Bronchoconstriction Research Articles

A comparative study of Twin-Block and van Beek Headgear-Activator on the three-dimensional morphology of the upper airway in growing children with mandibular retraction in skeletal class II malocclusion.

To compare the variations in the upper airway of children with skeletal Class II mandibular retrognathism treated with van Beek Headgear-Activator (vBHGA) and Twin-Block (TB) appliances. 40 children were involved in this retrospective study and divided into two intervention groups: the vBHGA group and the TB group, each comprising 20 individuals with an average age of 11.13 years. Employing Cone Beam Computed Tomography and Geometric Morphometric analysis, a comprehensive assessment of the upper airway's volume, minimum cross-sectional area (m-CSA), and 3D shape characteristics was conducted pre-and post-treatment. The total volume, oropharynx volume, oropharynx m-CSA, and hypopharynx m-CSA significantly increased in both the vBHGA and TB groups (p < 0.05). The sole discrepancy between the two groups was observed in comparing the nasopharynx m-CSA (p < 0.05). A morphological difference was observed in the vBHGA group before and after treatment (p < 0.05), characterized by a wider and shorter airway, positioning of the posterior nasal spine closer to the anterior inferior area, and a more posterior nasopharyngeal wall. However, there were no significant shape differences between the two groups or before and after treatment within the TB group. It appears that both vBHGA and TB interventions contribute positively to alleviating upper airway constriction. Nonetheless, the vBHGA group exhibits more alterations in the configuration of the nasopharynx. Both orthodontic appliances have a positive impact on the upper airway but still have differences, emphasizing the need for individualized consideration when selecting orthodontic interventions. This study was also registered with the Chinese Clinical Trial Registry with registration number ChiCTR2400086867.

CBCT Analysis of the Hyoid and Pharyngeal Airway Changes in Class III Patients With Orthognathic Surgery.

This study was designed to investigate the response of the respiratory structures to orthognathic surgery in patients with Class III malocclusion, with a specific emphasis on the vertical placement of the hyoid bone. The correlations of these changes were also analysed, followed by further subgroup analyses based on preoperative conditions. Dolphin software was used to obtain cephalometric landmarks, airway and hyoid bone measurements from pre- and postoperative CBCT scans of 31 patients. Statistical analyses included paired t-tests and Pearson's correlation analysis. Stomatological mandibular values and the nasopharynx height showed significant changes. Pearson's correlation identified significant correlations between changes in B and H horizontal coordinates (p < 0.05), as well as between changes in H longitudinal coordinates and specific airway dynamics (p < 0.05). Patients with a lower preoperative hyoid position experienced a more pronounced decrease in hypopharyngeal airway volume after surgery compared to those with a higher preoperative hyoid position, as evidenced by the significant mean differences and p values (p < 0.01). Class III patients experienced airway constriction following orthognathic surgery, particularly those with a lower preoperative hyoid bone position, who showed a more significant decrease in hypopharyngeal airway volume postsurgery compared to those with a higher preoperative hyoid position. These findings underscored the importance of individualised surgical planning and highlighted the need for further research with dynamic assessments to optimise respiratory outcomes.

Craniofacial anatomical determinants of pediatric sleep-disordered breathing: A comprehensive review.

This narrative review aims to elucidate the anatomical features of sleep-disordered breathing (SDB) in children. By identifying key structures and intervening proactively, we seek to alter craniofacial growth patterns and improve functional outcomes for SDB children. The literature on pediatric sleep-disordered breathing (PSDB), pediatric obstructive sleep apnea (OSA), anatomical predispositions, and the relationship between skeletal deformity and PSDB was examined using PubMed and Google Scholar databases, covering studies from 2006 to 2024. Forty relevant articles were reviewed, focusing on craniofacial characteristics associated with PSDB. The etiology of PSDB is multifactorial, with adenoid and palatal tonsil enlargement being the most common cause. While adenotonsillectomy is recommended as the primary treatment, residual SDB may result in craniofacial skeletal deformities contributing to upper airway constriction. Typical craniofacial phenotypes of SDB include excessive vertical growth and constriction of the maxilla, a retruded mandible, and posterior rotation, known as a Class II hyperdivergent pattern. Conversely, Class III with an underdeveloped maxilla shows a relatively lower risk for SDB due to reduced nasal cavity and nasopharyngeal airway volumes. Transverse maxillary constriction with a high, deep palatal vault is a significant risk factor. Additionally, nasal obstruction and low tongue posture, with or without a short lingual frenulum, are identified as craniofacial risk factors for SDB development in children. Early diagnosis and intervention are critical in managing PSDB. Dentists, through screening and early treatment, can significantly influence craniofacial growth and health outcomes. A multidisciplinary approach is essential for effective management, improving the quality of life and long-term health of affected children.

