The influence of leptin on Th1/Th2 balance in obese children with asthma

OBJECTIVE: In individuals with asthma, obesity induces the production of leptin and is associated with disease severity. Our objective was to evaluate the levels of serum leptin and their effect on Th1/Th2 balance in obese and non-obese children with asthma, as well as to investigate the association between serum leptin levels and clinical outcomes. METHODS: We evaluated 50 atopic children with physician-diagnosed moderate-to-severe persistent asthma and 20 controls. The children with asthma were divided into two groups, by body mass index percentile: obese (n = 25) and non-obese (n = 25). From all subjects, we collected peripheral blood samples in order to determine the levels of leptin, IFN-γ, and IL-4. Asthma severity was assessed by an asthma symptom score, and the results were correlated with the parameters studied. RESULTS: Serum leptin levels were significantly higher in the obese asthma group than in the non-obese asthma group, as well as being significantly higher in the children with asthma than in the controls, whereas IFN-γ levels were significantly higher and IL-4 levels were significantly lower in the obese asthma group than in the non-obese asthma group. In addition, the obese asthma group showed higher asthma symptom scores and significantly lower FEV1 (% of predicted) than did the non-obese asthma group. There was a significant positive correlation between leptin and IFN-γ levels only in the obese asthma group. CONCLUSIONS: Although leptin is involved in the pathogenesis of asthma in obese and non-obese children, its effect is more pronounced in the former. In the presence of high leptin levels, only obese children with asthma exhibited Th1 polarization, with higher IFN-γ levels and greater asthma severity.

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Evaluation of oral functions of the stomatognathic system according to the levels of asthma severity

Jornal da Sociedade Brasileira de Fonoaudiologia ◽

10.1590/s2179-64912012000200005 ◽

2012 ◽

Vol 24 (2) ◽

pp. 119-124 ◽

Cited By ~ 6

Author(s):

Mariana San Jorge de Castro ◽

Adyléia Aparecida Dalbo Contrera Toro ◽

Eulália Sakano ◽

José Dirceu Ribeiro

Keyword(s):

Persistent Asthma ◽

Asthma Severity ◽

Control Group ◽

Healthy Children ◽

Structural Part ◽

Assessment Protocol ◽

Group I ◽

Study Results ◽

Children With Asthma ◽

Asthma Group

PURPOSE: To compare the orofacial functions (chewing, swallowing and speech) in children with asthma and healthy children. METHODS: A cross sectional study including 54 children of both genders with ages between 7 and 10 years was conducted. Twenty-seven of these subjects composed the experimental group, and were subdivided into two severity levels of asthma: Group I - mild intermittent and persistent asthma; Group II - persistent moderate to severe asthma. Twenty-seven healthy children were included in the control group (Group III). Speech-language pathology evaluation used the adapted Orofacial Myofunctional Assessment Protocol. Adaptation consisted in the exclusion of the structural part of the test, since this was not the aim of the study. The structural part was excluded because it was not the aim of this study. RESULTS: It was found alterations in oral functions, with significant differences between the three groups. These alterations showed no correlation with asthma severity, since the highest rate of alterations was found in Group I (mild asthma). CONCLUSION: Regardless of the severity level, children with asthma have altered patterns of chewing, swallowing and speech.

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Food Allergy in Children with Asthma: Prevalence and Correlation with Clinical Severity of Respiratory Disease

The Open Allergy Journal ◽

10.2174/1874838400801010005 ◽

2008 ◽

Vol 1 (1) ◽

pp. 5-11 ◽

Cited By ~ 2

Author(s):

E. Calamelli ◽

G. Ricci ◽

V. Dell’Omo ◽

B. Bendandi ◽

M. Masi

Keyword(s):

