Clinical Manifestations Of Asthma Research Articles

Early Prediction of Asthma.

The clinical manifestations of asthma in children are highly variable, are associated with different molecular and cellular mechanisms, and are characterized by common symptoms that may diversify in frequency and intensity throughout life. It is a disease that generally begins in the first five years of life, and it is essential to promptly identify patients at high risk of developing asthma by using different prediction models. The aim of this review regarding the early prediction of asthma is to summarize predictive factors for the course of asthma, including lung function, allergic comorbidity, and relevant data from the patient's medical history, among other factors. This review also highlights the epigenetic factors that are involved, such as DNA methylation and asthma risk, microRNA expression, and histone modification. The different tools that have been developed in recent years for use in asthma prediction, including machine learning approaches, are presented and compared. In this review, emphasis is placed on molecular mechanisms and biomarkers that can be used as predictors of asthma in children.

Screening out serum protein biomarkers from both groups of asthma and ABPA patients

Clinical manifestations of asthma and allergic bronchopulmonary aspergillosis (ABPA) are very similar, so that they are easy to be misdiagnosed. To improve the diagnostic accuracy of these two diseases, the protein array was firstly applied for measuring serum proteins from asthma and ABPA patients,compared with normal control subjects in this study. Protein biomarkers associated to the disease processes and with diagnostic value were analyzed by bioinformatics. The multiple reaction monitoring mass spectrometry (MRM-MS) and enzyme linked immunosorbent assay (ELISA) were then used to verify the candidate biomarkers with enlarged size of samples. The diagnostic value of candidate proteins was additionally evaluated with the receiver operating characteristic (ROC) curve. Via the comparison analysis, the disease related-candidates were identified, including 7 differentially expressed proteins(DEPs) between asthma and normal groups, 15 DEPs between ABPA and normal groups, and 15 DEPs between ABPA and asthma groups. Using MRM method, SERPINF2, C6 and HABP2 proteins were showed differential expression significantly between asthma and normal groups,SERPINF2 and F10 were represented differential expression significantly between ABPA and normal control groups, and CPN2 and IGLL5 were displayed differential expression significantly between ABPA and asthma groups. Furthermore, ELISA validation data were also showed that serum CSF1 protein levels in ABPA patients were significantly lower than those in asthma patients, while TNFRSF10C levels in ABPA patients were significantly higher than those in asthma patients. ROC curve analysis revealed that the AUC of C6 were 0.9 with the sensitivity of 73.3% and the specificity of 99.9% in comparison between asthma and normal groups. The AUC of F10 was 0.871, with the sensitivity of 80.0% and the specificity of 85.7% in comparison between ABPA and normal groups. And the AUC of the combined diagnosis of CPN2 and IGLL5 was 0.867, with more sensitivity of 86.7% and the specificity of 80.0% in comparison those between ABPA and asthma groups. In conclusion, novel protein biomarkers in this study were closely related to the occurrence and development of asthma or ABPA, and might have potentials for assistant diagnostic and differential diagnosis of those two diseases in clinical application.

Evaluation of Asthma Management Outcomes

Background: Asthma is a serious global health problem with an estimated 300 million affected individuals. Clinical manifestations of asthma can be controlled with appropriate treatment. When asthma is controlled, severe exacerbations should be rare. The goal of treatment in Asthma is to reduce inflammation and to achieve¸ total control. Treatment with anti-inflammatory drugs can, to a large extent, reverse some of these processes; however, the successful response to therapy often requires weeks to achieve and, in some situations, may be incomplete. Objectives of the study: This study was performed to evaluate the outcomes of Asthma treatment amongst asthmatic patients on follow-up at King Hussein Medical Centre (KHMC) at the Royal Medical Services (RMS) in Jordan/Amman. Methods: A retrospective, observational study was designed and performed on the basis of the asthma patient medical files. The patients’ medical profiles of were revised and the results were assessed according global initiative for asthma (GINA) guidelines. The collected data was analyzed by using statistical Package for the Social Sciences (SPSS) version 22. Results: A total of 210 asthmatic patient’s profiles were revised, and amongst the patient's majority (62.6%) were males and the average age of the participants was 35.1 years with standard deviation (SD) of 9.4. The most (53.3%) have been prescribed asthmatic drug combination was fluticasone propionate and salmeterol xinafoate (Seretide®) for long term asthmatic symptoms management. Amongst the asthmatic patients, 58 % had used antibacterial for their respiratory tract infections (RTIs) and urinary tract infections (UTIs). Conclusion: This study has shown that, despite the existence of an effective medication for asthma, disease control is insufficient and falls short of the accepted global guidelines.

