RESUMO
OBJECTIVE: Aim: The purpose of this article is to review the literature on the applicability of biologic agents, their mechanism of action, safety and factors affecting their choice in selected chronic conditions: asthma, psoriasis, ankylosing spondylitis and ulcerative colitis. PATIENTS AND METHODS: Materials and Methods: The electronic databases MEDLINE/PubMed and ScienceScholar were searched for studies published in English and Polish and indexed from 2018 to April 2024. Dodatkowo uwzgledniono Stanowisko Polskiego Towarzystwa Alergologicznego i Polskiego Towarzystwa Chorób Ukladu Oddechowego, rekomendacje Polskiego Towarzystwa Dermatologicznego, wytyczne Polskiego Towarzystwa Gastroenterologii i konsultanta krajowego w dziedzinie gastroenterologii oraz wytyczne Global Initiative for Asthma (GINA). CONCLUSION: Conclusions: 1. Biological therapy demonstrates a significant reduction in the severity of clinical symptoms and complications associated with a variety of disease entities. An additional value of this therapy is its effectiveness among patients who do not respond to traditional treatment strategies. 2. In the perspective of the future of biologic treatment, it is important to study potential interactions between biologic drugs and other therapeutic methods. 3. To maximize benefits while minimizing complications, requires an individualized approach for each patient.
Assuntos
Asma , Colite Ulcerativa , Humanos , Colite Ulcerativa/terapia , Colite Ulcerativa/tratamento farmacológico , Asma/tratamento farmacológico , Asma/terapia , Doença Crônica , Psoríase/tratamento farmacológico , Psoríase/terapia , Espondilite Anquilosante/tratamento farmacológico , Espondilite Anquilosante/terapia , Terapia Biológica , Produtos Biológicos/uso terapêuticoAssuntos
Corticosteroides , Asma , Maus-Tratos Infantis , Humanos , Asma/tratamento farmacológico , Administração por Inalação , Criança , Adolescente , Feminino , Masculino , Corticosteroides/uso terapêutico , Corticosteroides/administração & dosagem , Resultado do Tratamento , Antiasmáticos/uso terapêuticoAssuntos
Asma , Diagnóstico Precoce , Doença Pulmonar Obstrutiva Crônica , Humanos , Asma/diagnóstico , Asma/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/terapia , Estudos Multicêntricos como Assunto , Espirometria , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Projetos de PesquisaRESUMO
Asthma is a chronic airway inflammatory disease. The excessive proliferation of airway smooth muscle cells (ASMCs) is associated with airway remodeling. Ze-Qi-Tang (ZQT) is a popular traditional Chinese medicine preparation and has been confirmed to have therapeutic effects on lung diseases. This study is aimed to probe the biological function of ZQT in asthma. RT-qPCR and ELISA were utilized for testing the mRNA levels and concentrations of pro-inflammatory factors. Colony formation and transwell assay were applied to test cell viability and migration. The mouse model with asthma was established by ovalbumin (OVA) induction. Western blot was utilized for detecting the activation of PI3K/AKT/NF-κB pathway. We found that the concentrations of proinflammatory factors in cells induced by PDGF-BB could been suppressed by ZQT. ZQT-H treatment notably repressed cell viability and proliferation. Furthermore, we proved the suppressive effect of ZQT on airway inflammation in asthma mice. Additionally, we discovered that ZQT could suppress the PI3K/AKT/NF-κB pathway in PDGF-BB-induced ASMCs. To sum up, ZQT reduced airway inflammation and remodeling in mice with asthma via inactivating PI3K/AKT/NF-κB pathway.
