scholarly journals Effect of CYP3A5*3 polymorphism on anti-inflamatory therapy in children with bronchial asthma

2019 ◽  
pp. 146-151
Author(s):  
A. K. Zastrozhina ◽  
S. V. Zaitseva ◽  
E. A. Grishina ◽  
K. A. Ryzhykova ◽  
O. O. Panfeorova ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Statistical Data ◽  
Inhaled Corticosteroids ◽  
Dynamic Assessment ◽  
Polymorphic Marker ◽  
Asthma Therapy ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Children With Asthma ◽  
Cyp3a5 Gene

Previous pharmacogenetic studies demonstrate significant genes’ polymorphisms effect on the efficacy and safety of pharmacotherapy, including in bronchial asthma (BA). According to the literature, there are data on the effect of polymorphisms CYP3A4*22 and CYP3A5*3 on the efficacy of inhaled corticosteroids in children with BA. Further research on the effect of pharmacogenetic features on the efficacy and safety of drugs is one of the way to optimize asthma therapy in children.Purpose. Identification of possible ways to optimize asthma therapy by the analysis of CYP3A5 (A6986G) gene polymorphism effect on the asthma therapy efficacy.Materials and methods. The study was conducted on the basis of three children’s polyclinics of Moscow. 100 children aged 6–17 years with an established diagnosis of BA were included. Dynamic assessment of asthma control and the amount of therapy needed was carried out. All patients underwent genotyping for the A6986G polymorphism of CYP3A5 gene by real-time PCR. Statistical data analysis was carried out using a programming language for statistical data processing R.3.4.0.Results. It was found that 8% of children with asthma were heterozygous for the A6986G polymorphism of the CYP3A5 gene, 92% of respondents were homozygous with the GG genotype. In 6 out of 8 heterozygotes, the amount of control therapy corresponded the third and fourth therapy stages according to GINA criteria. In the group of moderate and severe BA, the number of heterozygotes for the A6986G polymorphic marker of the CYP3A5 gene was statistically higher compared to the group of children with mild BA (p = 0,048).Conclusion. Thus, we identified a statistically significant difference in the occurrence of heterozygotes for the A6986G polymorphism of the CYP3A5 gene between groups of children with mild asthma and patients with moderate and severe asthma. The AG genotype and the presence of the A allele (CYP3A5 gene (A6986G)) are associated with more severe BA and the need for more anti-inflammatory therapy.

scholarly journals ASMANEX TWISTHALER - THE DRUG OF CHOICE AMONG INHALED CORTICOSTEROIDS

2013 ◽  
Vol 10 (6) ◽  
pp. 51-57
Author(s):  
T V Latysheva ◽  
E A Latysheva ◽  
O V Shubina
Keyword(s):  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Control Methods ◽  
Efficacy And Safety ◽  
Prior Therapy ◽  
Asthma Symptoms ◽  
Drug Of Choice ◽  
Systemic Corticosteroids ◽  
Before And After ◽  
Baseline Therapy

Goals. To reveal the clinical efficacy and safety of Asmanex in patients with moderate and severe bronchial asthma (BA), treated with inhaled and/or systemic glucocorticosteroids (GCS), depending on the severity and level of control. Methods. 40 patients (age 18 to 65 years) were treated with Asmanex with equivalent to prior therapy with inhaled corticosteroids (ICS) doses or in combination with systemic corticosteroids prior therapy (without increasing the dose of systemic corticosteroids) for 3 months. Efficacy was assessed before and after the treatment on a background of Asmanex treatment by the need of additional using of agonists of β 2-adrenoreceptors, severity of daytime and nighttime asthma symptoms, dynamics of spirometry parameters. The efficacy of Asmanex was compared with the original baseline therapy of other inhaled corticosteroids at equivalent doses using the new delivery system.

scholarly journals Relationship between montelukast and behavioral problems in preschool children with asthma

