scholarly journals Spontaneous resolution of atopic dermatitis incidental to participation in benralizumab clinical trial for severe, uncontrolled asthma: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
David N. Pham
Keyword(s):  
Atopic Dermatitis ◽  
Symptom Score ◽  
Asthma Symptom ◽  
Spontaneous Resolution ◽  
Cell Surface Receptor ◽  
Food Allergies ◽  
Uncontrolled Asthma ◽  
Exacerbation Rate ◽  
Asthma Symptoms ◽  
Asthma Symptom Score

Abstract Background T cell-mediated eosinophilia is associated with numerous conditions—including atopic dermatitis, food allergies, and asthma—collectively known as the “atopic march.” Benralizumab is a recombinant, humanized, afucosylated monoclonal antibody directed against the ⍺ chain of the eosinophil cell surface receptor IL-5R. Benralizumab treatment causes near-complete depletion of circulating eosinophils and was approved in 2017 for add-on, maintenance treatment of severe asthma with an eosinophilic phenotype, based on the results of the CALIMA and SIROCCO pivotal trials. Benralizumab is not currently approved for the treatment of eosinophilic conditions besides asthma; however, during the CALIMA trial, spontaneous resolution of atopic dermatitis was observed in a patient, concurrent with reduction in her asthma symptoms. Case presentation In January 2015, a 14-year-old Asian girl with severe, uncontrolled asthma was enrolled in CALIMA. The patient’s baseline eosinophil blood count was 1200 cells/μL, her pre-bronchodilator forced expiratory volume in 1 second (FEV1) was 1.9 L and FEV1/forced vital capacity (FVC) ratio was 71.4%, and her post-bronchodilator FEV1 was 3.2 L (FEV1/FVC of 115.9%). Her overall baseline asthma symptom score was 3.9 and her asthma exacerbation rate in the prior year was 4. She also displayed a pronounced, pruritic, chronic, inflammatory rash consistent with atopic dermatitis across her face. The investigator was blinded to the patient’s treatment group during treatment; however, her asthma symptoms diminished over the course of the study (FEV1 at 56 weeks, 3.01 L/110.5% (pre) and 3.25 L/119.3% (post); overall asthma symptom score 2.1; one influenza-associated exacerbation). Furthermore, her atopic dermatitis symptoms resolved spontaneously within the first 5 months of the study. After unblinding, the patient was confirmed to have been randomized to an active treatment arm, and her blood eosinophil count had dropped below the limit of detection after the first study dose. Conclusions Given the potential shared mechanisms between eosinophilic asthma and atopic dermatitis, it is plausible that benralizumab-induced eosinopenia factored into the resolution of the patient’s atopic dermatitis. Further clinical studies are warranted to determine whether benralizumab or other drugs targeted against IL-5/IL-5R may be useful in managing multiple conditions associated with eosinophilia.

scholarly journals Association between dietary fibre intake and asthma (symptoms and control): results from the French national e-cohort NutriNet-Santé

2019 ◽  
Vol 122 (9) ◽  
pp. 1040-1051 ◽  
Author(s):  
Roland M. Andrianasolo ◽  
Serge Hercberg ◽  
Emmanuelle Kesse-Guyot ◽  
Nathalie Druesne-Pecollo ◽  
Mathilde Touvier ◽  
...  
Keyword(s):  
Asthma Control ◽  
Symptom Score ◽  
Dietary Fibre ◽  
Asthma Symptom ◽  
Fibre Intake ◽  
Asthma Symptoms ◽  
Insoluble Fibre ◽  
Dietary Fibre Intake ◽  
Total Dietary Fibre ◽  
Asthma Symptom Score

