OBJECTIVE: To explore whether Soufeng Yuchuan(搜风愈喘, SFYC) formula alleviates asthma by promoting ferroptosis of airway epithelial cells. METHODS: A chronic asthma rat model was established using ovalbumin(OVA) com...OBJECTIVE: To explore whether Soufeng Yuchuan(搜风愈喘, SFYC) formula alleviates asthma by promoting ferroptosis of airway epithelial cells. METHODS: A chronic asthma rat model was established using ovalbumin(OVA) combined with aluminum hydroxide sensitization and OVA nebulization stimulation. Lung tissue pathology was assessed via hematoxylin and eosin staining and periodic acid-Schiff staining. Lung tissue ultrastructure was observed using transmission electron microscopy. Serum cytokine levels were measured by enzyme-linked immunosorbent assay. Malondialdehyde(MDA), glutathione, and tissue ferrous ion content in rat lung tissues and cells were detected using commercial kits. Immunohistochemical staining was used to determine the expression levels of interleukin-13(IL-13) and interleukin-6(IL-6) in lung tissue. Western blotting was employed to detect the expression levels of transferrin receptor 1(TFR1), transferrin receptor 2(TFR2), acyl-Co A synthetase longchain family member 4(ACSL4), glutathione peroxidase 4(GPX4), and solute carrier family 7 member 11(SLC7A11). Cell proliferation, apoptosis and reactive oxygen species(ROS) were evaluated using a cell counting kit-8 assay and flow cytometry. Intracellular lipid peroxidation was detected using a C11-BODIPY 581/591(C11-BODIPY) probe. RESULTS: SFYC formula effectively alleviates airway inflammation in asthmatic rats in a dose-dependent manner. It improves airway epithelial cell integrity, reduces alveolar wall thickening and expansion, inhibits goblet cell proliferation and mucus secretion, and decreases the expression of IL-6 and IL-13 in lung tissue, as well as the serum levels of IL-6, IL-13, interleukin-4(IL-4), and immunoglobulin E(Ig E). SFYC formula mitigates ferroptosis in lung tissue of asthmatic rats. At the cellular level, it promotes proliferation of rat airway epithelial cells, inhibits cell apoptosis, suppresses ROS, MDA, and lipid accumulation, reduces the expression of TFR1, TFR2, and ASCL4, and increases the expression of GPX4 and SLC7A11 to mitigate ferroptosis. CONCLUSION: SFYC formula alleviates asthma airway inflammation by inhibiting ferroptosis in airway epithelial cells, providing new insights and potential therapeutic targets for the development of new asthma treatment drugs.展开更多
OBJECTIVE:To assess the efficacy of point application therapy(PAT)in alleviating the exacerbation of chronic respiratory diseases represented by bronchial asthma.METHODS:In this multicenter randomized placebocontrolle...OBJECTIVE:To assess the efficacy of point application therapy(PAT)in alleviating the exacerbation of chronic respiratory diseases represented by bronchial asthma.METHODS:In this multicenter randomized placebocontrolled trial,eligible bronchial asthma patients received placebo PAT on the dog days of the first summer to establish a baseline,and then patients who continued to participate in the trial and repassed the eligibility review were randomized to receive regular or placebo PAT in the next two consecutive summers.The primary outcome was the change from baseline in the number of asthma exacerbations at 24 months.Secondary outcomes included severity of asthma exacerbation,asthma control test(ACT)score,percentage of forced expiratory volume in 1 s(FEV1)to the predicated value(FEV1%pred),peak expiratory flow(PEF),ratio of FEV1 to forced vital capacity(FEV1/FVC),and use of palliative drugs during bronchial asthma exacerbations at 12 and 24 months.The adverse events(AEs)were also assessed.RESULTS:A total of 835 patients with bronchial asthma were randomized in this trial.Compared with the placebo control,the PAT significantly decreased the mean number of asthma exacerbations(1.42;95%confidence interval,0.69 to 2.14;P<0.001),and increased the FEV1%pred at 24 months(P=0.039)and FEV1/FVC at 12 months(P=0.01)and 24 months(P=0.01).There were no significant differences between the groups in PEF or ACT score at 12 and 24 months,or in FEV1%pred at 12 months.Treatment-related AEs were mild and more common in the PAT group than in the placebo PAT group.No serious AEs were reported.CONCLUSION:PAT conducted on dog days could reduce asthma exacerbations in patients with bronchial asthma.展开更多
Objective Exposure to mixtures of environmental chemicals may influence asthma outcomes;however,the evidence remains equivocal.This study aimed to assess the association between mixed exposure to phenols and parabens ...Objective Exposure to mixtures of environmental chemicals may influence asthma outcomes;however,the evidence remains equivocal.This study aimed to assess the association between mixed exposure to phenols and parabens and asthma outcomes in adults and to explore the mediating role of body mass index(BMI).Methods Based on data from the National Health and Nutrition Examination Survey(NHANES,2013–2016),this study used multivariate generalized linear regression and weighted quantile sum(WQS)regression models to evaluate the associations between individual and joint exposure to phenols and parabens and asthma outcomes.These associations were further analyzed and stratified according to age and BMI.A mediation effect analysis was used to assess the role of BMI in this association.Results This study included 2,556 adults,of whom 400(15.7%)were diagnosed with asthma.After adjusting for all covariates,a significant positive correlation was observed between the chemical mixture and asthma,with an odds ratio of 1.33(95%confidence interval,1.06–1.68).Among the eight phenols and parabens,bisphenol F(BPF),propylparaben(PrP),and bisphenol S(BPS)were the major contributors.Additionally,BMI mediated 15.5%of the association between BPF exposure and asthma.Conclusion In this cross-sectional study,mixed exposure to phenols and parabens was significantly associated with asthma outcomes,with BPF,PrP,and BPS identified as the primary contributing chemicals.This study provides valuable insights into the association between mixed chemical exposure and asthma as well as potential control pathways.展开更多
Asthma, one of the most prevalent chronic inflammatory diseases, remains challenging to manage effectively. Current therapies commonly alleviate symptoms through broad immunosuppression and bronchodilation but fail to...Asthma, one of the most prevalent chronic inflammatory diseases, remains challenging to manage effectively. Current therapies commonly alleviate symptoms through broad immunosuppression and bronchodilation but fail to target disease-specific molecular pathways. Genetic intervention using small interfering RNA(siRNA) has emerged as a promising strategy for asthma therapy. However, its success is largely hindered by the lack of an efficient delivery approach targeting airway epithelial cells(AECs). Here, we developed a novel inhalable siRNA delivery system based on artificially prepared nanovesicles through designed extrusion processes of mesenchymal stem cells. To enable an effective inhalation delivery of siRNA via nanovesicles, various parameters, including extrusion cycles,membrane pore sizes, and centrifugal forces were examined through orthogonal testing.Results revealed that the artificially prepared nanovesicles demonstrated remarkable capability to deliver thymic stromal lymphopoietin-targeted siRNA into AECs and substantially suppressed the inflammatory pathways and goblet cell hyperplasia, and eventually achieved a significant inhibition of asthma symptoms in ovalbumin-induced asthma models. Thus, the present study provides a novel nebulized nanovesicle-based carrier for effective delivery of siRNA through local inhalation, offering a promising therapeutic delivery platform for asthma and potentially other respiratory diseases.展开更多
OBJECTIVE:To investigate the key targets and mechanisms of the Wenyang Huayin decoction(WYHYD,温阳化饮方)in treating bronchial asthma with cold fluid retention syndrome using network pharmacology and animal experiment...OBJECTIVE:To investigate the key targets and mechanisms of the Wenyang Huayin decoction(WYHYD,温阳化饮方)in treating bronchial asthma with cold fluid retention syndrome using network pharmacology and animal experiments.METHODS:On the one hand,we used network pharmacology method to explored the chemical components of the WYHYD and the main targets of bronchial asthma were acquired.Besides,a protein interaction network was built after protein interaction analysis to find potential protein functional modules.Then,we constructed the"WYHYD component-bronchial asthma target-pathway"network.On the other hand,the experimental intervention was as follows:first,we formed a rat model of bronchial asthma.Thereafter,we used the WYHYD to treat the disease while observing autophagyrelated indicators as the core target of network pharmacology.RESULTS:The network pharmacology revealed that there are 122 potential therapeutic targets in treating bronchial asthma with WYHYD.The biological processes mainly involved in the WYHYD included Gene Ontology:0110032:positive regulation of G2/MI transition of the medical cell cycle etc.and four major signaling pathways were involved.During laboratory investigations,various signs and clinical manifestations of the rat model group were the same.After administering the WYHYD,lung function,pathological sections,inflammatory factors,and other microscopic indicators improved to varying degrees,providing evidence for the study results.Meanwhile,we verified that the core targets of WYHYD in treating asthma through the intervention of autophagy are tumor necrosis factor,caspase 8,interleukin 1 beta,sirtuin 1,phosphatidylinositol 3-kinase catalytic subunit type 3,C-C chemokine receptor type 7,L/YN kinase,and protein tyrosine kinase 2.CONCLUSION:This preliminary study revealed the treatment process of bronchial asthma with multicomponent,multi-target,and multi-pathway mechanisms of the WYHYD.展开更多
