Chronic Respiratory Disease Research Articles

Improving diets and multimorbidity prevention

In 2023, the UK government announced a Major Conditions Strategy, publishing ‘The case for change and our strategic framework’, which set out the focus on cancers, diabetes, dementia, mental ill health, musculoskeletal disorders, CVD and chronic respiratory diseases. Together, these conditions account for 60% of total disability-adjusted life years lost to early death or ill health in England, and one in four adults has at least two (multimorbidity). This review considers some of the key dietary risks for these major conditions and population policies that may improve diets and reduce risks. UK Government dietary recommendations, based on independent risk assessment and advice from the Scientific Advisory Committee on Nutrition, are encapsulated in the national food model, the Eatwell Guide. Based on key sources of dietary data – chiefly consumption data from the National Diet and Nutrition Survey and consumer purchase data from Kantar – most people do not meet dietary recommendations. This review considers how science and evidence inform health improvement policy. This includes policies that encourage healthier food choices, such as labelling and public procurement standards to those that minimise the impact of the less healthy choice such as sugar and salt reduction and reformulation. The review also considers nutritional approaches to managing some non-communicable diseases. Given the role nutrition and excess weight play in the onset, prognosis and quality of life for those living with one or more of the major conditions, there are huge potential gains from even small dietary improvements across population groups.

Smokeless tobacco use and its associated factors among secondary school students of Rangeli Municipality of Morang district, Nepal

Background The tobacco epidemic is one of the biggest public health threats and the world’s leading cause of preventable death which is responsible for killing 8 million people every year. Adolescents are the vulnerable age group and are at greater risk of any tobacco use including smokeless tobacco (SLT) and nicotine addiction. Tobacco use at a young age increases the risk of various non-communicable diseases (NCDs) such as respiratory illness, asthma, chronic obstructive respiratory disease (COPD), reduced pulmonary function, and cancers. This study aimed to determine the prevalence of smokeless tobacco and its associated factors among secondary school students of grades 11 and 12 in Rangeli Municipality, Nepal. Methodology A cross-sectional study was conducted among 355 students from the selected secondary schools. A self-administered questionnaire was used to collect the data. Data was cleaned and then exported to IBM SPSS Statistics 20 for analysis. Participants’ characteristics were described using frequencies, percentages, mean, and standard deviation. Multivariate logistic regression was conducted to determine the association between individual characteristics and prevalence of smokeless tobacco. All the tests were performed at a 95% Confidence Interval (CI) and a p-value less than 0.05. Results The mean (±SD) age of the participants was 18.0±1.3 years. Most participants were female (61.1%). The majority of the participants were from grade 11 (58.3%), government schools (60%), and nuclear families (64.8%). This study found that 38.4% and 61.6% of the participants were SLT ever users and never users respectively. Among the ever users, 29.5% were current users and most tried (47.7%) at the age of 10–14 years. Most participants revealed that homes and public places were common sites for SLT use. Paan Masala and Gutkha were the most commonly preferrable SLTs. This study found that age (AOR = 1.5, CI: 1.2–2.2), sex (AOR = 2.6, CI:1.6–4.4), and school type (AOR = 1.8, CI:1.1–3.0) were significantly associated with the prevalence of SLT. Conclusion This study found that the prevalence of current SLT users is higher than the national survey. This study concludes that males, young adolescents, and students from private schools are at greater risk of SLT use and are unaware of the consequences on their health. Concerned stakeholders must expand awareness and promote educational programs on the harmful use of tobacco targeting secondary school students. The government organizations, educational institutions, and private organizations jointly work to strengthen the implementation of tobacco cessation programs and tobacco control strategies.

