Journal of Asthma最新文献

{"title":"A laboratory investigation of medication delivery by pressurized metered dose inhaler with valved holding chamber using a model adult oropharyngeal airway and inhalation flow profiles from trained healthy adults.","authors":"Mark W Nagel, Jason A Suggett, Jolyon P Mitchell","doi":"10.1080/02770903.2026.2730879","DOIUrl":"10.1080/02770903.2026.2730879","url":null,"abstract":"<p><strong>Objective: </strong>Patient inhalation flow-elapsed time profiles using pressurized metered dose inhalers (pMDIs) can be highly variable for several reasons, including inability to maintain a consistent flow rate-time profile. We report a laboratory-based study measuring how inhalation profiles from trained adults may affect inhaled potential lung-delivered mass of a widely prescribed short-acting bronchodilator <i>via</i> a pMDI-valved holding chamber (spacer) combination.</p><p><strong>Methods: </strong>Adult inhalation profiles from a previous study inhaling room air without medication were obtained after (a) taking a long slow inhalation followed by a 5-s breath hold (method A); (b) inhaling tidally for 2-3 respiration cycles (method B). Each profile was replayed in a simulation where albuterol (100 μg/actuation) was 'inhaled' <i>in vitro via</i> an adult oropharyngeal model connected to a filter distal to the model, with flow controlled <i>via</i> breathing simulator. Filter-collected albuterol provided total mass/actuation available for lung delivery (3-replicates/individual/inhalation profile).</p><p><strong>Results: </strong>Total inhaled volume varied widely and ranges between sexes differed (M: 155-5002 ml, F:214-2711 ml - deep inhalation; M: 617-7722 ml, F:450-3789 ml - tidal breathing). Large variability was observed in potential lung-deliverable drug mass (RSD = 30.1% method A; 30.3% method B) across all inhalation profiles for either method. Intra-profile variability was no worse with either breathing maneuver. Large inter-subject variability in inhalation profiles also existed with either method A or method B.</p><p><strong>Conclusion: </strong>The primary function of the valved holding chamber to retain medication until inhaled was met, since some albuterol was delivered to the filter distal to the oropharyngeal model even in the worst cases.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148989618","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":"Beyond the clinical snapshot: Integrating phenotypic nuances and Socio-Environmental barriers into the national asthma landscape.","authors":"Sumeyra Alan Yalim, Gulfem E Çelik","doi":"10.1080/02770903.2026.2730880","DOIUrl":"10.1080/02770903.2026.2730880","url":null,"abstract":"","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-3"},"PeriodicalIF":1.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906345","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":"Phenotypic predictors of response to IL-5 pathway inhibitors in severe eosinophilic asthma: a retrospective real-world cohort.","authors":"Emrah Harman, Fatih Çölkesen, Mehmet Emin Gerek, Ferhat Sağun, Seçim Kolak, Şükran Aslan Savaş, İsmail Yiğitdöl, Ümmügülsüm Yılmaz Ergün, Şevket Arslan","doi":"10.1080/02770903.2026.2730874","DOIUrl":"10.1080/02770903.2026.2730874","url":null,"abstract":"<p><strong>Objective: </strong>To identify real-world clinical and phenotypic predictors of treatment response to interleukin-5 (IL-5) pathway inhibitors in adults with severe eosinophilic asthma.</p><p><strong>Methods: </strong>In this retrospective cohort study, 128 adults with severe eosinophilic asthma treated with mepolizumab or benralizumab were followed for at least 12 months between June 2019 and June 2025. Treatment response was evaluated using a multidimensional composite outcome incorporating asthma control, exacerbation frequency, and oral corticosteroid reduction. Independent predictors of response were identified using multivariable logistic regression and sensitivity analyses.</p><p><strong>Results: </strong>During follow-up, most patients achieved clinically meaningful improvement. In adjusted analyses, baseline blood eosinophil counts were excluded from the primary multivariable model because they may have been influenced by systemic corticosteroid use. Nasal polyposis (OR = 5.01; 95% CI: 1.28-19.59) and earlier age at asthma onset (OR = 0.92 per year; 95% CI: 0.86-0.98) were independently associated with treatment response. Obesity and total immunoglobulin E (IgE) levels were not independently associated with response in the fully adjusted model. Sensitivity analyses incorporating baseline blood eosinophil counts and prior exacerbation frequency yielded consistent findings.