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Asma , Oscilometría , Humanos , Asma/diagnóstico , Asma/fisiopatología , Asma/epidemiología , Preescolar , Femenino , Masculino , Pulmón/fisiopatología , Pruebas de Función Respiratoria , NiñoRESUMEN
BACKGROUND: Oscillometry devices (also termed forced oscillation technique) devices such as MasterScreen-IOS® (Jaeger, Hochberg, Germany) and MostGraph-01® (Chest, Tokyo, Japan) are useful for obtaining physiological assessments in patients with obstructive lung diseases, including asthma. However, as oscillometry measurements have not been fully compared between MasterScreen-IOS® and MostGraph-01® in patients with asthma, it is unknown whether there are differences in the measurements between the devices. This study aimed to determine whether there is any difference in oscillometry measurements obtained using the two devices in patients with asthma. METHODS: Oscillometry measurements obtained using MasterScreen-IOS® and MostGraph-01® were retrospectively evaluated in 95 patients with asthma at Juntendo University Hospital between October 2009 and November 2009. RESULTS: There was a strong positive correlation in the measurements between the two devices. However, the values of R5, R20, ALX and Fres were lower when measured with MostGraph-01® than with MasterScreen-IOS®, and vice versa for the values of X5. The results were used in correction equations to convert oscillometry parameters measured using MasterScreen-IOS® to those measured using MostGraph-01®. CONCLUSIONS: To our knowledge, this is the first report to compare MostGraph-01® and MasterScreen-IOS® devices using practical clinical data obtained in patients with asthma. The values obtained by both devices can be interpreted in a similar way, although there is slight variation. The conversion equations produced in this study may assist to compare the oscillometry measurements obtained by each of the two devices.
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Asma , Oscilometría , Humanos , Asma/fisiopatología , Asma/diagnóstico , Oscilometría/métodos , Oscilometría/instrumentación , Masculino , Femenino , Persona de Mediana Edad , Anciano , Adulto , Estudios Retrospectivos , Pruebas de Función Respiratoria/métodos , Pruebas de Función Respiratoria/instrumentaciónRESUMEN
BACKGROUND: Asthma is a leading cause of emergency hospital visits and a significant factor in lost productive hours. The lack of a synthesized body of knowledge on bronchial asthma has notable public health implications. OBJECTIVE: This systematic review and meta-analysis aim to investigate the prevalence of asthma and its predictors among patients presenting in Ethiopian public hospitals. DESIGN: Duplicate studies were removed using EndNote version X9. The Newcastle-Ottawa Scale guided the quality assessment, and data extraction followed the Joanna Briggs Institute format. DATA SOURCE AND METHODS: The authors used advanced search methods, including databases such as PubMed, Scopus, Embase, Africa Index Medicus, Science Direct, HINARI, Google Scholar, and manual searches. Data presentation adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Publication bias was assessed using Egger's regression test and a funnel plot. Sensitivity analysis was also conducted. RESULTS: The search yielded 352 original articles, with 22 meeting the criteria for inclusion. Using the random-effects DerSimonian-Laird model, the prevalence of bronchial asthma was found to be 9.02% (95% CI: 7.50, 10.53). Several factors were associated with the prevalence of bronchial asthma, including the spring season (AOR 3.7; 95% CI: 2.11, 6.49), childhood age (AOR 4.2; 95% CI: 1.84, 9.55), and urban residence (AOR 1.7; 95% CI: 1.29, 2.31). Other significant factors include family history of asthma (AOR 2.89; 95% CI: 2.22, 3.75), insecticide exposure (AOR 3.3; 95% CI: 2.23, 4.91), and the presence of household insects like cockroaches (AOR 3.33; 95% CI: 2.15, 5.15). Smoking (AOR 3.64; 95% CI: 2.66, 4.98), obstructive sleep apnea (AOR 4.29; 95% CI: 2.37, 7.76), and recurrent upper respiratory tract infections (AOR 4.31; 95% CI: 2.24, 8.32) were also significant. CONCLUSION: The pooled prevalence of bronchial asthma is notably high in Ethiopia. Key predictors include childhood age, spring season, urban living, family history of asthma, exposure to insecticides, presence of cockroaches, smoking, obstructive sleep apnea, and recurrent upper respiratory infections. Targeted interventions are crucial and should focus on lifestyle improvements, allergen identification, cockroach control, smoking cessation, reducing insecticide exposure, and promoting a safe environment. TRIAL REGISTRATION: This review's protocol was pre-registered with the International Prospective Register of Systematic Reviews (PROSPERO registration number CRD42023491222).
