Asthmatic Patients Research Articles

Uncovering patterns of inhaler technique and reliever use: the value of objective, personalized data from a digital inhaler

Electronic inhalers provide information about patterns of routine inhaler use. During a 12-week study, 360 asthma patients using albuterol Digihaler generated 53,083 inhaler events that were retrospectively analyzed. A total of 41,528 (78%) of the recorded inhalation events were suitable for flow analysis (having a PIF ≥ 18 L/min and <120 L/min). Median PIF, inhalation volume, inhalation duration, and time to PIF for these events steadily decreased between the first and last 10 days of the study, by 5.1%, 12.6%, 15.9%, and 6.4%, respectively. Continuous short-acting beta2-agonist (SABA) overuse, defined as ≥2 SABA inhalations/week throughout the study period, was seen in 29% (n = 104) of patients. Of 260 patients with ≥1 instance of acute short-term SABA overuse, 55 (21%) had a confirmed exacerbation. Electronic recording of real-life inhaler use can capture valuable, objective information that could inform disease management and clinical decision-making.

Dietary antioxidant and inflammatory potential in asthmatic patients and its association with all-cause mortality

BackgroundThe occurrence and progression of asthma can be influenced by the components in food. Our study aims to determine whether dietary antioxidant and inflammatory potential are associated with the risk of mortality in asthma patients.MethodsParticipants from the 2001–2018 National Health and Nutrition Examination Survey (NHANES) aged 20 years and older with a diagnosis of asthma were included. Mortality status was obtained according to death certificate records from the National Death Index. The antioxidant and inflammatory potential of the diet was assessed using two widely used and dependable indices, Composite Dietary Antioxidant Index (CDAI) and Dietary Inflammatory Index (DII). Restricted cubic spline (RCS) regression was used to analyze the non-linear relationship between the two indexes and mortality. Multivariable Cox proportional risk models were used to estimate hazard ratio and 95% confidence intervals for mortality. Finally, the relationship between CDAI and DII was analyzed.ResultsA total of 4698 NHANES participants represented 23.2 million non-institutionalized residents of the US were enrolled in our study. Patients with higher CDAI or lower DII exhibited longer survival times. RCS regression showed a linear relationship of CDAI or DII with mortality. In the Cox regression, both crude and adjusted models demonstrated that higher CDAI or lower DII was linked to a reduced risk of all-cause mortality. Similar associations were found in subgroup analysis. Finally, a negative relationship was found between CDAI and DII.ConclusionReducing pro-inflammatory or increasing antioxidant diets could reduce all-cause mortality among adult asthma patients.

Biochemical and nutrients profile of asthma patients with perceived food allergy in India- a hospital based case control study

Objective: The current study explored the biochemical and dietary profile of asthma patients with and without perceived food allergy (FA). Methods: A case-controlled study was conducted with 286 patients (143 asthmatics with perceived food allergy and 143 age, sex, SES matched asthmatics with no perceived food allergy) aged 15-40 years. The blood sample was collected, and Food Frequency Questionnaire was recorded for laboratory investigations and nutrients calculation respectively. Relevant biochemical parameters (complete blood picture, total serum IgE etc.) were analyzed in the blood samples and macro and micronutrients (calories, protein, fat, Vit-B complex, Calcium etc.) were calculated and comparisons were made between the cases and controls. Results: Most of the cases had higher BMI (27.5±4.82) than controls (23.3±4.51) (p≤0.05); 59(41.3%) and 46(32.2%) had BMI in the range of 25-30 and &gt;30. The perceived food allergy in asthmatics was associated with biochemical parameters (Hb, TLC, Eosinophil counts, Monocytes, Serum IgE, Serum protein and serum calcium) and nutrients[protein(42.24±7.63g/d), fat(23.86±4.70g/d), thiamine(0.77±0.15mg/d), riboflavin(1.20±0.19mg/d), pyridoxine(1.53±0.16mg/d), folic acid(70.80±8.69µg/d), cobalamine(0.70±0.03 mg/d), ascorbicacid(34.51±4.26mg/d), calcium(304.10±62.36 mg/d), and iron(17.94±4.97 mg/d)] as compared to their counterparts with no perceived food allergy(p≤0.05). Conclusion: Asthmatics eliminate food items based on self-perception which may lead to nutrients deficiency and abnormal blood reports. There is a need to confirm FA diagnosis and develop appropriate framework to manage FA in asthmatics. More studies are needed to estimate association of asthma and food allergy with micronutrient deficiency and Body Mass Index. Key words: asthma, food allergy, laboratory investigations, nutrients intake, body mass index

