Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 604
Filter
1.
Drugs Today (Barc) ; 58(5): 241-247, 2022 May.
Article in English | MEDLINE | ID: covidwho-1833498

ABSTRACT

Outpatient treatment options for mild to moderate COVID-19 are severely limited. While many therapeutic options have been proposed, very few have demonstrated the appropriate safety and efficacy to warrant approval by national or international regulatory bodies. Monoclonal antibodies have been shown to decrease hospitalization in high-risk patients, but use remains limited due to challenges associated with both production and administration, and other treatment options are urgently needed. The anti-inflammatory drug fluticasone propionate has recently emerged as a potential outpatient treatment option, especially for those with newly diagnosed disease. This manuscript reviews what is known about fluticasone and looks ahead to examine how the drug may be used in the future to address the COVID-19 pandemic.


Subject(s)
Anti-Asthmatic Agents , Asthma , COVID-19 , Administration, Inhalation , Androstadienes/adverse effects , Anti-Asthmatic Agents/adverse effects , Asthma/drug therapy , COVID-19/drug therapy , Double-Blind Method , Fluticasone/adverse effects , Humans , Pandemics
2.
Eur Respir J ; 59(3)2022 Mar.
Article in English | MEDLINE | ID: covidwho-1833273

ABSTRACT

BACKGROUND: Individual case series and cohort studies have reported conflicting results in people with asthma on the vulnerability to and risk of mortality from coronavirus disease 2019 (COVID-19). RESEARCH QUESTION: Are people with asthma at a higher risk of being infected or hospitalised or poorer clinical outcomes from COVID-19? METHODS: A systematic review and meta-analysis based on five main databases including the World Health Organization COVID-19 database between 1 December 2019 and 11 July 2021 on studies with a control (non-asthma) group was conducted. Prevalence and risk ratios were pooled using Sidik-Jonkman random-effects meta-analyses. FINDINGS: 51 studies with an 8.08% (95% CI 6.87-9.30%) pooled prevalence of people with asthma among COVID-19 positive cases. The risk ratios were 0.83 (95% CI 0.73-0.95, p=0.01) for acquiring COVID-19; 1.18 (95% CI 0.98-1.42, p=0.08) for hospitalisation; 1.21 (95% CI 0.97-1.51, p=0.09) for intensive care unit (ICU) admission; 1.06 (95% CI 0.82-1.36, p=0.65) for ventilator use; and 0.94 (95% CI 0.76-1.17, p=0.58) for mortality for people with asthma. Subgroup analyses by continent revealed a significant difference in risk of acquiring COVID-19, ICU admission, ventilator use and death between the continents. INTERPRETATION: The risk of being infected with severe acute respiratory syndrome coronavirus 2 was reduced compared to the non-asthma group. No statistically significant differences in hospitalisation, ICU admission and ventilator use were found between groups. Subgroup analyses showed significant differences in outcomes from COVID-19 between America, Europe and Asia. Additional studies are required to confirm this risk profile, particularly in Africa and South America, where few studies originate.


Subject(s)
Asthma , COVID-19 , Asthma/epidemiology , Hospitalization , Humans , Intensive Care Units , SARS-CoV-2
4.
Commun Biol ; 5(1): 415, 2022 May 04.
Article in English | MEDLINE | ID: covidwho-1821623

ABSTRACT

IL-25 is implicated in the pathogenesis of viral asthma exacerbations. However, the effect of IL-25 on antiviral immunity has yet to be elucidated. We observed abundant expression and colocalization of IL-25 and IL-25 receptor at the apical surface of uninfected airway epithelial cells and rhinovirus infection increased IL-25 expression. Analysis of immune transcriptome of rhinovirus-infected differentiated asthmatic bronchial epithelial cells (BECs) treated with an anti-IL-25 monoclonal antibody (LNR125) revealed a re-calibrated response defined by increased type I/III IFN and reduced expression of type-2 immune genes CCL26, IL1RL1 and IL-25 receptor. LNR125 treatment also increased type I/III IFN expression by coronavirus infected BECs. Exogenous IL-25 treatment increased viral load with suppressed innate immunity. In vivo LNR125 treatment reduced IL-25/type 2 cytokine expression and increased IFN-ß expression and reduced lung viral load. We define a new immune-regulatory role for IL-25 that directly inhibits virus induced airway epithelial cell innate anti-viral immunity.