A novel chronic obstructive pulmonary disease mouse model induced by intubation-mediated intratracheal co-administration of porcine pancreatic elastase and lipopolysaccharide

BackgroundChronic obstructive pulmonary disease (COPD) is a significant respiratory disorder in humans characterized by persistent airway constriction or obstruction due to chronic bronchitis and pulmonary emphysema. Various methods of inducing COPD in mouse models are frequently used in COPD research; however, these cannot completely reproduce histopathologic lesions. This study aimed to establish a new COPD mouse model that reproduces histopathological lesions closely resembling clinical COPD within a shorter induction time.MethodsThe new strategy involved the co-administration of porcine pancreatic elastase (PPE) and lipopolysaccharide (LPS), with PPE intended to induce pulmonary emphysema and LPS intended to induce chronic bronchitis. Male C57BL/6J mice were administered PPE (8 U/kg) on days 0 and 3 and LPS (400 µg/kg) on days 6, 9, 12, and 15. Each administration was performed using a noninvasive intubation-mediated intratracheal instillation method with a laryngoscope.ResultsPostmortem examination on day 22 revealed that pulmonary emphysema and chronic bronchitis were simultaneously induced in 90.91% of the lung lobes. Molecular studies revealed higher messenger ribonucleic acid (mRNA) expression levels of interleukin-6(IL-6) and matrix metalloproteinase-12(MMP-12) associated with the pathogenesis of COPD.ConclusionA new method was developed to establish a COPD mouse model that displays a more severe representation of the histopathological findings of clinical COPD than previous COPD models. It also reduces the time required for model induction. This newly developed COPD mouse model is expected to be a valuable tool for the pathogenesis and therapeutic research on human COPD.

Non-local impact of distal airway constrictions on patterns of inhaled particle deposition.

Airway constriction and blockage in obstructive lung diseases cause ventilation heterogeneity and create barriers to effective drug deposition. Established computational particle-deposition models have not accounted for these impacts of disease. We present a new particle-deposition model that calculates ventilation based on the resistance of each airway, such that ventilation responds to airway constriction. The model incorporates distal airway constrictions representative of cystic fibrosis, allowing us to investigate the resulting impact on patterns of deposition. Unlike previous models, our model predicts how constrictions affect deposition in airways throughout the lungs, not just in the constricted airways. Deposition is reduced in airways directly distal and proximal to constrictions. When constrictions are clustered together, central-airways deposition can increase significantly in regions away from constrictions, but distal-airways deposition in those regions remains largely unchanged. We use our model to calculate lung clearance index (LCI), a clinical measure of ventilation heterogeneity, after applying constrictions of varying severities in one lobe. We find an increase in LCI coinciding with significantly reduced deposition in the affected lobe. Our results show how the model provides a framework for development of computational tools that capture the impacts of airway disease, which could significantly affect predictions of regional dosing.

Clinical Management of Respiratory Diseases in Neurosurgical Settings

Respiratory diseases, such as chronic obstructive pulmonary disease(COPD)and asthma, are becoming increasingly prevalent in super-aging societies. In Japan, the estimated prevalence of COPD among individuals aged 40 years and above is 8.6%, while asthma affects about 10% of adults. These statistics highlight the similarities between COPD and asthma in clinical settings. Both diseases involve chronic airway inflammation and present with symptoms such as chronic cough, sputum production, wheezing, and dyspnea. Exacerbations of these symptoms and complications are critical concerns during the perioperative period. COPD, often caused by long-term smoking, leads to irreversible airway and lung damage, while asthma is characterized by episodic and reversible airway constriction due to chronic inflammation. COPD diagnosis involves spirometry and the exclusion of other diseases, with treatment goals focusing on symptom improvement and risk reduction through smoking cessation, pharmacotherapy(mainly bronchodilators), and non-pharmacological methods(such as pulmonary rehabilitation). Asthma management aims to control inflammation and prevent exacerbations using inhaled corticosteroids and bronchodilators as standard treatments. Perioperative management of both diseases involves improving respiratory function with pharmacotherapy, careful anesthesia selection, and early postoperative mobilization. Consultation with respiratory specialists is recommended for effective management, especially in complex cases.

