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The incidence of bronchial hyperreactivity has increased to one-third of the population in developed countries, which requires the adoption of preventive and therapeutic measures. The objective of the present study was to assess the effects of a traditional Mediterranean diet on patients diagnosed with childhood asthma and determine if there is a beneficial effect from this dietary intervention.

METHODS: Prospective before-after comparison study of 50 girls and 54 boys aged 1-5 years, who were enrolled in the 1-year programme "Learning to Eat from the Mediterranean", designed to promote the adoption of a traditional Mediterranean diet. We studied the clinical and therapeutic variables and anthropometric measurements.

RESULTS: All studied symptomatic indicators (number and intensity of asthmatic attack, infections and hospital admissions) showed a positive and statistically significant evolution of bronchial hyperreactivity from the first weeks of the intervention onwards. Throughout the treatment, 32.2% of patients remained free of crisis, 35.3% of the patients only had one attack throughout the year and 24.9% had two episodes, compared to 4.73 episodes on average in the previous year. The use of inhaled corticosteroids markedly decreased from 3.92±1.61 to 1.11±1.09 times per patient per year (P<0.001) and that of inhaled bronchodilators decreased from 4.14±1.61 to 1.12±1.40 (P<0.001). As a result, the families involved in the programme reported a high level of satisfaction.

CONCLUSIONS: The adoption of a traditional Mediterranean diet could contribute significantly to the improvement of patients diagnosed with childhood asthma.

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A close relationship between upper and lower respiratory tract diseases has been reported. The purpose of this study was to evaluate lung function in patients with chronic rhinosinusitis (CRS) who have never smoked.

METHODS: A total of 208 patients with CRS were enrolled in this study. Of these subjects, 96 patients were ever smokers and 112 patients were never smokers. CRS patients with lower pulmonary diseases including chronic obstructive pulmonary disease (COPD) and asthma were excluded from this study. Age-matched normal control subjects (n = 55) who were never smokers were also recruited. Pulmonary function testing was performed using spirometry. Lund-Mackay computed tomography (CT) score, peripheral blood eosinophil count, and immunoglobulin E (IgE) level in serum samples were examined. Nasal obstruction was evaluated by active anterior rhinomanometry.

RESULTS: CRS patients who were ever smokers have decreased lung function. Never-smoking patients with CRS also showed significant obstructive lung function changes as compared with normal controls. No significant correlation was detected between the clinical parameters (CT score, eosinophil count, IgE level, and nasal resistance) and lung function.

CONCLUSION: Asymptomatic obstructive lung function changes were observed in never-smoking patients with CRS. Our findings suggest that patients with CRS should be followed carefully in order to detect lung diseases.

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There are few studies investigating the association between BCG vaccination and atopy or asthma in adults.
OBJECTIVE: We investigated the association between BCG scar and the occurrence of atopy and asthma in Korean adults.

METHODS: We carried out a retrospective study of Korean adults who underwent skin prick testing, and, in some cases, spirometry and bronchial provocation tests in a secondary care hospital from April 2010 to February 2011. Atopy status was classified according to allergen/histamine (A/H) ratio of wheal (A/H ratio ≥ 1, atopy; 0 < A/H ratio < 1, intermediate; A/H ratio = 0, non-atopy). A patient with asthma was defined as one who has symptoms compatible with asthma and showed either a positive provocation testing or bronchodilator reversibility.

RESULTS: Among 200 participants, neither the presence (intermediate vs. non-atopy: adjusted odds ratio (aOR) 0.83; 95% CI 0.26, 2.60; p = 0.75, atopy vs. non-atopy: aOR 0.89; 95% CI 0.33, 2.37; p = 0.81, respectively). nor the size of BCG scar was significantly associated with atopy status. However, among those patients who underwent either bronchodilator response testing or bronchial provocation testing, the presence of BCG scar (aOR 0.33; CI 0.14, 0.77; p = 0.01) and the size of BCG scar were inversely associated with asthma. (p = 0.01)

CONCLUSIONS: We found a significant association between BCG scar and asthmatic status in Korean adults, although there was no significant association between either the presence or size of BCG scar and atopy.

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Interleukin-13 (IL-13) has been difficult to quantify within human serum due to low abundance. Available assays have not been sensitive enough to detect IL-13 at the femtogram level. Thus, there are inconsistencies within the published literature as to IL-13 concentrations in normal or disease populations. To better understand IL-13 serum concentrations, a highly sensitive immunoassay was developed and used to determine concentrations from asthmatics with varying clinical severity.

METHODS: A single molecule counting (SMC) method was used to analyse serum samples from a total of 145 individuals (60 severe asthma, 60 moderate asthma, 60 mild asthma and 23 healthy donors).

RESULTS: IL-13 concentrations correlated with severity of asthma, with overlapping ranges. Mean IL-13 levels were highest in severe asthma. Mean IL-13 levels in moderate asthma population were second highest followed by mild asthma with the lowest IL-13 concentration. IL-13 concentrations in healthy donors were similar to the mild asthmatic population. The average concentrations of IL-13 in severe, moderate, mild and healthy donors were 1.286pg/mL, 0.672pg/mL, 0.508pg/mL and 0.155pg/mL respectively.

CONCLUSION: Severe asthma patients have elevated levels of IL-13.

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