Obesity-related asthma is a distinct clinical phenotype,characterized by severe respiratory symptoms,reduced responsiveness to conventional glucocorticoid therapy,and a significantly increase in disease burden.With th...Obesity-related asthma is a distinct clinical phenotype,characterized by severe respiratory symptoms,reduced responsiveness to conventional glucocorticoid therapy,and a significantly increase in disease burden.With the rising global prevalence of obesity,the number of individuals affected by obesity-related asthma is steadily growing,presenting a pressing public health issue.The pathogenesis of obesity-related asthma is multifactorial,involving a complex interplay of metabolic and immune pathways.Key mechanisms include dysregulated T-cell differentiation,pro-inflammatory macrophage polarization,oxidative stress,and altered cytokines and adipokines secretion,all contributing to airway inflammation and remodeling.Additionally,metabolic factors,such as adiposity and adipokine imbalance,further complicated disease progression.A major clinical challenge is developing targeted therapies to address the substantial heterogeneity in this patient population.Current treatment approaches,largely focused on corticosteroids,often fail to achieve satisfactory outcomes,emphasizing the need for novel,tailored therapies that target the specific pathophysiological features of obesity-related asthma.This review systematically explores the cellular and molecular mechanisms driving obesity-related asthma,focusing on how obesity-associated factors such as adipokines and airway remodeling influence disease progression.The review also evaluates emerging therapeutic interventions and highlights the ongoing challenges in clinical diagnosis and management.By synthesizing recent research,this study aims to provide insights into potential strategies for improving treatment and clinical outcomes for patients with obesity-related asthma.展开更多
AIM:To comprehensively assess the relationship between asthma and myopia based on the National Health and Nutrition Examination Survey(NHANES)database combined with Mendelian randomization(MR).METHODS:Initially,20497 ...AIM:To comprehensively assess the relationship between asthma and myopia based on the National Health and Nutrition Examination Survey(NHANES)database combined with Mendelian randomization(MR).METHODS:Initially,20497 subjects from the complete questionnaire cycle in the NHANES database from 2005 to 2008 were included.By exclusion criteria,8460 subjects were screened with 1676 myopia samples and 6784 control samples.Subsequently,baseline characteristics,association analyses,risk stratification analyses,and receive operating characteristic curve(ROC)were used to investigate the associations between covariates and myopia.Then,the causal relationship was explored in depth by MR analysis,and was estimated the reliability by sensitivity analyses and directionality tests.RESULTS:Baseline characteristics illustrated a significant difference between myopia and controls for both asthma and covariates(excluding gender;P<0.05).The results in all three models indicated that asthma was strongly associated with myopia and the effect on myopia was not significantly confounded by other covariates[model 3:odd ratio(OR)=1.31;95%CI=1.07-1.62;P=0.0133].The risk stratification analysis again verified that asthma remained strongly associated with myopia and was a risk factor for myopia(P<0.05,OR>1).ROC proved that the model was accurate in its prediction[area under curve(AUC)=0.7].Subsequently,the causal relationship between them was statistically significant(P<0.05)according to the inverse variance weighted(IVW)method in MR.Scatterplot showed that asthma and myopia had significant positive causality and were not affected by confounders.Forest plot displayed an increasing risk of myopia on asthma(OR>1).The funnel plot demonstrated compliance with Mendel’s second law.Sensitivity analysis and directional analysis further confirmed the confidence of the MR analysis results and a unidirectional causal relationship between them.CONCLUSION:A significant association and causality between asthma and myopia is found through the NHANES database and MR analysis,which is important implications for public health policy development and clinical practice.展开更多
BACKGROUND The relationship between diabetes mellitus(DM)and asthma is complex and can impact disease trajectories.AIM To explore the bidirectional influences between the two conditions on clinical outcomes and diseas...BACKGROUND The relationship between diabetes mellitus(DM)and asthma is complex and can impact disease trajectories.AIM To explore the bidirectional influences between the two conditions on clinical outcomes and disease control.METHODS We systematically reviewed the literature on the relationship between DM and asthma,focusing on their impacts,mechanisms,and therapeutic implications.Various studies were assessed,which investigated the effect of glycemic control on asthma outcomes,lung function,and exacerbations.The study highlighted the role of specific diabetes medications in managing asthma.RESULTS The results showed that poor glycemic control in diabetes can exacerbate asthma,increase hospitalizations,and reduce lung function.Conversely,severe asthma,especially in obese individuals,can complicate diabetes management and make glycemic control more difficult.The diabetes-associated mechanisms,such as inflammation,microangiopathy,and oxidative stress,can exacerbate asthma and decrease lung function.Some diabetes medications exhibit anti-inflammatory effects that show promise in mitigating asthma exacerbations.CONCLUSION The complex interrelationship between diabetes and asthma suggests bidirectional influences that affect disease course and outcomes.Inflammation and microvascular complications associated with diabetes may worsen asthma outcomes,while asthma severity,especially in obese individuals,complicates diabetes control.However,the current research has limitations,and more diverse longitudinal studies are required to establish causal relationships and identify effective treatment strategies for individuals with both conditions.展开更多
Bronchial asthma is divided into type 2 and non-type 2 asthma based on the immunopathogenesis.Type 2 inflammation is an inflammation mediated by T helper 2 cells,group 2 innate lymphoid cells and sustained by a specif...Bronchial asthma is divided into type 2 and non-type 2 asthma based on the immunopathogenesis.Type 2 inflammation is an inflammation mediated by T helper 2 cells,group 2 innate lymphoid cells and sustained by a specific subset of cytokines.In recent years,type 2 asthma has become the research hotspot in the field of asthma.For type 2 asthma,targeted therapies have become effective treatments and widely used in clinical practice.In order to further understand the progress of biologic drugs for bronchial asthma,as well as the disease outcomes in patients with type 2 asthma,and improve asthma control and remission,this article reviewed the progress and achievements of biologic drugs for asthma from May 1,2023 to April 30,2024,providing clinical perspective for the choosing appropriate targeted treatment of asthma.It also highlights selected poster pre-sentations from the ATS 2024 Annual Meeting to provide clinical insights for choosing appropriate targeted treatments for Type 2 asthma.展开更多
Chronic rhinosinusitis(CRS)is a persistent inflammatory condition affecting the mucosa of nasal cavity and paranasal sinus,often stemming from untreated or recurrent acute sinusitis.Asthma is characterized by airway i...Chronic rhinosinusitis(CRS)is a persistent inflammatory condition affecting the mucosa of nasal cavity and paranasal sinus,often stemming from untreated or recurrent acute sinusitis.Asthma is characterized by airway inflammation,intermittent bronchospasm,and symptoms such as wheezing and dyspnea.These two conditions frequently coexist,sharing overlapping pathogenic mechanisms and inflammatory pathways.Gastroesophageal reflux disease(GERD),a condition where stomach contents reflux into the esophagus,is another prevalent comorbidity associated with asthma and CRS.Notably,GERD is more common in CRS patients,suggesting the intricate and potentially bidirectional relationship among CRS,asthma,and GERD.Despite this complexity,a comprehensive understanding of these interconnections remains elusive in the literature.This review synthesizes findings from the past decade,focusing on the epidemiology,pathophysiology,and comorbidity mechanisms linking these three conditions.By addressing current knowledge gaps,it aims to provide insights into their shared mechanisms and implications for integrated clinical management.展开更多
