Asthma and aerobic exercise: A review of the empirical literature.

J Asthma. 2012 Dec 20;

Authors: Avallone KM, McLeish AC

Abstract
Objective: The purpose of the present paper was to provide a comprehensive review of the empirical literature on the association between asthma and aerobic exercise among adults. Methods: A literature search was conducted utilizing electronic search engines (i.e., PsycINFO and PubMed) using the following keyword algorithms: asthma AND (exercise OR physical activity). Results: These searches resulted in approximately 5,665 citations. Only results that were directly relevant were included in the present review. Conclusions: Overall, empirical evidence suggests that (1) individuals with asthma are less likely to engage in physical activity than those without asthma; (2) individuals with asthma are not biased in their subjective reporting of symptoms during aerobic exercise; (3) physical inactivity among individuals with asthma is associated with negative health consequences and increased asthma-related difficulties; and (4) regular aerobic exercise improves asthma symptom management, lung function, and mental health.

PMID: 23252987 [PubMed - as supplied by publisher]

Mechanisms of peripheral tolerance to allergens.

Allergy. 2012 Dec 18;

Authors: Soyer OU, Akdis M, Ring J, Behrendt H, Crameri R, Lauener R, Akdis CA

Abstract
The immune system is regulated to protect the host from exaggerated stimulatory signals establishing a state of tolerance in healthy individuals. The disequilibrium in immune regulatory vs effector mechanisms results in allergic or autoimmune disorders in genetically predisposed subjects under certain environmental conditions. As demonstrated in allergen-specific immunotherapy and in the healthy immune response to high-dose allergen exposure models in humans, T regulatory cells are essential in the suppression of Th2-mediated inflammation, maintenance of immune tolerance, induction of the two suppressive cytokines interleukin-10 and transforming growth factor-β, inhibition of allergen-specific IgE, and enhancement of IgG4 and IgA. Also, suppression of dendritic cells, mast cells, and eosinophils contributes to the construction of peripheral tolerance to allergens. This review focuses on mechanisms of peripheral tolerance to allergens with special emphasis on recent developments in the area of immune regulation.

PMID: 23253293 [PubMed - as supplied by publisher]

Multidisciplinary approach to management of maternal asthma (MAMMA [copyright]): the PROTOCOL for a randomized controlled trial.

BMC Public Health. 2012 Dec 19;12(1):1094

Authors: Lim A, Stewart K, Abramson MJ, Walker SP, George J

Abstract
ABSTRACT: BACKGROUND: Uncontrolled asthma during pregnancy is associated with the maternal hazards of disease exacerbation, and perinatal hazards including intrauterine growth restriction and preterm birth. Interventions directed at achieving better asthma control during pregnancy should be considered a high priority in order to optimise both maternal and perinatal outcomes. Poor compliance with prescribed asthma medications during pregnancy and suboptimal prescribing patterns to pregnant women have both been shown to be contributing factors that jeopardise asthma control. The aim is to design and evaluate an intervention involving multidisciplinary care for women experiencing asthma in pregnancy.Methods/design: A pilot single-blinded parallel-group randomized controlled trial testing a Multidisciplinary Approach to Management of Maternal Asthma (MAMMA(C)) which involves education and regular monitoring. Pregnant women with asthma will be recruited from antenatal clinics in Victoria, Australia. Recruited participants, stratified by disease severity, will be allocated to the intervention or the usual care group in a 1:1 ratio. Both groups will be followed prospectively throughout pregnancy and outcomes will be compared between groups at three and six months after recruitment to evaluate the effectiveness of this intervention. Outcome measures include Asthma Control Questionnaire (ACQ) scores, oral corticosteroid use, asthma exacerbations and asthma related hospital admissions, and days off work, preventer to reliever ratio, along with pregnancy and neonatal adverse events at delivery. The use of FEV1/FEV6 will be also investigated during this trial as a marker for asthma control. DISCUSSION: If successful, this model of care could be widely implemented in clinical practice and justify more funding for support services and resources for these women. This intervention will also promote awareness of the risks of poorly controlled asthma and the need for a collaborative, multidisciplinary approach to asthma management during pregnancy. This is also the first study to investigate the use of FEV1/FEV6 as a marker for asthma control during pregnancy.Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12612000681853).

PMID: 23253481 [PubMed - as supplied by publisher]

Asthma and paracetamol: Could we really know what happens between them?

Allergol Immunopathol (Madr). 2012 Dec 17;

Authors: Moral L, Marco N, Fuentes MJ, Toral T, Caño R, Pena MA

Abstract
An association between paracetamol use or exposure in different times of life, including gestation and childhood, and asthma has been observed in recent years. Causality cannot be established from observational studies because of the arguable presence of many confounding factors and biases. Randomised trials are needed to disclose the nature of the association, but are difficult to carry out because of ethic, economic and logistical issues as large patient samples should be involved for a long time in such studies. Pragmatic trials may be the best option to shed some light on this issue. Questions regarding the problems and difficulties of conducting such trials and the way to overcome them are discussed.

PMID: 23253685 [PubMed - as supplied by publisher]