An Overview of Pathological Pathway of Asthma and Molecular Mechanisms of Anti-Asthmatic Phytoconstituents

: Asthma presents with chronic inflammation and airway constriction triggered by allergens or pollution. Inflammatory mediators such as histamine and leukotrienes, released in response to inflammation, prompt bronchoconstriction, contracting the smooth muscles around the airways. This constriction obstructs airflow and worsens symptoms such as coughing, wheezing, and breathlessness. Additionally, airways become hyperresponsive, reacting excessively even to harmless stimuli. Persistent inflammation leads to the production of thick mucus, further blocking airflow and worsening symptoms. Mast cell-released histamine triggers bronchoconstriction, leukotrienes, and prostaglandins (eg, Interleukin-4, Interleukin-13) and promotes airway inflammation while cytokines drive Th2-mediated immune responses. Current therapies in asthma include long-acting beta agonists, leukotriene modifiers, inhaled corticosteroids, and immunomodulators. Natural products, due to their anti-inflammatory, antioxidant and immunomodulatory properties, have emerged as promising anti-asthmatic candidates. Polyphenols (quercetin, resveratrol, curcumin, etc.) and Omega-3 fatty acids offer anti-inflammatory benefits by suppressing cytokines and oxidative stress. Natural products intervene at various levels of these pathways. Quercetin inhibits the release of mast cell histamines, alleviating bronchoconstriction. Curcumin suppresses Th2 cytokines, mitigating the allergic response. Omega-3 fatty acids modulate leukotriene and prostaglandin production, reducing airway inflammation. This review concludes that natural phytobioactives have potential in asthma management due to their complex mechanisms that target various immuno-inflammatory mediators.

3D analysis of long-term airway evolution following orthognathic approach of bimaxillary setback surgery without segmental osteotomy.

Long-term evolution of airway space following bimaxillary setback surgery has been seldom reported. 31 patients with bimaxillary protrusion were included in this study. Bimaxillary setback surgery without segmental osteotomy were performed to alleviate their facial deformity. The pharyngeal airway volume and most constricted airway cross-sectional areas before surgery (T0), one week (T1), and one year (T2) after surgery were measured by 3D image analysis depending on CT data. To exclude the impact of post operational swelling on the airway analysis, the airway changes of another cohort of 10 orthognathic patients without sagittal maxilla or mandible movements were also measured as a control. Body mass index (BMI) was noted and analyzed as well to rule out its interference. Results showed that, in bimaxillary setback surgery patients, no post operational upper pharyngeal airway sleep disorders (UASD) occurred. The mean±SD of pharyngeal airway volume (PAV) and the minimum cross-sectional area (Min-CSA) at T0 were 14921.3±3910.1mm3 and 147.9±75.8mm2, reduced to 11834.1±3916.3mm3(79.3%, P<0.001) and 111.6±60.6mm2(75.4%, P<0.001at T1, and recovered to 14686.8±3917.1mm3(97.1%, P<0.001) and 132.7±62.8mm2 (89.6%, P<0.001) at T2. In control group patients, the mean±SD of PAV were 16540±5518mm3at T0 vs 14248±4340mm3at T1 (P=0.051) and Min-CSA were 156±61mm2(T0) vs159±61mm2at T1 (P=0.849). Besides, At T0 and T2, the mean±SD of the BMI was 20.19±1.80 and 20.04±2.53 respectively (P=0.772). This study suggests that Orthognathic bimaxillary setback reduce the pharyngeal airway space. However, the reduction will largely alleviate in long-term. Aesthetic oriented bimaxillary setback approach is relatively safe when the setback distance is controlled appropriately.

VRAC Complex Modulates Mechano-Electrical Signal Responses in Human Airway Smooth Muscle Shortening.

