Journal of Asthma最新文献

{"title":"Shared decision-making in severe asthma therapy: qualitative study of physician-patient communication.","authors":"Ember Lu, Zachary Hebert, Katya Solovyeva, Lisa Kietzer, Zeina Eid Antoun, Rafael Alfonso-Cristancho","doi":"10.1080/02770903.2025.2488000","DOIUrl":"10.1080/02770903.2025.2488000","url":null,"abstract":"<p><strong>Rationale: </strong>Biologics are indicated for severe asthma, but little is known about the factors driving patient and physician decisions surrounding their use.</p><p><strong>Objectives: </strong>To understand decision drivers for biologic use and conversational dynamics between patients with severe asthma and physicians.</p><p><strong>Methods: </strong>This retrospective database study used anonymized physician-patient conversations (recorded September 2018-August 2020) from routine clinical visits, captured in Verilogue's physician-patient syndicated database. Eligible conversations included those of patients with severe asthma, who were considering biologic therapy (Topic 1), had initiated biologic within 7 months of clinical visit (Topic 2), or were discontinuing/considering switching biologic treatment (Topic 3). Conversations were analyzed quantitatively and descriptively by topic.</p><p><strong>Results: </strong>Overall, 50 conversations between 14 physicians and 50 patients were included (considering biologic, <i>n</i> = 10; recent biologic initiation, <i>n</i> = 20; switched/discontinued biologic, <i>n</i> = 20). Physicians had 68-73% share of the conversation. When considering biologic treatment, the presence of symptoms (including coughing, wheezing, shortness of breath and chest tightness) drove the decision, with 3/10 patients providing additional symptom impact/severity details, and 2/10 describing adjustments to accommodate symptoms. Physicians set unspecified treatment goals and modest expectations for biologic efficacy, framing any symptom control as success (13/20 conversations). Patient symptom assessment drove the decision to continue, discontinue, or switch biologic treatment: in 5/20 cases, physicians asked patients if they were \"better\" or the medication is \"helping.\"</p><p><strong>Conclusions: </strong>This study suggests that patients relied on physicians to shape patient-physician interactions and treatment expectations. This suggests that shared decision-making may improve physicians' understanding of the impact severe asthma has on patients and facilitate the setting of treatment expectations.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1439-1449"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heated high flow nasal cannula and bilevel positive airway pressure in pediatric asthma exacerbations.","authors":"Shelby Nelipovich, Lauren Ozdowski, Michele E Smith","doi":"10.1080/02770903.2025.2478122","DOIUrl":"10.1080/02770903.2025.2478122","url":null,"abstract":"<p><strong>Objective: </strong>Heated High Flow Nasal Cannula (HHFNC) and Bilevel Positive Airway Pressure (BPAP) are noninvasive respiratory support modalities used in pediatric asthma exacerbations. We aim to examine differences in characteristics and outcomes for patients admitted to the Pediatric Intensive Care Unit (PICU) on standard therapy (ST) alone (continuous albuterol and systemic corticosteroids), ST plus HHFNC, and ST plus BPAP.</p><p><strong>Methods: </strong>This is a retrospective and prospective observational cohort study. Chi-Squared/Fisher's exact and Kruskal Wallis tests were used for categorical and continuous outcomes, respectively.</p><p><strong>Results: </strong>129 patients were included. Younger patients were placed on HHFNC while more severe patients were placed on BPAP. A multiple linear regression controlling for age, sex, race, ethnicity, and exacerbation severity revealed that patients admitted on BPAP had a longer duration of continuous albuterol compared to patients on ST alone (<i>p</i> = 0.02). No differences were found in respiratory support escalation, duration of respiratory support, or adverse events. The BPAP group had the most sedation use and longest length of stay (LOS). Median hourly respiratory rates (RR) increased in the HHFNC group over the first 12 h of admission and remained stable or decreased in the ST and BPAP groups.</p><p><strong>Conclusions: </strong>This study found that BPAP use in pediatric asthma exacerbations is associated with increased exacerbation severity, longer duration of continuous albuterol, increased sedation use, and longer LOS. Although a multiple linear regression analysis was performed to control for multiple covariates including exacerbation severity, it is possible that intrinsic patient characteristics influenced these outcomes rather than BPAP usage.