Sex Disparities in Asthma Development and Clinical Outcomes: Implications for Treatment Strategies.

A gender-related disparity exists in asthma morbidity and mortality, which shifts at around puberty from a male predominance to a female predominance. This is clinically reflected in the fact that asthma that occurs in childhood (childhood-onset asthma) mainly affects boys, and that asthma that occurs in adulthood (adult-onset asthma) mainly affects women. Adult-onset asthma is often non-atopic, more severe, and associated with a poorer prognosis, thus posing a marked burden to women’s health and healthcare system. Many factors have been indicated to explain this gender-related disparity, including sociocultural and environmental factors as well as biological sex differences (genetic, pulmonary and immunological factors). It has long been suggested that sex hormones may be implicated in at least these biological sex differences. Overall, the evidence remains equivocal for the role of most sex hormones in asthma pathogenesis and clinical outcomes. Well-designed randomized clinical trials are required assessing the potential preventive or therapeutic effects of hormonal contraceptives on asthma in women, thereby helping to advance the evidence to inform future practice guidelines. The mechanisms underlying the role of sex hormones in asthma are complex, and our understanding is not yet complete. Additional mechanistic studies elucidating sex hormone signaling pathways and their interactions involved in the pathogenesis and clinical manifestations of asthma will help to identify potential sex hormone-driven asthma endotypes and novel therapeutic targets, providing the basis for a more personalized asthma management strategy.

Altered transcriptional and chromatin responses to rhinovirus in bronchial epithelial cells from adults with asthma

There is a life-long relationship between rhinovirus (RV) infection and the development and clinical manifestations of asthma. In this study we demonstrate that cultured primary bronchial epithelial cells from adults with asthma (n = 9) show different transcriptional and chromatin responses to RV infection compared to those without asthma (n = 9). Both the number and magnitude of transcriptional and chromatin responses to RV were muted in cells from asthma cases compared to controls. Pathway analysis of the transcriptionally responsive genes revealed enrichments of apoptotic pathways in controls but inflammatory pathways in asthma cases. Using promoter capture Hi-C we tethered regions of RV-responsive chromatin to RV-responsive genes and showed enrichment of these regions and genes at asthma GWAS loci. Taken together, our studies indicate a delayed or prolonged inflammatory state in cells from asthma cases and highlight genes that may contribute to genetic risk for asthma.

5α-dihydrotestosterone abrogates sex bias in asthma like features in the mouse

Androgen levels inversely correlate with the incidence, susceptibility and severity of asthma. However, whether male sex hormones such as 5α-dihydrotestosterone (DHT) have beneficial effects on asthma symptoms and/or could affect asthma susceptibility have not been investigated. DHT administration to female mice, during the sensitization phase, abrogates the sex bias in bronchial hyperreactivity. This effect correlates with inhibition of leukotriene biosynthesis in the lung. DHT significantly inhibits also other asthma-like features such as airway hyperplasia and mucus production in sensitized female mice. Conversely, DHT does not affect plasma IgE levels as well as CD3+CD4+ IL-4+ cell and IgE+c-Kit+ cell infiltration within the lung but prevents pulmonary mast cell activation. The in vitro study on RBL‐2H3 cells confirms that DHT inhibits mast cell degranulation. In conclusion, our data demonstrate that immunomodulatory effects of DHT on mast cell activation prevent the translation of allergen sensitization into clinical manifestation of asthma.

Subphenotypes of nonsteroidal antiinflammatory disease-exacerbated respiratory disease identified by latent class analysis.