</p><p><strong>Conclusions: </strong>Nasal polyposis and earlier disease onset represent key phenotypic markers associated with a favorable response to IL-5-targeted biologic therapy. These findings support phenotype-oriented strategies for biologic selection and personalized management in routine clinical practice.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930057","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":"Asthma in college hostels: Unrecognized psychosocial burdens and management deficits.","authors":"Jawairya Muhammad Hussain, Madyana Bibi Abdul Rehman, Syeda Husna Shah, Rohan Chawla, Saim Mahmood Khan","doi":"10.1080/02770903.2026.2730889","DOIUrl":"10.1080/02770903.2026.2730889","url":null,"abstract":"<p><strong>Objective: </strong>To explore the overlooked intersection between asthma management, mental well-being, and institutional responsibility among college students living in hostels, where environmental triggers and psychosocial stressors may significantly affect quality of life, academic performance, and mental health.</p><p><strong>Methods: </strong>This article discusses environmental triggers such as poor ventilation, dampness, mold, and temperature-related conditions, as well as psychosocial stressors linked to communal living. It also examines how corticosteroid therapy, while essential for disease control, may contribute to psychiatric symptoms that further complicate adherence and daily functioning, along with stigma, embarrassment about inhaler use, and inadequate support from hostel staff during exacerbations.</p><p><strong>Results: </strong>These challenges collectively contribute to poor asthma control and academic decline among students living in hostels. Addressing these issues demands a shift beyond pharmacological approaches toward comprehensive institutional strategies, including environmental assessment and remediation, appropriate indoor temperature and humidity control, routine medical screening, staff training, peer support, and digital self-management tools.</p><p><strong>Conclusion: </strong>By fostering awareness and integrating psychosocial support into campus health systems, colleges can create safer and more inclusive environments for students with asthma, ultimately improving both respiratory outcomes and overall well-being.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-5"},"PeriodicalIF":1.6,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900214","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":"Inflammatory biomarker score and asthma risk: Longitudinal evidence from Chinese and English aging cohorts.","authors":"Zhe Yang, Lulu Liu, Yitong Shi, Meihui Zhang, Haoyong Ning","doi":"10.1080/02770903.2026.2734971","DOIUrl":"10.1080/02770903.2026.2734971","url":null,"abstract":"<p><p>Asthma is a prevalent airway disease influenced by various factors. Despite the known association between inflammation and asthma, no study has systematically investigated the relationship between inflammatory scores (INS) and asthma risk. This study aimed to explore this longitudinal relationship using two prospective cohorts: the China Health and Retirement Longitudinal Study (CHARLS) and the English Longitudinal Study of Ageing (ELSA).</p><p><p>This study included 8,541 CHARLS and 5,701 ELSA participants. A multivariate-adjusted logistic regression model was used to determine the association between INS and risk of developing asthma. Restricted cubic spline (RCS) methods were employed to explore potential nonlinear relationships. Stratification and interaction tests were performed . After performing multiple imputations for the missing data, a sensitivity analysis was conducted to verify the robustness of the conclusions.</p><p><strong>Results: </strong>In the fully adjusted model, INS were associated positively with asthma risk (OR = 1.087, 95% CI: 1.010-1.157). The fully adjusted ELSA model also showed a positive association (OR = 1.055, 95% CI: 1.004-1.108). RCS analyses revealed no significant nonlinear relationship between the INS and asthma. Subgroup analysis of the CHARLS cohort identified interaction effects between INS and asthma risk, particularly when stratified by age and smoking status.</p><p><p>Higher baseline INS was modestly associated with greater odds of subsequent asthma in both CHARLS and ELSA. These findings suggest a possible role of systemic inflammatory burden in asthma development, although further studies are required to establish causality and clinical relevance.