Asthmatic Patients Research Articles

Multiomic Integration Analysis for Monitoring Severe Asthma Treated With Mepolizumab or Omalizumab.

Biologics are becoming increasingly important in the management of severe asthma. However, little is known about the systemic immunometabolic consequences of Th2 response blockage. To provide a better immunometabolic understanding of the effects of mepolizumab and omalizumab treatments by identifying potential biomarkers for monitoring. In this exploratory longitudinal study severe asthmatic patients were followed for 18 months after initiating mepolizumab (n = 36) or Omalizumab (n = 20) treatment. Serum samples were collected before, 6, and 18 months after treatment. Targeted omic approaches were performed to analyze inflammatory metabolites (n = 35) and proteins (n = 45). Multiomic integration was performed individually for each treatment applying supervised analysis Data Integration Analysis for Biomarker discovery using Latent cOmponents (DIABLO) framework. Then, potential biomarkers were confirmed using multivariate ROC analyses and correlated with clinical variables along treatment. Mepolizumab and omalizumab were both effective (improved clinical variables) and showed different and specific metabolic and protein profiles in severe asthmatic patients during treatment. Multiomic integration and multivariate ROC analyses identified specific biomarkers, such as arachidonic acid, palmitoleic acid, oleic acid, propionylcarnitine, bilirubin, CCL11, and TNFSF10, which can explain the differences observed with Mepolizumab treatment over 18 months and significantly correlate with clinical improvement. However, no significant biomolecules and no discriminative multivariate ROC curves were found for Omalizumab treatment. Our results provide a comprehensive insight into the differential effects of mepolizumab and omalizumab on the immunometabolic kinetics of the inflammatory response in severe asthma. We identified a set of biomolecules with potential for monitoring mepolizumab treatment which could be useful for personalized medicine.

The economic burden of asthma in Italy: evaluating the potential impact of different treatments in adult patients with severe eosinophilic asthma.

Asthma is a prevalent chronic respiratory condition that significantly impacts public health, with severe asthma subtypes, such as severe eosinophilic asthma, imposing substantial socioeconomic burdens. Real-world data from the Italian Health Information System were analyzed to evaluate the economic consequences of asthma in Italy. An in-depth comparative analysis was conducted to investigate the economic implications of various asthma subtypes, focusing on severe eosinophilic asthma. Additionally, the study projected the potential cost-effectiveness of novel treatments aimed at reducing hospitalization rates, specialist visits, and oral corticosteroid use for patients with severe eosinophilic asthma in Italy. The analysis revealed that severe asthma, and notably severe eosinophilic asthma, places a substantial economic burden on the Italian National Health System. Estimates demonstrated that implementing innovative treatments to mitigate the risks of hospitalization and specialist visits, as well as reducing oral corticosteroid usage in severe eosinophilic asthma patients, could lead to significant cost savings. The cost-consequence analysis indicated potential yearly reductions of €50.0 million (27%) for the treatment of severe asthma and €31.7 million (26%) for severe eosinophilic asthma. This study presents a comprehensive evaluation of the economic repercussions of severe asthma in Italy. The findings emphasize the necessity of identifying and developing effective therapeutic strategies to improve the management of severe asthma while simultaneously reducing the economic burden on the healthcare system. These results offer valuable insights for healthcare policymakers and practitioners, facilitating evidence-based decisions in asthma management and healthcare policy in Italy.

Genetic Variations on Chromosome 6p21 Are Associated with Asthma Risk and Disease Severity: A Case–Control Study from Pakistan