The global incidence of asthma,a leading respiratory disorder affecting more than 235 million people,has dramatically increased in recent years.Characterized by chronic airway inflammation and an imbalanced response t...The global incidence of asthma,a leading respiratory disorder affecting more than 235 million people,has dramatically increased in recent years.Characterized by chronic airway inflammation and an imbalanced response to airborne irritants,this chronic condition is associated with elevated levels of inflammatory factors and symptoms such as dyspnea,cough,wheezing,and chest tightness.Conventional asthma therapies,such as corticosteroids,long-actingβ-agonists,and antiinflammatory agents,often evoke diverse adverse reactions and fail to reduce symptoms and hospitalization rates over the long term effectively.These limitations have prompted researchers to explore innovative therapeutic strategies,including stem cell-related interventions,offering hope to those afflicted with this incurable disease.In this review,we describe the characteristics of stem cells and critically assess the potential and challenges of stem cell-based therapies to improve disease management and treatment outcomes for asthma and other diseases.展开更多
BACKGROUND Diffuse panbronchiolitis(DPB)is a rare,chronic inflammatory lung disease mar-ked by chronic cough,breathlessness,and preceding sinusitis.Symptoms often persist for years and can be misdiagnosed as asthma,pa...BACKGROUND Diffuse panbronchiolitis(DPB)is a rare,chronic inflammatory lung disease mar-ked by chronic cough,breathlessness,and preceding sinusitis.Symptoms often persist for years and can be misdiagnosed as asthma,particularly in children.This report describes a DPB case resolved with long-term azithromycin therapy,em-phasizing the need for a timely and accurate diagnosis.CASE SUMMARY A 12-year-old girl,diagnosed with asthma at age five and managed with inhaled corticosteroids and long-acting beta-2 agonists,developed a history of chronic productive cough and chronic sinusitis for a year.On examination,she exhibited wheezing and coarse crackles.Despite receiving treatment for an asthma exacer-bation,her symptoms did not improve.A chest X-ray revealed reticulonodular infiltration in both lower lungs,prompting further evaluation with high-resolu-tion computed tomography(HRCT).The HRCT confirmed centrilobular nodule opacities,a'tree-in-bud'pattern,and non-tapering bronchi,suggesting DPB.Elevated cold hemagglutinin titers at 128 further supported the diagnosis.Her cough and sinusitis resolved within a month after starting azithromycin therapy,chosen for its anti-inflammatory and immunomodulatory effects.Follow-up HRCT scans after 1 year of continuous treatment showed complete normalization.CONCLUSION This case highlights the importance of early diagnosis and prompt treatment in achieving favorable outcomes for DPB.展开更多
Objective Asthma imposes a significant global health burden.This study examines changes in the asthma-related disease burden from 1990 to 2021 and projects future burdens for 2050 under different scenarios.Methods Usi...Objective Asthma imposes a significant global health burden.This study examines changes in the asthma-related disease burden from 1990 to 2021 and projects future burdens for 2050 under different scenarios.Methods Using data from the Global Burden of Disease 2021 study,we analyzed asthma incidence,prevalence,mortality,and disability-adjusted life years(DALYs)from 1990 to 2021.We projected the disease burden for 2050 based on current trends and hypothetical scenarios in which all risk factors are controlled.Temporal trends in age-standardized incidence,prevalence,mortality,and DALY rates were explored using Annual Percent Change.Results In 2021,the age-standardized rates for asthma incidence,prevalence,mortality,and DALYs in China were 364.17 per 100,000(95%uncertainty interval[UI]:283.22-494.10),1,956.49 per 100,000(95%UI:1,566.68-2,491.87),1.47 per 100,000(95%UI:1.15-1.79),and 103.76 per 100,000(95%UI:72.50-145.46),respectively.A higher disease burden was observed among Chinese men and individuals aged 70 years or older.Compared to the current trend,a combined scenario involving improvements in environmental factors,behavioral and metabolic health,child nutrition,and vaccination resulted in a greater reduction in the disease burden caused by asthma.Conclusion Addressing modifiable risk factors is essential for further reducing the asthma-related disease burden.展开更多
Background:To appraise the ameliorative potentials of Allium sativum aqueous extract in ovalbumin(OVA)-lipopolysaccharide(LPS)-induced asthma.Methods:Extraction,phytochemical analysis,determination of bioactive compou...Background:To appraise the ameliorative potentials of Allium sativum aqueous extract in ovalbumin(OVA)-lipopolysaccharide(LPS)-induced asthma.Methods:Extraction,phytochemical analysis,determination of bioactive compounds and LD50 study of aqueous extract of A.sativum were achieved using standard biochemical methods.Twenty-four(24)male Wistar rats averagely weighing between 168–255 g were grouped into four of six animals in each steel-metal cage.Groups 1 and 2 served as normal and positive groups respectively.Rats in groups 2–4 were sensitized and challenged with a combination of OVA and LPS.Groups 3 and 4 were administered 250 and 500 mg/kg b.w of aqueous extract of A.sativum respectively for two weeks.The effect of aqueous extracts of A.sativum in OVA and LPS-induced asthma on alterations in differential white blood cells,inflammatory cytokines,some serum biochemical as well as histological indicators of experimental rats were assessed.Results:The aqueous extract of 600 g of plant material yielded 74.1 g accounting for 11.9%of sample material used.The result of the Phytochemical analysis showed higher number of glycosides,flavonoids and phenols.The animals displayed zero behavioral adverse reaction when administered the aqueous extract up to the highest dose of 5,000 mg/kg b.w.Administrations of aqueous extract of A.sativum remarkably(P<0.05;95%confidence intervals CI)declined the levels of neutrophils,eosinophils and total white blood cell count as opposed to the untreated group.Levels of interleukin 4(IL-4),interleukin 5(IL-5),interleukin 13(IL-13)and immunoglobulin E(IgE)of groups 3 and 4 had a significant(P<0.05;95%CI)varying percentage reduction(IL-4=39.78%,49.51%;IL-5=34.66%,40.05%;IL-13=31.96%,30.81%;33.45%,21.38%)respectively in comparison to group 2(untreated).The result showed a significantly(P<0.05,95%CI)declined malonaldehyde(MDA)concentration and elevated catalase,decreased glutathione concentration and superoxide dismutase activity of the treatment groups compared to the untreated.Serum liver function enzymes including alkaline phosphatase,alanine transaminase,and aspartate transaminase in the groups receiving aqueous extract of A.sativum exhibited a significant(P<0.05;95%CI)reduction in levels compared to group 2(untreated).Conclusion:Findings from this study indicated that aqueous extracts of A.sativum have the potential to improve asthma symptoms by decreasing inflammatory cytokines and mitigating oxidative stress.This effect could enhance the efficacy of conventional treatments such as inhaled corticosteroids,including cortisone,hydrocortisone,dexamethasone,and prednisone,as well as bronchodilators,leukotriene modifiers,and biologic therapies.Further studies need to be carried out on human subjects and also expanded to other respiratory disorders like Chronic obstructive pulmonary disease and Coronavirus Disease 2019.展开更多
Salvia miltiorrhiza(S.miltiorrhiza)represents a crucial component of traditional Chinese medicine,demonstrating effects on blood circulation activation and stasis removal,and has been widely utilized in asthma treatme...Salvia miltiorrhiza(S.miltiorrhiza)represents a crucial component of traditional Chinese medicine,demonstrating effects on blood circulation activation and stasis removal,and has been widely utilized in asthma treatment.This study isolated a novel phenolic acid(S1)from S.miltiorrhiza and investigated its anti-asthmatic activity and underlying mechanisms for the first time.An allergic asthma(AA)model was established using ovalbumin(OVA).The mechanism of S1's effects on AA was investigated using multi-factor joint analysis,flow cytometry,and co-culture systems to facilitate clinical asthma treatment.S1(10 or 20 mg·kg-1)was administered daily to mice with OVA-induced AA(OVA-AA)during days 21-25.The study examined airway responsiveness,lung damage,inflammation,and levels of immunoglobulin E(IgE),PGD2,interleukins(IL-4,5,10,13,17A),tumor necrosis factorα(TNF-α),GM-CSF,CXCL1,CCL11,and mMCP-1.Additionally,mast cell(MC)activation and degranulation were explored,along with T helper type 17(Th17)/Treg immune cells and TLR4 pathway biomarkers.The antagonistic activity of that specific antagonist of TLR4(TAK-242)(1μmol·L^(-1)),a specific TLR4 blocker,against S1(10μmol·L^(-1))was examined in co-cultured 16 HBE cells and bone marrow-derived cells(BMDCs)or splenic lymphocytes(SLs)induced with LPS(1μg·mL^(-1))to elucidate the TLR4 pathway's mediating role.S1 demonstrated reduced airway responsiveness,lung damage,and inflammation,with downregulation of IgE,PGD2,interleukins,TNF-α,GM-CSF,CXCL1,CCL11,and mMCP-1.It also impeded MC activation and degranulation,upregulated IL^(-1)0,and influenced Th17/Treg immune cell transformation following OVA challenge.Furthermore,S1 inhibited the TLR4 pathway in OVA-AA mice,and TLR4 antagonism enhanced S1's positive effects.Analysis using an OVA-AA mouse model demonstrated that S1 alleviates AA clinical symptoms,restores lung function,and inhibits airway response.S1's therapeutic effects occur through regulation of Th17/Treg immune cells and inflammation,attributable at least partially to the TLR4 pathway.This study provides molecular justification for S1 in AA treatment.展开更多