BackgroundInduced sputum (IS) allows to measure mediators of asthmatic inflammation in bronchial secretions. NSAID‐exacerbated respiratory disease (NERD) is recognized as a distinct asthma phenotype, usually with a severe course, eosinophilic airway inflammation, and increased production of pro‐inflammatory eicosanoids. A more insightful analysis of NERD patients has shown this phenotype to be nonhomogeneous.ObjectiveWe aimed to identify possible subphenotypes in a cohort of NERD patients with the means of latent class analysis (LCA).MethodsA total of 95 asthma patients with aspirin hypersensitivity underwent sputum induction. High‐performance liquid chromatography or gas chromatography coupled with mass spectrometry was used to profile eicosanoids in induced sputum supernatant (ISS). Sixteen variables covering clinical characteristics, IS inflammatory cells, and eicosanoids were considered in the LCA.ResultsThree classes (subphenotypes) were distinguished within the NERD cohort. Class 1 subjects had mild‐to‐moderate asthma, an almost equal distribution of inflammatory cell patterns, the lowest concentrations of eicosanoids, and logLTE4/logPGE2 ratio. Class 2 represented severe asthma with impaired lung function despite high doses of steroids. High sputum eosinophilia was in line with higher pro‐inflammatory LTE4 in ISS and the highest logLTE4/logPGE2 ratio. Class 3 subjects had mild‐to‐moderate asthma and were also characterized by eosinophilic airway inflammation, yet increased production of pro‐ (LTE4, PGD2 and 11‐dehydro‐TBX2) was balanced by anti‐inflammatory PGE2. The value of logLTE4/logPGE2 was between values calculated for classes 1 and 3, similarly to disease control and severity.ConclusionsLCA revealed three distinct NERD subphenotypes. Our results support a more complex pathobiology of aspirin hypersensitivity. Considering NERD heterogeneity, the relationship between inflammatory pathways and clinical manifestations of asthma may lead to more individualized treatment in difficult to treat patients in the future.

Prévalence et contrôle de l’asthme chez les étudiants en médecine à Parakou, Bénin

The objective of this study was to determine the prevalence and to assess the control of asthma among students at the faculty of medicine of the university of Parakou in Benin. This cross-sectional study was carried out between January and November 2017. The Asthma Screening Questionnaire (ASQ) was filled out by medical students, followed by the Asthma Control Test questionnaire for those who were suspected of having clinical asthma (ASQ≥4). All students with clinical asthma or with a history of asthma were invited to perform a spirometry test. Overall, 837 (73.7%) students out of 1136 were included. The prevalence was 9.1% for ever diagnosed asthma, 14% for clinical asthma and 5.3% for confirmed asthma. Among 761 students, without a previous asthma diagnosis, 10.4% had clinical asthma and 3.3% a confirmed asthma. Female sex (aOR=2.1; 95%CI =1.0-4.1), a previous diagnosis of asthma (aOR=7; 95% CI=3.2-15.2) and allergic rhinitis (aOR=3.9; 95% CI=1.9-7.8) were associated with confirmed asthma. Asthma symptoms were controlled in 92 (78.6%) students, partly controlled in 20 (17.1%), and not controlled in 5 (4.3%). Clinical manifestations of asthma are frequent among medical students at Parakou. Some are not well controlled, suggesting a need for greater awareness and an improvement in clinical follow-up.

Влияние деструкции эпителия бронхов на клинические проявления бронхиальной астмы у больных с холодовой гиперреактивностью дыхательных путей

Влияние деструкции эпителия бронхов на клинические проявления бронхиальной астмы у больных с холодовой гиперреактивностью дыхательных путей

Accuracy of serum-specific IgE test with microfluidic array enzyme-linked immunosorbent assay for diagnosing inhalant allergen sensitization in asthma and/or rhinitis allergy patients in Jakarta, Indonesia.

BackgroundAsthma and allergic rhinitis are a global health burden. Inhalant allergens worsen the symptoms and clinical manifestations of asthma and allergic rhinitis. Skin prick test is the gold standard for diagnosing allergen sensitization but is associated with some limitations. In contrast, in vitro serum-specific immunoglobulin E (SSIgE) test is convenient and is not associated with an anaphylactic risk.ObjectiveThe present study compared the accuracy of the SSIgE test by using microfluidic array enzyme-linked immunosorbent assay (ELISA) with that of the skin prick test for diagnosing inhalant allergen sensitization in patients with asthma and/or allergic rhinitis.MethodsThis diagnostic study included patients with asthma and/or allergic rhinitis. Of these, 100 patients underwent the SSIgE test for diagnosing sensitization to house dust mites (Dermatophagoides pteronyssinus, Dermatophagoides farinae, and Blomia tropicalis), dog dander, cat dander, and cockroach allergen. All the patients also underwent the skin prick test for diagnosing allergen sensitization. The sensitivity, specificity, predictive value, and likelihood ratio (LR) of the SSIgE test were evaluated for each allergen.ResultsSensitivity of the SSIgE test for diagnosing house dust mite sensitization was 48%–77%, with the highest sensitivity (77%) observed for diagnosing D. farinae sensitization. Specificity of the SSIgE test for diagnosing house dust mite sensitization was 64%–95%, with the highest specificity (95%) observed for diagnosing B. tropicalis sensitization. Although the SSIgE test showed high specificity and LR+ for diagnosing cockroach allergen sensitization, it showed low sensitivity (12%). Moreover, the SSIgE test showed high specificity (89%) but low sensitivity (3%) for diagnosing dog dander sensitization and high specificity (88%) but low sensitivity (10%) for diagnosing cat dander sensitization.ConclusionThe SSIgE test using microfluidic array ELISA shows moderate accuracy for diagnosing house dust mite sensitization and low accuracy for diagnosing cockroach allergen and dog and cat dander sensitization.

