Clinical Severity Of Asthma Research Articles

β2_adrenergic receptor gene polymorphisms p.Gly16Arg and p. Glu27Gln in Sudanese patients with bronchial asthma: A case-control study

BackgroundSeveral reports have indicated the involvement of β2-adrenergic receptor gene (ADRB2) polymorphisms rs1042713 p.Gly16Arg and rs1042714 p.Glu27Gln in susceptibility to bronchial asthma and its clinical severity. This study investigated the genotype frequencies of these two polymorphisms in Sudanese patients with bronchial asthma, compared them to a healthy control group, and correlated the genotypes with the clinical severity of asthma. MethodsA case-control study, matched for age, sex, and body mass index (BMI) was conducted at Al-Shaab Teaching Hospital in Khartoum, Sudan, between January and April 2022. The study included fifty subjects in each arm: adults with bronchial asthma were cases and healthy individuals were controls. Genotyping for rs1042713 p.Gly16Arg and rs1042714 p.Glu27Gln was determined by allele-specific polymerase chain reaction. Adjusted odds ratio (aOR) was calculated using asthma as a dependent factor and variables like ADRB2 gene polymorphisms, age, BMI, and sex as independent factor. ResultsThe genotype GG (Gly16Gly) in the ADRB2 rs1042713 p.Gly16Arg was more prevalent in cases compared to controls (28 % vs. 10 %) and showed a significant risk effect for bronchial asthma [aOR = 3.81, 95 % CI (1.23–11.80); p = 0.020]. The allele G is more frequent in cases than controls, however it was not statistically significant [OR = 1.27, 95 % CI (0.72–2.22); p = 0.394]. For ADRB2 rs1042714 p.Glu27Gln, none of the genotypes or alleles showed any significant association with bronchial asthma. Additionally, none of the genotypes in the two gene polymorphisms were associated with the clinical severity of asthma. ConclusionIn this study, the ADRB2 rs1042713 p.Gly16Arg gene polymorphism showed a significant risk effect for bronchial asthma, while no association was observed with ADRB2 rs1042714 p.Glu27Gln, further study is needed.

Comparative assessment of cognitive function of asthmatic and non-asthmatic children in Ilorin, Nigeria

Background The presence of asthma in children may negatively impact their cognitive function, possibly due to intermittent hypoxia from repeated acute exacerbations, sleep deprivation, and school absenteeism. However, conflicting reports abound on cognitive performance among children with asthma. Objective To assess and compare the cognitive function of asthmatic and non-asthmatic children in Ilorin, Nigeria. Methods This cross-sectional study compared the cognitive performance scores of 66 children with asthma aged 6-17 years, and the corresponding scores of 66 healthy age- and gender-matched children without asthma. Data obtained included sociodemographic, anthropometric, and clinical details. Cognitive function was assessed with the Raven's Progressive Matrices (RPM) psychometric test. Results The male: female ratio was 1.3:1. The median RPM score of 50.0 [interquartile range (IQR) 25.0-75.0] in children with asthma was significantly higher than that of non-asthmatic children [32.5 (IQR 10.0-50.0)]; (P=0.016). A significantly higher proportion of asthmatic subjects (74.2%) were in the high grade RPM score category compared to the non-asthmatic children’s concomitant proportion (57.6%). Asthmatic subjects were twice as likely to belong to the high grade RPM score category than their non-asthmatic counterparts (OR=2.12; 95%CI 1.02 to 4.44; P=0.043). There was no significant association between RPM score grade and clinical severity of asthma in the subject population (P=0.554). Conclusion Children with asthma perform better in cognitive function assessment, using RPM test, compared to their non-asthmatic counterparts in Ilorin, Nigeria.

Clinical profiles, severity, and risk factors of pediatric asthma in Baghdad: A comparative study of early-onset and late-onset cases

Clinical profiles, severity, and risk factors of pediatric asthma in Baghdad: A comparative study of early-onset and late-onset cases

