Asthma, COPD, and ACO are chronic airway disorders with distinct and overlapping features. This study aimed to compare clinical profiles, inflammatory biomarkers, and quality of life among these groups. A cross-sectional study was conducted on 168 patients (56 each with asthma, COPD, and ACO). All participants underwent clinical assessment, spirometry, St George's Respiratory Questionnaire (SGRQ), skin prick testing, and measurement of inflammatory markers, including FeNO, eosinophil count, total IgE, vitamin D, hs-CRP, and interleukins (IL-4, 5, 6, 8, 13, 17, 33). ACO patients were younger than COPD patients but older than asthma patients. Asthma patients had the highest prevalence of allergic rhinitis and skin prick positivity. FEV 1 and FEV 1 /FVC were significantly lower in COPD and ACO compared to asthma, but not different between COPD and ACO. Bronchodilator response was higher in asthma and ACO than in COPD. Asthma patients had significantly higher FeNO, eosinophil counts, and IgE levels compared to COPD, with ACO showing intermediate values. IL-4 and IL-5 were highest in asthma, IL-6 and IL-8 in COPD, with ACO again showing intermediate levels. ACO patients had the highest SGRQ scores, indicating the worst quality of life. Correlation analysis showed group-specific associations between interleukins and clinical parameters. ACO exhibits intermediate clinical and inflammatory profiles between asthma and COPD. While individual biomarkers assist in characterizing these diseases, a combination of clinical, functional, and inflammatory parameters offers better differentiation. ACO patients experience a significant symptom burden, necessitating tailored diagnostic and therapeutic approaches.

Leukotriene receptor antagonist drugs as potential chemopreventive agents: A systematic review and meta-analysis of cancer risk in asthmatic patients.

Asthma's impact on brain function: an investigation of changes in functional connectivity and network topology.

Dehydroepiandrosterone increases airway epithelial cell pH in asthma patients.

To analyse metered-dose inhaler disposal behaviour in asthma patients, determine the patient characteristics that contribute to appropriate disposal and quantify the effect of a pharmacy-led educational intervention. We conducted a multicentre cross-sectional study in 40 Spanish hospitals followed by a pre-post quasi-experimental evaluation. We surveyed adults with uncontrolled severe asthma receiving biological therapy to determine sociodemographic, health, environmental attitude and disposal behaviour characteristics. At the time of biological therapy dispensation, we provided patients with an infographic on inhaler environmental impact and appropriate disposal. We resurveyed participants 3months later to assess changes in knowledge, attitude and disposal behaviour. We identified factors associated with correct inhaler disposal and quantified the impact of the intervention using a multivariate logistic regression and McNemar test, respectively. Despite 86.7% (435/502) of our study participants valuing environmental conservation and 91.6% (460/502) being aware of medication disposal programmes, only 46.6% (234/502) correctly disposed of inhalers. Factors associated with appropriate disposal included practising household recycling, high perception of inhaler environmental impact, awareness of medication disposal programme, low income and self-reported limitations to daily activities. On resurveying patients 3months after our pharmacy-led intervention, we observed an increase in correct inhaler disposal to 84.1% (418/497) with parallel gains in awareness and recycling behaviours. We revealed a discrepancy between the environmental concerns of asthma patients and inhaler disposal behaviour, due to limited knowledge of inhaler environmental impact. We demonstrated that this knowledge gap can be reduced, doubling the correct disposal of inhalers, through a targeted pharmacy-led intervention.

Assessment of bronchodilator response using forced oscillation technique in paediatric asthmatic patients from Central India: A cross-sectional study.