The Effects of Music Therapy on the Physiological Response of Asthmatic Children Receiving Inhalation Therapy

ABSTRACTThe clinical manifestation of asthma in children can interfere with their daily activities. Music therapy may become one of the alternative approaches to making children feel comfortable during inhalation therapy. The aim of the study was to identify the effects of music therapy on the physiological response of asthmatic preschool and school-age children receiving inhalation therapy. This study used a quasi-experimental, nonequivalent control group with a pre-test–post-test design. The 44 respondents consisted of preschool and school-age children assigned to intervention and control groups. The results showed a significant difference in average oxygen saturation, heart rate, and respiratory rate between the control and intervention groups before and after intervention (p < α; α = .05). Music therapy can be used as a nursing intervention to improve the physiological response of children with breathing problems.

Postpartum airway responsiveness and exacerbation of asthma during pregnancy - a pilot study.

BackgroundAirway responsiveness and inflammation are associated with the clinical manifestations of asthma and the response to pharmacological therapy.ObjectiveTo investigate if airway responsiveness and inflammatory characteristics are related to asthma exacerbations during pregnancy.Materials and methodsIn women with asthma who were prescribed controller medication and monitored closely during pregnancy, the risk of exacerbations was analyzed in relation to postpartum measures of fractional exhaled nitric oxide (FENO), skin prick test reactivity, static and dynamic lung volumes, diffusing capacity for carbon monoxide, bronchial responsiveness to inhaled mannitol, and inflammatory characteristics in induced sputum. Obtained data were analyzed in relation to exacerbation status during pregnancy. The PD15 is defined as the cumulative administered dose causing a 15% decline in forced expiratory volume in the first second (FEV1).ResultsFifty women (mean age ± standard deviation of 32±5 years) were enrolled over an 11-month period and examined on average 4 months postpartum. During pregnancy, 13 women had a total of 16 exacerbations (8 mild and 8 severe). Women with asthma exacerbation during pregnancy had more pronounced airway responsiveness to inhaled mannitol (geometric mean PD15 82 vs 171 mg, p=0.04) and were less likely to be atopic (62% vs 86%, respectively; p=0.04) than the non-exacerbators. No statistically significant difference was found between the 2 groups of women with regard to type of airway inflammation in sputum and fractional exhaled nitric oxide (FENO).ConclusionMore pronounced airway hyperresponsiveness together with nonatopic status appears to characterize women at high risk of exacerbation of asthma during pregnancy.

Cellular and molecular mechanisms of asthma and COPD.

Asthma and chronic obstructive pulmonary disease (COPD) both cause airway obstruction and are associated with chronic inflammation of the airways. However, the nature and sites of the inflammation differ between these diseases, resulting in different pathology, clinical manifestations and response to therapy. In this review, the inflammatory and cellular mechanisms of asthma and COPD are compared and the differences in inflammatory cells and profile of inflammatory mediators are highlighted. These differences account for the differences in clinical manifestations of asthma and COPD and their response to therapy. Although asthma and COPD are usually distinct, there are some patients who show an overlap of features, which may be explained by the coincidence of two common diseases or distinct phenotypes of each disease. It is important to better understand the underlying cellular and molecular mechanisms of asthma and COPD in order to develop new treatments in areas of unmet need, such as severe asthma, curative therapy for asthma and effective anti-inflammatory treatments for COPD.