Cytokine Patterns Associated with Bronchial Asthma in Saudi Patients

Asthma is a common respiratory disease worldwide; most patients exhibit mild to moderate states of clinical severity. The aim of this study was designed to measure different cytokines (IL-4 and IL-5) levels in Saudi asthmatic patients and healthy volunteers’ serum, in addition to evaluating of the role of cytokines in clinical severity and diagnosis of bronchial asthma in Saudi patients. Through this study, 70 cases of Saudi bronchial asthma patients at different ages and case severity will be included in addition to 20 apparently healthy cases as a control. Serum cytokines (IL-4 and IL-5) levels will be measured by cytokines assay using Enzyme immunoassay. The results proved that the total levels of IL-4 and IL-5 were significantly higher in asthmatic patients than in control volunteers. Moreover, the concentrations of IL-4 in severe were significantly higher than those detected in moderate cases at different age groups for IL-4 but not in all age groups for IL-4. The Mean±SD for IL-4 in moderate was 13.55±1.25 pg/ml whereas in severe was 15.49±1.73 pg/ml while the Mean±SD of control was 7.55±1.47 pg/ml. The concentrations of IL-5 were non-significant in severe when compared with moderate cases. The Mean±SD for total IL-5 in moderate was 4.24±1.38 pg/ml whereas in severe was 4.46±1.40 pg/ml although the total Mean±SD in control was 2.29±0.37 pg/ml. Our results prove that there was a non-significant role of gender in bronchial asthma severity and there were no significant differences between serum cytokines levels in males and females in bronchial asthma. These results also expressed a significant role of IL-4 in the disease severity of asthmatic patients. Furthermore, detecting serum levels of IL-4 and IL-5 indicates the role of these cytokines in the development and pathogenesis of bronchial asthma.

The Child Opportunity Index and asthma morbidity among children younger than 5 years old in Washington, DC

Place-based social determinants of health are associated with pediatric asthma morbidity. However, there is little evidence on how social determinants of health correlate to the disproportionately high rates of asthma morbidity experienced by children <5 years old. This study sought to evaluate census tract associations between the Child Opportunity Index ±COI) and at-risk rates (ARRs) for pediatric asthma-related emergency department (ED) encounters and hospitalizations in Washington, DC. This was a cross-sectional study of children <5 years old with physician-diagnosed asthma included in the DC Asthma Registry between January 2018 and December 2019. Census tract COI score (1-100) and its 3 domains (social/economic, health/environmental, and educational) were the exposures (source: www.diversitydatakids.org). ED and hospitalization ARRs (outcomes) were created by dividing counts of ED encounters and hospitalizations by populations with asthma for each census tract and adjusted for population-level demographic (age, sex, insurance), clinical (asthma severity), and community (violent crime and limited English proficiency) covariates. Within a study population of 3806 children with a mean age of 2.4± 1.4 years, 2132 (56%) had 5852 ED encounters, and 821 (22%) had 1418 hospitalizations. Greater census tract overall COI, social/economic COI, and educational COI were associated with fewer ED ARRs. There were no associations between the health/environmental COI and ED ARRs or between the COI and hospitalization ARRs. Improving community-level social, economic, and educational opportunity within specific census tracts may reduce ED ARRs in this population.

Blood CD62Llow inflammatory eosinophils are related to the severity of asthma and reduced by mepolizumab.

Eosinophils have been divided into different subpopulations with distinct phenotypes based on CD62L expression. No data are available regarding the correlation between eosinophils subphenotypes and clinical severity of asthma, as well as the effect of anti-IL-5 therapy on these cells. The study investigates the correlation between blood CD62Llow inflammatory eosinophils (iEos) and clinical severity of severe eosinophilic asthma (SEA) and evaluates the impact of mepolizumab on iEos. 112 patients were screened and were divided in two groups: biological-naive (n = 51) and biological-treated patients (n = 61). The Biological-naive patients were analyzed before treatment (Group A) and 19 out of 51 patients, were longitudinally analyzed before and after treatment with mepolizumab 100 mg s.c/4 weeks (Group B); 32 patients were excluded because they were being treated with other biological therapies. Blood eosinophils were analyzed by FACS and correlated with clinical scores. In vitro effect of IL-5 and mepolizumab on CD62L expression was assessed. A significant correlation between blood CD62Llow cells and clinical scores of asthma and nasal polyps, as well as the number of asthma exacerbations in the last year was shown in untreated patients. In longitudinally studied patients we observed a marked reduction of CD62Llow cells paralleled by an increase in the proportion of CD62Lbright cells, associated with clinical improvement of asthma control. In vitro, CD62L expression on eosinophils is modulated by IL-5 and anti-IL-5. A positive correlation between CD62Llow iEos and the baseline clinical features of SEA with CRSwNP was shown. Furthermore mepolizumab restores the healthy balance among eosinophils sub-phenotypes in SEA patients.

