Asthma In Life Research Articles

The Therapeutic Potential for Targeting Group 2 Innate Lymphoid Cells in Asthma

T helper type 2 cells (Th2 cells) and group 2 innate lymphoid cells (ILC2s) play an important role in the pathophysiology of asthma, including airway eosinophilic inflammation. ILC2s are activated by epithelial-derived cytokines [interleukin-25 (IL-25), IL-33, and thymic stromal lymphopoietin (TSLP)] from airway epithelial cells, leading to the release of high amounts of type 2 cytokines, such as IL-5 and IL-13. ILC2s induce airway inflammation in an antigen-independent manner, and ILC2s are considered to be involved in the pathogenesis of asthma exacerbation. Furthermore, ILC2 activation might also confer steroid resistance. Many recent studies in humans and mice are increasingly demonstrating that the function of ILC2s is regulated not just by epithelial-derived cytokines but by a variety of cytokines and mediators derived from innate immune cells. Furthermore, the biologics targeting these cytokines and/or their receptors have been shown to reduce asthma exacerbations and improve lung function and quality of life in asthmatics. This article reviews the current treatment landscape for type 2 airway inflammation in asthma and discusses the therapeutic potential for targeting ILC2s.

Buteyko Breathing Technique (BBT) terhadap Perubahan Nilai Peak Expiratory Flow Rate (PEFR) dan Kualitas Hidup Penderita Asma

This study aimed to determine the effect of Buteyko's breathing technique on changes in peak expiratory flow rate and quality of life of asthmatics. The method used in this research is literature search using online databases such as Pubmed/Medline, Proquest, Science Direct, and EBSCO. The results showed that from ten experimental studies of the Buteyko Breathing Technique, BBT significantly affected peak expiratory flow rate (PEFR) and quality of life in adult asthmatics. In conclusion, the Buteyko breathing technique proved to be quite effective in increasing the PEFR value and quality of life in asthmatics, without any side effects in the subjects studied.
 
 Keywords: Asthma, Buteyko Breathing Technique (BBT), Quality of Life, Peak Expiratory Rate, Peak Expiratory Flow Rate (PEFR)

A study on symptom improvement and efϑicacy of formoterol plus budesonide in the asthma management in northern parts of Tamil Nadu

The purpose is to study the asthma symptom improvement and efficacy of formoterol (LABA) and Budesonide (ICS) combination in the asthma management in northern districts of Tamilnadu. It is a multicentric, non-comparative, questionnaire and random sampling study was conducted in 145 mild to severe asthmatic patients. They were in Formoterol plus budesonide combination inhalation drugs available in DPI and pMDI. Among the 145 asthmatic patients, 45 patients, 6 patients and 94 patients were in DPI, nebuliser and pMDI devices respectively. During drug initiation, The Asthmatics were in mild (27%), Moderate (57%) and Severe (16%) stages. After one year of follow-up, the number of patients in the mild is 84%, moderate 14% and severe 2%. Among 45 DPI Asthmatic patients, 29 patients, 15 patients and 1 patient have reported the handling the devices as easy, medium and hard respectively. On the other hand, 94 pMDI asthmatic patients, 38 patients, 48 patients and 8 patients have reported the handling of devices as easy, medium and hard respectively. The treatment resulted in 77 patients as good, 65 as satisfactory and 3 as same. After one year, all the 145 asthmatic patients adhered with the treatment and experienced symptom improvement with 53% patients as good, 45% patients as satisfactory and 2% patients as same. The treatment of formoterol and budesonide combination in the northern districts of Tamilnadu have effectively controlled the asthmatic symptoms and improved the quality of life in asthmatics. Moreover, the patient's adherence to the treatment is good in the northern parts of Tamilnadu.