AbstractDespite growing evidence suggesting a potential health benefit of high fibre intake for the prevention of chronic inflammatory diseases, studies regarding the role of total dietary fibre intake, types and sources of fibre on asthma are lacking. The present study aimed to investigate the cross-sectional association of dietary fibre intakes and source of fibre with the asthma symptom score and asthma control. A total of 35 380 participants from the NutriNet-Santé cohort were included. Asthma was defined by the asthma symptom score and asthma control by the asthma control test. Fibre intake (g/d) was categorised according to sex-specific quintiles. Multi-adjusted negative binomial regressions were used to evaluate the association between dietary fibre with the asthma symptom score and logistic regressions with asthma control. Participants were aged on average 54 years. After adjustment for confounders, higher intake of total, soluble, insoluble fibres from cereals, fruit and seeds were significantly negatively associated with the asthma symptom score both among women and men; OR for the highest quintile of total dietary fibre compared with the lowest quintile were 0·73 (95 % CI 0·67, 0·79) in women and 0·63 (95 % CI 0·55, 0·73) in men. We also found inverse significant associations between total, soluble and insoluble fibre with uncontrolled asthma; OR for participants in the highest quintile of total dietary fibre was 0·72 (95 % CI 0·55, 0·95) in women and 0·45 (95 % CI 0·26, 0·79) in men. Our results suggested that higher intake of dietary fibre, mostly insoluble fibre and fibre from cereals, was associated with fewer asthma symptoms and greater asthma control.

Association between an individual dietary index based on the British Food Standard Agency Nutrient Profiling System and asthma symptoms

2019 ◽  
Vol 122 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Roland M. Andrianasolo ◽  
Chantal Julia ◽  
Raphaëlle Varraso ◽  
Manon Egnell ◽  
Mathilde Touvier ◽  
...  
Keyword(s):  
Public Health ◽  
Symptom Score ◽  
Nutritional Quality ◽  
Asthma Symptom ◽  
Food Choices ◽  
Asthma Symptoms ◽  
Dietary Index ◽  
Nutrient Profiling ◽  
Asthma Symptom Score

AbstractThe role of diet in asthma is still debated. In France, a front-of-pack (FOP) nutrition label based on a modified Food Standards Agency Nutrient Profiling System/High Council for Public Health (FSAm-NPS/HCSP) has recently been implemented to help consumers to make healthier food choices during purchase. At the individual level, the FSAm-NPS dietary index (DI) has been shown to reflect the nutritional quality of the diet. The aim of the present study was to investigate the association between the FSAm-NPS DI and the asthma symptom score. In total, 34 323 participants (25 823 women and 8500 men) from the NutriNet-Santé cohort were included. The overall nutritional quality of the diet was assessed using the FSAm-NPS DI. Increasing FSAm-NPS DI reflects decreasing overall diet quality. Asthma was defined by the asthma symptom score (sum of five questions). Negative binomial regression was used to evaluate the association between the FSA-NPS DI and the asthma symptom score. Overall, mean participant’s age was 54 ± 14 years, and about 27 % reported at least one asthma symptom. We observed a significant positive association between less healthy diet, as expressed by higher FSAm-NPS DI, and the asthma symptom score. The adjusted OR were 1·27 (95 % CI 1·17, 1·38) among women and 1·31 (95 % CI 1·13, 1·53) among men. Unhealthy food choices, as reflected by a higher FSAm-NPS DI, were associated with greater asthma symptoms. These results reinforce the relevance of public health approach to orient consumers towards healthier food choices by using a clear and easy-to-understand FOP nutrition label based on the FSAm-NPS, such as the Nutri-Score.

scholarly journals Associations between dietary scores with asthma symptoms and asthma control in adults

2018 ◽  
Vol 52 (1) ◽  
pp. 1702572 ◽  
Author(s):  
Roland M. Andrianasolo ◽  
Emmanuelle Kesse-Guyot ◽  
Moufidath Adjibade ◽  
Serge Hercberg ◽  
Pilar Galan ◽  
...  
Keyword(s):  
Asthma Control ◽  
Symptom Score ◽  
Asthma Symptom ◽  
Healthy Eating Index ◽  
Negative Association ◽  
Asthma Control Test ◽  
Asthma Symptoms ◽  
Adherence Score ◽  
Asthma Symptom Score