Background: Genetic factors play a role in asthma severity. However, low- and middle-income countries have minimal contribution to genomic asthma research. The current study investigates the influence of an important genetic asthma region (6p21) on severe asthma in a cohort of asthmatics in Pakistan. Materials and Methods: In this case–control study, mild to severe asthmatic patients (n = 255) and controls (n = 260) were enrolled from Lahore, Pakistan. Blood samples were collected, and genomic DNA was extracted for the genotyping of 11 single nucleotide polymorphisms located in the 6p21 region. Severe asthma was defined based on the defined daily dose of inhaled corticosteroids equivalent to 200 mcg of beclomethasone dipropionate (as per the global initiative for asthma guidelines). An additive genetic model was followed to find the associations between these variants and the outcome. Univariate and multivariate logistic regression, adjusted for confounders, was performed. Odds ratio (OR), 95% confidence interval (95% CI), p-value, and q-values after FDR adjustment were estimated. Results: The genetic variants rs3025028, rs987870, and rs3025039 showed strong associations with the incidence of asthma with odds ratios of 1.58, 1.62, and 2.70 (95% CI = 1.16–2.16, 1.15–2.30, and 1.40–5.39, respectively). Further stratification analysis to study the risk of severe asthma also revealed markedly significant associations for rs3025020 and rs1799964 (OR = 2.28 and 2.99; 95% CI = 1.39–3.86 and 1.75–5.33, respectively). However, the SNPs rs2070600, rs987870, and rs3025039 also showed a significant relationship with the severity (OR = 2.34, 1.75, and 2.72; 95% CI = 1.02–5.97, 1.07–2.98, and 1.11–7.71, respectively), but FDR-adjusted q-values were insignificant (0.10, 0.07, and 0.07, respectively). Conclusions: The 6p21 region variants rs3025028, rs987870, and rs3025039 are associated with the incidence, whereas rs3025020 and rs1799964 are associated with the risk of more severe asthma in the Pakistani population.

Characteristics of airway microbiome co-occurrence network in patients with type 2 and non-type 2 asthma

Objective: To study the characteristics of the airway microbiome co-occurrence network in patients with type 2 and non-type 2 asthma. Methods: In a prospective study based on a cohort of asthma patients, respiratory induced sputum samples were collected from 55 asthma patients [25 males and 30 females, with a median age of 47.7 years (age range 34.3-63.0 years)] admitted to the Department of Respiratory and Critical Care, Beijing Chaoyang Hospital, Capital Medical University and 12 healthy controls from the Physical Examination Centre of Beijing Chaoyang Hospital, Capital Medical University, from May 2021 to May 2022. According to the level of exhaled breath nitric oxide (FeNO), the asthma patients were divided into 22 cases in the high FeNO group (FeNO≥40 ppb, i.e., type 2 asthma group) and 33 cases in the low FeNO group (FeNO<40 ppb, i.e., non-type 2 asthma group). All induced sputum samples were subjected to second-generation macrogenomic sequencing and bioinformatic analyses of microbial community diversity, compositional characteristics, symbiotic network characteristics and metabolic function prediction. The Kruskal-Wallis rank sum test was used for between-group comparisons, and the linear discriminant analysis (LEfSe) method was used to compare the differences in flora composition between groups. The R language was used for microbial network analysis. In addition, PICRUSt was used to predict the metabolic-functional characteristics of the microbial communities. Results: The microbial communities in the healthy control group had a lower proportion of p_Firmicutes and p_Proteobacteria than asthma patients, 29% and 21%, respectively; 37% and 33% in the low FeNO group and 42% and 26% in the high FeNO group. The microbial network in the low FeNO group had 64 pairs of edges forming 16 communities, and about 75% of the nodes had eigenvector centrality values between 0 and 0.05, and 25% of the nodes had eigenvector centrality values between 0.10 and 0.45. There were four layers of κ-nucleosynthesis, and about 42% of the vertices were in the centre of the two layers. The microbial network of the high-FeNO group had 80 pairs of edges forming 18 clusters, and 81% of the nodes had eigenvector centrality values between 0 and 0.05, and 19% of the nodes had eigenvector centrality values between 0.10 and 0.35. The κ-nucleus decomposition had eight layers, and 21% of the vertices were located in the centre's two layers. The main functional differences between the low and high FeNO groups were shown in metabolic pathways (including sugar, lipid, amino acid, and energy metabolism), drug resistance, biofilm transport, signalling, intercellular communication, and cellular repair. Conclusions: Compared with non-type 2 asthmatics, type 2 asthmatics had a higher alpha diversity of respiratory microbiota, lower levels of microorganisms in the p_Proteobacteria, and a more aggregated microbial network. There was a significant difference in the predicted metabolic function of the two endotypes of asthmatics.

