Journal of Asthma最新文献

{"title":"Distinct characteristics of asthma overlap phenotypes: Insights from the Turkish adult asthma registry.","authors":"Secil Kepil Ozdemir, Bilun Gemicioglu, Fusun Yildiz, Serhat Hayme, Gulistan Alpagat, Nurgul Bozkurt, Ismet Bulut, Munevver Erdinc, Gul Karakaya, Metin Keren, Gulden Pacaci Cetin, Insu Yilmaz, Arzu Yorgancioglu, Omur Aydin, Derya Gokmen, Gozde Koycu Buhari, Zeynep Celebi Sozener, Sengul Beyaz, Cihan Orcen, Ebru Damadoglu, Tugce Yakut, Ayse Fusun Kalpaklioglu, Ayse Baccioglu, Sumeyra Alan Yalim, Ilkay Koca Kalkan, Mehmet Atilla Uysal, Elif Yelda Ozgun Niksarlioglu, Ali Fuat Kalyoncu, Muge Erbay, Sibel Nayci, Fatma Merve Tepetam, Aslı Gelincik, Hulya Dirol, Ozlem Goksel, Selen Karaoglanoglu, Ferda Oner Erkekol, Sacide Rana Isik, Yasemin Yavuz, Dilek Karadogan, Ummuhan Seker, Ipek Kivilcim Oguzulgen, Ilknur Basyigit, Serap Argun Baris, Elif Yilmazel Ucar, Tuba Erdogan, Mehmet Polatli, Dane Ediger, Fatma Esra Gunaydin, Murat Turk, Leyla Pur, Zeynep Yegin Katran, Yonca Sekibag, Enes Furkan Aykac, Dilsad Mungan, Ozcan Gul, Ali Cengiz, Bulent Akkurt, Seyma Ozden, Semra Demir, Derya Unal, Ayse Feyza Aslan, Ali Can, Reyhan Gumusburun, Gulhan Bogatekin, Hatice Serpil Akten, Sinem Inan, Aliye Candan Ogus, Murat Kavas, Demet Polat Yulug, Mehmet Erdem Cakmak, Saltuk Bugra Kaya, Eylem Sercan Ozgur, Oguz Uzun, Sule Tas Gulen, Gulseren Pekbak, Deniz Kizilirmak, Yavuz Havlucu, Halil Donmez, Bahar Arslan, Sadan Soyyigit, Bilge Yilmaz Kara, Gulden Pasaoglu Karakis, Adile Berna Dursun, Resat Kendirlinan, Ayse Bilge Ozturk, Can Sevinc, Gokcen Omeroglu Simsek, Oznur Abadoglu, Pamir Cerci, Taskin Yucel, Irfan Yorulmaz, Zahide Ciler Tezcaner, Emel Cadalli Tatar, Ahmet Emre Suslu, Serdar Ozer, Engin Dursun, Gulfem Elif Celik","doi":"10.1080/02770903.2025.2493134","DOIUrl":"10.1080/02770903.2025.2493134","url":null,"abstract":"<p><strong>Introduction: </strong>Considerable overlaps exist between asthma phenotypes and the clinical significance of these overlaps remains undetermined. The objective of this study is to analyze the characteristics of asthma overlap phenotypes using data from the Turkish Adult Asthma Registry (TAAR).</p><p><strong>Methods: </strong>This cross-sectional registry study included 2053 adult patients (74.8% female) with asthma.</p><p><strong>Results: </strong>Overall, 39.3% (<i>n</i> = 697) had allergic-eosinophilic (AE), 26.0% (<i>n</i> = 461) had allergic-non-eosinophilic (ANE), 21.3% (<i>n</i> = 377) had non-allergic-eosinophilic (NAE), and 13.4% (<i>n</i> = 237) had non-allergic-non-eosinophilic (NANE) asthma. Severe asthma exacerbations and emergency department (ED) visits were more frequent in the AE (28.3%, 31.2%, respectively) and NAE groups (36.0%, 34.0%, respectively) than in the ANE (14.3%, 20.6%, respectively) and NANE groups (12.6%, 16.7%, respectively) (<i>p</i> < 0.001). FEV1 values were significantly lower in the AE group than in the ANE and NANE groups (<i>p</i> < 0.001, <i>p</i> = 0.048, respectively) and in the NAE group than in the ANE group (<i>p</i> < 0.001). Risk factors for poor asthma control included living in rural areas, asthma-related ED visits, FEV1 < 60% in the NAE; being overweight, chronic rhinosinusitis, oral corticosteroids use, age < 40 years in the NANE; FEV1 < 80% in the AE; and severe asthma exacerbations, ED visits for AE and ANE groups.</p><p><strong>Conclusion: </strong>The considerable overlap between allergic and eosinophilic asthma phenotypes has clinical implications as increased rates of asthma exacerbations and healthcare utilization. The clinical heterogeneity among asthma phenotypes based on a single biomarker highlights the importance of multidimensional asthma phenotyping.