Journal of Asthma and Allergy最新文献

{"title":"Reduction in Artemisia Pollen-Specific IgE Levels During House Dust Mite Allergen Immunotherapy in Polysensitized Allergic Rhinitis Patients: A Three-Year Retrospective Study in Northern, China.","authors":"Xiaowei Sun, Xu Li, Tingting Gao, Peize Liu, Na Liu, Peng Jin, Lili Zhi","doi":"10.2147/JAA.S525620","DOIUrl":"https://doi.org/10.2147/JAA.S525620","url":null,"abstract":"<p><strong>Background: </strong> Allergen immunotherapy (AIT) is a well-established treatment for allergic diseases, particularly in patients with allergic rhinitis and asthma. In regions where patients are polysensitized, AIT can have broader immunomodulatory effects. This study investigates the impact of house dust mite AIT on IgE responses to both dust mites and non-target allergens, specifically Artemisia pollen, in polysensitized allergic rhinitis patients.</p><p><strong>Methods: </strong> This retrospective study included polysensitized patients aged 18 or older with a diagnosis of allergic rhinitis or rhinitis with asthma and positive IgE for both house dust mites and Artemisia pollen. Patients who completed at least three years of AIT for house dust mites were included. IgE levels for <i>Dermatophagoides pteronyssinus</i> (Der p), <i>Dermatophagoides farinae</i> (Der f), and Artemisia pollen were measured at baseline and after 1, 2, and 3 years of treatment. Clinical outcomes were also recorded, including Total Nasal Symptom Score (TNSS), Visual Analog Scale (VAS), and medication use.</p><p><strong>Results: </strong> Over three years, SIgE levels for Der p significantly decreased (p = 0.0001), while Der f showed a slight and significant decrease (p = 0.0334). Artemisia pollen-specific IgE decreased modestly (p = 0.0478), despite not being the target allergen. Total IgE levels increased slightly without statistical significance (p = 0.9026). Clinical outcomes improved significantly, with reductions in TNSS, VAS, and medication scores (all p < 0.0001), alongside a decrease in eosinophil counts, reflecting clinical and immunological benefits.</p><p><strong>Conclusion: </strong> House dust mite AIT not only reduces dust mite-specific IgE levels but also leads to unexpected reductions in IgE levels for non-target allergens, such as Artemisia pollen. This suggests that AIT has broader immunological benefits, improving overall tolerance to multiple allergens in polysensitized patients.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"665-673"},"PeriodicalIF":3.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000737","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 Between Hemoglobin A1c and Pediatric Asthma Control.","authors":"Hewlett Pham, Rachelle Koehl, Han Woo, Tianshi David Wu, Anna Yue Qiu, Emily P Brigham, Nadia N Hansel, Meredith C McCormack","doi":"10.2147/JAA.S498269","DOIUrl":"10.2147/JAA.S498269","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the relationship between Hemoglobin A1c (HbA1c) and asthma outcomes in an urban cohort of children with asthma.</p><p><strong>Methods: </strong>The AIRWEIGHS Study was a randomized controlled clinical trial of an air cleaner intervention testing the hypothesis that overweight/obese children would experience greater improvement in asthma control compared to normal weight children. The study enrolled 164 children with asthma from Baltimore, MD and assessed HbA1c levels and asthma outcomes during clinic visits at baseline and three months. HbA1c levels were analyzed as a continuous measure and categorized as either normal (<5.7%) or consistent with pre-diabetes (≥5.7%). Asthma outcomes included standardized questionnaires, spirometry, and fractional exhaled nitric oxide (FeNO). Generalized Estimating Equation (GEE) regression models were used to analyze the association between the HbA1c and asthma outcomes.</p><p><strong>Results: </strong>Participants included 164 children with an average age of 11 (± 2) years, predominately African American (85%), male (59%), moderate or severe asthma by NAEPP criteria (59%), households with an income below $34,999 (60%), publicly insured (83%), and overweight/obese (61%). 52 participants were excluded from the analysis due to unsuccessful blood draws or participant refusal. Twenty of 112 distinct participants (18%) had HbA1c measurements ≥5.7%, consistent with prediabetes. Increased HbA1c levels were associated with worse asthma control as indicated by an increase in the Asthma Therapy Assessment Questionnaire (β-0.74 p<0.05). In the interaction analysis, BMI percentile had a significant interaction with HbA1c such that HbA1c had a stronger association with maximum symptoms days and exacerbation risk among children with lower versus higher BMI percentile values.