Asthma and Memory Function in Children

ImportanceAsthma is a chronic respiratory disease affecting approximately 5 million children in the US. Rodent models of asthma indicate memory deficits, but little is known about whether asthma alters children’s memory development.ObjectiveTo assess whether childhood asthma is associated with lower memory abilities in children.Design, Setting, and ParticipantsThis cohort study used observational data from the Adolescent Brain Cognitive Development (ABCD) Study, a multisite longitudinal investigation that began enrollment in 2015. Approximately 11 800 children aged 9 to 10 years were enrolled at baseline with follow-up at 1 and 2 years. Participants were selected based on exposures described subsequently to determine longitudinal and cross-sectional associations between asthma and memory. Data were analyzed from Month year to Month year.ExposuresAsthma was determined from parent reports. For the longitudinal analysis, children were selected if they had asthma at baseline and at the 2-year follow-up (earlier childhood onset), at the 2-year follow-up only (later childhood onset), or no history of asthma. For the cross-sectional analysis, children were selected if they had asthma at any time point, or no history of asthma. The comparison group of children with asthma history was matched on demographic and health covariates for each analysis.Main Outcomes and MeasuresThe primary outcome was episodic memory. Secondary outcomes included processing speed, inhibition and attention.ResultsFour hundred seventy-four children were included in the longitudinal analysis (earlier childhood onset: 135 children; mean [SD] age, 9.90 [0.63] years; 76 [56%] male; 53 [28%] Black, 29 [21%] Hispanic or Latino, and 91 [48%] White; later childhood onset: 102 children; mean [SD] age 9.88 [0.59] years; 54 [53%] female; 22 [17%] Black, 19 [19%] Hispanic or Latino, and 83 [63%] White; comparison: 237 children; mean [SD] age, 9.89 [0.59] years; 121 [51%] male; 47 [15%] Black, 48 [20%] Hispanic or Latino, and 194 [62%] White). Children with earlier onset of asthma exhibited lower rates of longitudinal memory improvements relative to the comparison group (β = −0.17; 95% CI, −0.28 to −0.05; P = .01). Two thousand sixty-two children were selected for the cross-sectional analysis (with asthma: 1031 children; mean [SD] age, 11.99 [0.66] years; 588 [57%] male; 360 [27%] Black, 186 [18%] Hispanic or Latino, and 719 [54%] White; without asthma: 1031 children; mean [SD] age 12.00 [0.66] years; 477 [54%] female; 273 [21%] Black, 242 [23%] Hispanic or Latino, and 782 [59%] White). Children with asthma (1031 children) showed lower scores on episodic memory (β = −0.09; 95% CI, −0.18 to −0.01; P = .04), processing speed (β = −0.13; 95% CI, −0.22 to −0.03; P = .01), and inhibition and attention (β = −0.11; 95% CI, −0.21 to −0.02; P = .02).Conclusions and RelevanceIn this cohort study, asthma was associated with memory difficulties in children, which may be more severe if asthma onset is earlier in childhood and may extend to executive function abilities.

English

Introduction: Addressing the health problems of prison inmates is a major challenge for public administrations, which are responsible for guaranteeing the necessary services to deal with them. It is therefore essential to know which are the chronic pathologies that affect them most frequently, what impact they have on the oral cavity and what type of treatments are required. The aim of this study is to shed further light on these questions. Material and method: Articles in PubMed on chronic and oral pathologies and treatment needs were reviewed. Results: The most prevalent chronic pathologies are heart disease, chronic respiratory disease, diabetes and cancer. Anxiety and depression are also highly prevalent among the prison population, along with the consumption of tobacco, alcohol and drugs of abuse. They are responsible for the appearance of caries and periodontal diseases, the treatment of which should be carried out in the prison environment. Conclusions: The level of dental care among the prison population is very low. Therefore, it is necessary to implement preventive and therapeutic measures among inmates to improve their oral health and, consequently, their general health.

Nudge theories and strategies influencing adult health behaviors and outcomes in COPD management: a systematic review

ObjectiveChronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with high prevalence and mortality, and self-management is a key component for better outcomes of COPD. Recently, nudging has shown promising potential in COPD management. In the present study, we conducted a systematic review to collate the list of nudges and identified the variables that influence nudging.MethodsWe undertook a systematic review. We employed database searches and snowballing. Data from selected studies were extracted. The risk of bias was assessed using the Cochrane Effective Practice and Organization of Care risk of bias tool. The study is registered with PROSPERO, CRD42023427051.ResultsWe retrieved 4,022 studies from database searches and 38 studies were included. By snowballing, 5 additional studies were obtained. Nudges were classified into four types: social influence, gamification, reminder, and feedback. Medication adherence, inhalation technique, physical activity, smoking cessation, vaccination administration, exercise capacity, self-efficacy, pulmonary function, clinical symptoms, and quality of life were analyzed as targeted health behaviors and outcomes. We found medication adherence was significantly improved by reminders via mobile applications or text materials, as well as feedback based on devices. Additionally, reminders through text materials greatly enhance inhalation techniques and vaccination in patients.ConclusionThis review demonstrates nudging can improve the health behaviors of patients with COPD and shows great potential for certain outcomes, particularly medication adherence, inhalation techniques, and vaccination. Additionally, the delivery modes, the patient characteristics, and the durations and seasons of interventions may influence the successful nudge-based intervention.Clinical trial registrationThis review has been registered in the international Prospective Registry of Systematic Evaluation (PROSPERO) database (identifier number CRD42023427051).