In-silico identification and prioritization of therapeutic targets of asthma

Asthma is a “common chronic disorder that affects the lungs causing variable and recurring symptoms like repeated episodes of wheezing, breathlessness, chest tightness and underlying inflammation. The interaction of these features of asthma determines the clinical manifestations and severity of asthma and the response to treatment" [cited from: National Heart, Lung, and Blood Institute. Expert Panel 3 Report. Guidelines for the Diagnosis and Management of Asthma 2007 (EPR-3). Available at: https://www.ncbi.nlm.nih.gov/books/NBK7232/ (accessed on January 3, 2023)]. As per the WHO, 262 million people were affected by asthma in 2019 that leads to 455,000 deaths (https://www.who.int/news-room/fact-sheets/detail/asthma). In this current study, our aim was to evaluate thousands of scientific documents and asthma associated omics datasets to identify the most crucial therapeutic target for experimental validation. We leveraged the proprietary tool Ontosight® Discover to annotate asthma associated genes and proteins. Additionally, we also collected and evaluated asthma related patient datasets through bioinformatics and machine learning based approaches to identify most suitable targets. Identified targets were further evaluated based on the various biological parameters to scrutinize their candidature for the ideal therapeutic target. We identified 7237 molecular targets from published scientific documents, 2932 targets from genomic structured databases and 7690 dysregulated genes from the transcriptomics and 560 targets from genomics mutational analysis. In total, 18,419 targets from all the desperate sources were analyzed and evaluated though our approach to identify most promising targets in asthma. Our study revealed IL-13 as one of the most important targets for asthma with approved drugs on the market currently. TNF, VEGFA and IL-18 were the other top targets identified to be explored for therapeutic benefit in asthma but need further clinical testing. HMOX1, ITGAM, DDX58, SFTPD and ADAM17 were the top novel targets identified for asthma which needs to be validated experimentally.

Asthma and comorbidities: recent advances.

Asthma is usually associated with pulmonary and extrapulmonary comorbidities that are more common in patients with severe asthma than in those with mild‑to‑moderate illness or in the general population. These comorbidities may affect the clinical intensity and severity of asthma and, as a result, increase health care costs related to its therapy. On the other hand, their recognition and appropriate treatment appear to improve asthma outcomes while optimizing therapy by preventing overtreatment. Comorbid conditions such as gastroesophageal reflux disease, allergic rhinitis, obesity, depression, diabetes mellitus, and cardiovascular disease are commonly known, though their prevalence varies significantly between studies; however, many more comorbidities may remain undiagnosed and only be discovered in an experienced specialized environment. Unfortunately, the pathogenetic pathways linking asthma and many comorbidities are still unknown, which explains why they may often be misdiagnosed as diseases related to asthma treatment. Nevertheless, asthma and comorbid conditions often have common risk factors, and some evidence suggests that they share inflammatory pathways which exacerbate asthma. Inflammation was shown to play an essential role in the onset and development of various comorbidities. The role of systemic inflammation in asthma, on the other hand, remains unknown. Understanding the mechanism(s) that link(s) asthma and its concomitant disorders is critical for developing an effective treatment strategy. This review examines the epidemiology, pathophysiology, treatment suggestions, and significant knowledge gaps of these comorbidities.

Short-acting beta-2 agonist prescription patterns and clinical outcomes in Chinese patients with asthma: an observational study in mainland China for the SABINA programme.