Assuntos
Asma , Proliferação de Células , Medicamentos de Ervas Chinesas , Inflamação , NF-kappa B , Fosfatidilinositol 3-Quinases , Proteínas Proto-Oncogênicas c-akt , Transdução de Sinais , Animais , Proteínas Proto-Oncogênicas c-akt/metabolismo , NF-kappa B/metabolismo , Asma/tratamento farmacológico , Asma/metabolismo , Asma/patologia , Fosfatidilinositol 3-Quinases/metabolismo , Transdução de Sinais/efeitos dos fármacos , Medicamentos de Ervas Chinesas/farmacologia , Medicamentos de Ervas Chinesas/uso terapêutico , Camundongos , Inflamação/tratamento farmacológico , Inflamação/patologia , Inflamação/metabolismo , Proliferação de Células/efeitos dos fármacos , Medicina Tradicional Chinesa/métodos , Camundongos Endogâmicos BALB C , Modelos Animais de Doenças , Miócitos de Músculo Liso/efeitos dos fármacos , Miócitos de Músculo Liso/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Becaplermina/metabolismo , Movimento Celular/efeitos dos fármacos , OvalbuminaAssuntos
Asma , Diagnóstico Precoce , Doença Pulmonar Obstrutiva Crônica , Humanos , Asma/diagnóstico , Asma/tratamento farmacológico , Asma/economia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/economia , Doença Pulmonar Obstrutiva Crônica/terapia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Projetos de Pesquisa , Análise de Custo-Efetividade , Estudos Multicêntricos como Assunto , Espirometria/economia , Espirometria/estatística & dados numéricosRESUMO
The heterogeneous nature of asthma results in a wide range of presentations during exacerbation. Despite UK pre-hospital management guidelines focusing on ß2 agonists, variables such as cause, severity, underlying health, comorbidities, and drug side effects can often make emergency treatment optimisation difficult. This article examines paramedics' methods of observing, perceiving, interpreting, and treating asthma with ß2 agonists, often acting on limited information in rapidly evolving situations. We recruited paramedics from a single UK National Health Service ambulance Trust for qualitative semi-structured interviews. Responses underwent framework analysis to identify data similarities and differences. Fifteen qualitative interviews with paramedics revealed three main themes affecting patient management: clinician experience of presentation, adaptation of patient management approaches, and severity of side effects. Paramedics felt their ability to manage various asthma presentations was enhanced through guideline adaptation based on their own clinical experience and understanding of ß2 agonist side effects, allowing tailored responses based on a set of reinforcing factors. Inductive analysis revealed additional complexities within these themes, such as anxiety and diabetes, which may influence ß2 agonist administration and result in multiple care pathways being initiated during exacerbation. Paramedic care mirrors asthma's complexity, accounting for a range of characteristics. A dynamic, critically thought approach enables patient management to be based on the presenting conditions rather than strict adherence to a single algorithm. Comprehending the complexities and variables in treatment can be crucial to how paramedics rationalise their treatment and optimise the care provided.
Assuntos
Agonistas de Receptores Adrenérgicos beta 2 , Pessoal Técnico de Saúde , Asma , Nebulizadores e Vaporizadores , Pesquisa Qualitativa , Humanos , Asma/tratamento farmacológico , Agonistas de Receptores Adrenérgicos beta 2/uso terapêutico , Agonistas de Receptores Adrenérgicos beta 2/administração & dosagem , Masculino , Feminino , Serviços Médicos de Emergência/métodos , Entrevistas como Assunto , Adulto , Reino Unido , Auxiliares de Emergência , ParamédicoRESUMO
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.
Assuntos
Asma , Doença Pulmonar Obstrutiva Crônica , Humanos , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Asma/tratamento farmacológico , Asma/epidemiologia , Asma/diagnóstico , Idoso , Estudos Retrospectivos , Dinamarca/epidemiologia , Estudos de Coortes , Administração por Inalação , Adulto , Inaladores de Pó Seco , Clima , Inaladores Dosimetrados , Corticosteroides/administração & dosagem , Corticosteroides/efeitos adversos , Resultado do TratamentoRESUMO
Introduction: It is known that the use of inhaled corticosteroids increases the incidence of pneumonia in patients followed up with the diagnosis of chronic asthma and chronic obstructive pulmonary disease (COPD). This study aimed to investigate the contribution of inhaled steroid use to pneumonia severity and mortality in cases with COVID-19 pneumonia. Materials and Methods: The study is a retrospective, observational study. Among the cases admitted to the pandemic clinic, patients diagnosed with COVID-19 pneumonia were included. The plan was to compare cases who received and did not receive inhaled corticosteroids in terms of pneumonia severity and mortality. In order to define risk factors for mortality, univariate and multivariable negative binomial regression analyses were performed. Result: In our study, it was observed that n= 540 (75%) cases did not receive inhaled corticosteroids (group 1), and 180 (25%) cases used inhaled corti costeroids (group 2). Group 1 and group 2 cases were compared in terms of pneumonia severity with no significant difference between the two groups (p= 0.11). Then, risk factors affecting mortality in all cases were examined with univariate analyses. Increasing age, applying mechanical ventilation, having severe pneumonia, having interstitial lung disease, and applying prone position were found to be statistically significant factors in mortality (p < 0.05). Conclusions: In conclusion, in our study, it was observed that the use of inhaled corticosteroids did not increase the severity of pneumonia and mortality. It was thought that the treatment they received could be continued when the patients treated with inhaled corticosteroids due to asthma and COPD had COVID-19 pneumonia.
