Journal of Asthma and Allergy最新文献

{"title":"Glycosylation in T2 high and Th17 Asthma: A Narrative Review.","authors":"Xingxing Yuan, Chaofan Li, Jiawei Gao, Liuxin Yang, Bingyu Wang, Zhuying Li","doi":"10.2147/JAA.S509940","DOIUrl":"https://doi.org/10.2147/JAA.S509940","url":null,"abstract":"<p><p>Glycosylation, a fundamental biochemical process, entails the covalent attachment of sugar molecules to proteins, DNA, or RNA. Beginning with an overview of the pathophysiological features of asthma, this review proceeds to elucidate various facets of glycosylation in asthma pathology, specifically in T2 high asthma and Th17-mediated responses. We examined glycosylation's involvement in regulating airway inflammation, encompassing the modulation of pro-inflammatory cytokine release such as IL-4, IL-5, and IL-13, key components of T2 inflammation, as well as its significance in modulating immune cell functionality, notably T cells and dendritic cells. Moreover, we explored glycosylation's impact on airway remodeling processes, including its regulation of airway smooth muscle cell proliferation and migration. Addressing molecular mechanisms, this review delved into several glycosylation modifications of proteins and genes implicated in asthma pathogenesis, including IgE, IL-4 receptor, TGF-β, and the regulation of select glycosylation enzymes. Additionally, the review highlights the role of Th17 cells in T2 high asthma and their modulation through glycosylation. We underscored future research imperatives, including biomarker discovery, therapeutic realization, and the potential utility of glycosylation modifications in asthma prevention and management. In short, this review provides an in-depth analysis of the critical role of glycosylation in the pathogenesis of T2 high asthma and Th17 responses.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"545-558"},"PeriodicalIF":3.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006441","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 Urticaria to Correct Diagnosis: A Case Report of Cryopyrin-Associated Periodic Syndromes.","authors":"Xue Wang, Nan Zhou, Yuxiang Zhi","doi":"10.2147/JAA.S509939","DOIUrl":"https://doi.org/10.2147/JAA.S509939","url":null,"abstract":"<p><p>Cryopyrin-associated periodic syndrome (CAPS) is a rare autoinflammatory disorder often misdiagnosed as urticaria or urticarial vasculitis, thereby delaying treatment for patients. This report presents a large CAPS pedigree. The proband was a 57-year-old man with recurrent urticaria-like rash, fever, and arthralgia for more than 50 years and hearing loss for 28 years. Sixteen of his relatives had similar symptoms. One-generation sequencing revealed a c.778C>T; p.(Arg260Trp) variant in the NLRP3 gene, confirming the diagnosis of CAPS. The aim of this case report is to raise awareness of CAPS and its various clinical manifestations, highlighting that urticaria may be a presentation of autoinflammatory diseases, thereby improving diagnostic accuracy.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"539-544"},"PeriodicalIF":3.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991575","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":"Increased Serum EphA2 is Associated with Disease Severity in Pediatric Patients with Asthma.","authors":"Suli Ma, Weiguang Qu","doi":"10.2147/JAA.S515475","DOIUrl":"https://doi.org/10.2147/JAA.S515475","url":null,"abstract":"<p><strong>Background: </strong>Asthma is the most prevalent chronic inflammatory airway disease in children, with increasing incidence and prevalence. Ephrin type-A receptor 2 (EphA2) belongs to the Ephrin (Eph) family. It is predominantly found in bronchial epithelial cells and may play a potential role in mediating airway inflammation in asthma. However, this study aimed to evaluate the association between a novel biomarker, EphA2, in two distinct pediatric asthma populations stratified by disease severity.</p><p><strong>Materials and methods: </strong>Serum levels of interleukins (IL-1β, IL-4, IL-6, IL-8, IL-13), tumor necrosis factor-α (TNF-α), transforming growth factor-β1 (TGF-β1), matrix metalloproteinase (MMP-2 and MMP-9), and EphA2 were measured by ELISA in all participants. In addition, blood eosinophil counts, Total IgE levels and exhaled nitric oxide (FeNO) levels were evaluated.