The Effect of Iron Deficiency Anemia on Emergency Department Admission in Asthmatic Children.

Iron deficiency (ID) is the most common nutritional deficiency and cause of anemia in childhood. Iron deficiency anemia (IDA) is a common public health problem in Turkey as in the rest of the World. Asthma is a chronic inflammatory disease of the respiratory tract, affecting approximately 10% of the population in developing countries. There are very few reports available in the medical literature regarding the association of childhood asthma and anemia, as well as the effects of anemia on asthma. This study was designed to investigate the possible relationship between serum iron levels of asthmatic patients and their frequency of emergency admission for asthma exacerbation treatment. The patients who were followed up with a diagnosis of asthma for at least 12 months at the Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, whose current age is below 21, and whose serum iron, total iron binding capacity, and ferritin levels were checked between 2017 and 2019, were included in the study. In the assessment of 612 patients diagnosed with asthma, 105 individuals, constituting 18.4% of those under asthma follow-up, were identified as having anemia. Additionally, ID not progressing to anemia was observed in 120 patients, accounting for 21.1% of the total. Individuals with IDA and/or ID alone experienced a significantly higher frequency of emergency admissions for asthma exacerbations. Moreover, ID and/or IDA were established as independent risk factors linked to emergency admissions for asthma exacerbations. odds ratio = 1.56, confidence interval = 1.06-2.30 p = 0.022. In conclusion, it may be recommended to follow up the hemoglobin and iron parameters of asthmatic patients and to take nutritional and/or supportive preparations to keep them at a high level.

Implementation of written asthma action plan among asthma patients in Türkiye: a multicenter, cross-sectional, descriptive study

Implementation of written asthma action plan among asthma patients in Türkiye: a multicenter, cross-sectional, descriptive study

A decision tree analysis to evaluate the optimal approach to screen allergic bronchopulmonary aspergillosis in asthmatic patients

ABSTRACT Background Various methods are available to screen for allergic bronchopulmonary aspergillosis (ABPA) in asthma, but their comparative performance remains uncertain. Objectives To identify the optimal screening algorithm for ABPA in asthmatic patients and evaluate the crude cost of various diagnostic approaches. Methods We performed a post hoc analysis of prospectively collected data from consecutive adult asthmatic patients evaluated for ABPA. The diagnosis was based on the revised International Society for Human and Animal Mycology ABPA Working Group criteria. Initial evaluations included measurements of serum Aspergillus fumigatus-IgE (≥0.35 kUA/L), serum total IgE (≥500 IU/mL), serum A. fumigatus-IgG (≥27 mgA/L), blood eosinophil count (BEC ≥500 cells/μL), and chest CT findings. A decision tree was manually constructed using recursive partitioning to identify the most effective diagnostic pathway. Results Among 543 adult asthmatics, 106 were diagnosed with ABPA. Serum A. fumigatus-IgE was positive in 221 (40.7%) patients, while serum total IgE was elevated (≥500 IU/mL) in 300 (55.3%) patients. The serum total IgE-based approach required 196 additional tests during screening, compared to 115 in the A. fumigatus-IgE method. The BEC-based strategy missed 28 cases of ABPA. Although the CT-directed protocol had the fewest false positives, it required 437 additional screening radiographic procedures and missed eight ABPA cases. The A. fumigatus-IgE pathway emerged as the most cost-effective, whereas imaging-based strategies were the most expensive. Conclusions Serum A. fumigatus-IgE is the optimal screening test for ABPA in asthma. It minimizes unnecessary testing while maintaining high diagnostic accuracy, making it a preferable approach in clinical practice.

