scholarly journals Raised sputum extracellular DNA confers lung function impairment and poor symptom control in an exacerbation-susceptible phenotype of neutrophilic asthma

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mustafa Abdo ◽  
Mohib Uddin ◽  
Torsten Goldmann ◽  
Sebastian Marwitz ◽  
Thomas Bahmer ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Inflammation ◽  
Asthma Control ◽  
Symptom Control ◽  
Extracellular Dna ◽  
Healthy Controls ◽  
Air Trapping ◽  
P Values ◽  
Dna Production ◽  
Asthma Patients

Abstract Background Extracellular DNA (e-DNA) and neutrophil extracellular traps (NETs) are linked to asthmatics airway inflammation. However, data demonstrating the characterization of airway inflammation associated with excessive e-DNA production and its impact on asthma outcomes are limited. Objective To characterize the airway inflammation associated with excessive e-DNA production and its association with asthma control, severe exacerbations and pulmonary function, particularly, air trapping and small airway dysfunction. Methods We measured e-DNA concentrations in induced sputum from 134 asthma patients and 28 healthy controls. We studied the correlation of e-DNA concentrations with sputum neutrophils, eosinophils and macrophages and the fractional exhaled nitric oxide (FeNO). Lung function was evaluated using spirometry, body plethysmography, impulse oscillometry and inert gas multiple breath washout. We stratified patients with asthma into low-DNA and high-DNA to compare lung function impairments and asthma outcomes. Results Patients with severe asthma had higher e-DNA concentration (54.2 ± 42.4 ng/µl) than patients with mild-moderate asthma (41.0 ± 44.1 ng/µl) or healthy controls (26.1 ± 16.5 ng/µl), (all p values < 0.05). E-DNA concentrations correlated directly with sputum neutrophils (R = 0.49, p < 0.0001) and negatively with sputum macrophages (R = − 0.36, p < 0.0001), but neither with sputum eosinophils (R = 0.10, p = 0.26), nor with FeNO (R = − 0.10, p = 0.22). We found that 29% of asthma patients (n = 39) had high e-DNA concentrations above the upper 95th percentile value in healthy controls (55.6 ng /μl). High-DNA was associated with broad lung function impairments including: airflow obstruction of the large (FEV1) and small airways (FEF50%, FEF25–75), increased air trapping (RV, RV/TLC), increased small airway resistance (R5-20, sReff), decreased lung elasticity (X5Hz) and increased ventilation heterogeneity (LCI), (all P values < 0.05). We also found that high e-DNA was associated with nearly three-fold greater risk of severe exacerbations (OR 2·93 [95% CI 1.2–7.5]; p = 0·012), worse asthma control test (p = 0.03), worse asthma control questionnaire scores (p = 0.01) and higher doses of inhaled corticosteroids (p = 0.026). Conclusion Increased production of extracellular DNA in the airway characterizes a subset of neutrophilic asthma patients who have broad lung function impairments, poor symptom control and increased risk of severe exacerbations.

scholarly journals Body Mass and Fat Mass in Refractory Asthma: An Observational 1 Year Follow-Up Study

2010 ◽  
Vol 2010 ◽  
pp. 1-9 ◽  
Author(s):  
Mona Bafadhel ◽  
Amisha Singapuri ◽  
Sarah Terry ◽  
Beverley Hargadon ◽  
William Monteiro ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Inflammation ◽  
Body Mass ◽  
Fat Mass ◽  
Symptom Control ◽  
Asthma Control Questionnaire ◽  
Loss Of Weight ◽  
Asthma Patients ◽  
The Impact ◽  
Refractory Asthma