Objectives:The SABINA CHINA study aimed to determine prescription data for asthma medication with a focus on SABA and ICS in a representative population of patients with asthma in China.Methods:SABINA China was a multicentre, observational, cross-sectional study with data collected retrospectively from a convenience sample of 25 tertiary centres across China. Patients (age ⩾ 12 years) with ⩾3 consultations/year were enrolled. Data were collected on clinical characteristics, asthma severity, and symptom control (as per GINA 2017), treatment and history of severe exacerbations over the past year. SABA over-prescription was defined as ⩾3 SABA canisters/year. Descriptive statistics are presented.Results:Between March and August 2020, 498 patients were included in the outcome analysis. Mean (SD) age was 48.7 (15.0) years, 57.9% were female and 91% had moderate-to-severe asthma (n = 453). Overall, 12.5% (n = 62) and 26.4% (n = 131) of patients had uncontrolled and partly controlled asthma, respectively. SABA add-on was prescribed to 20.3% (n = 101) of patients; one patient with moderate-to-severe asthma was prescribed SABA-alone. SABA over-prescription in the overall population was 4.0% (n = 20; all with moderate-to-severe asthma) and 19.8% (20/101) among those prescribed SABA add-on. In the mild asthma group, 50% (n = 22) were prescribed ICS/LABA and 43.2% (n = 19) were prescribed LTRA. Among those with moderate-to-severe asthma, 97.4% (n = 441) were prescribed ICS/LABA and 55.0% (n = 249) were prescribed LTRA. Approximately 30% of patients (n = 149) experienced ⩾1% and 6.6% (n = 33) ⩾3 severe exacerbations in the preceding year; mean annual number of severe exacerbation/patient was 0.6 (1.2). Among those prescribed SABA add-on, ICS/LABA and LTRA (non-mutually exclusive groups due to overlapping prescriptions), 54.5%, 29.9%, and 35.3% had ⩾1 severe exacerbations, respectively.Conclusion:Among patients with predominantly moderate-to-severe asthma managed in tertiary care and were prescribed SABA, 1 in 5 received ⩾3 canisters/year. Fewer patients who received ICS/LABA prescriptions experienced annual exacerbations than those prescribed SABA add-on.

Serum IFNγ–induced protein 10 (IP10/CXCL10): association with asthma exacerbations and severity in children

Objective Asthma is a chronic disorder of the airways, in which chemokines coordinate airway inflammation and determine its severity. We aimed to study the chemokine interferonγ–inducible protein 10 kDa (IP10/CXCL10), a member of the CXC receptor 3 (CXCR3) ligand family, at the protein level in the serum of children, to evaluate the association between CXCL10 and exacerbations of childhood asthma. Methods Patients experiencing an asthma exacerbation (42 patients) and stable patients (43 patients) were investigated for serum CXCL10 levels. Results Patients with an asthma exacerbation expressed significantly higher CXCL10 levels in the serum than stable patients (p < 0.001). Additionally, CXCL10 values were elevated in severe asthma compared with moderate and mild disease (p < 0.001). In patients experiencing asthma exacerbations, higher values of CXCL10 were observed in atopic patients compared with non-atopic patients (p = 0.027) and in uncontrolled and partly controlled patients compared with controlled patients (p = 0.046). Conclusions CXCL10 is proposed as an inflammatory serum marker for asthma exacerbations and worsening asthma symptoms. The levels of CXCL10 are representative of the clinical severity of asthma.

Assessment of Clinical Asthma Score and Asthma Severity Score in Preschool Children with Recurrent Wheezing

Objective: There is no definitive consensus on asthma exacerbation scoring for preschool children with recurrent wheezing. The Clinical Asthma Score (CAS) and Asthma Severity Score (ASS) are two scoring systems that can be used in this population. The aim of this study was to evaluate the relationship between CAS and ASS, acute treatment, and exacerbation outcomes in preschool children with wheezing. Materials and Methods: The study included 70 patients aged 2-5 years who presented to the pediatric emergency department due to an acute wheezing episode. CAS and ASS were evaluated at exacerbation presentation and after initial salbutamol therapy. Results: Presenting scores were significantly higher among patients who had three or more episodes within the last year (p=0.01 for CAS, p=0.019 for ASS). Presenting scores were significantly higher in patients treated with systemic steroid therapy during the episode compared to those who were not (p=0.006 for CAS; p=0.003 for ASS). CAS and ASS predicted the use of acute steroid therapy with a sensitivity of 73.7% and 52.6%, and predicted hospitalization with a sensitivity of 95% and 82.5%, respectively. Conclusion: Our data suggest that these scoring systems can be used to judge the need for systemic steroid therapy and that high scores are associated with greater likelihood of hospital admission. Keywords: Asthma score, children, hospitalization, wheezing, exacerbation

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The significance of the distribution of the indicators of humoral and cell immunity and their role in the pathogenesis of bronchial asthma in children with the position of system analysis

