Journal of Asthma and Allergy最新文献

{"title":"Disparities in Cough Variant Asthma Management and Physician-Reported Pulmonary Function Testing Resources: A Cross-Sectional Survey of Respiratory Physicians Across Hospital Tiers in Zhejiang, China.","authors":"Jiangying Guo, Xi Zhang, Jianxing Lai, Jian Wang, Linfeng Shen, Yonghong Zhong, Huaqiong Huang","doi":"10.2147/JAA.S591955","DOIUrl":"10.2147/JAA.S591955","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to evaluate differences in cough variant asthma (CVA) management and physician-reported pulmonary function testing resources across hospital tiers in Zhejiang, China.</p><p><strong>Methods: </strong>From October 12 to November 15, 2025, a cross-sectional online questionnaire survey was conducted among physicians engaged in respiratory or chronic cough care in Zhejiang, China. The survey assessed physicians' knowledge of CVA diagnosis and treatment, awareness of prognosis, and reported access to pulmonary function testing resources. Responses were compared across hospital tiers.</p><p><strong>Results: </strong>A total of 550 submitted questionnaires were received, and 522 valid responses were included after data cleaning. Physicians in tertiary hospitals were most accurate in diagnosing CVA according to guideline criteria (85.79%), compared with those in secondary (70.59%) and primary hospitals (51.53%). Reported access to key tests, especially bronchial provocation testing, was lower in secondary and primary hospitals. The proportion of physicians who intended to use bronchial provocation testing exceeded the proportion who actually performed it (41.57% vs 23.75%). For initial treatment, 91.05% of tertiary hospital physicians selected inhaled corticosteroids (ICS) combined with long-acting beta2 agonists (LABA). This was significantly higher than the proportions in secondary and primary hospitals (69.12% and 37.24%, respectively). Physicians in tertiary hospitals also showed greater awareness of CVA prognosis.</p><p><strong>Conclusion: </strong>Clear differences exist in CVA care across hospital tiers in Zhejiang, China. Lower-tier hospitals showed gaps in diagnosis, access to bronchial provocation testing, and ICS/LABA selection. In addition, the gap between intended and performed use of bronchial provocation testing may reflect a potential barrier to objective CVA diagnosis.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"591955"},"PeriodicalIF":3.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene Polymorphisms Associated with Treatment Response of Asthma in Chinese Children.","authors":"Lili Zhu, Xinyi Jiang, Changchang Li, Tingting Zhu, Lei Chong, Changchong Li, Xiufeng Huang, Hailin Zhang","doi":"10.2147/JAA.S606206","DOIUrl":"10.2147/JAA.S606206","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the potential associations between therapeutically relevant single nucleotide polymorphisms (SNPs) with clinical characteristics and medication response of asthma in Chinese children.</p><p><strong>Methods: </strong>This prospective observational study was conducted at the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University from August 2021 to July 2022. Patients diagnosed with asthma and age-matched healthy individuals were recruited. Genotyping of 55 SNPs was performed using the Sequenom Mass Array platform. Both the association of 55 SNPs with clinical characteristics of asthma and the efficacy of budesonide/formoterol were analyzed.</p><p><strong>Results: </strong>A total of 412 asthma patients and 262 age-matched healthy were recruited. The Minor Allele Frequency of SNPs differs markedly from that observed in European, American, and African populations but closely in the Asian populations. Comparing genotype and allele frequencies revealed that <i>ORMDL3</i>-rs2872507 (AA) and <i>ZNF432</i>-rs3752120 (TT) were significantly more frequent in the asthma group than in the control group. <i>ZNF432</i>-rs3752120 and <i>ORMDL3</i>-rs2872507 were further analyzed, stratified by clinical features and laboratory indicators. Atopy was significantly more common in <i>ZNF432</i>-rs3752120 TT genotype carriers compared to CC and CT genotypes. Additionally, the demand for inhalation device use was higher in CT carriers compared to those with CC and TT genotypes. However, no significant differences in asthma clinical characteristics were observed among <i>ORMDL3</i>-rs2872507 genotypes. Besides, eight SNPs were confirmed to be associated with the response of inhaling Budesonide/Formoterol dry powder 80/4.5.