To assess the association between adherence to MD and asthma control in severe asthmatics. During the period between March 2022-2023, patients with severe asthma from 16 pulmonary centers all over Greece were recruited. Adherence to MD was assessed through a short interviewer-administered questionnaire, the MD Adherence Screener, previously validated in Mediterranean populations. The level of asthma control was assessed by the Asthma Control Test. A multiple logistic regression model was applied, adjusting for gender, age, body mass index, corticosteroid intake, comorbidities, treatment. The study sample included 315 severe asthmatics (30% males) with mean age 56.6 years (SD = 14.3 years). There is an indication, albeit not statistically significant, that higher adherence to MD was associated with better asthma control in patients with severe asthma (OR: 1.19, 95% CIs: 0.61, 2.34). Furthermore, controlling for the patients' personal characteristics and dietary habits, other diet related conditions and metabolic diseases, such as obesity or diabetes, were significantly associated with poorer asthma control. In a cross-sectional study undertaken in a Mediterranean population, we observed a positive, but not statistically significant, association between higher adherence to MD and better asthma control in severe asthmatic patients. However, our findings are limited by the study design which does not allow us to infer causality and by the use of a screener to assess adherence to Mediterranean diet.

ITGB5 encodes integrin subunit beta 5 of that has been implicated in the eosinophilic asthma phenotype. However, the secretory profile of ITGB5 in induced sputum and its clinical significance in asthma remains poorly understood. This study aimed to measure ITGB5 levels in induced sputum supernatant from asthma patients and investigate its potential clinical implications. We enrolled 78 participants (18 healthy controls and 60 asthma patients) and quantified ITGB5 protein levels in induced sputum supernatant using ELISA. Correlations between ITGB5 and inflammatory markers, as well as airway obstruction parameters, were analyzed. Subsequently, we performed comparative analyses to evaluate variations in inflammatory cytokines between high- and low-ITGB5 expression subgroups. Induced sputum ITGB5 levels were significantly elevated in asthma patients and markedly increased following inhaled corticosteroid (ICS) treatment. ITGB5 levels showed positive correlations with Th2-associated cytokines (IL-4, IL-5, IL-13, IL-25, IL-33, and TSLP) and Th2 signature genes (SERPINB2, CLCA1, and POSTN). Notably, IL-5, FeNO, and POSTN were significantly higher in the high-ITGB5(n = 30) than the low- ITGB5 (n = 30) expression group. Furthermore, sputum ITGB5 levels were inversely associated with pulmonary function (FEV1% pred, FVC% pred, MEF% pred, MEF25% pred and MEF50% pred). Increased sputum ITGB5 in asthma was positively associated with inflammatory mediators and negatively correlated with pulmonary function, suggesting that ITGB5 upregulation may be involved in airway inflammation and obstruction in asthma pathogenesis.

Asthma is a multifactorial chronic inflammatory airway disease influenced by complex interactions between genetic predisposition and environmental exposures. Polymorphisms in inflammatory pathway genes such as PTGS2 and IL17 may modulate immune regulation and allergic asthma susceptibility. However, evidence from Indian populations remains limited. This study investigated the association of PTGS2 rs5277, IL17A rs3804513, and IL17F rs763780 polymorphisms with allergic asthma susceptibility and disease-related phenotypes in a population from West Bengal, India. This case-control study involved 975 clinically confirmed allergic asthma patients and 600 healthy controls. Allergic asthma diagnosis was established using spirometry following GINA guidelines and atopy was confirmed by skin prick testing. Total serum IgE levels were measured using enzyme immunoassay. Genotyping was performed by polymerase chain reaction based restriction fragment length polymorphism. Associations were assessed using chi-square analysis under different genetic models, and odds ratios with 95% confidence intervals were calculated. Significant associations were observed for PTGS2 rs5277 and IL17F rs763780 polymorphisms with allergic asthma susceptibility. The rs5277 CC and rs763780 CC genotypes, as well as the corresponding C alleles, conferred increased allergic asthma risk. These risk genotypes were also associated with reduced FEV1/FVC ratios and elevated total IgE levels among patients. In contrast, IL17A rs3804513 showed no significant association with allergic asthma. Environmental factors such as damp housing and urban residence further influenced pulmonary function in patients. These findings demonstrate that PTGS2 rs5277 and IL17F rs763780 polymorphisms are associated with impaired lung function and enhanced IgE-mediated responses among the population of West Bengal, India.

