Journal of Asthma最新文献

{"title":"The efficacy of dexamethasone compared to prednisone/prednisolone for the management of pediatric patients with acute exacerbation of asthma: a systematic review and meta-analysis.","authors":"Haochang Wang, Jiapei Wang, Xuanya He","doi":"10.1080/02770903.2025.2526376","DOIUrl":"10.1080/02770903.2025.2526376","url":null,"abstract":"<p><strong>Objective: </strong>This updated meta-analysis aimed to investigate the efficacy of dexamethasone compared to prednisone/prednisolone for the management of pediatric patients with acute exacerbation of asthma.</p><p><strong>Data sources: </strong>PubMed, Web of Science, the Cochrane Library, and Scopus were systematically searched from the inception to March 8, 2025.</p><p><strong>Study selections: </strong>Randomized controlled trials comparing the effect of dexamethasone with prednisone/prednisolone on hospital admission, relapse, readmission, length of hospital stay, pediatric respiratory assessment measure (PRAM) score, intensive care unit (ICU) admission, noncompliance, and vomiting among pediatric patients with acute asthma exacerbation were identified. Studies other than randomized controlled trials, studies lacking both groups and those not reporting the outcomes of interest were excluded. A random-effects model was adopted to pool data.</p><p><strong>Results: </strong>Sixteen studies with 1481 individuals in the dexamethasone group and 1436 individuals in the prednisone/prednisolone group were included. No significant differences were found between dexamethasone and prednisone/prednisolone groups in terms of the risk of hospitalization (RR 0.96, 95% CI (0.79, 1.17), I² = 0.00%), ICU admission (RR 0.64, 95% CI (0.08, 4.88), I² = 0.00%), relapse (RR 0.99, 95% CI (0.71, 1.38), I² = 0.00%), hospital readmission (RR 0.90, 95% CI (0.34, 2.35), I² = 30.98%), the PRAM score (RR -0.24, 95% CI (-0.54, 0.06), I² = 41.30%), the length of hospital stay (RR -2.69 h, 95% CI (-6.91, 1.53), I² = 69.50%), and noncompliance (RR 0.47, 95% CI (0.07, 3.01), I² = 65.20%). Moreover, dexamethasone decreased the risk of vomiting (RR 0.39, 95% CI (0.25, 0.59), I² = 26.62%) compared to prednisone-prednisolone.</p><p><strong>Conclusion: </strong>Dexamethasone was not inferior to prednisolone/prednisone in the management of pediatric asthma exacerbation.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512008","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":"Stepping stones to adolescent asthma self-management: dealing with ups and downs.","authors":"Elif Isik, Rebecca J Schultz, Nina M Fredland","doi":"10.1080/02770903.2025.2526375","DOIUrl":"10.1080/02770903.2025.2526375","url":null,"abstract":"<p><strong>Objective: </strong>Asthma, a serious and increasing public health problem, affects about 4 million adolescents in the U.S. with prevalence as high as 8.4% among adolescents aged 11-21. The underlying reasons for poorly controlled asthma are complex, and the specific causes of differences in asthma management behaviors among adolescents are not yet well understood. This study aimed to elucidate the experiences, behaviors, and processes associated with acquiring asthma self-management behaviors among adolescents.</p><p><strong>Design: </strong>A constructivist grounded theory design guided data collection and analysis. Nineteen participants were recruited using purposive and theoretical sampling. Data were analyzed using constant comparative methods, including initial, focused, and theoretical coding, to generate a substantive theory grounded in participants' experiences.</p><p><strong>Results: </strong>The substantive theory of \"Dealing with Ups and Downs\" revealed three major categories: teenage brain, living today, and making decisions. These categories reflected various forms of taking action occurring through nonlinear phases of self-management.</p><p><strong>Conclusion: </strong>Each category and phase identified in the theory reflects the complex interplay of adolescents' backgrounds, prior experiences, and psychosocial influences within their social environments. Adolescents voiced challenges and asthma self-management strategies such as symptom monitoring, medication adherence, communication, and adapting activities based on asthma status. This substantive theory offers valuable insight that can inform future research and practical applications for public health nurses and healthcare providers related to acquiring self-management behaviors.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512007","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":"Impact of smoking on asthma control with extrafine beclomethasone/formoterol: post hoc analysis of a prospective cohort study.","authors":"Izabela Kupryś-Lipińska, Tomasz Dębowski, Cezary Palczyński, Roman Hożejowski, Piotr Lacwik, Piotr Kuna","doi":"10.1080/02770903.2025.2526373","DOIUrl":"10.1080/02770903.2025.2526373","url":null,"abstract":"<p><strong>Objective: </strong>Exposure to tobacco smoke is a major risk factor for poor asthma control. We aimed to assess the response to asthma treatment based on patients' smoking status.