Pulmonary Function In Asthmatics Research Articles

P3‐2: Impact of air pollutant of polycyclic aromatic hydrocarbons (PAHS) on the yearly decline of pulmonary function in asthmatics sensitized to house dust mite (HDM)

P3‐2: Impact of air pollutant of polycyclic aromatic hydrocarbons (PAHS) on the yearly decline of pulmonary function in asthmatics sensitized to house dust mite (HDM)

Impact of nasosinusal endoscopic surgery by polyposis on inflammation, control and pulmonary function in asthma

Impact of nasosinusal endoscopic surgery by polyposis on inflammation, control and pulmonary function in asthma

Impulse oscillometry usefulness in small-airway dysfunction in asthmatics and its utility in asthma control

BackgroundSmall-airway affection and its relation to clinical status in asthmatic patients became an increasing interest during the last decade. Spirometry is a basic diagnostic tool for measuring pulmonary function in asthmatics but not fully illustrative especially in assessing small airways. Impulse oscillometry (IOS) can be considered a complementary and sometimes alternative technique to spirometry because it is used during quiet breathing and so gives more data about small-airways affection in asthmatic patients.AimTo evaluate IOS usefulness in the detection of small-airways disease in asthma and its correlation to the level of disease control.Patients and methodsThe study was conducted on 44 asthmatic patients who were classified into two groups: controlled asthma and uncontrolled asthma by asthma control test questionnaire (ACT score). Spirometry and IOS were performed on all patients.ResultsSmall-airway IOS values (R5–20, X5, and AX) were found to be statistically significant between two groups. Moreover, they strongly correlated significantly with clinical symptoms, assessed by ACT. There was high sensitivity and specificity of (R5–20) 80 and 82%, (X5) 80 and 86%, and (AX) 86 and 89%, while for spirometric data only forced expiratory flow (FEF25–75%) showed a statistically significant difference between the two groups, and not FEV1% and there was poor correlation between ACT and FEF25–75%.ConclusionIOS provides an easy and rapid tool to diagnose and assess small-airways disease in adult, asthmatic patients

Improvement of exertional dyspnea and breathing pattern of inspiration to expiration after bronchial thermoplasty

BackgroundBronchial thermoplasty (BT) is a bronchoscopic treatment that can ameliorate the symptoms of severe asthma. However, little is known about the mechanism by which BT improves exertional dyspnea without significantly changing the resting pulmonary function in asthmatics. To understand the mechanism, cardiopulmonary variables were investigated using cardiopulmonary exercise testing (CPET) in a patient with severe asthma before and after BT.Case presentationA 57-year-old Japanese man visited our hospital for consultation of the intractable asthma, which we managed with three treatment sessions of BT. Comparison of the findings pre-BT and at 1 year after BT demonstrated that (1) the resting tests for respiration showed no improvement in forced expiratory volume in 1 s, but the forced oscillation technique showed decreases in both inhalation and exhalation respiratory resistance values, and (2) the CPET results showed (i) improvement in exertional dyspnea, exercise endurance, and arterial oxygen saturation at the end of exercise; (ii) that the expiratory tidal volume exceeded the inspiratory tidal volume during exercise, which implied that a sufficient exhalation enabled longer inspiratory time and adequate oxygen absorption; and (iii) that an increase in respiratory frequency could be prevented throughout exercise.ConclusionsThis case report described a novel mechanism of BT in improving exertional dyspnea and exercise duration, which was brought about by ventilatory improvements related to the breathing pattern of inspiration to expiration.

6.8 Pilot Study of the Effect of Attention-Deficit/Hyperactivity Disorder (ADHD) on Child Asthma: Autonomic Nervous System Dysregulation As a Mediator?

Childhood asthma and ADHD co-occur more frequently than their individual prevalence rates, with asthma disease severity being worse in these populations. The underlying cause of this is not known. There is evidence for autonomic nervous system (ANS) dysregulation in both stress-induced compromise of pulmonary function in asthma and in ADHD. We assessed ANS dysfunction, in particular vagal reactivity, as a possible mechanism by which ADHD could worsen child asthma because vagal/cholinergic mechanisms mediate airway constriction. We tested these hypotheses: 1) children with asthma plus ADHD have greater asthma disease severity, worse pulmonary function, and greater vagal reactivity compared to children with asthma alone; and 2) greater asthma disease severity and worse pulmonary function are associated with greater vagal reactivity.