</p><p><strong>Results: </strong>Serum EphA2 levels in patients with asthma (n=195) were significantly higher than those in healthy controls (n=120), and the levels were notably elevated in patients with severe asthma (n=82) than in those with mild-moderate asthma (n=113). Receiver Operating Characteristic (ROC) curve analysis revealed that the ideal threshold for serum EphA2 was 324.76 pg/mL. This cutoff point demonstrated a sensitivity of 88.7% and a specificity of 92.5%, yielding an Area Under the Curve (AUC) of 0.959. Further correlative analysis indicated that serum EphA2 level was negatively correlated with forced expiratory volume in 1 second (FEV1) (r=-0.376, P<0.001), the ratio of FEV1 to forced vital capacity (FVC) (r=-0.476, P<0.001), and peak expiratory flow (PEF) (r=-0.699, P<0.001). Furthermore, we observed that serum EphA2 positively correlated with Eosinophil count (r=0.227, P=0.001), Total IgE (r=0.715, P<0.001), FeNO (r=0.560, P<0.001), IL-1β (r=0.423, P<0.001), IL-4 (r=0.314, P<0.001), IL-6 (r=0.625, P<0.001), IL-8 (r=0.628, P<0.001), IL-13 (r=0.569, P<0.001), TNF-α (r=0.562, P<0.001), TGF-β1 (r=0.535, P<0.001), MMP-2 (r=0.273, P<0.001), and MMP-9 (r=0.266, P<0.001) in all asthma patients.</p><p><strong>Conclusion: </strong>Our research suggests that EphA2 might be a valuable marker for assessing the risk of exacerbation, inflammation of the airways, and airway remodelling in asthma patients.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"529-537"},"PeriodicalIF":3.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006563","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":"Utility of the Basophil Reactivity Test in the Clinical Management of People with Severe Uncontrolled Asthma.","authors":"Maria Del Mar García Ródenas, Luis Manuel Hernández Blasco, Francisco Javier Fernández Sánchez, Francisco Manuel Marco de la Calle, Jose-Francisco Pascual-Lledó, Ángel Sánchez Barbie, Cleofé Fernández Aracil","doi":"10.2147/JAA.S505951","DOIUrl":"https://doi.org/10.2147/JAA.S505951","url":null,"abstract":"<p><strong>Introduction: </strong>The prognosis of asthma has improved significantly since the availability of monoclonal antibodies (mAbs). However, there are no robust predictive markers of response to help clinicians select one of the multiple biologicals recommended in clinical practice guidelines. The aim of this study was to evaluate the utility of basophil reactivity, measured through the basophil activation test (BAT), as a marker of response to mAbs.</p><p><strong>Methods: </strong>We measured basophil reactivity, using anti-immunoglobulin E (anti-IgE) antibodies as a stimulus, in 72 consecutive patients with severe uncontrolled asthma before initiation of treatment with mAbs. Forty-nine patients received omalizumab, 28 received mepolizumab, and 23 received benralizumab at some point. The Spanish Asthma Management Guidelines (GEMA) informed clinical management throughout the study. We studied clinical characteristics, laboratory values, and measures of respiratory function and asthma control.</p><p><strong>Results: </strong>Basophil reactivity (at the highest anti-IgE dilution at which basophil activation was positive) was inversely associated with asthma control and response to any mAb. The patients with higher basophil reactivity (≥ 29% versus < 29%) had lower mAb complete response, more frequent mAb switches, and worse baseline lung function and Asthma Control Test (ACT) scores. The BAT was associated with poor response above the cut-off values of 10.5% for mepolizumab, 15.5% for omalizumab, and 28% for benralizumab.</p><p><strong>Conclusion: </strong>Patients with basophil reactivity greater than or equal to 29% were less likely to achieve full control of asthma when treated with omalizumab, mepolizumab, or benralizumab, independently of classic clinical or biological markers of type 2 asthma.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"519-528"},"PeriodicalIF":3.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11988192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992324","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":"Combining Dual Biologics Therapy for Severe Asthma: A Series of Ten Cases.","authors":"Yan Chen, Lu Wang, Jiaxing Xie","doi":"10.2147/JAA.S507008","DOIUrl":"https://doi.org/10.2147/JAA.S507008","url":null,"abstract":"<p><strong>Background: </strong>Biologic therapy has revolutionized the management of severe asthma, but a subset of patients with severe asthma exhibits symptoms inadequately controlled by monotherapy, potentially due to the involvement of multi-type 2 pathways. Dual biologic therapy has emerged as a promising strategy, but its efficacy and safety are not yet fully understood.</p><p><strong>Objective: </strong>To describe the characteristics, endotyping features, decision-making process and therapeutic response of patients with severe asthma on dual biologic therapy in a real-world setting.