2022 ◽  
Vol 50 (1) ◽  
pp. 85-91
Author(s):  
Eda Özata ◽  
Zülfikar Akelma ◽  
Sacit Günbey
Keyword(s):  
Preschool Children ◽  
Behavioral Problems ◽  
Inhaled Corticosteroids ◽  
Controlled Study ◽  
Control Group ◽  
Healthy Children ◽  
Significant Difference ◽  
Children With Asthma ◽  
Healthy Control ◽  
Asthma Group

Background: There is insufficient clarity regarding whether or not drugs used in asthma cause behavioral problems in children.Methods: A total of 155 individuals, categorized into an asthma group (n = 95) and a control group (n = 60), were enrolled in the current prospective controlled study. The asthma group consisted of patients receiving treatment (inhaled corticosteroids [ICS] or montelukast) for at least 1 month. Check Behavior Checklist (CBCL) for ages 1.5–5 scores for the asthma and controls were compared. The asthma group was divided into two subgroups based on prophylactic therapy received, ICS and montelukast, and these groups’ CBCL scores were also compared. Results: The asthma group consisted of 95 children (ICS subgroup 45, montelukast subgroup 50) and the healthy control group of 60 cases. The mean total CBCL score was higher in the asthma group than in the control group (42 vs 32, respectively, P = 0.001). Internalization and externalization scores were also higher in the asthma group compared to the control group (P = 0.004 and P = 0.005, respectively). No significant difference was determined in terms of CBCL scores between the ICS and montelukast groups (P = 0.3). Montelukast was discontinued in one asthmatic child due to hallucination.Conclusion: This study determined a higher rate of behavioral problems in preschool children with asthma compared to healthy children. In contrast to other studies in the literature, we determined no difference in terms of total CBCL, and internalization and externalization scores of children with asthma who received ICS and montelukast. Nevertheless, it should be kept in mind that montelukast may cause serious neuropsychiatric events such as hallucination.

scholarly journals Voice changes associated with inhaled steroids 1n obstructive lung disease patients

2020 ◽  
Vol 12 (1) ◽  
pp. 1-7
Author(s):  
Baraka M ◽  
Hossam ElDessouky ◽  
Ahmed Amer Khamees ◽  
Ayman Ali Abd ElFattah ◽  
Eman Ezzat ◽  
...  
Keyword(s):  
Side Effects ◽  
Lung Disease ◽  
Bronchial Asthma ◽  
Obstructive Lung Disease ◽  
Inhaled Corticosteroids ◽  
Group I ◽  
Voice Changes ◽  
Significant Difference ◽  
Local Side ◽  
Laryngeal Examination

Background/Aims: The widespread use of inhaled corticosteroids (ICS) for the treatment of obstructive lung disease may be associated with both systemic and local side effects. These local side effects; including voice problems, oropharyngeal candidiasis, throat clearing, sense of fullness, pharyngitis, and cough, are generally viewed as minor complications of therapy in what is called steroid inhaler laryngitis (SIL). Few studies have been performed to specifically evaluate local side effects of ICS. However, they can be clinically significant, affect patient's quality of life, hinder compliance with therapy, and mask symptoms of more serious disease. The aim of this study is to examine the effect of ICS on the larynx and subsequent voice changes, and highlighting if these voice problems related to the type of inhaled corticosteroids in order to determine the importance of regular laryngeal examination in those patients. Methods: 40patients with bronchial asthma and 40 patients with COPD admitted to Chest department in Menoufia and Zagazig University Hospitals during the period from March 2017 to March 2019 were included in the study. They were divided according to the type of cortisone used into four groups; group (I): beclomethasone dipropionate (BDP) users, group (II): budesonide (BUD) users, group (III): Ciclesonide users and group (IV): fluticasone propionate (FP) users. They were evaluated as regards videolaryngoscopic examination and acoustic analysis Results: The age of the patients with bronchial asthma ranged from 29 to 42years and the age of the patients with COPD ranged from 31 to 43years. There was a statistically significant difference among the four groups of cortisone inhalation regarding laryngoscopic findings; as presence of congestion (diffuse and local), mucus spills on VF and glottis gap were all higher in frequency among the group of patients used fluticasone FP, while least signs found among ciclesonide users. Also, average pitch, Jitter, H/N ratio and MPT were more worsen in fluticasone group when compared with Ciclesonide group. Conclusion: obstructive lung disease patients may suffer from voice problems related to the type of inhaled corticosteroids that could be fade when therapy is stopped. So, regular laryngeal examination in those patients is important.