BACKGROUND IgE plays a critical role in allergic inflammation and asthma pathogenesis.This study investigates the involvement of IgE cells in asthma exacerbation and evaluates the effectiveness of targeted interventio...BACKGROUND IgE plays a critical role in allergic inflammation and asthma pathogenesis.This study investigates the involvement of IgE cells in asthma exacerbation and evaluates the effectiveness of targeted interventions.AIM To evaluate the role of IgE in the exacerbation of allergic asthma and to determine the clinical efficacy of anti-IgE therapy in improving disease outcomes.Specifically,the study investigates changes in serum IgE levels,lung function,asthma control scores,and the frequency of acute exacerbations among patients receiving standard therapy with or without anti-IgE intervention.METHODS A total of 200 patients diagnosed with moderate to severe asthma were enrolled in this experimental study conducted from April 2024 to April 2025.Participants were randomized to receive either standard asthma therapy or therapy combined with anti-IgE agents.IgE levels and asthma control parameters were monitored.RESULTS Participants receiving anti-IgE treatment demonstrated a significant reduction in serum IgE levels(P<0.001),improved Forced expiratory volume in one second scores,and fewer exacerbation episodes compared to the control group.CONCLUSION IgE cells significantly contribute to asthma severity,and targeted therapy against IgE can improve disease outcomes.These findings underscore the importance of immunomodulatory strategies in asthma management.展开更多
The development of adrenergic agonists(AAs)for asthma has provided important mechanistic insights into acupuncture-based target discovery and treatment strategies.This review describes the historical evolution of AA t...The development of adrenergic agonists(AAs)for asthma has provided important mechanistic insights into acupuncture-based target discovery and treatment strategies.This review describes the historical evolution of AA therapy,including the precise optimization of nonselective toβ2-selective agonists,im-provement from short-acting to ultra-long-acting agents,shift from targeted monotherapy to combination regimens,and alterations in drug formulation.Additionally,this review summarizes recent advances in acupuncture treatment for asthma,including the development of novel targeted therapies,application of acupuncture-based combination regimens,and optimization of the mode of administration.Taken to-gether,this article discusses key insights from research on AA that inform acupuncture approaches,with a focus on:(1)precision targeting:identifying acupuncture-specific targets to improve efficacy;(2)syn-ergistic treatment:employing multi-target combination regimens to enhance therapeutic outcomes;(3)formulation innovation:advancing acupuncture delivery methods to improve patient compliance;and(4)evidence-based development:strengthening clinical research to generate high-quality evidence to inform the discovery of novel targets and treatment strategies for asthma.展开更多
In China,omalizumab is indicated for patients with moderate to severe persistent allergic asthma in whom symptoms remain inadequately controlled despite treatment with inhaled corticosteroids(ICS)in combination with l...In China,omalizumab is indicated for patients with moderate to severe persistent allergic asthma in whom symptoms remain inadequately controlled despite treatment with inhaled corticosteroids(ICS)in combination with long actingβ-agonists(LABA)(GINA step 3 or higher),and urticaria.We report a case of joint and Achilles tendon inflammatory reactions in a patient with Th2-type asthma receiving omalizumab treatment.An adult male presented with recurrent episodes of sneezing,rhinorrhea,wheezing,chest tightness,shortness of breath,and dyspnea.He exhibited allergies to multiple substances and demonstrated impaired lung function,ultimately being diagnosed with allergic rhinitis and asthma.Following initial treatment with ICS and LABA,his symptoms were initially controlled.However,as the disease progressed,the frequency of nocturnal attacks increased,and the incidence of attacks during the allergy season escalated,leading to a significant decline in lung function.Subsequently,he commenced subcutaneous injections of omalizumab at a dosage of 600 mg monthly.There was a partial improvement in the frequency of asthma attacks after two injections.Unfortunately,four days after the first treatment,he reported pain in the right Achilles tendon.Rheumatological screenings,including a five-item antinuclear antibody test and an 11-item autoantibody profile test,revealed no significant abnormalities.Ankle joint ultrasound indicated hyperechoic spots around the Achilles tendon with acoustic shadows,suggesting the presence of Achilles tendinopathy.Ten days later,the pain symptoms resolved spontaneously.Due to the sig-nificant improvement in asthma symptoms,omalizumab treatment continued,albeit with a dosage reduction to 300mg.After intermittent treatment over four sessions,asthma symptoms improved markedly,with the Asthma Control Test(ACT)score increasing from 14 to 20.Lung function improved from moderate obstruction to mild obstruction.The only drawback was the patient’s recurrent swelling,pain,and joint effusion in the joints(specifically the knee and ankle)during the treatment period.Omalizumab is an effective therapeutic option for the treatment of allergic asthma.Although the incidence of adverse events reported in current studies is low,there have been emerging reports of joint swelling,pain,and myalgia reactions in both children and adults receiving treatment for asthma and urticaria.Given the rarity and non-specific nature of these reactions,it is challenging to ascertain the true incidence rate.Previous reports have described symptoms that occur upon initiation of the medication,which can recur upon re-administration.While the factors that may increase the risk of joint inflammatory reactions to omalizumab remain to be elucidated,this case contributes to a deeper understanding of this adverse reaction associated with a well-tolerated and important therapeutic agent.展开更多
Objective:To analyze the clinical value of Pulmicort Respules inhalation combined with cetirizine in the treatment of pediatric asthma.Methods:From December 2023 to December 2024,82 children with asthma admitted to ou...Objective:To analyze the clinical value of Pulmicort Respules inhalation combined with cetirizine in the treatment of pediatric asthma.Methods:From December 2023 to December 2024,82 children with asthma admitted to our hospital were randomly divided into a control group and an observation group,with 41 cases in each group.The clinical symptom relief time(shortness of breath,cough,dyspnea,lung wheezing),lung function indicators(FEV1,FVC,FEV1/FVC),inflammatory indicators(TNF-α,IL-6,IL-8),and clinical treatment effects were analyzed in the two groups.Results:The relief time for shortness of breath,cough,dyspnea,and lung wheezing in the observation group was shorter than that in the control group(P<0.05).After treatment,compared with the control group,the levels of FEV1,FVC,FEV1/FVC,and treatment efficiency in the observation group were higher,while the levels of TNF-α,IL-6,and IL-8 were lower(P<0.05).Conclusion:The combination of Pulmicort Respules inhalation and cetirizine oral therapy for children with asthma can shorten the improvement time of clinical symptoms,inhibit inflammation,and improve lung function.展开更多
BACKGROUND Current drugs primarily target inflammation control but do not reverse tissue remodeling changes for asthma.Human mesenchymal stem cells are known for their anti-inflammatory and tissue remodeling capabilit...BACKGROUND Current drugs primarily target inflammation control but do not reverse tissue remodeling changes for asthma.Human mesenchymal stem cells are known for their anti-inflammatory and tissue remodeling capabilities.However,limited research has explored the therapeutic impact of varying doses and frequencies of human umbilical cord blood-derived mesenchymal stem cells(HUC-MSCs)on established airway remodeling in experimental asthma.AIM To explore and optimize the dosage and administration frequency of HUC-MSCs in experimental models of ovalbumin(OVA)-induced asthma.METHODS BALB/c mice underwent sensitization and were challenged using OVA.Control animals were administered a saline solution following the same protocol.HUC-MSCs were identified using flow cytometry.HUC-MSCs at incremental dosages(1×105,2×105,4×105)were injected via tail veins on day 30(the second after the final stimulation).After comparing each group and determining the optimal dose,supplement the optimal dose twice on day 30 and day 33(the second and fifth day after the final stimulation).Bronchoalveolar lavage fluid(BALF)and serum were harvested for analysis of concentrations of interleukin-4(IL-4),IL-13,immunoglobulin E and interferon-gamma(IFN-γ)by enzyme-linked immunosorbent assay.Pharmacology of airways and lung functions were also evaluated to identify the optimal group.RESULTS The study shows that HUC-MSC transplantation ameliorates OVA-induced asthma by significantly reducing airway inflammation and obstruction in preclinical models.This effect is associated with decreased Th2 cytokines IL-4 and IL-13,and increased Th1 cytokine IFN-γ.The optimal dose of 2×105 cells/mouse was identified as the most effective in reducing local asthmatic airway inflammation and changing levels of IL-4,IL-13,and IFN-γin serum and BALF compared to other single doses of HUC-MSC.Multiple treatments with the medium dose(2×105 cells)of HUC-MSCs on days 30 and 33 yield the best pathological and lung function outcomes.However,double treatments do not reduce IL-4 and IL-13 expression or enhance IFN-γproduction in serum or BALF more effectively than a single medium dose.CONCLUSION HUC-MSCs effectively regulate pro-inflammatory mediators in serum and BALF,modulating airway remodeling and lung function.In this acute mouse asthma model,a single dosage of 2×105 is optimal,with more significant effects of decreasing airway obstruction requiring repeated administration.展开更多