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1332-1340"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness of wildfire smoke among U.S. adults with and without asthma.","authors":"Maria C Mirabelli, Tia C Dowling, Lauren Freelander, Audrey F Pennington, Scott A Damon","doi":"10.1080/02770903.2025.2487994","DOIUrl":"10.1080/02770903.2025.2487994","url":null,"abstract":"<p><strong>Objective: </strong>To describe awareness of ambient wildfire smoke among U.S. adults with and without asthma.</p><p><strong>Methods: </strong>We analyzed data from the summer wave of the 2021 <i>ConsumerStyles</i> survey, a nationally representative survey of 4085 U.S. adults. Respondents self-reported their asthma status and awareness of wildfire smoke where they lived in the past 12 months. We linked survey responses by zip code of residence with satellite-detected wildfire smoke plume data that estimated the daily maximum smoke plume density over the preceding year. We estimated associations between asthma status and awareness of wildfire smoke across categories of maximum smoke plume density and days with medium- or heavy-density smoke as prevalence ratios (PRs) with 95% confidence intervals (CIs) using predicted marginal probabilities from logistic regression models.</p><p><strong>Results: </strong>Over 98% of the estimated population of U.S. adults lived in a zip code affected by ≥1 day of medium- or heavy-density wildfire smoke, which occurred on an average of 16 days in the past year. Awareness of wildfire smoke was reported by 19% of U.S. adults and was higher among adults with than without asthma (PR: 1.25; 95% CI: 1.01, 1.55), including in zip codes affected by heavy-density smoke (PR: 1.30, 95% CI: 1.04, 1.63) and with 22 or more days of medium- to heavy-density smoke (PR: 1.22, 95% CI: 1.01, 1.47).</p><p><strong>Conclusions: </strong>Although awareness of wildfire smoke was higher among U.S. adults with than without asthma, low percentages of awareness overall indicate a need for health communication about wildfire smoke and its health risks.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1431-1438"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12286720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding how sleep disorders are managed in people with asthma: a scoping review of the literature.","authors":"Emma Yau, Janet M Y Cheung, Bandana Saini, Stephen Hughes","doi":"10.1080/02770903.2025.2487986","DOIUrl":"10.1080/02770903.2025.2487986","url":null,"abstract":"<p><strong>Objective: </strong>People with asthma may experience sleep disturbances due to uncontrolled asthma symptoms and/or co-occurring sleep disorders. Asthma shares pathophysiological pathways with sleep disorders including insomnia and obstructive sleep apnea and the interrelationship between asthma and sleep disorders is bi-directional. Insufficient sleep in general and in people with asthma leads to worsened mental and physical health. How this is managed in people with asthma is less known.</p><p><strong>Data sources: </strong>This scoping review examines current literature around sleep health management employed by people with asthma and their care providers. Peer reviewed journal articles on sleep health interventions/management in adults with comorbid asthma were searched for in 4 databases, across 10 years, in a search strategy developed with medical librarians.</p><p><strong>Study selection: </strong>The search led to the inclusion of 13 studies that met the review criteria, which reported sleep management interventions tested in people with sleep disorders comorbid with asthma.</p><p><strong>Results: </strong>For people with obstructive sleep apnea and asthma, continuous positive pressure devices, oral appliances and bariatric surgery improved sleep and asthma outcomes. Improvements in other sleep disorders and asthma were shown with behavioral interventions and digital interventions including fitness tracker use.</p><p><strong>Conclusion: </strong>The limited studies retrievable on this topic suggest management of sleep disorders in people with asthma is an under-researched area. Future research directed at how and when to assess sleep management in people with asthma will better inform specific guidelines and achieve improved sleep health in this population.