Physical comorbidity is associated with overnight hospitalization in U.S. adults with asthma: an assessment of the 2005–2018 National Health and Nutrition Examination Surveys

Objective Identifying the effects of comorbidity on healthcare utilization is critical for understanding the benefits of improved comorbidity management. Asthma is a common respiratory condition, associated with gastrointestinal, metabolic, psychiatric, and other respiratory conditions. Adults with asthma represent a key population in understanding comorbidity and its consequences. The objective was to explore the relationship between comorbidity and overnight hospitalizations in U.S. adults with asthma. Study design and methods A cross-sectional sample of 3,887 subjects aged 20–79 was aggregated from seven cycles (2005–2018) of the National Health and Nutrition Examination Survey (NHANES). The survey design was created using the full seven cycles, then a subpopulation was used for the analysis. Design-based modified Poisson regression with robust standard errors compared the prevalence of overnight hospitalizations in subjects with and without comorbidities. Comorbidity was defined as the presence of one or more additional chronic conditions. Results Over half (61.6%) of patients with asthma reported having comorbidities. The overnight hospitalization prevalence was higher in those with comorbidities (21.6%) than those without (7.4%). The adjusted prevalence ratio of overnight hospitalizations in those with comorbidities vs. those without was 2.02 (95% CI: 1.54–2.66). Conclusions from sensitivity analyses remained the same. Conclusions Comorbidity in U.S. adult asthma patients is associated with increased overnight hospitalizations. Study results concur with examinations of other healthcare utilization outcomes, revealing how comorbidity influences healthcare utilization patterns in patients with asthma. The reduction of overnight hospitalizations should be a targeted goal when developing and evaluating interventions to manage comorbidities in patients with asthma.

Study of the Galectin-3 as a Biomarker for Assessment of Asthma

Asthma is a common chronic inflammatory disorder that causes reversible obstruction in the airways leading to hard breath and difficulty in the doing of the daily activities. It’s multifactorial disorder effected by many biomarkers, one of this biomarkers is Gal -3. The present study aims to assessment of Galectin-3 as new biomarker and its role on developing of the asthma. In this research, a comparison was made between a group of asthmatic patients and a control group, with a total of fifty individuals in each category. Among the asthmatic patients, fifty appeared to be in good health, and their conditions were confirmed through consultations with specialists at Merjan Teaching Hospital in Hilla, Iraq. Upon examining the data, it was found that the serum Gal-3 levels in asthmatic patients were notably lower than those in the control group. Furthermore, it was observed that individuals with severe asthma had even lower levels of Gal-3 compared to those with mild asthma.

The visceral adiposity index is associated with asthma, especially current asthma: A cross-sectional study of NHANES, 2003 to 2018.

To investigate the association between the visceral adiposity index (VAI) and asthma using data from National Health and Nutrition Examination Survey 2003 to 2018 by a cross-sectional study. We explored the potential relationship between the VAI and asthma incidence via a cross-sectional study of the National Health and Nutrition Examination Survey from 2003 to 2018. Multiple logistic regression analysis, restricted cubic spline analysis and subgroup analysis were performed. Among the 80,312 participants, 1984 had been told by a doctor or other health professional, and 1142 still had asthma. With all confounders controlled, the VAI was positively associated with asthma incidence (odds ratios 1.04, 95% confidence interval: 1.01, 1.08). When comparing the second, third, and fourth VAI quartiles to the lowest quartile, the adjusted odds ratios (95% confidence intervals) for asthma risk were 1.02 (0.86, 1.21), 1.14 (0.96, 1.36), and 1.18 (1, 1.39), respectively (P for trend = .02). Subgroup analysis revealed no significant interaction effect among the subgroups (P > .05). The positive association was stronger in current asthma patients (odds ratios 1.13, 95% confidence interval: 1.03, 1.24). When comparing the second, third, and fourth VAI quartiles to the lowest quartile, the adjusted odds ratios for current asthma risk were 1.15 (0.81, 1.64), 1.29 (0.91, 1.84), and 1.51 (1.01, 2.24), respectively (P for trend .04). The restricted cubic spline regression analysis did not reveal a nonlinear correlation between the VAI and asthma or current asthma. Subgroup analysis revealed a significant interaction effect between age (P for interaction = .03) and diabetes status (P for interaction = .02). Except in the age ≥60 years, Less than high school, normal body mass index subgroup, VAI, and current asthma were positively correlated. A positive relationship between the VAI and asthma incidence was observed. In particular, there was a strong positive correlation between the VAI score and current asthma. According to the subgroup analysis, more attention should be given to individuals aged 40 to 59 years who have diabetes.