Food Allergy ◽

Persistent Asthma ◽

Asthma Severity ◽

Specific Ige ◽

Clinical Severity ◽

Asthma Prevalence ◽

Epidemiological Evidence ◽

Prick Test ◽

Asthmatic Children ◽

Children With Asthma

Epidemiological evidence suggests that there is a link between asthma and food allergy. The aim of this study was to estimate the prevalence of food allergy in asthmatic children and to evaluate a possible impact of food allergy on asthma severity. The study enrolled 103 asthmatic children (mean age: 11 years). Skin prick-test, dosage of specific IgE to a standardized panel of inhalant and food allergens and spirometric evaluation was made for each patient. Twenty-four (23%) patients presented food allergy, 75 (77%) were sensitized to at least one food. A lower rate of children with controlled symptoms was found in children with food allergy and a higher rate of persistent asthma was found in children sensitized to at least 4 foods. In conclusion, food allergy/sensitization should always be investigated in asthmatic children for its association with increasing severity (only in food sensitized patients) and reduced control of asthmatic symptoms.

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Phenotypic characteristics and asthma severity in an East African cohort of adults and adolescents with asthma: findings from the African severe asthma project

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2019-000484 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000484 ◽

Cited By ~ 1

Author(s):

Bruce Kirenga ◽

Jeremiah Chakaya ◽

Getnet Yimer ◽

George Nyale ◽

Tewodros Haile ◽

...

Keyword(s):

Inhaled Corticosteroids ◽

Persistent Asthma ◽

Asthma Severity ◽

Adult Onset ◽

Phenotypic Characteristics ◽

Multivariable Logistic Regression Model ◽

Prick Test ◽

Asthma Morbidity ◽

Severe Persistent Asthma ◽

History Of

RationaleThe relationship between clinical and biomarker characteristics of asthma and its severity in Africa is not well known.MethodsUsing the Expert Panel Report 3, we assessed for asthma severity and its relationship with key phenotypic characteristics in Uganda, Kenya and Ethiopia. The characteristics included adult onset asthma, family history of asthma, exposures (smoking and biomass), comorbidities (HIV, hypertension, obesity, tuberculosis (TB), rhinosinusitis, gastro-oesophageal disease (GERD) and biomarkers (fractional exhaled nitric oxide (FeNO), skin prick test (SPT) and blood eosinophils). We compared these characteristics on the basis of severity and fitted a multivariable logistic regression model to assess the independent association of these characteristics with asthma severity.ResultsA total of 1671 patients were enrolled, 70.7% women, with median age of 40 years. The prevalence of intermittent, mild persistent, moderate persistent and severe persistent asthma was 2.9%, 19.9%, 42.6% and 34.6%, respectively. Only 14% were on inhaled corticosteroids (ICS). Patients with severe persistent asthma had a higher rate of adult onset asthma, smoking, HIV, history of TB, FeNO and absolute eosinophil count but lower rates of GERD, rhinosinusitis and SPT positivity. In the multivariate model, Ethiopian site and a history of GERD remained associated with asthma severity.DiscussionThe majority of patients in this cohort presented with moderate to severe persistent asthma and the use of ICS was very low. Improving access to ICS and other inhaled therapies could greatly reduce asthma morbidity in Africa.

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Faculty Opinions recommendation of Are operating room nurses at higher risk of severe persistent asthma? The Nurses' Health Study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718048280.793486435 ◽

2013 ◽

Author(s):

Sherwood Burge

Keyword(s):

Operating Room ◽

Persistent Asthma ◽

Health Study ◽

Severe Persistent Asthma ◽

Operating Room Nurses

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Expression Levels of MicroRNA-125b in Serum Exosomes of Patients with Asthma of Different Severity and its Diagnostic Significance

Current Drug Metabolism ◽

10.2174/1389200220666191021100001 ◽

2019 ◽

Vol 20 (10) ◽

pp. 781-784 ◽

Cited By ~ 1

Author(s):

Meizhen Zhao ◽

Li Juanjuan ◽

Fan Weijia ◽

Xie Jing ◽

Huang Qiuhua ◽

...