Study of vitamins, antioxidant and trace elements on various spirometric parameters and quality of life in patients of bronchial asthma

Study of vitamins, antioxidant and trace elements on various spirometric parameters and quality of life in patients of bronchial asthma - IJCAAP- Print ISSN No: - 2581-5555 Online ISSN No:- 2456-9542 Article DOI No:- 10.18231/j.ijcaap.2019.030, IP International Journal of Comprehensive and Advanced Pharmacology-IP Int

Τhe Co-Existence of Obstructive Sleep Apnea and Bronchial Asthma: Revelation of a New Asthma Phenotype?

Bronchial asthma (BA) and obstructive sleep apnea (OSA) are common respiratory obstructive diseases that may coexist. It would be interesting to study the possible influence of that coexistence on both diseases. Until now, reviews focused mainly on epidemiology. The aim of this study was to review the literature in relation to epidemiology, pathophysiology, consequences, screening of patients, and treatment of the coexistence of OSA and BA. We pooled studies from the PubMed database from 1986 to 2019. OSA prevalence in asthmatics was found to be high, ranging from19% to 60% in non-severe BA, reaching up to 95% in severe asthma. Prevalence was correlated with the duration and severity of BA, and increased dosage of steroids taken orally or by inhalation. This high prevalence of the coexistence of OSA and BA diseases could not be a result of just chance. It seems that this coexistence is based on the pathophysiology of the diseases. In most studies, OSA seems to deteriorate asthma outcomes, and mainly exacerbates them. CPAP (continuous positive airway pressure) treatment is likely to improve symptoms, the control of the disease, and the quality of life in asthmatics with OSA. However, almost all studies are observational, involving a small number of patients with a short period of follow up. Although treatment guidelines cannot be released, we could recommend periodic screening of asthmatics for OSA for the optimal treatment of both the diseases.

Impact of Education on the Quality of Life of Asthmatics: Evaluative Study of 100 Cases in Pneumophtisiology Department of the Fann National University Hospital Center (FNUHC), Senegal

Introduction: Therapeutic patient education is a continuous, integrated, patient-centered process. A study was conducted in the Asthma School in the pneumophtisiology department of Senegal. Overall goal was to determine the influence of therapeutic education on the quality of life of asthmatics. Method: Transverse study, descriptive and evaluative therapeutic education provided in the school of asthma on quality of life for asthma patients. Data were analyzed through IBM SPSS (Statistical Package for Social Science) version 20. Results: 100 asthmatic patients were included with a sex ratio of 0.37. The average age of the patients was 36.76 years old. The majority (81.3%) (n = 39) being new participants. The average scores for symptoms, exposure to stimuli, emotions and limiting activities stay higher for adherent patients as well as the score overall quality of life. Conclusion: The school of asthma, associated with the therapeutic management, can improve the control of the disease and the quality of life of the patient.

PHARMACIST LEAD PATIENT COUNSELLING: IMPACT ON QUALITY OF LIFE IN ASTHMA PATIENTS

Safe and effective drug therapy depends on patients being well informed about their medication. The proper use of drugs and patient education are vital for asthma management. Increasing patient’s knowl-edge about their asthma therapy is a necessary component of asthma management. This study was carried out to assess the patient counseling impact on quality of life (QOL) in asthma patients using SF 36questionnaire. In this study a total of hundred patients diagnosed with asthma were enrolled by considering the inclusion and exclusion criteria. Out of this, 50 (50%) patients were in intervention and 50 (50%) patients in the control group. As per our study it was found that the predominant risk factor for Asthma was fumes and smoking was found to be the major risk factor in males. After patient counseling intervention group showed improvement in QOL from the baseline to1st and 2nd follow-ups. But control group doesn’t show significant improvement in the QOL from the baseline to 1st and 2nd follow-ups. Physical activity and daily activity was also found to be increased during second follow-up in intervention group than in control group. Our study concluded that continuous education programs and counseling should be conducted for chronic diseases to emphasize and re-emphasize the importance of Quality of Life, to prevent recurrences, reduce progression of disease and ultimately minimize the hospitalization and there is a need of continuous pharmaceutical care services/ monitoring to improve the better quality of life.

