Journal of Clinical Medicine

Research

11 pages, 293 KiB

Open AccessFeature PaperArticle

Does Asthma Disrupt Psychological Wellbeing in Pregnancy?

by Paola C. Fernández-Paredes, Eva Morales, Concepción Lopez-Soler, Luis Garcia-Marcos and on behalf of the NELA Study Group

J. Clin. Med. 2023, 12(19), 6335; https://doi.org/10.3390/jcm12196335 - 2 Oct 2023

Cited by 2 | Viewed by 1301

Abstract

(1) Background: Asthma is a very prevalent disease with special characteristics during pregnancy, however, little is known about its relationship to the psychological wellbeing of women in this period; we aimed to know whether depression and anxiety symptoms are more frequent in asthmatic [...] Read more.

(1) Background: Asthma is a very prevalent disease with special characteristics during pregnancy, however, little is known about its relationship to the psychological wellbeing of women in this period; we aimed to know whether depression and anxiety symptoms are more frequent in asthmatic pregnant women. (2) Methods: Family Apgar (week 20), Edinburgh Postnatal Depression Scale (weeks 20 and 32) and State-Trait Anxiety Inventory (STAI) (week 32) tests were administered to 738 pregnant women (81 asthmatics) in the Nutrition in Early Life and Asthma (NELA) birth cohort. (3) Results: There were no significant differences between asthmatic and non-asthmatic pregnant women in any of the different tests at any of the time points. The mean scores for the different tests and timepoints between asthmatic and non-asthmatic pregnant women were: Apgar 20, 17.9 ± 2.2 vs. 10.0 ± 2.2; Edinburgh 20, 6.7 ± 4.2 vs. 6.9 ± 4.3; Edinburgh 32, 5.9 ± 4.4 vs. 5.6 ± 4.3; and STAI 32, 16.7 ± 8.4 vs. 15.8 ± 8.3. The proportion of pregnant women out of the normal range score for any of the tests and time points was also similar in both populations. (4) Conclusions: asthma is not associated with the psychological wellbeing of pregnant women. Full article

(This article belongs to the Special Issue Asthma and Allergic Inflammation: Risks, Mechanisms, and New Treatments: Part II)

Review

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16 pages, 1456 KiB

Open AccessReview

On-Demand ICS + FABA Combinations in 6–11-Year-Old Children

by Elsy M. Navarrete-Rodríguez, Blanca E. Del-Rio-Navarro, Désirée Larenas-Linnemann and Jose A. Castro-Rodriguez

J. Clin. Med. 2023, 12(23), 7270; https://doi.org/10.3390/jcm12237270 - 23 Nov 2023

Cited by 1 | Viewed by 1583

Abstract

In recent years, some new concepts have been added to asthma treatment such as “anti-inflammatory reliever” (β2-agonist use associated to an inhaled corticosteroid (ICS) as a reliever treatment) that combines the benefits of both therapies and provides short- and long-term benefits for treatment [...] Read more.

In recent years, some new concepts have been added to asthma treatment such as “anti-inflammatory reliever” (β2-agonist use associated to an inhaled corticosteroid (ICS) as a reliever treatment) that combines the benefits of both therapies and provides short- and long-term benefits for treatment in asthma patients. Robust evidence has been presented in patients over 12 years, and the main changes in the international guidelines for asthma treatment were originally made in this age group. However, a few suggestions have been added to treatments in younger patients, in part because of the scarce evidence that exists in this group. We aim to analyze the information regarding the utilization of ICS + fast-acting beta-agonist (FABA) combination in children between 6 and 11 years. Although up until today only three published trials exist (two studies use beclomethasone + albuterol and one study uses budesonide + formoterol), they provide significant information on the benefits of ICS + FABA use in this population. Full article

(This article belongs to the Special Issue Asthma and Allergic Inflammation: Risks, Mechanisms, and New Treatments: Part II)

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21 pages, 921 KiB

Open AccessReview

Asthma Phenotypes in the Era of Personalized Medicine

by Victor Gonzalez-Uribe, Sergio J. Romero-Tapia and Jose A. Castro-Rodriguez

J. Clin. Med. 2023, 12(19), 6207; https://doi.org/10.3390/jcm12196207 - 26 Sep 2023

Cited by 4 | Viewed by 3836

Abstract

Asthma is a widespread disease affecting approximately 300-million people globally. This condition leads to significant morbidity, mortality, and economic strain worldwide. Recent clinical and laboratory research advancements have illuminated the immunological factors contributing to asthma. As of now, asthma is understood to be [...] Read more.