</p><p><strong>Conclusion: </strong>This study revealed that the <i>ORMDL3</i>-rs2872507 AA genotype and the <i>ZNF432</i>-rs3752120 TT genotype might be susceptible genotypes in Chinese children with asthma. rs1042713, rs2305089, rs2540487, rs2712807, rs28364072, rs320995, rs4980524, and rs730012 were identified as potentially associated with the efficacy of Budesonide/Formoterol (80/4.5) inhalation therapy in a cohort of children with asthma from southern Zhejiang, China.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"606206"},"PeriodicalIF":3.3,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13524118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-Life Allergen Sensitization Phenotypes and Exploratory Machine-Learning Interpretation of School-Age Asthma Risk.","authors":"Mingwei Cao, Xiaoxue Guan, Binghong Zhang, Ge Xiong, Jingjing Ma, Hui Shi, Haiju Zhang","doi":"10.2147/JAA.S626238","DOIUrl":"10.2147/JAA.S626238","url":null,"abstract":"<p><strong>Background: </strong>Early-life allergen sensitization is associated with childhood asthma, but sensitization patterns are heterogeneous. This study aimed to characterize early-life sensitization phenotypes and evaluate their associations with school-age asthma, with exploratory machine-learning analyses examining model-derived allergen contributions.</p><p><strong>Methods: </strong>Electronic medical records from Renmin Hospital of Wuhan University (2014-2022) were used. Two samples were derived: a phenotype discovery sample (Sample A, n = 4989) and a nested case-control sample (Sample B, n = 435; 84 cases and 351 controls). In Sample A, latent class analysis (LCA) identified population-level sensitization phenotypes. In Sample B, pre-specified multivariable logistic regression models adjusted for age and sex evaluated associations of LCA-derived phenotypes and individual inhalant allergen sensitization with school-age asthma. Random Forest and XGBoost/SHAP were used as exploratory analyses to assess allergen feature importance and model-derived contributions to predicted asthma probability.</p><p><strong>Results: </strong>LCA identified four sensitization phenotypes: predominantly non-sensitized, food-dominant, inhalant-dominant, and pet dander-predominant. After adjustment for age and sex, The inhalant-dominant phenotype was associated with higher odds of school-age asthma (adjusted OR = 3.14, 95% CI: 1.43-6.91), whereas the pet dander-predominant phenotype showed a positive but non-significant association (adjusted OR = 1.75, 95% CI: 0.94-3.26). In the pre-specified multivariable allergen model, dust mite sensitization remained significantly associated with asthma (adjusted OR = 3.30, 95% CI: 1.94-5.62). Exploratory analyses identified consistent model-derived contribution patterns for dust mite, whereas dog dander sensitization showed more variable patterns. XGBoost AUC decreased from an apparent AUC of 0.859 to a mean internally validated AUC of 0.636.</p><p><strong>Conclusion: </strong>Early-life sensitization showed distinct population-level phenotypes, with the inhalant-dominant phenotype associated with school-age asthma. Dust mite showed the most consistent signal across association and exploratory prediction analyses. Dog dander findings were model-dependent and should be interpreted as exploratory prediction patterns. SHAP findings require external validation before clinical application.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"626238"},"PeriodicalIF":3.