Asthma is characterized by variable airway obstruction, and proper inhaler choice and use are critical for effective treatment. This study aimed to identify factors influencing treatment response in newly diagnosed patients started on dry powder inhalers (DPIs) or metered-dose inhalers (MDIs). Between March and September 2025, 177 newly diagnosed asthma patients were screened. Eighty patients with at least high-school education, correct inhaler use, and good adherence were included (40 DPI, 40 MDI). Pulmonary function, respiratory muscle strength, Asthma Control Test (ACT), and handgrip strength (HGS) were assessed at baseline and after one month. After one month, improvements in forced expiratory volume in 1 second (FEV1) (% predicted), maximum inspiratory pressure (MIP) and MIP (%), and maximum expiratory pressure (MEP) (%) were significantly greater in the DPI group compared with the MDI group (p = 0.03, 0.04, 0.02 respectively). In multivariate regression, among MDI users, MIP (kPa) (B = -11.305, p = 0.001), MIP (%) (B = -0.902, p = 0.003), ACT (B = 1.277, p = 0.014), and HGS (B = 0.103, p = 0.039) were independent predictors of ΔFEV1 (%). Among DPI users, MIP (kPa) (B = 11.987, p = 0.015), MIP (%) (B = 1.041, p = 0.009), MEP (kPa) (B = -6.554, p = 0.014), MEP (%) (B = -0.816, p < 0.001), and HGS (B = 0.201, p = 0.005) were significant determinants of ΔFEV1. DPIs may be preferable for patients with higher inspiratory muscle strength, whereas MDIs may be better for those with lower MIP. HGS appears to be an important factor for both inhaler control and treatment efficacy.

Histidine metabolic reprogramming drives oxidative stress induced mtDNA release to promote necroptosis and airway inflammation in severe asthma.

Kv1.3 Modulates Macrophage M2 Polarization via the STAT3 Pathway: A Novel Mechanism and Therapeutic Target for Steroid-Resistant Asthma.

Vitamin D regulates bone metabolism and immune function, influencing inflammatory biomarkers such as CRP, TNF-α, and IL-6. Evidence from RCTs and meta-analyses on its anti-inflammatory effects remains inconsistent. To synthesize evidence from meta-analyses of RCTs on vitamin D supplementation and its effects on circulating inflammatory biomarkers, and to assess the quality and certainty of this evidence. A comprehensive literature search was conducted in PubMed, Embase, Web of Science, and Scopus from inception to January 2025. Eligible studies included systematic reviews and meta-analyses of RCTs reporting effects of vitamin D supplementation on inflammatory markers (CRP, hs-CRP, TNF-α, IL-1β, IL-6, IL-8, IL-10, oxidative stress markers, IgE). Data extraction was performed independently by two reviewers. Methodological quality was assessed using AMSTAR-2, and the certainty of evidence was graded with GRADE. Corrected Covered Area (CCA) was calculated to quantify overlap among primary studies. This umbrella review analyzed seven meta-analyses covering 97 RCTs with ~ 11,600 participants on vitamin D supplementation's effects on inflammation and oxidative stress markers. Vitamin D significantly reduced CRP, TNF-α, and IL-6 levels in individuals with abnormal glucose homeostasis (Hedges'g = - 0.67, - 0.81, and - 1.93, respectively; p < 0.001), and improved oxidative stress markers in pregnant women, evidenced by decreased MDA (Hedges'g = - 0.46) and increased TAC (Hedges'g = 2.13) and glutathione (Hedges'g = 4.37). In type 2 diabetes, a significant reduction in hs-CRP (Hedges'g = - 0.45, p = 0.005) and TNF-α (Hedges'g = - 0.75, p = 0.05) was observed. Conversely, studies in obese/overweight and asthmatic populations revealed no significant changes in inflammatory markers, except for a highly heterogeneous and potentially unreliable increase in IL-10 among asthma patients (Hedges'g = 18.85, p = 0.04). Vitamin D supplementation exerts significant anti-inflammatory and antioxidant effects, particularly in metabolic disorders, though evidence remains heterogeneous across populations and biomarkers.