Subject(s)
Asthma , Interleukin-17/immunology , Virus Diseases , Antiviral Agents/pharmacology , Asthma/metabolism , Humans , Immunity, Innate , Rhinovirus
5.
Int J Environ Res Public Health ; 19(6)2022 03 17.
Article in English | MEDLINE | ID: covidwho-1818109

ABSTRACT

BACKGROUND: Exposure to air pollution is associated with acute pediatric asthma exacerbations, including reduced lung function, rescue medication usage, and increased symptoms; however, most studies are limited in investigating longitudinal changes in these acute effects. This study aims to investigate the effects of daily air pollution exposure on acute pediatric asthma exacerbation risk using a repeated-measures design. METHODS: We conducted a panel study of 40 children aged 8-16 years with moderate-to-severe asthma. We deployed the Biomedical REAI-Time Health Evaluation (BREATHE) Kit developed in the Los Angeles PRISMS Center to continuously monitor personal exposure to particulate matter of aerodynamic diameter < 2.5 µm (PM2.5), relative humidity and temperature, geolocation (GPS), and asthma outcomes including lung function, medication use, and symptoms for 14 days. Hourly ambient (PM2.5, nitrogen dioxide (NO2), ozone (O3)) and traffic-related (nitrogen oxides (NOx) and PM2.5) air pollution exposures were modeled based on location. We used mixed-effects models to examine the association of same day and lagged (up to 2 days) exposures with daily changes in % predicted forced expiratory volume in 1 s (FEV1) and % predicted peak expiratory flow (PEF), count of rescue inhaler puffs, and symptoms. RESULTS: Participants were on average 12.0 years old (range: 8.4-16.8) with mean (SD) morning %predicted FEV1 of 67.9% (17.3%) and PEF of 69.1% (18.4%) and 1.4 (3.5) puffs per day of rescue inhaler use. Participants reported chest tightness, wheeze, trouble breathing, and cough symptoms on 36.4%, 17.5%, 32.3%, and 42.9%, respectively (n = 217 person-days). One SD increase in previous day O3 exposure was associated with reduced morning (beta [95% CI]: -4.11 [-6.86, -1.36]), evening (-2.65 [-5.19, -0.10]) and daily average %predicted FEV1 (-3.45 [-6.42, -0.47]). Daily (lag 0) exposure to traffic-related PM2.5 exposure was associated with reduced morning %predicted PEF (-3.97 [-7.69, -0.26]) and greater odds of "feeling scared of trouble breathing" symptom (odds ratio [95% CI]: 1.83 [1.03, 3.24]). Exposure to ambient O3, NOx, and NO was significantly associated with increased rescue inhaler use (rate ratio [95% CI]: O3 1.52 [1.02, 2.27], NOx 1.61 [1.23, 2.11], NO 1.80 [1.37, 2.35]). CONCLUSIONS: We found significant associations of air pollution exposure with lung function, rescue inhaler use, and "feeling scared of trouble breathing." Our study demonstrates the potential of informatics and wearable sensor technologies at collecting highly resolved, contextual, and personal exposure data for understanding acute pediatric asthma triggers.


Subject(s)
Air Pollutants , Air Pollution , Asthma , Ozone , Air Pollutants/adverse effects , Air Pollutants/analysis , Air Pollution/adverse effects , Air Pollution/analysis , Asthma/epidemiology , Child , Environmental Exposure/adverse effects , Environmental Exposure/analysis , Humans , Nitrogen Dioxide , Ozone/analysis , Particulate Matter/adverse effects , Particulate Matter/analysis
6.
Am J Physiol Lung Cell Mol Physiol ; 322(3): L503-L506, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1816806
7.
Eur Rev Med Pharmacol Sci ; 26(7): 2556-2568, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1811976

ABSTRACT

OBJECTIVE: During the coronavirus disease 2019 (COVID-19) pandemic, emergency department utilization and hospitalization rates for allergic diseases declined and the severity of allergies among admitted patients was low. This study aimed to determine the prevalence of allergic diseases among adolescents and the changes in trend during the COVID-19 pandemic compared with those during the preceding 11 years. SUBJECTS AND METHODS: We analyzed data from the nationwide web-based self-report Korea Youth Risk Behavior Survey. From 2009 to 2020, adolescents aged 13-18 years participated in the survey. The survey period was divided into pre-pandemic Periods I (2009-2011), II (2012-2014), III (2015-2017), and IV (2018-2019) and the pandemic period (Period V, 2020). The current prevalence of asthma, allergic rhinitis, atopic dermatitis, allergic morbidity (having at least one of the three conditions) and changes in the prevalence before and during the COVID-19 pandemic were analyzed. RESULTS: Data of 787,043 participants were analyzed after weighting the study population (mean age, 15.1 years; males, 52.3%). The prevalence of asthma, allergic rhinitis, atopic dermatitis, and allergic morbidity was 2.1%, 18.4%, 6.8%, and 23.6%, respectively. The prevalence of allergic morbidity increased between Periods I and IV but declined significantly from Periods IV to V. From Periods I to IV, the prevalence of asthma decreased, the prevalence of allergic rhinitis increased, and the prevalence of atopic dermatitis remained unchanged. During Period V, the prevalence of all three conditions decreased. CONCLUSIONS: It is necessary to update management measures and develop relevant policies in response to the altered prevalence of allergic diseases since the outbreak of COVID-19.