</p><p><strong>Conclusion: </strong>Higher HbA1c levels were associated with worse asthma control among children with asthma, adding to evidence that metabolic dysfunction may influence asthma morbidity. Additionally, HbA1c could have a stronger influence among non-obese children with underlying metabolic dysfunction, suggesting the need for future studies to investigate metabolic pathways in asthma.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"649-654"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025910","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":"Detection of Inadequately Controlled Asthma in Adults Using Impulse Oscillometry and Fractional Exhaled Nitric Oxide.","authors":"Xuwen Yang, Meishan Liu, Honglei Shi, Mengjia Hu, Yong Lu, Xiaohong Chang, Kewu Huang","doi":"10.2147/JAA.S516257","DOIUrl":"https://doi.org/10.2147/JAA.S516257","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effectiveness of impulse oscillometry (IOS) and its combination with fractional expiratory nitric oxide (FeNO) in distinguishing inadequately controlled asthma (ICA) from well-controlled asthma (WCA) in adults.</p><p><strong>Patients and methods: </strong>Adult patients aged 18 and above with asthma were recruited and underwent routine blood tests, FeNO, IOS, and spirometry before and after bronchodilator administration on the same day. Asthma control level was assessed using Asthma Control Test (ACT) scores; WCA was defined as a score above 20, while ICA was defined as a score of 20 or below. Receiver operating characteristic curve (ROC) and logistic regression analyses were employed to determine the relationship between IOS and FeNO measurements and asthma control.</p><p><strong>Results: </strong>The <i>z</i> score values of IOS parameters, specifically resistance at 5 hz (R5), resistance at 20 hz (R20), and the area under reactance curve between 5 hz and resonant frequency (AX) after bronchodilator administration were significantly different between the WCA (n = 75) and ICA (n = 77) groups. IOS parameters, R5, R20, and AX, after bronchodilation identified patients with ICA, with areas under receiver operating characteristic curve (AUC) of 0.654, 0.690, and 0.708, respectively, adjusted for smoke exposure, variable airflow limitation and fixed airflow obstruction. Combining IOS parameters with FeNO significantly increased the AUC (0.728, 0.752, and 0.763) for detecting ICA compared to IOS parameters with R5, R20, and AX, alone. Patients with abnormal IOS and FeNO values had significantly higher odds ratio (OR) of having ICA by logistic regression analyses, especially for abnormally higher AX, with an OR of 6.48.</p><p><strong>Conclusion: </strong>IOS is useful in discriminating ICA from WCA in adults, with its effectiveness further enhanced when combined with FeNO measurements.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"637-647"},"PeriodicalIF":3.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997401","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":"Eosinophilic Granulomatous Polyangiitis with Autoimmune Hemolytic Anemia: A Case Report and Review of the Literature.","authors":"Mengrong Xie, Ruiqin Ni, Jingying Zhang, Mingmei Zhong, Ping Wang","doi":"10.2147/JAA.S506965","DOIUrl":"https://doi.org/10.2147/JAA.S506965","url":null,"abstract":"<p><p>EGPA can affect multiple organ systems, typically presenting with respiratory symptoms as the initial manifestation. The absence of specific diagnostic biomarkers makes it prone to misdiagnosis. This article describes a 40-year-old female patient who presented with asthma-like symptoms, neurosensory impairment, anemia, peripheral blood eosinophilia, and pulmonary involvement. The patient was diagnosed with EGPA combined with AIHA. After ineffective treatment with glucocorticoids alone, the patients' symptoms were relieved by the addition of the immunosuppressant cyclophosphamide. Cyclophosphamide was discontinued after the total dose reached 7g and the patient relapsed. Subsequent treatment for the patients involved a combination of glucocorticoids and MMF, with no evidence of recurrence. This case is relatively rare in clinical practice, and fortunately the final treatment effect is satisfactory.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"629-635"},"PeriodicalIF":3.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991403","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":"The Correlation Between the Expression Levels of Serum miR-19b and SOCS-1 mRNA and Clinical Symptoms in Patients with Allergic Rhinitis.","authors":"Zhaopeng Kang, Lingling Di, Yi Liu, Wei Qu, Yi Zeng, Xue Lu, Lixin Wang","doi":"10.2147/JAA.S518177","DOIUrl":"https://doi.org/10.2147/JAA.S518177","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation between the expression levels of microRNA-19b (miR-19b) and suppressor of cytokine signaling 1 messenger RNA (SOCS-1 mRNA) in the serum of patients with allergic rhinitis (AR) and clinical symptoms.