Assessment of significance of Yoga on quality of life in asthma patients: A randomized controlled study.

Background:Asthma is a chronic inflammatory respiratory disease characterized by periodic attacks of wheezing, shortness of breath and a tight feeling in the chest. The current study is based on the effect of Yoga on quality of life in asthmatics in Northern India.Materials and Methods:A total of 300 participants of mild-to-moderate persistent asthma (FEV1 >60%) aged between 12 and 60 years were recruited from the Department of Pulmonary Medicine. Their quality of life was assessed with the help of mini asthma quality-of-life questionnaire (AQLQ) at baseline and then after 3rd and 6th month from baseline. Forty-five participants were dropped out during the study while 255 participants completed the study successfully.Results:In “the Yoga group,” significant improvements were found in all the subdomains of AQLQ at 3rd month and at 6th month in comparison to “the control group.” The number needed to treat was found to be 2.67 for the total AQLQ score which was greater than the minimal important difference.Conclusion:“The Yoga group” got significantly better improvement in asthma quality-of-life scores than “the control group.” Thus, Yoga can be used as an adjuvant therapy in the management of asthma.

Impact of Long-term Employment of a Self-Management Program in Asthmatics

Background: Self-management of asthmatics is thought to facilitate early detection and treatment of asthma exacerbations, and to reduce asthma-related morbidity and mortality. Aim: To evaluate the efficacy of a self-management program on the long-term follow-up of asthma and determine the factors influencing the success of such program in asthmatic patients. Methods: Objective parameters (criteria of asthma control, FEV1 and FEV1/FVC) were assessed at inclusion and at the end of the retrospective study, 8.9±8 years later, using a 1-year recall patient-based questionnaire and lung function measurements. Results: Among the 112 patients who answered the questionnaire (63% of response), 69 patients followed the self-management program, either partially with the help of a phone call to their physician (22%) or exclusively (78%), the latter displaying higher education levels (p<0.05). In the “self-management” group, GINA status was stabilized or improved (80%), FEV1 was significantly improved, a less frequent use of emergency services was reported, corticosteroid dependence was reduced (22% vs. 7%, p=0.03) and smoking dropped (p=0.05). Additionally, higher global quality of life scores were obtained in the self-management group (21% vs. 7.9%, p= 0.05). Conclusion: A self-management program significantly improved control of asthma and quality of life of asthmatics. Because control of asthma is lacking for the vast majority of asthmatics, these results argue for an usual employment of such program in the long term follow-up of asthmatics.

Study of Aerosol Therapy Compliance in Bronchial Asthmatics

Asthma is commonly controllable but often neglected disease associated with huge burden to family and society. It is important to obtain optimal control to improve quality of life in asthmatics. The suboptimal control of disease occurs due to very poor adherence to aerosol therapy. Objective is to study the aerosol therapy compliance in bronchial asthmatics and the factors responsible for non compliance of aerosol therapy and effect of repeated health education on compliance. It is a prospective study where patient was followed up monthly for three months for collecting data and checking the compliance. This study included 113 bronchial asthmatics who were taking aerosol therapy for 1 or more years. After three months it was observed that only 45 patient (39.82%) were compliant and 68 (60.17%) were non compliant to aerosol therapy as advised by doctor, after employing various strategies, compliance improved in 22 (32.35%) of the previously compliant patients. Factors responsible for poor compliance were low level of education, patients from poor socioeconomic strata, poorly accessible pharmacy, adverse effect and fear of adverse effect (forgetfulness busy life style, ill altitude to chronic condition) felt better with medications, negligence dislike medication. Non compliance with treatment is an eminent challenge in asthma management and various compliance improving strategies can helpful to improve compliance in few patient.