Asthma is a widespread disease affecting approximately 300-million people globally. This condition leads to significant morbidity, mortality, and economic strain worldwide. Recent clinical and laboratory research advancements have illuminated the immunological factors contributing to asthma. As of now, asthma is understood to be a heterogeneous disease. Personalized medicine involves categorizing asthma by its endotypes, linking observable characteristics to specific immunological mechanisms. Identifying these endotypic mechanisms is paramount in accurately profiling patients and tailoring therapeutic approaches using innovative biological agents targeting distinct immune pathways. This article presents a synopsis of the key immunological mechanisms implicated in the pathogenesis and manifestation of the disease’s phenotypic traits and individualized treatments for severe asthma subtypes. Full article

(This article belongs to the Special Issue Asthma and Allergic Inflammation: Risks, Mechanisms, and New Treatments: Part II)

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18 pages, 340 KiB

Open AccessReview

Dissecting Airborne Allergens

by Javier Torres-Borrego and Manuel Sánchez-Solís

J. Clin. Med. 2023, 12(18), 5856; https://doi.org/10.3390/jcm12185856 - 8 Sep 2023

Cited by 3 | Viewed by 1818

Abstract

Asthma is a heterogeneous and very complex group of diseases, and includes different clinical phenotypes depending on symptoms, progression, exacerbation patterns, or responses to treatment, among other characteristics. The allergic phenotype is the most frequent, especially in pediatric asthma. It is characterized by [...] Read more.

Asthma is a heterogeneous and very complex group of diseases, and includes different clinical phenotypes depending on symptoms, progression, exacerbation patterns, or responses to treatment, among other characteristics. The allergic phenotype is the most frequent, especially in pediatric asthma. It is characterized by sensitization (the production of specific IgEs) to allergens and frequent comorbidity with rhinitis as well as atopic dermatitis. Given the complexity of allergic asthma, knowledge of it must be approached from different points of view: clinical, histological, physiological, epidemiological, biochemical, and immunological, among others. Since partial approaches do not allow for the understanding of this complexity, it is necessary to have multidimensional knowledge that helps in performing the optimal management of each case, avoiding a “blind men and elephant parable” approach. Allergens are antigens that trigger the production of specific IgE antibodies in susceptible individuals, who present symptoms that will depend on the type and intensity of the allergenic load as well as the tissue where the interaction occurs. Airborne allergens cause their effects in the respiratory tract and eyes, and can be indoor or outdoor, perennial, or seasonal. Although allergens such as mites, pollens, or animal dander are generally considered single particles, it is important to note that they contain different molecules which could trigger distinct specific IgE molecules in different patients. General practitioners, pediatricians, and other physicians typically diagnose and treat asthma based on clinical and pulmonary function data in their daily practice. This nonsystematic and nonexhaustive revision aims to update other topics, especially those focused on airborne allergens, helping the diagnostic and therapeutic processes of allergic asthma and rhinitis. Full article

(This article belongs to the Special Issue Asthma and Allergic Inflammation: Risks, Mechanisms, and New Treatments: Part II)

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Graphical abstract

22 pages, 400 KiB

Open AccessReview

Early Prediction of Asthma

by Sergio de Jesus Romero-Tapia, José Raúl Becerril-Negrete, Jose A. Castro-Rodriguez and Blanca E. Del-Río-Navarro

J. Clin. Med. 2023, 12(16), 5404; https://doi.org/10.3390/jcm12165404 - 20 Aug 2023

Cited by 3 | Viewed by 2218

Abstract

The clinical manifestations of asthma in children are highly variable, are associated with different molecular and cellular mechanisms, and are characterized by common symptoms that may diversify in frequency and intensity throughout life. It is a disease that generally begins in the first [...] Read more.

The clinical manifestations of asthma in children are highly variable, are associated with different molecular and cellular mechanisms, and are characterized by common symptoms that may diversify in frequency and intensity throughout life. It is a disease that generally begins in the first five years of life, and it is essential to promptly identify patients at high risk of developing asthma by using different prediction models. The aim of this review regarding the early prediction of asthma is to summarize predictive factors for the course of asthma, including lung function, allergic comorbidity, and relevant data from the patient’s medical history, among other factors. This review also highlights the epigenetic factors that are involved, such as DNA methylation and asthma risk, microRNA expression, and histone modification. The different tools that have been developed in recent years for use in asthma prediction, including machine learning approaches, are presented and compared. In this review, emphasis is placed on molecular mechanisms and biomarkers that can be used as predictors of asthma in children. Full article

(This article belongs to the Special Issue Asthma and Allergic Inflammation: Risks, Mechanisms, and New Treatments: Part II)

16 pages, 766 KiB

Open AccessReview

Are Babies Born Preterm High-Risk Asthma Candidates?

by Carlo Caffarelli, Serena Gracci, Giuliana Giannì and Roberto Bernardini

J. Clin. Med. 2023, 12(16), 5400; https://doi.org/10.3390/jcm12165400 - 19 Aug 2023

Cited by 2 | Viewed by 2707

Abstract

Among preterm infants, the risk of developing asthma is a matter of debate. This review discusses the state of the art of poorly understood prematurity-associated asthma. Impaired pulmonary function is common in children born prematurely. Preterm infants are prone to developing viral respiratory [...] Read more.

