Journal of Asthma最新文献

{"title":"Evaluation of sexual problems in asthmatic patients.","authors":"Suayip Ceylan, Ahmet Cagın, Onur Ozturk","doi":"10.1080/02770903.2026.2666085","DOIUrl":"10.1080/02770903.2026.2666085","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated sexual function in patients with asthma and its association with sociodemographic and clinical factors.</p><p><strong>Methods: </strong>This cross-sectional study included 380 individuals (aged 18-49) diagnosed with asthma for at least six months and was conducted at the pulmonology outpatient clinic of Samsun University Training and Research Hospital. Data were collected using a structured sociodemographic and sexual repertoire form and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Statistical analyses included Chi-square, Mann-Whitney's <i>U</i>, and independent samples <i>t</i>-tests, followed by multivariable linear regression to identify independent predictors of sexual dysfunction.</p><p><strong>Results: </strong>A total of 380 individuals participated in the study, with an equal number of male and female participants. Females had significantly higher total GRISS scores than males (<i>p</i> = 0.001). Married individuals reported higher sexual satisfaction than singles (<i>p</i> = 0.004) in univariate analysis; however, marital status was not an independent factor in multivariable regression analysis. GRISS scores decreased with increasing education level (<i>p</i> = 0.008). Married participants reported a significant reduction in vaginal intercourse (<i>p</i> = 0.019). Additionally, participants who experienced fear of an asthma attack during intercourse had significantly higher scores than those who did not (<i>p</i> = 0.003).</p><p><strong>Conclusions: </strong>Women, single individuals, and those with lower educational levels reported higher GRISS scores, indicating more sexual dysfunction. Similarly, high scores were observed among participants who experienced fear of an asthma attack during intercourse. These findings suggest that asthma appears to be associated with multidimensional impairments in sexual health.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1308-1316"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772294","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":"Baseline blood eosinophil count does not predict short-term changes in oscillometric psarameters in steroid-naïve asthma.","authors":"Osamu Matsuno","doi":"10.1080/02770903.2026.2660094","DOIUrl":"10.1080/02770903.2026.2660094","url":null,"abstract":"<p><strong>Background: </strong>Peripheral blood eosinophil (PBE) count is widely used as a biomarker to guide treatment decisions in asthma. However, whether eosinophil levels predict early changes in airway mechanics assessed by oscillometry remains unclear, particularly in steroid-naïve patients.</p><p><strong>Objective: </strong>To determine whether baseline PBE levels are associated with early changes in oscillometric indices of airway function in steroid-naïve asthma.</p><p><strong>Methods: </strong>We retrospectively analyzed adult patients with steroid-naïve asthma who underwent oscillometry at baseline and after 12 wk of inhaled corticosteroid-based therapy. Patients were stratified according to baseline PBE count (≥300 vs <300 cells/μL). Percentage changes in R5, R20, R5-R20, X5, resonant frequency (Fres), and area of low-frequency reactance (ALX) were compared using the Mann-Whitney <i>U</i> test. Effect sizes were estimated using the Hodges-Lehmann method with exact confidence intervals.</p><p><strong>Results: </strong>A total of 57 patients were included (<i>n</i> = 33 with eosinophils ≥300 cells/μL; <i>n</i> = 24 with eosinophils <300 cells/μL). No significant differences were observed between groups in percentage changes of oscillometric parameters. Hodges-Lehmann estimates of group differences were small, and all confidence intervals crossed zero, indicating no clinically meaningful association between baseline eosinophil levels and early oscillometric improvement.</p><p><strong>Conclusions: </strong>In steroid-naïve asthma, baseline PBE count does not appear to predict early changes in oscillometric indices. These findings suggest that baseline PBE counts may be informative for spirometric responses to inhaled corticosteroid-based therapy, whereas their utility for anticipating early changes in oscillometric indices is limited. Spirometry and oscillometry may therefore provide complementary, rather than interchangeable, information when assessing early treatment responses in asthma.