Assuntos
Corticosteroides , COVID-19 , Índice de Gravidade de Doença , Humanos , Masculino , Administração por Inalação , Estudos Retrospectivos , Feminino , Pessoa de Meia-Idade , COVID-19/mortalidade , COVID-19/complicações , Idoso , Corticosteroides/uso terapêutico , Corticosteroides/administração & dosagem , Fatores de Risco , Tratamento Farmacológico da COVID-19 , SARS-CoV-2 , Adulto , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/mortalidade , Doença Pulmonar Obstrutiva Crônica/complicações , Asma/tratamento farmacológico , Asma/complicações , Asma/mortalidadeRESUMO
This study aims to explore the active components and mechanism of Wuhu Decoction in treating respiratory syncytial virus(RSV)-induced asthma. Ultra-high performance liquid chromatography coupled with high-resolution mass spectrometry was used to determine the components of Wuhu Decoction in the blood. By utilizing databases, Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analysis and Gene Ontology(GO) functional analysis were conducted to investigate the targets of the components of Wuhu Decoction in asthma. Furthermore, the information on target proteins, and metabolite-target-pathway was imported into the STRING database to construct a network interaction diagram to identify the core components and key pathways of Wuhu Decoction. In the in vivo experiment, an asthma model was established using RSV combined with ovalbumin(OVA) in mice. The intervention effect of Wuhu Decoction on RSV-induced asthma in mice was validated through lung function tests, hematoxylin-eosin(HE) staining, enzyme-linked immunosorbent assay(ELISA), Western blot, and immunohistochemistry. The results showed that the main components of Wuhu Decoction in the blood were flavonoids, phenylpropanoids, lignans, and terpenoids. The core components of Wuhu Decoction in treating pediatric asthma included(-)-epigallocatechin, kaempferol, isoliquiritigenin, diosmetin, betulinic acid, ursolic acid, daphnetin, aescin. The main pathways targeted by Wuhu Decoction were calcium signaling pathway, neuroactive ligand-receptor interaction, NOD-like receptor signaling pathway, T cell receptor signaling pathway, and Toll-like receptor signaling pathway. The results of in vivo experiments demonstrated that Wuhu Decoction could improve lung function indicators, down-regulate levels of interleukin-6(IL-6), interleukin-17(IL-17), and tumor necrosis factor-alpha(TNF-α), and reduce the expression of proteins such as NOD-like receptor pyrin domain-containing 3(NLRP3), mitogen-activated protein kinase 1(MAPK1), mitogen-activated protein kinase 14(MAPK14), and nuclear factor kappaB subunit 1(NFKB1) in lung tissue, thereby alleviating neutrophilic inflammation and pulmonary congestion. These findings indicate that Wuhu Decoction intervenes in virus-induced asthma through a synergistic effect on multiple components, targets, and pathways, and it can inhibit the activation of the NOD-like receptor signaling pathway, thereby alleviating airway inflammation and injury in asthmatic mice.