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Progression to Chronicity or Recurrent Episodes in Pediatric Acute Urticaria: A 1-Year Cohort Study.","authors":"Yu He, Wanshu Liu, Mei Long, Zhili Wang, Yizhu Xiao, Hua Wang, Xiaoyan Luo","doi":"10.2147/JAA.S622571","DOIUrl":"10.2147/JAA.S622571","url":null,"abstract":"<p><strong>Background: </strong>Acute urticaria (AU) is common and often considered self-limiting in children; however, a subset may progress to chronic spontaneous urticaria (CSU) or develop recurrent AU. Clinical characteristics associated with these unfavorable outcomes remain poorly characterized.</p><p><strong>Methods: </strong>In this single-center retrospective cohort study, 475 children (<18 years) with AU presenting to dermatology settings were included. Demographic, clinical, and laboratory data were extracted from electronic medical records. Personal and family histories of atopy were confirmed, and 1-year outcomes were assessed via structured telephone follow-up. Independent risk factors were identified using Firth penalized multivariable logistic regression.</p><p><strong>Results: </strong>Follow-up was completed for 358 of 475 (75.4%) patients. Median age was 4.25 years, with 51% being male. At 1 year, 50 patients (14.0%) progressed to CSU and 37 patients (10.3%) experienced recurrent AU. Firth penalized multivariable analysis identified non-first-episode presentation (CSU: aOR 7.89, 95% CI 3.54-17.92; recurrent AU: aOR 6.73, 95% CI 2.57-17.31) and family history of CSU (CSU: aOR 4.35, 95% CI 1.27-13.65; recurrent AU: aOR 8.85, 95% CI 2.76-27.19) as independent predictors of both adverse outcomes. Family history of asthma was associated with CSU progression (aOR 32.26, 95% CI 1.67-477.76), and family history of chronic inducible urticaria was associated with recurrent AU (aOR 9.07, 95% CI 2.02-40.99); however, these estimates were imprecise because of small exposed case numbers. Notably, systemic corticosteroid use was not independently associated with either adverse outcome.</p><p><strong>Conclusion: </strong>Recurrent AU, in addition to CSU progression, is an important 1-year outcome after pediatric AU. Non-first-episode AU and family history of CSU are readily ascertainable predictors that enable early risk stratification and follow-up. The single-center retrospective design and loss to follow-up should be considered when interpreting the generalizability of these findings.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"622571"},"PeriodicalIF":3.3,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From FEV₁ to Small Airways: AMethodological Review of Lung Function Assessment in Biologic-Treated Asthma.","authors":"Hai-Ling Yang, Ya-Jia Chen, Xue-Qiong Mai, Xiao-Ling Zou, Wenwen Ding, Shao-Zhu Wu","doi":"10.2147/JAA.S628156","DOIUrl":"https://doi.org/10.2147/JAA.S628156","url":null,"abstract":"<p><p>Biologics have revolutionized the treatment of severe asthma, yet their clinical efficacy assessment has focused primarily on exacerbation reduction and symptom control, often overlooking the comprehensive evaluation of lung function improvement. Traditionally, forced expiratory volume in onesecond (FEV₁) has been the cornerstone metric for assessing airflow limitation. However, accumulating evidence highlights small airway dysfunction (SAD) as acritical driver of asthma symptoms, exacerbation risk, and heterogeneity in treatment response. This review explores the existing tools and metrics and their clinical relevance for assessing the impact of biologics on lung function, with aparticular emphasis on small airway function in asthma patients. Methodologically, we appraise the physiological validity, repeatability, feasibility, responsiveness, and current regulatory readiness of small-airway endpoints for biologic trials and real-world effectiveness studies. We propose that these measures complement, rather than replace, FEV₁ within amultidimensional endpoint framework. We explore the application of techniques ranging from conventional spirometry (FEV₁, FEF₂ ₅-₇ ₅, ie, forced expiratory flow at 25-75% of forced vital capacity) to more advanced methods such as impulse oscillometry (IOS), body plethysmography, multiple-breath nitrogen washout (MBNW), and novel imaging modalities. Our analysis reveals the differences in the effects of various biologics (anti-IgE, anti-IL-5/5Rα, anti-IL-4Rα, anti-TSLP, etc.). on large and small airways. Furthermore, we also discuss the methodological frameworks, challenges, and future directions for integrating small airway function assessment into both clinical trial design and real-world effectiveness evaluations.