scholarly journals 17: OBESE ADIPOCYTE-DERIVED EXOSOMAL MIRNAS TARGETING TGF-β SIGNALING ARE ASSOCIATED WITH POOR ASTHMA CONTROL

2016 ◽  
Vol 64 (3) ◽  
pp. 813.2-814 ◽  
Author(s):  
S Epstein ◽  
S Ferrante ◽  
E Nadler ◽  
M Barberio ◽  
M Golberg ◽  
...  
Keyword(s):  
Asthma Control ◽  
Airway Remodeling ◽  
Act Scores ◽  
Asthma Control Test ◽  
Mrna Targets ◽  
Obese Youth ◽  
Exosomal Mirnas ◽  
Obese Subjects ◽  
Visceral Adipose ◽  
Serum And Urine

Purpose of StudyObesity is a major risk factor for difficult-to-control asthma. We reported obese visceral adipose-derived exosomes contain miRNAs capable of impairing TGF-β signaling, a pathway involved in airway remodeling, associated with poor asthma clinical outcomes. We hypothesized that adipose-derived exosomal miRNAs from obese youth with asthma would be associated with poor asthma control.Methods UsedAsthMaP-2 Subjects (youth with physician-diagnosed asthma) were selected at extremes of obesity (n=10) and leanness (n=10). We profiled RNA from adipose-derived exosomes from serum and urine and identified significant correlations (p≤0.05) between obese adipose-derived exosomal miRNAs and Asthma Control Test (ACT) scores. Ingenuity Pathway Analysis generated predicted mRNA targets and pathways.Summary of ResultsObese subjects had a BMI≥98th percentile and lean subjects had a BMI≤13th percentile for age and sex. Serum adipose-derived exosomes contained 12 ACT-correlated miRNAs predicted to target 2,963 mRNAs with TGF-β Signaling as the top pathway (ratio=36/87; p=3×10−9). Urinary adipose-derived exosomes contained 7 ACT-correlated miRNAs predicted to target 2,387 mRNAs with TGF-β Signaling among the top pathways (ratio=18/87; p=0.01). The serum exosomal miRNAs were predicted to target TGF-β signaling mediators' mRNAs: downregulation of ACVR2B, SMAD3, SMAD5, and SMAD7 by miR-15a-5p (Fold Change (FC)=1.5; p=0.039) and upregulation of TGFB2 and TGFBR2 by miR-153-3p (FC=−1.7; p=0.041). The urinary exosomal miRNAs were also predicted to target TGF-β signaling mediators' mRNAs, the net effects were the opposite direction: upregulation of ACVR2B and SMAD4 by miR-138-5p (FC=−1.2; p=0.033) and downregulation of TGFB2 and TGFBR2 by miR-153-3p (FC=1.6; p=0.026) and SMAD6 by miR-3187-5p (FC=2.3; p=0.008).ConclusionsPoor asthma control in obese youth is associated with adipose-derived exosomal miRNAs in both serum and urine, in particular those that are predicted to affect TGF-β signaling. Due to anatomic considerations, visceral adipose-derived exosomes are expected to predominate in urine, while serum will contain a mix of both visceral and subcutaneous adipose-derived exosomes. Therefore, adipose-derived exosomes derived from urine may be useful biomarkers in obese subjects with asthma.

scholarly journals Yoga Education Program for Reducing Drug Dependency and Promoting Better Asthma Control for Chronic Asthmatic Children: A Multicity Experiment

2019 ◽  
Vol 6 ◽  
pp. 2333794X1983745 ◽  
Author(s):  
Samta Pandya
Keyword(s):  
Asthma Control ◽  
Education Program ◽  
Intervention Group ◽  
Control Group ◽  
Act Scores ◽  
Asthma Control Test ◽  
Drug Dependency ◽  
Asthmatic Children ◽  
Standard Family ◽  
Family Setups