Assuntos
Asma , Medicamentos de Ervas Chinesas , Camundongos Endogâmicos BALB C , Farmacologia em Rede , Infecções por Vírus Respiratório Sincicial , Vírus Sinciciais Respiratórios , Animais , Medicamentos de Ervas Chinesas/farmacologia , Medicamentos de Ervas Chinesas/administração & dosagem , Asma/tratamento farmacológico , Asma/metabolismo , Camundongos , Infecções por Vírus Respiratório Sincicial/tratamento farmacológico , Vírus Sinciciais Respiratórios/efeitos dos fármacos , Humanos , Feminino , Pulmão/efeitos dos fármacos , Pulmão/metabolismoRESUMO
This study examines the anti-inflammatory activity of cynaropicrin against lipopolysaccharide (LPS) in vitro and ovalbumin (OVA)-challenged asthma in mice. Cynaropicrin's antimicrobial effects were tested on Escherichia coli (E. coli) and Streptococcus pyogenes (S. pyogenes) using the disc diffusion technique. Cytotoxicity was assessed with an (3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide) assay. The anti-inflammatory property was evaluated in LPS-induced RAW264.7 cells, while OVA-challenged asthmatic mice were treated with 10 mg/kg of cynaropicrin. Key inflammatory and antioxidant markers were quantified, and lung histology was examined to confirm therapeutic roles. The antimicrobial studies proved that cynaropicrin effectively inhibited the growth of E. coli and S. pyogenes. Cynaropicrin displayed no cytotoxicity on RAW264.7 cells. Furthermore, it significantly inhibited inflammatory cytokine synthesis upon LPS induction. Cynaropicrin treatment decreased the inflammatory cell counts and also suppressed specific allergic markers in OVA-challenged mice. It also decreased nitric oxide and myeloperoxidase levels and reduced pulmonary edema. Cynaropicrin increased antioxidant levels and decreased proinflammatory cytokines in the asthmatic mice. Lung histological examination confirms the ameliorative potency of cynaropicrin against OVA-induced asthmatic pulmonary inflammation in mice. Our findings suggest cynaropicrin possesses significant ameliorative potency against allergen-induced pulmonary inflammation.
Assuntos
Asma , Citocinas , Lipopolissacarídeos , Ovalbumina , Animais , Camundongos , Asma/tratamento farmacológico , Asma/induzido quimicamente , Asma/metabolismo , Asma/patologia , Lipopolissacarídeos/toxicidade , Células RAW 264.7 , Citocinas/metabolismo , Sesquiterpenos/farmacologia , Camundongos Endogâmicos BALB C , Escherichia coli , Streptococcus pyogenes , Anti-Inflamatórios/farmacologia , Masculino , Feminino , LactonasRESUMO
BACKGROUND: Allergic asthma is a chronic inflammatory disease characterized by airway hyperresponsiveness, inflammation and remodeling. ROCK inhibitors have now been shown to have the potential to alleviate these symptoms, although the specific effects of a new ROCK inhibitor, GSK429286 A, remain underexplored. OBJECTIVE: The aim of this study was to evaluate the therapeutic effects of a novel ROCK inhibitor, GSK429286 A, which exhibits a high affinity for both ROCK1 and ROCK2 isoforms, on allergic asthma in a guinea pig model, focusing on its effects on airway hyperresponsiveness, inflammation, and remodeling. METHODS: To induce allergic asthma, guinea pigs were sensitized with ovalbumin for 28 days, and in the middle of sensitization they were treated with different doses of the RoCK inhibitor, GSK429286 A. The study evaluated the effect of the administered doses on the reduction of airway hyperresponsiveness, by measuring specific airway resistance (sRaw), and the number of coughs after citric acid inhalation. We also monitored the anti-inflammatory effect by measuring levels of inflammatory cytokines, IL-2, IL-4, IL-5, IL-13, and remodeling markers, such as collagen deposition, and goblet cell hyperplasia. In addition, we monitored the possible anti-remodeling effect of GSK429286 A by histopathological examination. RESULTS: The ROCK inhibitor, GSK429286 A, showed an effect on suppressing airway hyperresponsiveness by reducing sRaw and the number of coughs in treated guinea pigs compared to controls. Our investigated drug suppressed the release of key mediators of inflammation, including IL-2, IL-4, and IL-5, thus demonstrating the effect of this ROCK inhibitor on the suppression of inflammation in the airways. Finally, GSK429286 A reduced markers of airway remodeling such as collagen deposition and goblet cell hyperplasia. CONCLUSION: GSK429286 A, an inhibitor of the ROCK pathway, exhibits significant anti-inflammatory and antiremodeling effects in a guinea pig model of allergic asthma. Indeed, we demonstrate its effect on suppressing airway hyperreactivity and reducing cough frequency. These findings suggest that GSK429286 A may be a promising therapeutic agent for allergic asthma, although further studies are needed to investigate its long-term efficacy, underlying mechanisms, and optimal dosing strategy.