Bronchial asthma is one of the common diseases in children of different ages. In recent years, around the world, including in Ukraine, there is a trend towards its sustainable growth. To date, there are no methods of systemic immunodiagnostics that would allow with high diagnostic accuracy to identify clinical forms and severity of asthma, which would allow more fully reveal the pathogenetic mechanisms and individualize approaches to the treatment of asthma in children. The aim of this work was to study the hierarchy of immunological parameters in the pathogenetic matrix, which will determine the features of clinical forms and severity of asthma in children on the basis of systematic analysis. A comprehensive clinical and immunological examination of 176 children with asthma aged 6 to 15 years. To detect the autoimmune component used lipopolysaccharide antigens obtained from homologous cell-tissue structures of the trachea, bronchi and lung tissue from sectional samples of the bronchopulmonary system from accidentally killed children with group I (0) blood 2–4 hours after death. The level of autoantibodies to lipopolysaccharide antigens of the bronchopulmonary system was determined by quantifying the autoantibody index – Qφ. As a result of the study for the first time to improve the diagnosis and differentiation of clinical forms and severity of asthma from the standpoint of system analysis was developed immunodiagnostic complex, which took into account the degree of deviation from the norm values (Student's t-test, t = 1.96) and their distribution in pathogenetic matrix. This approach to ranking the positions of immunological parameters allowed to determine the features of humoral and cellular immunity, the process of apoptosis of cell-tissue structures of the bronchopulmonary system and the autoimmune component in the pathogenesis of asthma in children, which opens approaches to individualization of pathogenetic therapy.

Correlation of induced sputum eosinophil, absolute eosinophil count and serum IgE with clinical severity of bronchial asthma

Background: Asthma is a chronic inflammatory disorder of the airway. Eosinophil and Serum IgE being a marker of airway inflammation, can serve as a tool for assessing severity and response to treatment in asthma patients. The correlation of clinical assessment with various markers of airway inflammation in asthma is not well established in the Indian population. Present study correlates induced sputum eosinophil, blood eosinophil and Serum IgE count in assessing the clinical severity in bronchial asthma. Aims: To study the correlation of sputum eosinophil, absolute eosinophil count and Serum IgE in assessing the clinical severity of asthma. Methods: It was a cross sectional quantitative study, which was carried out between Feb 2020 to feb 2021. Total 70 asthmatics was selected which underwent history, examinations and spirometry, after written consent. Severity of asthma was assessed by clinical features and by FEV1 in spirometry. (as per GINA guidelines). After assessing the severity of Bronchial asthma all patient underwent Sputum examination for sputum eosinophil counts, blood sampling for Absolue eosinophil counts and Serum IgE levels. After that sputum eosinophil counts, absolute eosinophil counts and serum IgE levels were correlated with severity of Bronchial Asthma. Conclusion: Assessment of eosinophil count in sputum and blood, and serum IgE in blood are simple and inexpensive method that can show a direct measurement of airway inflammation. Thus it can help to identify specific phenotypes in asthmatic patients who are more responsive to steroids, which needs to be demonstrated in future studies. It could be the preferred method in routine practice in monitoring airway inflammation and guiding management.

Bronchodilatory effects of B-type natriuretic peptide in acute asthma attacks: a randomized controlled clinical trial.

B-type natriuretic peptide (BNP) regulates different physiological processes such as blood pressure, cardiac growth, and neural and skeletal development. Thus, the aim of this study w as to evaluate the effect of BNP in the treatment of acute asthma attacks. In this randomized clinical trial, patients with acute asthma attacks were enrolled. The patients were divided randomly into two groups. Patients in the interventional group received BNP via intravenous infusion. Two µg/kg of BNP was injected as a bolus in 60 seconds. Then, infusion of BNP immediately began and was given in 0.01, 0.02, and 0.03 µg/kg/min doses every 30 minutes for the first 1.5 hours. The patients in the control group received nebulized salbutamol. Afterwards, peak flow meter findings, hemodynamic parameters, and estimation of the clinical severity of asthma in both groups were checked every 30 minutes. In total, 40 patients were included in this study. The values of PEFR in the 60th and 90th minutes in the control group were lower than those in the interventional group. In the 60th minute, the mean of PEFR was 377.3 in the BNP group but 335.95 in the control group (P = 0.049). Moreover, this difference remained significant in the 90th minute (P = 0.021). However, forced expiratory volume in one second (FEV1) did not differ between the groups at any time (p > 0.05). Although a large experimental study is needed to verify our hypothesis, it seems that BNP might be a therapeutic option in asthma exacerbations, particularly in those with b2 agonist receptor polymorphism.

