More severe asthma can persist from childhood into adulthood without remission. Another important tendency in the natural history is for symptoms to remit in adolescence only to return again in adulthood. In general, the amount of wheezing in early adolescence seems to be a guide for severity in early adult years, with 73% of those with few symptoms at age 14 years continuing to have little or no asthma progression at age 28 years. Similarly 68% of those with frequent wheezing at 14 years still suffered from recurrent asthma at age 28 years. Most subjects with frequent wheezing at 21 years continued to have comparable asthma at 28 years. In addition to the importance of symptoms in childhood, childhood degree of bronchial responsiveness in combination with a low FEV-1 were also related to the outcome of asthma in adulthood. (more…)
In the Tucson CRS study, about 50% of young children experienced a period of recurrent wheezing and/or coughing in the first 6 ...
Exposure and allergic sensitization to cockroach was associated with a significantly greater risk of asthma hospitalization and ...
With the help of well-trained and experienced pulmonary function technicians, children as young as 4 to 5 years of age should b ...
Asthma is a complex syndrome rather than a single disease entity. Different phenotypes with varying prognosis and determinants have ...
It is clear from the results of large epidemiologic studies that while atopy is a major risk factor for asthma, it is usually n ...
Airway remodelling is considered to be of major importance in the pathology of asthma, with subepithelial basement membrane thickening in particular being indicative of early development of the disease and characteristic of its progression. Airway fibroblasts are central cells in the processes of remodelling: increased deposition of fibroblast-derived connective tissue proteins and differentiation of fibroblasts into contractile myofibroblasts are consistent observations in morphological studies of moderate to severe asthmatic airways. The secretory function of fibroblasts is under the control of locally produced growth factors such as vascular endothelial cell growth factor (VEGF, see below) and platelet-derived growth factor (PDGF). (more…)
Vascular Endothelial Growth Factor (VEGF), originally described as a vascular permeability factor generating tissue oedema, has be ...
Local micro environmental factors are crucial in determining both susceptibility to vascular remodeling and the extent of angio ...
Tumour Necrosis Factor is a pro-inflammatory cytokine implicated in the pathogenesis of asthmatic airway inflammation, hyper-react ...
Asthma is a continuing problem for healthcare, particularly in the industrialized world. Some 150 million people are estimated ...
Airway hyper-responsiveness in asthma may involve smooth muscle growth, a manifestation of airway remodelling. The involvement ...
In 2004, there were 2.4 million children aged 5 to 14 years, or 5.9% of this population group, with a self-reported asthma attack, with no decrease in prevalence since 1997 1 in spite of the much improved therapies available. In this interval, the number of physician office visits for asthma doubled, from 1.7 to 3.3 million which many leads to asthma morbidity and asthma mortality. (more…)
Negative family characteristics such as family conflict and family dysfunction discriminated children who died of asthma from c ...
Asthma control is improved by combining inhaled corticosteroids with long acting beta-agonists but patients still require relie ...
Asthmatic children who also have Allergic Rhinitis seem to have higher morbidity and to use more healthcare resources. This was fur ...
What is Flu? Influenza, commonly known as “the flu,” is a contagious disease caused by a virus. It can cause mild to severe ...
Patients with severe persistent asthma who are inadequately controlled despite Global Initiative for Asthma (GINA) 2002 step 4 ther ...
Some features seem to be common to severe asthma and Chronic Obstructive Pulmonary Disease with reversibility of airflow limitation. The neutrophil chemoattractant leukotriene B 4 (LTB 4) may play a role in Chronic Obstructive Pulmonary Disease and in some forms of asthma. In this study, 55 smokers with no disease, Chronic Obstructive Pulmonary Disease (with or without bronchodilator reversibility of airflow limitation) or asthma underwent measurement of LTB 4 in sputum supernatants and exhaled breath condensate asthma (EBC). Both Chronic Obstructive Pulmonary Disease and asthma patients had higher levels of LTB 4 than control subjects; patients with asthma or reversible Chronic Obstructive Pulmonary Disease exhibited significantly higher levels of LTB 4 than those with irreversible Chronic Obstructive Pulmonary Disease. (more…)
Leukotrienes are present in increased amounts in exhaled breath condensate (EBC) in patients with asthma. So far, no data have ...
The cysteinyl leukotrienes (LTC 4 , LTD 4 and LTE 4 ) are lipid mediators produced from an arachidonic acid precursor following ...
A role for Leukotriene B4 in the induction of airway hyper-responsiveness was explored through the use of transgenic mice defic ...
Adjusting the inhaled glucocorticoid dose based on indices of airway inflammation has been proposed as a means of achieving more ef ...
With the help of well-trained and experienced pulmonary function technicians, children as young as 4 to 5 years of age should b ...
Adjusting the inhaled glucocorticoid dose based on indices of airway inflammation has been proposed as a means of achieving more effective control of asthma than the conventional approach of adjusting steroid dose based on symptoms, lung function and rescue medication use. In a single-blind, placebo-controlled trial, 97 asthmatic patients received fluticasone doses adjusted on the basis either of conventional guidelines or of exhaled nitric oxide fraction (FE NO ). (more…)
For most patients, asthma is not controlled as defined by guidelines; whether this is achievable has not been prospectively stu ...
The new corticosteroid ciclesonide has been evaluated in various studies to assess its efficacy and adverse effect profile in a ...
Despite optimum drug delivery and good compliance with inhaled corticosteroids, many patients experience symptoms and exacerbat ...