Seasonal Effect of Eicosanoids on Pulmonary Function in Asthma with Concomitant Rhinitis Caused By Japanese Cedar Pollinosis.

Seasonal Effect of Eicosanoids on Pulmonary Function in Asthma with Concomitant Rhinitis Caused By Japanese Cedar Pollinosis.

Asthma is not only an airway disease, but also a vascular disease.

Multiple studies have identified an expansion and morphological dysregulation of the bronchial vascular network in the airways of asthmatics. Increased number, size and density of blood vessels, as well as vascular leakage and plasma engorgement, have been reported in the airways of patients with all grades of asthma from mild to fatal. This neovascularisation is an increasingly commonly reported feature of airway remodelling; however, the pathophysiological impact of the increased vasculature in the bronchial wall and its significance to pulmonary function in asthma are unrecognised at this time. Multiple factors capable of influencing the development and persistence of the vascular network exist within asthmatic airway tissue. These include structural components of the altered extracellular matrix (ECM), imbalance of proteases and their endogenous inhibitors, release of active matrikines and the dysregulated levels of both soluble and matrix sequestered growth factors. This review will explore the features of the asthmatic airway which influence the development and persistence of the increased vascular network, as well as the effect of enhanced tissue perfusion on chronic inflammation and airway dynamics. The response of cells of the airways to the altered vascular profile and the subsequent influence on the features of airway remodelling will also be highlighted. We will explore the failure of current asthma therapeutics in "normalising" this vascular remodelling. Finally, we will summarize the outcomes of recent clinical trials which provide hope that anti-angiogenic therapies may be a potent asthma-resolving class of drugs and provide a new approach to asthma management in the future.

Study effect of two breathing techniques on pulmonary function in asthma

Aim of our study is effect of breathing techniques on pulmonary functions in bronchial asthma before and after yogic pranayama intervention of 2 months. Eighty stable asthmatic-patients were randomized into two groups i.e group 1 (Pranayama training group) and group 2 (control group). Each group included forty patients. Lung functions were recorded on all patients at baseline, and then after two months. Both the groups were allowed to continue with their usual physical activity and medications. Group 1 subjects showed a statistically significant improvement (P<0.001) in Forced vital capacity (FVC), Forced expiratory volume in 1st sec (FEV1), Peak expiratory flow rate (PEFR). Quality of life also increased significantly. Training-induced changes were greater in group 1 than 2 for following variables: increase of FVC (% predicted) (p=0.11), FEV1 (% predicted) , (p=0.15), PEF (%predicted) from (p<0.05), It was concluded that pranayama & yoga breathing techniques are useful to increasing the strength of chest muscles, expand the lung capacity, raise energy levels, and calm the mind and body.

Hydrogen Peroxide Content and pH of Expired Breath Condensate from Patients with Asthma and COPD

Background: Oxidative stress is implicated in the pathogenesis of asthma and chronic obstructive pulmonary disease (COPD). Analysis of the expired breath condensate (EBC) has been suggested to provide non-invasive inflammatory markers that reflect oxidative stress in the airways. Objective: The present study attempts to elucidate whether the hydrogen peroxide (H2O2) levels and pH values in EBC may be useful as biomarkers of the activity or severity of asthma and COPD. Methods: We measured the H2O2 levels and pH values using a derivatives of reactive oxygen metabolites exhalation test kit (Diacron) and a pH analyser, respectively, in EBC obtained using an EcoScreen from 29 patients with asthma, 33 with COPD, and 33 healthy individuals (all non-smokers). We then examined the relationships among oxidative stress and the asthma control test (ACT) or COPD assessment test (CAT) scores, pulmonary function, fractional exhaled nitric oxide (FeNO), and the extent of low attenuation areas on HRCT. Results: The H2O2 levels were elevated and pH was lower in both asthma (H2O2; 8.75 ± 0.88 μM, p < 0.01, pH; 7.14 ± 0.07, p < 0.05) and COPD (H2O2; 7.44 ± 0.89 μM, p < 0.01, pH; 6.87 ± 0.10, p < 0.01) compared with control subjects (H2O2; 3.42 ± 0.66 μM, pH; 7.35 ± 0.04). Neither the H2O2 levels nor pH correlated with the ACT scores and FeNO in asthma patients. Neither the H2O2 levels nor pH significantly correlated with the pulmonary function in asthma and COPD. However, the CAT scores significantly correlated with the H2O2 levels in patients with COPD (r = 0.52, p < 0.01). Conclusions: These findings suggest that oxidative stress is involved in the pathogenesis of asthma and COPD and that the H2O2 levels in EBC might reflect the health status in COPD.