scholarly journals Real-world efficacy of the impulse oscillometry system for the management of bronchial asthma

2020 ◽  
Author(s):  
Hiroyuki Sugawara ◽  
Atsushi Saito ◽  
Saori Yokoyama ◽  
Kazunori Tsunematsu ◽  
Hirofumi Chiba ◽  
...  
Keyword(s):  
Particle Size ◽  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Strong Association ◽  
Therapeutic Effects ◽  
Impulse Oscillometry ◽  
Asthma Control Test ◽  
Subtype Classification ◽  
Predominant Type ◽  
Significant Difference

Abstract Background: Bronchial asthma (BA) has different phenotypes, and it requires a clinically effective subtype classification system. The impulse oscillometry system (IOS) is a novel device used in respiratory functional tests. However, its efficacy has not been validated. Therefore, this study aimed to assess the relationship between BA and the IOS parameters, and the difference in the therapeutic effects of inhaled corticosteroids (ICSs) among the subtype classifications was evaluated using the IOS.Methods: The following ICSs were randomly prescribed in daily medical care: coarse-particle ICS (fluticasone propionate [FP]), fine-particle ICS (mometasone furoate [MF]), and moderate-particle ICS (budesonide [BUD]). The treatment effects were assessed using the Asthma Health Questionnaire (AHQ) and the Asthma Control Test (ACT), and were compared among the three subtypes (central predominant, peripheral predominant, and resistless) using the IOS.Results: In the central predominant type, the AHQ score of the MF group was significantly higher than that of the FP and BUD groups. In the peripheral predominant type, the MF group had a significantly lower AHQ than the FP group. In the resistless type, no significant difference was observed in the AHQ scores among the three groups. Moreover, similar results were obtained in the study using ACTConclusions: A strong association was observed between IOS subtype classification and ICS particle size in terms of therapeutic efficiency in BA. This result indicates that the ICS particle size must be identified using the IOS subtype classification before treatment.

scholarly journals THE EFFECT OF MAGNETO-LASER THERAPY ON THE PHENOTYPE OF BASOPHILS IN CHILDREN WITH ATOPIC ASTHMA

2019 ◽  
Vol 29 (2) ◽  
pp. 35-38
Author(s):  
Elena Asiryn ◽  
Pavel Novikov ◽  
Volha Matsiushchanka ◽  
Nadiezhda Titova ◽  
Lukas Vaidelys ◽  
...  
Keyword(s):  
Laser Therapy ◽  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Atopic Asthma ◽  
Relative Level ◽  
Atopic Bronchial Asthma ◽  
Significant Difference ◽  
Group A ◽  
The Absolute ◽  
Group B

In recent years there has been growing evidence to suggest a major role of basophils alongside eosinophils and mast cells in allergic inflammation. The aim of this study was to analyze the dynamics of the basophil phenotypes after the use of magneto-la-ser therapy in children with atopic bronchial asthma. Materials and methods. A total of 66 children with mild persistent atopic bronchial asthma (aged 6 to 18 years old) were examined. Group A included 34 children who received magneto-laser therapy together with basic asthma treatment (low dose of inhaled corticosteroids). Group B included 32 children who received only basic asthma therapy. The level of CD203с + , CD203с + CD63 + , CD203с + IgE + basophils was determined in peripheral blood in the beginning of the study, after 2 weeks and after 3 months. Results. A statistically significant decrease in the absolute levels of CD203с+CD63+ and CD203с + IgE + basophils and in the relative level of CD203с + IgE + among all CD203с + basophils was determined in group A after magneto-laser therapy. The comparison of group A and group B indices revealed a significant difference between the relative level of CD203с + IgE + basophils after 12-15 days from the beginning of the study. This indicator was significantly lower in group A than in group B (p<0.05). The absolute level of CD203с + IgE + basophils was significantly lower in group A in comparison with group B after 82-90 days (p<0.05). Conclusions. Magneto-laser therapy can change the phenotype of basophils in children with atopic bronchial asthma, causing suppression of proallergic pa-rameters. Considering these results there is reason to believe, that it is possible to use this method as an additional immunocorrective treatment in patients with basophilic phenotype of atopic asthma.