</p><p><strong>Methods: </strong>We present ten patients on dual biologics for severe asthma. The biologic combinations include mepolizumab+ dupilumab (n=7), benralizumab+dupilumab (n=1), omazulab+mepolizumab (n=2). Therapeutic response was assessed by type 2 inflammation biomarkers, symptom control, frequency of acute exacerbations, daily oral corticosteroid (OCS) dosage and side effects.</p><p><strong>Results: </strong>In our 10 cases, six of them are women, the mean age was 56±15 years old. The mean duration of combination therapy use was 13.5 months (range from 4 to 36 months). Dual biologic therapy was initiated because of inadequate asthma control (N1, N2, N6), poor control of comorbidities (N5, N7, N8, N9) or anti-IL4/13R-induced hypereosinophilia (N3, N4, N5, N7, N10) when treated with a single biologic agent. All ten patients exhibited good tolerance to the combined biologic therapies, leading to improvements in asthma and comorbidity management, and a reduction in OCS usage. No serious adverse events were reported.</p><p><strong>Conclusion: </strong>Dual biologics have been shown to be both effective and safe. However, more studies are needed to fully assess the long-term benefits and potential risks of different combinations of biologic treatments.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"507-517"},"PeriodicalIF":3.7,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003216","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":"Clinical and Laboratory Profiles of Rhinovirus-Infected Preschool Children: Identifying Risk Factors for Subsequent Asthma.","authors":"Peter Kunc, Jaroslav Fabry, Katarina Istvankova, Martina Neuschlova, Renata Pecova","doi":"10.2147/JAA.S511147","DOIUrl":"https://doi.org/10.2147/JAA.S511147","url":null,"abstract":"<p><strong>Background: </strong>Rhinovirus infection is considered a significant risk factor for the development of asthma in children. However, not all children with rhinovirus infections ultimately manifest asthma.</p><p><strong>Aim of study: </strong>To analyze the clinical and laboratory profiles of children under five years of age with proven rhinovirus infection and identify potential common factors predisposing them to an increased risk of future asthma.</p><p><strong>Materials and methods: </strong>A retrospective longitudinal study was conducted at the National Institute of Pediatric Tuberculosis and Respiratory Diseases in Slovakia. The study population consisted of 122 preschool children (mean age 2.5 years ±1.84, 69% boys vs 31% girls) hospitalized with PCR-confirmed rhinovirus infection. The children were followed for a minimum of three years to monitor the potential development of bronchial asthma.</p><p><strong>Results: </strong>Fifty of 122 children (41%) developed asthma (group 1), while 72 (59%) did not (group 2). Children in group 1 had a higher prevalence of family history of atopy (p < 0.001), sensitization to allergens (especially house dust mites and grass; p = 0.0002), elevated peripheral eosinophilia (p = 0.047), and higher total IgE levels (p<0.05) compared to group 2. The use of inhaled corticosteroids was significantly higher in group 1 (p<0.001). No significant differences were found between the groups in terms of prematurity, pathological perinatal history, and upper respiratory tract colonization by common microbial pathogens.</p><p><strong>Conclusion: </strong>Atopy, sensitization to aeroallergens, and inhaled corticosteroid use were significant risk factors for asthma development in children with rhinovirus infections. The early identification of these risk factors may help in the timely management of these children to mitigate the potential long-term consequences of chronic airway inflammation. This personalized approach allows for more intensive medical surveillance and targeted therapeutic interventions in high-risk individuals, potentially improving the long-term outcomes.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"479-489"},"PeriodicalIF":3.7,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006010","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":"Peripheral Airway Obstruction in Association with Symptoms and Quality of Life in Asthma.","authors":"Georgia Papapostolou, Abir Nasr, Linnea Jarenbäck, Kerstin Romberg, Alf Tunsäter, Jaro Ankerst, Leif Bjermer, Ellen Tufvesson","doi":"10.2147/JAA.S497218","DOIUrl":"https://doi.org/10.2147/JAA.S497218","url":null,"abstract":"<p><strong>Introduction: </strong>Forced Oscillation Technique (FOT) is increasingly used to measure obstruction in the airways; however, the association between airway obstruction and the actual symptom burden in asthma is not known. Therefore, we aimed to investigate central and peripheral airway obstruction, measured by FOT, in association to symptoms and quality of life in asthma.