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1266-1279"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of short-term exposure to PM_2.5 and its components with hospital admission for asthma in Shanghai: a time-stratified case-crossover study.","authors":"Xuesong Zhou, Jia Qiu, Ning Kang, Jingwei Zhang, Yandan Xu, Jian Zhang, Xiuli Tang, Yinghao Yuchi, Mingjia Xu, Chongjian Wang","doi":"10.1080/02770903.2025.2478503","DOIUrl":"10.1080/02770903.2025.2478503","url":null,"abstract":"<p><strong>Introduction: </strong>Associations between PM_2.5 and the risk of asthma admission have been established in previous researches. However, evidence about the specific impacts of PM_2.5 components on asthma-related hospitalizations across different populations and environments is limited and inconsistent. The purpose of this study was to examine the association between short-term exposure PM_2.5 and its components with asthma hospital admission.</p><p><strong>Method: </strong>A total of 930 people hospitalized for asthma were included in the study in Shanghai between December 2018 and December 2022. Air pollution data were assigned to individuals based on their residential address using the Tracking Air Pollution (TAP) platform. A time-stratified case-crossover design and a conditional logistic regression model were used to estimate the risk of asthma admissions related to exposure to PM_2.5. We also conducted stratified analyzes by age, gender, and season.</p><p><strong>Results: </strong>Each 10 μg/m³ increase in PM_2.5, BC, NO₃^-, NH₄⁺, SO₄^2- and OM at lag-5 day were associated with increased risk of asthma admission, with ORs of 1.04(1.00,1.08), 2.59(0.99,6.76), 1.17(1.02,1.33), 1.33(1.06,1.66), 1.28(1.05,1.55) and 1.16(0.98,1.37), respectively. Stratified analysis showed that PM_2.5 and its components had a more significant impact on the risk of asthma admission for women; individuals aged ≥ 65 years, and during cold seasons at lag-5 day. The results remained stable in the sensitivity analysis.</p><p><strong>Conclusion: </strong>Short-term exposure to PM_2.5 and its components (NO₃^-, NH₄⁺, SO₄^2-) increases hospitalization risk in asthma patients, particularly among women, elder and those admitted during cold seasons. It provides new insight for reducing the asthma burden associated with particulate air pollution.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1341-1350"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal relationships between allergic diseases and significant declines in lung function: a multivariable Mendelian randomization study.","authors":"Jiannan Lin, Xiaoyu Zhao, Shuwen Lu","doi":"10.1080/02770903.2025.2472359","DOIUrl":"10.1080/02770903.2025.2472359","url":null,"abstract":"<p><strong>Background: </strong>Asthma and other allergic diseases are increasing globally each year, with some patients experiencing the co-occurrence of two or more conditions, significantly impacting their quality of life. While these diseases may share certain immune mechanisms, the independent causal relationships between them and lung function remain unclear.</p><p><strong>Objective: </strong>This study aims to investigate the independent and interactive effects of allergic asthma, atopic dermatitis, allergic rhinitis, and allergic conjunctivitis on significant declines in lung function. By elucidating the potential causal relationships between these allergic diseases and reduced lung function, we hope to provide valuable scientific evidence for managing asthma patients who are co-morbid with multiple allergic conditions.</p><p><strong>Methods: </strong>In this study, we conducted Mendelian randomization (MR) analysis using data from the FinnGen database and the UK Biobank. We rigorously selected instrumental variables (IVs) based on established criteria and employed both univariable and multivariable MR approaches to investigate the relationship between various allergic diseases and significant declines in lung function.</p><p><strong>Results: </strong>In univariable MR analysis, the inverse variance-weighted (IVW) method or the weighted median approach indicated a causal relationship between allergic conjunctivitis, atopic dermatitis, and allergic asthma with significant declines in lung function. However, in multivariable MR analysis, the independent effects of atopic dermatitis and allergic conjunctivitis on lung function were no longer significant. Only allergic asthma continued to show a significant causal relationship with decreased lung function (OR [95%CI]: 1.019 [1.008-1.030], <i>p</i> < .001).