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1233-1240"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716865","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":"Unraveling the \"anxiety-adherence paradox\": illness perception clusters predict non-adherence in newly diagnosed asthma.","authors":"Yuling Hu, Hailun Huang, Li Jiang, Zhaoqian Gong, Liyu Yang, Shuyu Huang, Jianpeng Liang, Yisheng Lan, Wenshan Ouyang, Wenqu Zhao, Shaoxi Cai, Haijin Zhao","doi":"10.1080/02770903.2026.2734970","DOIUrl":"10.1080/02770903.2026.2734970","url":null,"abstract":"<p><strong>Background: </strong>Medication adherence is critical for asthma management but often suboptimal. Illness perceptions (IP), patients' cognitive and emotional representations of illness, are key determinants of adherence.</p><p><strong>Objective: </strong>This study aimed to identify IP clusters at diagnosis and determine their predictive value for medication adherence over the 6-month follow-up period and clinical outcomes.</p><p><strong>Methods: </strong>In this prospective cohort study, 212 newly diagnosed asthma patients were enrolled. We applied consensus clustering analysis to the Brief Illness Perception Questionnaire (B-IPQ) to identify robust IP clusters. Multivariable logistic regression was used to assess whether cluster membership independently predicted medication adherence over the 6-month follow-up period.</p><p><strong>Results: </strong>Four distinct IP clusters were identified: Pessimistic-Helpless, Underestimating-Low Control, Hypersensitive-Anxious, and Adaptive-Vigilant. Over the 6-month follow-up period, the Hypersensitive-Anxious cluster, despite reporting the highest level of concern, demonstrated the poorest medication adherence and suboptimal asthma control, suggesting an \"anxiety-adherence paradox\". Moreover, baseline cluster membership independently predicted good medication adherence over follow-up.</p><p><strong>Conclusions: </strong>Illness perceptions are heterogeneous early in asthma. Baseline IP clusters may aid risk stratification and personalized management.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008742","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":"α7nAChR agonist PNU-282987 suppresses allergic airway inflammation and is associated with reduced JAK2/STAT3 protein expression in murine asthma.","authors":"Xiaoqin Li, Yuxia Cui","doi":"10.1080/02770903.2026.2738100","DOIUrl":"10.1080/02770903.2026.2738100","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated α7 nicotinic acetylcholine receptor (α7nAChR) expression and its relationship with the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) pathway in allergic asthma, and evaluated the therapeutic efficacy of the α7nAChR agonist PNU-282987 compared with ipratropium bromide.</p><p><strong>Methods: </strong>Twenty-eight BALB/c mice were randomized into four groups (<i>n</i> = 7 each): control (Group A), asthma (Group B), asthma + PNU-282987 (Group C), and asthma + ipratropium bromide (Group D). Asthma was induced by intraperitoneal ovalbumin sensitization (days 1,7,14) followed by nebulized 5% ovalbumin challenge (days 21,28). Groups C and D received PNU-282987 (0.5 mg/kg IP) and nebulized ipratropium bromide (0.25 mg/mL, 10 min), respectively, 2 h post-challenge. Controls received saline. Behavioral assessment, histopathology, and ELISA for IL-4, IL-5, and IL-17 were performed. α7nAChR, JAK2, and STAT3 expression were measured by Western blot.</p><p><strong>Results: </strong>Asthmatic mice (Group B) showed significant behavioral changes, peribronchial inflammation, and airway secretions, and elevated IL-4, IL-5, and IL-17 versus controls (<i>p</i> < 0.05). α7nAChR was lower in Group B versus Groups A and C (<i>p</i> < 0.05); JAK2 and STAT3 were higher in Group B versus Groups A and C (<i>p</i> < 0.05). PNU-282987 (Group C) attenuated inflammation, reduced cytokines to control levels (<i>p</i> > 0.05), restored α7nAChR, and downregulated JAK2 and STAT3 total protein expression. Ipratropium bromide (Group D) reduced cytokines and inflammation but did not alter α7nAChR, JAK2, or STAT3 expression versus the asthma group (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>α7nAChR expression is reduced in asthmatic lung tissue. The α7nAChR agonist PNU-282987 attenuates airway inflammation and is associated with reduced JAK2 and STAT3 total protein expression, suggesting a potential association between α7nAChR activation and reduced JAK2/STAT3 protein expression. α7nAChR may represent a potential novel therapeutic target for asthma.