基金Supported by Natural Science Foundation-funded Project:the Study on the Mechanism of Soufeng Yuchuan Formula in Regulating Airway Remodeling in Asthmatic Rats Based on Epithelial-Mesenchymal Transition(No. 82174438)。
文摘OBJECTIVE: To explore whether Soufeng Yuchuan(搜风愈喘, SFYC) formula alleviates asthma by promoting ferroptosis of airway epithelial cells. METHODS: A chronic asthma rat model was established using ovalbumin(OVA) combined with aluminum hydroxide sensitization and OVA nebulization stimulation. Lung tissue pathology was assessed via hematoxylin and eosin staining and periodic acid-Schiff staining. Lung tissue ultrastructure was observed using transmission electron microscopy. Serum cytokine levels were measured by enzyme-linked immunosorbent assay. Malondialdehyde(MDA), glutathione, and tissue ferrous ion content in rat lung tissues and cells were detected using commercial kits. Immunohistochemical staining was used to determine the expression levels of interleukin-13(IL-13) and interleukin-6(IL-6) in lung tissue. Western blotting was employed to detect the expression levels of transferrin receptor 1(TFR1), transferrin receptor 2(TFR2), acyl-Co A synthetase longchain family member 4(ACSL4), glutathione peroxidase 4(GPX4), and solute carrier family 7 member 11(SLC7A11). Cell proliferation, apoptosis and reactive oxygen species(ROS) were evaluated using a cell counting kit-8 assay and flow cytometry. Intracellular lipid peroxidation was detected using a C11-BODIPY 581/591(C11-BODIPY) probe. RESULTS: SFYC formula effectively alleviates airway inflammation in asthmatic rats in a dose-dependent manner. It improves airway epithelial cell integrity, reduces alveolar wall thickening and expansion, inhibits goblet cell proliferation and mucus secretion, and decreases the expression of IL-6 and IL-13 in lung tissue, as well as the serum levels of IL-6, IL-13, interleukin-4(IL-4), and immunoglobulin E(Ig E). SFYC formula mitigates ferroptosis in lung tissue of asthmatic rats. At the cellular level, it promotes proliferation of rat airway epithelial cells, inhibits cell apoptosis, suppresses ROS, MDA, and lipid accumulation, reduces the expression of TFR1, TFR2, and ASCL4, and increases the expression of GPX4 and SLC7A11 to mitigate ferroptosis. CONCLUSION: SFYC formula alleviates asthma airway inflammation by inhibiting ferroptosis in airway epithelial cells, providing new insights and potential therapeutic targets for the development of new asthma treatment drugs.
基金Supported by“12th Five-year” National Science and Technology Pillar Program by the Ministry of Science and Technology of the People’s Republic of China:Clinical Evaluation and Technical Operation Specification Research on Preventing Bronchial Asthma Attacks by Acupoint Application in Winter Disease Summer Treatment(No. 2015BAI04B11)。
文摘OBJECTIVE:To assess the efficacy of point application therapy(PAT)in alleviating the exacerbation of chronic respiratory diseases represented by bronchial asthma.METHODS:In this multicenter randomized placebocontrolled trial,eligible bronchial asthma patients received placebo PAT on the dog days of the first summer to establish a baseline,and then patients who continued to participate in the trial and repassed the eligibility review were randomized to receive regular or placebo PAT in the next two consecutive summers.The primary outcome was the change from baseline in the number of asthma exacerbations at 24 months.Secondary outcomes included severity of asthma exacerbation,asthma control test(ACT)score,percentage of forced expiratory volume in 1 s(FEV1)to the predicated value(FEV1%pred),peak expiratory flow(PEF),ratio of FEV1 to forced vital capacity(FEV1/FVC),and use of palliative drugs during bronchial asthma exacerbations at 12 and 24 months.The adverse events(AEs)were also assessed.RESULTS:A total of 835 patients with bronchial asthma were randomized in this trial.Compared with the placebo control,the PAT significantly decreased the mean number of asthma exacerbations(1.42;95%confidence interval,0.69 to 2.14;P<0.001),and increased the FEV1%pred at 24 months(P=0.039)and FEV1/FVC at 12 months(P=0.01)and 24 months(P=0.01).There were no significant differences between the groups in PEF or ACT score at 12 and 24 months,or in FEV1%pred at 12 months.Treatment-related AEs were mild and more common in the PAT group than in the placebo PAT group.No serious AEs were reported.CONCLUSION:PAT conducted on dog days could reduce asthma exacerbations in patients with bronchial asthma.
基金supported by the National Natural Science Foundation of China(No.22276017)the Beijing Natural Science Foundation(Nos.7232236 and 7244455).
文摘Objective Exposure to mixtures of environmental chemicals may influence asthma outcomes;however,the evidence remains equivocal.This study aimed to assess the association between mixed exposure to phenols and parabens and asthma outcomes in adults and to explore the mediating role of body mass index(BMI).Methods Based on data from the National Health and Nutrition Examination Survey(NHANES,2013–2016),this study used multivariate generalized linear regression and weighted quantile sum(WQS)regression models to evaluate the associations between individual and joint exposure to phenols and parabens and asthma outcomes.These associations were further analyzed and stratified according to age and BMI.A mediation effect analysis was used to assess the role of BMI in this association.Results This study included 2,556 adults,of whom 400(15.7%)were diagnosed with asthma.After adjusting for all covariates,a significant positive correlation was observed between the chemical mixture and asthma,with an odds ratio of 1.33(95%confidence interval,1.06–1.68).Among the eight phenols and parabens,bisphenol F(BPF),propylparaben(PrP),and bisphenol S(BPS)were the major contributors.Additionally,BMI mediated 15.5%of the association between BPF exposure and asthma.Conclusion In this cross-sectional study,mixed exposure to phenols and parabens was significantly associated with asthma outcomes,with BPF,PrP,and BPS identified as the primary contributing chemicals.This study provides valuable insights into the association between mixed chemical exposure and asthma as well as potential control pathways.
基金supported by National Natural Science Foundation of China (U22A20383)Natural Science Foundation of Zhejiang Province (LY24H300001)+2 种基金Fundamental Research Funds for the Central Universities (226-2022-00125)Zhejiang Province Postdoctoral Research Excellence Funding Project (ZJ2023151)Pharmacy 80 Basic Research Funding in College of Pharmaceutical Sciences, Zhejiang University Education Foundation。
文摘Asthma, one of the most prevalent chronic inflammatory diseases, remains challenging to manage effectively. Current therapies commonly alleviate symptoms through broad immunosuppression and bronchodilation but fail to target disease-specific molecular pathways. Genetic intervention using small interfering RNA(siRNA) has emerged as a promising strategy for asthma therapy. However, its success is largely hindered by the lack of an efficient delivery approach targeting airway epithelial cells(AECs). Here, we developed a novel inhalable siRNA delivery system based on artificially prepared nanovesicles through designed extrusion processes of mesenchymal stem cells. To enable an effective inhalation delivery of siRNA via nanovesicles, various parameters, including extrusion cycles,membrane pore sizes, and centrifugal forces were examined through orthogonal testing.Results revealed that the artificially prepared nanovesicles demonstrated remarkable capability to deliver thymic stromal lymphopoietin-targeted siRNA into AECs and substantially suppressed the inflammatory pathways and goblet cell hyperplasia, and eventually achieved a significant inhibition of asthma symptoms in ovalbumin-induced asthma models. Thus, the present study provides a novel nebulized nanovesicle-based carrier for effective delivery of siRNA through local inhalation, offering a promising therapeutic delivery platform for asthma and potentially other respiratory diseases.