The Relationship Between Iron Deficiency and Asthma Severity: Detection The Role of Gender and Ferritin Level

Emerging research suggests a complex interplay between asthma severity and ferritin levels, with evidence indicating that lower serum ferritin may be associated with increased asthma exacerbations, highlighting the potential role of iron homeostasis in respiratory health and disease management. The study aims to examine the impact of ferritin levels on asthma severity, assess the moderating effect of gender, and identify biomarkers that exacerbate symptoms in the context of low ferritin. This study enrolled 180 individuals over 18 years, including 120 allergic asthma patients and 60 healthy controls. Asthma patients were categorized based on ferritin levels into 43 males and 17 females with normal levels, and 17 males and 43 females with low levels. The study excluded individuals with other respiratory, autoimmune, or oncologic diseases, and smokers. Blood samples were collected for complete blood count (CBC), ferritin, and Immunoglobulin E (IgE) measurements, with serum samples frozen at -70°C for further analysis. Out of 180 participants, 120 (66.6%) were asthma cases, split evenly between normal and low ferritin levels. The study found significant hematocrit differences (P &lt; 0.01), with the lowest levels in the low ferritin asthma group (35.18 ± 6.74). Ferritin and IgE levels varied markedly across groups (P &lt; 0.05 and P &lt; 0.001, respectively), with the lowest ferritin (9.80 ± 2.39 ng/ml) and highest IgE (327.91 ± 106.81 IU/ml) in the low ferritin asthma group. Regression analysis showed an inverse relationship between ferritin levels and asthma severity (B = -20.46, P &lt; 0.001),

Small airway involvement in severe asthma: how common is it and what are its implications?

Asthma is a prevalent chronic respiratory disease affecting all age groups globally, causing significant morbidity and mortality. Small airway involvement, often undetected by traditional spirometry, has emerged as a critical aspect of asthma pathophysiology, especially in severe cases. This retrospective observational study aimed to assess small airway dysfunction using impulse oscillometry (IOS) in 94 severe asthma patients. Results indicated that 27.3% of patients had small airway obstruction. While spirometry showed no statistical differences between groups, IOS parameters were significantly different, highlighting its sensitivity in detecting small airway disease. Patients with small airway involvement exhibited poorer asthma control, emphasizing the clinical relevance of identifying and addressing small airway dysfunction. The study underscores the need for comprehensive evaluation tools like IOS alongside spirometry, especially in severe asthma management. Further large-scale studies are warranted to validate IOS's utility in optimizing therapeutic strategies and improving asthma control, particularly in resource-limited settings. Recognizing and addressing small airway involvement could lead to individualized management approaches and better outcomes in severe asthma patients.

Budesonide/formoterol turbuhaler vs pMDI salbutamol for acute asthma in outpatient emergency department: a prospective, randomized, open-label study

Background The Global Initiative for Asthma (GINA) has suggested the need for more studies on inhaled corticosteroid (ICS)-formoterol in the Emergency Department (ED). Objectives We aimed to compare the outcomes of budesonide/formoterol (160/4.5 mcg/inhalation) turbuhaler versus pressurized metered-dose inhaler (pMDI) salbutamol (100 mcg/puff) in acute asthma in the outpatient ED. Methods This single-centre, prospective, randomized, and open-label study involved adult asthma patients with mild to moderate asthma exacerbation who attended the outpatient ED of a tertiary hospital in Malaysia. The intervention arm received budesonide/formoterol (Symbicort® 160/4.5 mcg) turbuhaler, while the control arm received pMDI salbutamol with a valved holding chamber. Stratified randomization with variable baseline ICS use was employed. Direct discharge rate from outpatient ED was the primary outcome. Vital signs pre- and post-treatment between the two arms were also compared. Results Seventy-four (n = 37 for each arm) asthma patients were recruited. Baseline clinical characteristics were comparable between the two arms. Direct discharge rates from ED were comparable between the intervention (94.6%) and the control (91.9%) arms (p = 1.000). Post-treatment outcomes (respiratory rate, oxygen saturation, peak expiratory flow rate) were similar between the two arms, except for the higher increment of heart rate (p < 0.001) and lesser reduction of blood pressure in the control arm (p = 0.013). Intravenous hydrocortisone use was significantly higher in the control arm (n = 19, 51.4%) than in the budesonide/formoterol arm (n = 6, 16.2%) (p = 0.001). Conclusion Budesonide/formoterol turbuhaler is as effective as pMDI salbutamol in treating asthma exacerbation in the outpatient ED with less effect on heart rate and lower usage of intravenous corticosteroids.