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"628156"},"PeriodicalIF":3.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Mechanisms Linking Eosinophils to Lung Function Impairment in Respiratory Diseases.","authors":"Meiqi Li, Anhao Zheng, Yi Liu","doi":"10.2147/JAA.S625304","DOIUrl":"https://doi.org/10.2147/JAA.S625304","url":null,"abstract":"<p><p>Eosinophils are key immunopathological cells in respiratory diseases and contribute to airway inflammation, tissue remodeling, and disease heterogeneity. Although eosinophils have traditionally been regarded as biomarkers of type 2 inflammation, increasing evidence indicates that they also function as active mediators of lung function impairment in selected respiratory diseases, including chronic obstructive pulmonary disease, asthma, and eosinophilic pneumonia. These disorders were selected because they represent distinct yet complementary models of eosinophil-associated airway and parenchymal injury, allowing comparison of shared and disease-specific mechanisms. Mechanistically, eosinophils impair lung function through the coordinated release of cytotoxic granule proteins, reactive oxygen species, lipid mediators, and cytokines, while interacting with epithelial, immune, and structural cells to amplify inflammation, airway remodeling, and tissue injury. These advances have improved understanding of eosinophil biology and facilitated the development of clinically relevant biomarkers and targeted therapies. Blood and sputum eosinophil counts remain the most widely used biomarkers, whereas emerging biomarkers, including eosinophil-derived neurotoxin, may further improve disease stratification and treatment monitoring. Biologics targeting interleukin-5 and its receptor have demonstrated therapeutic benefit in selected eosinophilic respiratory diseases, although treatment responses differ among disease phenotypes. This review summarizes current evidence regarding the molecular mechanisms linking eosinophils to lung function impairment, discusses the evolving role of eosinophils as both biomarkers and pathogenic drivers, and highlights the biomarker and therapeutic implications for precision management of respiratory diseases.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"625304"},"PeriodicalIF":3.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13484600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D Deficiency in Children with Asthma and Overweight/Obesity in Qatar.","authors":"Lina H M Ahmed, Safa Noor, Mohannad N AbuHaweeleh, Harshita Shailesh, Antonisamy Belavendra, Haneen Aldulaimi, Amal Al-Naimi, Ibrahim Janahi","doi":"10.2147/JAA.S594510","DOIUrl":"https://doi.org/10.2147/JAA.S594510","url":null,"abstract":"<p><strong>Background: </strong>Childhood asthma, obesity, and vitamin D deficiency are all highly prevalent in Qatar, and children with concurrent asthma and obesity experience greater disease severity and poorer treatment response than those with asthma alone. Although vitamin D deficiency has been linked to asthma, the combined effect of co-existing asthma and overweight/obesity on vitamin D status has not been characterized in this population, warranting further investigation.</p><p><strong>Methods: </strong>This cross-sectional observational study assessed serum 25-hydroxyvitamin D levels in children aged 6-17 years, residing in Qatar. A total of 364 children were divided into four groups: children with normal weight and asthma (NW-A), children with overweight/obesity and asthma (OO-A), children with overweight/obesity and no asthma (OO), and children with normal weight and no asthma (NW). Between-group differences were assessed using chi-square, Dunn (Bonferroni-corrected), and Spearman correlation tests, and a multivariable logistic regression model adjusted for age, sex, BMI, and atopy was used to examine the association between asthma and vitamin D status.