This article reports a 1-year long yoga education program (YEP) experiment aimed at reducing drug dependency and promoting better asthma control for chronic asthmatic children. Participants were 450 chronic asthmatic children across 4 cities. Two measures were used: Pediatric Asthma Diary (PAD) and Childhood Asthma Control Test (C-ACT). Results indicated that intervention group children had better asthma control in terms of lower average PAD scores and higher C-ACT scores and reduced drug intake vis-à-vis the control group. Within the intervention cohort, asthma symptoms persistence was lower and control was higher for children from Asian cities, boys, Hindus, middle-class children, those whose mothers were their primary caregivers, who lived in standard family setups, who also attended the optional YEP rounds, and regularly self-practiced. The strongest predictor of lower posttest PAD scores and higher C-ACT scores was self-practice. The YEP can be used as an effective complementary treatment for chronic asthmatic children.

scholarly journals Pengaruh Teknik Pernapasan Buteyko terhadap ACT

2018 ◽  
Vol 1 (2) ◽  
pp. 47-61
Author(s):  
Marlin Sutrisna ◽  
Emmy H Pranggono ◽  
Titis Kurniawan
Keyword(s):  
Asthma Control ◽  
Control Test ◽  
Act Scores ◽  
Asthma Control Test ◽  
Group Design ◽  
Post Test ◽  
Quasi Experimental ◽  
Act Score ◽  
Post Hoc ◽  
Better Than

This study aims to determine the effect of buteyko breathing technique on asthma control test.The quasi experimental study with the pretest and post test one group design approach involved 14 patients with asthma selected from the Lung Polyclinic of Dr. Hasan Sadikin Bandung with consecutive sampling. Asthma control was collected using time series ACT. The collected data were analyzed descriptively and inferentially with the scale of significance p smaller than 0.05.The results showed a significantly higher mean difference between ACT scores after buteyko breathing technique 19.79 more or less 1.47 with ACT score at week III 17.50 moe or less 1.78 week II 12.64 more or less 1.82, week I 9.57 more or less 1.95, and pretest 7.64 more or less 1.82. Post hoc analysis found the fourth week post test score 19.79 more or less 1.47 significantly better than post test week III 17.50 more or less 1.78, week II 12.64 more or less 1.82, week I 9.57 more or less 1.95, and pretest 7.64 more or less 1.82 in improving asthma control. It was concluded that there was an effect of buteyko breathing technique on asthma control test. Thus, the results of this study become important as a study material for nurses at the Hospital in an effort to increase asthma control test. Keywords: ACT, Breathing Technique, Bronchial Asthma, Buteyko  

Asthma Management Responsibility, Control, and Quality of Life Among Emerging Adolescents

2019 ◽  
Vol 45 (1) ◽  
pp. 40-49
Author(s):  
Mallory Netz ◽  
David A Fedele ◽  
Rachel Sweenie ◽  
Dawn Baker ◽  
Michael Light ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
Healthcare Providers ◽  
Asthma Management ◽  
Life Questionnaire ◽  
Act Scores ◽  
Asthma Control Test ◽  
Significant Difference ◽  
Related Quality

Abstract Objective To examine how asthma control is related to the association between the division of responsibility for asthma management and asthma-related quality of life among early adolescents. Methods Forty-nine youth aged 10–15 years (Mage = 12.25, 57.1% female) with a physician-verified asthma diagnosis completed the Standardized Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and Asthma Control Test (ACT). Youth and their caregivers also completed the Asthma Responsibility Questionnaire (ARQ). Higher ACT scores indicate better asthma control. Results There was a significant difference in ARQ scores between youth and caregivers (p < .001, d = .94). Youth reported sharing equal responsibility for asthma management with caregivers, while caregivers reported having more responsibility relative to youth. Greater youth-reported ARQ (p = .004) and greater ACT scores (p < .001) were associated with higher PAQLQ scores. ACT scores moderated the effect of youth-reported ARQ on PAQLQ scores (p = .043). For youth with lower ACT scores, higher youth-reported responsibility was associated with higher PAQLQ scores; while for youth with higher ACT scores, PAQLQ scores were high regardless of perceived responsibility. The interaction between caregiver ARQ scores and ACT scores was not significant. Conclusion This study suggests youth and caregivers report discrepant ARQ for asthma management tasks. Responsibility and level of asthma control are important factors for PAQLQ, with results indicating that fostering responsibility is an important factor, even among youth with poorly controlled asthma. Findings suggest that healthcare providers should assess family responsibility and help caregivers support adolescents in developing asthma management skills.