LPG 18:0 is a general biomarker of asthma and inhibits the differentiation and function of regulatory T cells.

The diagnosis, severity assessment, and development of therapeutic strategies for asthma are crucial aspects of disease management. Since biomarkers are reliable tools in disease management, we aimed to identify and explore asthma-associated biomarkers and investigate their mechanisms. Lipidomics was used to profile serum glycerophospholipids in asthmatic patients and controls. The absolute concentration of lysophosphatidylglycerol (LPG) 18:0 was quantified in various asthma subtypes. Mouse asthma models were used to confirm its potential as a biomarker and investigate its mechanisms in vivo. The effects of LPG 18:0 on CD4+ T cell differentiation, proliferation, and apoptosis were assessed in vitro by flow cytometry, while mitochondrial dysfunction was evaluated through mitochondrial membrane potential, reactive oxygen species, and ATP production measurements. The intracellular mechanism of LPG 18:0 in Tregs was investigated using small molecule inhibitors. The serum glycerophospholipid profile varied between asthmatic patients and control group, with LPG 18:0 levels being notably higher in asthmatic patients, correlating with asthma severity and control level. In vivo and in vitro studies revealed that LPG18:0 impaired naïve CD4+ T cell differentiation into Tregs and compromised their suppressive function. Further investigation demonstrated that LPG18:0 treatment reduced the FOXP3 protein level via SIRT1-mediated deacetylation during Treg differentiation. This study identifies that serum levels of LPG 18:0 are generally elevated in asthmatics and serve as a biomarker for asthma. LPG 18:0 impairs Treg function via the NAD+/SIRT1/FOXP3 pathway. Our research reveals the potential of LPG18:0 as a biomarker for asthma, elucidating its role in asthma diagnosis and treatment.

Assessing the Impact of the Updated 2021 European Respiratory Society/American Thoracic Society Criteria on Bronchodilator Responsiveness in Asthma.

Introduction The European Respiratory Society/American Thoracic Society (ERS/ATS) Task Force released new technical standards on spirometry interpretation in 2021. Our study compares bronchodilator responsiveness (BDR) in asthma, evaluating the impact of the 2005 and 2021 ERS/ATS criteria and the influence of predictive equations. Methods A retrospective cohort study of adult patients with asthma was referred to spirometry with a BDR test at the Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia. The study included adult patients with asthma who underwent BDR testing in the Department of Respiratory Pathophysiology at the institute and had available data on height, gender, age, race, and eosinophil count. Results Among 197 patients, 69 were men (35.0%), the median age was 47 years (interquartile range (IQR) 38-60), and a positive BDR test occurred in 50 (25.38%)according to the 2005 criteria and 42 (21.32%) according to 2021 criteria when using the Global Lung Initiative (GLI) reference equations. Strong agreement was observed between the ERS/ATS 2005 and 2021 criteria (Cohen's kappa index: 0.887, 95%, CI 0.810 to 0.963). Similar results were found with the Third National Health and Nutrition Examination Survey (NHANES III) and the European Community of Coal and Steel (ECCS) predictive equations. Positive BDR tests were common in patients with moderately severe and severe forced expiratory volume in one second (FEV1) impairment and were not associated with eosinophil count or total serum immunoglobulin E (IgE) levels. Conclusion The introduction of the 2021 ERS/ATS criteriadid not significantly alter the classification of BDR in the majority of asthma patients, ensuring diagnostic stability. Whichever criterion was used, positive BDR correlated with the extent of FEV1 impairment, but not asthma biomarkers.