ОСОБЕННОСТИ ЛЕЧЕНИЯ БРОНХИАЛЬНОЙ АСТМЫ В ПЕРИОД БЕРЕМЕННОСТИ

2019 ◽  
Author(s):  
O.V. Lavrova ◽  
M.A. Petrova ◽  
G.B. Fedoseev
Keyword(s):  
Pregnant Women ◽  
Bronchial Asthma ◽  
Pregnancy Complications ◽  
Inhaled Corticosteroids ◽  
Combined Therapy ◽  
Persistent Asthma ◽  
Asthma Therapy ◽  
Complete Control ◽  
Basic Therapy ◽  
Standard Procedures

Цель. Анализ характера терапии бронхиальной астмы, а также течения беременности у пациенток с бронхиальной астмой в период с 2002 по 2017 г. Материалы и методы. С 2002 по 2017 г. обследованы и проходили наблюдение в период беременности 3890 пациенток, страдающих бронхиальной астмой. Проводилось комплексное клинико-функциональное обследование. Пациентки находились под наблюдением акушера-гинеколога весь срок беременности, проходили стандартное обследование, оценивалась частота осложнений беременности. Было проведено сравнение характера базисной терапии бронхиальной астмы в группах пациенток с персистирующим течением заболевания, наблюдавшихся с 2002 по 2009 г. (1-я группа) и с 2010 по 2017 г. (2-я группа) в сопоставлении с частотой встречаемости осложнений беременности в данных группах. Результаты. При сравнении частоты встречаемости угрозы прерывания беременности, гипертензивных расстройств, преэклампсии выявлена достоверно более низкая частота встречаемости этих осложнений беременности во 2-й группе (2010-2017 гг.). При этом частота назначения ингаляционных глюкокортикостероидов (ИГКС) в составе комбинированных препаратов возросла с 21,79 до 63,87, что практически в три раза превышает данный показатель в 1-й группе (2002-2009 гг.). Заключение. При сопоставлении изменений в характере базисной терапии, произошедших с 2002 по 2017 г., с достоверным снижением частоты встречаемости осложнений беременности в группе, наблюдавшейся с 2010 по 2017 г., можно предположить, что именно терапия комбинированными препаратами ИГКС/ агонистов Р2-адренорецпторов длительного действия позволяет наиболее полноценно обеспечивать контроль бронхиальной астмы, приводя к снижению частоты осложнений беременностиStudy goal. To analyse asthma therapy in pregnant women with bronchial asthma at a period since 2002 to 2017. Materials and methods. 3890 pregnant women with asthma were examined and followed up during pregnancy at a period since 2002 to 2017. Comprehensive clinicalfunctional examination was conducted. Patients were under surveillance of the obstetriciangynecologist during the whole pregnancy, standard procedures were carried out, and the frequency of complications of pregnancy was estimated. Basic therapy of asthma was compared in groups with the persistent asthma duration, followed up since 2002 to 2009 (1 group) and since 2010 to 2017 (2 group). Also, frequency of pregnancy complications was estimated in these groups. Results. The second group (2010-2017) demonstrated reliably lower frequency of threatening abortion, hypertension and preeclampsia. At the same time the frequency of inhaled corticosteroids (ICS) administration as a part of the combined therapy increased from 21.79 to 63.87 (almost to three times) in comparison with the first group (2002-2009). Conclusions. Combined therapy with ICS/LABA provides most complete control of bronchial asthma, and decreases frequency of pregnancy complications in pregnant women with BA.

scholarly journals Factors Associated with Poor Asthma Control in Children Aged Five to 13 years