Subject(s)
Asthma , COVID-19 , Dermatitis, Atopic , Rhinitis, Allergic , Adolescent , Asthma/epidemiology , COVID-19/epidemiology , Dermatitis, Atopic/epidemiology , Humans , Male , Pandemics , Prevalence , Republic of Korea/epidemiology , Rhinitis, Allergic/epidemiology
8.
BMJ Open ; 12(4): e060390, 2022 Apr 24.
Article in English | MEDLINE | ID: covidwho-1807418

ABSTRACT

OBJECTIVES: We aimed to investigate the impact of the first and second waves of the COVID-19 pandemic on healthcare service use by non-COVID-19 patients. DESIGN: Retrospective cohort study. SETTING: Hospital-based claims database from anonymised hospitals in Japan. PARTICIPANTS: Patients (n=785 495) who visited and/or were hospitalised in 26 anonymised hospitals in Japan between January 2017 and November 2020. OUTCOME MEASURES: We compared changes in the monthly number of hospitalisations (overall or by diagnosis), outpatient visits, endoscopic fibrescopies (EFs), rehabilitations, outpatient chemotherapy treatments, maintenance haemodialysis treatments and outpatient prescriptions between pre-COVID-19 years and the same period in 2020. RESULTS: The overall number of hospitalisations and outpatient visits decreased by 27% and 22%, respectively, in May 2020, of which the most substantial decrease was observed in the paediatrics department (65% and 51%, respectively). The number of hospitalisations for respiratory diseases, circulatory diseases, malignant neoplasms and digestive diseases decreased by a maximum of 55%, 32%, 10% and 26%, respectively, in 2020. The number of hospitalisations for non-COVID-19 pneumonia in patients aged <16 years, patients aged ≥16 years and patients with asthma decreased by 93%, 43% and 80%, respectively, in May 2020. EFs and outpatient rehabilitations decreased by >30%. In contrast, outpatient chemotherapy and maintenance haemodialysis treatments decreased by <10%, if at all. Outpatient prescriptions decreased by a maximum of 20% in 2020, with the largest decrease observed in drugs for obstructive airway diseases and cough and cold preparations. CONCLUSIONS: The use of healthcare services by non-COVID-19 patients was most affected during the first wave of the COVID-19 pandemic in May 2020. The number of hospitalisations for respiratory diseases, particularly non-COVID-19 pneumonia and asthma, drastically decreased, while the number of hospitalisations and outpatient chemotherapies for malignant neoplasms or maintenance haemodialysis was less affected.


Subject(s)
Asthma , COVID-19 , COVID-19/epidemiology , Child , Delivery of Health Care , Humans , Japan/epidemiology , Pandemics , Retrospective Studies , SARS-CoV-2
9.
WMJ ; 121(1): 54-57, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1801492

ABSTRACT

BACKGROUND: Public health measures combatting the COVID-19 pandemic also led to a decrease in other pediatric respiratory illnesses. We describe the local pattern of pediatric respiratory hospitalizations in southeast Wisconsin prior to COVID-19 and during the first year of the pandemic. METHODS: We performed a cross-sectional examination of hospitalizations for asthma, bronchiolitis, and bacterial pneumonia at a single tertiary children's hospital prior to COVID-19 through the first year of the COVID-19 pandemic. RESULTS: We found a significant decrease in the average monthly hospitalization rates prior to and during COVID-19 for asthma, bronchiolitis, and bacterial pneumonia (P < 0.001), with average percent decrease of hospitalizations per month of 48%, 78%, and 47.7%, respectively. CONCLUSIONS: The decrease in hospitalizations is likely multifactorial and related to public health measures, behavior changes, and other epidemiological factors.