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024950","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":"Bridging the gap between clinical outcomes and patient experiences in asthma: a targeted review of exacerbation, control, and remission outcomes.","authors":"Natalie V J Aldhouse, Samantha Wratten, Katie Mellor, Catherine Bottomley, Chibo Lee, Lucia de Prado Gomez, Jane R Wells","doi":"10.1080/02770903.2026.2734974","DOIUrl":"10.1080/02770903.2026.2734974","url":null,"abstract":"<p><strong>Objective: </strong>Understanding patients' lived experiences are vital for evaluating new treatments, yet patients' perspectives remain underutilized in asthma clinical trials. This study explored how asthma exacerbations, control, and remission are conceptualized and/or measured in clinical guidelines/expert recommendations and recent primary research studies, and the extent that patient perspectives were incorporated.</p><p><strong>Methods: </strong>A targeted literature review was conducted using electronic databases, ClinicalTrials.gov, regulatory websites, and reference lists. Conceptualizations of asthma exacerbations, control, and remission were analyzed using content analysis, and measurement strategies in recent primary research studies were extracted to evaluate alignment.</p><p><strong>Results: </strong>Exacerbations, control, and remission are interrelated concepts but lack universally accepted definitions, with inconsistencies across published sources and limited alignment between patients and clinicians. Although there was some alignment on what constitutes a severe exacerbation, the patient perspective was not well-captured. Asthma control was more consistently defined and measured using tools such as the Asthma Control Questionnaire (ACQ) and Asthma Control Test (ACT); however, there are still opportunities for making control endpoints more patient-informed. For remission, clinical guidelines emphasized symptom reduction/absence and improved lung function; however, the role of treatment and timeframe imposed varied. Few primary research studies measured remission, and patient conceptualizations of remission were limited.</p><p><strong>Conclusions: </strong>Greater alignment between clinical trial endpoints and patient-reported experiences is needed. The lack of consensus complicates the development of standardized, patient-informed measurement approaches, and should be addressed in the development of novel asthma endpoints.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989665","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":"Immunopathogenic endotypes of asthma: from type 2 and non-type 2 inflammation to precision therapeutic strategies.","authors":"Pradip S More, Uma D Kabra, Krishna R Gupta, Milind J Umekar","doi":"10.1080/02770903.2026.2738098","DOIUrl":"10.1080/02770903.2026.2738098","url":null,"abstract":"<p><p>Asthma is a chronic heterogeneous airways disease with multifactorial origins that plagues millions of people around the globe and has a huge global burden in terms of the recurrent exacerbations, diminished quality of life, and enormous costs of care- up to 10% of severe cases cannot be treated by steroids- so far. This extensive revision clarifies its immunopathogenesis, which involves a dynamic interaction between T2-high endotypes (supported by Th2/ILC2 cytokines IL-4/5/13 that promotes the eosinophilic inflammation, IgE-mediated allergy, hypersecretory mucus, and reversible obstruction) and T2-low (supported by Th1/Th17 cytokines IFN-7) phenotypes, which result in neutrophilic, remodeling prone, and cortic Indirectly, mixed severe asthma is supported by bidirectional T1-T2 crosstalk whereby TNF enhances ILC2 survival by TNFR2, IL-33 alarmins promote IL-5/13, and epithelial pro-inflammatory cascades, thus supporting therapeutic failures and the future of precision medicine. Depending on type of inflammation, eosinophilic (anti-IL-5 (mepolizumab) and mixed inflammation (dupilumab/tezepelumab) and high IgE (omalizumab) biomarkers are pivotal in stratifying phenotypes, predicting exacerbation, and informing targeted biologics, including anti-IL-5 (mepolizumab) and dupilumab/tezepelumab, respectively. This synthesis heralds a paradigm shift of empirical symptom control to personalized interventions, reduction of exacerbations, lessening of overtreatment, and the identification of new targets in multi-omics era to overcome the unmet needs of severe, steroid-resistant asthma.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-17"},"PeriodicalIF":1.