Clinical characteristics of adult asthma patients hospitalized by COVID-19 in Mexico City: a real-world study

Background The COVID-19 pandemic raised concerns about whether individuals with chronic respiratory diseases, such as asthma, were at higher risk of severe outcomes. Although several studies were published on this topic, not all included asthma as a risk factor. Therefore, describing the clinical characteristics of COVID-19-infected asthma patients in a specialized respiratory center is valuable as a real-life study. Objective To investigate the clinical characteristics and disease severity in SARS-CoV-2-infected adults with pre-existing asthma hospitalized at the National Institute of Respiratory Diseases (INER) in Mexico City. Methods We conducted a retrospective, observational study on adults with confirmed COVID-19 hospitalized from March 2020 to June 2021. Out of 2,249 reviewed medical records, we identified asthmatic patients and compared them with a matched non-asthmatic control group to assess asthma’s impact on COVID-19 severity and outcomes. Results Based on the clinical records, asthma prevalence among hospitalized patients was low (1.51%); of these, 73% had allergic and 27% had non-allergic asthma. COVID-19 severity did not vary significantly between asthma phenotypes, although there was higher mortality among patients with non-allergic asthma. Most patients in both groups developed a severe form of the disease and higher mortality rates than non-asthmatics, though the differences were not statistically significant. Conclusion Asthma prevalence among patients with COVID-19 was low, but mortality was higher in asthma patients. Although the small sample size limits the generalizability of these findings, this study in a Mexican population hospitalized in a reference hospital provides insights for improving asthma management in future pandemics.

Add-on inhalation devices correlation and influence on Asthmatic patients

Add-on inhalation devices correlation and influence on Asthmatic patients

Results from a UK consensus about the optimal prescribing of medium strength triple therapy in uncontrolled adult asthma patients in the NHS

ABSTRACT Context: An inhaled corticosteroid (ICS) in combination with a long-acting β2-agonist (LABA) is a common treatment approach for asthma patients not controlled on ICS alone, but a significant proportion of patients remain uncontrolled on this combination and treatment adherence can also be a challenge. One of the options for adults whose asthma is uncontrolled in an ICS/LABA is the addition of a long-acting muscarinic receptor antagonist (LAMA), an approach commonly referred to as ‘triple therapy’. The use of medium-strength ICS/LABA/LAMA is established in treating chronic obstructive pulmonary disease but is less well-established in asthma. Lack of clarity exists regarding who should prescribe ICS/LABA/LAMA and in which patients, and this is compounded by a lack of consistency among guidelines. Aims: To define the optimal prescribing of medium-strength ICS/LABA/LAMA triple therapy in adult asthma patients uncontrolled on ICS/LABA. Methods and Material: Using a modified Delphi method, a panel of experts developed 39 Likert scale statements across six key domains. These statements were used to develop an online survey that was distributed to healthcare providers (HCPs) working with adult asthma throughout the UK. The threshold for consensus was set at 75%. Results: In total, 314 responses were received from primary and secondary care stakeholders involved in the management of asthma. On analysis, 22/39 statements reached a very strong agreement (≥90%) and 16/39 attained strong agreement (≥75% and &lt; 90). From these results, the panellists developed a set of twelve recommendations to help define how an optimal approach for prescribing triple therapy in patients who are uncontrolled on an ICS/LABA can be achieved. Conclusions: The strength of agreement shows that HCPs support the use of medium-strength ICS/LABA/LAMA triple therapy in appropriate asthma patients, and that clarity is needed regarding how best this can be achieved. The proposed set of recommendations provides such guidance to support the prescribing of triple therapy in primary care.

Ecuadorian healthcare professionals’ perspectives on attributes of asthma care coordination: a qualitative study

ObjectiveThis study explored the attributes of asthma care coordination from the perspective of healthcare professionals at different levels of care in Ecuador.DesignQualitative descriptive study. The Integrated Health Networks Model was...

What is the true target population for biologics in real-life COPD or asthma-COPD overlap patients?