Subject(s)
Asthma , Bronchiolitis , COVID-19 , Asthma/epidemiology , Bronchiolitis/epidemiology , COVID-19/epidemiology , Child , Cross-Sectional Studies , Hospitalization , Humans , Pandemics , Wisconsin/epidemiology
10.
Ther Adv Respir Dis ; 16: 17534666221091183, 2022.
Article in English | MEDLINE | ID: covidwho-1794079

ABSTRACT

BACKGROUND: Severe asthma increases the risk of severe COVID-19 outcomes such as hospitalization and death. However, more studies are needed to understand the association between asthma and severe COVID-19. METHODS: A cohort of 150,430 adult asthma patients were identified in the Swedish National Airway Register (SNAR) from 2013 to December 2020. Data on body mass index, smoking habits, lung function, and asthma control test (ACT) were obtained from SNAR, and uncontrolled asthma was defined as ACT ⩽19. Patients with severe COVID-19 were identified following hospitalization or in death certificates based on ICD-10 codes U07.1 and U07.2. The Swedish Prescribed Drug register was used to identify comorbidities and data from Statistics Sweden for educational level. Multivariate logistic regression analyses were used to estimate associations with severe COVID-19. RESULTS: Severe COVID-19 was identified in 1067 patients (0.7%). Older age (OR = 1.04, 95% CI = 1.03-1.04), male sex (1.42, 1.25-1.61), overweight (1.56, 1.27-1.91), obesity (2.12, 1.73-2.60), high-dose inhaled corticosteroids in combination with long-acting ß-agonists (1.40, 1.22-1.60), dispensed oral corticosteroids ⩾2 (1.48, 1.25-1.75), uncontrolled asthma (1.64, 1.35-2.00), cardiovascular disease (1.20, 1.03-1.40), depression (1.47, 1.28-1.68), and diabetes (1.52, 1.29-1.78) were associated with severe COVID-19, while current smoking was inversely associated (0.63, 0.47-0.85). When comparing patients who died from COVID-19 with those discharged alive from hospital until 31 December 2020, older age, male sex, and current smoking were associated with COVID-19 death. CONCLUSION: Patients with uncontrolled asthma and high disease burden, including increased asthma medication intensity, should be identified as risk patients for severe COVID-19. Furthermore, current smoking is strongly associated with COVID-19 death in asthma.


Subject(s)
Asthma , COVID-19 , Adrenal Cortex Hormones/therapeutic use , Adult , Asthma/complications , Asthma/drug therapy , Asthma/epidemiology , Hospitalization , Humans , Male , Sweden/epidemiology
11.
Br J Pharmacol ; 179(10): 2208-2222, 2022 May.
Article in English | MEDLINE | ID: covidwho-1794736

ABSTRACT

BACKGROUND AND PURPOSE: Despite the availability of a variety of treatment options, many asthma patients have poorly controlled disease with frequent exacerbations. Proteinase-activated receptor-2 (PAR2) has been identified in preclinical animal models as important to asthma initiation and progression following allergen exposure. Proteinase activation of PAR2 raises intracellular Ca2+ , inducing MAPK and ß-arrestin signalling in the airway, leading to inflammatory and protective effects. We have developed C391, a potent PAR2 antagonist effective in blocking peptidomimetic- and trypsin-induced PAR2 signalling in vitro as well as reducing inflammatory PAR2-associated pain in vivo. We hypothesized that PAR2 antagonism by C391 would attenuate allergen-induced acutely expressed asthma indicators in murine models. EXPERIMENTAL APPROACH: We evaluated the ability of C391 to alter Alternaria alternata-induced PAR2 signalling pathways in vitro using a human airway epithelial cell line that naturally expresses PAR2 (16HBE14o-) and a transfected embryonic cell line (HEK 293). We next evaluated the ability for C391 to reduce A. alternata-induced acutely expressed asthma indicators in vivo in two murine strains. KEY RESULTS: C391 blocked A. alternata-induced, PAR2-dependent Ca2+ and MAPK signalling in 16HBE14o- cells, as well as ß-arrestin recruitment in HEK 293 cells. C391 effectively attenuated A. alternata-induced inflammation, mucus production, mucus cell hyperplasia and airway hyperresponsiveness in acute allergen-challenged murine models. CONCLUSIONS AND IMPLICATIONS: To our best knowledge, this is the first demonstration of pharmacological intervention of PAR2 to reduce allergen-induced asthma indicators in vivo. These data support further development of PAR2 antagonists as potential first-in-class allergic asthma drugs.