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024952","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":"Allergic rhinitis duration and small-airway dysfunction in adolescents without asthma: a cross-sectional impulse oscillometry study.","authors":"Gulce Polat, Cihangir Sahin, Zeynep Gulec Koksal, Adnan Mercan, Simge Atar Bese, Gulten Tuncerler, Nur Torer, Ozge Cevik, Imran Kurt Omurlu, Selime Ozen Boluk, Pinar Uysal, Duygu Erge","doi":"10.1080/02770903.2026.2738097","DOIUrl":"10.1080/02770903.2026.2738097","url":null,"abstract":"<p><strong>Objective: </strong>Allergic rhinitis (AR) is a mucosal inflammatory disease increasingly viewed within a united-airway framework, yet whether lower-airway function deteriorates as AR persists in adolescents without asthma remains unclear. We used impulse oscillometry (IOS) to examine the relationship between AR duration and small-airway function, and examined serum endocan (endothelial cell-specific molecule-1, ESM-1), whose relationship to airway function in AR is unknown, as a candidate systemic biomarker.</p><p><strong>Methods: </strong>Forty treatment-naïve, aeroallergen-sensitized adolescents (12-17 years) with AR and 37 non-atopic controls of comparable age and sex underwent IOS, serum endocan measurement (ELISA, enzyme-linked immunosorbent assay), specific immunoglobulin E (IgE) testing, and skin prick testing. Symptoms were scored on a visual analog scale, and core IOS indices were expressed as age- and sex-adjusted <i>z</i>-scores.</p><p><strong>Results: </strong>No IOS parameter differed between patients and controls. However, longer AR duration was associated with higher total-airway resistance (zR5 <i>r</i> = 0.323, <i>p</i> = 0.042) and lower reactance (zX5 <i>r</i> = -0.502, <i>p</i> < 0.001); specific IgE also increased with age, duration, and severity. Serum endocan levels were similar in patients and controls (median 200.8 vs. 218.8 ng/mL; <i>p</i> = 0.517) and, within the AR group, did not correlate with severity, persistence, or IOS parameters.</p><p><strong>Conclusions: </strong>Greater oscillometric small-airway dysfunction was associated with longer AR duration, supporting the use of IOS to assess lower-airway function in adolescents with long-standing AR. Serum endocan did not distinguish patients from controls; because paired airway sampling was not performed, whether any endocan signal in AR is confined to the airway mucosa remains speculative.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030346","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":"Is it feasible to assess clinical remission in asthma via a customized data extraction approach from a real-world clinical electronic medical records database in Japan? A retrospective real-world study.","authors":"Hiroyuki Nagase, Takuro Sakagami, Masashi Takano, Ryota Hibi, Alison Moore, Stephen G Noorduyn, Atsushi Mizukami, Saki Takimoto, Yuki Moriyama, Risako Ito","doi":"10.1080/02770903.2026.2730888","DOIUrl":"10.1080/02770903.2026.2730888","url":null,"abstract":"<p><strong>Objective: </strong>Clinical remission (CR) is an ambitious and attainable treatment goal for patients with asthma. This retrospective, observational study determined the feasibility of assessing CR using an electronic medical record (EMR) database.</p><p><strong>Methods: </strong>Data from the JAMDAS database were analyzed for patients with asthma initiating fluticasone furoate/umeclidinium/vilanterol single-inhaler triple therapy between August 18, 2020 and December 31, 2024. Asthma Control Test (ACT) scores were extracted using structured query language. For exacerbations, hospitalization and emergency transport data were extracted using a large language model. The proportion of patients meeting Japanese Practical Guidelines for Asthma Management 2024 CR definition (oral corticosteroid [OCS]-free, no exacerbations, ACT ≥ 23), treatment patterns, adherence and persistence were assessed at 3-month intervals until 18-months post-initiation. Additionally, forced expiratory volume in 1 s (FEV₁%)/forced vital capacity and fractional exhaled nitric oxide (FeNO) test frequency were extracted.</p><p><strong>Results: </strong>Of 32 258 eligible patients, only 1.8-3.0%, 0.5-1.5% and 4.5-10.1% had 3- to 18-month ACT, FEV₁% or FeNO data available. Among patients with 3-month ACT data (2.9% [<i>n</i> = 934/32 258]), 98.6% (<i>n</i> = 921/934) had no exacerbations and 81.0% (<i>n</i> = 757/934) had no OCS use. Among evaluable patients (3-months: 2.9%; 18-months: 3.0%), 41.1% (<i>n</i> = 384/934) met all CR components at 3-months and 69.3% (<i>n</i> = 199/287) at 18-months post-initiation.