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Asma , Hospitales Públicos , Asma/epidemiología , Asma/diagnóstico , Asma/fisiopatología , Prevalencia , Humanos , Etiopía/epidemiología , Factores de Riesgo , Adulto , Masculino , Femenino , Niño , Adolescente , Persona de Mediana Edad , Adulto Joven , Estaciones del Año , Medición de Riesgo , Preescolar , AncianoRESUMEN
COPD is the second leading cause of death in India. The guidelines for early detection of COPD were released by the Government of India in 2019. However, due to the COVID-19 pandemic, its implementation could not be optimal. Diagnosis of COPD is based on the presence of respiratory symptoms, the presence of exposure to risk factors, and the presence of poorly reversible airflow obstruction as assessed using a spirometer. Spirometers are currently available only at a few district hospitals. The existing guidelines expect the patient to visit the Rural hospital/ Community Health Centre, which does not have a spirometer or a pulmonary medicine specialist. Also, it is not feasible or accessible for patients to visit the district hospital to get diagnosed. The current study will be implemented to determine the prevalence, annual incidence of COPD and asthma, quality of life, and nutritional status of COPD and asthma patients. The novelty of this implementation research, which will be conducted in collaboration with Zilla Parishad (i.e., Government), Pune district, is the empowerment of an Accredited Social Health Activist (ASHA), a peripheral health worker to screen all individuals using a peak flow meter and confirmation of the diagnosis at health and wellness center (HWC). An accredited Social Health Activist (ASHA) will take relevant history to suspect COPD and asthma in 30+-year-old adults, and she will refer the suspected cases to the Community Health Officer (CHO) at the Health and Wellness Center. The CHO/ Medical officer of PHC will initiate the appropriate treatment after confirming the diagnosis using a portable spirometer. The difficult-to-diagnose patients with comorbidity and acute exacerbations will be referred to the nearest higher center, i.e., Primary Health Centre (PHC) or Community Health Centre (CHC), where a primary care physician is available. The ASHA workers will provide two follow-ups to these patients in a year, depending on the severity, to ensure compliance with the treatment. Thus, early diagnosis and appropriate treatment of COPD and asthma at the community level may help to reduce the episodes of acute exacerbations.
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Asma , Tamizaje Masivo , Enfermedad Pulmonar Obstructiva Crónica , Espirometría , Humanos , India/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Asma/diagnóstico , Asma/epidemiología , Tamizaje Masivo/métodos , COVID-19/epidemiología , COVID-19/diagnóstico , Personal de Salud , Femenino , Empoderamiento , Calidad de Vida , Masculino , Guías de Práctica Clínica como AsuntoRESUMEN
OBJECTIVE: Aim: To develop the criteria of small airways response to bronchodilators (by spirometry indices maximal expiratory flow (MEF50 and MEF25) as the markers of uncontrolled asthma course. PATIENTS AND METHODS: Materials and Methods: The study involved 92 participants (64 boys and 28 girls) aged 6 to 17 years (60 were less than 12 years old) with diagnosed asthma. Asthma control was assessed with the use of Asthma Control Test and Asthma Control Questionnaire. Spirometry and bronchodilator responsiveness testing were performed for all participants. RESULTS: Results: Mostly, the studied children had a normal level of forced expiratory volume in the first second (FEV1), even at unsatisfactory symptoms control. The indicators of the medium and small airways patency were significantly worse in uncontrolled asthma children even in normal FEV1. Among children, the lack of asthma control can be caused by small airways obstruction in up to 80% cases. Among children who need the high dose inhaled corticosteroids treatment 93.3% have uncontrolled asthma with small airways obstruction. We found out that MEF50 and MEF25 could be the signs of the reversibility of bronchial obstruction and uncontrolled asthma with high sensitivity and specificity. CONCLUSION: Conclusions: Indices MEF50 and MEF25 allow detecting the small airways obstruction and their reversibility as a mark of uncontrolled asthma (MEF25 has a higher diagnostic value). In case of MEF50 and/or MEF25 increasing for 22% or 25% accordingly in bronchodilator test in children, the asthma should be considered uncontrolled.