Subject(s)
Asthma , Receptor, PAR-2 , Allergens , Alternaria/metabolism , Animals , Asthma/drug therapy , Asthma/metabolism , HEK293 Cells , Humans , Mice
12.
PLoS One ; 16(11): e0260416, 2021.
Article in English | MEDLINE | ID: covidwho-1793553

ABSTRACT

This study determined the association between respiratory symptoms and death from respiratory causes over a period of 45 years. In four cohorts of random samples of Norwegian populations with 103,881 participants, 43,731 persons had died per 31 December 2016. In total, 5,949 (14%) had died from respiratory diseases; 2,442 (41%) from lung cancer, 1,717 (29%) chronic obstructive pulmonary disease (COPD), 1,348 (23%) pneumonia, 119 (2%) asthma, 147 (2%) interstitial lung disease and 176 (3%) other pulmonary diseases. Compared with persons without respiratory symptoms the multivariable adjusted hazard ratio (HR) for lung cancer deaths increased with score of breathlessness on effort and cough and phlegm, being 2.6 (95% CI 2.1-3.2) for breathlessness score 3 and 2.1 (95% CI 1.7-2.5) for cough and phlegm score 5. The HR of COPD death was 6.4 (95% CI 5.4-7.7) for breathlessness score 3 and 3.0 (2.4-3.6) for cough and phlegm score 5. Attacks of breathlessness and wheeze score 2 had a HR of 1.6 (1.4-1.9) for COPD death. The risk of pneumonia deaths increased also with higher breathlessness on effort score, but not with higher cough and phlegm score, except for score 2 with HR 1.5 (1.2-1.8). In this study with >2.4 million person-years at risk, a positive association was observed between scores of respiratory symptoms and deaths due to COPD and lung cancer. Respiratory symptoms are thus important risk factors, which should be followed thoroughly by health care practitioners for the benefit of public health.


Subject(s)
Lung Diseases/diagnosis , Respiration Disorders/diagnosis , Adolescent , Adult , Asthma/diagnosis , Asthma/epidemiology , Cohort Studies , Cough/diagnosis , Cough/epidemiology , Dyspnea/epidemiology , Female , Forced Expiratory Volume , Humans , Lung Diseases/epidemiology , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Male , Middle Aged , Norway/epidemiology , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Respiration Disorders/epidemiology , Respiratory Sounds , Risk Factors , Young Adult
13.
Environ Pollut ; 303: 119134, 2022 Jun 15.
Article in English | MEDLINE | ID: covidwho-1788062

ABSTRACT

It is undeniable that exposure to outdoor air pollution impacts the health of populations and therefore constitutes a public health problem. Any actions or events causing variations in air quality have repercussions on populations' health. Faced with the worldwide COVID-19 health crisis that began at the end of 2019, the governments of several countries were forced, in the beginning of 2020, to put in place very strict containment measures that could have led to changes in air quality. While many works in the literature have studied the issue of changes in the levels of air pollutants during the confinements in different countries, very few have focused on the impact of these changes on health risks. In this work, we compare the 2020 period, which includes two lockdowns (March 16 - May 10 and a partial shutdown Oct. 30 - Dec. 15) to a reference period 2015-2019 to determine how these government-mandated lockdowns affected concentrations of NO2, O3, PM2.5, and PM10, and how that affected human health factors, including low birth weight, lung cancer, mortality, asthma, non-accidental mortality, respiratory, and cardiovascular illnesses. To this end, we structured 2020 into four periods, alternating phases of freedom and lockdowns characterized by a stringency index. For each period, we calculated (1) the differences in pollutant levels between 2020 and a reference period (2015-2019) at both background and traffic stations; and (2) the resulting variations in the epidemiological based relative risks of health outcomes. As a result, we found that relative changes in pollutant levels during the 2020 restriction period were as follows: NO2 (-32%), PM2.5 (-22%), PM10 (-15%), and O3 (+10.6%). The pollutants associated with the highest health risk reductions in 2020 were PM2.5 and NO2, while PM10 and O3 changes had almost no effect on health outcomes. Reductions in short-term risks were related to reductions in PM2.5 (-3.2% in child emergency room visits for asthma during the second lockdown) and NO2 (-1.5% in hospitalizations for respiratory causes). Long-term risk reductions related to PM2.5 were low birth weight (-8%), mortality (-3.3%), and lung cancer (-2%), and to NO2 for mortality (-0.96%). Overall, our findings indicate that the confinement period in 2020 resulted in a substantial improvement in air quality in the Grenoble area.