</p><p><strong>Conclusions: </strong>This study suggests it may be feasible to assess CR using EMR data in Japanese patients with asthma. However, infrequent recording of CR components in clinical practice, particularly ACT and lung function tests, limits availability of EMR data for CR assessments and the potential generalizability of CR findings.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968894","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":"<i>Nocardia</i> lung infection in severe asthma with immune dysfunction.","authors":"Meida Baublyte, Gabija Stulgyte, Sarita Thawanaphong, Sergey Fedosenko, Carmen Venegas Garrido, Terence Ho, Susan Waserman, Parameswaran Nair","doi":"10.1080/02770903.2026.2734975","DOIUrl":"10.1080/02770903.2026.2734975","url":null,"abstract":"<p><p>Lung infections with opportunistic pathogens, such as <i>Pneumocystis</i> or <i>Nocardia,</i> are infrequent in patients with severe asthma despite the use of high doses of inhaled or oral corticosteroids. We report two patients with severe eosinophilic asthma complicated by <i>Nocardia</i> infection in the respiratory tract. Both patients had exposure to chronic corticosteroid therapy and developed recurrent respiratory infections. The first patient had nodular pulmonary nocardiosis associated with hypocomplementemia and heterozygous variants in C1QB and NOD2, while the second patient had <i>Nocardia farcinica</i> tracheobronchitis, associated with selective immunoglobulin M reduction, and a heterozygous F508del mutation in the CFTR gene. Following appropriate antibiotic therapy and immunoglobulin replacement, both patients experienced fewer respiratory infections and stable pulmonary function. These cases highlight that opportunistic infections like <i>Nocardia</i> can occur in severe asthma under chronic immunosuppression, emphasizing the need for thorough immunologic evaluation and vigilant infection monitoring.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-5"},"PeriodicalIF":1.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976877","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":"Comparative surface microbial contamination of a cardboard spacer MDI plus^® and conventional plastic inhalation devices under simulated repeated use.","authors":"Ahlam Ismail, Ahmed H M Sobh, Hadeer S Harb, Yasmin M Madney, Mina Nicola, Raffah Khamis Mahal, Abeer Salah Eldin Mohamed, Mohamed E A Abdelrahim","doi":"10.1080/02770903.2026.2734969","DOIUrl":"10.1080/02770903.2026.2734969","url":null,"abstract":"<p><strong>Background: </strong>Pressurized metered-dose inhalers and spacer devices repeatedly come in contact with the mouth, raising concerns regarding microbiological contamination during routine use. Limited data compares microbial contamination across different spacer materials under simulated real-world handling and storage conditions.</p><p><strong>Methods: </strong>We quantified external and internal-surface bioburden (CFU/cm²) on the plastic AeroChamber Plus^® valved holding chamber, plastic pMDI mouthpieces, and the cardboard MDI PLUS^® spacer at baseline and after a standardized use protocol of 20 actuations (4 actuations/day for 5 days) followed by 7 days of ambient storage. Testing was performed with salbutamol (100 µg), beclometasone (250 µg), and a beclometasone/salbutamol combination (250/100 µg). Organisms were cultured on selective media and identified by standard biochemical assays and Analytical Profile Index (API).</p><p><strong>Results: </strong>Across all formulations and time points, the cardboard MDI PLUS^® spacer consistently showed lower recoverable surface microbial contamination compared with the plastic devices (AeroChamber Plus^® and pMDI mouthpiece). Gram-negative organisms, including Pseudomonas spp., were detected on plastic spacers and pMDI mouthpieces but were not recovered from the cardboard spacer under any condition. Total microbial counts on plastic devices ranged from approximately 40-48 CFU/cm², whereas counts on the cardboard spacer remained lower, ranging from approximately 22-26 CFU/cm². <i>Candida albicans</i> was detected on plastic devices, but was not recovered from the cardboard spacer following repeated use and storage in some formulations.</p><p><strong>Conclusions: </strong>Under simulated repeated use, the cardboard-based spacer exhibited lower recoverable surface microbial contamination than the conventional plastic inhalation devices. These data highlight the potential influence of device material on microbial retention and may inform device selection and hygiene practices in routine respiratory care.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982854","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}