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Asma , Broncodilatadores , Espirometría , Humanos , Asma/tratamiento farmacológico , Asma/diagnóstico , Asma/fisiopatología , Niño , Femenino , Masculino , Adolescente , Broncodilatadores/uso terapéutico , Broncodilatadores/administración & dosificación , Volumen Espiratorio Forzado/efectos de los fármacos , BiomarcadoresRESUMEN
Asthma is a respiratory disorder caused by airway inflammation which may worsen after allergen exposure. Recent cohort studies demonstrate a positive association between skin cancer and asthma or hay fever (allergy to outdoor allergens such as pollen). Nationally-representative data for adults in the United States remains limited. We aimed to characterize skin cancer prevalence among individuals in the United States who have asthma or hay fever. To achieve this aim, we extracted nationwide cross-sectional data from 16,277 adult participants (total survey-weighted sample = 174,765,931) of the Third National Health and Nutrition Examination Survey from 1988 to 1994. This study uses survey-weighted regression to compare the nationwide prevalence of skin cancer among participants with or without a history of asthma or hay fever. Sensitivity analysis examined the influence of sex, 25-hydroxyvitamin D, chronic bronchitis or emphysema, geographical region, urban proximity, and oral glucocorticoid use. Of the included participants, the age-adjusted prevalence of skin cancer was 7.2%, similar to national estimates. Skin cancer prevalence was higher among participants who had asthma with hay fever (adjusted prevalence ratio, 1.79; 95% confidence interval, 1.16, 2.76), but not among participants with asthma only or hay fever only. Similarly, skin cancer prevalence was higher for those with asthma and positive pollen allergen skin prick testing (SPT), but not for those with hay fever and positive pollen SPT. No association was noted between skin cancer and wheezing triggered by pollen. Hay fever or immunoglobulin-E sensitization to pollen may increase skin cancer prevalence among individuals with a history of asthma.
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Asma , Encuestas Nutricionales , Rinitis Alérgica Estacional , Neoplasias Cutáneas , Humanos , Estudios Transversales , Masculino , Rinitis Alérgica Estacional/epidemiología , Rinitis Alérgica Estacional/inmunología , Rinitis Alérgica Estacional/diagnóstico , Femenino , Adulto , Persona de Mediana Edad , Estados Unidos/epidemiología , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/diagnóstico , Prevalencia , Asma/epidemiología , Asma/inmunología , Asma/diagnóstico , Alérgenos/inmunología , Alérgenos/efectos adversos , Pruebas Cutáneas , Anciano , Adulto Joven , Polen/inmunología , Polen/efectos adversos , Factores de RiesgoRESUMEN
Objective: To analyze the clinical characteristics of asthmatic children with persistent airflow limitation (PAL) in order to improve understanding of PAL and improve asthma management. Methods: The clinic data of asthmatic children aged 6 to 18 years with and without PAL, who visited the Department of Allergy at Children's Hospital of the Capital Institute of Pediatrics between January 2021 and June 2023, were analyzed retrospectively. The study included a total of 197 patients (153 males and 44 females), with a median age of 9.0 (7.0, 12.0) years. The analysis encompassed demographic features, disease-related factors, laboratory tests, and spirometry parameters. Quantitative data differences between the two groups were assessed using the Student's t-test or the Mann-Whitney U test. Qualitative data comparisons were made using the Chi-square test or Fisher's exact test. Results: This study included 100 non-PAL and 97 PAL patients. The female-to-male ratio in the two groups was 27/73 and 17/80, respectively. Age and BMI were 11.0 (10.0, 13.0) years and 20.3 (17.7, 24.1) kg/m2 in the PAL group, which was significantly higher than in the non-PAL group (P<0.001). Among the PAL group, 49.5% fell within the 9-12 age group. The PAL group had a higher percentage of patients with an asthma duration of more than 3 years (89.7% vs. 62.0%, P<0.001) and a history of pneumonia (13.4% vs. 4.0%, P=0.036) compared to the non-PAL group. Regarding laboratory tests, a higher percentage of patients in the PAL group had an elevated FeNO level (60.9% vs. 37.6%, P=0.002) and animal sensitization (50.7% vs. 30.7%, P=0.022) compared to the non-PAL group. Of the 69 patients who underwent spirometry before and after PAL development, FEV1%pred, FEV1/FVC, and MMEF%pred values gradually decreased, with a significant decline in the year preceding PAL development. Conclusions: Asthmatic children with PAL had characteristics such as relatively older age, higher BMI, longer duration of asthma, eosinophilic inflammation, and atopy. Lung function decline occurred several years before PAL development. Long-term follow-up should focus on the evolving trend of spirometry parameters.