</p><p><strong>Methods: </strong>This post hoc analysis used data from a large prospective asthma cohort treated with inhaled extrafine beclomethasone/formoterol. Patients were retrospectively categorized as current smokers, former smokers, or nonsmokers. Asthma control and symptom severity were evaluated over 6 months using Global Initiative for Asthma (GINA) criteria. The primary outcome was the proportion of patients who achieved an improved GINA category of asthma control, while the secondary outcome was the proportion with well-controlled asthma. To account for baseline differences, the cohorts were propensity score-matched (1:1:1) based on age, sex, body mass index, self-reported physical activity, education level, and FEV₁.</p><p><strong>Results: </strong>From an initial cohort of 17 098 patients, a matched sample of 2856 (952 per group) was selected, ensuring comparable baseline characteristics. After 6 months, an improved GINA category was observed in 78% of current smokers, 75% of former smokers, and 77% of nonsmokers (<i>p</i> = 0.381). The rates of well-controlled asthma were comparable across groups (current smokers: 58%, former smokers: 54%; nonsmokers: 57%, <i>p</i> = 0.255). Uncontrolled asthma remained infrequent but was more prevalent in current (10%) and former (8.9%) smokers than in nonsmokers (5.7%) (<i>p</i> = 0.002 and <i>p</i> = 0.033, respectively).</p><p><strong>Conclusions: </strong>Asthma patients, regardless of smoking status, demonstrate a similar response to treatment. Uncontrolled asthma, though rare under treatment, is more common among smokers, due to their higher baseline severity.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512005","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}

{"title":"Overestimation of asthma control and misperception of the place of short-acting β2-agonists in asthma management: a prospective, real-world study among physicians in Poland.","authors":"Radosław Gawlik, Grażyna Bochenek, Dorota Brzostek, Adam Stasiulewicz, Wojciech Barg, Grzegorz Brożek, Piotr Dąbrowiecki, Andrzej Dąbrowski, Rafał Dobek, Aleksandra Kucharczyk, Maciej Kupczyk, Izabela Kupryś-Lipińska, Agnieszka Mastalerz-Migas, Marek L Kowalski","doi":"10.1080/02770903.2025.2472354","DOIUrl":"10.1080/02770903.2025.2472354","url":null,"abstract":"<p><strong>Objective: </strong>Overestimation of asthma control remains a substantial healthcare issue. Overuse of short-acting β2-agonists (SABA), one of the aspects of poor asthma control, was highlighted by the SABINA project as a worldwide problem. The objective of this study was to investigate the asthma control assessment and the perception of the SABA role in asthma therapy among Polish allergists, pulmonologists, and general practitioners.</p><p><strong>Methods: </strong>The study included 253 Polish allergists, pulmonologists, and general practitioners.Data were gathered using a qualitative questionnaire regarding physicians' practices and opinions and a quantitative one - an extended Patient Diary Study with information about asthma control of 2482 patients. The answers were compared with Global Initiative for Asthma (GINA) criteria.</p><p><strong>Results: </strong>Physicians assessed asthma control at 69.1-89.8% of visits, based mainly on symptoms (96% of physicians), followed by drug consumption (65-80%) and diagnostic tests (40-79%). According to GINA standards, 32.4-43.3% of patients had controlled and 27.3-33.9% uncontrolled asthma. Physicians in all specialties overestimated the percentage of patients with controlled asthma and the level of control was overestimated for 68-84% of uncontrolled patients. Over 90% of physicians agreed or strongly agreed that SABA consumption is an important indicator of asthma control; 58-81% agreed that SABA consumption should be monitored as an indicator of asthma control; 74-90% stated that SABA were rescue medications that patients must have; 59-68% agreed that SABA consumption should be reduced.</p><p><strong>Conclusions: </strong>The results of this study show a strong need for physicians' education regarding objective asthma control assessment and the role of SABA in asthma therapy.