Chronic rhinosinusitis in asthma is a negative predictor of quality of life: results from the Swedish GA2LEN survey

Asthma and chronic rhinosinusitis (CRS) both impair quality of life, but the quality-of-life impact of comorbid asthma and CRS is poorly known. The aim of this study was to evaluate the impact of CRS and other relevant factors on quality of life in asthmatic subjects. This Swedish cohort (age 17-76 years) consists of 605 well-characterized asthmatics with and without CRS, 110 individuals with CRS only, and 226 controls and is part of the Global Allergy and Asthma European Network (GA(2) LEN) survey. The Mini Asthma Quality of Life Questionnaire (mAQLQ), the Euro Quality of Life (EQ-5D) health questionnaire, spirometry, skin prick test (SPT), exhaled nitric oxide (FeNO), smell test, and peak nasal inspiratory flow were used. Subjects having both asthma and CRS have lower mAQLQ scores in all domains (P < 0.001) and a lower EQ-5D index value and EQ-5D VAS value (P < 0.001) compared to those with asthma only. Asthmatics with CRS have significantly lower FEV1%pred and FVC%pred (88.4 [85.1-91.7] and 99.9 [96.7-103.0], respectively) compared with asthma only (91.9 [90.3-93.4] and 104.0 [102.5-105.5], respectively P < 0.05). Multiple regression analysis shows that low asthma quality of life is associated with having CRS (P < 0.0001), lower lung function (P = 0.008), current smoking (P = 0.01), BMI > 30 kg/m2 (P = 0.04), high age (P = 0.03), and a negative SPT (P = 0.04). Comorbid CRS was a significant and independent negative predictor of quality of life in asthmatics. Other negative factors were lower lung function, current smoking, obesity, advanced age, and having nonatopic asthma.

Yoga versus Physiotherapy: Effect on Pulmonary function, Breath Holding Time &amp; Quality of Life in Asthmatics

Asthma is a reversible obstructive disorder characterized by remissions and exacerbations. Various therapies including yoga and physiotherapy have played a role in symptomatic relief and improving quality of life in asthmatics.

Factors influencing quality of life in asthmatics – a case–control study

The quality of life (QOL) in persons with asthma is reduced and different factors such as demography, asthma severity and psychiatric comorbidity play an influential role. However, little is known about the interplay of these factors. To describe QOL in relation to asthma and analyse for the relative impact of asthma severity, psychiatric comorbidity, lifestyle (smoking and obesity) and demographic determinants on QOL in persons with asthma. One thousand one hundred sixty-one subjects from an earlier cohort with and without asthma were sent an asthma screening questionnaire and a generic QOL measuring instrument (15D). Seven hundred seventy-eight valid responses (67%). QOL was significantly reduced in persons with asthma compared with controls (P = 0.001), almost on all domains of 15D. In the adjusted regression model, asthma severity, depression, female gender and smoking were associated with reduced QOL, suggesting that these factors play an independent role on lowering QOL. Depression did not inflate the relationship between asthma severity and worse QOL, suggesting that asthma severity plays an independent role on everyday life regardless of psychological state. Asthma severity, psychiatric comorbidity, female gender and smoking were identified in this study to be major contributors to decreased QOL in asthmatics. Health professionals should be aware of this complex picture and take these factors into consideration when choosing the proper treatment of asthma patients. Asthma, asthma severity, epidemiology, psychiatric comorbidity, QOL.

Determinants for a low health-related quality of life in asthmatics

People with asthma suffer from impaired health-related quality of life (HRQL), but the determinants of HRQL among asthmatics are not completely understood. The aim of this investigation was to study determinants of low HRQL in asthmatics and to study whether the determinants of HRQL differ between sexes and age groups. A cohort of three age groups in Sweden was investigated in 1990 using a questionnaire with focus on respiratory symptoms. To study quality of life, the generic instrument Gothenburg Quality of Life was used. The participants were also investigated with interviews, spirometry, and allergy testing. Asthma was diagnosed in 616 subjects. Fifty-eight per cent (n = 359) of the subjects were women; and 24% were smokers, 22% ex-smokers, and 54% were non-smokers. Women were more likely than men to report poor health-related quality of life. Respiratory symptoms severity was another independent determinant of a lower quality of life as well as airway responsiveness to irritants. Current and former smokers also reported lower quality of life. Finally, absenteeism from school and work was associated with lower quality of life. Factors such as sex, smoking habits, airway responsiveness to irritants, respiratory symptom severity, allergy, and absenteeism from school and work were associated with low HRQL in asthmatics.