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Asma , Espirometría , Humanos , Niño , Asma/fisiopatología , Asma/diagnóstico , Masculino , Femenino , Estudios Retrospectivos , Adolescente , Volumen Espiratorio Forzado , Pruebas de Función RespiratoriaRESUMEN
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and asthma can be treated with inhaled corticosteroids (ICS) delivered by low climate impact inhalers (dry powder inhalers) or high climate impact inhalers (pressurized metered-dose inhalers containing potent greenhouse gasses). ICS delivered with greenhouse gasses is prescribed ubiquitously and frequent despite limited evidence of superior effect. Our aim was to examine the beneficial and harmful events of ICS delivered by low and high climate impact inhalers in patients with asthma and COPD. METHODS: Nationwide retrospective cohort study of Danish outpatients with asthma and COPD treated with ICS delivered by low and high climate impact inhalers. Patients were propensity score matched by the following variables; age, gender, tobacco exposure, exacerbations, dyspnoea, body mass index, pulmonary function, ICS dose and entry year. The primary outcome was a composite of hospitalisation with exacerbations and all-cause mortality analysed by Cox proportional hazards regression. RESULTS: Of the 10,947 patients with asthma and COPD who collected ICS by low or high climate impact inhalers, 2,535 + 2,535 patients were propensity score matched to form the population for the primary analysis. We found no association between high climate impact inhalers and risk of exacerbations requiring hospitalization and all-cause mortality (HR 1.02, CI 0.92-1.12, p = 0.77), nor on pneumonia, exacerbations requiring hospitalization, all-cause mortality, or all-cause admissions. Delivery with high climate impact inhalers was associated with a slightly increased risk of exacerbations not requiring hospitalization (HR 1.10, CI 1.01-1.21, p = 0.03). Even with low lung function there was no sign of a superior effect of high climate impact inhalers. CONCLUSION: Low climate impact inhalers were not inferior to high climate impact inhalers for any risk analysed in patients with asthma and COPD.
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Asma , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Asma/tratamiento farmacológico , Asma/epidemiología , Asma/diagnóstico , Anciano , Estudios Retrospectivos , Dinamarca/epidemiología , Estudios de Cohortes , Administración por Inhalación , Adulto , Inhaladores de Polvo Seco , Clima , Inhaladores de Dosis Medida , Corticoesteroides/administración & dosificación , Corticoesteroides/efectos adversos , Resultado del TratamientoRESUMEN
Obstructive lung diseases such as bronchial asthma, COPD, and cystic fibrosis are a burden on many patients across the globe. Spirometry is considered the gold standard for diagnosing airflow obstruction, but it can be difficult for pediatric patients to do and requires a lot of effort. As a result, healthcare providers need new, effortless methods to diagnose airway obstructions, particularly in young children and individuals unable to perform the spirometry maneuver. The forced oscillation technique is a modern method requiring only tidal breathing combined with the application of external, source of low-amplitude oscillations to evaluate the respiratory system's response. It might be essential for identifying early respiratory changes caused by smoking, childhood asthma, and may prove more sensitive than spirometry in identifying peripheral airway disturbances or evaluating the long-term success of therapy. This review describes the methodology and the indications for the forced oscillation technique and outlines its relevance in clinical practice.