Small airway dysfunction links asthma exacerbations with asthma control and health-related quality of life

BackgroundSmall airway dysfunction not only affects asthma control, but also has adverse effects on the psychological and/or social activities of asthma patients. However, few long-term observational studies have explored the complex relationship between small airway dysfunction and asthma control and health-related quality of life in patients with asthma exacerbations.MethodsThe study recruited 223 patients with exacerbations of asthma (i.e. those with at least one asthma attack over the past year) and 228 patients without exacerbations of asthma (i.e. those without asthma attacks over the past year). We evaluated SAD in patients with asthma exacerbations using impulse oscillometry method. At each evaluation time point within one year of follow-up, the attending physician conducts a case investigation of the patients. We analyzed the correlation between SAD and general characteristics (age, obesity, smoking history), type 2 inflammation (blood eosinophils, exhaled nitric oxide), FEV1, as well as asthma control (ACT) and health-related quality of life (mini-AQLQ) in patients with asthma exacerbations, and constructed a structural equation model to evaluate the causality of these clinical variables.ResultsThe SAD prevalence in patients with asthma exacerbation is as high as 75%. SAD is connected with poor asthma control and poor health-related quality of life. The structural equation model indicates that age, obesity, FeNO, and FEV1 are independent predictive factors of SAD. SAD is the main determinant factor of asthma control, which in turn affected health-related quality of life. FEV1 and age directly affect asthma control and affect health-related quality of life through asthma control. In addition, there is a bidirectional relationship between FEV1 and small airway dysfunction and between asthma control and health-related quality of life.ConclusionsSmall airways are involved from an early stage in asthma. Abnormal function of the small airways can significantly increase airway resistance in asthma patients, while worsening their clinical symptoms. In addition, aging is also a key risk factor for asthma control. Especially, small airway dysfunction links asthma control with health-related quality of life.

Traditional Herbal Drug Approach used in the Treatment of Asthma: A Review

Asthma is a persistent inflammatory disease of the lower respiratory airway where the tracheobronchial smooth muscles of the lungs become tremendously narrow due to various causative agents like virus, allergens, exercise and become extremely responsive which leads to increase in secretions, mucosal oedema and mucus plugging. This results in repeating episodes of dyspnoea, wheezing, chest tightness, breathlessness, and coughing which might limit a person’s ability to work and function depending on the time and intensity of the episode. WHO’s assessment suggests that more than 339 million individuals had Asthma internationally and there were 417,918 deaths because of asthma worldwide in 2016. A review affirms that 1 out of every 10 Asthma patients are from India. Asthma can have various etiologies and types. The treatment involves Anticholinergics, corticosteroids, β2 agonists, Xanthine drugs. These oral administration drugs are effective but come with their own respective side effects to some extent. Since ancient times the mankind has always turned to natural substances to cure various diseases and ailments. In a similar manner, Asthma treatment is also seeing new advances with the use of traditional herbal drugs from various plant sources. They work in various complex mechanisms and have very minimal side effects. This review deals with Mangifera indica and Laurus nobilis as treatment options for Asthma and the mechanism with which they work. Keywords: Asthma, Mangifera indica, Mangiferin, Vimang, Laurus nobilis, Magnolialide

Effectiveness of hydroalcoholic extract of Nasturtium Officinale on sleep quality, asthma control and quality of life in asthmatic patients: a randomized controlled trial

