Related Articles

Eosinophilic inflammation in allergic asthma.

Front Pharmacol. 2013;4:46

Authors: Possa SS, Leick EA, Prado CM, Martins MA, Tibério IF

Abstract
Eosinophils are circulating granulocytes involved in pathogenesis of asthma. A cascade of processes directed by Th2 cytokine producing T-cells influence the recruitment of eosinophils into the lungs. Furthermore, multiple elements including interleukin (IL)-5, IL-13, chemoattractants such as eotaxin, Clara cells, and CC chemokine receptor (CCR)3 are already directly involved in recruiting eosinophils to the lung during allergic inflammation. Once recruited, eosinophils participate in the modulation of immune response, induction of airway hyperresponsiveness and remodeling, characteristic features of asthma. Various types of promising treatments for reducing asthmatic response are related to reduction in eosinophil counts both in human and experimental models of pulmonary allergic inflammation, showing that the recruitment of these cells really plays an important role in the pathophysiology of allergic diseases such asthma.

PMID: 23616768 [PubMed]

Related Articles

Update on clinical inflammometry for the management of airway diseases.

Can Respir J. 2013 Mar-Apr;20(2):117-20

Authors: Nair P

Abstract
Airway inflammation is a central feature of many airway diseases such as asthma, chronic bronchitis, bronchiectasis and chronic cough; therefore, it is only logical that it is measured to optimize its treatment. However, most treatment recommendations, including the use of anti-inflammatory therapies such as corticosteroids, are based on assessments of only airflow and symptoms. Over the past 10 years, methods have been developed to assess airway inflammation relatively noninvasively. Quantitative cell counts in sputum and the fraction of exhaled nitric oxide are the most validated tests. Judicious use of currently available drugs, such as corticosteroids, bronchodilators and antibiotics, and other anti-inflammatory therapies guided by sputum eosinophil and neutrophil counts, have been demonstrated to decrease exacerbations of asthma and chronic obstructive pulmonary disease, ameliorate cough, improve quality of life in patients with these diseases and is cost effective compared with treatment strategies based on guidelines that do not incorporate these measurements. Thus, it is unfortunate that this is not used more widely in the management of airway diseases, particularly in patients with severe asthma and chronic obstructive pulmonary disease who experience frequent exacerbations.

PMID: 23616969 [PubMed - in process]

Fast beneficial systemic anti-inflammatory effects of inhaled budesonide and formoterol on circulating lymphocytes in asthma.

Respirology. 2013 Apr 26;

Authors: Rüdiger JJ, Gencay M, Yang JQ, Bihl M, Tamm M, Roth M

Abstract
BACKGROUND AND OBJECTIVE: Inhaled glucocorticoids and long acting β2 -agonists reduce airway inflammation. It is unclear if this effect is based on the local action of the drugs or is due to a systemic effect on circulating peripheral blood lymphocytes. We assessed whether inhaled budesonide and/or formoterol modify the activity of circulating peripheral blood lymphocytes. METHODS: Placebo controlled crossover design, including healthy (n=10) or mild asthmatic males (n=8). Blood was collected in the morning at 08:00 before drug inhalation, and drugs (placebo, budesonide 400μg, formoterol 12μg), were inhaled alone or in combination at 08:30. Four more blood samples were collected after inhalation at 09:00, 09:30, 12:30, and at 09:30 am on the following day. The activity of the glucocorticoid receptor, NFκB and IκB was determined in isolated lymphocytes. Lymphocytes were stimulated with lipopolysaccharide (LPS 10μg/ml) for 24 hours and IL-1β, IL-6, IL-8, TNF-α, eotaxin level were determined. Lymphocyte proliferation was induced by phytohaemagglutinin (PHA 10μg/ml) over 24 hours. RESULTS: When combined, the drugs synergistically activated the glucocorticoid receptor within 30 minutes, but did not modify NFκB or IκB activity. Inhaled budesonide significantly reduced LPS-induced IL-1β, IL-6, IL-8, and TNF-α secretion, while inhaled formoterol had no such effect; however when combined, the inhibitory effect of budesonide was significantly increased by formoterol. PHA-induced proliferation was reduced by both drugs alone and in combination. CONCLUSIONS: Combined budesonide and formoterol may reduce airway inflammation and immune reactivity of circulating lymphocytes through its local and systemic effects.

PMID: 23617551 [PubMed - as supplied by publisher]

A Randomized Controlled Trial of a Self-Regulation Intervention for Older Adults with Asthma.

J Am Geriatr Soc. 2013 Apr 25;

Authors: Baptist AP, Ross JA, Yang Y, Song PX, Clark NM

Abstract
OBJECTIVES: To evaluate a self-regulation intervention for asthma for older adults. DESIGN: A blinded randomized controlled trial. SETTING: Single-center tertiary care academic center. PARTICIPANTS: Seventy older adults aged 65 and older with persistent asthma randomized to an intervention or control group. INTERVENTION: Participants participate in a six-session program conducted over the telephone and in group sessions. Participants selected an asthma-specific goal, identified problems, and addressed potential barriers. MEASUREMENTS: Outcomes were assessed at 1, 6, and 12 months and included the mini-Asthma Quality of Life Questionnaire (mAQLQ), Asthma Control Questionnaire (ACQ), healthcare utilization, exhaled nitric oxide (FENO), and percentage of predicted forced expiratory volume in 1 second (FEV1%). RESULTS: The mAQLQ score was significantly higher in the intervention group at 1, 6, and 12 months, even after controlling for confounding factors. The between-group difference decreased over time, although at 12 months, it remained greater than 0.5 points. The ACQ was better in the intervention group than in the control group at 1, 6, and 12 months. At 12 months, those in the intervention group were 4.2 times as likely as those in the control group to have an ACQ score in the controlled range. Healthcare utilization was lower in the intervention group, although no difference was observed in FENO or predicted FEV1%. CONCLUSION: A self-regulation intervention can improve asthma control, quality of life, and healthcare utilization in older adults.

PMID: 23617712 [PubMed - as supplied by publisher]