Associations between asthma and the nutritional quality of diet remain poorly understood. We investigated the associations between overall quality of diet evaluated by three dietary scores (the Alternate Healthy Eating Index 2010 (AHEI-2010), the literature-based adherence score to Mediterranean diet (MEDI-LITE) and the modified Programme National Nutrition Santé Guideline Score (mPNNS-GS)) and the asthma symptom score and asthma control.In 2017, 34 766 participants from the NutriNet-Santé cohort answered a detailed respiratory questionnaire. Asthma was defined by the asthma symptom score (as the sum of five questions) and asthma control by the asthma control test (ACT).Roughly 25% of participants reported at least one asthma symptom and for the three dietary scores we observed a statistically significant negative association between a healthier diet and the asthma symptom score (for AHEI-2010, the adjusted OR was 0.79 (95% CI 0.75–0.84) for women and 0.67 (95% CI 0.60–0.75) for men). Among participants with asthma (n=2609) we also observed a negative association between a healthier diet and poorly controlled asthma. This was significant in men (OR 0.39 (95% CI 0.18–0.84) for the AHEI-2010) and borderline significant in women (OR 0.73 (95% CI 0.53–1.01) for the AHEI-2010; p=0.06 for trend).Healthier diet behaviours were associated with fewer asthma symptoms and greater asthma control.

scholarly journals Comparison of a Barcode-Based Smartphone Application to a Questionnaire to Assess the Use of Cleaning Products at Home and Their Association with Asthma Symptoms

2021 ◽  
Vol 18 (7) ◽  
pp. 3366
Author(s):  
Pierre Lemire ◽  
Sofia Temam ◽  
Sarah Lyon-Caen ◽  
Catherine Quinot ◽  
Etienne Sévin ◽  
...  
Keyword(s):  
Symptom Score ◽  
Measurement Errors ◽  
Asthma Symptom ◽  
Respiratory Health ◽  
Smartphone Application ◽  
Epidemiological Research ◽  
Logistic Regression Models ◽  
Asthma Symptoms ◽  
Cleaning Products ◽  
Asthma Symptom Score

Household disinfectant and cleaning products (HDCPs) assessment is challenging in epidemiological research. We hypothesized that a newly-developed smartphone application was more objective than questionnaires in assessing HDCPs. Therefore, we aimed to compare both methods, in terms of exposure assessments and respiratory health effects estimates. The women of the SEPAGES birth cohort completed repeated validated questionnaires on HDCPs and respiratory health and used an application to report HDCPs and scan products barcodes, subsequently linked with an ingredients database. Agreements between the two methods were assessed by Kappa coefficients. Logistic regression models estimated associations of HDCP with asthma symptom score. The 101 participants (18 with asthma symptom score ≥1) scanned 617 different products (580 with available ingredients list). Slight to fair agreements for sprays, bleach and scented HDCP were observed (Kappa: 0.35, 0.25, 0.11, respectively). Strength of the associations between HDCP and asthma symptom score varied between both methods but all odds ratios (OR) were greater than one. The number of scanned products used weekly was significantly associated with the asthma symptom score (adjusted-OR [CI 95%]: 1.15 [1.00–1.32]). This study shows the importance of using novel tools in epidemiological research to objectively assess HDCP and therefore reduce exposure measurement errors.

Item Responsiveness of a Rhinitis and Asthma Symptom Score During a Pollen Season

1999 ◽  
Vol 36 (5) ◽  
pp. 459-465 ◽  
Author(s):  
Jean-Blaise Wasserfallen ◽  
Karen Gold ◽  
Kevin A. Schulman ◽  
James N. Baraniuk
Keyword(s):  
Symptom Score ◽  
Pollen Season ◽  
Asthma Symptom ◽  
Asthma Symptom Score

Prospective cohort study of cured meat intake and asthma symptom score in the EGEA study

2015 ◽  
Author(s):  
Zhen Li ◽  
Marta Rava ◽  
Annabelle Bédard ◽  
Judith Garcia-Aymerich ◽  
Bénédicte Leynaert ◽  
...  
Keyword(s):  
Cohort Study ◽  
Symptom Score ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Asthma Symptom ◽  
Meat Intake ◽  
Cured Meat ◽  
Asthma Symptom Score

scholarly journals Occupational Exposures to Organic Solvents and Asthma Symptoms in the CONSTANCES Cohort