Breastfeeding, genetic susceptibility, and the risk of asthma and allergic diseases in children and adolescents: a retrospective national population-based cohort study.

Asthma and allergic diseases (such as allergic rhinitis) are multifactorial chronic respiratory diseases, and have many common pathogenic mechanisms. This study aimed to assess the joint effects of breastfeeding and genetic susceptibility on asthma, allergic disease in children and adolescents and sought to examine whether the effect of breastfeeding was consistent under distinct levels of genetic risk. A total of 351,931 UK Biobank participants were analyzed. Firstly, Cox proportional hazards model was used to evaluate the relation between breastfeeding and asthma, allergic disease and their comorbidity. Next, we incorporated the polygenic risk score as an additional covariate into the model. Then, we explored the role of breastfeeding at each stage of asthma and allergic disease through a multi-state model. Meanwhile, several sensitivity analyses were conducted to evaluate the robustness of our results. Finally, we calculated the attributable protection and population attributable protection of breastfeeding. Breastfeeding was related to a reduced risk of occurring asthma (adjusted hazard ratio [HR] = 0.89, 95% confidence interval [CI] 0.86 ~ 0.93), allergic disease (HR = 0.89, 95%CI 0.87 ~ 0.91) and comorbidity (HR = 0.89, 95%CI 0.83 ~ 0.94). The effect of breastfeeding was almost unchanged after considering PRS and did not substantially differ across distinct genetic risk levels. Breastfeeding showed a stronger risk-decreased impact on individuals who developed from allergic rhinitis to comorbidity (HR = 0.83, 95%CI 0.73 ~ 0.93). Further, the influence of breastfeeding was robust against covariates considered and the confounding influence of adolescent smoking. Finally, due to breastfeeding, 12.0%, 13.0% or 13.0% of the exposed population would not suffer from asthma, allergic diseases and the comorbidity, while 7.1%, 7.6% or 7.6% of the general population would not suffer from these diseases. This study provided supportive evidence for the risk-reduced effect of breastfeeding on asthma, allergic diseases, and the comorbidity in children and adolescents, and further revealed that such an influence was consistent across distinct genetic risk levels.

Unraveling heterogeneity and treatment of asthma through integrating multi-omics data

Asthma has become one of the most serious chronic respiratory diseases threatening people's lives worldwide. The pathogenesis of asthma is complex and driven by numerous cells and their interactions, which contribute to its genetic and phenotypic heterogeneity. The clinical characteristic is insufficient for the precision of patient classification and therapies; thus, a combination of the functional or pathophysiological mechanism and clinical phenotype proposes a new concept called “asthma endophenotype” representing various patient subtypes defined by distinct pathophysiological mechanisms. High-throughput omics approaches including genomics, epigenomics, transcriptomics, proteomics, metabolomics and microbiome enable us to investigate the pathogenetic heterogeneity of diverse endophenotypes and the underlying mechanisms from different angles. In this review, we provide a comprehensive overview of the roles of diverse cell types in the pathophysiology and heterogeneity of asthma and present a current perspective on their contribution into the bidirectional interaction between airway inflammation and airway remodeling. We next discussed how integrated analysis of multi-omics data via machine learning can systematically characterize the molecular and biological profiles of genetic heterogeneity of asthma phenotype. The current application of multi-omics approaches on patient stratification and therapies will be described. Integrating multi-omics and clinical data will provide more insights into the key pathogenic mechanism in asthma heterogeneity and reshape the strategies for asthma management and treatment.