基金Supported by National Natural Science Foundation of China:Study on the Mechanism of Airway Inflammation in Rats with Bronchial Asthma Cold Drink Lung Syndrome Treated with Metastasis Associated Lung Adenocarcinoma Transcript 1 Regulated Autophagy(No.82004233)the Shandong Province Traditional Chinese Medicine Science and Technology Project:Exploring the Mechanism of Xiaoqinglong Tang's Intervention in Bronchial Asthma Cold Drink Lung Syndrome through the"Temperature Sensing Channel Transient Receptor Potential Mitochondrial Autophagy"Pathway based on Transcriptomics Combined with Proteomics(No.MR20241737)+3 种基金Shandong Province Traditional Chinese Medicine Science and Technology Project:Optimization of Ultrasonic Extraction Process and Study on Structure and Activity of Asarum Polysaccharides(No.Q-2023042)Shandong Province Traditional Chinese Medicine Science and Technology Project:Study on the Mechanism of Ma Gui Synergistic Intervention on Airway Inflammatory Response in Rats with Asthma Cold Drink and Lung Accumulation Syndrome(No.Q-2023122)2023 Qilu Biancang Traditional Chinese Medicine Talent Cultivation ProjectShandong Province Medical and Health Science and Technology Development Plan Project:Study on the Mechanism of Airway Epithelial Cell Inflammation Induced by Cellular Autophagy Regulation lnc RNA Metastasis Associated Lung Adenocarcinoma Transcript 1 Antagonism Against Ovalbumin Intervention(No.202203020866)。
文摘OBJECTIVE:To investigate the key targets and mechanisms of the Wenyang Huayin decoction(WYHYD,温阳化饮方)in treating bronchial asthma with cold fluid retention syndrome using network pharmacology and animal experiments.METHODS:On the one hand,we used network pharmacology method to explored the chemical components of the WYHYD and the main targets of bronchial asthma were acquired.Besides,a protein interaction network was built after protein interaction analysis to find potential protein functional modules.Then,we constructed the"WYHYD component-bronchial asthma target-pathway"network.On the other hand,the experimental intervention was as follows:first,we formed a rat model of bronchial asthma.Thereafter,we used the WYHYD to treat the disease while observing autophagyrelated indicators as the core target of network pharmacology.RESULTS:The network pharmacology revealed that there are 122 potential therapeutic targets in treating bronchial asthma with WYHYD.The biological processes mainly involved in the WYHYD included Gene Ontology:0110032:positive regulation of G2/MI transition of the medical cell cycle etc.and four major signaling pathways were involved.During laboratory investigations,various signs and clinical manifestations of the rat model group were the same.After administering the WYHYD,lung function,pathological sections,inflammatory factors,and other microscopic indicators improved to varying degrees,providing evidence for the study results.Meanwhile,we verified that the core targets of WYHYD in treating asthma through the intervention of autophagy are tumor necrosis factor,caspase 8,interleukin 1 beta,sirtuin 1,phosphatidylinositol 3-kinase catalytic subunit type 3,C-C chemokine receptor type 7,L/YN kinase,and protein tyrosine kinase 2.CONCLUSION:This preliminary study revealed the treatment process of bronchial asthma with multicomponent,multi-target,and multi-pathway mechanisms of the WYHYD.
基金supported by the Pediatric Medicine Phase Ⅱ Scientific Research Special Fund of the Jiangsu Medical Association(Grant No.SYH-32034-0106[2024010])the Wuxi Science and Technology Development Fund(Grant No.K20241001).
文摘Obesity-related asthma is a distinct clinical phenotype,characterized by severe respiratory symptoms,reduced responsiveness to conventional glucocorticoid therapy,and a significantly increase in disease burden.With the rising global prevalence of obesity,the number of individuals affected by obesity-related asthma is steadily growing,presenting a pressing public health issue.The pathogenesis of obesity-related asthma is multifactorial,involving a complex interplay of metabolic and immune pathways.Key mechanisms include dysregulated T-cell differentiation,pro-inflammatory macrophage polarization,oxidative stress,and altered cytokines and adipokines secretion,all contributing to airway inflammation and remodeling.Additionally,metabolic factors,such as adiposity and adipokine imbalance,further complicated disease progression.A major clinical challenge is developing targeted therapies to address the substantial heterogeneity in this patient population.Current treatment approaches,largely focused on corticosteroids,often fail to achieve satisfactory outcomes,emphasizing the need for novel,tailored therapies that target the specific pathophysiological features of obesity-related asthma.This review systematically explores the cellular and molecular mechanisms driving obesity-related asthma,focusing on how obesity-associated factors such as adipokines and airway remodeling influence disease progression.The review also evaluates emerging therapeutic interventions and highlights the ongoing challenges in clinical diagnosis and management.By synthesizing recent research,this study aims to provide insights into potential strategies for improving treatment and clinical outcomes for patients with obesity-related asthma.
基金Supported by the Hainan Provincial Natural Science Foundation of China(No.825RC898)Hainan Province Clinical Medical Center。
文摘AIM:To comprehensively assess the relationship between asthma and myopia based on the National Health and Nutrition Examination Survey(NHANES)database combined with Mendelian randomization(MR).METHODS:Initially,20497 subjects from the complete questionnaire cycle in the NHANES database from 2005 to 2008 were included.By exclusion criteria,8460 subjects were screened with 1676 myopia samples and 6784 control samples.Subsequently,baseline characteristics,association analyses,risk stratification analyses,and receive operating characteristic curve(ROC)were used to investigate the associations between covariates and myopia.Then,the causal relationship was explored in depth by MR analysis,and was estimated the reliability by sensitivity analyses and directionality tests.RESULTS:Baseline characteristics illustrated a significant difference between myopia and controls for both asthma and covariates(excluding gender;P<0.05).The results in all three models indicated that asthma was strongly associated with myopia and the effect on myopia was not significantly confounded by other covariates[model 3:odd ratio(OR)=1.31;95%CI=1.07-1.62;P=0.0133].The risk stratification analysis again verified that asthma remained strongly associated with myopia and was a risk factor for myopia(P<0.05,OR>1).ROC proved that the model was accurate in its prediction[area under curve(AUC)=0.7].Subsequently,the causal relationship between them was statistically significant(P<0.05)according to the inverse variance weighted(IVW)method in MR.Scatterplot showed that asthma and myopia had significant positive causality and were not affected by confounders.Forest plot displayed an increasing risk of myopia on asthma(OR>1).The funnel plot demonstrated compliance with Mendel’s second law.Sensitivity analysis and directional analysis further confirmed the confidence of the MR analysis results and a unidirectional causal relationship between them.CONCLUSION:A significant association and causality between asthma and myopia is found through the NHANES database and MR analysis,which is important implications for public health policy development and clinical practice.
文摘BACKGROUND The relationship between diabetes mellitus(DM)and asthma is complex and can impact disease trajectories.AIM To explore the bidirectional influences between the two conditions on clinical outcomes and disease control.METHODS We systematically reviewed the literature on the relationship between DM and asthma,focusing on their impacts,mechanisms,and therapeutic implications.Various studies were assessed,which investigated the effect of glycemic control on asthma outcomes,lung function,and exacerbations.The study highlighted the role of specific diabetes medications in managing asthma.RESULTS The results showed that poor glycemic control in diabetes can exacerbate asthma,increase hospitalizations,and reduce lung function.Conversely,severe asthma,especially in obese individuals,can complicate diabetes management and make glycemic control more difficult.The diabetes-associated mechanisms,such as inflammation,microangiopathy,and oxidative stress,can exacerbate asthma and decrease lung function.Some diabetes medications exhibit anti-inflammatory effects that show promise in mitigating asthma exacerbations.CONCLUSION The complex interrelationship between diabetes and asthma suggests bidirectional influences that affect disease course and outcomes.Inflammation and microvascular complications associated with diabetes may worsen asthma outcomes,while asthma severity,especially in obese individuals,complicates diabetes control.However,the current research has limitations,and more diverse longitudinal studies are required to establish causal relationships and identify effective treatment strategies for individuals with both conditions.
基金supported by Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2021-I2M-1-049)Noncommunicable Chronic Diseases-National Science and Technology Major Project(2024ZD0529800).
文摘Bronchial asthma is divided into type 2 and non-type 2 asthma based on the immunopathogenesis.Type 2 inflammation is an inflammation mediated by T helper 2 cells,group 2 innate lymphoid cells and sustained by a specific subset of cytokines.In recent years,type 2 asthma has become the research hotspot in the field of asthma.For type 2 asthma,targeted therapies have become effective treatments and widely used in clinical practice.In order to further understand the progress of biologic drugs for bronchial asthma,as well as the disease outcomes in patients with type 2 asthma,and improve asthma control and remission,this article reviewed the progress and achievements of biologic drugs for asthma from May 1,2023 to April 30,2024,providing clinical perspective for the choosing appropriate targeted treatment of asthma.It also highlights selected poster pre-sentations from the ATS 2024 Annual Meeting to provide clinical insights for choosing appropriate targeted treatments for Type 2 asthma.
基金supported by the Jiangsu Province Excellent Postdoctoral Program[2023ZB410]of China.
文摘Chronic rhinosinusitis(CRS)is a persistent inflammatory condition affecting the mucosa of nasal cavity and paranasal sinus,often stemming from untreated or recurrent acute sinusitis.Asthma is characterized by airway inflammation,intermittent bronchospasm,and symptoms such as wheezing and dyspnea.These two conditions frequently coexist,sharing overlapping pathogenic mechanisms and inflammatory pathways.Gastroesophageal reflux disease(GERD),a condition where stomach contents reflux into the esophagus,is another prevalent comorbidity associated with asthma and CRS.Notably,GERD is more common in CRS patients,suggesting the intricate and potentially bidirectional relationship among CRS,asthma,and GERD.Despite this complexity,a comprehensive understanding of these interconnections remains elusive in the literature.This review synthesizes findings from the past decade,focusing on the epidemiology,pathophysiology,and comorbidity mechanisms linking these three conditions.By addressing current knowledge gaps,it aims to provide insights into their shared mechanisms and implications for integrated clinical management.