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1512-1524"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007035","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":"Bibliometric perspectives on inflammatory and immunological research in pediatric asthma.","authors":"Danqing Hu, Ling Mei, Dongyang An, Zengyu Zhang, Yugen Sha, Wei Zhou","doi":"10.1080/02770903.2025.2494231","DOIUrl":"10.1080/02770903.2025.2494231","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric bronchial asthma, a prevalent chronic inflammatory respiratory disease, significantly affects children globally. However, bibliometric analyses focused on its inflammatory and immunological aspects are limited. This study aims to provide an overview of the field, identify key focus areas, and predict emerging trends.</p><p><strong>Methods: </strong>We collected and analyzed relevant literature published from January 1, 2000, to May 31, 2024, from the Web of Science Core Collection. Collaborative network analysis was conducted using CiteSpace 5.8.R3, VOSviewer 1.6.20, and Bibliometrix.</p><p><strong>Results: </strong>A total of 911 papers were retrieved, showing growth in research output since 2006, with the United States leading in publications. The University of Western Australia ranks first in publication count, while the University of Wisconsin-Madison has the highest average citations per paper. Among 5,059 authors, 146 core authors contributed to 592 articles, accounting for 64.98% of total publications, with Anne M. Fitzpatrick as the leading author. The journal \"Allergy, Asthma & Immunology Reviews\" is the most influential, and \"asthma\" is the most cited keyword. Co-citation analysis reveals 20 keyword clusters, with hotspots including \"efficacy\" and \"allergic rhinitis.\" The most cited paper is by D. P. Strachan in the \"British Medical Journal.\"</p><p><strong>Conclusion: </strong>This study reveals a significant increase in pediatric asthma research from 2000 to 2024, with the U.S. leading in scholarly contributions. Key findings highlight allergic airway inflammation and type 2 inflammation as primary mechanisms underlying the disease. Inhaled corticosteroids and biologics are identified as effective treatments. These insights emphasize the importance of global collaboration and ongoing research efforts to advance understanding of pathogenic mechanisms and clinical management in pediatric asthma patients.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1547-1559"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035919","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":"Biologicals reduce drug burden and improve physical and mental health in severe eosinophilic asthma.","authors":"Vincenzo Patella, Roberta Zunno, Girolamo Pelaia, Luciana Pierro, Giovanni Florio, Carmine Nicoletta, Corrado Pelaia","doi":"10.1080/02770903.2025.2490106","DOIUrl":"10.1080/02770903.2025.2490106","url":null,"abstract":"<p><strong>Objective: </strong>This real-world study evaluates the improvement in asthma control, drug burden reduction, and physical and mental health in patients with severe eosinophilic asthma treated with biologicals.</p><p><strong>Methods: </strong>We enrolled 127 patients with severe eosinophilic asthma from two centers, treating them with add-on biological therapy. The asthma control test (ACT) and the Short-form Health Survey-12 (SF-12), including Physical Component Summary (PCS) and Mental Component Summary (MCS), were used, assessing drug history at baseline (T0) and after 32 weeks of biological therapy (T1).</p><p><strong>Results: </strong>A significant improvement in asthma control was observed after the biological treatment (ACT score: 11(8) vs 23(3), <i>p</i> < 0.0001), with most patients achieving asthma control at T1 (110, 86.6%). There was a statistically significant reduction in the use of non-biological drugs at T1, such as oral corticosteroids (40.2% vs 17.3%, <i>p</i> < 0.0001), inhalation therapy (75.6% vs 57.5%, <i>p</i> = 0.001), leukotriene receptor antagonists (34.6% vs 25.2%, <i>p</i> < 0.0001), and antihistamines (42.5% vs 18.1%, <i>p</i> < 0.0001). ACT and PCS scores at T1 had a strong positive correlation (<i>r</i> = 0.749, <i>p</i> < 0.0001), as did ACT and MCS scores (<i>r</i> = 0.744, <i>p</i> < 0.0001). Our study shows that the biological treatments for severe eosinophilic asthma, properly characterized through a careful phenotypic assessment, significantly improve asthma control and reduce drug burden (notably oral corticosteroids, inhalation therapy, leukotriene receptor antagonists, and antihistamines), as well as enhance both physical and mental health irrespective of age and sex.