters and clinical features in U-BIOPRED were replicated in the matched ATLANTIS cohort. In the U-BIOPRED cohort, RAC1 (n=30) was predominantly female with elevated BMI, mild airflow limitation, normal qCT parameters and upregulation of the complement pathway. RAC2 (n=34) subjects had a lower degree of airflow limitation, airway wall thickness and dilatation, with upregulation of proliferative pathways, including neurotrophic receptor tyrosine kinase 2/tyrosine kinase receptor B (NTRK2/TRKB), and down-regulation of semaphorin pathways. RAC3 (n=41) showed increased lung attenuation area and air trapping, severe airflow limitation, hyperinflation, and upregulation of cytokine signaling and signaling by interleukin pathways, and matrix metallopeptidase 1, 2 and 9. U-BIOPRED severe asthma qCT clusters were replicated in a matched independent asthmatic cohort and associated with specific molecular pathways. Radiomultiomics might represent anovel strategy to identify new molecular pathways in asthma pathobiology.

Association between asthma and visceral adipose tissue in adults, a cross-sectional study from NHANES 2011-2018.

Asthma is a chronic inflammatory disease that affects millions of people worldwide. Obesity, particularly visceral adipose tissue (VAT), is known to secrete adipokines and pro-inflammatory factors, which are closely associated with various metabolic and cardiovascular diseases. Research indicates that these metabolic disturbances can exacerbate inflammatory conditions, contributing to both cardiovascular and respiratory diseases, including asthma. Despite these associations, studies on the specific relationship between VAT and asthma remain limited and warrant further investigation. Utilizing the NHANES database from 2011 to 2018, we included a total of 11,137 participants. Multivariable regression analysis was performed, stratifying subjects based on VAT levels and adjusting for various confounders. Subgroup interaction analysis and nonlinear analysis were conducted to explore potential effect modifiers and nonlinear associations. In this study, 11,137 participants were included, with 49.74% being female. Among the 509 asthma patients, 69.35% were female. The number of asthma patients among Non-Hispanic Whites was 212, representing 41.65% of the total, the highest proportion among the studied groups. The VAT for asthma patients was 529g, significantly higher than the 455g in the non-asthma group (P < 0.001). Multivariable regression analysis showed that for every 200g increase in VAT, the risk of asthma increased by 10.4% (P = 0.032), 20.8% (P < 0.001), and 20.3% (P = 0.004) across three models (unadjusted, adjusted for demographic factors, and fully adjusted). Subgroup analysis indicated a stronger association between VAT and asthma risk in females and individuals over 40 years old. Nonlinear analysis uncovers a J-shaped relationship between VAT and asthma, with the lowest risk observed at 464.57g (P < 0.001). The study findings suggest that increased VAT is associated with elevated asthma risk, particularly among females and older individuals. These results underscore the importance of considering VAT in asthma risk assessment and highlight potential targeted interventions to reduce asthma risk associated with excess visceral adiposity.

Prevalence of GERD among adult asthmatics visiting a tertiary care hospital

Asthma and its control is influenced by both external environmental factors and also on the presence of several comorbid conditions like allergic rhinitis, gastro esophageal reflux disease(GERD), obesity etc. We aim to study the prevalence of GERD in adult asthmatic patients visiting a tertiary care hospital. We conducted a period prevalence survey of adult asthmatics visiting the outpatient department. Gastro esophageal reflux disease was diagnosed clinically through GERD-Q questionnaire. The study was conducted at Sri Venkateswaraa Medical College and Hospital and Research Institute, Chennai. A total of 110 patients were taken for the study. GERD was prevalent among 50% of the study population. 86.2% of the smokers in the study were having GERD. Mean Body Mass Index(BMI) in the study population was 29.14 +/- 4.8 with 72.7% of the patients with gastro esophageal disease were overweight in their body mass index. Significant number of patients with asthma are known to suffer from GERD. GERD worsens the symptoms in asthma and makes it difficult to control with regular inhalational therapy. Being overweight in BMI, smoking are risk factors to the development of gastro esophageal disease and also influence lung function in asthma patients. Symptoms for GERD must be questioned to treat the disease and adequately control asthma.