Subject(s)
Air Pollutants , Air Pollution , Asthma , COVID-19 , Lung Neoplasms , Air Pollutants/analysis , Air Pollution/analysis , Child , Communicable Disease Control , Environmental Monitoring , Humans , Nitrogen Dioxide , Particulate Matter/analysis
14.
BMC Pediatr ; 22(1): 195, 2022 04 11.
Article in English | MEDLINE | ID: covidwho-1785147

ABSTRACT

BACKGROUND: Literature on factors influencing medication adherence within paediatric clinical trials is sparse. The Paracetamol and Ibuprofen in the Primary Prevention of Asthma in Tamariki (PIPPA Tamariki) trial is an open-label, randomised controlled trial aiming to determine whether paracetamol treatment, compared with ibuprofen treatment, as required for fever and pain in the first year of life, increases the risk of asthma at age six years. To inform strategies for reducing trial medication crossovers, understanding factors influencing the observed ibuprofen-to-paracetamol crossovers (non-protocol adherence) is vital. The aim of this study was to investigate the factors influencing the decision-making process when administering or prescribing ibuprofen to infants that may contribute to the crossover events in the PIPPA Tamariki trial. METHODS: Constructivist grounded theory methods were employed. We conducted semi-structured interviews of caregivers of enrolled PIPPA Tamariki infants and healthcare professionals in various healthcare settings. Increasing theoretical sensitivity of the interviewers led to theoretical sampling of participants who could expand on the teams' early constructed codes. Transcribed interviews were coded and analysed using the constant comparative method of concurrent data collection and analysis. RESULTS: Between September and December 2020, 20 participants (12 caregivers; 8 healthcare professionals) were interviewed. We constructed a grounded theory of prioritising infant welfare that represents a basic social process when caregivers and healthcare professionals medicate feverish infants. This process comprises three categories: historical, trusting relationships and being discerning; and is modified by one condition: being conflicted. Participants bring with them historical ideas. Trusting relationships with researchers, treating clinicians and family play a central role in enabling participants to challenge historical ideas and be discerning. Trial medication crossovers occur when participants become conflicted, and they revert to historical practices that feel familiar and safer. CONCLUSIONS: We identified factors and a basic social process influencing ibuprofen use in infants and trial medication crossover events, which can inform strategies for promoting adherence in the PIPPA Tamariki trial. Future studies should explore the role of trusting relationships between researchers and treating clinicians when conducting research.


Subject(s)
Asthma , Ibuprofen , Acetaminophen/therapeutic use , Asthma/drug therapy , Fever/drug therapy , Grounded Theory , Humans , Ibuprofen/therapeutic use , Infant , Infant Welfare
15.
Front Immunol ; 13: 705379, 2022.
Article in English | MEDLINE | ID: covidwho-1779938

ABSTRACT

Objectives: Recent studies suggest that asthma may have a protective effect on COVID-19.We aimed to investigate the causality between asthma and two COVID-19 outcomes and explore the mechanisms underlining this connection. Methods: Summary results of GWAS were used for the analyses, including asthma (88,486 cases and 447,859 controls), COVID-19 hospitalization (6,406 hospitalized COVID-19 cases and 902,088 controls), and COVID-19 infection (14,134 COVID-19 cases and 1,284,876 controls). The Mendelian randomization (MR) analysis was performed to evaluate the causal effects of asthma on the two COVID-19 outcomes. A cross-trait meta-analysis was conducted to analyze genetic variants within two loci shared by COVID-19 hospitalization and asthma. Results: Asthma is associated with decreased risk both for COVID-19 hospitalization (odds ratio (OR): 0.70, 95% confidence interval (CI): 0.70-0.99) and for COVID-19 infection (OR: 0.83, 95%CI: 0.51-0.95). Asthma and COVID-19 share two genome-wide significant genes, including ABO at the 9q34.2 region and OAS2 at the 12q24.13 region. The meta-analysis revealed that ABO and ATXN2 contain variants with pleiotropic effects on both COVID-19 and asthma. Conclusion: In conclusion, our results suggest that genetic liability to asthma is associated with decreased susceptibility to SARS-CoV-2 and to severe COVID-19 disease, which may be due to the protective effects of ongoing inflammation and, possibly, related compensatory responses against COVID-19 in its early stage.


Subject(s)
Asthma , COVID-19 , Asthma/epidemiology , Asthma/genetics , COVID-19/genetics , Genome-Wide Association Study , Humans , Mendelian Randomization Analysis , SARS-CoV-2
16.
PLoS One ; 16(12): e0261333, 2021.
Article in English | MEDLINE | ID: covidwho-1779728