Influence of 8week therapy with Omeprazole on asthma symptoms, pulmonary function and quality of life in asthmatics with acid reflux symptoms

Influence of 8week therapy with Omeprazole on asthma symptoms, pulmonary function and quality of life in asthmatics with acid reflux symptoms

Zileuton: clinical implications of 5-Lipoxygenase inhibition in severe airway disease

The 5-Lipoxygenase pathway results in the formation of leukotrienes, including leukotriene B(4) (LTB(4)), 5-oxo-6E,8Z,11Z,14Z-eicosatetranoic acid and the cysteinyl leukotrienes (LTC(4), LTD(4) and LTE(4)) and activates all four leukotriene receptors, BLT1, BLT2, cysLT(1) and cysLT(2). Zileuton is the only commercially available inhibitor of the 5-Lipoxygenase pathway. In a number of clinical trials, zileuton has been shown to improve airway function and inflammation, asthma symptom control and quality of life in asthmatics. Given the important role that leukotrienes play in airway inflammation, zileuton provides an additional therapeutic option in the management of chronic, persistent asthma, particularly those asthmatics with more severe disease. In addition, zileuton has shown promise in a number of other conditions, including upper airway inflammatory conditions, dermatological disease and chronic obstructive pulmonary disease. The development of new formulations, including a controlled release tablet formulation for b.i.d. dosing and an intravenous preparation for acute asthma exacerbations may enhance clinical utility and expand therapeutic indications.

The Relationship between Pharmaceutical Costs, Disease Severity, and Health-Related Quality of Life in Asthmatics in Swedish Primary Care

The objective of this study is to explore the relationship between variables that may influence pharmaceutical costs in asthma and to generate a predictive model for these costs in primary health care. The understanding of these relationships is important since costs of drugs may place unnecessary economic burden on patients and society. During 2003, prospective clinical data were collected from 105 patients in 24 primary health care centers located in Stockholm. The relationships between cost of drugs and quality of life, lung function, and asthma severity were analyzed in a regression model. Twenty-three percent of the observed variation in pharmaceutical costs could be explained by asthma severity, disease-specific quality of life, and clinical practice. There was a weak inverse correlation between pharmaceutical costs, generic quality of life, and lung function. Even when severity was accounted for, there were large variations in costs between different primary health care units.

Bronchial Hyperresponsiveness and Quality of Life in Asthmatics

Background: Quality of Life (QoL) measurements are more responsive to clinically significant changes that are not evaluated by conventional clinical measures. Objective: The objective of this study is to examine the relationship between bronchial hyperresponsiveness (BHR) and QoL in asthmatic patients. Patients and Methods: 394 patients underwent clinical follow-up, pulmonary function tests and the methacholine challenge test (MCHt), and completed the Asthma Quality of Life Questionnaire (AQLQ). Results: 200 patients had a positive MCHt and in 194 it was negative. For all 32 items, asthmatic patients had a median value of 4.7 (4.2–5.9) compared to 5.6 (4.7–6.3) in patients with negative MCHt (p < 0.01). For physical activities, patients with positive MCHt showed a median value of 5.0 (4.5–6.0) compared to 5.7 (4.8–6.3) in patients with negative MCHt (p < 0.05). Median scores of 12 items of symptoms and 5 items of emotions were significantly lower in patients with positive MCHt [4.5 (3.7–5.8) and 5.1 (4.2–6.1)] than in patients with negative MCHt [5.5 (4.4–6.1) and 6.3 (5.2–6.9), respectively, (p < 0.01)]. For items of environmental stimuli the median score was 4.7 (3.7–5.9) in patients with positive MCHt, being significantly lower than in patients with negative MCHt [5.4 (4.2–6.4), p < 0.05]. Patients with positive MCHt had lower values of QoL than patients with negative MCHt. Conclusions: QoL changes may be more sensitive than evaluation of BHR. The measurement of Qol may be important because it enables us to characterize patients who could be candidates eventually to a pharmacological treatment for BHR because they have an impaired QoL.