Adverse Impacts of Corticosteroid Treatment on Osteoporosis/Osteopenia in Adult Asthmatics: A Retrospective ICARUS Cohort Study

Inhaled corticosteroid (ICS) and oral corticosteroid (OCS) are often used in asthma management. This study evaluated the long-term effect of ICS/OCS on osteoporosis, osteopenia, fractures, and bone metabolism in adult asthmatics in real-world clinical practice. This is a retrospective study investigating de-identified electronic health records from Ajou University Medical Center (Korea). Adult asthmatics receiving maintenance ICS with/without OCS for at least 1 year were enrolled. They were classified into the high/low-dose of ICS or OCS groups. Primary outcomes (incidences of osteoporosis, osteopenia, and fractures) and secondary outcomes (drug prescription and laboratory values related to bone metabolism including albumin and alkaline phosphatase [ALP]) were compared after 5 years of follow-up. After propensity score matching, both high- and low-dose OCS groups included 468 patients, and high/low-dose ICS groups each comprised 1,252 patients. The risk of osteoporosis/major fracture was higher (hazard ratio [95% CI]; 2.00 [1.15-3.57]/3.03 [1.04-11.11]) in the high-dose OCS group (especially in females aged ≥50 years) than in the low-dose group, although the ICS groups showed no significant differences. The high-dose ICS group showed a higher risk of osteopenia (1.92 [1.05-3.70]) than the low-dose ICS group. The linear mixed model of laboratory values showed significantly decreased serum albumin and increased ALP in the high-dose OCS group than in the low-dose OCS group. The results of this study suggest that long-term use of OCS can increase the risk of osteoporosis and osteoporosis-related fractures, while long-term use of ICS may increase the risk of osteopenia in adult asthmatics.

Long-term exposure to PM2.5 has significant adverse effects on childhood and adult asthma: A global meta-analysis and health impact assessment

Long-term exposure to PM2.5 has significant adverse effects on childhood and adult asthma: A global meta-analysis and health impact assessment

NFATc1 in CD4+ T cells and CD11c+ dendritic cells drives TH2-mediated eosinophilic inflammation in allergic asthma

BackgroundAsthma, a chronic lung disease, is a significant public health problem worldwide. It is marked by increased Th2 response resulting in eosinophil accumulation. The pathophysiology of asthma involves various cell types, including epithelial cells, dendritic cells (DCs), innate lymphoid cells (ILCs), B cells, and effector cells. Nuclear factor of activated T-cells, cytoplasmic 1 (NFATc1), a critical transcription factor for immune regulation, is known for its role in T cells and, more recently, in myeloid cells. However, the specific contributions of NFATc1 in T cells and DCs in the context of asthma are not well understood. ObjectiveExplore NFATc1’s role in T cells and dendritic cells in modulating Th2 immune responses within the pathophysiology of allergic asthma. MethodsMice lacking Nfatc1 in CD4+T cells or CD11c+ dendritic cells, were induced with asthma using house dust mite (HDM), enabling investigation into NFATc1's role in both cell types in experimental allergic asthma. Additionally, the study examined NFATc1 expression in these cells and its correlation with blood eosinophil levels in an adult asthma cohort. ResultsIn HDM-induced asthma model, we found that Nfatc1 deficiency either in CD4+ T cells or CD11c+ dendritic cells resulted in reduced Th2-driven eosinophilic inflammation, immunoglobulin E (IgE) levels, and mast cell presence in the lung of asthmatic mice. Nfatc1's absence in CD4+ T cells directly hampered Th2 cell polarization and functionality, whereas in CD11c+ dendritic cells, it affected DC differentiation and maturation, thereby weakening T cell priming, proliferation and subsequent Th2 differentiation. Correspondingly, translational research indicated significant correlations between CD4+NFATc1+ and CD11c+NFATc1+ cell populations and eosinophil levels in asthmatic patients, but not in healthy controls. ConclusionNFATc1 in T cells and dendritic cells modulate Th2-mediated eosinophilic inflammation in allergic asthma, which offering insights into asthma pathogenesis and identifying NFATc1 as a potential target for therapeutic intervention.