The management of asthma in the community involves patient education to avoid the triggers, doubling the dose of inhaled steroi ...
Treating allergic rhinitis may have a downstream effect on concomitant asthma and this may be due to attenuation of the underlying ...
Increasing evidence demonstrates that cytokines of Th1 and Th2 cells play important roles in allergic disorders. This study examined polymorphisms in the IL-12B gene, a primary inducer of the development of Th1 cells with downregulation of the Th2 cytokines. The exons, splice sites and portions of the 5” and 3” flanking regions of the IL-12B gene were sequenced and 13 polymorphisms identified. A case–control study of Japanese children (297 cases) with asthma stratified by asthma-related phenotypes was conducted on a subset of three of these SNPs. The functional effects of the identified polymorphisms were examined using luciferase and RNA stability assays. (more…)
The T-bet (T-box 21) gene (TBX21) encodes a transcription factor, T-box expressed in T cells, which has been implicated in asthma t ...
A previous genome-wide screen for mite-sensitive atopic dermatitis asthma in Japanese families indicated linkage to chromosome 5q33 ...
The Tcell Ig domain and mucin domain (TIM) proteins, the genes for which are located on chromosome 5q, have been suggested to b ...
CD14 is part of the receptor complex for endotoxin, which is a component of tobacco smoke. The CD14 gene is located on chromoso ...
Genome-wide scans have pointed to a number of genomic regions implicated in asthma. This study used an elegant scheme to invest ...
The management of asthma in the community involves patient education to avoid the triggers, doubling the dose of inhaled steroids and increasing the use of rescue medications during an exacerbation in order to prevent unnecessary hospital visits. This randomized, controlled study looks at whether doubling the dose of inhaled corticosteroid in isolation is effective when asthma deteriorates. (more…)
This study was similar to the study of Harrison and colleagues, which looked at doubling the dose of inhaled corticosteroid dur ...
The guidelines for asthma management recommend the use of regular inhaled corticosteroid in patients with mild persistent asthma, b ...
The role of oral and inhaled corticosteroids in the management of acute asthma is well known. This study compared the effects of in ...
For most patients, asthma is not controlled as defined by guidelines; whether this is achievable has not been prospectively stu ...
Patients with severe persistent asthma who are inadequately controlled despite Global Initiative for Asthma (GINA) 2002 step 4 ther ...
The sensory neuropeptides substance P and neurokinin A (NKA) are members of the tachykinin family, present within pulmonary sensory nerves and immune cells. In the airways they mainly interact with tachykinin (NK1, NK2) receptors to induce bronchoconstriction, bronchial hyperresponsiveness, mucus secretion, vasodilatation, increased vascular permeability, and attraction and activation of inflammatory cells. In this randomized, double-blind, placebocontrolled crossover multicentre trial the effects of a single dose of a dual tachykinin NK1/NK2 receptor, DNK333, were assessed on NKA-induced bronchoconstriction in asthma. (more…)
Anticholinergic agents, including nebulized glycopyrrolate, a potent but non-selective muscarinic receptor blocker, have been f ...
Leukotrienes can be found in the airway and urine following both spontaneous exacerbations of asthma and acute exposure to bron ...
The prevalence of aspirin-sensitive asthma is uncertain although it may exist in up to 20% of all asthmatics patients. The char ...
Regular use of ß-agonists has been known to lead to tolerance to their bronchodilator effects. It is not known how quickly toleranc ...
Marimastat is a synthetic broad-spectrum matrix metalloproteinase (MMP) inhibitor. This study assessed the anti-inflammatory effect ...
Treatment of allergic diseases in childhood presents unique challenges, as both the beneficial effects and the detrimental effects of intervention(s) may last for decades and even for a lifetime. Most allergic diseases are managed in a community setting by primary care physicians, rather than in a hospital setting by allergy specialists. Here, we describe outpatient treatment, which is focused on prevention and relief of morbidity from allergic diseases and on the identification of children at high risk (more…)
Allergen-specific immunotherapy aims to correct the underlying immune imbalance associated with specific immunotherapy allergic rhi ...
Expert GA ² LEN, the Global Network European Allergy and Asthma European Academy of Allergy and Clinical Immunology, EAACI, warn th ...
Specific immunotherapy has been widely used to treat allergic rhinitis symptoms. As with any other form of specific immunotherapy, ...
Allergic rhinitis is a very common problem associated with poor quality of life, reductions in social and work activities and p ...
Many kids’ deaths in the United States over the years happened both in schools and children camps because of lack of access to ...
Asthma is a continuing problem for healthcare, particularly in the industrialized world. Some 150 million people are estimated to suffer from asthma worldwide, with 5.2 million sufferers in the UK. Hospital admissions for asthma number 69 000 per annum in the UK, including 28 500 children. Approximately 1400 people die from asthma in the UK annually, of whom over 30% are under the age of 65. Asthma costs the UK National Health Service almost £90 million per annum (statistics from Asthma UK, http://www.asthma.org.uk). (more…)
Vascular Endothelial Growth Factor (VEGF), originally described as a vascular permeability factor generating tissue oedema, has be ...
Airway hyper-responsiveness in asthma may involve smooth muscle growth, a manifestation of airway remodelling. The involvement ...
Airway remodelling is considered to be of major importance in the pathology of asthma, with subepithelial basement membrane thi ...
Contact of pathogens with the innate immune system will most frequently occur at epithelia, and the biology of the airway epitheliu ...
Some features seem to be common to severe asthma and Chronic Obstructive Pulmonary Disease with reversibility of airflow limita ...