Concordancia entre el puntaje de la escala modificada de Wood y el lugar de manejo de los pacientes con bronquiolitis aguda

Introducción: La escala de severidad clínica de asma modificada de Wood (M-WCAS), validada en Colombia, es una herramienta útil para medir la severidad en bronquiolitis aguda. La escala podría evitar la variabilidad interobservador y así apoyar la decisión acerca del lugar de manejo de los pacientes (ambulatorio, hospitalización, unidad de cuidado intensivo pediátrico). Objetivo: Estimar la concordancia que existe entre la severidad de la bronquiolitis aguda medida la escala M-WCAS en el primer momento de atención, el lugar de manejo y los días de estancia hospitalaria de los pacientes con bronquiolitis aguda en un centro de referencia pediátrico. Métodos: Estudio de concordancia, retrospectivo. Se revisaron 364 historias clínicas de pacientes con bronquiolitis aguda y se calculó el puntaje de la escala M-WCAS para cada paciente. Se estimó la concordancia entre el puntaje de la escala al ingreso hospitalario, con el lugar de manejo (ambulatorio, piso, unidad de cuidado intensivo pediátrico) y los días de estancia de los pacientes con manejo intrahospitalario. Resultados: Índice de kappa de -0,51 entre la severidad clínica por la escala M-WCAS con el lugar de manejo y un coeficiente de concordancia de Lin de 0.03 entre el puntaje M-WCAS y los días de estancia hospitalaria. Conclusiones: No se evidenció concordancia entre la severidad clínica de los pacientes con bronquiolitis aguda medida por la escala M-WCAS con el lugar de manejo. Se encontró una concordancia leve entre el puntaje de la escala M-WCAS y los días de estancia hospitalaria.

Analysis of clinical features of adult asthma according to blood basophils and their association with cytokines in exhaled breath condensate

Purpose: Although basophils are major effector cells involved in asthma, their pathophysiological role in asthma remains uncertain. In this study, we investigated the relationship between blood basophils, clinical features in asthmatics, and cytokines in exhaled breath condensate (EBC) which could be noninvasively obtained. Methods: A total of 13 adult asthmatics were prospectively enrolled. We obtained information on demographics, asthma control levels, history of acute exacerbation as well as the asthma control test and Quality of Life Questionnaire for Adult Korean Asthmatics (QLQAKA) scores. Peripheral blood and EBC samples were collected, and pulmonary function test was also performed. The associa tion between blood basophil count and clinical feature and severity of asthma or inflammatory cytokines in EBC was analyzed. Results: The percentage of blood basophils was positively correlated with that of blood eosinophils (Spearman r=0.665, P=0.013). The number of acute exacerbations was significantly larger (1.2±0.6 vs. 5.3±5.8, P=0.049) in the group with blood basophils ≥50 cells/μL, while the QLQAKA score was lower (68.8±7.9 vs. 49.0±12.0, P=0.028). There were no significant differences in age, atopy status, smoking history, and forced expiratory volume in 1 second according to blood basophil count. Blood basophil count was positively correlated with interleukin-33 (IL-33) (r=0.651, P=0.016) and IL-17 (r=0.732, P=0.004) in EBC. Conclusion: Blood basophils may be associated with frequent asthma exacerbations and lower quality of life due to asthma. IL-33 and IL-17 may be the key mediators that stimulate basophils to participate in the pathogenesis of asthma. (Allergy Asthma Respir Dis 2020;8:119-126)

An evaluation of the effects of saffron supplementation on the asthma clinical symptoms and asthma severity in patients with mild and moderate persistent allergic asthma: a double-blind, randomized placebo-controlled trial