Screening for Eosinophilic Esophagitis in the Pediatric Asthma Clinic Leads to Increased Diagnosis and Identifies a High Prevalence of Disease.

Profilins are ubiquitous pan-allergens responsible for cross-reactivity between pollens and plant foods. While we previously demonstrated that recombinant Acanthamoeba profilin (rAc-PF) drives allergic airway inflammation via Th2/Th17 pathways in murine models, its clinical relevance in human allergic disease remains unclear. This study investigated rAc-PF as a novel inhalant allergen and its immunological impact on patients with allergic airway diseases. A total of 176 patients with allergic airway diseases underwent skin prick tests with rAc-PF and a standard panel of 55 common aeroallergens. Acanthamoeba-specific and rAc-PF-specific serum IgE levels were quantified using ELISA. To elucidate immune mechanisms, peripheral blood mononuclear cells from atopic asthma patients were stimulated with rAc-PF, and Th2/Th17 cytokine production was analyzed. Thirteen patients (7.4%) showed positive skin prick tests reactions to rAc-PF. This sensitization was significantly associated with tree, grass, and weed pollens, indicating a pan-allergen characteristic due to high cross-reactivity. Notably, one patient sensitized to rAc-PF reacted to no other common inhalants, suggesting rAc-PF as a unique causative agent. Patients exhibited significantly elevated levels of serum Acanthamoeba-specific and rAc-PF-specific IgE compared to healthy controls. Furthermore, rAc-PF stimulation of peripheral blood mononuclear cells from asthmatic patients induced robust production of IL-4, IL-5, IL-13, and IL-17A in humans. rAc-PF is identified as a novel allergen capable of inducing IgE-mediated sensitization and mixed Th2/Th17 responses. The strong association with pollen sensitization supports its role as an environmental pan-allergen. Therefore, rAc-PF should be considered a clinically relevant diagnostic target, especially in patients with polysensitization or unidentified triggers.

Exercise training is a crucial non-pharmacological approach in asthma management, yet asthmatic patients are not routinely referred to these programs. Recognizing that significant benefits can be achieved even with highly accessible, standardized exercise programs, the aim of our study was to investigate the effectiveness of a standardized, low-cost, and easily implementable home-based exercise program, supported by weekly supervision, in women with asthma. Thirty female patients with asthma were randomized into training and control groups. Patients in the training group participated in supervised exercise sessions with a physiotherapist once a week for 8 weeks and performed the prescribed exercise program at home 3 days per week. The control group received general physical activity recommendations via an educational booklet. Primary outcomes were respiratory function assessed using spirometry and functional capacity assessed using the 6-minute walk test (6MWT). Secondary outcomes included asthma control assessed using the Asthma Control Test, dyspnea assessed using the modified Medical Research Council dyspnea scale (mMRC), health-related quality of life assessed using the St. George's Respiratory Questionnaire (SGRQ), and lower extremity muscle strength assessed using the 30-second sit-to-stand test (30-s STST). The training group showed statistically significant improvements in peak expiratory flow parameter of spirometry (PEF%), 6MWT, activity subscore of SGRQ, and 30-s STST values compared with the control group (p < 0.05). This study demonstrates that a standardized, accessible, and sustainable home-based exercise program, supplemented by minimal supervision, was associated with significantly greater improvements compared to general physical activity recommendations in enhancing key outcomes in asthma management. This approach offers a valuable, low-cost alternative for reducing sedentary behavior and improving clinical outcomes, particularly in settings where access to complex or technologically advanced rehabilitation centers is limited. These findings may be particularly relevant for women with asthma, who often face greater barriers to physical activity and experience a higher symptom burden. This trial registration was prospectively registered at ClinicalTrials.gov, ID number: NCT04088669.