scholarly journals Asthma Control and Asthma Medication Use among Swedish Elite Endurance Athletes

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Hampus Persson ◽  
Anne Lindberg ◽  
Nikolai Stenfors
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Reference Group ◽  
Medication Use ◽  
Study Groups ◽  
Asthma Medication ◽  
Endurance Athletes ◽  
Act Scores ◽  
Asthma Control Test ◽  
Long Acting

Background. Asthma is common in elite athletes. In this study, we examined the use of asthma medication and asthma control in endurance athletes in Sweden and compared the findings with those in a reference group of patients with asthma. Methods. The Asthma Control Test (ACT) and a questionnaire on asthma, respiratory symptoms, and medication use were posted to endurance athletes n=711 and the reference group of patients with asthma n=1026. Four hundred and sixty-nine athletes (66%) responded, of whom 141 (20%) reported physician-diagnosed asthma. In the reference group, 397 (39%) responded. Results. Seventy-seven percent of the athletes with asthma reported using asthma medication during the previous year; 39% used short/long-acting β2-agonists, 31% used inhaled corticosteroids, and 31% used both daily. According to the ACT scores, 19%, 24%, and 58% of athletes with asthma had uncontrolled, partially controlled, or well-controlled asthma, respectively. After adjustment, there was no difference in ACT scores or daily use of asthma medication between the study groups. Conclusions. Many endurance athletes had uncontrolled or partially controlled asthma, and one-third used inhaled corticosteroids and long-acting β2-agonists daily. Their adjusted ACT scores and use of asthma medication were similar to the values in the reference population.

scholarly journals The Effect of Aspirin on Moderate to Severe Asthmatic Patients with Aspirin Hypersensitivity, Chronic Rhinosinusitis, and Nasal Polyposis.

2021 ◽  
Author(s):  
Saba Arshi ◽  
Sepideh Darougar ◽  
Mohammad Nabavi ◽  
Mohammad Hassan Bemanian ◽  
Morteza Fallahpour ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Asthma Control ◽  
Severe Asthma ◽  
Nasal Polyposis ◽  
Clinical Findings ◽  
Act Scores ◽  
Asthma Control Test ◽  
Asthmatic Patients ◽  
Before And After ◽  
Aspirin Hypersensitivity

Asthmatic patients may have aspirin-exacerbated respiratory disease and experience acute dyspnea and nasal symptoms within 3 hours after the ingestion of aspirin. This study aimed to evaluate the effect and outcome of daily low-dose aspirin in the treatment of moderate to severe asthma in patients with concomitant aspirin hypersensitivity and chronic rhinosinusitis with nasal polyposis (CRSwNP). This clinical trial was conducted from February 2014 to February 2015 on 46 adult patients with moderate to severe asthma accompanied by CRSwNP. Patients with a positive aspirin challenge were blindly randomized in three groups receiving placebo/day (A); aspirin 100 mg/day (B); and aspirin 325mg/day (C), respectively. Clinical findings, FEV1 and ACT scores were recorded and compared before, during, and after treatment for 6 months (IRCT2015061521970N2). Of 46 participants at baseline, 30 patients completed this 6-month trial study. The level of asthma control was significant; based on Asthma Control Test (ACT) when comparing the results in groups A and C and also groups B and C, but it was not significant when comparing ACT scores between groups A and B. FEV1 before and after treatment was significant when comparing groups A and B, groups A and C, and groups B and C. To conclude, aspirin desensitization with a daily dose of 325 mg aspirin resulted in the improvement of long-term control of asthma. A daily aspirin dose of 100 mg was not associated with such an increase in ACT score.

scholarly journals Does asthma control as assessed by the asthma control test reflect airway inflammation?