Leucine-rich repeat containing 8A (LRRC8A) is an obligatory constituent of the volume-regulated anion channel (VRAC) that is fundamental to a wide range of biological processes, including regulating cell size, proliferation, and migration. Here we explored the physiological role for VRAC in excitation-contraction (E-C) coupling and shortening of human airway smooth muscle (HASM). In HASM cells, pharmacological inhibition of VRAC with DCPIB (0.1-10 μM) markedly attenuated swell-activated Cl- conductance and contractile agonist (histamine or carbachol)-induced cellular stiffening as measured by single-cell patch clamp and optical magnetic twisting cytometry, respectively. In addition, HASM cells treated with DCPIB or transfected with LRRC8A-targeting siRNA showed reduced agonist-induced phosphorylation of protein kinase B (AKT), paxillin, myosin phosphatase target subunit 1 (MYPT1), and myosin light chain (MLC). Consistent with the changes of these E-C coupling effectors, DCPIB appreciably decreased agonist-induced small airways narrowing in human precision-cut lung slices (hPCLS). Taken together, our findings shed a new light on the mechanistic link between HASM shortening and regulatory volume decrease via LRRC8A, revealing a previously unrecognized nodal point for modulation of the E-C coupling and acute airways constriction.

MrgprC11+ Jugular Neurons Control Airway Hyperresponsiveness in Allergic Airway Inflammation.

The lung is densely innervated by sensory nerves, the majority of which are derived from the vagal sensory neurons. Vagal ganglia consist of two different ganglia, termed nodose and jugular ganglia, with distinct embryonic origins, innervation patterns, and physiological functions in the periphery. Since nodose neurons constitute the majority of the vagal ganglia, our understanding of the function of jugular nerves in the lung is very limited. This study aims to investigate the role of MrgprC11+ jugular sensory neurons in a mouse allergic asthma model. Our previous study has shown that MrgprC11+ jugular neurons mediate cholinergic bronchoconstriction. In this study, we found that in addition to MrgprC11, several other Mrgpr family members including MrgprA3, MrgprB4, and MrgprD are also specifically expressed in the jugular sensory neurons. MrgprC11+ jugular neurons exhibit dense innervation in the respiratory tract including the larynx, trachea, proximal, and distal bronchus. We also found that receptors for IL-4 and oncostatin M, two critical cytokines promoting allergic airway inflammation, are mainly expressed in jugular sensory neurons. Both IL-4 and oncostatin M can sensitize the neuronal responses of MrgprC11+ jugular neurons. Moreover, ablation of MrgprC11+ neurons significantly inhibited airway hyperresponsiveness in the asthmatic lung, demonstrating the critical role of MrgprC11+ neurons in controlling airway constriction. Our results emphasize the critical role of jugular sensory neurons in respiratory diseases.

Airway management for patients with tracheal stenosis and severe scar contracture of the face and neck via bronchoscopy: a case report

Both anaesthesiologists and surgeons experience challenges in managing airway stenosis and scar contracture in the face and neck. Herein, we report the case of a 38-year-old woman (BMI 23.1 kg/m2, third-degree burns covering 40% of her body, an American Society of Anaesthesiologists physical status III) with an unusual case of airway constriction. This patient had a predictable difficult airway (mouth opening of 2 cm, bilateral nostril scar hyperplasia, Mallampatti score III, scarring of the head and neck, and severe tracheal stenosis). Tracheal stenosis measuring 5.5 mm in width as observed 8 cm below the glottis, and the bronchoscope could not pass through it. After two failed attempts at laryngeal mask insertion, we decided to instead insert a custom-made tracheal tube under the guidance of a fiberoptic bronchoscope. The operation was successful, and the patient was transferred to the intensive care unit (ICU).

ROLE OF CHATURBHADRA CHURNA IN THE MANAGEMENT OF TAMAKA SHWASA WITH SPECIAL REFERENCE TO BRONCHIAL ASTHMA IN CHILDREN: A REVIEW

Balyavasta is period predominated by Kapha dosha and due to the peculiar nature of children prevalence of Kaphaja vyadhy’s are very common in them. Bronchial asthma is one such respiratory disorder, which is very much similar to Tamaka Shwasa in explained in Ayurveda. Vitiated Kapha and Vata are the two key factors involved in its etiopathogenesis resulting in Margavarodha (Broncho constriction) leading to shwasakrichrta, Kapha nistheevana, muhur muhur shwasa etc symptoms. Ayurveda emphasise removal of margavarodha as well as Kapha-Vata hara line of treatment in the management of Tamaka Shwasa. Chaturbhadra churna with madhu as anupana is one such unique preparation, which is said to be highly potent enough in its management. Majority of ingredients in Chaturbhadra churna are ushna, tikshna and Vata-Kapha hara in nature. Few drugs are having Rasayana properties too. Madhu as an anupana can enhance the potency of other drugs. Overall, the whole formulation could be an Innovative and effective in the management of Tamaka Shwasa in Minimizing as we all preventing the recurrence of disease.