</p><p><strong>Methods: </strong>This prospective study included a total of 86 patients with allergic rhinitis who were admitted to the People's Hospital Affiliated to Hubei University of Medicine from January 2022 to January 2023. Seventy healthy individuals were included in the control group. The case group was further divided into a mild group (n=45) and a moderate to severe group (n=41) according to the severity of AR. The expression levels of miR-19b and SOCS-1 mRNA in serum samples of the two groups were detected and compared using real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) technique. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were utilized to evaluate the predictive value of miR-19b and SOCS-1 levels for the severity of AR.</p><p><strong>Results: </strong>The expression level of miR-19b in the serum of the case group was 1.52±0.36, significantly higher than that of the control group (1.02±0.24, P<0.05). Logistic regression analysis indicated that low levels of serum miR-19b and SOCS-1 mRNA were independent risk factors for moderate to severe AR, with an odds ratio (OR) of 3.575 (95% CI: 1.572-8.133, P<0.001) for miR-19b and 3.725 (95% CI: 1.637-8.473, P<0.001) for SOCS-1 mRNA. ROC curve analysis demonstrated that the levels of serum miR-19b and SOCS-1 mRNA had high accuracy in predicting moderate to severe AR, with AUC values of 0.879 (95% CI: 0.791-0.940) and 0.795 (95% CI: 0.694-0.875), respectively. When combined for prediction, the efficacy was significantly higher than that of individual detection, with an AUC value of 0.923 (95% CI: 0.856-0.967), Z=3.261, P<0.01.</p><p><strong>Conclusion: </strong>The expression levels of serum miR-19b and SOCS-1 mRNA are closely related to the severity of clinical symptoms in patients with AR and may serve as new biomarkers for evaluating the condition of AR and guiding treatment.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"619-627"},"PeriodicalIF":3.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003169","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":"Real-Life Effectiveness of Budesonide/Formoterol as Maintenance and Reliever Treatment via the Elpenhaler^® Device in Patients with Asthma: The NOTOS Observational Study.","authors":"Athena Gogali, Nikoletta Rovina, Konstantinos Samitas, Paschalis Steiropoulos, Dimitrios Potonos, Maria Bertoli, Polyanthi Papanastasiou, Alexandros Ginis, Konstantinos Kostikas","doi":"10.2147/JAA.S517932","DOIUrl":"https://doi.org/10.2147/JAA.S517932","url":null,"abstract":"<p><strong>Aim: </strong>Inhaled corticosteroid (ICS)/long-acting β2-agonist combinations are crucial for the effective treatment of asthma. ICS/formoterol regimens serve both as controller and reliever medications, as recommended by GINA 2019 onwards. In the six-month real-life NOTOS study, we aimed to evaluate the real-life effectiveness of budesonide/formoterol (BUD/FOR) administered with the Elpenhaler^® device as controller and/or reliever medication on asthma control, quality of life, and lung function in patients with asthma.</p><p><strong>Methods: </strong>We performed a multicenter open-label observational prospective study of adult asthma patients receiving BUD/FOR via Elpenhaler. Assessments were performed with Asthma Control Questionnaire (ACQ-6), Mini Asthma Quality of Life Questionnaire (MiniAQLQ), and spirometry. The incidence of exacerbations, frequency of rescue therapy use, and safety data were also recorded.</p><p><strong>Results: </strong>In the 1107 patients recruited, we observed statistical and clinically relevant improvements at 6 months from baseline, in ACQ-6 [mean change (95% CI) -1.55 (-1.61, -1.4) points, p<0.001], MiniAQLQ [1.76 (1.68, 1.82) points, p<0.001], and FEV₁ [0.35 (0.31,0.38) L, p<0.001]. Subgroup analyses, according to the maintenance (A: BUD/FOR 200/6 μg \"as needed\", B: BUD/FOR 200/6 maintenance, or C: BUD/FOR 400/12 μg maintenance) and the reliever treatments (none, BUD/FOR or short-acting β2-agonists), showed significant improvements across all groups, with greater improvements observed in the higher maintenance dose of BUD/FOR group. The frequency of rescue therapy use was overall markedly reduced, and we observed no safety issues.</p><p><strong>Conclusion: </strong>In this real-life study, treatment with BUD/FOR, as controller and/or reliever via the Elpenhaler device, was associated with significant improvement in patients' asthma control, quality of life, and lung function, over 6 months.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"605-618"},"PeriodicalIF":3.