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1231-1239"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673955","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 between asthma and risk of cardiovascular disease in Korean adults.","authors":"Jihye Jung, Jimin Sung, Sunwoo Kim, Jeonghu Kim, Chanbin Park, Minsu Sung, Sol Choi, Mi Ah Han","doi":"10.1080/02770903.2025.2463962","DOIUrl":"10.1080/02770903.2025.2463962","url":null,"abstract":"<p><strong>Objectives: </strong>Cardiovascular disease (CVD) is a major cause of death in Korea, and studies have reported that asthma can have a negative impact on CVD. This study aimed to identify the association between asthma and CVD, including the current status, treatment status, and duration of asthma in Korean adults.</p><p><strong>Methods: </strong>The Korea National Health and Nutrition Examination Survey (2016-2021) was used, and 34,384 adults aged 19 years or older were included. Exposures were asthma-related characteristics, and outcomes were hypertension, ischemic heart disease, and stroke. The association between asthma characteristics and CVD was analyzed using the chi-square test and multiple logistic regression analysis.</p><p><strong>Results: </strong>The asthma diagnosis experience rate of the population was 3.1%; 1.6% were currently suffering from asthma, 1.0% were receiving asthma treatment, 0.6% were receiving regular medication, and 1.5% had a disease duration of 11 years or more. The CVD diagnosis rates in the population were 20.2% for hypertension, 2.3% for ischemic heart disease, and 1.8% for stroke. Compared to those who had no asthma diagnosis, those who had been diagnosed with asthma (OR = 2.06, 95% CI = 1.47-2.87), received asthma treatment (OR = 1.93, 95% CI = 1.22-3.04), and had a long duration of asthma (OR = 3.54, 95% CI = 1.71-7.33) had a significantly higher risk of ischemic heart disease. However, hypertension and stroke were not significantly correlated with asthma-related characteristics.</p><p><strong>Conclusions: </strong>Asthma diagnosis and asthma-related characteristics were associated with an increased risk of ischemic heart disease. Our study suggests that research on risk assessment and management of CVD in patients with asthma would be needed.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1133-1140"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189340","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":"Therapeutic evaluation of Wumei Pill (WP) for nocturnal asthma in Bmal1 gene knockout mice.","authors":"Po Hu, Yili Tao, Yunwei Chen, Ying Yang, Bohan Wang, Wenxing Mei, Kejian Wang, Ye Wu","doi":"10.1080/02770903.2025.2469317","DOIUrl":"10.1080/02770903.2025.2469317","url":null,"abstract":"<p><strong>Objective: </strong>Previous clinical studies have demonstrated that Wumei Pill (WP), a traditional Chinese medicine formula, can effectively alleviate nocturnal asthma-related anxiety and improve nighttime symptoms. The therapeutic mechanism of WP may involve the regulation of inflammatory chemokines in peripheral blood. This mechanism is potentially linked to modulation of the circadian clock gene ARNT-like protein-1 (Bmal1), but precise pathways underlying this interaction remain unclear, requiring further investigation.</p><p><strong>Methods: </strong>Bmal1 knockout and wild-type mice were utilized to establish asthma models. Techniques such as flow cytometry, RT-PCR, and ELISA were employed to measure the levels of serum inflammatory mediators, specifically IFN-γ, CXCL16, I-TAC, and PARC. Furthermore, the pathological alterations in airway thickness were assessed. Additionally, we investigated the regulation of the Bmal1 gene and its influence on the circadian rhythm-related recruitment of leukocytes, as well as the expression patterns of downstream mediators.</p><p><strong>Results: </strong>Compared to the wild-type (WT) group, the model group showed significantly higher levels of CXCL16, I-TAC, and PARC (<i>p</i> < 0.05), as well as a notable decrease in IFN-γ expression. WP treatment effectively normalized the levels of these inflammatory factors in the model group, indicating a regulatory effect of WP on inflammatory chemokines.</p><p><strong>Conclusion: </strong>The knockout of the Bmal1 gene, a crucial regulator of circadian rhythms, disrupts the circadian expression of inflammatory chemokines. Treatment with WP modulated Bmal1 expression, influencing the release of these mediators, offering a promising strategy for managing nocturnal asthma. Notably, wild-type nocturnal asthma mice exhibited significantly better control of airway inflammation compared to their Bmal1-deficient counterparts, highlighting the importance of circadian regulation in the pathophysiology of asthma.