Association between body mass index (BMI), respiratory symptoms, and asthma prevalence among the population in Khulna City, Bangladesh: an in-depth cross-sectional investigation

BackgroundAsthma, a chronic respiratory disease, has been steadily increasing in prevalence and significantly impacts global health. In Bangladesh, it remains a major public health concern. The relationship between asthma and body mass index (BMI) is complex, with higher rates observed among overweight individuals. This study aims to explore the association between BMI, respiratory symptoms, and asthma in Khulna City, Bangladesh, addressing the lack of comprehensive data for this region.MethodsThis study was a cross-sectional study. For data collection purposes, we considered Khulna Medical College and Hospital (KMC). Data collection involved a well-structured questionnaire during in-person meetings held from September 18 to November 6, 2022. We selected a total of 310 participants through simple random sampling and performed statistical analyses, including chi-square tests and logistic regression, to examine associations.ResultsThe majority of participants were aged above 60 years (36.5%), with most having a normal BMI (74.8%) and being male (69.0%). We found significant associations between the prevalence of asthma, age, BMI categories, and respiratory symptoms such as wheezing, coughing, chest tightness, and shortness of breath. Overweight individuals showed a higher likelihood of developing asthma (AOR 7.01; 95% CI 5.04–7.11), as did those with primary education (AOR 1.51; 95% CI 1.11–2.95) and smokers (AOR 2.80; 95% CI 1.27–6.15).ConclusionThis study identifies a higher asthma prevalence in Khulna City, associated with older age, overweight status, primary education level, and respiratory symptoms such as wheezing, coughing, chest tightness, and shortness of breath. Smoking further exacerbates the severity of the condition. We recommend public health strategies such as promoting healthier lifestyles, improving healthcare access, raising awareness about smoking risks, enhancing air quality, and establishing specialised asthma clinics for effective management and improved quality of life.

Accelerated biological age mediates the associations between sleep patterns and chronic respiratory diseases: Findings from the UK Biobank Cohort

BackgroundUnhealthy sleep patterns and accelerated biological age are frequently associated with multiple chronic respiratory diseases (CRDs), including COPD, asthma, and interstitial lung disease (ILD). However, few studies have explored the role of biological age in the relationship between sleep patterns and CRDs. ObjectivesTo explore the association between sleep patterns and CRD, and the extent to which biological age mediates the relationship between sleep patterns and CRD. MethodsThis was a prospective cohort study based on UK Biobank. The sleep score was derived from five self-reported sleep traits: sleep duration, daytime sleepiness, chronotype, snoring, and insomnia. The score ranged from 0 (least healthy) to 5 (healthiest). Biological age was represented by PhenoAgeAccel. ResultsAmong 303,588 participants, 11,105 (3.7 %), 9,380 (3.1 %), and 1,667 (0.5 %) were diagnosed with asthma, COPD, and ILD, respectively. Each 1-point increase in the sleep score was associated with a 0.156-year reduction in PhenoAgeAccel, and 14.3 %, 12.4 %, and 6.7 % reduction in asthma, COPD, and ILD, respectively. For each 1-year increase in PhenoAgeAccel, the risk of asthma, COPD, and ILD increased by 2.8 %, 4.3 %, and 5.7 %, respectively. PhenoAgeAccel mediated the associations between the sleep score and asthma, COPD, and ILD, with a mediated proportion (95 % CI) of 2.81 % (2.35 % to 3.27 %), 4.94 % (4.23 % to 5.66 %), and 12.48 % (10.43 % to 14.53 %), respectively. ConclusionA better sleep score was significantly associated with younger biological age and decreased risk of CRDs, with biological age playing a mediating role in the association between sleep score and CRDs.

The Effects of Turmeric and Mangosteen Pericarp Ethanol Extract on Eosinophil Count, TNF-α and TGF-β1 Gene Expression in Asthmatic Rat Model.