</p><p><strong>Methods: </strong>319 asthma patients were recruited and answered questionnaires focusing on symptoms (ACT, ACQ, Nijmegen, HADS and SNOT-22) and quality of life (MiniAQLQ and MiniRQLQ) and performed FOT measurements estimating airway resistance (R5: total resistance, R19: central resistance, R5-R19: peripheral resistance) and reactance (X5) during inspiration and expiration.</p><p><strong>Results: </strong>Asthma groups classified based on ACT score cut-off points at 16, 20, and 25 showed higher R5, R5-R19, and lower X5 with increasing symptoms, which was not evident when applying a cut-off of only 20. ACQ-5 cut-offs at 0.75 and 1.5 captured differences in R5 and X5, whereas a Nijmegen cut-off of 23 showed differences in R5 and R19. The total scores from most questionnaires (except for the HADS and SNOT-22) correlated with many of the FOT results, but there were different patterns of correlation between airway obstruction and symptoms in uncontrolled and controlled asthma. Additionally, specific questions were associated with airway obstruction.</p><p><strong>Conclusion: </strong>The increasing symptoms in patients with asthma assessed using questionnaires correlated well with predominantly increasing peripheral airway obstruction. A correlation also exists with the Nijmegen score, which is not specific to asthma. The cut-off points used to define asthma control may capture peripheral airway dysfunction.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"491-505"},"PeriodicalIF":3.7,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025911","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":"Proposal and Verification of New Revised Criteria for ABPA/ABPM Diagnosis.","authors":"Runjin Cai, Huan Ge, Bin Liu, Yuling Tang, Jun Wang, Xuemei Chen, Bing Liu, Xinyue Hu, Shuanglinzi Deng, Hui Li, Lixue Dai, Jiale Tang, Chendong Wu, Xiaoxiao Gong, Guo Wang, Xiaozhao Li, Juntao Feng","doi":"10.2147/JAA.S514664","DOIUrl":"10.2147/JAA.S514664","url":null,"abstract":"<p><strong>Background: </strong>Although several diagnostic criteria for allergic bronchopulmonary aspergillosis (ABPA) have been proposed, the disease remains frequently misdiagnosed and underdiagnosed. In 2021, Asano et al introduced new diagnostic criteria for allergic bronchopulmonary mycosis (ABPM), which were found to improve diagnostic sensitivity compared to existing criteria, but the specificity was lower.</p><p><strong>Methods: </strong>To develop revised scoring criteria for ABPA/ABPM diagnosis, delphi surveys were conducted with two rounds in 14 experts. The integer value of the mean importance scores for each item was used as the assigning values of revised scoring criteria. We evaluated the performance of existing diagnostic criteria against revised scoring criteria, using both physician diagnosis and latent class analysis (LCA) diagnosis of ABPM as reference standard.</p><p><strong>Results: </strong>We screened a total of 168 patients as initial suspected ABPM. Using physician diagnosis as the reference, diagnostic sensitivity for the Rosenberg-Patterson criteria, ISHAM criteria, revised ISHAM criteria, Asano criteria and revised scoring criteria were 39.8%, 51.6%, 64.5%, 76.3% and 86.0%, while the diagnostic specificity was 100%, 100%, 100%, 85.3% and 94.7%, respectively. When using LCA as the reference, the sensitivities of these criteria were 45.1%, 48.0%, 56.7%, 71.0%, and 76.4%, the diagnostic specificity was 100%, 100%, 98.4%, 83.8% and 95.2%, respectively.</p><p><strong>Conclusion: </strong>Revised scoring criteria showed improved diagnostic sensitivity compared to existing criteria while also enhancing specificity compared to the Asano criteria.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"467-477"},"PeriodicalIF":3.