Assuntos
Remodelação das Vias Aéreas , Asma , Ovalbumina , Quinases Associadas a rho , Animais , Cobaias , Quinases Associadas a rho/antagonistas & inibidores , Quinases Associadas a rho/metabolismo , Asma/tratamento farmacológico , Asma/imunologia , Remodelação das Vias Aéreas/efeitos dos fármacos , Masculino , Citocinas/metabolismo , Modelos Animais de Doenças , Inibidores de Proteínas Quinases/farmacologia , Pulmão/efeitos dos fármacos , Pulmão/patologia , Pulmão/metabolismo , Pulmão/imunologia , Pulmão/enzimologia , Anti-Inflamatórios/farmacologia , Inflamação/tratamento farmacológico , Antiasmáticos/farmacologiaRESUMO
The prevalence of obesity-induced asthma increases in women after menopause. We hypothesized that the increase in obese asthma in middle-aged women results from estrogen loss. In particular, we focused on the acute action of estrogen through the G protein-coupled estrogen receptor 1 (GPER), previously known as GPR30. We investigated whether GPER activation ameliorates obesity-induced asthma with a high-fat diet (HFD) using G-1, the GPER agonist, and G-36, the GPER antagonist. Administration of G-1 (0.5 mg/kg) suppressed HFD-induced airway hypersensitivity (AHR), and increased immune cell infiltration, whereas G-36 co-treatment blocked it. Histological analysis showed that G-1 treatment inhibited HFD-induced inflammation, fibrosis, and mucus hypersecretion in a GPER-dependent manner. G-1 inhibited the HFD-induced rise in the mRNA levels of pro-inflammatory cytokines in the gonadal white adipose tissue and lungs, whereas G-36 co-treatment reversed this effect. G-1 increased anti-inflammatory M2 macrophages and inhibited the HFD-induced rise in pro-inflammatory M1 macrophages in the lungs. In addition, G-1 treatment reversed the HFD-induced increase in leptin expression and decrease in adiponectin expression in the lungs and gonadal white adipose tissue. The results suggest that activation of GPER could be a therapeutic option for obesity-induced asthma.
Assuntos
Asma , Dieta Hiperlipídica , Macrófagos , Obesidade , Receptores de Estrogênio , Receptores Acoplados a Proteínas G , Animais , Receptores Acoplados a Proteínas G/metabolismo , Obesidade/complicações , Obesidade/metabolismo , Obesidade/tratamento farmacológico , Asma/metabolismo , Asma/tratamento farmacológico , Macrófagos/metabolismo , Macrófagos/efeitos dos fármacos , Camundongos , Receptores de Estrogênio/metabolismo , Dieta Hiperlipídica/efeitos adversos , Camundongos Endogâmicos C57BL , Feminino , Quinolinas/farmacologia , Pulmão/patologia , Pulmão/metabolismo , Pulmão/efeitos dos fármacos , Citocinas/metabolismoRESUMO
Numerous studies have highlighted the role of translationally controlled tumor protein (TCTP) as a key inflammatory mediator of asthma and allergies. Our previous study revealed that blocking the cytokine-like activity of TCTP using JEW-M449, an anti-TCTP monoclonal antibody (mAb), alleviated allergic inflammation in asthmatic mice. This study aimed to determine whether directly delivering JEW-M449 into the respiratory tract is a more effective way of mitigating airway inflammation in a mouse model of ovalbumin (OVA)-induced allergic airway inflammation than delivering this antibody via the intraperitoneal (IP) route. OVA-sensitized mice were intranasally administered JEW-M449 to enable its direct delivery to the respiratory tract before OVA challenge. We evaluated the changes in the levels of bronchoalveolar lavage fluid (BALF) cells, T helper type 2 (Th2) cytokines, OVA-specific immunoglobulin E (IgE), and histopathological alterations in the lung tissues. Intranasal (IN) administration of JEW-M449 significantly ameliorated the pathological changes associated with OVA-induced lung injury, including reduced inflammatory cell infiltration and mucus hypersecretion. Mice IN administered JEW-M449 also showed decreased OVA-mediated induction of Th2 cytokines in BALF and lung homogenates. Importantly, JEW-M449 delivered via the IN route reached the lung tissue more effectively and exerted superior anti-inflammatory effects in OVA-challenged mice than the IP-delivered JEW-M449. This study is the first to demonstrate the efficacy of directly delivering JEW-M449 anti-TCTP mAb into the respiratory tract to alleviate the asthma phenotype in a mouse model, thereby highlighting a potential delivery strategy for novel inhaled mAb therapeutics for human asthma.