Asthma is a chronic respiratory disease that is characterized by inflammation, bronchial hyperreactivity, and airway remodeling. The long-term use of corticosteroids at high doses causes various side effects. Traditional herbal medicine has been suggested as an alternative therapy that is safe and effective in dealing with asthma. Natural plants such as turmeric and mangosteen are known to treat asthma and reduce inflammation. The purpose of this study was to investigate the effects of turmeric and mangosteen pericarp ethanol extracts on the eosinophil counts, TNF-α and TGF-β1 gene expression, and inflammatory cell counts in the histopathology of an asthmatic rat model. The preliminary study used 30 rats, which were divided into a normal group, negative control group (OVA-sensitized), turmeric normal group, mangosteen group, and positive control group. Blood samples were collected after the sensitization period to determine eosinophil counts. TNF-α and TGF-β1 gene expression, and histopathology were observed in the rat's lungs. The follow-up study used 30 rats divided into a normal group, negative control group (OVA-sensitized), combination of turmeric and mangosteen group (54m/200gr rats, 36mg/200gr rats, and 36mg/200gr rats), and positive control group. The examination procedures were the same as in the preliminary study. The administration of single ethanol extracts of turmeric and mangosteen significantly decreased eosinophils and improved the histopathological features of the lungs (inflammatory cell counts, bronchial inflammatory score, and bronchial smooth muscle thickness) (p<0.05). The combination of turmeric and mangosteen extracts at all doses significantly decreased eosinophils and improved the histopathological features of the lungs (inflammatory cell counts, bronchial inflammatory score, and bronchial smooth muscle thickness) (p<0.05). Both the single and combined administration of turmeric and mangosteen ethanol extracts did not cause significant changes in TNF-alpha and TGF-beta (p>0.05). Turmeric ethanol extract and mangosteen pericarp ethanol extract have a reductional effect on the parameters of asthma based on the eosinophil counts, the inflammatory cell counts and score, and bronchial smooth muscle thickness.

Impact of 2022 flood on socio-economic and health status of people residing in flood-stricken areas of Pakistan: a cross-sectional survey

Background: The events of extreme weather and climate-related disasters such as drought, flood, and heat waves are increasing worldwide. This paper highlights the impact of the 2022 flood in Pakistan on the socio-economic and health status of people residing in flood-stricken areas of Pakistan. Methodology: A post-flood survey was conducted from three districts of Pakistan with a myriad of questions inquiring about the biopsychosocial aspects of the affected community. Data were collected through a validated questionnaire and was analyzed through SPSS software version 25. Results: Forty percent of people became homeless; the number of individuals with a low income decreased by 9%; and the number of individuals with a moderate income decreased by 22%. Additionally, 48.7% of subjects lost their income due to flooding, 83.4% of subjects reported having some type of illness or disability since the flooding (previously 16.4%), and 92.8% believed that the floods had affected the health and sanitation of their area. Importantly, 22.6% of subjects expressed difficulty in accessing food after flooding compared to before and 59.9% of respondents noted they were unaware of proper pre-flood evacuation protocols in their area. Conclusion: The authors’ study indicates that the floods had a significant impact on the socio-economic and health status of residents, particularly those with lower incomes depriving a large proportion of nutrition, health facilities, and property. Without access to necessities and healthcare, individuals are more vulnerable to illnesses, such as chronic respiratory disease, diabetes, and heart disease. The authors stress the importance of providing infrastructural, nutritional, and medical services support to ensure that a community such as Pakistan can recover and thrive post-environmental disaster.

Effect of vaccination against Mycoplasma hyopneumoniae on divergent pig genetic groups

The bacterium Mycoplasma hyopneumoniae (Mhp) causes a chronic infectious respiratory disease in pigs, leading to important economic losses. This study aimed to compare the immune response of the local Piau breed and a commercial line to Mhp vaccination. For this, two phases were carried out. In the first, gene expression of toll-like receptors (TLR2, TLR4, TLR6, and TLR10) and cytokines (IL2, IL6, IL8, IL10, IL12, IL13, TNFα, and TGFβ) was assessed in porcine blood mononuclear cells (PBMC) from the two genetic groups before and after vaccination. In the second experiment, nitric oxide production, specific antibodies, and gene expression of toll-like receptors and cytokines were evaluated in bronchoalveolar lavage fluid (BALF) cells of vaccinated and unvaccinated pigs. After vaccination against Mhp, TLR2, TLR4, TLR6, TLR10, IL6, TNFα, and TGFβ expression levels were elevated in PBMC from commercial animals, and TLR6, TLR10, and TGFβ expression levels were elevated in PBMC from the Piau group. Vaccination also increased the production of Mhp-specific IgG antibodies in BALF cells in the Piau breed. Comparison of the two genetic groups revealed differences in TNFα and IL10 expression in BALF cells. These results show that Piau pigs have different immune responses to vaccination compared with commercial animals. It is worth noting that these genetic differences between both genetic groups may be related to phenotypic differences in Mhp resistance or susceptibility.