IntroductionBiologics provide significant benefits in asthma, reducing exacerbations and symptoms. Some biologics have shown promising results in small subgroups of patients with chronic obstructive pulmonary disease (COPD) and frequent exacerbations....

Longitudinal multi-trajectory phenotypes of severe eosinophilic asthma on type 2 biologics treatment

BackgroundLimited understanding exists regarding the progression trajectory of severe eosinophilic asthma (SEA) patients on type 2 biologics therapies. ObjectiveWe aim to explore distinct longitudinal phenotypes of these patients based on crucial asthma biomarkers. MethodsWe enrolled 101 adult patients with SEA. Of these, 51 were treated with anti-IL5/IL5Rα or anti-IL5/IL5RαR antibody, and 50 with anti-IL-4Rα antibody. Multi-trajectory analysis, an extension of univariate group-based trajectory modeling, was used to categorize patients based on their trajectories of forced expiratory volume in 1 s (FEV1), blood eosinophil counts (BEC), and fractional exhaled nitric oxide (FeNO) levels at baseline, and after 1, 6, and 12 months of treatment. Associations between trajectory-based clusters and clinical parameters were examined. ResultsAmong anti-IL5/IL5Rα antibody-treated patients, 2 clusters were identified. The cluster characterized by higher baseline BEC and lower FEV1 showed a better response, with improvements in FEV1 and reductions in BEC over time. Among anti-IL-4Rα antibody-treated, 3 clusters were identified. Clusters with moderate BEC and FeNO at baseline demonstrated better improvements in FEV1 and reductions in FeNO, despite increased BEC during follow-up. Conversely, individuals with extremely low FeNO and high BEC at baseline were more likely to experience poorer progression, demonstrating an increase in FeNO and a reduction in FEV1. ConclusionTo optimally monitor treatment response in SEA patients on type 2 biologics, integrating longitudinal biomarker features is essential.

A randomized crossover study assessing critical errors, preferences, and ease of use of two multidose powder inhalers

ABSTRACT Background The effectiveness of inhaled medications in asthma and COPD is significantly impacted by inhalation errors. Feedback mechanisms, built into the design of the inhaler might reduce the number of critical errors. This study compares critical errors, preferences, and ease of use of two dry powder inhalers, the Nexthaler and the Turbuhaler. Research design and methods In this multi-center, prospective, randomized, open-label, cross-over study, the proportions of asthma and COPD patients making critical errors were compared between the Nexthaler and Turbuhaler after 4 weeks of clinical use, after having been trained in the correct use of both inhalers. Results 90 and 49 patients with asthma and COPD, respectively were assessed. No significant difference was found in the number of critical errors between the two inhalers (3 with Nexthaler and 5 with Turbuhaler). However, more patients preferred the Nexthaler (57.6%) over the Turbuhaler (34.5%) (p = 0.006), while 7.9% stated no preference. Conclusions The study found no significant differences in critical error rate between the Nexthaler and Turbuhaler but the Nexthaler was preferred over the Turbuhaler. This study highlights the importance of dedicating sufficient time to instructing patients in correct inhalation technique, which can lead to long-term retention of the inhalation technique. Trial Registration The trial is registered at International Clinical Trials Registry Platform. Trial number NL-OMON55778.

Assessment of Exercise Capacity in Patients Diagnosed with Moderate and Severe Bronchial Asthma: Preliminary Prospective Observational Study.