High throughput screening of airway constriction in mouse lung slices

The level of airway constriction in thin slices of lung tissue is highly variable. Owing to the labor-intensive nature of these experiments, determining the number of airways to be analyzed in order to allocate a reliable value of constriction in one mouse is challenging. Herein, a new automated device for physiology and image analysis was used to facilitate high throughput screening of airway constriction in lung slices. Airway constriction was first quantified in slices of lungs from male BALB/c mice with and without experimental asthma that were inflated with agarose through the trachea or trans-parenchymal injections. Random sampling simulations were then conducted to determine the number of airways required per mouse to quantify maximal constriction. The constriction of 45 ± 12 airways per mouse in 32 mice were analyzed. Mean maximal constriction was 37.4 ± 32.0%. The agarose inflating technique did not affect the methacholine response. However, the methacholine constriction was affected by experimental asthma (p = 0.003), shifting the methacholine concentration–response curve to the right, indicating a decreased sensitivity. Simulations then predicted that approximately 35, 16 and 29 airways per mouse are needed to quantify the maximal constriction mean, standard deviation and coefficient of variation, respectively; these numbers varying between mice and with experimental asthma.

Cigarette smoke-induced exosomal miR-221-3p facilitates M1 macrophage polarization via the STAT3 pathway in chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is marked by irreversible airflow limitations stemming from small airway constriction and lung emphysema. The advancement of COPD is greatly influenced by the M1 polarization of macrophages. The mechanisms governing macrophage polarization in inflammation conditions in COPD are not yet fully understood. To investigate the interplay between exosomes triggered by cigarette smoke and the polarization of macrophages, we utilized a combination of flow cytometry, quantitative real-time reverse transcription PCR, and western blot analysis. Our research reveals that cigarette smoke (CS) exposure induces the secretion of exosomes from human bronchial epithelial cells, with exosomal miR-221-3p identified as a key player in modulating the polarization of M1 macrophages. The evidence indicates that cigarette smoke promotes exosome secretion in these cells, with exosomal miR-221-3p targeting SOCS3 and regulating the STAT3 signaling pathway to facilitate M1 macrophage polarization. This research delves into the molecular pathways through which miR-221-3p facilitates the polarization of M1 macrophages, presenting a groundbreaking approach for potential targeted therapy in COPD.

Evidence to support cultivated fruiting body of Ophiocordyceps sinensis (Ascomycota)'s role in relaxing airway smooth muscle

Ethnopharmacological relevanceOphiocordyceps sinensis (O. sinensis) is a genus of Ascomycete fungus that is endemic to the alpine meadows of the Tibetan Plateau and adjoining Himalayas. It has been used traditionally as a tonic to improve respiratory health in ancient China as well as to promote vitality and longevity. Bioactive components found in O. sinensis such as adenosine, cordycepin, 3-deoxyadenosine, L-arginine and polysaccharides have gained increasing interest in recent years due to their antioxidative and other properties, which include anti-asthmatic, antiviral, immunomodulation and improvement of general health. Aim of the studyThis study's primary aim was to investigate the effect of a cultivated fruiting body of O. sinensis strain (OCS02®) on airways patency and the secondary focus was to investigate its effect on the lifespan of Caenorhabditis elegans. Materials and methodsA cultivated strain, OCS02®, was employed and the metabolic profile of its cold-water extract (CWE) was analysed through liquid chromatography-mass spectrometry (LC-MS). Organ bath approach was used to investigate the pharmacological properties of OCS02® CWE when applied on airway tissues obtained from adult male Sprague-Dawley rats. The airway relaxation mechanisms of OCS02® CWE were explored using pharmacological tools, where the key regulators in airway relaxation and constriction were investigated. For the longevity study, age-synchronised, pos-1 RNAi-treated wild-type type Caenorhabditis elegans at the L4 stage were utilised for a lifespan assay. ResultsVarious glycopeptides and amino acids, particularly a high concentration of L-arginine, were identified from the LC-MS analysis. In airway tissues, OCS02® CWE induced a significantly greater concentration-dependent relaxation when compared to salbutamol. The relaxation response was significantly attenuated in the presence of NG-Nitro-L-arginine methyl ester (L-NAME), 1H-[1,2,4]oxadiazolo [4,3-a]quinoxalin-1-one (ODQ) and several K+ channel blockers. The longevity effect induced by OCS02® CWE (5 mg/mL and above) was observed in C. elegans by at least 17%. ConclusionsThese findings suggest that the airway relaxation mechanisms of OCS02® CWE involved cGMP-dependent and cGMP-independent nitric oxide signalling pathways. This study provides evidence that the cultivated strain of OCS02® exhibits airway relaxation effects which supports the traditional use of its wild O. sinensis in strengthening respiratory health.