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12024486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006016","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":"An Updated Systematic Review on Asthma Exacerbation Risk Prediction Models Between 2017 and 2023: Risk of Bias and Applicability.","authors":"Anqi Liu, Yue Zhang, Chandra Prakash Yadav, Wenjia Chen","doi":"10.2147/JAA.S509260","DOIUrl":"https://doi.org/10.2147/JAA.S509260","url":null,"abstract":"<p><strong>Background: </strong>Accurate risk prediction of exacerbations in asthma patients promotes personalized asthma management.</p><p><strong>Objective: </strong>This systematic review aimed to provide an update and critically appraise the quality and usability of asthma exacerbation prediction models which were developed since 2017.</p><p><strong>Methods: </strong>In the Embase and PubMed databases, we performed a systematic search for studies published in English between May 2017 and August 2023, and identified peer-reviewed publications regarding the development of prognostic prediction models for the risk of asthma exacerbations in adult patients with asthma. We then applied the Prediction Risk of Bias Assessment tool (PROBAST) to assess the risk of bias and applicability of the included models.</p><p><strong>Results: </strong>Of 415 studies screened, 10 met eligibility criteria, comprising 41 prediction models. Among them, 7 (70%) studies used real-world data (RWD) and 3 (30%) were based on trial data to derive the models, 7 (70%) studies applied machine learning algorithms, and 2 (20%) studies included biomarkers like blood eosinophil count and fractional exhaled nitric oxide in the model. PROBAST indicated a generally high risk of bias (80%) in these models, which mainly originated from the sample selection (\"Participant\" domain, 6 studies) and statistical analysis (\"Analysis\" domain, 7 studies). Meanwhile, 5 (50%) studies were rated as having a high concern in applicability due to model complexity.</p><p><strong>Conclusion: </strong>Despite the use of big health data and advanced ML, asthma risk prediction models from 2017-2023 had high risk of bias and limited practical use. Future efforts should enhance generalizability and practicality for real-world implementation.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"579-589"},"PeriodicalIF":3.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993723","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":"Serum miR-130a-3p and miR-326: Correlation with Airway Inflammation and Prognostic Implications in Pediatric Bronchial Asthma.","authors":"Danhong Liu, Fanda Liao, Hongbing Wang","doi":"10.2147/JAA.S508372","DOIUrl":"https://doi.org/10.2147/JAA.S508372","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between serum microRNA (miR)-130a-3p, miR-326 and airway inflammation in children suffering from bronchial asthma.</p><p><strong>Methods: </strong>A retrospective study was conducted on 122 children suffering from bronchial asthma. According to the disease progression, 122 cases were divided into a remission group of 73 cases and an attack group of 49 cases. Total 50 healthy children received physical examinations during the same period were taken as the control group. These cases were graded as a well-controlled group of 91 cases and a poorly controlled group of 31 cases following 8 weeks of symptomatic treatment. The interaction was analyzed using a multiplication model (by calculating the odds ratio and other indicators of the occurrence of outcomes under different combinations of factor exposures). ROC curve was used to analyze the predictive value. Multivariate Logistic regression was used to analyze the influencing factors.</p><p><strong>Results: </strong>Serum miR-130a-3p and miR-326 levels were negatively correlated with serum IL-4, TGF-β1 and CKLF-1 levels (all <i>P</i> < 0.001), but positively correlated with serum IL-10 levels (r = 0.673 and 0.768; both <i>P</i> < 0.001). The poorly controlled group had much lower levels of serum miR-130a-3p and miR-326 than the well-controlled group (<i>t</i> = 13.637 and 8.482; both <i>P</i> < 0.05). The sensitivity and specificity of the combination of the two factors in predicting poor prognosis were 81.25% and 85.00%, which had certain clinical value. The elevation of serum levels of IL-4, TGF-β1 and CKLF-1 increased the risk of asthma and poor prognosis, but IL-10, miR-130a-3p and miR-326 were protective factors (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The decreased levels of serum miR-130a-3p and miR-326 were related to airway inflammation in children with bronchial asthma. The interaction between the two miRNAs may increase the risk of poor prognosis in children. Detection of the two miRNAs can provide important reference for clinicians to judge the prognosis of children.