The main objective of the study was to assess exercise capacity and physical activity levels in patients with bronchial asthma compared to a control group without asthma, as well as to investigate how asthma severity affects the results of the 6MWT and physical activity as measured by the IPAQ questionnaire. A total of 63 individuals were studied, divided into two groups: Group A, consisting of 33 individuals with bronchial asthma, and Group B, consisting of 30 individuals from the general population without bronchial asthma. In both groups, the following assessments were performed: The Six-Minute Walk Test (6MWT), The International Physical Activity Questionnaire (IPAQ) and the Borg rating of perceived exertion scale (the Borg RPE scale) ABB. It was demonstrated that patients with moderate asthma covered more distance during the 6MWT than patients diagnosed with severe asthma. The difference in metres covered between the two groups was statistically significant (p < 0.001), which could be observed during the walk test. The results indicate that a larger proportion of patients with asthma (76%) fall into the insufficient physical activity category compared to those without asthma (24%). Conversely, a higher percentage of non-asthmatic individuals (66.67%) report sufficient physical activity compared to asthmatic patients (33.33%)(P=0.005). This study demonstrated that asthma severity significantly impacts exercise capacity, as shown by shorter distances covered in the 6-minute walk test (6MWT) among patients with severe asthma. While overall physical activity levels (measured by the IPAQ) were not significantly different between asthma and non-asthma groups, asthma patients exhibited significantly more sitting time, suggesting a more sedentary lifestyle.

Reproducibility of spirometry in asthmatic children between 5-12 years of age.

Objective: To investigate how consistently children (aged 5-12) attending the asthma clinic at Abbasi Shaheed Hospital could perform forced expiratory maneuvers during standard spirometric evaluation. Study Design: Cross-sectional. Setting: Department of Paediatric, Abbasi Shaheed Hospital, Karachi. Period: October, 2021 till April, 2022. Methods: Prospective data collection was conducted on 128 suspected asthmatic patients following verbal consent. Simple descriptive statistics, including mean and standard deviation, were used to summarize quantitative data, while qualitative variables were reported as frequencies and percentages. Stratification was used to manage effect modifiers and evaluate their influence on the outcome variable. A post-stratification chi-square test was employed, with a significance level set at p ≤ 0.5. Results: A total of 128 suspected asthmatic patients were included in this study. Mean age in our study was 9.14±2.09 years. 58 (45.3%) were male and 70 (54.7%) were female. Out of 128 suspected asthmatic patients, 95 (74.2%) and 33 (25.8%) had and did not have reproducibility. Conclusion: In a busy clinical environment, a significant number of school-aged children demonstrate the ability to perform technically acceptable and repeatable spirometry. This indicates that spirometry could serve as an effective screening tool for identifying abnormal lung function, such as asthma, in this age group.

Associations of advanced lung cancer inflammation index with all-cause and respiratory disease mortality in adults with asthma: NHANES, 1999–2018

The Advanced Lung Cancer Inflammation Index (ALI) represents both the inflammatory and nutritional status of the host, but its link with mortality in asthma patients is uncertain. The purpose of this study was to look at the relationship between ALI levels and all-cause and respiratory disease mortality in asthmatic patients. We conducted our research using cohort data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. The National Death Index was used to calculate mortality until December 31, 2019. The study employed multivariate logistic regression to look into the relationship between ALI levels and asthma prevalence. Weighted Kaplan–Meier and multivariate-adjusted Cox analyses were utilized for investigating the relationship between ALI levels and all-cause and respiratory disease mortality in individuals with asthma. A restricted cubic spline (RCS) analysis was used to assess their nonlinear relationship. Subgroup and sensitivity analyses were also performed to evaluate the robustness of the results that were obtained. We enrolled 40,497 people in our study, and 5,469 of them had asthma, representing a 14% prevalence. A median follow-up of 11.19 (9.38, 14.29) years revealed 109 fatalities from respiratory diseases and 724 deaths from all causes. After correcting for several covariates, there was no longer any link (P-trend = 0.2) between ALI levels and the prevalence of asthma. When compared to the lowest quartile, the highest quartile of ALI levels was substantially linked to a lower risk of mortality from respiratory diseases and all causes (all P-trend < 0.001). In the RCS regression model, the relationship between ALI level and both all-cause and respiratory disease mortality in asthmatic participants was nonlinear, with P for nonlinearity of 0.006 and 0.015, respectively. We also discovered that the probability of mortality from respiratory disease decreased progressively to a nadir at an ALI level of 109.13 and then increased as the ALI level increased. Multiple subgroup and sensitivity analyses revealed that ALI was consistently related to lower all-cause and respiratory disease mortality in asthma patients. Our findings suggest that ALI is associated with a reduced risk of all-cause and respiratory disease mortality in asthma patients.