Journal of Asthma and Allergy最新文献

{"title":"The Expression Levels of Transforming Growth Factor β1 and Tumor Necrosis Factor Receptor Associated Factor 6 in Allergic Rhinitis Patients and Their Potential Relationship with Epithelial - Mesenchymal Transition: A Pilot Prospective Observational Study.","authors":"Kai Wang, Qin Gao, Yelong Bai, Rong Yu, Qing Luo","doi":"10.2147/JAA.S474445","DOIUrl":"10.2147/JAA.S474445","url":null,"abstract":"<p><strong>Objective: </strong>To study the role of transforming growth factor beta 1 (TGF-β1) and tumor necrosis factor receptor related factor 6 (TRAF6) in the progression of epithelial mesenchymal transformation (EMT) in allergic rhinitis (AR).</p><p><strong>Methods: </strong>A total of 30 patients underwent nasal endoscopic surgery at our Hospital were selected for 15 patients in each group based on their allergy status. Inferior turbinate mucosa tissue was obtained and analyzed using immunohistochemical (IHC) tests, real-time quantitative PCR (qRT-PCR) detection, and Western blotting (WB) tests to measure TGF-β1, TRAF6, E-cadherin, Vimentin, and α-Smooth Muscle Actin (α-SMA) expression levels.</p><p><strong>Results: </strong>The expression levels of TGF-β1, TRAF6, Vimentin, and α-SMA were significantly higher in the AR group compared to the control group as shown by IHC, qRT-PCR, and WB (P < 0.05). E-cadherin expression was significantly lower group than in the control group (P < 0.05). Protein expression of TGF-β1 showed significantly positive correlations with TRAF6 (r = 0.8188, P = 0.0002), α-SMA (r = 0.8076, P = 0.0003), and Vimentin (r = 0.6917, P = 0.0043). There was a significantly negative correlation between protein expression of TGF-β1 and E-cadherin (r = -0.8032, P = 0.0003). Protein expression of TRAF6 showed a significantly negative correlation with E-cadherin (r = -0.6405, P = 0.0101) but positive correlations with α-SMA (r = 0.5809, P = 0.0231) and Vimentin (r = 0.555, P = 0.0318).</p><p><strong>Conclusion: </strong>TGF-β1, TRAF6, and EMT-related markers (Vimentin, α-SMA) were highly expressed in the nasal mucosa of AR patients. TGF-β1 and TRAF6 may be involved in the epithelial-mesenchymal transition in allergic rhinitis.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"17 ","pages":"1083-1092"},"PeriodicalIF":3.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583297","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":"Effectiveness of Threshold-Pressure Inspiratory Muscle Training on Pulmonary Rehabilitation in Children and Adolescents with Asthma.","authors":"Ping Wu, Xin Qian, Yijing Hu, Xiaoxia Yan","doi":"10.2147/JAA.S479398","DOIUrl":"10.2147/JAA.S479398","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this systematic review and meta-analysis was to assess the effectiveness of TIMT on pulmonary function in children and adolescents with asthma.</p><p><strong>Method: </strong>We searched for randomized controlled clinical trials in the MEDLINE, Embase, the Cochrane Library, Web of Science, CINAHL, Sino Med, Wan fang, CNKI, and VIP until March 2024. In addition, the references included in the literature and the relevant systematic evaluation were manually traced in order to avoid the omission of any relevant literature. These trials compared TIMT against blank TIMT and conventional care. Eligible studies were assessed in terms of risk of bias and quality of evidence using RoB II tool. Where feasible, data were pooled and subjected to meta-analysis. The mean difference (MD) and 95% confidence interval (CI) were estimated by fixed effect models or random effect models.</p><p><strong>Result: </strong>Six studies were included in the present meta-analysis involving 337 children and adolescents ranged from 4 to 18 years. The meta-analysis showed that TIMT could significantly improve lung function. Compared to the control group, TIMT can significantly improve FEV1 (MD 4.63 mL, 95% CI 2.64 to 6.62 mL, I² = 4%), FVC (to the control group (MD 7.46 mL, 95% CI 5.09 to 9.82 mL, I² = 0%), FEV1/FVC (MD 7.33%, 95% CI: 5.01 to 9.65%) and ACT (MD 1.86, 95% CI 0.96 to 2.75 mL, I² = 12%) of patients at the end of intervention. There was no significant heterogeneity in these meta-analyses.</p><p><strong>Conclusion: </strong>In conclusion, the results of this systematic review and meta-analysis support the effectiveness of TIMT training in restoring lung function and relieving asthma symptoms of asthmatic children. More high-quality and RCTs with large sample size are urgently required to verify the conclusion.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"17 ","pages":"1073-1082"},"PeriodicalIF":3.