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"591-603"},"PeriodicalIF":3.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968161","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 Comorbid Asthma on Life Quality of Patients with Chronic Rhinosinusitis and Nasal Polyps.","authors":"Pei-Wen Wu, Po-Hung Chang, Chi-Che Huang, Ta-Jen Lee, Yu-Hsi Fan, Chien-Chia Huang","doi":"10.2147/JAA.S517258","DOIUrl":"https://doi.org/10.2147/JAA.S517258","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to characterize the clinical features of patients with comorbid asthma and chronic rhinosinusitis with nasal polyps and to evaluate the impact of comorbid asthma on the quality of life of these patients.</p><p><strong>Methods: </strong>Adult patients with bilateral chronic rhinosinusitis with nasal polyps scheduled for sinus surgery were prospectively enrolled. Clinical information of the participants, including laboratory data and computed tomography images. The Sinonasal Outcome Test-22 was used to evaluate nasal symptoms and quality of life impairment of participants.</p><p><strong>Results: </strong>A total of 170 participants were recruited, of whom 32 (18.8%) had comorbid asthma. Compared to patients with chronic rhinosinusitis with nasal polyps and without comorbid asthma, patients with asthma exhibited significant higher age, computed tomography ethmoid/maxillary ratio, computed tomography olfactory cleft opacification score, serum total IgE, serum eosinophil cationic protein levels, and blood and tissue eosinophil count. Patients with comorbid chronic rhinosinusitis with nasal polyps and asthma exhibited significant higher total, and rhinologic- and sleep-related domains of the Sinonasal Outcome Test-22 than did those without comorbid asthma.</p><p><strong>Conclusion: </strong>Comorbid asthma is associated with more severe type 2 eosinophilic inflammation and has a significant impact on the nasal symptoms and quality of life of patients with chronic rhinosinusitis with nasal polyps, particularly as shown in the rhinologic- and sleep-related domains of the Sinonasal Outcome Test-22. This information may assist physicians in decision-making when treating these patients.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"567-578"},"PeriodicalIF":3.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063870","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 Intervention with Mepolizumab, Corticosteroids, and Intravenous Immunoglobulin for Dupilumab-Triggered Eosinophilic Granulomatosis with Polyangiitis: A Case Report.","authors":"Shota Kaburaki, Toru Tanaka, Koichiro Kamio, Yosuke Tanaka, Kazuo Kasahara, Masahiro Seike","doi":"10.2147/JAA.S513640","DOIUrl":"10.2147/JAA.S513640","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare complication during dupilumab therapy. However, the optimal treatment strategy for dupilumab-triggered EGPA remains unclear, particularly the timing and role of anti-interleukin-5 therapy.</p><p><strong>Case study: </strong>A 48-year-old female with severe eosinophilic rhinosinusitis and asthma, increased blood eosinophils (2098/μL) and myeloperoxidase-specific antineutrophil cytoplasmic antibody (MPO-ANCA) (46.1 U/mL) without vasculitic symptoms, developed systemic symptoms, including fever, arthralgia, and peripheral neuropathy immediately after dupilumab administration.</p><p><strong>Results: </strong>Physical assessment revealed bilateral expiratory wheezes and laboratory tests revealed marked elevations in blood eosinophil (11,889/μL) and MPO-ANCA levels (125.0 U/mL). Other conditions, including parasitic infections, allergic bronchopulmonary aspergillosis, and <i>FIP1L1-PDGFRA</i>-positive disease, were excluded. Early intervention with mepolizumab (300 mg), methylprednisolone pulse therapy, and intravenous immunoglobulin (IVIG) was initiated after discontinuing dupilumab, resulting in rapid normalization of blood eosinophil counts and clinical improvement. Residual neuropathy was successfully treated with intravenous immunoglobulin (IVIg). Prednisolone was reduced to 15 mg daily with negative MPO-ANCA one month after treatment initiation.</p><p><strong>Conclusion: </strong>This case emphasizes the importance of monitoring preexisting MPO-ANCA and blood eosinophils before and during dupilumab therapy. Early intervention with mepolizumab combined with conventional therapy is considered an optimal treatment strategy for dupilumab-triggered EGPA.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"559-565"},"PeriodicalIF":3.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970291","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}