2019 ◽  
Vol 6 ◽  
Author(s):  
Mine Bora ◽  
Aylin Ozgen Alpaydin ◽  
Arzu Yorgancioglu ◽  
Gizem Akkas ◽  
Aydın Isisag ◽  
...  
Keyword(s):  
Airway Inflammation ◽  
Asthma Control ◽  
Pulmonary Function Tests ◽  
Provocation Test ◽  
Induced Sputum ◽  
Control Test ◽  
Act Scores ◽  
Asthma Control Test ◽  
Asthmatic Patients

Background and aims: The treatment of asthmatic patients is particularly focused on the control of symptoms as well as functional and inflammatory parameters. In our study, we investigated the relationship between the asthma control test (ACT) which evaluates symptoms and airway inflammation and functional parameters. Materials and methods: Stable asthmatic patients admitted to our pulmonary outpatient clinic were enrolled in the study consecutively and underwent the ACT, pulmonary function tests and methacholine bronchial provocation test (MBPT). Additionally, fractional exhaled nitric oxide level (FeNO) and induced sputum cell distribution were assessed. All these parameters were re-evaluated at the third month after adjusting medications of the patients according to baseline ACT scores. Results: Of the 101 patients screened, we analyzed 83 who proceeded to the follow up visit. At the baseline visit, 8 were totally controlled, 36 partially controlled and 39 uncontrolled according to ACT. At the follow up visit, 10 were totally controlled, 39 partially controlled and 34 uncontrolled. Comparison of the two visits in terms of all parameters revealed significant reductions only in the percentages of patients with MBPT positivity (p = 0.029) and FeNO levels > 20 ppb (p = 0.025) at follow up. The percentages of patients with FeNO > 20 ppb, MBPT positivity, induced sputum eosinophilia or induced sputum neutrophilia did not show significant differences between totally controlled, partially controlled and uncontrolled groups at both baseline and follow up visits. Conclusion: Although the ACT scores did not show significant correlations with the airway inflammation parameters tested in this study, a marked reduction in the percentage of patients with MBPT positivity and FeNO > 20 ppb at follow up may suggest the importance of the control concept in the management of asthma.

Comparability of Asthma Control Test (ACT) scores between self and physician administered test.

2018 ◽  
Author(s):  
Sabrina Genco ◽  
Enrico Heffler ◽  
Claudia Crimi ◽  
Raffaele Campisi ◽  
Giovanni Paoletti ◽  
...  
Keyword(s):  
Asthma Control ◽  
Control Test ◽  
Act Scores ◽  
Asthma Control Test

scholarly journals Agreement between self-reported asthma symptoms and exhaled nitric oxide levels: impact on inhaled corticosteroid prescribing in general practice. An observational study

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Raj Gill ◽  
E. Mark Williams
Keyword(s):  
Nitric Oxide ◽  
Primary Care ◽  
Asthma Control ◽  
Exhaled Nitric Oxide ◽  
Annual Review ◽  
Act Scores ◽  
Asthma Control Test ◽  
Medication Prescription ◽  
National Review ◽  
Kendall’S Τ

Abstract Background The National Review of Asthma Deaths UK highlighted that 46% of deaths could be avoided and recommended that all sufferers receive a structured asthma annual review which assess asthma control. In primary care this is commonly achieved using symptom-based questionnaires such as the Asthma Control Test (ACT). A newer method of assessing asthma control is Fractional Exhaled Nitric Oxide (FeNO) testing, which is currently recommended for the diagnosis of asthma, but not for monitoring of asthma control. The study aim was to assess the correlation between self-reported symptoms as measured by the ACT and FeNO testing and the subsequent impact of FeNO testing on prescribing of asthma medication. Methods A retrospective review of 65 patients who had received both ACT and FeNO testing as part of their asthma annual review. A spearman correlation was used to estimate the correlation between ACT scores and FENO levels. A χ2 test was used to compare prompting frequency of the measures and Kendalls τ statistic was made to estimate their concordance and influence on subsequent ICS medication prescription. Results The mean age of the participants was 41 years (4–93 years). There was no statistically significant correlation between ACT and FeNO (ρ = 0.195, p = 0.120). The median FeNO was 26 ppb (range 8–279 ppb), and the ACT score 20 (range 5 to 25 points). Furthermore, FeNO more frequently prompts a change in medication than ACT, 66% versus 42% (p = 0.005). A low concordance between the measures was found (Kendall’s τ statistic − 0.321). Conclusion FeNO should be considered for monitoring of control in asthma. To balance the cost of implementing this technology into primary care a risk stratified approach could be applied to testing.

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