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568385","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":"Response to Level of Compliance with Spanish Guideline Recommendations in the Management of Asthma [Letter].","authors":"Agussalim","doi":"10.2147/JAA.S501133","DOIUrl":"10.2147/JAA.S501133","url":null,"abstract":"","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"17 ","pages":"1071-1072"},"PeriodicalIF":3.7,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545617","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":"Disease Burden and Access to Biologic Therapy in Patients with Severe Asthma, 2017-2022: An Analysis of the International Severe Asthma Registry.","authors":"Tham T Le, David B Price, Clement Erhard, Bill Cook, Anna Quinton, Rohit Katial, George C Christoff, Luis Perez-de-Llano, Alan Altraja, Celine Bergeron, Arnaud Bourdin, Mariko Siyue Koh, Lauri Lehtimäki, Bassam Mahboub, Nikolaos G Papadopoulos, Paul Pfeffer, Chin Kook Rhee, Victoria Carter, Neil Martin, Trung N Tran","doi":"10.2147/JAA.S468068","DOIUrl":"10.2147/JAA.S468068","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with severe asthma may be prescribed biologic therapies to improve disease control. The EVEREST study aimed to characterize the global disease burden of patients with severe asthma without access to biologics and those who have access but do not receive biologics, as well as the remaining unmet need despite use of these therapies.</p><p><strong>Methods: </strong>This was a historical cohort study of patients with severe asthma (aged ≥18 years) in the International Severe Asthma Registry receiving Global Initiative for Asthma (GINA) 2018 step 5 treatment, or with uncontrolled disease at GINA step 4. Prospective data on patient clinical characteristics, healthcare resource utilization, and medication use over a 12-month period between December 2017 and May 2022 were assessed for the following five groups: biologics accessible (omalizumab, mepolizumab, reslizumab, benralizumab, or dupilumab); biologics inaccessible; biologics accessible but not received; biologics accessible and received; and biologic recipients whose asthma remained suboptimally controlled.</p><p><strong>Results: </strong>Overall, 9587 patients from 21 countries were included. Among patients in the biologics accessible (n=5073), biologics inaccessible (n=3041), and biologics accessible but not received (n=382) groups, 41.4%, 18.7%, and 49.6% experienced at least two exacerbations, 11.5%, 10.5%, and 6.2% required at least one hospitalization, 47.9%, 54.6%, and 71.2% had uncontrolled asthma, and 23.9%, 8.6%, and 11.0% received long-term oral corticosteroids (LTOCS), respectively. Following biologic therapy, among patients who received biologics overall (n=2666) and among those whose asthma remained suboptimally controlled (n=1780), 19.1% and 23.0% experienced at least two exacerbations, 2.7% and 2.9% required at least one hospitalization, and 16.7% and 22.0% received LTOCS, respectively.</p><p><strong>Conclusion: </strong>There is a substantial disease burden in both patients without access to biologics and those with access who do not receive these therapies, although specific outcomes may vary between these groups. There also remains a high unmet need among biologic recipients, many of whom have a suboptimal response to treatment.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"17 ","pages":"1055-1069"},"PeriodicalIF":3.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545616","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":"Sub-Optimal Disease Control and Low Blood Eosinophil Testing Frequency in Chinese Adult Patients with Asthma Receiving GINA Step 4/5 Treatment: A Real-World Study.","authors":"Victoria S Benson, James Siddall, Adam Haq, Mark Small, Zhiliu Tang, Tao Ye, Peter Howarth, Anna Richards, Rafael Alfonso-Cristancho","doi":"10.2147/JAA.S474338","DOIUrl":"10.2147/JAA.S474338","url":null,"abstract":"<p><strong>Purpose: </strong>To inform effective management strategies for severe asthma in China, this study aimed to comprehensively characterize clinical characteristics, treatment patterns, disease control status, and healthcare resource utilization among patients on GINA Step 4/5 therapies by analyzing data from the Adelphi Asthma Disease Specific Program conducted in China.</p><p><strong>Patients and methods: </strong>All information was retrieved from medical records or collected from physicians and patients on the survey date (August-December 2018); no follow-up was conducted. Results were summarized descriptively for patients on GINA Step 4/5 therapies, who were pooled from a consecutive sample (comprising three or more consecutive patients with physician-diagnosed asthma from each participating physician) and an oversample (comprising the next two patients with physician-perceived severe asthma from each participating physician).