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Enfermedades Pulmonares Obstructivas , Humanos , Niño , Enfermedades Pulmonares Obstructivas/diagnóstico , Enfermedades Pulmonares Obstructivas/terapia , Enfermedades Pulmonares Obstructivas/fisiopatología , Espirometría/métodos , Asma/diagnóstico , Asma/terapia , Asma/fisiopatología , Fibrosis Quística/diagnóstico , Fibrosis Quística/terapia , Fibrosis Quística/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/terapia , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Pruebas de Función Respiratoria , Oscilometría/métodosAsunto(s)
Asma , Diagnóstico Precoz , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Asma/diagnóstico , Asma/tratamiento farmacológico , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/terapia , Estudios Multicéntricos como Asunto , Espirometría , Aceptación de la Atención de Salud/estadística & datos numéricos , Proyectos de InvestigaciónAsunto(s)
Asma , Diagnóstico Precoz , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Asma/diagnóstico , Asma/tratamiento farmacológico , Asma/economía , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/economía , Enfermedad Pulmonar Obstructiva Crónica/terapia , Aceptación de la Atención de Salud/estadística & datos numéricos , Proyectos de Investigación , Análisis de Costo-Efectividad , Estudios Multicéntricos como Asunto , Espirometría/economía , Espirometría/estadística & datos numéricosRESUMEN
OBJECTIVES: To find possible relationship between asthma exacerbation and metabolomic profile of airways, assessed by non-invasive method - free volatile organic compounds (VOCs) in exhaled air in children. MATERIAL AND METHODS: The study included 80 children aged 4-18 years with asthma: 42 children with a min. 3 asthma exacerbations in the past 12 months, and 38 children without a history of exacerbations in the past year. During the study visit, each patient was examined, medical history (including information regarding atopy and eosinophil blood count) was taken, spirometry and fractional exhaled nitric oxide (FeNO) were tested, an exhaled air sample was taken to test for the presence of VOCs, and the patient also completed standardized form - Asthma Control Questionnaire. Volatile organic compounds were measured by combined gas chromatography coupled to mass spectrometry. RESULTS: The obtained results of VOCs were correlated with the history of the disease. The 2 gas profiles were defined and they formed 2 clinically distinct clusters (p = 0.085). Cluster 2 was characterized for children with a higher number of bronchial asthma exacerbations and worse lung function parameters (predicted percentage forced expiratory volume in 1 s [FEV1] [p = 0.023], FEV1/ forced vital capacity ratio [FVC] [p = 0.0219]). The results were independent of the age, sex, BMI, atopy (house dust mite allergy) and eosinophil blood count. CONCLUSIONS: The study findings suggest that a relative group of gases may be a useful predictor of having asthma exacerbations in children. Additionally, a single FeNO value was unlikely to be clinically useful in predicting asthma exacerbations in children. The VOCs profile reflecting the metabolism of the airway epithelium and local microbiota was associated with the course of asthma, which strongly justifies further prospective validation studies. Int J Occup Med Environ Health. 2024;37(3):351-59.
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Asma , Pruebas Respiratorias , Compuestos Orgánicos Volátiles , Humanos , Asma/fisiopatología , Asma/diagnóstico , Niño , Compuestos Orgánicos Volátiles/análisis , Masculino , Femenino , Adolescente , Preescolar , Espiración , EspirometríaRESUMEN
Objectives: Addressing the challenge of cost-effective asthma diagnosis amidst diverse symptom patterns among patients, this study aims to develop a machine learning-based asthma prediction tool for self-detection of asthma. Methods: Data from 6,665 participants in the Sri Lanka Health and Ageing Study (2018-2019) are used for this research. Thirteen machine learning algorithms, including Logistic Regression, Support Vector Machine, Decision Tree, Random Forest, Naïve Bayes, K-Nearest Neighbors, Gradient Boost, XGBoost, AdaBoost, CatBoost, LightGBM, Multi-Layer Perceptron, and Probabilistic Neural Network, are employed. Results: A hybrid version of Logistic Regression and LightGBM outperformed other models, achieving an AUC of 0.9062 and 79.85% sensitivity. Key predictive features for asthma include wheezing, breathlessness with wheezing, shortness of breath attacks, coughing attacks, chest tightness, nasal allergies, physical activity, passive smoking, ethnicity, and residential sector. Conclusion: Combining Logistic Regression and LightGBM models can effectively predict adult asthma based on self-reported symptoms and demographic and behavioural characteristics. The proposed expert system assists clinicians and patients in diagnosing potential asthma cases.