Role and Clinical Significance of Il-33 in Patients with Asthma

Abstract Introduction. Asthma is a chronic inflammatory disease of the airways in which many cells play a role with secreting a variety of mediators responsible for the clinical manifestation of asthma. It is assumed that IL-33 is one of the earliest-released mediators and can orchestrate the immune cascade of the disease. The aim of this study was to examine the role and clinical significance of IL-33 as a new and insufficiently explored mediator of inflammation in patients with uncontrolled moderate asthma. Methods. The study included 87 patients with asthma. Serum IL-33 was measured in all patients by ELISA method. The obtained data were statistically analyzedusing the Kolmogorov-Smirnov and Shapiro-Wilk's test. Qualitative data were presented in absolute and relative numbers, and quantitative data were presented with measures of descriptive statistics. Statistically significant values were considered forp &lt;0.05. Results. Majority of included patients were female (75.86%). The average age of patientswas 42.3±15.9 years. The results of IL-33 in all patients were significantly increased compared to the reference value of IL-33 which is 0pg/ml. The average values of IL-33 ranged from 6.47±29.3 and they were insignificantly higher in the group with female patients compared to males (p=0.27), and insignificantly correlated with age (p=0.26). Conclusion. Even though a limited number of studies haveexplored the IL-33, results have shown higher serum level of IL-33 in asthma patients compared to healthy people, emphasizing the factthat IL-33 is an attrac tive candidate for targeted therapy and prognosis inasthma patients.

Clinical manifestations of acute asthma in children at the Department of Child Health Cipto Mangunkusumo Hospital

Background Acute asthma is an asthma attack or worsening ofasthma manifestation and pulmonary function. Severe asthma at-tack might be prevented by early recognition of the attack and ap-propriate therapy. Clinical manifestations of asthma in children varywidely, so does the assessment of the attack that is often not accu-rately defined by doctors. This leads to delayed and inadequatetreatment of the attack.Objective This study aimed to know the clinical manifestationsof acute asthma in children at the Department of Child Health, Medi-cal School University of Indonesia/Cipto Mangunkusumo Hospi-tal.Methods This was a descriptive, cross sectional study, conductedat the emergency room (ER), the Pediatric Pulmonology Outpa-tient Clinic, and the Pediatric Outpatient Clinic. Subjects were asth-matics who were having attack and aged 2-18 year-old. Data ofage, sex, pulse rate, respiratory rate, duration of attack, expiratory,and inspiratory effort signs were obtained by history and physicalexamination followed by the assessment of attack severity.Results Subjects consisted of 92 children, mostly obtained fromthe ER (40%), with male to female ratio of 1.5:1 and average ageof 5.8 years old. Most of the subjects had mild attack (83%) andduration of attack of less than 24 hours (56%). Most subjects (70%)only had signs of increased expiratory effort, in which all of themhad mild attack. The rest of the subjects showed the combinationof inspiratory and expiratory efforts; 12 patients with mild attack,15 with moderate attack, and 1 with severe attack.Conclusion Patients who only showed expiratory effort usuallyhad mild attack. Patients showing expiratory and inspiratory ef-forts usually had mild or moderate attack. Treatment should betailored to the degree of attack

The role of endosomal toll-like receptors in asthma

Asthma is a heterogeneous inflammatory disease caused by association of genetic and environmental factors and its incidence has significantly increased over the latest years. The clinical manifestations of asthma are the result of airway hyper-reactivity to a variety of triggers such as aeroallergens, viral and bacterial components. Toll-like receptors (TLRs) are pathogen associated molecular pattern receptors, which are also expressed in the lung tissue as well as in several cells of the innate and adaptive immune system. Ligation of TLRs results in alterations in the expression of several inflammatory and anti-inflammatory mediators, which are known to be involved in the pathogenesis of asthma. The endosomal TLRs have been shown to be associated with the induction of asthmatic inflammation (TLR3), and with disease exacerbations (TLR7, TLR8 and TLR9). Targeting these receptors seems to be an effective choice for suppressing airway inflammation, eosinophilia and airway hyperresponsiveness in asthmatic patients. In this review we provide information regarding endosomal TLRs and their role in the pathogenesis of asthma as well as their potential use as targets for the development of novel treatments for the therapy of asthma.