Beurteilung der Lebensqualität von Asthmatikern durch Visual Analog Skala und St. George’s Respiratory Questionnaire

Background:The objective was to determine the correlation rate between 2 different instruments measuring quality of life (QoL) of adult asthmatics. Methods:We examined the QoL of 321 asthmatic patients with a disease specific instrument, the St. George's Respiratory Questionnaire (SGRQ), and a general QoL instrument, the visual analogue scale (VAS). Data was analysed by using Statistical Programme for Social Sciences statistical software. Stepwise multivariate analyses were conducted. Results: The VAS scores were as follows according to asthma severity: intermittent 76%, mild 69%, moderate 60%, severe 49%, where 100% equates to maximum health. The relationship between spirometry and QoL data was moderate (r = 0.36; p = 0,001). Results of the SGRQ were the following: (in this case higher scores refer to lower level of QoL): Intermittent: symptom 16%, activity 20%, impact 14%, and the total score 16%. Mild: symptom 36%, activity 37%, impact 32%, and the total score 34%. Moderate: symptom 53%, activity 55%, impact 46%, and the total score 50%. Sever: symptom 66%, activity 62%, impact 53%, and the total score 58%. The relationship between spirometry and QoL is not as strong (r = 0.37, p = 0,001) as expected. We found fairly good correlations between the QoL scores measured by the 2 different instruments (r = - 0,619; p = 0,001). Conclusion: Our results indicate that although we have reliable techniques to measure the severity of airflow obstruction, which is the basic symptom of asthma, we cannot predict how patients see their actual health condition, quality of life. This fact gives further perspective to asthma-management, as more emphasis should be taken on the patient's global view of their asthma. Since we found good correlation between the results of the visual analogue scale and the SGRQ, the quality of life of asthmatics can be well assessed even with a very simple instrument, the like the VAS.

Omeprazole improves peak expiratory flow rate and quality of life in asthmatics with gastroesophageal reflux

Objective: The aim of this study was to determine if omeprazole improves pulmonary function and quality of life in asthmatics with gastroesophageal reflux. Methods: This was a double blind, randomized, placebo-controlled cross-over trial. After a 4-wk lead-in period, nine patients with documented asthma and gastroesophageal reflux, were prescribed either omeprazole 20 mg, daily or placebo for 8 wk and then crossed over to the alternate treatment. Outcome measurements included: forced expiratory volume at 1 s (FEV 1), peak expiratory flow rate (PEFR), and responses on the Asthma Quality of Life Questionnaire, a validated disease specific measure of functional status. Results: After omeprazole treatment, compared with placebo, patients had higher mean morning and evening PEFR, mean absolute difference (95% CI): morning: 37.8 L/min. (10.9–64.6), evening: 31.2 (3.2–59.2). Omeprazole treatment led to higher mean overall scores on the Asthma Quality of Life Questionnaire, and on the subdomains of activity limitation, symptoms, and emotions ( p = 0.039, 0.049, 0.024, 0.040). A trend toward higher FEV 1 (mean: 15.6% difference) with omeprazole failed to reach statistical significance ( p > 0.2). Conclusions: After taking omeprazole for 8 wk, asthmatics with GER have better PEFR and quality of life than after placebo.