Among preterm infants, the risk of developing asthma is a matter of debate. This review discusses the state of the art of poorly understood prematurity-associated asthma. Impaired pulmonary function is common in children born prematurely. Preterm infants are prone to developing viral respiratory tract infections, bronchiolitis in the first year of life, and recurrent viral wheezing in preschool age. All of these conditions may precede asthma development. We also discuss the role of both atopic sensitization and intestinal microbiome and, consequently, immune maturation. Diet and pollution have been considered to better understand how prematurity could be associated with asthma. Understanding the effect of factors involved in asthma onset may pave the way to improve the prediction of this asthma phenotype. Full article

(This article belongs to the Special Issue Asthma and Allergic Inflammation: Risks, Mechanisms, and New Treatments: Part II)

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13 pages, 1005 KiB

Open AccessReview

Effect of Obesity on Lung Function in the Pediatric and Adult Populations with Asthma: A Review

by Nayely Reyes Noriega, Blanca E. Del-Río-Navarro, Arturo Berber, Sergio de Jesús Romero Tapia and Darío Jorge Mario Molina Díaz

J. Clin. Med. 2023, 12(16), 5385; https://doi.org/10.3390/jcm12165385 - 19 Aug 2023

Cited by 4 | Viewed by 2315

Abstract

Obesity and asthma are major global health concerns, particularly in industrialized nations. Obesity has been shown to have detrimental effects on the respiratory system and lung function owing to metabolic issues and immunological consequences. Research has indicated that obese patients with asthma (atopic [...] Read more.

Obesity and asthma are major global health concerns, particularly in industrialized nations. Obesity has been shown to have detrimental effects on the respiratory system and lung function owing to metabolic issues and immunological consequences. Research has indicated that obese patients with asthma (atopic or T2-high and non-atopic or T2-low) have diminished lung function in terms of functional residual capacity (FRC), residual volume (RV), expiratory reserve volume (ERV), the FEV1/FVC ratio, and FEF 25–75% due to mechanical fat loading on the diaphragm and central adiposity when compared to non-obese asthmatic patients. Therefore, it is plausible that changes in lung function are the result of a combination of mechanical (fat loading on the diaphragm, central adiposity, bronchial hyper-reactivity, and an increase in cholinergic tone), environmental (diet and exercise), and inflammatory factors (local and systemic), which can lead to the obesity-related asthma phenotype characterized by severe asthma symptoms, poor response to corticosteroid treatment, loss of lung function, and poor quality of life from an early age. Full article

(This article belongs to the Special Issue Asthma and Allergic Inflammation: Risks, Mechanisms, and New Treatments: Part II)

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Other

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11 pages, 408 KiB

Open AccessSystematic Review

The Association between CFTR Gene Mutation Heterozygosity and Asthma Development: A Systematic Review

by Despoina Koumpagioti, Dafni Moriki, Barbara Boutopoulou, Vasiliki Matziou, Ioanna Loukou, Kostas N. Priftis and Konstantinos Douros

J. Clin. Med. 2023, 12(6), 2403; https://doi.org/10.3390/jcm12062403 - 21 Mar 2023

Cited by 2 | Viewed by 3133

Abstract

Asthma is caused by complex interactions between environmental and genetic factors. Various genes have been implicated as potential risk factors in the development of asthma; among them is cystic fibrosis transmembrane conductance regulator (CFTR) gene. The aim of this systematic review was to [...] Read more.

Asthma is caused by complex interactions between environmental and genetic factors. Various genes have been implicated as potential risk factors in the development of asthma; among them is cystic fibrosis transmembrane conductance regulator (CFTR) gene. The aim of this systematic review was to investigate the association of CFTR mutation heterozygosity with the development of asthma, by updating the existing data with recent studies’ findings. Therefore, a systematic review of the literature was conducted on Pubmed, ESBCO (Cinahl) and Scopus Databases up to December 2022. After the eligibility assessment, 17 studies were included in this review. Nine of them supported a lack of relationship between CFTR mutation heterozygosity and asthma susceptibility, and eight reported a positive association. Consequently, more extensive research is needed through high-quality studies to provide valid evidence and highlight the clinical benefits of identifying CFTR mutations in asthma patients, their impact on asthma severity, or treatment perspectives. Full article

(This article belongs to the Special Issue Asthma and Allergic Inflammation: Risks, Mechanisms, and New Treatments: Part II)

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