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Asma , Aprendizaje Automático , Humanos , Asma/diagnóstico , Sri Lanka , Femenino , Masculino , Persona de Mediana Edad , Adulto , Modelos Logísticos , Anciano , AlgoritmosRESUMEN
BACKGROUND: To date, several questionnaires have been developed as easy-to-use screening tools for assessing and monitoring asthma control as the Asthma Control Test (ACT). However, the assessment of the reliability of the ACT questionnaire translated into the Kazakh language has not been carried out yet. The study aimed to evaluate the reliability and validity of the Kazakh-language ACT questionnaire as an asthma control tool. METHODS: A multi-centre study was conducted in three Kazakhstan medical institutions for the period: from 02.05.2022 to 06.05.2022. The study included 222 Kazakh patients (Kazakhs in the third generation) with a confirmed diagnosis of bronchial asthma. In this study, the ACT questionnaire translated into Kazakh was used to assess the level of asthma control. The form of asthma was determined in accordance with the recommendations of the Global Initiative on Asthma (GINA). The internal consistency of the questionnaire was analysed by using the reliability index (Cronbach's alpha). The clinical and demographic data were collected, including data on the spirometry. RESULTS: The Kazakhstani version of the ACT questionnaire showed high reliability, with Cronbach's alpha of 0.991. The majority of patients (87.4%) had controlled asthma. A significant difference was found in ACT scores between patients with a duration of asthma of 0-12 months and those with asthma for 10 years or more. Similarly, significant differences were found in ACT scores based on the severity of asthma and the age of the patients. CONCLUSIONS: The ACT questionnaire translated into Kazakh proved to be useful tools for assessing asthma control in the Kazakhstani population.
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Asma , Humanos , Asma/diagnóstico , Kazajstán , Femenino , Encuestas y Cuestionarios , Masculino , Reproducibilidad de los Resultados , Adulto , Persona de Mediana Edad , Lenguaje , Adulto JovenRESUMEN
BACKGROUND: Asthma, a prevalent chronic inflammatory disorder, is shaped by a multifaceted interplay between genetic susceptibilities and environmental exposures. Despite strides in deciphering its pathophysiological landscape, the intricate molecular underpinnings of asthma remain elusive. The focus has increasingly shifted toward the metabolic aberrations accompanying asthma, particularly within the domain of pyrimidine metabolism (PyM)-a critical pathway in nucleotide synthesis and degradation. While the therapeutic relevance of PyM has been recognized across various diseases, its specific contributions to asthma pathology are yet underexplored. This study employs sophisticated bioinformatics approaches to delineate and confirm the involvement of PyM genes (PyMGs) in asthma, aiming to bridge this significant gap in knowledge. METHODS: Employing cutting-edge bioinformatics techniques, this research aimed to elucidate the role of PyMGs in asthma. We conducted a detailed examination of 31 PyMGs to assess their differential expression. Through Gene Set Enrichment Analysis (GSEA) and Gene Set Variation Analysis (GSVA), we explored the biological functions and pathways linked to these genes. We utilized Lasso regression and Support Vector Machine-Recursive Feature Elimination (SVM-RFE) to pinpoint critical hub genes and to ascertain the diagnostic accuracy of eight PyMGs in distinguishing asthma, complemented by an extensive correlation study with the clinical features of the disease. Validation of the gene expressions was performed using datasets GSE76262 and GSE147878. RESULTS: Our analyses revealed that eleven PyMGs-DHODH, UMPS, NME7, NME1, POLR2B, POLR3B, POLR1C, POLE, ENPP3, RRM2B, TK2-are significantly associated with asthma. These genes play crucial roles in essential biological processes such as RNA splicing, anatomical structure maintenance, and metabolic processes involving purine compounds. CONCLUSIONS: This investigation identifies eleven PyMGs at the core of asthma's pathogenesis, establishing them as potential biomarkers for this disease. Our findings enhance the understanding of asthma's molecular mechanisms and open new avenues for improving diagnostics, monitoring, and progression evaluation. By providing new insights into non-cancerous pathologies, our work introduces a novel perspective and sets the stage for further studies in this field.