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976982","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":"IgG marks the past, IgA marks the risk: an isotype-stratified meta-analysis of C. pneumoniae and asthma.","authors":"Xiang Wang, Liang Sun","doi":"10.1080/02770903.2026.2734973","DOIUrl":"10.1080/02770903.2026.2734973","url":null,"abstract":"<p><strong>Objective: </strong>Growing evidence links Chlamydia pneumoniae (C. pneumoniae) infection to asthma pathogenesis, though the consistency and robustness of this association remain disputed. This study aimed to clarify the associations between different C. pneumoniae antibody isotypes and asthma risk via isotype-stratified meta-analysis, to distinguish past infection markers and predictive risk indicators for asthma.</p><p><p>Relevant literature was systematically retrieved from four mainstream databases, including PubMed, Embase, Web of Science, and Cochrane Library, with the retrieval time spanning from database inception to May 2026. Eligible observational studies focusing on the association between C. pneumoniae seropositivity and asthma were included. Random-effects meta-analysis was adopted for data pooling. Subgroup analysis by age, leave-one-out sensitivity analysis, and Egger's test for publication bias were performed for comprehensive assessment.</p><p><strong>Results: </strong>A total of 21 qualified studies were enrolled. Cp-IgG seropositivity showed no significant association with asthma (OR = 1.05, 95%CI: 0.90-1.22, I2=0%). Cp-IgA significantly elevated overall asthma risk (OR = 1.43, 95%CI: 1.05-1.96, p = 0.024, I2=56.5%), with a more prominent effect in adults than children. Cp-IgE presented a strong positive association but exhibited poor stability in sensitivity analysis. No publication bias was observed in Cp-IgG and Cp-IgA analyses.</p><p><strong>Conclusion: </strong>Cp-IgA rather than Cp-IgG is a valid risk marker for asthma, especially in adult populations. Continuous mucosal immune stimulation from persistent C. pneumoniae exposure contributes to asthma development, while Cp-IgE may correlate with specific asthma phenotypes and requires further verification.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-13"},"PeriodicalIF":1.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976948","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":"Recovery patterns of pulmonary function after acute asthma exacerbation in children: a prospective study using time-to-event analysis.","authors":"Ezgi Dilan Sencan, Sebnem Ozdogan, Fatma Yolsal, Aysenur Kaya, Nafiye Urganci","doi":"10.1080/02770903.2026.2730887","DOIUrl":"10.1080/02770903.2026.2730887","url":null,"abstract":"<p><strong>Objective: </strong>Recovery of pulmonary function following acute asthma exacerbations varies considerably among pediatric patients, and factors associated with delayed recovery remain poorly understood. This prospective study aimed to determine the time to pulmonary function recovery using a time-to-event approach and to identify clinical factors associated with delayed recovery in children with moderate-to-severe asthma exacerbations.</p><p><strong>Methods: </strong>Forty-two children admitted with a diagnosis of a moderate-to-severe asthma attack to our hospital were included in this prospective study. Demographic and clinical characteristics of the patients were recorded. After the initial asthma attack treatment, pulmonary function tests were performed on days 1, 5, 14, and 28. Recovery was defined as the time to reach the highest recorded FEV1% during follow-up.</p><p><strong>Results: </strong>The median time to pulmonary function recovery was 14 days. Although most patients achieved recovery within two weeks, approximately one-third required up to four weeks, demonstrating substantial interindividual variability. Kaplan-Meier analysis showed no significant difference in recovery according to initial FEV₁% at presentation (log-rank <i>p</i> > 0.05). In the multivariable Cox model, baseline FEV₁% (adjusted HR 1.004, 95% CI 0.981-1.029) and exacerbation severity (adjusted HR 0.924, 95% CI 0.351-2.430) were not significantly associated with recovery time.</p><p><strong>Conclusion: </strong>Pulmonary function recovery following pediatric asthma exacerbations generally occurred within two weeks but extended to four weeks in a considerable proportion of patients. We did not identify statistically significant clinical predictors of recovery duration; however, modest associations cannot be excluded because of the limited sample size. These findings support individualized follow-up after asthma exacerbations and highlight the need for larger prospective studies investigating biological and clinical determinants of pulmonary function recovery.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900285","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":"Mediterranean diet in obese children with asthma: a single-arm pilot study.","authors":"Senay Catak, Nilufer Acar Tek","doi":"10.1080/02770903.2026.2730884","DOIUrl":"10.1080/02770903.2026.2730884","url":null,"abstract":"<p><strong>Background: </strong>Obesity-related asthma is characterized by metabolic dysfunction and systemic inflammation.