A systematic review and meta-analysis exploring the bidirectional association between asthma and gastroesophageal reflux disease in children

Background: Asthma is the most prevalent chronic respiratory disease in children, and gastroesophageal reflux disease (GERD) is one of its extraesophageal complications of asthma. Both conditions are commonly observed in pediatric outpatient clinics, but the causality between them in children is still debated. Therefore, we conducted a systematic review and meta-analysis to evaluate the bidirectional association between asthma and GERD in children. Methods: We systematically reviewed original studies published from January 2000 to February 2024 by searching the data bases. We also performed manual retrieval and screening to identify studies that met the inclusion criteria. The quality of the final included studies was evaluated by using the Newcastle‐Ottawa Scale, and outcome measures were extracted. Results: We identified nine eligible studies, which included 304,399 children of different ages from seven countries. Overall, the risk of developing GERD in children with asthma (odds ratio [OR] 2.16 [95% confidence interval [CI], 1.6‐2.91) was higher than the risk of developing asthma in children with GERD (OR 1.55 [95% CI, 1.32‐1.82]). Conclusion: Based on the available studies, it can be concluded that asthma and GERD are mutually aggravating factors in children, presenting a bidirectional association. However, the risk of developing GERD in children with asthma is higher to some extent. More large-scale and high-quality prospective cohort studies are needed in the future to provide richer evidence and more research opportunities.

Influence and distinctions of particulate matter exposure across varying etiotypes in chronic obstructive pulmonary disease (COPD) mouse model

BackgroundAir pollution, notably particulate matter (PM), significantly impacts chronic respiratory disease such chronic obstructive pulmonary disease (COPD). Although asthma-COPD overlap (ACO), considered one of the COPD etiotype, is associated with greater severity in both symptoms and outcomes, effects of PM exposure remain unclear. Thus, this study aimed to evaluate impact of PM on chronic airway disease animal models.MethodsWe established two distinct COPD etiotypes, cigarette smoking-related COPD (COPD-C) and COPD with asthma (COPD-A), using porcine pancreatic elastase (PPE) for COPD-C and a combination of PPE with ovalbumin for COPD-A. To reflect smoking influence, cigarette smoking extract was administered to both disease models. To assess impact of PM exposure, bronchoalveolar lavage fluid (BALF), proinflammatory cytokines, lung histology, and cellular damage mechanisms were analyzed.ResultsIn the COPD-A model, cell counts and type 2 cytokines were elevated in BALF independent of PM exposure. All models exhibited increased lung inflammation and emphysema due to PM exposure. Expression levels of apoptosis-related protein B-cell lymphoma protein 2 (Bcl-2) associated X (Bax) showed an inclination to increase with PM exposure. In the COPD-A model, decreased expression of basal nuclear factor erythroid-derived 2-like 2 (Nrf-2) and increased production of reactive oxygen species (ROS) due to PM exposure were noted.ConclusionWe developed two distinct models for the etiotypes of COPD and found increased vulnerability to cell damage in COPD-A after PM exposure. Moreover, the control group displayed escalated airway inflammation and emphysema due to PM exposure, substantiating the risk of respiratory diseases.

Yunpi Xiefei Huatan Tang decoction reduces airway inflammation and airway remodeling in asthmatic mice through Wnt/β-catenin signaling pathway