</p><p><strong>Results: </strong>Of the included patients (n=754), 51.5% had ever had a blood eosinophil measurement taken, 22.1% had available records for their most recent blood eosinophil measurements (68.9% of them had an elevated level ≥150 cells/µL), 39.9% had ever been tested for specific immunoglobulin E or radioallergosorbent, and 8.0% were prescribed maintenance oral corticosteroids. Asthma was not well controlled in 69.2% of patients. In the prior year, 27.1% experienced at least one severe exacerbation and 22.8% experienced at least one hospitalization (emergency visit or overnight stay) due to asthma.</p><p><strong>Conclusion: </strong>In Chinese patients with asthma on GINA Step 4/5 therapies, biomarker testing was underutilized, asthma was not well controlled, and severe exacerbations were not infrequent. These findings highlight the urgent need for optimized asthma management for patients on GINA Step 4/5 therapies in China.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"17 ","pages":"1041-1054"},"PeriodicalIF":3.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500943","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":"Effect of Dupilumab on Radiological Remission in Patients with Chronic Rhinosinusitis with Nasal Polyp: A One Step Forward Toward Clinical Remission.","authors":"Mona Al-Ahmad, Asmaa Ali, Haitham A Dawood, Gerges M Beshreda","doi":"10.2147/JAA.S478040","DOIUrl":"10.2147/JAA.S478040","url":null,"abstract":"<p><strong>Background and objectives: </strong> While achieving complete radiological improvement in patients with nasal polyps is often observed following surgical resection, the impact of biologic therapy, specifically dupilumab, on polyp size is an area of great interest. The objective of this study was to assess the effect of dupilumab in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) by assessing nasal polyps using the computed tomography (CT) staging system, Lund-Mackay score (LMS).</p><p><strong>Methods: </strong> A two-year prospective cohort study was conducted on 29 patients diagnosed with CRSwNP and asthma and eligible for dupilumab as an add-on therapy. The study involved comprehensive assessments of patients before biologic initiation and after the study. These assessments included clinical, laboratory, and radiological evaluations.</p><p><strong>Results: </strong>Dupilumab treatment reduces LMS across sinuses (p<0.001) and improves nasal obstruction (p=0.001). Blood eosinophil count (BEC) predicts persistent sinus obstruction, doubling the likelihood per unit increase (odds ratio: 1.67, p=0.02). BEC levels identify persistent nasal obstruction (AUC: 76%, p=0.04), with a cutoff point above 255.5 cells per microliter, revealing a sensitivity of 100% and a specificity of 42%. The probability of persistent nasal obstruction at the 20th month is 55%, regardless of prior nasal polyp surgery (p=0.41).</p><p><strong>Conclusion: </strong>Dupilumab led to significant radiological improvements in patients with CRSwNP, demonstrating a potential role of radiological remission, irrespective of prior nasal polyp surgery. Additionally, BEC levels may guide the likelihood of persistent nasal obstruction.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"17 ","pages":"1027-1040"},"PeriodicalIF":3.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11505379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500942","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":"Impulse Oscillometry Combined to FeNO in Relation to Asthma Control Among Preschool Children.","authors":"Jiying Xiao, Lingyue Liu, Kamran Ali, Suling Wu, Junsong Chen","doi":"10.2147/JAA.S489639","DOIUrl":"10.2147/JAA.S489639","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to observe and analyze the differences in impulse oscillometry (IOS) and fractional expiratory nitric oxide (FeNO) in relation to asthma control among preschool children, and to explore the predictive value of IOS combined with FeNO for uncontrolled asthma.</p><p><strong>Methods: </strong>This study enrolled 171 preschool children with asthma and 30 healthy preschool children between June 2022 and June 2023. We categorized the asthmatic children as having controlled asthma (n=85) and uncontrolled asthma (n=86) after a 3-month follow-up. IOS and FeNO were collected on the first visit at baseline. Differences in metrics were compared between controlled asthma, uncontrolled asthma and healthy control groups. The area under the receiver operating characteristic curve (AUROC) was utilized to explore the discriminative ability of IOS and FeNO, alone or in combination, against uncontrolled asthma.