</p><p><strong>Results: </strong>Children in all the four groups demonstrated a high prevalence of vitamin D deficiency (<50 nmol/L), regardless of asthma or BMI. Vitamin D deficiency was present in 81.1% of OO, 73.9% OO-A, 68.3% of NW, and 66.3% of NW-A, with no statistically significant difference across groups. Vitamin D levels were similar between NW-A and OO-A, but OO group had significantly lower levels. A negative correlation between BMI and vitamin D levels was observed in OO-A (<i>ρ</i>=-0.279, p=0.008) and OO (<i>ρ</i>=-0.266, p=0.009), but not in normal-weight children. Multivariable logistic regression showed no significant association between vitamin D levels and asthma status.</p><p><strong>Conclusion: </strong>Higher BMI was associated with lower serum vitamin D levels in overweight/obese children, independent of asthma status, whereas asthma was not independently associated with vitamin D deficiency. Given the cross-sectional design, these findings indicate associations rather than causal relationships. The high prevalence of vitamin D deficiency across all study groups highlights a substantial public-health concern and supports the value of routine screening, nutritional and lifestyle measures, and where indicated, vitamin D supplementation, in pediatric health management in Qatar, pending confirmation from longitudinal and interventional studies.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"594510"},"PeriodicalIF":3.3,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IL-Mediated Macrophage Polarization Axis: From Inflammatory Positive Feedback Loop to Precision Biomarkers and Therapeutic Targets for Allergic Rhinitis-A Narrative Review.","authors":"Wanying Peng, Liangzhen Xie, Yuanchun Liu, Yan Li","doi":"10.2147/JAA.S631200","DOIUrl":"https://doi.org/10.2147/JAA.S631200","url":null,"abstract":"<p><p>This narrative review comprehensively elaborates the complicated interleukin (IL)-macrophage polarization axis as the core pathogenesis of allergic rhinitis (AR), focusing on layered molecular regulatory mechanisms covering inflammatory signaling, metabolic reprogramming and epigenetic modulation. Pro-inflammatory IL-1β, IL-6, IL-17 and TNF-α bind to TLR receptors to activate NF-κB, NLRP3 inflammasome and PI3K/Akt cascades, triggering M1 macrophage overactivation and acute nasal congestion, rhinorrhea via robust inflammatory mediator release. By contrast, anti-inflammatory IL-4 and IL-10 predominantly activate STAT6 signaling to drive abnormal M2 macrophage accumulation, sustaining persistent type 2 inflammation and irreversible nasal tissue remodeling; notably, IL-17 presents concentration-dependent bidirectional regulation on macrophage phenotypes. Metabolic reprogramming featured with glycolysis-oxidative phosphorylation switch, together with DNA methylation, histone modification and non-cRNA-mediated epigenetic regulation, serve as vital downstream executors linking IL signals to macrophage polarization imbalance. Conventional glucocorticoids, antihistamines and monoclonal antibodies including omalizumab and dupilumab (targeting IL-4Rα) exert therapeutic efficacy via intervening this axis, while multiple natural herbal constituents and classic TCM formulas also modulate relevant inflammatory pathways to alleviate AR symptoms. For translational application, the CD206/CD86 macrophage polarization ratio is highlighted as a representative candidate biomarker for disease severity assessment. Collectively, this review integrates multi-layered regulatory evidence and lays theoretical support for developing novel precision-targeted anti-allergic therapies.