</p><p><strong>Conclusions: </strong>This study suggests that while atopic dermatitis and allergic conjunctivitis may indirectly affect lung function and lead to significant declines, their independent effects are not notable when asthma is well-controlled. Therefore, clinicians should recognize that acute exacerbations of allergic diseases are unlikely to be the primary reason for significant declines in lung function among asthma patients with multiple allergic conditions, provided that their asthma is well-managed.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1296-1303"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous thromboembolism associated with severe dyspnea and asthma in 21,205 adults from the Danish population.","authors":"Kristin Felicia Nilausen, Delia-Ioana Radutiu, Eskild Morten Landt, Suzan Al-Shuweli, Børge G Nordestgaard, Uffe Bødtger, Morten Salling Olesen, Christina Ellervik, Morten Dahl","doi":"10.1080/02770903.2025.2478512","DOIUrl":"10.1080/02770903.2025.2478512","url":null,"abstract":"<p><strong>Background: </strong>Long-term consequences after a pulmonary embolism include lung function deficits, dyspnea, and chronic thromboembolic pulmonary hypertension. Recent studies suggest patients who experience pulmonary embolism may also be at increased risk of asthma.</p><p><strong>Methods: </strong>We tested the hypothesis that individuals with pulmonary embolism or deep vein thrombosis (venous thromboembolism) have lower lung function, or higher risks of dyspnea and asthma using data from 21,205 random adults from the Danish General Suburban Population Study.</p><p><strong>Results: </strong>Prevalences of pulmonary embolism, deep vein thrombosis, and venous thromboembolism were 0.60%, 1.7%, and 1.9%, respectively. Individuals with pulmonary embolism or deep vein thrombosis had FEV₁% predicted of 86% and 89% compared with 95% in individuals without venous thromboembolism (<i>t</i>-test: <i>p</i> < .001). Corresponding values for FVC% predicted were 92% and 94% versus 99% (<i>p</i> < .001). Individuals with versus without venous thromboembolism had adjusted odds ratios for light, moderate, and severe dyspnea of 1.6 (95% CI: 1.1-2.2), 1.8 (1.2-2.6), and 2.6 (1.8-3.8), respectively. Individuals with versus without venous thromboembolism had adjusted odds ratios for asthma and use of asthma medication of 1.6 (1.2-2.2) and 1.9 (1.4-2.6), respectively. The adjusted odds ratio for asthma in individuals with versus without venous thromboembolism was increased among individuals who received no treatment with anticoagulants (2.0, 1.4-3.0) compared to those who received treatment (1.0, 0.6-1.6) (<i>p</i> for interaction = .02).</p><p><strong>Conclusions: </strong>Individuals with venous thromboembolism have lower lung function, 2.6-fold higher risk of severe dyspnea, and 1.6-fold higher risk of asthma in the Danish population.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1364-1370"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sevoflurane-induction via the Flow-i ventilator in the pediatric intensive care unit for the treatment of status asthmaticus: a case report and literature review.","authors":"Ahmani DoDoo, Melissa Cregan, Kailey A Remien, Ambrish Patel","doi":"10.1080/02770903.2025.2482995","DOIUrl":"10.1080/02770903.2025.2482995","url":null,"abstract":"<p><strong>Introduction: </strong>Status asthmaticus is a severe asthma exacerbation commonly associated with hypercarbia, hypoxia, and respiratory acidosis that can be unresponsive to conventional therapies. Non-invasive positive pressure ventilation is utilized as the first modality of respiratory support. Inhaled anesthetic agents are non-standard treatment options which can be considered for their bronchodilator properties once the patient is intubated.</p><p><strong>Case report: </strong>We present a 14-year-old adolescent with a history of severe persistent asthma who was admitted to the pediatric intensive care unit (PICU) in status asthmaticus. The patient required intubation, was induced with sevoflurane, and mechanically ventilated with the Flow-i ventilator.</p><p><strong>Discussion: </strong>Status asthmaticus is described as severe asthma that is refractory to repeated administration of beta-agonists, while near-fatal asthma is described as exacerbations requiring intubation and mechanical ventilation. When mechanical ventilation and conventional therapies are inadequate, inhalational anesthetics and extracorporeal membrane oxygenation (ECMO) are considered. This article examines the use of sevoflurane as a treatment modality for pediatric patients with status asthmaticus highlighting the therapeutic approach and outcome.