Clinical manifestations of asthma during combination therapy using ceruloplasmin

To estimate the time course of clinical changes in patients with asthma during combination therapy using ceruloplasmin (CP). A total of 92 asthmatic patients were examined. Their medical history data were collected; external lung function testing and clinical, laboratory, and instrumental examinations, involving the determination of the indicators of lipid peroxidation (LPO) (malonic dialdehyde (MDA), methemoglobin, carboxyhemoglobin) and the antioxidant system (superoxide dismutase (COD), sulfhydryl groups), were performed in all the patients over time. According to the therapy used, the patients were divided into 2 groups matched for gender, age, and clinical manifestations of the disease. A study group consisted of 45 patients who took CP in addition to conventional therapy. A comparison group included 47 patients receiving standard therapy. During the combination therapy using CP, the asthmatic patients showed a reduction in the elevated concentrations of MDA, methemoglobin, and carboxyhemoglobin and increases in the activity of COD and in the levels of sulfhydryl groups, which was followed by a considerable clinical improvement. During the conventional therapy, the indicators of LPO remained high and those of the antioxidant system did low, suggesting permanent oxidative stress. CP incorporation into the combination therapy of asthmatic patients contributes to elimination of prooxidant-antioxidant imbalance, which is followed by a marked positive clinical effect.

Chrysin inhibits human airway smooth muscle cells proliferation through the extracellular signal-regulated kinase 1/2 signaling pathway.

Asthma is a chronic airway inflammatory disease characterized by an increased mass of airway smooth muscle (ASM). Chrysin (5,7-dihydroxyflavone), a natural flavonoid, has been shown to exert multiple biological activities, including anti-inflammatory, anti-proliferative and anti-oxidant effects, as well as the potency to ameliorate asthma in animal models. The objective of the present study was to identify the underlying mechanism of the therapeutic effects of chrysin. The impact of chrysin on basal and platelet-derived growth factor (PDGF)-induced proliferation and apoptosis of human airway smooth muscle cells (HASMCs) was investigated. Furthermore, the activation of the extracellular signal-regulated protein kinase (ERK) signaling pathway was evaluated in HASMCs. The results revealed that chrysin significantly inhibited basal as well as PDGF-induced HASMC proliferation, most likely through the suppression of ERK1/2 phosphorylation. However, chrysin did not significantly reduce PDGF-induced apoptosis of HASMCs. The present study indicated that chrysin may be a promising medication for controlling airway remodeling and clinical manifestations of asthma.

Prevalence of bronchial asthma and respiratory symptoms in a group of students from grodno. An example of standardized epidemiological survey

Introduction: Due to an insufficient knowledge of the real asthma prevalence rate among children and adults in Belarus, we conducted a population-based respiratory health survey.Aim of the study: The study aimed at estimating the prevalence rate of asthma and major respiratory symptoms among students of the Grodno Region (Western Belarus).Material and methods: The cross-sectional study was conducted in 2014 and included 833 students aged 20-40 (young adults). Physician-diagnosed respiratory diseases and symptoms were ascertained using electronic version of the ISAAC questionnaire (web LimeSurvey).Results: The prevalence of asthma was 2.88% (physician-diagnosed). The obstructive (asthmatic) bronchitis (without established diagnosis of asthma) was found in 5.04% of the respondents. A chronic respiratory symptom occurring in the past 12 months and suggestive of asthma included attacks of dyspnea at rest, cough (5.88%) or in previous periods (8.88%), and wheezing in the chest (one of the most characteristic symptoms of asthma) - 8.04%, which may indicate a higher prevalence of asthma among patients. Wheezing and wheeze without diagnosed asthma, colds or infections were reported in a small number of cases (about 1.0%). 32 respondents (3.84%) can be attributed to the group of risk for asthma due to the presence of specific respiratory symptoms.Conclusions: The findings show a low prevalence of physician-diagnosed asthma among students of Western Belarus. Relatively low prevalence of allergic disorders among respondents of Belarus suggest underdiagnosis of allergic diseases, in particular of asthma. Presumably, cases of asthma might be diagnosed as spastic bronchitis, “obstructive bronchitis”, “asthmatic bronchitis”, a traditional label for clinical manifestation of asthma in medical practice in the region.

The cell biology of asthma.

The clinical manifestations of asthma are caused by obstruction of the conducting airways of the lung. Two airway cell types are critical for asthma pathogenesis: epithelial cells and smooth muscle cells. Airway epithelial cells, which are the first line of defense against inhaled pathogens and particles, initiate airway inflammation and produce mucus, an important contributor to airway obstruction. The other main cause of airway obstruction is contraction of airway smooth muscle. Complementary experimental approaches involving cultured cells, animal models, and human clinical studies have provided many insights into diverse mechanisms that contribute to airway epithelial and smooth muscle cell pathology in this complex disease.