Background: Asthma is one of the most prevalent chronic respiratory diseases among children, markedly impairing patient’s health and imposing an increasing burden on the healthcare system. Several traditional Chinese medicines have demonstrated efficacy in alleviating asthma symptoms through studies conducted on animal models. Recent studies have shown that the Yunpi Xiefei Huatan Tang decoction (YPD) exhibits significant therapeutic outcomes in treating phlegm-obstructed pulmonary asthma. However, the precise regulatory effects of YPD on the progression of asthma require additional investigation. Objective: To explore the functions of YPD in asthma progression. Material and Methods: The asthma rat model triggered by ovalbumin (OVA) was established successfully. The pathological changes of lung tissues were examined through Hematoxylin and Eosin (H&amp;E) staining. The levels of Interleukin 6 (IL-6) and IL-1β were tested through Enzyme-Linked-Immunosorbent Serologic Assay (ELISA). The number of total cells or eosinophils in bronchoalveolar lavage fluid was confirmed through cell counter. The collagen deposition in bronchi was assessed through Masson staining. The protein expressions were measured through western blot. Results: This study demonstrated that YPD could mitigate airway inflammation in an OVA-triggered asthma rat model. Furthermore, YPD was found to decrease the production of inflammatory cytokines in the lungs and suppress the infiltration of inflammatory cells into bronchoalveolar lavage fluid. Additionally, the airway remodeling stimulated by OVA could be suppressed following YPD treatment. Finally, it was disclosed that YPD inhibited the wingless-related integration site–beta-catenin (Wnt/β-catenin) signaling pathway in the OVA-stimulated asthma rat model. Conclusion: YPD alleviated airway inflammation and remodeling in asthmatic mice via the Wnt/β-catenin signaling pathway. This research offers significant insights into the potential application of YPD in the treatment of asthma.

Cough in pulmonary rehabilitation: a retrospective analysis of responders/non-responders

Pulmonary rehabilitation (PR) is essential for people with chronic respiratory diseases (CRD), yet its impact on cough-related quality of life (CR-QoL) remains unexplored. We assessed the PR effects on CR-QoL, described the characteristics of responders and non-responders to PR and explored determinants of responsiveness in this health domain in individuals with CRD.A retrospective study was conducted. We assessed CR-QoL using the Leicester Cough Questionnaire (LCQ) and the impact of the disease with the COPD Assessment Test (CAT), before and after PR. Cut-offs of &lt;17.05 in LCQ total score and ≥10 in CAT were used to detect low CR-QoL and medium impact of the disease. Responders were defined as achieving a minimal clinically important difference (MCID) of ≥1.3 on the LCQ total score. Pre-post PR analysis involved t-test/Wilcoxon/McNemar tests and comparisons between groups included independent t /Mann-Whitney U/Fisher's exact tests. Logistic regression was employed to investigate factors influencing MCID achievement.135 participants with CRD (39%♀; 68±10 years old; 61% COPD; FEV1%predicted 62.6±23.0) were included. After PR, significant improvements were observed in all LCQ domains and CAT. 31% of participants were identified as responders in the LCQ (36%♀; 66±10 years; 62% COPD; FEV1%predicted 60.0±22.3) showcasing significant differences in LCQ and CAT compared to non-responders. People with low CR-QoL and/or medium/high impact of the disease at baseline were 11 and 4 times, more likely to respond to PR in CR-QoL, respectively.PR enhances CR-QoL. Identification of CR-QoL and disease impact traits at baseline offers insights to optimize this outcome responsiveness to PR.

Hypnotic-based intervention for people with non-communicable diseases : A scoping review

This scoping study aimed to explore the use of hypnotic-based interventions for individuals with Non-Communicable Diseases (NCDs). Four research questions were addressed: the types of hypnosis-based interventions, the types of NCDs studied, the targeted outcomes, and the evidence of effectiveness. Using Arksey and O'Malley's framework, a systematic search of databases (Cochrane Library, Google Scholar, Scopus, PubMed) was conducted from March to April 2021. Studies published in English between 2001 and 2021, employing Randomized Controlled Trials (RCTs), were included. Out of 6,382 unique records, 11 primary studies met the inclusion criteria, encompassing 589 participants across four NCD subgroups: diabetes, chronic respiratory diseases, cancer, and cardiovascular diseases. Five types of hypnotic interventions were identified: mindfulness, relaxation, self-hypnosis, hypnotherapy, and cognitive behavior therapy plus hypnosis. The outcomes assessed included pain, fatigue, anxiety, sleep quality, dyspnoea, emotion, panic, and quality of life. While the results suggest that hypnotic-based interventions hold promise as supportive therapy for NCD patients, especially in addressing psychological symptoms, the evidence remains inconclusive. Further research is needed to establish the overall effectiveness of hypnosis in this context. Nonetheless, these findings highlight the potential of hypnosis to complement medical treatments for NCDs.