2006 ◽  
Vol 13 (1) ◽  
pp. 23-29 ◽  
Author(s):  
SL Mcghan ◽  
C MacDonald ◽  
DE James ◽  
P Naidu ◽  
E Wong ◽  
...  
Keyword(s):  
Asthma Control ◽  
Tobacco Smoke ◽  
Inhaled Corticosteroids ◽  
Psychosocial Impact ◽  
Control Group ◽  
Action Plans ◽  
Poor Control ◽  
The Poor ◽  
Significant Difference ◽  
Children With Asthma

BACKGROUND: Most children with asthma should be able to achieve acceptable control. However, are there differences between those with acceptable and poor control, and if so, how can health care approaches be modified accordingly?OBJECTIVE: To examine the characteristics of elementary school children aged five to 13 years with acceptable and poor levels of asthma control.METHODS: The present cross-sectional study of children with asthma used five indicators of control, as outlined by the Canadian Asthma Consensus Report, to categorize acceptable and poor asthma control.RESULTS: Of 153 children, 115 (75%) were rated as having poorly controlled asthma. Of those with poor control, 65 (64%) children were currently using inhaled corticosteroids, and 65% of those reported using inhaled corticosteroids daily versus as needed. Fifty-one per cent of the children with poorly controlled asthma had exposure to tobacco smoke, whereas 79% of the children with asthma under acceptable control were from households with no smokers (P=0.002). The poor control group also had significantly worse parental perceptions of the psychosocial impact of asthma on their child. No significant difference was found in the percentage of those who had written action plans in the poor control group (28%) compared with the acceptable control group (26%), and similar percentages in each group stated that they used the plans.CONCLUSIONS: Despite the high use of inhaled corticosteroids, the majority of children had poorly controlled asthma. The poor control group had more exposure to tobacco smoke and a worse psychosocial impact due to asthma. Few children had past asthma education and action plans, suggesting that there is a need to improve access to and tools for education.

ОСОБЕННОСТИ ЛЕЧЕНИЯ БРОНХИАЛЬНОЙ АСТМЫ В ПЕРИОД БЕРЕМЕННОСТИ

2019 ◽  
pp. 14-19
Author(s):  
O.V. Lavrova ◽  
M.A. Petrova ◽  
G.B. Fedoseev
Keyword(s):  
Pregnant Women ◽  
Bronchial Asthma ◽  
Pregnancy Complications ◽  
Inhaled Corticosteroids ◽  
Combined Therapy ◽  
Persistent Asthma ◽  
Asthma Therapy ◽  
Complete Control ◽  
Basic Therapy ◽  
Standard Procedures