Bronchiectasis frequently coexists with other chronic airway diseases, particularly chronic obstructive pulmonary disease (COPD) and asthma, forming clinically significant bronchiectasis-COPD overlap and bronchiectasis-asthma overlap phenotypes. However, the global proportion of COPD and asthma among patients with bronchiectasis has not been comprehensively quantified. This study aimed to estimate the pooled proportion of COPD and asthma in bronchiectasis and to explore potential sources of heterogeneity. PubMed, Embase, and Web of Science were systematically searched up to January 8, 2026. Studies reporting the proportion of COPD or asthma in adults with bronchiectasis confirmed by high-resolution computed tomography were eligible. Random-effects models were used to calculate pooled proportions. Subgroup analyses and meta-regression were performed to explore heterogeneity. Publication bias was assessed using funnel plots and Egger's test. Fifty-two studies (81,779 patients) were included for COPD and 47 studies (71,605 patients) for asthma. The pooled proportion of COPD among bronchiectasis patients was 18% (95% CI: 14-22%; I² = 99.4%), and the pooled proportion of asthma was 16% (95% CI: 11-20%; I² = 99.3%). Subgroup analyses revealed variations by geographic region, study design, and age. Meta-regression identified female proportion as a statistically significant but weak predictor of asthma prevalence (β = 3.97, 95% CI: 0.91-7.03; P = 0.011), explaining only 10.6% of the between-study heterogeneity. No covariates significantly explained heterogeneity in COPD prevalence. Egger's test showed no significant publication bias (COPD: P = 0.506; asthma: P = 0.153), and sensitivity analyses confirmed the stability of the findings. COPD and asthma coexist in approximately one-fifth of patients with bronchiectasis, highlighting the importance of systematic assessment for these overlap syndromes. A weak association between female sex and asthma prevalence was observed, but this factor explained only a small fraction of the heterogeneity, indicating that other unmeasured variables are more important determinants. These findings support a more integrated, phenotype-driven approach to the management of chronic airway diseases. PROSPERO registration: CRD42023400445.

Redefining asthma through new immune response pattern: A clinically driven perspective.

HECT E3 ubiquitin ligase SMURF2 orchestrates FcεRI-dependent mast cell activation and allergic responses.

BackgroundAsthma and pneumonia are common respiratory conditions worldwide. Pneumonia is a life-threatening lung infection and a frequent comorbidity among adult asthmatic patients, often causing hospital admission. Despite the global burden, evidence on determinants of pneumonia among adult asthmatic patients in Ethiopia is limited.ObjectiveThis study aimes to identify determinants of pneumonia among adult asthmatic patients attending public hospitals in Awi Zone, Northwest Ethiopia.MethodsA multicenter unmatched case-control study was conducted from August 20 to October 25, 2025 among 359 adult asthmatic patients (120 cases and 239 controls) in public hospitals of Awi Zone, Northwest Ethiopia. Eligible participants were adults aged ≥18 years with ≥6 months asthma diagnosis and ≥3 months follow-up. Cases were asthmatic patients with pneumonia, and controls were those without pneumonia. Patients with COPD and newly diagnosed asthma were excluded. Participants were selected consecutively. Data were collected using interviewer-administered questionnaires and medical records. Determinants were identified using bivariable and multivariable logistic regression, with statistical significance set at p<0.05.ResultsCases were older than controls, with mean ages of 60.25 ± 15.36 and 44.85 ± 11.04 years, respectively. In multivariable analysis, demographic, behavioral, and clinical factors were associated with pneumonia. Increasing age (AOR = 1.06, 95% CI: 1.01–1.10) and current alcohol use (AOR = 2.93, 95% CI: 1.03–4.38) increased the odds. Prior hospital admission for acute asthma exacerbation showed the strongest association (AOR = 13.22, 95% CI: 9.55–19.51). Inhaled corticosteroid use (AOR = 4.06, 95% CI: 3.16–7.23) and loss of follow-up (AOR = 4.48, 95% CI: 3.42–7.16) were also associated with higher odds, while controlled asthma was protective (AOR = 0.06, 95% CI: 0.02–0.16).ConclusionAge, alcohol use, prior hospitalization, inhaled corticosteroid use, and irregular follow-up increased pneumonia risk, while controlled asthma was protective. Strengthening follow-up and interventions may reduce pneumonia among asthmatic patients.