基金the Joint Innovation Project Funds of Huaqiao University,No.2022YX001.
文摘The global incidence of asthma,a leading respiratory disorder affecting more than 235 million people,has dramatically increased in recent years.Characterized by chronic airway inflammation and an imbalanced response to airborne irritants,this chronic condition is associated with elevated levels of inflammatory factors and symptoms such as dyspnea,cough,wheezing,and chest tightness.Conventional asthma therapies,such as corticosteroids,long-actingβ-agonists,and antiinflammatory agents,often evoke diverse adverse reactions and fail to reduce symptoms and hospitalization rates over the long term effectively.These limitations have prompted researchers to explore innovative therapeutic strategies,including stem cell-related interventions,offering hope to those afflicted with this incurable disease.In this review,we describe the characteristics of stem cells and critically assess the potential and challenges of stem cell-based therapies to improve disease management and treatment outcomes for asthma and other diseases.
文摘BACKGROUND Diffuse panbronchiolitis(DPB)is a rare,chronic inflammatory lung disease mar-ked by chronic cough,breathlessness,and preceding sinusitis.Symptoms often persist for years and can be misdiagnosed as asthma,particularly in children.This report describes a DPB case resolved with long-term azithromycin therapy,em-phasizing the need for a timely and accurate diagnosis.CASE SUMMARY A 12-year-old girl,diagnosed with asthma at age five and managed with inhaled corticosteroids and long-acting beta-2 agonists,developed a history of chronic productive cough and chronic sinusitis for a year.On examination,she exhibited wheezing and coarse crackles.Despite receiving treatment for an asthma exacer-bation,her symptoms did not improve.A chest X-ray revealed reticulonodular infiltration in both lower lungs,prompting further evaluation with high-resolu-tion computed tomography(HRCT).The HRCT confirmed centrilobular nodule opacities,a'tree-in-bud'pattern,and non-tapering bronchi,suggesting DPB.Elevated cold hemagglutinin titers at 128 further supported the diagnosis.Her cough and sinusitis resolved within a month after starting azithromycin therapy,chosen for its anti-inflammatory and immunomodulatory effects.Follow-up HRCT scans after 1 year of continuous treatment showed complete normalization.CONCLUSION This case highlights the importance of early diagnosis and prompt treatment in achieving favorable outcomes for DPB.
文摘Objective Asthma imposes a significant global health burden.This study examines changes in the asthma-related disease burden from 1990 to 2021 and projects future burdens for 2050 under different scenarios.Methods Using data from the Global Burden of Disease 2021 study,we analyzed asthma incidence,prevalence,mortality,and disability-adjusted life years(DALYs)from 1990 to 2021.We projected the disease burden for 2050 based on current trends and hypothetical scenarios in which all risk factors are controlled.Temporal trends in age-standardized incidence,prevalence,mortality,and DALY rates were explored using Annual Percent Change.Results In 2021,the age-standardized rates for asthma incidence,prevalence,mortality,and DALYs in China were 364.17 per 100,000(95%uncertainty interval[UI]:283.22-494.10),1,956.49 per 100,000(95%UI:1,566.68-2,491.87),1.47 per 100,000(95%UI:1.15-1.79),and 103.76 per 100,000(95%UI:72.50-145.46),respectively.A higher disease burden was observed among Chinese men and individuals aged 70 years or older.Compared to the current trend,a combined scenario involving improvements in environmental factors,behavioral and metabolic health,child nutrition,and vaccination resulted in a greater reduction in the disease burden caused by asthma.Conclusion Addressing modifiable risk factors is essential for further reducing the asthma-related disease burden.
文摘Background:To appraise the ameliorative potentials of Allium sativum aqueous extract in ovalbumin(OVA)-lipopolysaccharide(LPS)-induced asthma.Methods:Extraction,phytochemical analysis,determination of bioactive compounds and LD50 study of aqueous extract of A.sativum were achieved using standard biochemical methods.Twenty-four(24)male Wistar rats averagely weighing between 168–255 g were grouped into four of six animals in each steel-metal cage.Groups 1 and 2 served as normal and positive groups respectively.Rats in groups 2–4 were sensitized and challenged with a combination of OVA and LPS.Groups 3 and 4 were administered 250 and 500 mg/kg b.w of aqueous extract of A.sativum respectively for two weeks.The effect of aqueous extracts of A.sativum in OVA and LPS-induced asthma on alterations in differential white blood cells,inflammatory cytokines,some serum biochemical as well as histological indicators of experimental rats were assessed.Results:The aqueous extract of 600 g of plant material yielded 74.1 g accounting for 11.9%of sample material used.The result of the Phytochemical analysis showed higher number of glycosides,flavonoids and phenols.The animals displayed zero behavioral adverse reaction when administered the aqueous extract up to the highest dose of 5,000 mg/kg b.w.Administrations of aqueous extract of A.sativum remarkably(P<0.05;95%confidence intervals CI)declined the levels of neutrophils,eosinophils and total white blood cell count as opposed to the untreated group.Levels of interleukin 4(IL-4),interleukin 5(IL-5),interleukin 13(IL-13)and immunoglobulin E(IgE)of groups 3 and 4 had a significant(P<0.05;95%CI)varying percentage reduction(IL-4=39.78%,49.51%;IL-5=34.66%,40.05%;IL-13=31.96%,30.81%;33.45%,21.38%)respectively in comparison to group 2(untreated).The result showed a significantly(P<0.05,95%CI)declined malonaldehyde(MDA)concentration and elevated catalase,decreased glutathione concentration and superoxide dismutase activity of the treatment groups compared to the untreated.Serum liver function enzymes including alkaline phosphatase,alanine transaminase,and aspartate transaminase in the groups receiving aqueous extract of A.sativum exhibited a significant(P<0.05;95%CI)reduction in levels compared to group 2(untreated).Conclusion:Findings from this study indicated that aqueous extracts of A.sativum have the potential to improve asthma symptoms by decreasing inflammatory cytokines and mitigating oxidative stress.This effect could enhance the efficacy of conventional treatments such as inhaled corticosteroids,including cortisone,hydrocortisone,dexamethasone,and prednisone,as well as bronchodilators,leukotriene modifiers,and biologic therapies.Further studies need to be carried out on human subjects and also expanded to other respiratory disorders like Chronic obstructive pulmonary disease and Coronavirus Disease 2019.
基金supported by the National Natural Science Foundation of China(No.32200322)Henan Science and Technology Research and Development Plan Joint Fund(No.242301420082)+1 种基金Henan Province“Science and Technology Vice General”Three-Year Action Plan(2024-2026)Henan Postdoctoral Fund(No.HN2025059)。
文摘Salvia miltiorrhiza(S.miltiorrhiza)represents a crucial component of traditional Chinese medicine,demonstrating effects on blood circulation activation and stasis removal,and has been widely utilized in asthma treatment.This study isolated a novel phenolic acid(S1)from S.miltiorrhiza and investigated its anti-asthmatic activity and underlying mechanisms for the first time.An allergic asthma(AA)model was established using ovalbumin(OVA).The mechanism of S1's effects on AA was investigated using multi-factor joint analysis,flow cytometry,and co-culture systems to facilitate clinical asthma treatment.S1(10 or 20 mg·kg-1)was administered daily to mice with OVA-induced AA(OVA-AA)during days 21-25.The study examined airway responsiveness,lung damage,inflammation,and levels of immunoglobulin E(IgE),PGD2,interleukins(IL-4,5,10,13,17A),tumor necrosis factorα(TNF-α),GM-CSF,CXCL1,CCL11,and mMCP-1.Additionally,mast cell(MC)activation and degranulation were explored,along with T helper type 17(Th17)/Treg immune cells and TLR4 pathway biomarkers.The antagonistic activity of that specific antagonist of TLR4(TAK-242)(1μmol·L^(-1)),a specific TLR4 blocker,against S1(10μmol·L^(-1))was examined in co-cultured 16 HBE cells and bone marrow-derived cells(BMDCs)or splenic lymphocytes(SLs)induced with LPS(1μg·mL^(-1))to elucidate the TLR4 pathway's mediating role.S1 demonstrated reduced airway responsiveness,lung damage,and inflammation,with downregulation of IgE,PGD2,interleukins,TNF-α,GM-CSF,CXCL1,CCL11,and mMCP-1.It also impeded MC activation and degranulation,upregulated IL^(-1)0,and influenced Th17/Treg immune cell transformation following OVA challenge.Furthermore,S1 inhibited the TLR4 pathway in OVA-AA mice,and TLR4 antagonism enhanced S1's positive effects.Analysis using an OVA-AA mouse model demonstrated that S1 alleviates AA clinical symptoms,restores lung function,and inhibits airway response.S1's therapeutic effects occur through regulation of Th17/Treg immune cells and inflammation,attributable at least partially to the TLR4 pathway.This study provides molecular justification for S1 in AA treatment.