</p><p><strong>Conclusion: </strong>The use of inhaled anesthetic gases and advanced anesthesia machines can diversify and enhance treatment for patients with refractory status asthmaticus. With continuous monitoring of hemodynamics, anesthesia machines may be an integral therapeutic option for treating refractory status asthmaticus within the PICU without the need for extracorporeal life support.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1450-1457"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long non-coding RNA AK007111 mediates mast cells apoptosis via targeting of protein MOAP1.","authors":"Xiao Ma, Yingying Luo, Jiejing Xu, Feng Liu, Changdi Xu, Heng Tang","doi":"10.1080/02770903.2025.2463974","DOIUrl":"10.1080/02770903.2025.2463974","url":null,"abstract":"<p><strong>Background: </strong>Long non-coding RNAs (lncRNAs) are emerging regulators of pathophysiological processes in a variety of diseases including asthma. In this study, we reported the identification of lncRNA-AK007111 as an essential modulator of mast cell apoptosis and investigated its potential mechanism.</p><p><strong>Methods: </strong>RNA-seq profiling and transcriptome sequencing technology were adopted to screen for differentially expressed genes. Transfection was done by small interfering RNAs (siRNAs) to down-regulate lncRNA-AK007111 and Modulator of apoptosis 1 (MOAP1). Starvation was used to induce apoptosis. The apoptotic rate was measured by flow cytometry. Western Blot was conducted to detect the expression of apoptosis-related proteins.</p><p><strong>Results: </strong>LncRNA-AK007111 was highly expressed in IgE/Ag-mediated activation of mast cells. Down-regulation of LncRNA-AK007111 promoted apoptosis of mast cells. Down-regulation of MOAP1 attenuated apoptosis in mast cells induced by the down-regulation of lncRNA-AK007111.</p><p><strong>Conclusion: </strong>LncRNA-AK007111 may be a potential regulator of mast cell apoptosis by interaction with MOAP1.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1166-1175"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic property of central airway walls assessed by computed tomography: correlation with asthma pathophysiology.","authors":"Masafumi Yamaguchi, Akio Niimi, Hisako Matsumoto, Tetsuya Ueda, Masaya Takemura, Makiko Jinnai, Tsuyoshi Oguma, Yasutaka Nakano, Michiaki Mishima","doi":"10.1080/02770903.2025.2469312","DOIUrl":"10.1080/02770903.2025.2469312","url":null,"abstract":"<p><strong>Objective: </strong>A subset of asthmatics suffers from frequent exacerbations. Various features of airway remodeling and the resultant elastic property of airway walls may play pathophysiological roles in these exacerbations. The aim of the study was to examine the collapsibility of airways and sputum biomarkers associated with airway remodeling with different frequencies of exacerbations.</p><p><strong>Methods: </strong>We studied 29 moderate-to-severe asthmatics classified by the number of exacerbations in the previous year as, ≤1: stable, <i>n</i> = 18; ≥2: difficult, <i>n</i> = 11, and 11 healthy controls (HC). The absolute wall area (Awa) and luminal area (Ai) of a segmental bronchus were measured by computed tomography at full inspiration (FI) and full expiration (FE). We examined the %change of Ai (a measure of airway collapsibility) and Awa (a possible measure of vascular/water contents in the airway wall) from FI to FE. Sputum biomarkers associated with fibrosis [TGF-β₁ and matrix metalloproteinase (MMP)-9/tissue inhibitors of metalloproteinase (TIMP)-1 molar ratio] and those associated with angiogenesis/edema [vascular endothelial growth factor (VEGF) and vascular permeability index (sputum/serum ratio of albumin levels)] were examined.</p><p><strong>Results: </strong>Airway collapsibility was greater in difficult asthmatics than in stable asthmatics and HC. Sputum TGF-β₁ levels were higher and MMP-9/TIMP-1 molar ratios were lower in stable asthmatics than in HC. Sputum VEGF levels and vascular permeability index were higher in difficult asthmatics than in HC.</p><p><strong>Conclusions: </strong>Collapsibility of thickened airway walls may determine their susceptibility to exacerbations. This may depend on the balance between fibrosis and angiogenesis/edema in the airways.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1195-1202"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}