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Comparison of the effects of budesonide/formoterol maintenance and reliever therapy with fluticasone/salmeterol fixed-dose treatment on airway inflammation and small airway impairment in patients who need to step-up from inhaled corticosteroid monotherapy

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Comparison of the effects of budesonide/formoterol maintenance and reliever therapy with fluticasone/salmeterol fixed-dose treatment on airway inflammation and small airway impairment in patients who need to step-up from inhaled corticosteroid monotherapy.

Pulm Pharmacol Ther. 2014 Jan 2;

Authors: Hozawa S, Terada M, Hozawa M

Abstract
BACKGROUND: If asthma patients fail to achieve symptom control using a medium dose of inhaled corticosteroid (ICS) alone, adding a long-acting β2 agonist (LABA) is the preferred treatment. We aimed to compare the effect of two widely available ICS/LABA combinations in these patients in real-life conditions: budesonide/formoterol (BUD/FM; Symbicort(®)) for maintenance and reliever therapy (SMART) and a fixed dose of fluticasone propionate/salmeterol (FP/SM).
METHODS: Inadequately controlled asthma patients treated with a medium dose of ICS alone, with an Asthma Control Questionnaire (ACQ) score >0.75 and using a short-acting β2-agonist (SABA) 2-6 occasions/week, were enrolled. Patients were randomized into two groups and treated with two inhalation twice-daily BUD/FM 160/4.5 μg plus as-needed BUD/FM (SMART group, n=15) or one inhalation twice-daily FP/SM 250/50 μg plus as-needed procaterol (FP/SM group, n=15) for 8 weeks.
RESULTS: Both groups showed significant improvement in airway inflammation, pulmonary functions and symptoms from baseline. The SMART group showed significant improvement in the fraction of nitric oxide, ACQ score, rescue medication use and small airway parameter R5-R20 measured by impulse oscillometry compared with the FP/SM group.
CONCLUSION: For stepping up treatment from ICS alone to an ICS/LABA combination, SMART is preferable for controlling asthma symptoms by suppressing airway inflammation and improving small airway impairment compared with a fixed dose of FP/SM. It may be achieved by the property of BUD/FM itself and as-needed use, but the degree of each contribution must be investigated further.

PMID: 24388868 [PubMed - as supplied by publisher]

Is vitamin D deficiency correlated with childhood wheezing and asthma?

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Is vitamin D deficiency correlated with childhood wheezing and asthma?

Front Biosci (Elite Ed). 2014;6:31-9

Authors: Comberiati P, Tsabouri S, Piacentini GL, Moser S, Minniti F, Peroni DG

Abstract
There is increasing evidence that vitamin D regulates immune responses. There is also epidemiological evidence of a relationship between vitamin D deficiency and development of asthma. In addition, several epidemiological studies suggest that low levels of vitamin D during pregnancy and early life are inversely associated with the risk of developing respiratory infections and wheezing in childhood. Vitamin D also seems to reduce asthma exacerbation and increase the response to glucocorticoids. These findings have led to considering a possible link between the occurrence of allergic respiratory diseases and low levels of vitamin D. However, the precise role of vitamin D in the pathogenesis of asthma still remains unclear, emphasizing the need for well-designed trials on vitamin D supplementation to decipher its role in preventing and/or managing the disease. This review examines the relationship that exists between vitamin D deficiency and childhood wheezing and asthma.

PMID: 24389138 [PubMed - in process]

Asthma and viruses: is there a relationship?

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Asthma and viruses: is there a relationship?

Front Biosci (Elite Ed). 2014;6:46-54

Authors: Moser S, Peroni DG, Comberiati P, Piacentini GL

Abstract
Asthma is a multifactorial disease in which many factors play a role in its development and exacerbations. Viral infections are known to be the main cause of asthmatic exacerbations and are often the first manifestation of asthma in preschool age. However, there is much evidence suggesting a role of viral infections even in asthma development. Respiratory Syncytial Virus (RSV). has been first associated with an increased risk to develop asthma, but recently new viruses have been proposed to be involved in asthma pathogenesis. Further studies will be needed to demonstrate a causative role of viral infections in asthma development, in order to implement preventive strategies in high-risk children.

PMID: 24389140 [PubMed - in process]

Lung function in wheezing infants.

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Lung function in wheezing infants.

Front Biosci (Elite Ed). 2014;6:185-97

Authors: Sanchez-Solis M, Garcia-Marcos L

Abstract
Recurrent wheeze is a very frequent disease during infancy. In many cases, this condition is a transient one, but some infants who suffer from this illness, have a persistent recurrent wheeze. During the past decades different international cohorts have been designed to answer what are the risk factors to develop recurrent wheeze and to make the conditon persistent even into the adulthood. Infant lung function could explain some aspects of this pathophysiology. The aim of this article is to review the current knowledge on the relationships of recurrent wheeze with an eventual impairment in lung function, the beginning of this impairment early in life, its relationship with asthma later in life and what risk factors are related with low lung function.

PMID: 24389152 [PubMed - in process]

IL-17A and IL-17F genes variants and susceptibility to childhood asthma in Tunisia.

IL-17A and IL-17F are new pro-inflammatory cytokines implicated in neutrophilic inflammation and thus, involved in the pathogenesis of asthma. We investigated the possible association between asthma and IL-17A -197G/A (rs2275913), IL-17F 7488A/G (rs763780) and IL-17F 7383A/G (rs2397084).

Methods: The study was performed in 171 patients with asthma (mean age 9.5years, 105 boys and 66 girls) and 171 healthy individuals matched with patients in age and sex. The PCR-RFLP method was used to detect genes' polymorphisms.

Results: IL-17A -197G/A and IL-17F 7383A/G were associated with asthma in children (p=0.008, p=0.001 respectively). No association was found with IL-17F 7488A/G polymorphism. Haplotype analysis revealed a significant association between GA and AG haplotypes and asthma (p=0.004, p=0.02). When patients were stratified according to atopic status, no significant association was detected with any of the three studied variants.

Conclusion: Our results suggested that SNPs in IL-17A and IL-17F confer susceptibility to childhood asthma in Tunisia.

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