Brainstem Dbh+ neurons control allergen-induced airway hyperreactivity

Exaggerated airway constriction triggered by repeated exposure to allergen, also called hyperreactivity, is a hallmark of asthma. Whereas vagal sensory neurons are known to function in allergen-induced hyperreactivity1–3, the identity of downstream nodes remains poorly understood. Here we mapped a full allergen circuit from the lung to the brainstem and back to the lung. Repeated exposure of mice to inhaled allergen activated the nuclei of solitary tract (nTS) neurons in a mast cell-, interleukin-4 (IL-4)- and vagal nerve-dependent manner. Single-nucleus RNA sequencing, followed by RNAscope assay at baseline and allergen challenges, showed that a Dbh+ nTS population is preferentially activated. Ablation or chemogenetic inactivation of Dbh+ nTS neurons blunted hyperreactivity whereas chemogenetic activation promoted it. Viral tracing indicated that Dbh+ nTS neurons project to the nucleus ambiguus (NA) and that NA neurons are necessary and sufficient to relay allergen signals to postganglionic neurons that directly drive airway constriction. Delivery of noradrenaline antagonists to the NA blunted hyperreactivity, suggesting noradrenaline as the transmitter between Dbh+ nTS and NA. Together, these findings provide molecular, anatomical and functional definitions of key nodes of a canonical allergen response circuit. This knowledge informs how neural modulation could be used to control allergen-induced airway hyperreactivity.

Association between orthodontic treatment and upper airway changes in children assessed with cone-beam computed tomography (CBCT): A systematic review.

Some orthodontic devices used in children share similar design principles to appliances used to treat obstructive sleep apnoea in adults. As well as treating malocclusion, orthodontic appliances used in children may therefore also have effects on the upper airway. A review of the literature to assess the effects of orthodontic treatment on the upper airway dimensions in children assessed on CBCT. Following registration of the protocol (PROSPERO CRD42023439056), a systematic electronic search of published studies was performed using several databases (PubMed; Scopus, Web of Science and Science Direct) in accordance with the PRISMA guidelines. Inclusion criteria were as follows: age under 18 years, orthodontic treatment with any appliance, a control group who received no treatment or a non-active alternative treatment and airway measurement using CBCT. RoB-2 and ROBINS-I tools were used to assess risk of bias and quality of the evidence. In total, 341 studies were identified following the initial search. Title and abstract screening resulted in 45 studies for further full-text analysis. On completion of the screening process, a total of 23 studies met the inclusion criteria. Study interventions included functional appliances (10 studies), rapid maxillary expansion (RME) (9 studies), reverse-pull headgear (1 study) and 4 premolar dental extractions (3 studies). The included studies had moderate to high risk of bias, and the quality of evidence was low. The scientific evidence shows that functional appliances are associated with significant improvements in both upper airway volume and constriction when used in children however, the effects on the nasal cavity are limited. RME was associated with a significant increase in nasal cavity and nasopharyngeal dimensions, but not the upper pharyngeal airway. Neither reverse-pull headgear nor dental extractions were associated with any change in airway dimensions; however, the evidence is limited. Functional appliances may reduce the severity of obstructive sleep apnoea (OSA) in children.