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1493-1498"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966830","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 the 2020 Healthy Eating Index with asthma in children and adolescents in the United States: a cross-sectional study of NHANES.","authors":"Tong Lu, Qiang Yu, Liyong Che, Xiaolan Zhang, Chao Che, Linjun Du, Jia Jia","doi":"10.1080/02770903.2025.2512596","DOIUrl":"10.1080/02770903.2025.2512596","url":null,"abstract":"<p><strong>Objective: </strong>Our goal was to investigate the connection between asthma and HEI-2020.</p><p><strong>Data sources: </strong>A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2020.</p><p><strong>Study selections: </strong>Diet quality was measured as HEI-2020 scores using 24-h and 2-day dietary recall data. A range of statistical methods, including as sensitivity analysis, restricted triple spline analysis, subgroup analysis, and multivariate logistic regression, were used to assess the relationship between the HEI-2020 and asthma.</p><p><strong>Results: </strong>2,740 (17.5%) of the 15,667 said a doctor or other health care provider had diagnosed them with asthma. The lower a child or adolescent's risk of developing asthma, after adjusting for pertinent factors, the higher the overall HEI-2020 score. The adjusted odds ratios (OR) for asthma in the second (Tertiles 2, 42.92-<51.9) and third (Tertiles 3, 42.92-51.9) groups were 0.93 (0.84-1.03) and 0.83 (0.73-0.94), respectively, in comparison to the group with the lowest HEI-2020 values (Tertiles 1, 18.35-<42.92). The results' resilience was further validated using stratified and sensitivity analyses. Asthma risk may also be decreased by eating less sodium and added sweets and more total fruits, whole fruits, seafood and plant proteins.</p><p><strong>Conclusion: </strong>There is a negative correlation between asthma and the Healthy Eating Index-2020 in children and adolescents in the United States.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1483-1492"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173862","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":"Jian'er Qiangshen ointment treating bronchial asthma by inhibiting lung inflammation and regulating intestinal microbiota.","authors":"Yanlin Li, Zhenghua Wang, Hui Zhu, Gang Cao, Shanshan Yang","doi":"10.1080/02770903.2025.2505462","DOIUrl":"10.1080/02770903.2025.2505462","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the ameliorative effects and mechanisms of Jian'er Qiangshen (JEQS) ointment on asthma.</p><p><strong>Methods: </strong>Twenty-four BALB/c mice were randomly and equally divided into four groups: blank control, ovalbumin (OVA), OVA + dexamethasone (DXMS), and OVA + JEQS. Lung tissue sections were isolated for H&E and Masson staining, and inflammatory factor levels were measured. Ultra-high performance liquid chromatography-time-of-flight mass spectrometry (UHPLC-TOF-MS) was employed to analyze and identify blood components in mice following intragastric administration of JEQS extract. Network pharmacology analysis was subsequently utilized to predict the pharmacological targets and mechanisms of JEQS in asthma treatment. 16S rRNA sequencing was conducted to determine bacterial community composition and diversity.</p><p><strong>Results: </strong>Animal experiments indicated that compared to the OVA group, the OVA + drug groups (DXMS and JEQS) exhibited milder asthma symptoms and significantly improved pathological changes. JEQS significantly reduced IFN-γ, IL-4, IL-5, and IL-13 levels in lung tissue.</p><p><strong>Conclusions: </strong>Through network pharmacology and 16S rRNA sequencing, JEQS ointment was found to alleviate asthma-related inflammatory responses and improve asthma symptoms via multi-target mechanisms and modulation of intestinal microbiota. Network pharmacology revealed 28 effective components in JEQS for asthma treatment, with α-linolenic acid, 9-oxononanoic acid, inosine, linoleic acid, and amygdalin as primary active constituents. One hundred core targets were identified, including AKT1, IL-6, ALB, TNF, and MAPK3. 