Journal of Asthma and Allergy最新文献

{"title":"Biologics for Children and Adolescents with Asthma: A Systematic Review and Exploratory Indirect Comparative Analysis.","authors":"Mengwei Wu, Haoyuan Li, He Geng, Peize Liu, Chao Wang, Ling Zhou, Na Liu, Xu Li, Lili Zhi","doi":"10.2147/JAA.S629339","DOIUrl":"10.2147/JAA.S629339","url":null,"abstract":"<p><strong>Background: </strong>Biologics targeting type 2 inflammation have expanded treatment options for children and adolescents with uncontrolled asthma, but pediatric randomized evidence is limited and direct head-to-head comparisons are unavailable. We reappraised comparative efficacy and safety evidence and the certainty of current indirect estimates.</p><p><strong>Methods: </strong>We searched PubMed, Embase, ClinicalTrials.gov, the China National Knowledge Infrastructure, and public trial sources through May 25, 2026, for randomized controlled trials of biologics in children or adolescents with asthma. The primary efficacy outcome was annualized exacerbation rate (AER); safety outcomes were adverse events (AEs) and serious adverse events (SAEs). Between-biologic effects were explored using Bucher adjusted indirect comparisons through placebo as the common comparator. Transitivity was assessed qualitatively, and evidence certainty was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.</p><p><strong>Results: </strong>Three placebo-controlled pediatric trials evaluating omalizumab, dupilumab, and mepolizumab contributed to the primary analysis. Each biologic reduced AER versus placebo. The adjusted indirect estimate for dupilumab versus mepolizumab was below 1, but this finding was derived from a sparse, clinically heterogeneous evidence structure and was considered hypothesis-generating rather than evidence of superiority. Omalizumab and dupilumab were not associated with a clear increase in overall AEs, whereas mepolizumab had higher broad AE reporting in MUPPITS-2. SAE estimates were imprecise. Certainty was moderate for biologics versus placebo on AER, low for between-biologic comparisons, and low to very low for safety outcomes.</p><p><strong>Conclusion: </strong>Randomized pediatric evidence supports biologics for reducing exacerbation burden versus placebo. Current adjusted indirect estimates do not establish a biologic hierarchy. Phenotype-stratified head-to-head pediatric trials remain necessary.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"629339"},"PeriodicalIF":3.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968903","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":"Extreme Cold Events and Pediatric Asthma Outpatient Visits: The Modifying Role of Ambient Carbon Monoxide and Sulfur Dioxide.","authors":"Xing Gong, Li Wei, Yunshu Xu, Changdi Xu, Yi Zhang, Fengxia Sun, Man Tian, Liya Wang, Hengxue Wang, Ming Ge, Feng Liu, Lilin Xiong, Wei Pan","doi":"10.2147/JAA.S483101","DOIUrl":"10.2147/JAA.S483101","url":null,"abstract":"<p><strong>Purpose: </strong>Extreme cold exposure may trigger respiratory morbidity in children, but whether concurrent ambient air pollution modifies cold-related risks of pediatric asthma remains unclear. This study evaluated associations between extreme cold events and pediatric asthma outpatient visits and assessed whether these associations differed according to ambient pollutant concentrations.</p><p><strong>Patients and methods: </strong>We conducted a time-series study of 62,167 pediatric asthma outpatient visits among children diagnosed with asthma at a tertiary children's hospital in Nanjing, China, from 2019 to 2024. Daily asthma visits were linked with meteorological variables and ambient concentrations of PM₁₀, PM_2.5, NO₂, SO₂, CO, and O₃. Extreme cold events were defined as ≥2, ≥3, or ≥4 consecutive days with daily mean temperature ≤4.5°C (the 10th percentile of the study-period distribution). Quasi-Poisson distributed-lag non-linear models were used to estimate cumulative relative risks over lag 0-14 days. Pollutant-related effect modification was evaluated using stratified analyses and interaction measures.</p><p><strong>Results: </strong>Overall, extreme cold events were not significantly associated with pediatric asthma outpatient visits. However, stronger associations were observed during periods with higher CO and SO₂ concentrations. For lag 0-14 days, cumulative relative risks for ≥2-day cold events were 2.60 (95% CI: 1.13-5.95) in the higher-CO stratum and 3.41 (95% CI: 1.15-10.11) in the higher-SO₂ stratum. Similar patterns were observed for longer cold-event definitions. Multiplicative interactions were identified for both CO and SO₂, whereas additive interaction evidence was clearer for CO. Other pollutants showed less consistent modification patterns.</p><p><strong>Conclusion: </strong>The association between extreme cold events and pediatric asthma outpatient visits may depend on concurrent gaseous pollutant conditions. Relatively elevated CO and SO₂ may help identify cold-event periods with greater pediatric asthma outpatient burden.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"483101"},"PeriodicalIF":3.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968870","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 Tirzepatide versus Semaglutide with Risk of Asthma Exacerbation in Patients with Asthma and Type 2 Diabetes: A US Multicenter Retrospective Cohort Study.","authors":"Chun-Tse Hung, Chen-Yen An, Chi-Won Suk, Ting-Wei Lee, Shun-Hsing Hung","doi":"10.2147/JAA.S637738","DOIUrl":"10.2147/JAA.S637738","url":null,"abstract":"<p><strong>Background: </strong>While glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show promise in improving respiratory outcomes, the comparative effectiveness of dual glucose-dependent insulinotropic polypeptide/GLP-1 RA versus GLP-1 RA alone remains unclear.</p><p><strong>Objective: </strong>To assess the association of tirzepatide versus semaglutide with the risk of asthma exacerbation among patients with asthma and type 2 diabetes (T2D).</p><p><strong>Methods: </strong>Data from the TriNetX US Collaborative Network were used. Adults with asthma and T2D who initiated tirzepatide or semaglutide between June 01, 2022, and December 31, 2024, were included. The study period ended on December 1, 2025. The primary outcome was time to first asthma exacerbation over a 12-month follow-up. Secondary outcomes included systemic corticosteroid and short-acting beta-agonist (SABA) use. Propensity score matching was used to balance baseline covariates. Kaplan-Meier curves and Cox regression models were used to estimate comparative effectiveness.</p><p><strong>Results: </strong>After 1:1 matching, 8176 patients were included in each group. The risk of asthma exacerbation was similar between tirzepatide and semaglutide (11.0% vs 11.1%; HR, 1.00; 95% CI, 0.91-1.10). This finding remained consistent across sensitivity and subgroup analyses. For secondary outcomes, tirzepatide was associated with a lower risk of SABA use (HR, 0.92; 95% CI, 0.88-0.96) and a similar risk of systemic corticosteroid use (HR, 1.01; 95% CI, 0.96-1.05) compared with semaglutide.</p><p><strong>Conclusion: </strong>Among patients with asthma and T2D, no difference in the risk of asthma exacerbation between tirzepatide and semaglutide was observed. Further investigation through randomized controlled trials is warranted to clarify the potential role of GLP-1 RA-based therapies in patients with asthma and T2D.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"19 ","pages":"637738"},"PeriodicalIF":3.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13565390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955928","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":"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}