Keyword(s):

Correlation Analysis ◽

Roc Curve ◽

Quantitative Polymerase Chain Reaction ◽

Persistent Asthma ◽

Asthma Severity ◽

Control Group ◽

Spearman Correlation ◽

Diagnostic Efficacy ◽

Expression Levels ◽

Serum Exosomes

Background: This study aimed to investigate the expression levels of microRNA (miRNA)-125b in serum exosomes and its diagnostic efficacy for asthma severity. Methods: The study included 80 patients with untreated asthma and 80 healthy volunteers. The patients were divided into 4 groups according to disease severity: 20 with the intermittent state, 20 with the mildly persistent state, 20 with the moderately persistent state, and 20 with the severely persistent state. The expression levels of miRNA-125b in serum exosomes of each group were detected using a quantitative polymerase chain reaction and compared. The Spearman correlation analysis was used to study the correlation between the expression levels of miRNA-125b in serum exosomes and asthma severity. The diagnostic efficacy of the expression levels of miRNA-125b in exosomes for asthma severity was evaluated using the Receiver Operating Characteristic (ROC) curve. Results: The expression levels of miRNA-125b in serum exosomes of patients with intermittent, mildly persistent, moderately persistent, and severely persistent asthma were all higher than those in the healthy control group, with statistically significant differences. The expression levels of miRNA-125b were also statistically significantly different among patients in each group. The Spearman correlation analysis showed a positive correlation of the relative expression of miRNA-125b in serum exosomes with asthma severity. The area under the ROC curve of the diagnostic efficacy of miRNA-125b in serum exosomes for patients with intermittent, mildly, moderately, and severely persistent asthma was 0.7770, 0.8573, 0.9111, and 0.9995, respectively. Conclusion: The expression levels of miRNA-125b in serum exosomes had a high diagnostic efficacy and might serve as a noninvasive diagnostic marker for asthma severity.

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Ventilation heterogeneity in children with severe asthma

European Journal of Pediatrics ◽

10.1007/s00431-021-04101-3 ◽

2021 ◽

Author(s):

Amy G. Nuttall ◽

Caroline S. Beardsmore ◽

Erol A. Gaillard

Keyword(s):

Severe Asthma ◽

Airway Disease ◽

Asthma Severity ◽

Small Airway ◽

Cross Sectional ◽

Lung Clearance ◽

Moderate Asthma ◽

Lung Clearance Index ◽

Children With Asthma ◽

Ventilation Heterogeneity

AbstractSmall airway disease, characterised by ventilation heterogeneity (VH), is present in a subgroup of patients with asthma. Ventilation heterogeneity can be measured using multiple breath washout testing. Few studies have been reported in children. We studied the relationship between VH, asthma severity, and spirometry in a cross-sectional observational cohort study involving children with stable mild-moderate and severe asthma by GINA classification and a group of healthy controls. Thirty-seven participants aged 5–16 years completed multiple breath nitrogen washout (MBNW) testing (seven controls, seven mild-moderate asthma, 23 severe asthma). The lung clearance index (LCI) was normal in control and mild-moderate asthmatics. LCI was abnormal in 5/23 (21%) of severe asthmatics. The LCI negatively correlated with FEV1z-score.Conclusion: VH is present in asthmatic children and appears to be more common in severe asthma. The LCI was significantly higher in the cohort of children with severe asthma, despite no difference in FEV1 between the groups. This supports previous evidence that LCI is a more sensitive marker of airway disease than FEV1. MBNW shows potential as a useful tool to assess children with severe asthma and may help inform clinical decisions. What is Known:• Increased ventilation heterogeneity is present in some children with asthma• Spirometry is not sensitive enough to detect small airway involvement in asthma What is New• Lung clearance index is abnormal in a significant subgroup of children with severe asthma but rarely in children with mild-moderate asthma• Our data suggests that LCI monitoring should be considered in children with severe asthma

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