Background. Asthma and obesity are common; however the impact of obesity upon asthma remains uncertain. Objectives. To assess relationships between obesity and fat mass with airway inflammation, lung function, and disease control in patients with refractory asthma. Methods. 151 refractory asthma patients were characterised for measures of airway inflammation, lung function, Juniper asthma control questionnaire (JACQ), body mass index (BMI), and fat mass index (FMI) derived from dual energy X-ray absorptiometry. Patients were reassessed over 12 months. Results. 74% of patients had an elevated BMI. BMI and FMI correlated (r=0.9, P<.001). FMI and JACQ correlated in men (r=0.3, P=.01). After 12 months 23% lost weight. Weight change over 12 months correlated with FEV1 change (r=−0.3, P=.03), but not with change in JACQ or exacerbations. Conclusion. Increased fat mass is common in refractory asthma and is associated with asthma symptom control in men. Loss of weight is associated with improvement in lung function in refractory asthma.

scholarly journals Assessment of disease control in patients with asthma

Medicina ◽  
2009 ◽  
Vol 45 (12) ◽  
pp. 943 ◽  
Author(s):  
Guoda Pilkauskaitė ◽  
Kęstutis Malakauskas ◽  
Raimundas Sakalauskas
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Control Level ◽  
Asthma Management ◽  
Control Test ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Inhaled Steroids ◽  
Asthma Patients ◽  
Β2 Agonists

International guidelines indicate that the main criterion of asthma management is asthma control level. The aim of this study was to assess asthma control and its relation with age, gender, and lung function. Material and methods. A total of 106 family physicians and 13 pulmonologists and allergists took part in this study. Each doctor had selected 10–15 asthma patients and had sent invitations to them by post. On the visit day, the patients themselves filled in the Asthma Control Test. The doctors interviewed the patients and filled in a special questionnaire. Pulmonologists and allergists also assessed lung function by performing spirometry. According to the results of the Asthma Control Test, the disease control level was indicated as “totally controlled” (25 points), “well controlled” (24–20 points), and “uncontrolled” (19 points or less). Results. A total of 876 asthma patients were examined. Uncontrolled asthma was diagnosed to 56.2% of the patients, 36.5% of patients had well controlled and 7.3% totally controlled asthma. There was no significant difference in asthma control level comparing men and women. A correlation between asthma control level and age was found revealing poorer asthma control in older patients. Ninety-five percent of patients were treated with inhaled steroids; most of them had used inhaled steroids in combination with long-acting β2 agonists. It was found that lung function correlated with clinical symptoms of asthma, the demand of shortacting β2 agonists, and asthma control level. Conclusion. The study showed that uncontrolled asthma was diagnosed to more than half of the patients, despite most of them used inhaled steroids. Asthma control was worsening with the age of patients with asthma and it correlated with lung function. We suggest that periodical assessment of asthma control should help to optimize asthma management.

Childhood asthma: Exhaled markers of airway inflammation, asthma control score, and lung function tests

2004 ◽  
Vol 38 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Philippe P.R. Rosias ◽  
Edward Dompeling ◽  
Mieke A. Dentener ◽  
Herman J. Pennings ◽  
Han J.E. Hendriks ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Inflammation ◽  
Asthma Control ◽  
Childhood Asthma ◽  
Lung Function Tests ◽  
Control Score ◽  
Function Tests

scholarly journals Bronchial asthma control, quality of life, and psychiatric disorders vicious cycle: Asyut society point of view

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Samiaa Hamdy Sadek ◽  
Maha Mohamed El-kholy ◽  
Fareda Ahmed Mohammed ◽  
Reham Mohammed El-Morshedy
Keyword(s):  
Quality Of Life ◽  
Psychiatric Disorders ◽  
Asthma Control ◽  
Bronchial Asthma ◽  
Hospital Admissions ◽  
Symptom Control ◽  
Anxiety And Depression ◽  
Asthma Patients ◽  
Healthy Control

Abstract Background Poorly controlled bronchial asthma limits patients’ quality of life (QOL), the condition which may potentiate the development of psychiatric disorders. The aim of this study was the assessment of anxiety and depression in bronchial asthma patients, and their interrelation with both level of asthma control and quality of life in our society. Results This study included 102 bronchial asthma patients, and 50 healthy control individuals. Patients had poorer QOL, and higher anxiety and depression scores compared to healthy control, moreover these scores were higher in uncontrolled asthma patients compared to controlled group. Poor QOL, frequent hospital admissions, and poor asthma control were the predictors for psychiatric disorders. Conclusion Depression and anxiety are frequently encountered in patients with bronchial asthma in our society; poor symptom control, poor QOL, and frequent hospital admissions are the main predictors for these psychiatric disorders.