Objectives: Considering the role of oxidants in asthma, airway inflammation, and the anti-inflammatory effects of Nasturtium officinale extract, this study aimed to investigate the impact of the hydroalcoholic extract of Nasturtium officinale on sleep quality, asthma control, and quality of life in asthmatic patients. Methods: This parallel group randomized clinical trial was conducted in Yasuj, Iran. It included 60 patients who randomly received either Nasturtium officinale hydroalcoholic extract (500 mg daily, for four weeks, orally plus routine care) or a placebo (500 mg capsule containing flour daily, for four weeks, orally plus routine care). To achieve the study objectives, lung function (FEV1, FVC, PEF, FEF 25-75%, and FEV1/FVC), quality of life as measured by the 12-item Short Form Health Survey (SF-12), sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI), and asthma control as examined by the Asthma Control Test (ACT) were assessed at baseline and one-month follow-up. Results: In total, 48 patients (22 patients in the intervention group and 26 patients in the control group) completed the study. The analyses showed no significant differences between the two groups regarding changes in lung function, quality of life, sleep quality, and status of asthma control within a one-month follow-up. Conclusion: The findings suggest that the hydroalcoholic extract of Nasturtium Officinale does not appear to improve sleep quality, asthma control, and quality of life in asthmatic patients in the short term.

Time is lung: Higher preservation of lung function in severe asthma patients after earlier mepolizumab treatment

Time is lung: Higher preservation of lung function in severe asthma patients after earlier mepolizumab treatment

Assessing the Impact of Spatial and Temporal Variability in Fine Particulate Matter Pollution on Respiratory Health Outcomes in Asthma and COPD Patients.

Ambient air pollution's health impacts are well documented, yet the domestic environment remains underexplored. We aimed to compare indoor versus outdoor (I/O) air quality and estimate the association between indoor/ambient fine particulate matter (PM2.5) exposure and lung function in asthma and chronic obstructive pulmonary disease (COPD) patients. The study involved 24 h monitoring of PM2.5 levels indoors and outdoors, daily peak expiratory flow (PEF), and biweekly symptoms collection from five patients with asthma and COPD (average age of 50 years, 40% male) over a whole year. Data analysis was performed with linear mixed effect models for PEF and generalized estimating equations (GEE) for exacerbations. More than 5 million PM2.5 exposure and meteorological data were collected, demonstrating significant I/O PM2.5 ratio variability with an average ratio of 2.20 (±2.10). Identified indoor PM2.5 sources included tobacco use, open fireplaces, and cooking, resulting in average indoor PM2.5 concentrations of 63.89 μg/m3 (±68.41), significantly exceeding revised World Health Organization (WHO) guidelines. Analysis indicated a correlation between ambient PM2.5 levels and decreased PEF over 0-to-3-day lag, with autumn indoor exposure significantly impacting PEF and wheezing. The study underscores the need to incorporate domestic air quality into public health research and policy-making. A personalized approach is required depending on the living conditions, taking into account the exposure to particulate pollution.

A new Anticalin protein for IL-23 inhibits non-type 2 allergen-driven mouse lung inflammation and airway hyperresponsiveness.

Severe asthma is a syndromic label assigned to patients based on clinical parameters, yet there are diverse underlying molecular endotypes in severe asthma pathobiology. Immunophenotyping of asthma biospecimens commonly includes a mixture of granulocytes and lymphocytes. Recently, a subset of severe asthma patients was defined as non-type 2 with neutrophil-enriched inflammation associated with increased Th17 CD4+ T cells and IL-17 levels. Here, we used an allergen-driven mouse model of increased IL-17 and mixed granulocyte lung inflammation to determine the impact of upstream regulation by an Anticalin protein that specifically binds IL-23. Airway administration of the IL-23 binding Anticalin protein (AcIL-23) decreased lung neutrophils, eosinophils, macrophages, and lymphocytes, IL-17+ CD4 T cells, mucous cell metaplasia and methacholine-induced airway hyperresponsiveness. Selective targeting of IL-23 with a monoclonal antibody (IL-23p19) (αIL-23) also decreased macrophages, IL-17+ CD4 T cells and airway hyperresponsiveness. In contrast, a monoclonal antibody against IL-17A (αIL-17A) had no significant effect on airway hyperresponsiveness, but did decrease lung neutrophils, macrophages, and IL-17+ CD4 T cells. Targeting the IL-23 pathway did not significantly change IL-5+ or IL-13+ CD4 T cells. Together, these data indicate that airway AcIL-23 mirrored the activity of systemic anti-IL-23 antibody to decrease airway hyperresponsiveness in addition to mixed granulocytic inflammation, and that these protective actions were broader than blocking only IL-17A or IL-5, which selectively decreased airway neutrophils and eosinophils, respectively.