</p><p><strong>Results: </strong>Compared to the controlled asthma group, the IOS values of R5, X5, R5-R20, and Fres were significantly higher in the uncontrolled asthma group, except for R20. R5 and R5-R20 had the highest area under the curve (AUC), which could reach 0.74 (95% CI 0.66-0.82) and 0.72 (95% CI 0.64-0.80). R20 had the lowest AUC of 0.59. The AUC for FeNO alone was 0.88 (95% CI 0.84-0.93) with a cutoff value of 17.50 ppb, sensitivity and specificity of 0.73 and 0.89. The AUCs of all IOS metrics combined with FeNO were significantly higher, with the highest AUC of 0.92 (95% CI 0.87-0.96) for R5-R20+FeNO, and with a sensitivity and specificity of 0.88 and 0.84.</p><p><strong>Conclusion: </strong>There were significant differences in IOS and FeNO in relation to asthma control among preschooler children. FeNO might be the best predictor of asthma control, and adding any of IOS metrics increased moderately the predictive value.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"17 ","pages":"1015-1025"},"PeriodicalIF":3.7,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466163","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":"Fixed Airflow Obstruction in Asthma Can Be Identified Early by Low FEF25-75% and is Associated with Environmental Exposure.","authors":"Ziheng Chen, Jinxin Ma, Jiahui Lei, Yi Li, Ruijuan Zhao, Limin Zhao","doi":"10.2147/JAA.S479215","DOIUrl":"https://doi.org/10.2147/JAA.S479215","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify environmental risk factors associated with asthmatic fixed airflow obstruction (FAO) and assess the relationship between small airway abnormalities defined by forced expiratory flow at 25-75% (FEF25-75%) and FAO.</p><p><strong>Patients and methods: </strong>We analyzed data from 312 han Chinese patients with stable asthma on standard treatment. Low FEF25-75% was defined as post-bronchodilator FEF25-75% z-score <-0.8435, and FAO as post-bronchodilator FEV1/FVC z-score <-1.645. Exposure levels were retrospectively analyzed in relation to FAO risk in asthmatics. Asthmatics were grouped by low FEF25-75% and FAO, and lung function, environmental exposure, daily symptoms, and exacerbations in the previous year were compared cross-sectionally across groups.</p><p><strong>Results: </strong>In retrospective analyses, pack-years of smoking in male patients (adjusted odd ratio [95% confidence interval] 1.05 [1.03-1.07], <i>P</i><0.001), biomass exposure for >20 years (2.65 [1.13-6.43], <i>P</i>=0.027), occupational exposure for >10 years (2.01 [1.06-3.86], <i>P</i>=0.035) and occupational exposure for >20 years (2.67 [1.24-5.91], <i>P</i>=0.013) were associated with asthmatic FAO. In cross-sectional analyses, compared with the normal FEF25-75%/ asthmatics without FAO (NON-FAO) group, the low FEF25-75%/ asthmatics with FAO (FAO) group had lower FEV1 z-scores and FEV1/FVC z-scores, more pack-years and years of biomass and occupational exposure, higher Asthma Control Questionnaire-5 and Chronic Obstructive Pulmonary Disease Assessment Test scores, and more frequent exacerbations. The low FEF25-75%/NON-FAO group showed the same trend, but to a lesser extent.</p><p><strong>Conclusion: </strong>Chronic airway inflammation is not the only driver of asthmatic FAO, and management and treatment targeting environmental risk factors (smoking and biomass and occupational exposures) may slow FAO progression in asthmatics. The FEF25-75% determined by the z-score is a reliable marker of small airway abnormalities, and patients with low FEF25-75% are at greater risk for FAO, requiring more frequent follow-up.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"17 ","pages":"1001-1014"},"PeriodicalIF":3.7,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466162","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":"Oscillometry in Asthma: Respiratory Modeling and Analysis in Occupational and Work-Exacerbated Phenotypes.","authors":"Monique da Silva Pinto, Caroline de Oliveira Ribeiro, Paula Morisco de Sá, Hermano Albuquerque Castro, Thiago Prudente Bártholo, Agnaldo José Lopes, Pedro Lopes Melo","doi":"10.2147/JAA.S473639","DOIUrl":"https://doi.org/10.2147/JAA.S473639","url":null,"abstract":"<p><strong>Background: </strong>Asthma onset or worsening of the disease in adulthood may be associated with occupational asthma (OA) or work-exacerbated asthma (WEA). Oscillometry and respiratory modeling offer insight into the pathophysiology and contribute to the early diagnosis of respiratory abnormalities.