Цель. Анализ характера терапии бронхиальной астмы, а также течения беременности у пациенток с бронхиальной астмой в период с 2002 по 2017 г. Материалы и методы. С 2002 по 2017 г. обследованы и проходили наблюдение в период беременности 3890 пациенток, страдающих бронхиальной астмой. Проводилось комплексное клиникофункциональное обследование. Пациентки находились под наблюдением акушерагинеколога весь срок беременности, проходили стандартное обследование, оценивалась частота осложнений беременности. Было проведено сравнение характера базисной терапии бронхиальной астмы в группах пациенток с персистирующим течением заболевания, наблюдавшихся с 2002 по 2009 г. (1я группа) и с 2010 по 2017 г. (2я группа) в сопоставлении с частотой встречаемости осложнений беременности в данных группах. Результаты. При сравнении частоты встречаемости угрозы прерывания беременности, гипертензивных расстройств, преэклампсии выявлена достоверно более низкая частота встречаемости этих осложнений беременности во 2й группе (20102017 гг.). При этом частота назначения ингаляционных глюкокортикостероидов (ИГКС) в составе комбинированных препаратов возросла с 21,79 до 63,87, что практически в три раза превышает данный показатель в 1й группе (20022009 гг.). Заключение. При сопоставлении изменений в характере базисной терапии, произошедших с 2002 по 2017 г., с достоверным снижением частоты встречаемости осложнений беременности в группе, наблюдавшейся с 2010 по 2017 г., можно предположить, что именно терапия комбинированными препаратами ИГКС/ агонистов Р2адренорецпторов длительного действия позволяет наиболее полноценно обеспечивать контроль бронхиальной астмы, приводя к снижению частоты осложнений беременностиStudy goal. To analyse asthma therapy in pregnant women with bronchial asthma at a period since 2002 to 2017. Materials and methods. 3890 pregnant women with asthma were examined and followed up during pregnancy at a period since 2002 to 2017. Comprehensive clinicalfunctional examination was conducted. Patients were under surveillance of the obstetriciangynecologist during the whole pregnancy, standard procedures were carried out, and the frequency of complications of pregnancy was estimated. Basic therapy of asthma was compared in groups with the persistent asthma duration, followed up since 2002 to 2009 (1 group) and since 2010 to 2017 (2 group). Also, frequency of pregnancy complications was estimated in these groups. Results. The second group (20102017) demonstrated reliably lower frequency of threatening abortion, hypertension and preeclampsia. At the same time the frequency of inhaled corticosteroids (ICS) administration as a part of the combined therapy increased from 21.79 to 63.87 (almost to three times) in comparison with the first group (20022009). Conclusions. Combined therapy with ICS/LABA provides most complete control of bronchial asthma, and decreases frequency of pregnancy complications in pregnant women with BA.

scholarly journals Real-world efficacy of the impulse oscillometry system for the management of bronchial asthma

2020 ◽  
Author(s):  
Hiroyuki Sugawara ◽  
Atsushi Saito ◽  
Saori Yokoyama ◽  
Kazunori Tsunematsu ◽  
Hirofumi Chiba ◽  
...  
Keyword(s):  
Particle Size ◽  
Bronchial Asthma ◽  
Inhaled Corticosteroids ◽  
Strong Association ◽  
Therapeutic Effects ◽  
Impulse Oscillometry ◽  
Subtype Classification ◽  
Predominant Type ◽  
Significant Difference ◽  
Act Score

Abstract Background: Bronchial asthma (BA) has different phenotypes, and it requires a clinically effective subtype classification system. The impulse oscillometry system (IOS) is a novel device used in respiratory functional tests. However, its efficacy has not been validated. Therefore, this study aimed to assess the relationship between BA and the IOS parameters, and the difference in the therapeutic effects of inhaled corticosteroids (ICSs) among the subtype classifications was evaluated using the IOS.Methods: Of the 245 patients with bronchial asthma who were screened, 108 patients were enrolled in this study. These patients were divided based on three subtypes according to the IOS result: Central predominant type (n=34), Peripheral predominant type (n=58), and resistless type (n=16). Then, the following ICSs were randomly prescribed in daily medical care: coarse-particle ICS (fluticasone propionate [FP]), fine-particle ICS (mometasone furoate [MF]), and moderate-particle ICS (budesonide [BUD]). The treatment effects were assessed using the Asthma Health Questionnaire (AHQ) and the Asthma Control Test (ACT), and were compared among the three subtypes.Results: In the central predominant type, the AHQ score of the MF group was significantly higher than that of the FP group (15.4 vs. 3.6, p<0.01) and BUD group (15.4 vs. 8.8, p<0.05), and the ACT score of the FP group was significantly higher than that of the MF and BUD groups (24.3 vs 21.7, 22.3, respectively, p<0.05) at 4 weeks after treatment. In the peripheral predominant type, the AHQ score of the FP group was significantly higher than that of the MF group (14.1 vs. 3.4, p<0.05) and the ACT score of the FP group was lower than that of the MF and BUD groups (22.8 vs 24.6, 24.4, respectively, p<0.01) at 4 weeks after treatment. In the resistless type, no significant difference was observed in the both scores among the three groups. Conclusions: A strong association was observed between IOS subtype classification and ICS particle size in terms of therapeutic efficiency in BA. This result indicates that the ICS particle size must be identified using the IOS subtype classification before treatment.

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