scholarly journals Correlation of illness perception, asthma control, and lung function value to the quality of life of asthma outpatients

2019 ◽  
Vol 4 (1) ◽  
pp. 43
Author(s):  
Nadia Aisah Mayzika ◽  
Asri Wido Mukti
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
Asthma Control ◽  
Illness Perception ◽  
Life Quality ◽  
Equation Modeling ◽  
Asthmatic Patients ◽  
Asthma Patients ◽  
The Relationship

Asthma is a heterogeneous disease and chronic inflammation of the respiratory tract that has an impact on the decreased quality of life. The design of this research is non-experimental cross-sectional. The variables of this study are illness perception, control of asthma, lung function values, and life quality of asthma patients. The relationship of asthma control, illness perception, lung function value, and life quality of asthma patients can be seen with structural equation modeling using Smart-PLS software. The results are only control of asthma affects life quality, where the coefficient value is 0.511, which is positive and significant (p = 0,000). Lung function value and asthma quality indicate that lung function has a positive relationship direction seen from the coefficient value of 0.306 but not significant (p = 0.061). The correlation between illness perception and life quality of asthma was negative, where the coefficient value was - 0.142 and not significantly different (p = 0.332). This means that the direction of the relationship is reversed; it means the quality of life of asthmatic patients, which affects illness perception by 14.2%. The conclusion is that the life quality of asthmatic patients is influenced by the control of asthma and lung function. But it’s different from illness perception, where there is a negative relationship between illness perception and life quality of asthma patients. Which means illness perception affects the life quality of asthma patients.

scholarly journals Asthma control, lung function, nutritional status, and health-related quality of life: differences between adult males and females with asthma

2018 ◽  
Vol 44 (4) ◽  
pp. 273-278 ◽  
Author(s):  
Gabriele Carra Forte ◽  
Maria Luiza Hennemann ◽  
Paulo de Tarso Roth Dalcin
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
Nutritional Status ◽  
Asthma Control ◽  
Health Related Quality ◽  
Asthma Patients ◽  
Related Quality ◽  
Health Related ◽  
Males And Females

ABSTRACT Objective: To evaluate health-related quality of life in asthma patients treated at a referral center in southern Brazil, identifying differences between male and female patients, as well as to evaluate differences between the males and females in terms of asthma control, lung function, and nutritional status. Methods: This was a cross-sectional study involving patients ≥ 18 years of age treated at an asthma outpatient clinic. We evaluated clinical parameters, lung function, nutritional status, and quality of life. Results: A total of 198 patients completed the study. The mean age was 56.2 ± 14.8 years, and 81.8% were female. The proportion of patients with uncontrolled asthma was higher among females than among males (63.0% vs. 44.4%; p = 0.041). The body mass index (BMI) and percentage of body fat were higher in females than in males (30.2 ± 5.8 kg/m2 vs. 26.9 ± 4.5 kg/m2 and 37.4 ± 6.4% vs. 26.5 ± 7.4%; p = 0.002 and p < 0.001, respectively). Quality of life was lower in females than in males in the following domains: symptoms (3.8 ± 1.5 vs. 4.6 ± 1.7; p = 0.006); activity limitation (3.6 ± 1.3 vs. 4.4 ± 1.5; p = 0.001); emotional function (3.6 ± 1.9 vs. 4.5 ± 1.7; p = 0.014); and environmental stimuli (3.2 ± 1.6 vs. 4.3 ± 1.9; p = 0.001). Conclusions: Male asthma patients appear to fare better than do female asthma patients in terms of health-related quality of life, asthma control, BMI, percentage of body fat, and comorbidities.