16S rRNA sequencing demonstrated increased proportions of Proteobacteria and Actinobacteria following JEQS treatment. Probiotics such as Clostridium, Escherichia, Bacteroides, and Candidatus Saccharimonas became dominant microbiota.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1627-1643"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078015","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":"Enhancing the nutraceutical and nutritional features of wheat germ to reduce atopic asthma symptoms in children.","authors":"Fahri Bayiroglu, Nilgun Erdonmez, Leyla Aydin, Mehmet Salih Kaya","doi":"10.1080/02770903.2025.2499833","DOIUrl":"10.1080/02770903.2025.2499833","url":null,"abstract":"<p><strong>Background: </strong>The rise in childhood asthma has increased interest in nutraceutical treatment options such as specific nutritional supplements, as medical treatments may not always produce the desired results. Despite treatment, between 30 and 50% of children with asthma do not attain adequate control.</p><p><strong>Objectives: </strong>For the first time, the effects of adding fermented wheat germ to the daily diet of children with atopic asthma on respiratory function-related disease symptoms, serum IgE, and eosinophil levels were studied.</p><p><strong>Methods: </strong>The study comprised 52 patients (control group <i>n</i> = 26, experimental group <i>n</i> = 26) aged 12-18 years with a clear diagnosis of atopic asthma. The experimental group consumed 100 g of fermented wheat bread with 5% wheat germ every day for three months, while the control group consumed standard bread. The groups were assessed at baseline and at the end of each month with spirometry (FVC, FEV1, PEF), serum eosinophil and IgE measurements, and the application of the Asthma Control Test (ACT) scale.</p><p><strong>Results: </strong>There was no significant difference between the control and experimental groups in terms of any measurement. The experimental group had significant increases in PEF (<i>p</i> < 0.05), FVC, and IgE levels (<i>p</i> < 0.001) compared to monthly measurements. Both groups showed statistically significant improvements in ACT and FEV1 (<i>p</i> < 0.001). Nonetheless, the control and experimental groups showed no significant difference in time-dependent eosinophil levels (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Although the inclusion of fermented wheat germ to asthmatic children's diets has been shown to improve PEF and IgE levels, these findings require further investigation.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1599-1607"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077930","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":"Efficacy of tiotropium bromide on spirometric measurements and control of asthma in real life: data from a 1-year clinical follow-up.","authors":"Fatma Dindar Çelik, Kurtuluş Aksu, Enes Çelik, Hatice Çelik Tuğlu, Melis Yağdıran, Özgür Akkale, Onur Telli, Gözde Köycü Buhari, Sakine Nazik Bahçecioğlu, Funda Aksu","doi":"10.1080/02770903.2025.2499823","DOIUrl":"10.1080/02770903.2025.2499823","url":null,"abstract":"<p><strong>Objective: </strong>Real-life studies are needed to evaluate the clinical outcomes of add-on tiotropium therapy in patients with asthma. The effects of adding tiotropium bromide to the treatment of asthmatic patients on pulmonary functions and asthma control using real-life data.</p><p><strong>Methods: </strong>In a retrospective study, spirometric measures and asthma control states were compared before and one year after of tiotropium treatment in asthmatic adults whose disease was not adequately controlled with a combination of inhaled corticosteroids and long-acting β2-agonists.