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1211-1220"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458027","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":"Relationship of depression and asthma: a observational and Mendelian randomization study.","authors":"Shiyuan Guo, Yilong Lin, Junting Li, Yan Zheng, Xin Lan, Jiaojiao Chen, Shuying Li, Yingjie Feng, Songsong Wang","doi":"10.1080/02770903.2025.2463973","DOIUrl":"10.1080/02770903.2025.2463973","url":null,"abstract":"<p><strong>Background: </strong>Both depression and asthma have a significant impact on the quality of life for individuals. Studies have shown that patients with depression often experience comorbid asthma; however, the precise relationship between these two conditions remains unclear. The objective of this study is to investigate the causal relationship between depression and asthma.</p><p><strong>Methods: </strong>In a cross-sectional study, we utilized data from the National Health and Nutrition Examination Survey (NHANES) 2009-2014 and employed logistic regression to assess the correlation between depression and asthma. In the subsequent Mendelian randomization (MR) analysis, we selected single nucleotide polymorphisms (SNPs) closely linked to both depression and asthma as instrumental variables, based on summary data from genome-wide association studies (GWAS). The inverse variance weighted method (IVW) was then applied to ascertain the causal relationship between depression and asthma.</p><p><strong>Results: </strong>Based on the results of the cross-sectional study, it was found that the status of depression was significantly associated with a higher risk of asthma (OR = 2.15, 95%CI = 1.79 ∼ 2.59, <i>p</i> < 0.001). Furthermore, in the MR analysis, a causal relationship was further identified between depression, severe depression, and the increased incidence of asthma (OR = 1.11, 95%CI = 1.05 ∼ 1.18, <i>p</i> < 0.001), (OR = 1.01, 95%CI = 1.01 ∼ 1.02, <i>p</i> < 0.001); the results of the reverse MR analysis indicated no causal relationship between asthma and the increased incidence of depression and severe depression (OR = 1.01, 95%CI0.99 ∼ 1.03, <i>p</i> = 0.50), (OR = 1.07, 95%CI: 0.82 ∼ 1.40, <i>p</i> = 0.64).</p><p><strong>Conclusion: </strong>This study has revealed a causal relationship between depression and an increased risk of developing asthma, offering new insights for the clinical intervention of both asthma and depression.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1156-1165"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189426","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":"Evaluation of a cardboard-based spacer for enhancing aerosol delivery from pressurized metered dose inhalers.","authors":"Haitham Saeed, Wesam G Ammari, Hasnaa Osama, Ahmed M Abdelfattah, Mohamed E A Abdelrahim, Basma M E Mohamed","doi":"10.1080/02770903.2025.2463965","DOIUrl":"10.1080/02770903.2025.2463965","url":null,"abstract":"<p><strong>Objective: </strong>The current study aimed to evaluate a novel paper card-based spacer (MDI Plus) <i>in vitro</i> and <i>in vivo</i> as a cost-effective alternative to traditional spacers (AeroChamber Plus).</p><p><strong>Methodology: </strong>The <i>in vitro</i> part evaluated salbutamol's aerodynamic particle size distribution (APSD) after 0, 20, 50, 120, and 200 uses of Ventolin pressurized metered dose inhaler (pMDI) when connected to MDI Plus using an Andersen cascade impactor at an inhalation flow of 28.3 L/min. The <i>in vivo</i> part recruited a cohort of adult asthmatic patients. It assessed their pMDI usage and the number of training sessions to enhance their ability to use their pMDI alone and in combination with MDI Plus and AeroChamber Plus. Moreover, the amount of salbutamol deposited within the spacer devices, on the pMDI, and on the hand of the patients after 0, 20, 50, 120, and 200 uses were evaluated.</p><p><strong>Results: </strong>The durability tests revealed that while there were reductions in aerodynamic performance over the lifespan of the pMDI, the decreases were insufficient to render the spacer ineffective. The fine particle fraction decreased slightly, and the mass median aerodynamic diameter increased somewhat, but the spacer maintained functional performance. The study indicated that spacers significantly improved patients' ability to use their MDIs correctly with minimal training. The MDI Plus showed a slightly significant positive impact (<i>p</i> < 0.05), requiring fewer training sessions for effective use. The amount left in the MDI Plus was significantly lower than within the AeroChamber Plus (<i>p</i> < 0.05). The amount deposited on the MDI and the hands of the patients after multiple storage in the MDI Plus box and uses was insignificant and within the allowed limits.</p><p><strong>Conclusion: </strong>The MDI Plus simultaneously can act as an pMDI packaging box and spacer, serving as a practical, affordable, and accessible alternative to traditionally commercially available plastic spacers, particularly in resource-limited settings.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1141-1147"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189417","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}