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"631200"},"PeriodicalIF":3.3,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13480175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of IL-5 Pathway Inhibition on Circulating Eosinophil- and Remodeling-Related Biomarkers in Severe Eosinophilic Asthma.","authors":"Piotr Damiański, Anna Kumor-Kisielewska, Adam J Białas, Piotr Kuna, Maciej Kupczyk","doi":"10.2147/JAA.S619744","DOIUrl":"https://doi.org/10.2147/JAA.S619744","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the effects of IL-5 pathway inhibition with mepolizumab or benralizumab on circulating eosinophil-related and selected remodeling-associated biomarkers in severe eosinophilic asthma (SEA), and to determine whether these profiles differ according to four-component study-defined early clinical remission (ECR) status.</p><p><strong>Patients and methods: </strong>This prospective, observational, single-center cohort study included 30 adults with SEA treated with mepolizumab or benralizumab. Clinical assessment, spirometry, and blood sampling were performed at baseline and after 6 months. The primary endpoint was change in circulating biomarker concentrations; secondary endpoints included clinical improvement and ECR rate.</p><p><strong>Results: </strong>IL-5 pathway inhibition improved asthma control and lung function, with OCS-treated exacerbations occurring in 4 of 30 patients during follow-up. These changes were accompanied by marked reductions in eosinophil-related biomarkers, with median decreases of 95.3% in blood eosinophils, 79.5% in eosinophil-derived neurotoxin, and 32.9% in galectin-10, respectively; false discovery rate (FDR)-adjusted p≤0.003. Significant but smaller decreases were observed in MMP-10, TGF-β1, and TGF-β2, with median reductions of 5.0%, 21.2%, and 10.9%, respectively; FDR-adjusted p≤0.002. No significant group-level changes were observed for eotaxin-1, MMP-9, TIMP-1, fibulin-1, tenascin-C, or periostin. ECR was achieved in 16 of 30 patients (53.3%). Compared with non-ECR patients, those achieving ECR had lower baseline OCS burden and fewer relevant comorbidities, whereas neither baseline biomarker concentrations nor 6-month biomarker changes differed significantly between groups. Exploratory comparisons did not show consistent differences in clinical outcomes or biomarker changes between mepolizumab and benralizumab.</p><p><strong>Conclusion: </strong>IL-5 pathway inhibition in SEA was associated with marked suppression of eosinophil-related biomarkers, more selective changes in remodeling-associated mediators, and meaningful clinical benefit after 6 months. Similar biomarker responses in patients with and without ECR should be interpreted cautiously, but suggest that incomplete clinical response may reflect broader disease burden, particularly comorbidities, rather than insufficient suppression of eosinophilic inflammation alone.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"619744"},"PeriodicalIF":3.3,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Easier Biologic Access with Remission and Other Clinical Outcomes in Severe Asthma: A Global Real-World Study.","authors":"Susanne Hansen, Ming-Ju Tsai, Trung N Tran, John D Blakey, Benjamin Emmanuel, Shawn D Aaron, Yahya Habis, Valeria Perugini, Alan Altraja, Rohit K Katial, Luis Perez-de-Llano, Paul E Pfeffer, Nikolaos G Papadopoulos, John Townend, Ghislaine Scelo, Aaron Beastall, Lakmini Bulathsinhala, John Busby, Andrew W Lindsley, Wendy C Moore, Reynold A Panettieri, Giorgio Walter Canonica, Enrico Heffler, Cristina Cardini, Giuseppe Guida, Celeste M Porsbjerg, Anne-Sofie Bjerrum, Anna Von Bülow, Ole Hilberg, Kjell Erik Julius Håkansson, Marianne Baastrup Soendergaard, Charlotte Suppli Ulrik, Eileen Wang, Michael E Wechsler, Nicholas Chapman, Flavia C L Hoyte, Kanao Otsu, Liam G Heaney, David J Jackson, Pujan H Patel, Dermot Ryan, Celine Bergeron, Shelley Abercromby, Mohit Bhutani, Kenneth R Chapman, Andréanne Côté, Beth E Davis, Delbert R Dorscheid, Leiana Hoshyari, Brianne Philipenko, Hana Serajeddini, Florence Schleich, Renaud Louis, Piotr Kuna, Borja G Cosio, Désirée