</p><p><strong>Objective: </strong>This study evaluated whether an 8-week personalized Mediterranean diet intervention was associated with clinical, anthropometric, dietary, metabolic, inflammatory, and oxidative stress-related changes in obese children with asthma.</p><p><strong>Materials and methods: </strong>This single-arm exploratory pilot study included 37 obese asthmatic children aged 6-15 years who completed an 8-week personalized Mediterranean diet intervention. Anthropometry, pulmonary function, asthma control, quality of life, dietary indices, metabolic markers, inflammatory/adipokine parameters, and oxidative stress biomarkers were assessed before and after the intervention.</p><p><strong>Results: </strong>BMI Z-score, waist circumference, and body fat percentage decreased significantly in both sexes. ACT scores increased in both sexes, while PAQLQ scores increased significantly only in boys. Changes in C-DII, KIDMED score, and BMI Z-score, as well as sex, were associated with changes in quality of life in exploratory regression analysis. In boys, fasting glucose, total cholesterol, triglycerides, HOMA-IR, IL-1β, and leptin decreased significantly. In girls, insulin, HOMA-IR, total cholesterol, TOS, and OSI decreased significantly, whereas IL-1β increased.</p><p><strong>Conclusion: </strong>In this single-arm pilot study, an 8-week personalized Mediterranean diet intervention was associated with favorable changes in quality of life, body composition, and selected metabolic and inflammatory biomarkers in obese children with asthma. Larger randomized controlled trials are needed to confirm these preliminary findings.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906394","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":"Inhaled corticosteroids with short-acting β₂-agonists as rescue therapy for asthma: a systematic review and meta-analysis of randomized controlled trials.","authors":"Abaan Butt, Sarah Qureshi, Nida Tanveer, Nabah Hussain, Riya Mary Jacob, Sindhuja Kannan, Maryam Sadig Nadeem, Basel Al Khatib, Navin Sampathkumar, Ahmed Bera Nasuhbeyoglu, Asma'a Munasar Ali Alsubari, Praveen Kumar Komminni, Imama Ahmad, Fiza Gillani, Padmini Badhriraju, Asim Elahi","doi":"10.1080/02770903.2026.2730882","DOIUrl":"10.1080/02770903.2026.2730882","url":null,"abstract":"<p><strong>Objective: </strong>The Global Initiative for Asthma (GINA) recommends inhaled corticosteroid (ICS)-containing regimens for all patients, advising against short-acting β₂-agonist (SABA) monotherapy. While ICS-formoterol is the preferred reliever, the role of ICS-SABA remains less clearly defined.</p><p><strong>Data sources: </strong>We searched CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and WHO ICTRP from inception to November 2025 without language restrictions.</p><p><strong>Study selection: </strong>Eligible studies were randomized controlled trials (RCTs) comparing as-needed ICS-SABA with SABA-only reliever therapy in patients with asthma. Random-effects models were used to pool relative risks (RR), hazard ratios (HR), mean differences (MD), and standardized mean differences (SMD).</p><p><strong>Results: </strong>Five RCTs were included in the meta-analysis. ICS-SABA significantly reduced exacerbation rates (RR = 0.69, 95% CI: 0.52-0.91), risk of at least one exacerbation (RR = 0.69, 95% CI: 0.51-0.93), and prolonged time to first exacerbation (HR = 0.74, 95% CI: 0.62-0.89). Only the rate interaction favored milder asthma (GINA steps 1-2; one trial); the time-to-first and risk interactions were nonsignificant. Symptom-control and quality-of-life estimates favored ICS-SABA but were nonsignificant; systemic corticosteroid exposure was markedly reduced (MD = -38.51 mg, 95% CI: -65.97 to -11.04). No increase in adverse or serious adverse events was observed.</p><p><strong>Conclusions: </strong>ICS-SABA reliever therapy provides consistent reductions in asthma exacerbations and systemic corticosteroid use without compromising safety, supporting its role as a pragmatic alternative to ICS-formoterol rescue therapy. Future research should include head-to-head comparisons with ICS-formoterol, pediatric-focused trials, and long-term real-world studies to optimize asthma care.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900250","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":"Beyond nasal eosinophilia: toward integrated cytological patterns as local biomarkers.","authors":"Matteo Gelardi","doi":"10.1080/02770903.2026.2730885","DOIUrl":"10.1080/02770903.2026.2730885","url":null,"abstract":"","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-2"},"PeriodicalIF":1.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897223","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}