</p><p><strong>Purpose: </strong>This study aims to compare the changes due to OA and WEA and evaluate the diagnostic accuracy of this method.</p><p><strong>Patients and methods: </strong>Ninety-nine volunteers were evaluated: 33 in the control group, 33 in the OA group, and 33 in the WEA group. The area under the receiver operator characteristic curve (AUC) was used to describe diagnostic accuracy.</p><p><strong>Results: </strong>Oscillometric analysis showed increased resistance at 4 hz (R4, p<0.001), 20 hz (R20, p<0.05), R4-R20 (p<0.0001), and respiratory work (p<0.001). Similar analysis showed reductions in dynamic compliance (p<0.001) and ventilation homogeneity, as evaluated by resonance frequency (Fr, p<0.0001) and reactance area (p<0.0001). Respiratory modeling showed increased peripheral resistance (p<0.0001), hysteresivity (p<0.0001), and damping (p<0.0001). No significant changes were observed comparing OA with WEA in any parameter. For OA, the diagnostic accuracy analyses showed Fr as the most accurate among oscillometric parameters (AUC=0.938), while the most accurate from respiratory modeling was hysteresivity (AUC=0.991). A similar analysis for WEA also showed that Fr was the most accurate among traditional parameters (AUC=0.972), and hysteresivity was the most accurate from modeling (AUC=0.987). The evaluation of differential diagnosis showed low accuracy.</p><p><strong>Conclusion: </strong>Oscillometry and modeling have advanced our understanding of respiratory abnormalities in OA and WEA. Furthermore, our study presents evidence suggesting that these models could aid in the early diagnosis of these diseases. Respiratory oscillometry examinations necessitate only tidal breathing and are straightforward to conduct. Collectively, these practical considerations, coupled with the findings of our study, indicate that respiratory oscillometry in conjunction with respiratory modeling, may enhance lung function assessments in OA and WEA.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"17 ","pages":"983-1000"},"PeriodicalIF":3.7,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466164","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":"Reduced Effectiveness of Anti-IgE Treatment Among Adults with Severe Asthma with Older Age of Asthma Onset: Results from the CHRONICLE Study.","authors":"Dennis K Ledford, Warner W Carr, Wendy C Moore, Njira L Lugogo, Arjun Mohan, Bradley Chipps, Alexander R Mackie, Andrew W Lindsley, Joseph Spahn, Christopher S Ambrose","doi":"10.2147/JAA.S476774","DOIUrl":"https://doi.org/10.2147/JAA.S476774","url":null,"abstract":"<p><strong>Purpose: </strong>Younger age of asthma onset (AAO) has been associated with an allergic phenotype, whereas eosinophilic phenotypes have been associated with older AAO. In randomized trials, biologic efficacy among adults with severe asthma (SA) has varied by age at asthma onset. To determine whether these associations observed in trials apply to real-world outcomes, this study examined biologic effectiveness by AAO and biologic class in a large, real-world cohort.</p><p><strong>Patients and methods: </strong>CHRONICLE is an ongoing, real-world study of US adults with subspecialist-treated SA receiving biologics, maintenance corticosteroids, or who are uncontrolled on high-dosage inhaled corticosteroids with additional controllers. Patients enrolled between February 2018 and February 2022 who initiated a biologic for SA and had complete data for analysis were included. A locally estimated scatterplot smoothing (LOESS) analysis was used to plot the relationship between percentage exacerbation rate reduction and AAO by biologic class.</p><p><strong>Results: </strong>Of 578 patients with complete data, 198, 149, and 231 were diagnosed with asthma at age <18, 18-39, and ≥40 years, respectively. Across subgroups, patients were predominantly White (72-78%), female (67-73%), and commercially insured (54-71%). In the LOESS analysis, exacerbation rate reductions were similar for anti-IgE and anti-IL-5/5R and anti-IL-4R subgroups with younger AAO, but the exacerbation rate reduction diminished for patients with older AAO receiving anti-IgE therapy, particularly with asthma onset age ≥40 years.</p><p><strong>Conclusion: </strong>Clinicians should consider age of onset in biologic treatment decisions, given reduced effectiveness of omalizumab in patients with asthma onset at age ≥40 years.</p><p><strong>Clinicaltrialsgov identifier: </strong>NCT03373045.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"17 ","pages":"977-982"},"PeriodicalIF":3.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466165","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}