ABSTRACT

Allergic airway disease is the most common chronic airway inflammatory disorder in developed countries. House dust mite, cockroach, and mold are the leading allergens in most tropical and subtropical countries, including Taiwan. As allergen avoidance is difficult for patients allergic to these perennial indoor allergens, allergen-specific immunotherapy (ASIT) is the only available allergen-specific and disease-modifying treatment. However, for patients sensitized to multiple allergens, ASIT using each corresponding allergen is cumbersome. In the present study, we developed a recombinant L. lactis vaccine against the three most common indoor aeroallergens and investigated its effectiveness for preventing respiratory allergy and safety in mice. Three recombinant clones of Der p 2 (mite), Per a 2 (roach), and Cla c 14 (mold) were constructed individually in pNZ8149 vector and then electroporated into host strain L.lactis NZ3900. BALB/c mice were fed with the triple vaccine 5 times per week for 4 weeks prior to sensitization. The effectiveness and safety profile were then determined. Oral administration of the triple vaccine significantly alleviated allergen-induced airway hyper-responsiveness in the vaccinated mice. The allergen-specific IgG2a was upregulated. IL-4 and IL-13 mRNA expressions as well as inflammatory cell infiltration in the lungs decreased significantly in the vaccinated groups. No body weight loss or abnormal findings in the liver and kidneys were found in any of the groups of mice. This is the first report to describe a triple-aeroallergen vaccine using a food-grade lactococcal expression system. We developed a convenient oral delivery system and intend to extend this research to develop a vaccination that can be self-administered at home by patients.


Subject(s)
Allergens/chemistry , Asthma/immunology , Desensitization, Immunologic/methods , Hypersensitivity/metabolism , Lactococcus lactis , Vaccines , Animals , Antigens, Dermatophagoides/chemistry , Antigens, Dermatophagoides/immunology , Arthropod Proteins/chemistry , Electroporation , Female , Fermentation , Insect Proteins , Mice , Mice, Inbred BALB C , Pyroglyphidae/immunology , Respiratory Hypersensitivity/prevention & control
17.
Pediatr Allergy Immunol ; 33 Suppl 27: 38-40, 2022 01.
Article in English | MEDLINE | ID: covidwho-1779268

ABSTRACT

Airborne particulate (PM) components from fossil fuel combustion can induce oxidative stress initiated by reactive oxygen species (ROS) that are strongly correlated with airway inflammation and asthma. A valid biomarker of airway inflammation is fractionated exhaled nitric oxide (FENO). The oxidative potential of PM2.5 can be evaluated with the dithiothreitol (DTT) dosage, which represents both ROS chemically produced and intracellular ROS of macrophages. This correlates with quality indicators of the internal environment and ventilation strategies such as dilution and removal of airborne contaminants.


Subject(s)
Air Pollutants , Air Pollution , Asthma , Air Pollutants/analysis , Air Pollutants/toxicity , Air Pollution/statistics & numerical data , Exhalation , Humans , Oxidative Stress , Particulate Matter/toxicity
18.
J Glob Health ; 12: 04023, 2022.
Article in English | MEDLINE | ID: covidwho-1776559

ABSTRACT

Background: Asthma was one of the top causes of hospitalization and unscheduled medical attendances due to acute exacerbations and its complications. In Malaysia, all pilgrims must undergo a mandatory health examination and certified fit to perform pilgrimage. We studied the current organisational and clinical routines of Hajj health examination in Malaysia with a focus on the delivery of care for pilgrims with asthma. Methods: We conducted non-participant observation to obtain ethnographic understanding of Hajj health examination activities for 2019. Observations were guided by a checklist and recorded as notes that were analysed thematically. The study was conducted at 11 public (from each region in Malaysia, namely, North, South, East, West of Peninsular Malaysia, and Sabah and Sarawak of East Malaysia) and two private primary care clinics. Results: We observed considerable variation in the implementation and practice of Hajj health examinations among the 11 public clinics but no marked variation among the private clinics. The short time span of between three to four months was inadequate for disease control measures and had put pressure on health care providers. They mostly viewed the Hajj health examination as merely a certification of fitness to perform the pilgrimage, though respiratory health assessment was often inadequate. The opportunity to optimise the health of pilgrims with asthma by providing the appropriate medications, asthma action plan and asthma education including the preventive measures was disregarded. The preliminary health screening, which aimed to optimise pilgrims' health before the actual Hajj health examination was not appreciated by either pilgrims or health care providers. Conclusions: There is great potential to reform the current system of Hajj health certification in order to optimise its potential benefits for pilgrims with asthma. A systematic approach to restructuring the delivery of Hajj health examination could address the time constraints, clinical competency of primary health care providers and resources limitations.