Exploration of the shared gene signatures and molecular mechanisms between asthma and COVID-19

Background: COVID-19 and asthma both entail respiratory distress, with inflammation central to their pathogenesis. Asthma, inherently inflammatory, features airway constriction, while COVID-19 triggers immune system inflammation. Asthma patients are deemed at high risk after COVID-19 infection. However, the mechanisms between them remain unclear. Methods: Employing a comprehensive methodology, we analyzed data from the Gene Expression Omnibus (GEO) database, and conducting differential gene expression analysis, identifying shared genes, and exploring their functions via Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. Subsequently, protein-protein interaction (PPI) networks were constructed for deciphering the hub genes, followed by functional analysis, validation, transcriptional regulatory relationships examination, and immune cell infiltration detection. Results: Overall, 60 up-regulated DEGs and 188 down-regulated DEGs were identified. 10 hub genes (PTPRC, IRF8, TNF, CXCR2, IL6R, IL1A, BTK, ANXA5, MYD88, LCP2) emerged as common risk biomarkers, and the enriched pathways are predominantly involved in immune regulation and inflammation. Conclusion: Shared genes such as PTPRC, IRF8, TNF, CXCR2, IL6R, IL1A, BTK, ANXA5, MYD88, and LCP2, along with immune regulation and inflammation pathways, were identified, which elucidate the interplay between asthma and COVID-19. These findings may offer potential therapeutic targets for both conditions.

Sleep disruption and premolar absence, NHANES, 2017-2020: A cross-sectional study.

Orthodontic treatment often involves four first premolar extractions. There is concern that the retraction of the anterior teeth due to extraction of first premolars may constrict tongue space and will reduce oral cavity and oropharynx space. Constricted airways are often associated with sleep disordered breathing (SDB) and sleep disruption. The aim of this study was to determine if there is an association of SDB factors with the absence of first premolars. A cross-sectional study was conducted using National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 data on participants, aged 18-65 years (n = 4742). Variables of interest included self-reports of SDB (symptoms of disrupted sleep such as snoring, snorting, daytime sleepiness, and inappropriate number of hours of sleep). Data for the presence/absence of first premolars were gathered from the oral examination section of NHANES. An assumption was made that absence of four first premolars in dentate participants indicated extractions for orthodontic treatment. Data analyses were conducted with Rao Scott chi squared test. There were no significant associations of SDB and symptoms of disrupted sleep associated with the absence of four first premolars in dentate participants. Concerns of the impact of first premolar extractions on SDB were not supported with this study.

IMMUNOGLOBULIN E IN PEDIATRIC ASTHMA: ADVANCES IN UNDERSTANDING AND MANAGEMENT

Asthma, a pervasive chronic inflammatory ailment of the respiratory system, remains a global health conundrum. The Global Burden of Disease Study (GBD) of 2019 underscores its widespread impact, revealing that asthma afflicts 262 million individuals worldwide, translating into an age-standardized prevalence of 3,416 per 100,000 population. The incidence among children is particularly alarming, with nearly 14% of the global pediatric population diagnosed with the condition. This statistic positions asthma as the foremost chronic respiratory disease among children, a trend that is on the rise, especially across Asia and Europe, as evidenced by the International Study of Asthma and Allergies in Childhood (ISAAC). Characterized by variable airflow limitation, bronchial hyperresponsiveness, excessive mucus production, and airway inflammation leading to airway constriction, asthma’s multifaceted nature complicates its management. In the realm of immunology, Immunoglobulin E (IgE) has been identified as a pivotal player. Recognized officially as the fifth class of serum immunoglobulins during the 1968 WHO International Reference Center for Immunoglobulins conference in Lausanne, IgE’s crucial role in the pathophysiology of asthma has been rigorously studied. Serum IgE levels, both total and specific, have been proven instrumental in the diagnosis, treatment, and prevention of pediatric asthma. The landmark approval of Omalizumab by the US Food and Drug Administration in 2003 heralded a new era in the biologic management of asthma, targeting children aged six and above. This was followed by the development of Ligelizumab and Quilizumab, innovative anti-IgE medications currently under investigation for their potential to alleviate symptoms and decelerate the disease’s progression. The integration of Allergy Immunotherapy (AIT) alongside monoclonal antibody therapies like Omalizumab, Ligelizumab, and Quilizumab signifies a monumental shift toward personalized medicine in asthma care. These advances promise not only to ameliorate the quality of life for pediatric asthma patients but also to redefine the landscape of asthma management. Nonetheless, the quest for enhanced treatment modalities for young asthmatics necessitates further in-depth research. The burgeoning field of anti-IgE therapy, in concert with AIT, is poised to set new benchmarks in pediatric asthma management, steering us towards a future where asthma’s grip on children’s health is significantly loosened.