Larenas-Linnemann, Carlos A Torres-Duque, María José Fernández-Sánchez, Elizabeth Garcia, Fabio Bolívar-Grimaldos, Libardo Jiménez-Maldonado, Diana Jimena Cano-Rosales, Ivan Solarte, Riyad Al-Lehebi, Adeeb A Bulkhi, Mona Al-Ahmad, Takashi Iwanaga, Soichiro Hozawa, Hisako Matsumoto, Tatsuya Nagano, Tomoko Tajiri, Bernt Bøgvald Aarli, Diahn-Warng Perng, Yi-Han Hsiao, Pin-Kuei Fu, Chau-Chyun Sheu, Konstantinos Kostikas, Mina Gaga, Athena Gogali, Maria Kallieri, Stelios Loukides, Michael Makris, Maria Dimosthenis Ntakoula, Andriana I Papaioannou, Giannis Paraskevopoulos, Fotios Psarros, Bassam Mahboub, Laila Salameh, Mariko Siyue Koh, Mei Fong Liew, Pee Hwee Pang, Tze Lee Tan, Tunn Ren Tay, Paulo Márcio Pitrez, Chin Kook Rhee, Njira Lugogo, Arjun Mohan, João A Fonseca, Ana Alves da Silva, Cláudia Chaves Loureiro, Hadassa Cristhina de Azevedo Soares Dos Santos, Jorge Fernando Máspero, Ledit R F Ardusso, María Eugenia Franchi, Martin Sivori, Ana María Stok, Anahí Yañez, George Christoff, Todor A Popov, Patrick D Mitchell, Sundeep Santosh Salvi, Richard W Costello, Eve Denton, Mark Hew, Christine R Jenkins, David Langton, Peter G Middleton, Matthew J Peters, Lauri Lehtimäki, Arnaud Bourdin, Camille Taillé, Christian Taube, Zsuzsanna Csoma, Dóra Lúdvíksdóttir, Job F M van Boven, James Fingleton, Leif Bjermer, Helena Emery, Graham Lough, Roy Alton Pleasants, Diego J Maselli, Christopher S Ambrose, Cathy Emmas, Andrew N Menzies-Gow, Victoria Carter, Nevaashni Eleangovan, Ruth B Murray, Chris A Price, Mohsen Sadatsafavi, David B Price","doi":"10.2147/JAA.S597657","DOIUrl":"10.2147/JAA.S597657","url":null,"abstract":"<p><strong>Purpose: </strong>Time to biologic initiation for the treatment of severe asthma (SA) is affected by many factors, including ease of access to biologics, which is often subject to approval by regulatory authorities and reimbursement criteria by relevant agencies. We investigated the association between ease of biologic access (using the biologic accessibility score [BACS] as a proxy) and post-biologic asthma outcomes, including remission.</p><p><strong>Methods: </strong>This ecological study, using data from CHRONICLE (a US severe asthma registry), the International Severe Asthma Registry (ISAR), and the Optimum Patient Care Research Database (OPCRD), included patients with SA from 21 countries. Associations at the country level, between BACS, a composite score of prescription criteria for biologics in SA, and the proportion of patients with a favorable asthma outcome 1-year post-biologic in each setting (ie ISAR country or in the CHRONICLE or OPCRD datasets) were tested. Several definitions of favorable outcome were used, including proportion of patients who achieved clinical remission (defined using 2, 3 and 4 domains), experienced no exacerbations, had well- or partly controlled asthma, a percent predicted forced expiratory volume in 1 second (ppFEV₁) or percent predicted peak expiratory flow rate (ppPEFR) ≥80%, and no long-term oral corticosteroid (LTOCS) use.</p><p><strong>Results: </strong>A total of 9,183 patients were included. A higher BACS (as a proxy of easier access to biologics) was associated with a higher likelihood of achieving clinical remission (p≤0.001), no exacerbations (p<0.001), well- or partly controlled asthma (p=0.047), a ppFEV₁ or ppPEFR ≥80% (p=0.004), and no need for LTOCS (p=0.045) 1 year post-biologic initiation.</p><p><strong>Conclusion: </strong>Easier access to biologics for patients with SA, a prerequisite for shorter time-to-initiation, was associated with a greater probability of achieving clinical remission and other favorable asthma outcomes. Initiating biologics earlier in the asthma disease course may help unlock greater therapeutic potential in SA. These findings warrant confirmation in additional studies to further establish the causal relationship between biologic accessibility, timing of initiation, and clinical outcomes in SA.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"597657"},"PeriodicalIF":3.3,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}