Assuntos
Administração Intranasal , Anticorpos Monoclonais , Asma , Líquido da Lavagem Broncoalveolar , Citocinas , Modelos Animais de Doenças , Camundongos Endogâmicos BALB C , Ovalbumina , Proteína Tumoral 1 Controlada por Tradução , Animais , Asma/tratamento farmacológico , Asma/imunologia , Asma/induzido quimicamente , Ovalbumina/imunologia , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais/farmacologia , Líquido da Lavagem Broncoalveolar/imunologia , Feminino , Citocinas/metabolismo , Camundongos , Imunoglobulina E/sangue , Pulmão/efeitos dos fármacos , Pulmão/patologia , Pulmão/metabolismo , Pulmão/imunologia , Células Th2/imunologia , Células Th2/efeitos dos fármacosRESUMO
Endocrine disruptors are considered estrogenic disruptors, and recent researches suggested that they may have a link to the severity of asthma. We aim to validate the correlation between endocrine disruptors and various clinical measurements of asthma, depending on the menopausal status. A pilot case-control study was performed in female asthmatic patients who visited allergy clinic in SMG-SNU Boramae Medical Center. Medical information and the urinary concentrations of 4 endocrine disruptors on their first visit were collected and analyzed: bisphenol A, mono (2-ethyl-5-hydroxyhexyl) phthalate, mono (2-ethyl-5-oxohexyl) phthalate, and mono-n-butyl phthalate. A total of 35 female participants enrolled in the study, including 20 asthmatic patients and 15 healthy controls. The average concentrations of urinary endocrine disruptors in patient and control group did not demonstrate significant differences. Twenty asthmatic patients were divided into 2 groups according to their menstrual state. Using the Spearman rank correlation test in premenopausal asthmatic patients (nâ =â 7), we found negative correlations between urinary concentration of mono-n-butyl phthalate and asthma control test score, as well as postbronchodilator forced expiratory flow at 25% to 75% of forced vital capacity (P-valueâ =â .007 and .04, respectively). In contrast, it did not show any correlation with asthma control test or postbronchodilator forced expiratory flow at 25% to 75% of forced vital capacity (P-valueâ =â 1.00 and .74, respectively) in postmenopausal group (nâ =â 13). Endocrine disruptors might have an impact on the decline of small airway function and asthma management among premenopausal, but not postmenopausal, female asthmatic patients.
Assuntos
Asma , Compostos Benzidrílicos , Fenóis , Ácidos Ftálicos , Humanos , Feminino , Asma/urina , Asma/tratamento farmacológico , Projetos Piloto , Fenóis/urina , Fenóis/efeitos adversos , Ácidos Ftálicos/urina , Ácidos Ftálicos/efeitos adversos , Compostos Benzidrílicos/urina , Compostos Benzidrílicos/efeitos adversos , Adulto , Estudos de Casos e Controles , Pessoa de Meia-Idade , Disruptores Endócrinos/urina , Disruptores Endócrinos/efeitos adversos , Exposição Ambiental/efeitos adversosRESUMO
Allergic asthma is an important public health problem and is a complicated respiratory sickness that is characterized by bronchial inflammation, bronchoconstriction, and breathlessness. Asthma is orchestrated by type 2 immune response and remodeling is one of the important outputted problem in chronic asthma. Thymol is a naturally occurring monocyclic phenolic, it has a series of biological properties, and its immunomodulatory and anti-remodeling effects on allergic asthma were evaluated. The OVA-LPS-induced asthmatic mice were treated with thymol. Methacholine challenge test, eosinophil count, and levels of IL-4, IL-5, IL-13, and IL-33 in bronchoalveolar lavage fluid, total and OVA-specific IgE levels in serum, remodeling factors, gene expression of TGF-ß, Smad2, Smad3, and lung histopathology were done. Treatment with thymol could control AHR, eosinophil percentage levels of Th2 cytokines and Igs, remodeling factors, expression of TGF-ß, Smad2 and Smad3 genes, inflammation, goblet cell hyperplasia, and mucus production in asthmatic mice. Thymol can control asthma pathogens and related remodeling and fibrosis bio-factors and can be a potential treatment of asthma.