scholarly journals Follow-up of patients with uncontrolled asthma: clinical features of asthma patients according to the level of control achieved (the COAS study)

2017 ◽  
Vol 49 (3) ◽  
pp. 1501885 ◽  
Author(s):  
Rosa Munoz-Cano ◽  
Alfons Torrego ◽  
Joan Bartra ◽  
Jaime Sanchez-Lopez ◽  
Rosa Palomino ◽  
...  
Keyword(s):  
Lung Function ◽  
Asthma Control ◽  
Forced Expiratory Volume ◽  
Uncontrolled Asthma ◽  
Asthma Control Test ◽  
Disease Evolution ◽  
Factors Associated ◽  
Asthma Patients ◽  
The Mean ◽  
Global Initiative

Our aim was to study the asthma control achieved in patients with uncontrolled asthma who had received appropriate treatment according to the Global Initiative for Asthma (GINA) 2010 (valid at the time the study was designed), and to analyse the factors associated with a lack of asthma control.This was a multicentre study in routine clinical practice performed in patients with uncontrolled asthma according to GINA 2010. At visit 1, we recorded demographics, asthma characteristics and spirometry. We assessed asthma control using GINA 2010 criteria and the Asthma Control Test (ACT). Treatment was optimised according to GINA 2010. At visit 2, 3 months later, we reassessed spirometry, asthma control and factors associated with failure to achieve control.We recruited 1299 patients with uncontrolled asthma (mean age 46.5±17.3 years, 60.7% women, 25.8% obese). The mean percentage of predicted forced expiratory volume in 1 s was 76.4±12.8% and the mean post-bronchodilator increase was 14.9±6.8%. We observed poor agreement between ACT and GINA 2010 when evaluating asthma control (kappa = −0.151). At visit 2, asthma in 71.2% of patients was still not fully controlled. Patients whose asthma remained uncontrolled were older, had a higher body mass index, greater disease severity, longer disease evolution and worse lung function.After treatment optimisation, most patients did not achieve optimal control according to GINA 2010. Risk factors for failure to achieve asthma control were time of disease evolution, severity, age, weight and lung function impairment (excluded in the GINA 2014).

scholarly journals How does the GINA definition of control correlate with quality of life and sputum cellularity?

2019 ◽  
Vol 5 (1) ◽  
pp. 00146-2018
Author(s):  
Marcia Margaret Menezes Pizzichini ◽  
Cristiane Cinara Rocha ◽  
Michelle Gonçalves de Souza Tavares ◽  
Leila John Marques Steidle ◽  
Rosemeri Maureci da Silva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Airway Inflammation ◽  
Asthma Control ◽  
Symptom Control ◽  
Life Questionnaire ◽  
Sputum Induction ◽  
Activity Impairment ◽  
Global Initiative ◽  
Definition Of

Since 2014, the Global Initiative for Asthma (GINA) has stated that asthma control should be measured using four questions concerning diurnal and nocturnal symptoms, activity limitation, and rescue medication use. We assessed how asthma control by this definition correlates with airway inflammation and quality of life.113 asthmatic subjects consecutively recruited from their routine clinical appointment underwent spirometry, sputum induction and answered the Standardised Asthma Quality of Life Questionnaire (AQLQ(S)) during a single visit.43 (38.1%), 37 (32.7%) and 33 (29.2%) subjects had controlled asthma, partly controlled asthma and uncontrolled asthma, respectively. The majority of subjects with controlled asthma (67.4%) had paucigranulocytic sputum. Eosinophilic sputum was present in all levels of asthma control. Although most subjects with controlled asthma (58.1%) achieved an AQLQ(S) score ≥6 (minimal or no impairment), the remaining patients (41.9%) had moderate/some impairment (AQLQ(S) score <6 and ≥3) due to activity impairment and environmental exposure.The present GINA definition of current symptom control reflects control of airway inflammation. However, quality of life impairment can be present even in these patients. Measuring quality of life may provide useful information when evaluating asthma control.

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