scholarly journals Inhaled corticosteroids improve lung function, airway hyper-responsiveness and airway inflammation but not symptom control in patients with mild intermittent asthma: A meta-analysis

2017 ◽  
Vol 14 (2) ◽  
pp. 1594-1608 ◽  
Author(s):  
Wei Du ◽  
Ling Zhou ◽  
Yingmeng Ni ◽  
Yuanyuan Yu ◽  
Fang Wu ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Inflammation ◽  
Inhaled Corticosteroids ◽  
Meta Analysis ◽  
Symptom Control ◽  
Improve Lung Function ◽  
Intermittent Asthma

scholarly journals 552The lung function and airway inflammation markers associated with short-term pollen exposure- A systematic review

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
N. Sabrina Idrose ◽  
Caroline Lodge ◽  
Jennifer Koplin ◽  
Don Vicendese ◽  
Jo Douglass ◽  
...  
Keyword(s):  
Lung Function ◽  
Airway Inflammation ◽  
Meta Analysis ◽  
Qualitative Synthesis ◽  
Short Term ◽  
Cross Sectional ◽  
Random Effects Models ◽  
Newcastle Ottawa Scale ◽  
Pollen Exposure

Abstract Background Experimental challenge studies have shown that pollen can affect the lungs and airways. Here, we systematically reviewed community-based studies investigating outdoor pollen exposure, lung function and/or airway inflammation. Methods Four online databases were searched. The search strategy included terms relating to both exposure and outcomes. Inclusion criteria were studies published in English that were representative of the community. We only considered cross-sectional or short-term longitudinal studies which investigated pollen exposure by levels or season. Study quality assessment was performed using the Newcastle-Ottawa scale. Meta-analysis was conducted using random-effects models. Results We included 27 of 6,551 studies identified from the search. Qualitative synthesis indicated associations between pollen exposure and predominantly type-2 inflammation in both the upper and lower airways, but little evidence for lung function changes. People with ever asthma and/or seasonal allergic rhinitis (SAR) were at higher risk of such airway inflammation. Meta-analysis confirmed a positive relationship between pollen season and eosinophilic airway inflammation in people with ever SAR but the results between studies were highly variable. Heterogeneity was reduced after further subgrouping by age and the forest plots indicated that eosinophilic airway inflammation to outdoor pollen exposure increased with age. Conclusion Among people with ever asthma and ever SAR, exposure to increased ambient pollen triggers type-2 airway inflammation rather than a non-specific or innate inflammation. Key messages This review indicates pollen exposure influences predominantly type-2 airway inflammation, but little evidence on lung function.

scholarly journals Tailoring asthma treatment on eosinophilic markers (exhaled nitric oxide or sputum eosinophils): a systematic review and meta-analysis

Thorax ◽  
2018 ◽  
Vol 73 (12) ◽  
pp. 1110-1119 ◽  
Author(s):  
Helen L Petsky ◽  
Chris J Cates ◽  
Kayleigh M Kew ◽  
Anne B Chang
Keyword(s):  
Nitric Oxide ◽  
Lung Function ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Exhaled Nitric Oxide ◽  
Significant Group ◽  
Cochrane Reviews ◽  
Sputum Eosinophils

BackgroundAsthma guidelines guide health practitioners to adjust treatments to the minimum level required for asthma control. As many people with asthma have an eosinophilic endotype, tailoring asthma medications based on airway eosinophilic levels (sputum eosinophils or exhaled nitric oxide, FeNO) may improve asthma outcomes.ObjectiveTo synthesise the evidence from our updated Cochrane systematic reviews, for tailoring asthma medication based on eosinophilic inflammatory markers (sputum analysis and FeNO) for improving asthma-related outcomes in children and adults.Data sourcesCochrane reviews with standardised searches up to February 2017.Study selectionThe Cochrane reviews included randomised controlled comparisons of tailoring asthma medications based on sputum analysis or FeNO compared with controls (primarily clinical symptoms and/or spirometry/peak flow).ResultsThe 16 included studies of FeNO-based management (seven in adults) and 6 of sputum-based management (five in adults) were clinically heterogeneous. On follow-up, participants randomised to the sputum eosinophils strategy (compared with controls) were significantly less likely to have exacerbations (62 vs 82/100 participants with ≥1 exacerbation; OR 0.36, 95% CI 0.21 to 0.62). For the FeNO strategy, the respective numbers were adults OR 0.60 (95% CI 0.43 to 0.84) and children 0.58 (95% CI 0.45 to 0.75). However, there were no significant group differences for either strategy on daily inhaled corticosteroids dose (at end of study), asthma control or lung function.ConclusionAdjusting treatment based on airway eosinophilic markers reduced the likelihood of asthma exacerbations but had no significant impact on asthma control or lung function.

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.

Outdoor pollen‐related changes in lung function and markers of airway inflammation: A systematic review and meta‐analysis

2021 ◽  
Vol 51 (5) ◽  
pp. 636-653 ◽  
Author(s):  
Nur Sabrina Idrose ◽  
E. Haydn Walters ◽  
Jingwen Zhang ◽  
Don Vicendese ◽  
Ed J. Newbigin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lung Function ◽  
Airway Inflammation ◽  
Meta Analysis

scholarly journals Azithromycin as an add-on treatment for persistent uncontrolled asthma in adults: protocol of a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032770
Author(s):  
Wei Liu ◽  
Wei Mu ◽  
Huiting Zhang ◽  
Jingbo Zhai ◽  
Xiaodan Li ◽  
...  
Keyword(s):  
Lung Function ◽  
Standard Treatment ◽  
Inhaled Corticosteroids ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Primary Data ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
China National Knowledge Infrastructure ◽  
Beta Agonists

IntroductionClinical management of asthma remains a public challenge. Despite standard treatment with inhaled corticosteroids (ICS) and long-acting beta-agonists (LABAs), asthma remains uncontrolled in a substantial number of chronic asthma patients who risk reduced lung function and severe exacerbations. Azithromycin could have add-on effects for these patients. This study is proposed to systematically evaluate the efficacy of azithromycin as an add-on treatment for adults with persistent uncontrolled symptomatic asthma.Methods and analysisTwo reviewers will perform a comprehensive search of PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and four Chinese electronic databases including China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), WanFang Data and VIP Database from inception to May 2019. Only randomised controlled trials will be included. There is no restriction on language or publication status. Combined oral azithromycin and an ICS or/and a LABA will be compared with standard treatment alone or with a placebo. The primary outcomes are the number or frequency of asthma exacerbations, changes in asthma symptoms and lung function. Secondary outcomes include the number or frequency of inhalations of beta-agonists with or without corticosteroids for rescue use, eosinophil counts in blood or sputum, adverse events and others. A meta-analysis will be attempted to provide an estimate of the pooled treatment effect. Otherwise, qualitative descriptions of individual studies will be given.Ethics and disseminationEthical approval is not required because no primary data will be collected. Study findings will be presented at scientific conferences or published in a peer-reviewed journal.PROSPERO registration numberCRD42019117272.

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