The complicated relationship between asthma and swimming

Introduction: Apart from pharmacological treatment, non-pharmacological strategies including physical activity play a significant role in the management of asthma. The aim of this paper is to examine various topics related to swimming and asthma. They include the detailed effect of swimming on asthma control,the potential role of swimming in early childhood asthma development, exercise induced asthma in swimmers as well as the relationship between asthma and cold water swimming. Review methods: This article is based on the literature found in the PubMed Database from the period of 1971-2024 with the use of keywords such as “asthma”, “swimming”, “cold water swimming”, “exercise induced asthma”, “childhood asthma” Description of the state of knowledge: Swimming is a safe form of physical activity for asthma patients.Swimming training enhances aerobic capacity, reduces exercise-induced bronchoconstriction and improves lung function in both pediatric and adult patients. However, there is a concern regarding indoor swimming pools that chlorine can potentially induce airway inflammation. There is research suggesting that early life swimming pool exposure may contribute to the asthma development in atopic children. There is some premise to the thought that cold water swimming may help alleviate asthma symptoms, but it also carries many risks.Swimming is a major cause of exercise induced asthma in professional athletes. Conclusions: Alongside appropriate pharmacological treatment, swimming is a valuable strategy in asthma management in both pediatric and adult asthma patients. The risks of chlorinating pools are still not known to outweigh the benefits of swimming for asthmatics. Further research should be carried out on safety of early swimming in atopic children. Cold water swimming should also be evaluated in terms of safety and potential benefits for asthma patients.

The Effectiveness of Some Chronic Pulmonary Management Units for Patients with COPD and Asthma in Vietnam

Introduction: Asthma and chronic obstructive pulmonary diseases are chronic diseases and have high mortality rates in Vietnam and other countries. The chronic pulmonary disease Management Unit is a management model connecting inpatient and outpatient treatment for asthma and COPD patients. Patients receive long-term management and full consultation to share experiences and be provided with necessary information about the disease. The main purpose was to evaluate the effectiveness of the unit for patients with COPD and asthma in Vietnam. Material and Methods: A Combined cross-sectional study and retrospective longitudinal study were conducted on 310 COPD and asthma patients at Hai Duong, Bac Giang, Thai Nguyen. The questionnaires included 30 questions with two sections including sociodemographic data and using management and treatment services. Results: After 24 months of management and treatment, knowledge of the disease, medicine use, symptoms, range of activities, eating, sleeping status, and disease control of patients were improved better. For ACT score, the points increased by 2.1 points, 3.4 points, and 4 points, respectively. For the CAT score, the point reduced by 3.7 points, 6.4 points, and 9.1 points, respectively. Improved severe breathlessness efficiency index from 0.6% at 6 months to 9.5% after 24 months. Conclusion: Our findings suggest that the government needs to invest in facilities, equipment, and human resources to maintain and replicate the model nationwide to help patients receive timely management and treatment, contributing to reducing treatment costs and improving the quality of life for asthma and COPD patients.

Impaired diffusion at submaximal lung inflation in asthma and copd patients

IntroductionDissolved-phase 129Xe MRI metrics suggest that gas diffusion may be more compromised at submaximal lung inflation compared to maximal inflation. We hypothesized that this diffusion deficit could be detected by comparing the carbon monoxide transfer coefficient (Kco) at submaximal lung inflation to that measured routinely at total lung capacity (TLC). MethodsAsthma and COPD patients performed carbon monoxide diffusion tests, first at maximal lung inflation for routine Kco and alveolar volume VA and then, at a 30 % reduced inflation (redux; obtaining Kcoredux and VAredux). At both inflations mixing efficiency was determined as VA/TLC and VAredux/TLCredux to examine a potential effect on Kcoredux/Kco behavior. ResultsIn normal subjects (n=36), median Kcoredux/Kco amounted to 130 [IQR:122–136]% as expected for normal Kco recruitment response. However, 60 % of asthma patients (49/83) and 80 % of COPD patients (44/55) showed reduced Kco recruitment at submaximal inflation (Kcoredux/Kco<122 %). In the asthma group, with otherwise normal routine Kco, Kcoredux/Kco was significantly correlated with RV/TLC ratio (r=-0.53;P<0.001), but not with VA/TLC. In COPD patients, all with abnormal routine Kco, abnormal Kcoredux/Kco response occurred in those patients with lower FEV1, higher RV/TLC and lower VA/TLC (P<0.01 for all). ConclusionSizeable portions of COPD and asthma patients showed a lack of normal Kco recruitment at submaximal lung inflation, related to high RV/TLC. In asthma, this was the case despite normal Kco at full lung inflation, suggesting that hyperinflation at lung volumes less than TLC affects the carbon monoxide diffusion rate constant by distorting pulmonary capillaries and alveolar–capillary membranes.