文摘BACKGROUND IgE plays a critical role in allergic inflammation and asthma pathogenesis.This study investigates the involvement of IgE cells in asthma exacerbation and evaluates the effectiveness of targeted interventions.AIM To evaluate the role of IgE in the exacerbation of allergic asthma and to determine the clinical efficacy of anti-IgE therapy in improving disease outcomes.Specifically,the study investigates changes in serum IgE levels,lung function,asthma control scores,and the frequency of acute exacerbations among patients receiving standard therapy with or without anti-IgE intervention.METHODS A total of 200 patients diagnosed with moderate to severe asthma were enrolled in this experimental study conducted from April 2024 to April 2025.Participants were randomized to receive either standard asthma therapy or therapy combined with anti-IgE agents.IgE levels and asthma control parameters were monitored.RESULTS Participants receiving anti-IgE treatment demonstrated a significant reduction in serum IgE levels(P<0.001),improved Forced expiratory volume in one second scores,and fewer exacerbation episodes compared to the control group.CONCLUSION IgE cells significantly contribute to asthma severity,and targeted therapy against IgE can improve disease outcomes.These findings underscore the importance of immunomodulatory strategies in asthma management.
基金Supported by National Natural Science Foundation of China:No.82374583,82274646.
文摘The development of adrenergic agonists(AAs)for asthma has provided important mechanistic insights into acupuncture-based target discovery and treatment strategies.This review describes the historical evolution of AA therapy,including the precise optimization of nonselective toβ2-selective agonists,im-provement from short-acting to ultra-long-acting agents,shift from targeted monotherapy to combination regimens,and alterations in drug formulation.Additionally,this review summarizes recent advances in acupuncture treatment for asthma,including the development of novel targeted therapies,application of acupuncture-based combination regimens,and optimization of the mode of administration.Taken to-gether,this article discusses key insights from research on AA that inform acupuncture approaches,with a focus on:(1)precision targeting:identifying acupuncture-specific targets to improve efficacy;(2)syn-ergistic treatment:employing multi-target combination regimens to enhance therapeutic outcomes;(3)formulation innovation:advancing acupuncture delivery methods to improve patient compliance;and(4)evidence-based development:strengthening clinical research to generate high-quality evidence to inform the discovery of novel targets and treatment strategies for asthma.
文摘In China,omalizumab is indicated for patients with moderate to severe persistent allergic asthma in whom symptoms remain inadequately controlled despite treatment with inhaled corticosteroids(ICS)in combination with long actingβ-agonists(LABA)(GINA step 3 or higher),and urticaria.We report a case of joint and Achilles tendon inflammatory reactions in a patient with Th2-type asthma receiving omalizumab treatment.An adult male presented with recurrent episodes of sneezing,rhinorrhea,wheezing,chest tightness,shortness of breath,and dyspnea.He exhibited allergies to multiple substances and demonstrated impaired lung function,ultimately being diagnosed with allergic rhinitis and asthma.Following initial treatment with ICS and LABA,his symptoms were initially controlled.However,as the disease progressed,the frequency of nocturnal attacks increased,and the incidence of attacks during the allergy season escalated,leading to a significant decline in lung function.Subsequently,he commenced subcutaneous injections of omalizumab at a dosage of 600 mg monthly.There was a partial improvement in the frequency of asthma attacks after two injections.Unfortunately,four days after the first treatment,he reported pain in the right Achilles tendon.Rheumatological screenings,including a five-item antinuclear antibody test and an 11-item autoantibody profile test,revealed no significant abnormalities.Ankle joint ultrasound indicated hyperechoic spots around the Achilles tendon with acoustic shadows,suggesting the presence of Achilles tendinopathy.Ten days later,the pain symptoms resolved spontaneously.Due to the sig-nificant improvement in asthma symptoms,omalizumab treatment continued,albeit with a dosage reduction to 300mg.After intermittent treatment over four sessions,asthma symptoms improved markedly,with the Asthma Control Test(ACT)score increasing from 14 to 20.Lung function improved from moderate obstruction to mild obstruction.The only drawback was the patient’s recurrent swelling,pain,and joint effusion in the joints(specifically the knee and ankle)during the treatment period.Omalizumab is an effective therapeutic option for the treatment of allergic asthma.Although the incidence of adverse events reported in current studies is low,there have been emerging reports of joint swelling,pain,and myalgia reactions in both children and adults receiving treatment for asthma and urticaria.Given the rarity and non-specific nature of these reactions,it is challenging to ascertain the true incidence rate.Previous reports have described symptoms that occur upon initiation of the medication,which can recur upon re-administration.While the factors that may increase the risk of joint inflammatory reactions to omalizumab remain to be elucidated,this case contributes to a deeper understanding of this adverse reaction associated with a well-tolerated and important therapeutic agent.
文摘Objective:To analyze the clinical value of Pulmicort Respules inhalation combined with cetirizine in the treatment of pediatric asthma.Methods:From December 2023 to December 2024,82 children with asthma admitted to our hospital were randomly divided into a control group and an observation group,with 41 cases in each group.The clinical symptom relief time(shortness of breath,cough,dyspnea,lung wheezing),lung function indicators(FEV1,FVC,FEV1/FVC),inflammatory indicators(TNF-α,IL-6,IL-8),and clinical treatment effects were analyzed in the two groups.Results:The relief time for shortness of breath,cough,dyspnea,and lung wheezing in the observation group was shorter than that in the control group(P<0.05).After treatment,compared with the control group,the levels of FEV1,FVC,FEV1/FVC,and treatment efficiency in the observation group were higher,while the levels of TNF-α,IL-6,and IL-8 were lower(P<0.05).Conclusion:The combination of Pulmicort Respules inhalation and cetirizine oral therapy for children with asthma can shorten the improvement time of clinical symptoms,inhibit inflammation,and improve lung function.
基金Supported by the Joint Innovation Project Funds of Huaqiao University,No.2022YX001。
文摘BACKGROUND Current drugs primarily target inflammation control but do not reverse tissue remodeling changes for asthma.Human mesenchymal stem cells are known for their anti-inflammatory and tissue remodeling capabilities.However,limited research has explored the therapeutic impact of varying doses and frequencies of human umbilical cord blood-derived mesenchymal stem cells(HUC-MSCs)on established airway remodeling in experimental asthma.AIM To explore and optimize the dosage and administration frequency of HUC-MSCs in experimental models of ovalbumin(OVA)-induced asthma.METHODS BALB/c mice underwent sensitization and were challenged using OVA.Control animals were administered a saline solution following the same protocol.HUC-MSCs were identified using flow cytometry.HUC-MSCs at incremental dosages(1×105,2×105,4×105)were injected via tail veins on day 30(the second after the final stimulation).After comparing each group and determining the optimal dose,supplement the optimal dose twice on day 30 and day 33(the second and fifth day after the final stimulation).Bronchoalveolar lavage fluid(BALF)and serum were harvested for analysis of concentrations of interleukin-4(IL-4),IL-13,immunoglobulin E and interferon-gamma(IFN-γ)by enzyme-linked immunosorbent assay.Pharmacology of airways and lung functions were also evaluated to identify the optimal group.RESULTS The study shows that HUC-MSC transplantation ameliorates OVA-induced asthma by significantly reducing airway inflammation and obstruction in preclinical models.This effect is associated with decreased Th2 cytokines IL-4 and IL-13,and increased Th1 cytokine IFN-γ.The optimal dose of 2×105 cells/mouse was identified as the most effective in reducing local asthmatic airway inflammation and changing levels of IL-4,IL-13,and IFN-γin serum and BALF compared to other single doses of HUC-MSC.Multiple treatments with the medium dose(2×105 cells)of HUC-MSCs on days 30 and 33 yield the best pathological and lung function outcomes.However,double treatments do not reduce IL-4 and IL-13 expression or enhance IFN-γproduction in serum or BALF more effectively than a single medium dose.CONCLUSION HUC-MSCs effectively regulate pro-inflammatory mediators in serum and BALF,modulating airway remodeling and lung function.In this acute mouse asthma model,a single dosage of 2×105 is optimal,with more significant effects of decreasing airway obstruction requiring repeated administration.