Association between Type of Tobacco Use and Allergic Rhinitis and Bronchial Asthma in Adults

Association between Type of Tobacco Use and Allergic Rhinitis and Bronchial Asthma in Adults

The association between adult asthma in the United States and dietary total energy intake: a retrospective cross-sectional analysis from NHANES

BackgroundEpidemiological research links asthma progression to dietary nonallergic factors, particularly high-calorie intake. However, evidence supporting the relationship with total dietary calorie consumption remains scarce.ObjectiveThis study aimed to explore the potential correlation between asthma occurrence and total dietary energy intake.MethodsA retrospective cross-sectional study of 21,354 US adults collected comprehensive participant data, including demographics, blood parameters, fatty acids, zinc, fiber intake, and asthma outcomes. Statistical analyses included interaction effects analysis, smooth curve fitting, and logistic regression.ResultsOf 21,354 participants, 14.77% self-reported asthma diagnosis. After adjusting for confounders, odds ratios (OR) for asthma decreased with higher energy intake: Q2 (OR = 0.77, 95% CI: 0.69–0.86, p < .001), Q3 (OR = 0.66, 95% CI: 0.59–0.75, p < .001), and Q4 (OR = 0.61, 95% CI: 0.53–0.69, p < .001) compared to Q1 (< 17.73 kcal/kg/day). A non-linear (L-shaped) association between energy intake and asthma was observed (p < .001), with a critical threshold around 24 kcal/kg/day, supported by subgroup and sensitivity analyses.ConclusionThis study reveals an L-shaped trend between total energy intake and asthma in US adults, with a significant threshold at approximately 24 kcal/kg/day.

Associations of Lifestyle, Ambient Air Pollution With Progression of Asthma in Adults: A Comprehensive Analysis of UK Biobank Cohort.

We aim to investigate the associations between lifestyle, ambient air pollution with crucial outcomes in the progression of adult asthma, including asthma new-onset and asthma hospitalisation. 176,800 participants were included to assess the prospective association between baseline risk exposures and the subsequent asthma onset, 17,387 participants were used to evaluate asthma hospitalisation. Cox regression models were employed to examine the associations. In terms of lifestyle factors, the HRs (95% CIs) of the least healthy lifestyle categories for asthma incidence and hospitalization were 1.099 (1.017-1.187) and 1.064 (1.008-1.123), respectively. For pollutants, PM2.5, especially the traffic-related PM2.5 component, was consistently recognized as a significant risk factor for asthma onset (HR = 1.064, 95% CI: 1.034-1.094) and hospitalisation (HR = 1.031, 95% CI: 1.010-1.052) under various model adjustments. Low socioeconomic status also played a major role in the progression of adult asthma. Our study provides crucial insights into factors influencing the progression of adult asthma. Monitoring and reducing exposure to air pollution, particularly PM2.5, promoting healthier lifestyle, and addressing socioeconomic inequity are important in preventing and managing asthma.

Exploring CD26-/lo subpopulations of lymphocytes in asthma phenotype and severity: A novel CD4+ T cell subset expressing archetypical granulocyte proteins.

Asthma pathology may induce changes in naïve/memory lymphocyte proportions assessable through the evaluation of surface CD26 (dipeptidyl peptidase 4/DPP4) levels. Our aim was to investigate the association of asthma phenotype/severity with the relative frequency of CD26-/lo, CD26int and CD26hi subsets within different lymphocyte populations. The proportion of CD26-/lo, CD26int and CD26hi subsets within CD4+ effector T cells (Teff), total CD4- lymphocytes, γδ-T cells, NK cells and NKT cells was measured in peripheral blood samples from healthy (N = 30) and asthma (N = 119) donors with different phenotypes/severities by flow cytometry. We performed K-means clustering analysis and further characterised the CD4+CD26-/lo Teff cell subset by LC-MS/MS and immunofluorescence. Cluster analysis including clinical and flow cytometry data resulted in four groups, two of them with opposite inflammatory profiles (neutrophilic vs. eosinophilic). Neutrophilic asthma presented reduced CD4-CD26hi cells, which negatively correlated with systemic inflammation. Eosinophilic asthma displayed a general expansion of CD26-/lo subsets. Specifically, CD4+CD26-/lo Teff expansion was confirmed in asthma, especially in atopic patients. Proteomic characterisation of this subset with a TEM/TEMRA phenotype revealed upregulated levels of innate (e.g. MPO and RNASE2) and cytoskeleton/extracellular matrix (e.g. MMP9 and ACTN1) proteins. Immunofluorescence assays confirmed the presence of atypical proteins for CD4+ T cells, and an enrichment in 'flower-like' nuclei and MMP9/RNASE2 levels in CD4+CD26-/lo Teff compared to CD4+ T lymphocytes. There is an association between CD26 levels in different lymphocyte subsets and asthma phenotype/severity. CD4+CD26-/loTEMRA cells expressing innate proteins specific to eosinophils/neutrophils could be determinant in sustaining long-term inflammation in adult allergic asthma.