The role of eosinophils and basophils in allergic diseases considering genetic findings

Basophils and eosinophils represent less than 1 and 5% of white blood cells, respectively. Their role in asthma and allergic inflammation remains incompletely defined. The present review addresses recent advances regarding the role of these two cell populations in allergic inflammation and asthma regarding both biological and genetic point of view. Regarding eosinophils, the role of interleukin(IL)-25, IL-33 and thymic stromal lymphoprotein (TSLP) have been evidenced, and activation states of eosinophil β1 and β2 integrins have been found to correlate with the measurement of eosinophil recruitment and pulmonary function in asthma. New insights into the biology of basophils concern their role as regulators of Th2 cell response through IL-4 expression or the differentiation of monocytes to macrophages, and their population heterogeneity in human. The transcription factor PU.1 was reported to be involved in controlling transcription of specific genes both in eosinophils and basophils. Candidate genetic studies on eosinophils have explored genes involved in the intracellular calcium influx and apoptosis. At the genome-wide level, studies identified genetic variants belonging to IL1RL1, TSLP and IL-33, and four loci with pleiotropic effects on eosinophil and basophil counts [GATA2 (3q21), MHC (6p21), HBS1L-MYB (6q23), and ERG (21q22)]. Recent findings from biological and genetic studies on eosinophils and basophils highlight the role of epithelial cell-derived cytokines such as TSLP and IL-33 in asthma and allergic diseases.

Integrin Activation States and Eosinophil Recruitment in Asthma

Eosinophil arrest and recruitment to the airway in asthma are mediated, at least in part, by integrins. Eosinophils express α4β1, α6β1, αLβ2, αMβ2, αXβ2, αDβ2, and α4β7 integrins, which interact with counter-receptors on other cells or ligands in the extracellular matrix. Whether a given integrin-ligand pair mediates cell adhesion and migration depends on the activation state of the integrin. Integrins exist in an inactive bent, an intermediate-activity extended closed, and a high-activity extended open conformation. Integrin activation states can be monitored by conformation-specific monoclonal antibodies (mAbs). Studies in mice indicate that both β1 and β2 integrins mediate eosinophil recruitment to the lung. In vitro studies indicate that α4β1 and αMβ2 are the principal integrins mediating eosinophil adhesion, including to vascular cell adhesion molecule-1 and the novel αMβ2 ligand periostin. In vivo, blood eosinophils have intermediate-activity β1 integrins, as judged by mAb N29, apparently resulting from eosinophil binding of P-selectin on the surface of activated platelets, and have a proportion of their β2 integrins in the intermediate conformation, as judged by mAb KIM-127, apparently due to exposure to low concentrations of interleukin-5 (IL-5). Airway eosinophils recovered by bronchoalveolar lavage (BAL) after segmental antigen challenge have high-activity β1 integrins and high-activity αMβ2 that does not require IL-5. Here we review information on how the activation states of eosinophil β1 and β2 integrins correlate with measurements of eosinophil recruitment and pulmonary function in asthma. Blood eosinophil N29 reactivity is associated with decreased lung function under various circumstances in non-severe asthma and KIM-127 with BAL eosinophil numbers, indicating that intermediate-activity α4β1 and αMβ2 of blood eosinophils are important for eosinophil arrest and consequently for recruitment and aspects of asthma.

Gastroesophageal reflux disease in our asthma patients: the presence of dysphagia can influence pulmonary function