Oligodeoxynucleotides containing CpG motifs (CpG-ODN) restores immune regulatory functions of airway macrophages of patients with asthma.

Allergic asthma is characterized by the polarization of Th2 cells and impaired immune regulation. Macrophages occupy the largest proportion of airway immune cells. This study aims to discover the mechanism that hinders the immune regulatory functions of airway macrophages. In this study, macrophages were isolated from cells in bronchoalveolar lavage fluids (BALF) collected from asthma patients and normal control (NC) subjects. The results indicated that macrophages occupied the largest portion of the cellular components in BALF. The frequency of IL-10+ macrophage was significantly lower in asthma patients than in NC subjects. The expression of IL-10 in macrophages of BALF was associated with the levels of asthma-related parameters. The immune-suppressive functions of BALF M0 cells were defective in asthma patients. The inducibility of IL-10 expression was impaired in BALF macrophages of asthma patients, which could be restored by exposing to CpG. In conclusion, the induction of IL-10 in macrophages of BALF in asthma patients was impaired, and it could be restored by exposure to CpG.

10-20-30 exercise training improves fitness and health.

Intense interval exercise training has been shown to improve performance and health of untrained and trained people. However, due to the exercise intensity causing high-perceived exertion, the participants often do not wish to continue the training. The 10-20-30 training concept consists of low intensity for 30s, 20s at a moderate pace, and then 10s with high intensity either running or cycling. A 10-20-30 training session consist of two to four 5-min blocks. The 10-20-30 training improved fitness and performance as well as lowered blood pressure and body fat of both untrained and trained individuals even with a significant reduction in the training volume. Similarly, hypertensive, diabetic, and asthmatic patients lowered body fat, improved fitness, and performance during a 10-20-30-training intervention period. In addition, hypertensive patients reduced systolic and diastolic blood pressure markedly with the 10-20-30 training twice a week for 8weeks. Diabetic patients lowered long-term blood sugar (HbA1c), which did not occur with moderate-intensity exercise training. Furthermore, asthmatic patients improved their control of asthma and asthma-related quality of life with the 10-20-30 training. The adherence for the patient groups was high (>80%), and no adverse events were reported. Thus, the 10-20-30 training seems to be time efficient and feasible for untrained and trained individuals as well as patients and may be used in the prevention and treatment of noncommunicable diseases.

Family Physicians’ Awareness of the Burden of Oral Corticosteroids in Asthma Patients

Objective. The objective of this study was to identify when family physicians decide to prescribe oral corticosteroids (OCS) to treat asthma, to establish the factors affecting their decision, and how familiar family physicians are with the side effects of OCS. Materials and Methods. A cross-sectional observational study was conducted among physicians that are members of the Slovenian Family Medicine Society. Results. The study included 122 family physicians from all 12 Slovenian regions. The great majority (86.9%) reported they had previously prescribed OCS to asthma patients. The largest share of these (45.1%) tended to prescribe a limited number of tablets, although many (42.6%) also prescribed the entire pack. Regarding the adverse effects associated with OCS, the physicians listed a range of potential problems, highlighting hyperglycemia and exacerbated diabetes, the impact on bone density, a suppressed immune system and increased risk of infection as the most common. Conclusion. In the future, it is vital to improve family physicians’ awareness of when OCS may be prescribed to treat severe asthma, and to define the clinical pathway for severe asthma, which should also involve interdisciplinary collaboration.