</p><p><strong>Results: </strong>One year after tiotropium treatment, mean FEV1, FEV1%, and FEV1/FVC ratio increased significantly compared to pretreatment values. Among 32 patients added tiotropium due to symptomatic asthma, 28 (87.5%) patients achieved well-controlled (ACT ≥ 20) end of the year and GINA treatment step-down in 4 (12.5%) patients. Monoclonal antibody therapies (mepolizumab or omalizumab) were initiated in 9 patients (28.1%). FEV1 values and FEV1/FVC ratios showed a statistically significant improvement from baseline measurements obtained prior to the initiation of tiotropium therapy, independent of monoclonal antibody use (<i>p</i> < .001 for each). The mean age of these patients was 48.78 ± 11.64 (range: 28-81) years, and 25 (78.1%) of them were female.</p><p><strong>Conclusions: </strong>Tiotropium bromide is an effective and reliable add-on therapy for symptomatic asthma when combined with ICS plus LABA, also leads to improvements in respiratory function and asthma control.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1584-1590"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017335","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":"Bitter taste receptors as therapeutic targets: a review of the role and recent advances of bitter traditional Chinese medicine in bronchial asthma.","authors":"Xinru Zhang, Jiaqi Ma, Anan Zhang, Jinmei Zhang, Lixia Wu, Fang Wang, Dandan Hu","doi":"10.1080/02770903.2025.2552740","DOIUrl":"https://doi.org/10.1080/02770903.2025.2552740","url":null,"abstract":"<p><strong>Objective: </strong>This review explores recent advances in taste receptors type 2 (TAS2Rs) as potential therapeutic targets for bronchial asthma, focusing on the regulatory effects of bioactive compounds from bitter traditional Chinese medicines to provide new strategies for asthma prevention and treatment.</p><p><strong>Methods: </strong>Relevant studies were identified through PubMed, including in vitro experiments, animal models, and clinical observations. Literature on the activation of TAS2Rs by bitter traditional Chinese medicine-derived compounds such as alkaloids, flavonoids, and terpenoids was analyzed, emphasizing mechanisms involving airway smooth muscle (ASM) relaxation, anti-inflammatory responses, and immune modulation.</p><p><strong>Results: </strong>TAS2Rs are widely expressed in the respiratory tract. Their activation induces ASM relaxation, inhibits inflammatory factor release, and modulates immune responses. Bitter compounds like kudinoside A, baicalin, naringin, and artesunate act as TAS2R agonists, improving airway hyperresponsiveness and inflammation. Some components, such as baicalin, can also regulate TAS2R expression at the gene transcription level.</p><p><strong>Conclusions: </strong>TAS2Rs regulate key respiratory processes, offering a new target for treating asthma and other respiratory diseases. Bitter traditional Chinese medicine bioactive compounds show anti-inflammatory and bronchodilatory effects by activating TAS2Rs, showing clinical promise. However, most of the related research is still in the basic research stage, and clinical evidence remains insufficient. Future efforts should focus on large-scale clinical trials and further mechanistic studies to promote the modernization of bitter traditional Chinese medicine in asthma treatment.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-9"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955145","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":"Video directly observed therapy to improve inhaler technique among pediatric patients with persistent asthma.","authors":"Lina Mahmood, Kasturi R Sarkar, Kaymon Neal, Rita C Brown, Andrew W Brown, Scott Stewart, Robert D Pesek, Akilah A Jefferson, Tamara T Perry","doi":"10.1080/02770903.2025.2499829","DOIUrl":"10.1080/02770903.2025.2499829","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility of at-home video directly observed therapy (vDOT) among pediatric patients with asthma to learn and retain proper inhaler technique.