Background: The prevalence of Gastroesophageal Reflux Disease (GERD) in Turkey is reported as 11.6%. Studies of pulmonary function in asthmatics have demonstrated a correlation between lung resistance and the occurrence of spontaneous gastroesophageal reflux. Few studies have included measures of lung diffusing capacity for carbon monoxide. The aim of this study is to assess whether asthma patients had worse lung function and gas diffusion according to diversity of GERD symptoms they concurrently experienced. The secondary aim of the study is to determine the frequency and different faces of GERD in our asthma patients compared to healthy controls. Methods: Sixty consecutive asthma patients evaluatd at the pulmonary specialty outpatient clinic were included in the study. The control group included 60 healthy volunteers who had normal pulmonary function and routine laboratory tests. A modified version of a self-reported questionnaire developed by Locke and associates at the Mayo Clinic was conducted face-to-face with consecutive asthma patients and control subjects. Pulmonary function measurements were taken using spirometry. DLCO (mL/dk/mmHg) and DLCO/VA (DLCO adjusted according to alveolar volume) were measured using a single-breath technique. Statistical analyses were performed using the SPSS 17.0 statistical software. Results: DLCO and DLCO/VA were significantly lower in asthma patients who had dysphagia symptoms. Frequent and significant acid regurgitations were seen in 28.33% (n = 17) of patients in the study group and 6.7% (n = 4) of patients in the control group. Severe, troublesome heartburn symptoms were reported by 28.2% (n = 17) of patients in the study group and 16.7% (n = 10) of subjects in the control group. Dysphagia was detected in 38.3% (n = 23) of all asthma cases and in 1.7% (n = 1) of the subjects in the control group. Conclusions: There were many faces of gastroesophageal reflux disease in our asthmatic patients. Dysphagia was the only GERD symptom influencing on pulmonary function tests, while gastroesophageal reflux symptoms and nocturnal awakening attacks were common in this study.

Gastroesophageal reflux disease in our asthma patients: the presence of dysphagia can influence pulmonary function

BackgroundThe prevalence of Gastroesophageal Reflux Disease (GERD) in Turkey is reported as 11.6%. Studies of pulmonary function in asthmatics have demonstrated a correlation between lung resistance and the occurrence of spontaneous gastroesophageal reflux. Few studies have included measures of lung diffusing capacity for carbon monoxide. The aim of this study is to assess whether asthma patients had worse lung function and gas diffusion according to diversity of GERD symptoms they concurrently experienced. The secondary aim of the study is to determine the frequency and different faces of GERD in our asthma patients compared to healthy controls.MethodsSixty consecutive asthma patients evaluatd at the pulmonary specialty outpatient clinic were included in the study. The control group included 60 healthy volunteers who had normal pulmonary function and routine laboratory tests. A modified version of a self-reported questionnaire developed by Locke and associates at the Mayo Clinic was conducted face-to-face with consecutive asthma patients and control subjects. Pulmonary function measurements were taken using spirometry. DLCO (mL/dk/mmHg) and DLCO/VA (DLCO adjusted according to alveolar volume) were measured using a single-breath technique. Statistical analyses were performed using the SPSS 17.0 statistical software.ResultsDLCO and DLCO/VA were significantly lower in asthma patients who had dysphagia symptoms. Frequent and significant acid regurgitations were seen in 28.33% (n = 17) of patients in the study group and 6.7% (n = 4) of patients in the control group. Severe, troublesome heartburn symptoms were reported by 28.2% (n = 17) of patients in the study group and 16.7% (n = 10) of subjects in the control group. Dysphagia was detected in 38.3% (n = 23) of all asthma cases and in 1.7% (n = 1) of the subjects in the control group.ConclusionsThere were many faces of gastroesophageal reflux disease in our asthmatic patients. Dysphagia was the only GERD symptom influencing on pulmonary function tests, while gastroesophageal reflux symptoms and nocturnal awakening attacks were common in this study.

326 Lung Age/Chronological Age Index as Indicator of Clinical Improvement or Severity in Asthma Patients

BackgroundSpirometry is a very useful clinical test to evaluate pulmonary function in asthma. However pulmonary function could be affected by the sex, time of clinical evolution, lung age (LA) and chronological age (CA). The aim of this study was to evaluate LA/CA as index of clinical improvement or severity in asthma patients.MethodsThe tenets of the Declaration of Helsinki were followed, and all patients gave their informed consent to participate in this study. Asthma severity was evaluated according with GINA classification. Spirometry was performed at the beginning of this study, at 46 days, 96 days, 192 days and after 8 months. Statistical analysis was performed using t test, 2-way ANOVA test, correlation and multiple regression models as well as ROC curves were also performed, a P < 0.05 was considered as significant.Results70 asthma patients were included (22 male and 48 female), mean CA was 35-years old; mean LA was 48-years with a LA/CA index = 1.4, time of clinical evolution was 13 years. A LA/CA index = 1 (range 0.5 to 0.9) was observed in asymptomatic patients. LA/CA index over 1 were related with airway inflammation, and a LA/CA index more than 2 correlated with GINA step 3. Interestingly when we analyzed CA and LA, we observed that in female group more than 10 years of difference between CA and LA, (GINA Step2 and 3); while in male we observed (GINA Step1, Step2 and Step3). LA/CA index ≤ 1 was considered as normal.ConclusionsLA/CA index is a good as clinical indicator of clinical improvement or severity in asthma patients in with excellent correlation of pulmonary function and age.