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803316","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 Effect of Mepolizumab on Blood Eosinophil Subtype Distribution and Granule Protein Gene Expression in Severe Eosinophilic Asthma.","authors":"Airidas Rimkunas, Andrius Januskevicius, Egle Vasyle, Jolita Palacionyte, Virginija Kalinauskaite-Zukauske, Skaidrius Miliauskas, Kestutis Malakauskas","doi":"10.2147/JAA.S509001","DOIUrl":"10.2147/JAA.S509001","url":null,"abstract":"<p><strong>Purpose: </strong>Mepolizumab, which causes a decrease in the number of blood eosinophils, is used to treat patients with severe eosinophilic asthma (SEA). However, there is a relative lack of data on dynamic changes in blood eosinophil subtype distribution and their granule protein expression following anti-interleukin (IL)-5 treatment. Our objective was to evaluate blood inflammatory-like (iEOS-like) and resident-like (rEOS-like) eosinophil subtype distribution and <i>CLC, EDN, EPX, ECP</i>, and <i>MBP</i> gene expression following up to 24 weeks of treatment with mepolizumab in SEA patients.</p><p><strong>Patients and methods: </strong>Ten free of oral steroids SEA patients and 9 healthy control subjects (HS) were included. Patients were treated with mepolizumab 100 mg subcutaneously/4 weeks, and investigation tests were performed at 0, 4, 12, and 24 weeks. Blood eosinophils were isolated by Ficoll centrifugation and magnetic separation, then subtyped using magnetic separation against CD62L. Gene expression investigation was done using quantitative real time-polymerase chain reaction analysis.</p><p><strong>Results: </strong>Approximately three-quarters of isolated blood eosinophils were iEOS-like cells before mepolizumab treatment, p<0.01. Blood eosinophil granule protein gene expression was increased in SEA patients compared to the HS, <i>p</i><0.05, and iEOS-like cells <i>EPX, MBP</i>, and <i>CLC</i> gene expressions were higher than rEOS-like cells, <i>p</i><0.05. Following 4, 12, and 24 weeks of treatment with mepolizumab, residual blood eosinophils shifted towards rEOS-like cells, <i>p</i><0.05, and <i>CLC, EPX, ECP</i>, and <i>MBP</i> gene expression of both eosinophil subtypes decreased to HS levels.</p><p><strong>Conclusion: </strong>Treating SEA patients with mepolizumab shifts blood eosinophil subtype distribution towards rEOS-like cells and reduces granule protein gene expression levels to those of healthy individuals.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"455-466"},"PeriodicalIF":3.7,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772388","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":"Access to Pediatric Asthma Specialty Care: A Survey and Geospatial Analysis Across a Rural State.","authors":"James C Bohnhoff, Dana Schwartz, Anya Cutler, Jill S Halterman","doi":"10.2147/JAA.S511581","DOIUrl":"10.2147/JAA.S511581","url":null,"abstract":"<p><strong>Objective: </strong>Although children with asthma have improved outcomes when accessing asthma specialists (allergist/immunologists and pediatric pulmonologists), this care may not be available if no specialists are located nearby, or if nearby specialists do not accept children or a given child's insurance. We aimed to describe the physical proximity of children to pediatric asthma specialty care in a largely rural state and to assess the degree to which the availability of pediatric specialty asthma care was impacted by provider nonacceptance of pediatric patients and patients with Medicaid insurance.</p><p><strong>Methods: </strong>We conducted a telephone survey of pediatric pulmonology and allergy/immunology practices in the rural state of Maine and adjacent areas during June and July 2024, asking whether they accepted pediatric patients, whether they accepted pediatric patients with Maine Medicaid insurance, and their wait times for new patient appointments. We assessed the association of acceptance policies and clinician specialty (allergy vs pulmonology), training (physician vs advanced practice provider), and state (Maine vs other) using Fisher's exact tests and we calculated the travel time to the nearest provider locations for children across Maine.</p><p><strong>Results: </strong>Among 49 asthma specialists in and around Maine, 41 (84%) accepted pediatric patients. Eighty-nine percent of Maine providers and 6% of out-of-state providers accepted children with Maine Medicaid insurance. The median distance to any asthma specialist was 30.5 minutes (IQR 17.2, 51.0) and 18% of children would need to travel >60 minutes for care.</p><p><strong>Conclusion: </strong>Nearly one in five children in Maine would be required to travel more than 60 minutes to reach an asthma specialist, nearly one in five allergy providers do not accept children, and few out of state providers accept Maine Medicaid insurance. Future research should assess the impacts of these barriers on children's receipt of care.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"447-454"},"PeriodicalIF":3.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719342","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}