2021 ◽  
Vol 18 (17) ◽  
pp. 9258
Author(s):  
Guillaume Sit ◽  
Noémie Letellier ◽  
Yuriko Iwatsubo ◽  
Marcel Goldberg ◽  
Bénédicte Leynaert ◽  
...  
Keyword(s):  
Symptom Score ◽  
Organic Solvents ◽  
Asthma Symptom ◽  
Negative Binomial ◽  
Occupational Exposures ◽  
Population Based ◽  
Self Report ◽  
Cross Sectional ◽  
Current Asthma ◽  
Asthma Symptom Score

Solvents are used in many workplaces and may be airway irritants but few studies have examined their association with asthma. We studied this question in CONSTANCES (cohort of ‘CONSulTANts des Centres d’Examens de Santé’), a large French cohort. Current asthma and asthma symptom scores were defined by participant-reported respiratory symptoms, asthma medication or attacks, and the sum of 5 symptoms, in the past 12 months, respectively. Lifetime exposures to 5 organic solvents, paints and inks were assessed by questionnaire and a population-based Job-Exposure Matrix (JEM). Cross-sectional associations between exposures and outcomes were evaluated by gender using logistic and negative binomial regressions adjusted for age, smoking habits and body mass index. Analyses included 115,757 adults (54% women, mean age 47 years, 9% current asthma). Self-reported exposure to ≥1 solvent was significantly associated with current asthma in men and women, whereas using the JEM, a significant association was observed only in women. Significant associations between exposures to ≥1 solvent and asthma symptom score were observed for both self-report (mean score ratio, 95%CI, women: 1.36, 1.31–1.42; men: 1.34, 1.30–1.40) and JEM (women: 1.10, 1.07–1.15; men: 1.14, 1.09–1.18). Exposure to specific solvents was significantly associated with higher asthma symptom score. Occupational exposure to solvents should be systematically sought when caring for asthma.

scholarly journals Symptoms and exacerbations in asthma: an apparent paradox?

2019 ◽  
Vol 10 ◽  
pp. 204062231988438 ◽  
Author(s):  
Jaymin B. Morjaria ◽  
Alan S. Rigby ◽  
Alyn H. Morice
Keyword(s):  
Symptom Severity ◽  
Poor Correlation ◽  
Uncontrolled Asthma ◽  
Apparent Paradox ◽  
Exacerbation Rate ◽  
Asthma Symptoms ◽  
Exacerbation Frequency ◽  
Severity Scores ◽  
Symptom Severity Score ◽  
Post Hoc

Background: There is a dearth of data on prospectively recorded symptoms in patients with uncontrolled asthma. Asthma symptoms and exacerbation rate are commonly thought to be associated. The aim of this study was to analyse asthma symptoms of cough, wheeze, chest tightness and breathlessness in an uncontrolled asthma cohort. We also examined the effect of maintenance and reliever therapy (MART) on these symptoms and its effect on exacerbation rate. Methods: Adults with uncontrolled asthma electronically recorded their asthma symptom severity scores twice-daily over a period of 48 weeks following randomisation to beclometasone/formoterol twice daily plus pro re nata (prn) salbutamol or MART. Subjects with symptom scores of ⩾2 (ranging from 0 to 3 for each symptom) were considered more symptomatic, whereas those below a score of 2 were considered less severe. The influence treatment on exacerbation frequency and symptom profiles were then correlated. Results: Of the 1701 subjects in the analyses, 1403 were symptomatic with ⩾100 symptom episodes for one symptom. The remaining 298 subjects were classified as pauci-symptomatic. There was poor association between the frequency and symptom severity score for each symptom. Surprisingly, wheeze was the least reported symptom. Females were more likely to be polysymptomatic. MART compared with prn salbutamol markedly attenuated severe asthma exacerbations. This effect was most notable in subjects with fewer symptoms. Conclusions: In uncontrolled asthma, there is a poor correlation between reported symptoms and exacerbation frequency. This post hoc analysis suggests that MART should not be reserved for symptomatic subjects but achieves the greatest benefit in pauci-symptomatic patients with asthma. Trial registration: ClinicalTrials.gov identifier: NCT00861926

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