The Role ofMycoplasma pneumoniaeInfection in Asthma

The Role of<i>Mycoplasma pneumoniae</i>Infection in Asthma

The role of medical antireflux in asthmatics with gastroesophageal reflux:a systematic review

to evaluate the effect of antireflux treatment in asthma patients with gastroesophageal reflux disease (GERD). prospective randomized trials of antireflux treatment in asthma patients with gastroesophageal reflux were all included. Antireflux treatment should be double-blinded. Sample size and matching ways were not restricted. The study subjects were defined as asthmatic patients with gastroesophageal reflux aged 13 or older. Computer searching included The Cochrane Central Register of Controlled Trials, PubMed, Embase, OVID database, Chinese Biological Medicine database (CBMdisc), China National Knowledge Infrastructure (CNKI), and Wanfang Data. Manual searching included Chinese Journal of Tuberculosis and Respiratory Diseases, Chinese Journal of Digestion, Chinese Journal of Internal Medicine, CHEST and the references of trails included. The search ended on November of 2009. Trials with subjects using antireflux drugs in 3 days before entry, trials repeatly or mutiply published, and trials with methodology quality under grade B were excluded. With the method of Cochrane systematic review, 2 reviewers assessed the quality of the studies, extracted data independently and cross checked the data. Data were combined and analyzed with RevMan 4.3.2 to evaluate the effect of antireflux treatment on asthmatic patients with gastroesophageal reflux disease. fourteen randomized controlled studies met inclusion criteria, including 1555 cases. Meta-analyses demonstrated that antireflux treatment improved the pulmonary function in asthmatics with gastroesophageal reflux. Compared to the placebo group, FEV(1) improved [WMD 0.11 L; 95%CI (0.02 - 0.20); Z = 2.49, P = 0.010]; and PEF also improved, including daytime PEF [WMD 42.33 L/min; 95%CI (3.39 - 81.28), Z = 2.13, P = 0.030], morning PEF [WMD 16.16 L/min; 95%CI (5.91 - 26.41); Z = 3.09, P = 0.002], and nighttime PEF [WMD 18.35 L/min; 95%CI (6.77 - 29.92); Z = 3.11, P = 0.002]. However, no significant difference was found in the decrease of provocative concentration of acetylcholine causing a 20% decrease in FEV(1) (PC20-FEV(1)) [WMD -0.07 mg/L; 95%CI (-0.33 -0.19); Z = 0.55, P = 0.590]. Eight out of 14 studies showed improvement in asthma symptoms after antireflux treatment, but neither daytime symptoms nor nighttime symptoms showed significant improvement in this Meta-analysis. antireflux treatment in asthmatics with gastroesophageal reflux could improve pulmonary function, but showed no significant effect on airway hyper-responsiveness or asthma symptoms.

Aerosolized red tide toxins (brevetoxins) and asthma: Continued health effects after 1 h beach exposure

Blooms of the toxic dinoflagellate, Karenia brevis, produce potent neurotoxins in marine aerosols. Recent studies have demonstrated acute changes in both symptoms and pulmonary function in asthmatics after only 1 h of beach exposure to these aerosols. This study investigated if there were latent and/or sustained effects in asthmatics in the days following the initial beach exposure during periods with and without an active Florida red tide. Symptom data and spirometry data were collected before and after 1 h of beach exposure. Subjects kept daily symptom diaries and measured their peak flow each morning for 5 days following beach exposure. During non-exposure periods, there were no significant changes in symptoms or pulmonary function either acutely or over 5 days of follow-up. After the beach exposure during an active Florida red tide, subjects had elevated mean symptoms which did not return to the pre-exposure baseline for at least 4 days. The peak flow measurements decreased after the initial beach exposure, decreased further within 24 h, and continued to be suppressed even after 5 days. Asthmatics may continue to have increased symptoms and delayed respiratory function suppression for several days after 1 h of exposure to the Florida red tide toxin aerosols.