Subject(s)
Asthma , Travel , Asthma/diagnosis , Humans , Islam , Malaysia
19.
Zhonghua Jie He He Hu Xi Za Zhi ; 45(4): 341-354, 2022 Apr 12.
Article in Chinese | MEDLINE | ID: covidwho-1776389

ABSTRACT

As the first targeted biotherapy for asthma, Omalizumab, was officially approved in China in August 2017, and was applied in clinical practice since March, 2018. Dozens of experts in Respirology and Allergy from China fully discussed the important clinical issues on the use of Omalizumab in allergic asthma by referring to the relevant publications over the world and the first version of consensus published in March 2018. Until now, over 30, 000 allergic asthma patients have received the treatment of Omalizumab. Therefore, with the latest evidence of clinical and basic research around the world, we updated the consensus with the following issues: (1) The mechanisms and available evidence on anti-IgE treatment; (2) Selection and exclusion criteria for patients using Omalizumab; (3) Cautions on the administration of Omalizumab and highlights of the use of Omalizumab with various vaccines, including novel Coronavirus vaccines, and key points to note during a Novel Coronavirus pandemic; (4) Long-term use and safety; (5) The use of Omalizumab in specific populations; (6) Clinical applications of omalizumab with other targeted therapies and allergen-specific immunotherapy. Omalizumab, combining to the Cε3 area of IgE, reduces the free IgE level, and downregulates the expression of FcεRⅠ, which inhibits the release of inflammatory mediators of mast cell sources, and leads to reduced asthma exacerbation, decreased rate of emergency visit and hospitalization, improved symptoms and quality of life, as well as less concomitant moderate to severe asthma, poorly controlled after at least 3 months treatment of ICS/LABA, and confirmed with allergic status through skin prick test or serum total IgE or specific IgE. Conditions that exclude the use of Omalizumab include patients who are suspected to be allergic to drug ingredients. Omalizumab is administered based on dosing tables by subcutaneous injection. Omalizumab should be administered by a health care professional (doctor or nurse) in a medical institution equipped with facilities for post-injection observation and rescue treatment for anaphylactic shock. After the injection, the patient should be closely monitored whether there is an anaphylactic reaction. The duration of Omalizumab treatment should be at least 16 weeks to judge its effectiveness, after 16 weeks, Omalizumab treatment will be continued or withdrawn based on the overall asthma control evaluation. Patients should be followed every 3 months to assess the disease control and dosing adjustment. The common adverse reactions were injection sites reactions. Based on the latest evidence around the word, we focused on updating the relevant treatment course, administration method and use of specific populations, in order to guide clinicians in the use of Omalizumab. The use of Omalizumab in China still requires long-term observation and further research. With the increase of clinical evidence, this consensus will be continuously improved and supplemented.


Subject(s)
Anti-Asthmatic Agents , Asthma , COVID-19 , Anti-Asthmatic Agents/therapeutic use , Antibodies, Monoclonal/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Asthma/drug therapy , Consensus , Humans , Omalizumab/therapeutic use , Quality of Life
20.
Medicina (Kaunas) ; 58(4)2022 Apr 05.
Article in English | MEDLINE | ID: covidwho-1776287

ABSTRACT

The coronaviruses belong to the Coronaviridae family, and one such member, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is causing significant destruction around the world in the form of a global pandemic. Although vaccines have been developed, their effectiveness and level of protection is still a major concern, even after emergency approval from the World Health Organisation (WHO). At the community level, no natural medicine is currently available as a cure. In this study, we screened the vast library from Drug Bank and identified Hemi-Babim and Fenoterol as agents that can work against SARS-CoV-2. Furthermore, we performed molecular dynamics (MD) simulation for both compounds with their respective proteins, providing evidence that the said drugs can work against the MPro and papain-like protease, which are the main drug targets. Inhibiting the action of these targets may lead to retaining the virus. Fenoterol is a beta-2 adrenergic agonist used for the symptomatic treatment of asthma as a bronchodilator and tocolytic. In this study, Hemi-Babim and Fenoterol showed good docking scores of -7.09 and -7.14, respectively, and performed well in molecular dynamics simulation studies. Re-purposing the above medications has huge potential, as their effects are already well-proven and under public utilisation for asthma-related problems. Hence, after the comprehensive pipeline of molecular docking, MMGBSA, and MD simulation studies, these drugs can be tested in-vivo for further human utilisation.


Subject(s)
Asthma , COVID-19 , COVID-19/drug therapy , Fenoterol/pharmacology , Fenoterol/therapeutic use , Humans , Molecular Docking Simulation , Papain , Peptide Hydrolases , Protease Inhibitors/metabolism , Protease Inhibitors/pharmacology , SARS-CoV-2
SELECTION OF CITATIONS
SEARCH DETAIL