</p><p><strong>Methods: </strong>We conducted a randomized pilot study with 22 children with persistent asthma aged 6-11 years who were newly prescribed an asthma controller inhaler. Patients underwent 1:1 randomization into one group receiving standard inhaler education during clinic and another receiving standard education plus vDOT for 30 days. vDOT is a method by which trained professionals observe patients self-administering medications through a virtual platform to monitor adherence and proper medication use. We measured inhaler technique, age-appropriate Asthma Control Test (ACT) score, symptom-free days, and healthcare utilization in both groups at 3 months.</p><p><strong>Results: </strong>Median inhaler technique accuracy percentage score was 88% (IQR 66, 100) for vDOT participants compared to 75% (IQR 38, 88) for controls (<i>p</i> = 0.11). Technique errors within the vDOT group included inadequate breath-holding (34%), inadequate breathing technique (29%), incorrect/no shaking of inhaler (22%) and failure to rinse mouth (15%). There was no difference between groups in change in ACT score, resource utilization or controller prescription refill rates. In the first 30 days, the median number of days until vDOT participants had no observed technique errors was 10 days (range 0-25).</p><p><strong>Conclusion: </strong>vDOT is a viable technique to provide initial and continual education and real-time feedback on inhaler technique after the initial education provided in clinic.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1591-1598"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12353540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025301","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":"Balancing efficacy and portability: comparative <i>in vitro</i>/<i>in vivo</i> evaluation of MDI PLUS® versus AeroChamber2go™ spacers for aerosol delivery.","authors":"Ahmed H M Sobh, Marwa Mohsen, Ahmed M Abdelfattah, Mohamed E A Abdelrahim, Basma M E Mohamed","doi":"10.1080/02770903.2025.2552742","DOIUrl":"https://doi.org/10.1080/02770903.2025.2552742","url":null,"abstract":"<p><strong>Background: </strong>The Global Initiative for Asthma (GINA) recommended using spacers or valved holding chambers to counter the common problems of poor pressurized metered dose inhaler (pMDI) technique. However, many subjects avoid using conventional spacers because they are bulky and inconvenient to carry around in public.</p><p><strong>Objective: </strong>We aimed to compare the novel, MDI PLUS^® spacer, with AeroChamber2go™ on their <i>in vitro</i> and <i>in vivo</i> aerosol performance, as well as their user training requirements.</p><p><strong>Methods: </strong><i>In vitro</i>, aerosol characteristics were assessed using an Andersen cascade impactor at 28.3 L/min with Ventolin^® pMDI (5 puffs, 100 µg/puff); HPLC quantified drug deposition on each stage. <i>In vivo</i>, 20 asthmatic subjects received 500 µg salbutamol via pMDI alone, and pMDI + AeroChamber2go™ or MDI PLUS^®. Urine samples were collected at 30 min and cumulatively over 24 h after inhaler use, and salbutamol samples were extracted and assessed using HPLC. <i>Ex vivo</i> delivery and user inhaler mastery were also assessed.</p><p><strong>Results: </strong>The fine-particle dose increased from 94.98 µg (pMDI alone) to 128.45 µg with AeroChamber2go™ and 130.04 µg with MDI PLUS^®, while the fine-particle fraction rose from 26.58% to 65.72% and 67.19%, respectively (<i>p</i> < .05). Thirty-minute urinary salbutamol excretion nearly doubled with both the MDI PLUS^® and the AeroChamber2go, whereas systemic bioavailability over 24 h was significantly reduced from 143.35 µg with pMDI alone to approximately 60 µg with either device (<i>p</i> < .01). Notably, MDI PLUS required the fewest training sessions to master (1.03, <i>p</i> < .05).</p><p><strong>Conclusions: </strong>Both the MDI PLUS^® and the AeroChamber2go™ significantly enhanced pulmonary delivery and reduced systemic exposure compared to pMDI alone, while MDI PLUS^® might potentially show a superior ease of use. These findings support the adoption of either device to optimize inhaler therapy.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-6"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955204","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}