Effectiveness of aerobic exercise training in improving pulmonary function in asthmatics

Asthma exemplifies a major medical concern and is a considerable cause of morbidity and mortality in Western society. Controversy stillexists regarding the most effective mode and intensity of exercise training for asthmatics. Thus, the purpose of the study was to determine whether walking or jogging at 60% of age-predicted heart rate maximum canincrease effort-dependent pulmonary function parameters in moderate, persistent asthmatics. Forty-four sedentary asthmatics were randomly assigned to either a non-exercising control (NE) group (n = 22) or an eight-week moderate-intensity aerobic exercise (AE) group (n = 22). Results indicated that the subjects in the AE training group significantly(p = 0.05) increased their forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximal voluntary ventilation (MVV) and inspiratory vital capacity (IVC). The NE group did not exhibit any significant changes in any of the measured variables. Therefore, walking or jogging at 60% heart rate maximum for 30 minutes three times a week for eight weeks can effectively improve the effort-dependent pulmonary parameters in moderate, persistentasthmatics. This represents a strong argument to support the inclusion of this mode of aerobic training in the treatment of moderate, persistent asthma due to its effectiveness, inexpensiveness and lowrisk.

Randomized, placebo-controlled study of a selective PDE4 inhibitor in the treatment of asthma

Phosphodiesterase-4 (PDE4) inhibitors have potential utility as a new therapeutic approach to improving symptoms and pulmonary function in asthma and COPD. This study evaluated the efficacy and safety of MK-0359, a selective and potent oral PDE4 inhibitor, in chronic asthma. Adults (N=88) with > or =1 year asthma history and an FEV(1) 50-80% predicted were randomized to double-blind treatment with MK-0359 (15mg/day) or placebo for 14 days, then crossed-over to the other treatment for 14 days. The primary endpoint was the change from baseline in FEV(1) at the end of each 2-week treatment period. Secondary and other endpoints included the changes from baseline in Daytime asthma symptom score, Nighttime asthma symptom score, Total daily beta-agonist use (puffs/day), AM and PM peak expiratory flow (PEF) and overall asthma-specific quality-of-life. Safety and tolerability were assessed by clinical adverse experiences. MK-0359 significantly improved the primary endpoint (versus placebo): the least-squares mean difference in change from baseline in FEV(1) (L) was 0.09L (95% CI 0.01, 0.18). Endpoints of Daytime asthma symptom score, Nighttime asthma symptom score, Total daily beta-agonist use, AM PEF, PM PEF, and quality-of-life were also significantly improved. Nineteen patients (24.1%) on MK-0359 and 8 patients (10.4%) on placebo reported gastrointestinal clinical adverse experiences. Serious gastrointestinal clinical adverse experiences were reported in 3 patients while receiving MK-0359. Over a 14-day treatment period, the oral PDE4 inhibitor MK-0359 improved lower airway function, symptoms and rescue medication use in chronic asthma, although at the expense of gastrointestinal adverse experiences. (Clinical trial registry number: NCT00482898.).

Effect of omeprazole and domperidone on adult asthmatics with gastroesophageal reflux

To study the effect of combined omeprazole (Ome) and domperidone (Dom) therapy on asthma symptoms and pulmonary function in asthmatics with gastroesophageal reflux. We selected 198 asthmatics with gastroesophageal reflux diagnosed by 24-h esophageal pH monitoring to receive Ome 20 mg twice daily and Dom 10 mg three times daily or placebo for 16 wk (1:1 double-blind randomization). Spirometry was done at baseline and after 16 wk of treatment. The primary outcome measures were: mean daily daytime and nighttime asthma symptom scores. Mean daily reflux symptom scores, albuterol use as rescue medication (number of puffs), daytime and nighttime peak expiratory flow rate (PEFR), postbronchodilator forced expiratory volume in 1 second (FEV1) and postbronchodilator forced vital capacity (FVC) were secondary outcome measures. Comparison of mean change from baseline between antireflux therapy and placebo groups revealed significant reduction in daytime asthma symptom score (17.4% vs 8.9%), nighttime asthma symptom score (19.6% vs 5.4%), reflux symptom score (8.7% vs 1.6%) and rescue medication use (23.2% vs 3.1%) after antireflux therapy compared to mean change in placebo group (P < 0.001). There was significant improvement in morning PEFR (7.9% vs 0.2%), evening PEFR (9.8% vs 0.5%), FEV1 (11.1% vs 3.78%) and FVC (9.3% vs 1.52%) in the antireflux therapy group compared to placebo on comparing the mean change from baseline after 16 wk (P < 0.01). Combined therapy with Ome and Dom in adult asthmatics with gastroesophageal reflux may be beneficial by reducing asthma symptoms, rescuing medication use, and improving pulmonary function.