Research Priorities in Pulmonary Rehabilitation: The Urgent Need to Increase the Portfolio of Rehabilitation Options for Chronic Lung Disease.

Pulmonary rehabilitation (PR) plays a crucial role in improving outcomes for individuals with chronic respiratory diseases. The most outstanding challenge in PR is the low referral, uptake, and adherence that is dramatically low in the post-hospitalization period in rural, minority, and low-income populations. Research efforts to increase the portfolio of PR through the testing and implementation of new and effective options for home-based and community-based programs are potential research targets. Other potential foci of research efforts are the pursuit of behavior-change techniques to achieve a lifestyle change during PR and the referral process to increase uptake and adherence rates. Creating new rehabilitation options for chronic lung disease that can reach more people may require expanding the definition of PR for chronic lung disease to one more flexible and perhaps concordant with the World Health Organization's definition of rehabilitation as "a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment." While efforts to augment access to conventional PR are warranted, it is time to devote research efforts to reach many more individuals with chronic lung disease, particularly minorities, rural, and low-income individuals that currently have no access to any rehabilitation, a social injustice that requires action. This manuscript outlines suggested future directions in rehabilitation research with the pursuit of evidence to support feasible and effective programs that may increase the rehabilitation portfolio to accommodate most individuals with chronic lung disease.

Oxidative Stress and Antioxidants in Pediatric Asthma’s Evolution and Management

Within the pediatric population, bronchial asthma is one of the most prevalent chronic respiratory system diseases. The number of exacerbations, severity, and duration of symptoms all have a significant impact on children’s life quality. In the last decades, the prevention and management strategies of this pathology have focused on maintaining or even increasing the pulmonary function to maximum levels in early childhood, as it has been demonstrated that functional deficits at this level occurring before school age cause pathological manifestations later, in adulthood. The epithelium of the airways and implicitly that of the lung is the first barrier against the lesions caused by pro-oxidative factors. Both oxidative and antioxidative factors can be of endogenous origin (produced by the body) or exogenous (from the environment or diet). Good functioning of antioxidant defense mechanisms from the molecular level to the tissue level, and a balance between pro-oxidative factors and anti- oxidative factors, influence the occurrence of compensatory mechanisms at the level of the respiratory epithelium, causing the delay of local responses to the stress induced by chronic inflammation (bronchial remodeling, thickening of airway smooth muscles, bronchoconstriction, bronchial hyper-reactivity). These mechanisms underlie the pathophysiological changes in asthma. Numerous studies carried out among the pediatric population inclusively have demonstrated the effectiveness of antioxidants in the prophylaxis, slowing down and preventing the progression of this pathology. This review complements the scientific articles, aiming at emphasizing the complexity of oxidative physio-pathological pathways and their importance in the occurrence, development, and therapeutic response in asthma, providing a good understanding of the relationship between oxidative and antioxidative factors, and being a source of future therapeutic strategies.

Understanding the Risk Factors, Burden, and Interventions for Chronic Respiratory Diseases in Low- and Middle-Income Countries: A Scoping Review

ObjectiveThis scoping review aims to identify risk factors for COPD and asthma, examine the burden and intervention measures, and clarify the findings in the context of climate change, with a particular focus on LMICs.MethodsFollowing the PRISMA-ScR guidelines, we conducted a scoping review using PubMed, Embase, and Scopus, focusing on studies published from 2011 to 2024.ResultsOur review included 52 studies that encompassed 244,004 participants. Predominantly conducted in SSA (n = 43, 83%) and Asia (n = 16, 31%), they address indoor and ambient air pollution, occupational hazards, and environmental conditions. Climate change exacerbates risks, varying regionally. SSA faces severe household and occupational exposures, while other LMICs deal with industrial and urban pollution. Stigma, social exclusion and economic burden underscore the necessity for intervention strategies (e.g., educational programs, pulmonary rehabilitation, low-emission cookstoves).ConclusionOur research shows a strong link between air pollution, occupational and environmental exposures, and the prevalence of COPD and asthma in LMICs. It suggests that targeted interventions are effective ways to mitigate these diseases and also highlights the significant impact of climate change on respiratory health.