BackgroundAsthma is a heterogeneous disease which is usually associated with chronic airway inflammation. Saffron has anti-inflammatory effects and may has beneficial effects on asthma.HypothesisThe present study was intended to survey the effects of saffron supplementation on blood pressure, lipid profiles, basophils, eosinophils and clinical symptoms in patients with allergic asthma.Study designOur study was a clinical trial.MethodsSubjects (N = 80, 32 women and 48 men, 41.25 ± 9.87 years old) with mild and moderate allergic asthma were randomized into two groups: the intervention group who received two capsules of saffron (100 mg/d), and the control group who received two capsules of placebo for 8 weeks. SPSS software (version 16.0) was used for the data analysis.ResultsSaffron improved the frequency of clinical symptoms of the patients (i.e., frequency of the shortness of breath during the day and night time, use of salbutamol spray, waking up due to asthma symptoms and activity limitation) in comparison to the placebo (p < 0.001). Besides, asthma severity decreased almost significantly in the saffron group (p = 0.07). It was also found that saffron, in comparison with the placebo, significantly reduced the systolic and diastolic blood pressure, triglycerides and low density lipoprotein cholesterol. Moreover, eosinophils and basophils concentration reduced in the saffron group (p = 0.06 and 0.05 respectively).ConclusionSaffron seems to be an effective and safe option (in 8 weeks supplementation) to improve clinical symptoms of patients with allergic asthma but the toxicity and/or long-term effects of saffron intake are not known. Registration ID in IRCT (IRCT2017012132081N2).

Association Between Epithelial Cytokines and Clinical Phenotypes of Elderly Asthma.

PurposeAsthma in the elderly has different clinical features including more severe phenotypes with higher comorbidities. Epithelial cells are known to initiate innate/adaptive immune responses in asthmatic airways. We investigated clinical features and epithelial derived cytokine levels in elderly asthmatics compared to non-elderly asthmatics in a cross-sectional cohort of adult asthmatics in order to further understand its pathogenic mechanisms.MethodsA total of 1,452 adult asthmatics were enrolled from a single tertiary hospital and were classified into 2 groups: 234 elderly (≥ 60 years at initial diagnosis) and 1,218 non-elderly (< 60 years at initial diagnosis) asthmatics. Asthma-related clinical parameters were compared between the 2 groups. Serum levels of epithelial cell-derived cytokines including interleukin (IL)-31, IL-33, IL-8, eotaxin-2, transforming growth factor beta 1 (TGF-β1) and periostin were measured by enzyme-linked immunosorbent assay.ResultsSignificantly higher prevalence rates of late-onset asthma (onset age ≥ 40 years) and severe asthma, as well as the lower rate of atopy, blood/sputum eosinophil counts, total immunoglobulin E and eosinophil cationic protein levels were noted in elderly asthmatics compared to non-elderly asthmatics (P < 0.05, respectively). The forced expiratory volume in 1 second (FEV1, % predicted) level tended to be lower in elderly asthmatics (P = 0.07). In addition, serum IL-33 and IL-31 levels were significantly lower in elderly asthmatics, while no differences were found in the serum level of IL-8, eotaxin-2, TGF-β1 or periostin. Among elderly asthmatics, subjects with severe asthma had lower FEV1 (% predicted) value, but showed significantly higher serum levels of eotaxin-2 and TGF-β1, than those with non-severe asthma (P < 0.05 for each).ConclusionsThese findings suggest that age-related changes of epithelial cell-derived cytokines may affect clinical phenotypes and severity of elderly asthma: decreased levels of IL-33 and IL-31 may contribute to less Th2 phenotype, while increased levels of eotaxin-2 and TGF-β1 may contribute to severity.

Early maladaptive schemas and asthma: disconnection and rejection domains may have an effect on the severity of asthma.

Early maladaptive schemas (EMSs) that are being shaped through the early period of development of humans have been reported to affect the functions of asthmatic patients. This study focuses on the probable relationship between the personality schemas and areas with severity of asthma. Fifty asthmatic patients were entered this descriptive cross-sectional study in Tabriz University of Medical Sciences from March to August, 2016. We measured the personality schema of patients by using the Young Schema Questionnaire - Short Form (YSQ-SF; Young, 1994). On the other hand, patients' clinical findings and severity of asthma were assessed by spirometry and the Asthma Control Test (ACT) questionnaire. Uncontrolled (ACT score < 20) and controlled (ACT score ≥ 20) asthma had significant defect in 'Disconnection domain' (p = 0.001). Also, significant reverse linear correlation was found between FEV₁ and 'Disconnection domain', 'Rejection' schema area (r = -0.29, p = 0.03), and 'Over vigilance domain' (r = -0,36, p = 0.01). Whereas, significant reverse linear correlation was revealed between FEV₁/FVC and Over vigilance domain (r = -0.41, p = 0.003). EMSs possibly have potential effects on clinical characteristics and severity of asthma in asthmatic patients.