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Asma , Biomarcadores , Biología Computacional , Aprendizaje Automático , Pirimidinas , Asma/genética , Asma/metabolismo , Asma/diagnóstico , Humanos , Biología Computacional/métodos , Biomarcadores/metabolismo , FemeninoRESUMEN
Recent advancements in asthma management include non-invasive methodologies such as sputum analysis, exhaled breath condensate (EBC), and fractional exhaled nitric oxide (FeNO). These techniques offer a means to assess airway inflammation, a critical feature of asthma, without invasive procedures. Sputum analysis provides detailed insights into airway inflammation patterns and cellular composition, guiding personalized treatment strategies. EBC collection, reflecting bronchoalveolar lining fluid composition, provides a non-invasive window into airway physiology. FeNO emerges as a pivotal biomarker, offering insights into eosinophilic airway inflammation and aiding in asthma diagnosis, treatment monitoring, and the prediction of exacerbation risks. Despite inherent limitations, each method offers valuable tools for a more comprehensive assessment of asthma. Combining these techniques with traditional methods like spirometry may lead to more personalized treatment plans and improved patient outcomes. Future research is crucial to refine protocols, validate biomarkers, and establish comprehensive guidelines in order to enhance asthma management with tailored therapeutic strategies and improved patient outcomes.
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Asma , Biomarcadores , Pruebas Respiratorias , Esputo , Humanos , Asma/diagnóstico , Asma/fisiopatología , Asma/metabolismo , Esputo/metabolismo , Pruebas Respiratorias/métodos , Biomarcadores/metabolismo , Espiración , Óxido Nítrico/metabolismo , Óxido Nítrico/análisisRESUMEN
BACKGROUND: In recent years, the incorporation of LAMAs into asthma therapy has been expected to enhance symptom control. However, a significant number of patients with asthma continue to experience poorly managed symptoms. There have been limited investigations on LAMA-induced airway alterations in asthma treatment employing IOS. In this study, we administered a LAMA to patients with poorly controlled asthma, evaluated clinical responses and respiratory function, and investigated airway changes facilitated by LAMA treatments using the IOS. METHODS: Of a total of 1282 consecutive patients with asthma, 118 exhibited uncontrolled symptoms. Among them, 42 switched their treatment to high-dose fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) (ICS/LABA/LAMA). The patients were then assessed using AHQ-33 or LCQ and ACT. Spirometry parameters (such as FEV1 or MMEF) and IOS parameters (such as R20 or AX) were measured and compared before and after exacerbations and the addition of LAMA. RESULTS: Of the 42 patients, 17 who switched to FF/UMEC/VI caused by dyspnea exhibited decreased pulmonary function between period 1 and baseline, followed by an increase in pulmonary function between baseline and period 2. Significant differences were observed in IOS parameters such as R20, R5-R20, Fres, or AX between period 1 and baseline as well as between baseline and period 2. Among the patients who switched to inhaler due to cough, 25 were classified as responders (n = 17) and nonresponders (n = 8) based on treatment outcomes. Among nonresponders, there were no significant differences in spirometry parameters such as FEV1 or PEF and IOS parameters such as R20 or AX between period 1 and baseline. However, among responders, significant differences were observed in all IOS parameters, though not in most spirometry parameters, between period 1 and baseline. Furthermore, significant differences were noted between baseline and period 2 in terms of FEV1, %MMEF, %PEF, and all IOS parameters. CONCLUSION: ICS/LABA/LAMA demonstrates superiority over ICS/LABA in improving symptoms and lung function, which is primarily attributed to the addition of LAMA. Additionally, IOS revealed the effectiveness of LAMA across all airway segments, particularly in the periphery. Hence, LAMA can be effective against various asthma phenotypes characterized by airway inflammation, even in real-world cases.