Assuntos
Remodelação das Vias Aéreas , Asma , Modelos Animais de Doenças , Camundongos Endogâmicos BALB C , Transdução de Sinais , Proteína Smad3 , Timol , Fator de Crescimento Transformador beta , Animais , Timol/farmacologia , Asma/imunologia , Asma/tratamento farmacológico , Remodelação das Vias Aéreas/efeitos dos fármacos , Remodelação das Vias Aéreas/imunologia , Proteína Smad3/metabolismo , Camundongos , Fator de Crescimento Transformador beta/metabolismo , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/imunologia , Citocinas/metabolismo , Feminino , Ovalbumina/imunologia , Líquido da Lavagem Broncoalveolar/imunologia , Líquido da Lavagem Broncoalveolar/citologia , Eosinófilos/imunologia , Eosinófilos/efeitos dos fármacos , Humanos , Imunoglobulina E/imunologia , Imunoglobulina E/sangue , Proteína Smad2/metabolismoAssuntos
Asma , Produtos Biológicos , Pólipos Nasais , Humanos , Pólipos Nasais/tratamento farmacológico , Pólipos Nasais/epidemiologia , Asma/tratamento farmacológico , Asma/epidemiologia , Produtos Biológicos/uso terapêutico , Antiasmáticos/uso terapêutico , Comorbidade , Anticorpos Monoclonais Humanizados/uso terapêuticoRESUMO
This research aims to produce orodispersible films (ODFs) and determine their potential use in the oral delivery of montelukast sodium for asthma treatment and allergic rhinitis. ODFs were successfully developed by Three-dimensional (3D) printing using propylene glycol (PG), and hydroxypropyl methylcellulose (HPMC), polyethylene glycol 400 (PEG). Finally, the amount of montelukast sodium in the ODFs was 5% (w/w). Drug-excipients compatibility with Fourier Transformed Infrared (FTIR) spectroscopy, mass uniformity, thickness, disintegration time, folding endurance, moisture absorption, pH, in vitro drug release (dissolution), drug content, moisture loss, moisture content, mechanical properties, and cytotoxicity studies were performed on the prepared films. All formulations disintegrated in approximately 40 s. Over 98% of drug release from all films within 2 min was confirmed. It was reported that Fm1-4 (8% HPMC and 1% PEG) and Fm2-4 (10% HPMC and 3% PEG) are more suitable for drug content, but Fm2-4 may be the ideal formulation considering its durability and transportability properties. Based on the characterization results and in vitro release values, the montelukast sodium ODF can be an option for other dosage forms. It was concluded that the formulations did not show toxic potential by in vitro cytotoxicity study with 3T3 cells. This new formulation can efficiently treat allergic rhinitis and asthma diseases.
Assuntos
Acetatos , Antiasmáticos , Asma , Ciclopropanos , Liberação Controlada de Fármacos , Polietilenoglicóis , Impressão Tridimensional , Quinolinas , Sulfetos , Ciclopropanos/administração & dosagem , Quinolinas/administração & dosagem , Quinolinas/química , Acetatos/química , Acetatos/administração & dosagem , Sulfetos/química , Asma/tratamento farmacológico , Polietilenoglicóis/química , Administração Oral , Antiasmáticos/administração & dosagem , Antiasmáticos/química , Antiasmáticos/farmacologia , Animais , Excipientes/química , Camundongos , Sistemas de Liberação de Medicamentos/métodos , Química Farmacêutica/métodos , Derivados da Hipromelose/química , Propilenoglicol/química , Espectroscopia de Infravermelho com Transformada de Fourier/métodos , SolubilidadeRESUMO
Asthma is common among the pediatric population. Exacerbations of this chronic condition can lead to emergency department visits and hospitalizations, resulting in time away from school. Children spend the majority of their day at school, where they may need access to quick relief medication to treat respiratory distress. Students' personal asthma medication is not always available in school. School nurses in Illinois collected data and undertook a quality improvement project to increase the number of schools in North Suburban Cook County with undesignated asthma medication. A toolkit was created and shared, helping to remediate barriers associated with obtaining undesignated asthma medication. With access to undesignated asthma medication, school nurses ensure students with asthma receive prompt treatment and coordination of care.