• 文章类型: Journal Article
    据报道,土地利用和气候变化的变化会减少环境和人类微生物群的生物多样性。生物多样性的这些减少可能导致免疫调节回路的刺激不足和不平衡,最终,临床疾病,比如哮喘和过敏。
    我们总结了关于内在(肠道,皮肤,和气道)和外部(空气,土壤,天然水域,植物,和动物)哮喘发展过程中的生物多样性层,喘息,和过敏致敏。
    我们在SciVerseScopus进行了系统的搜索,PubMedMEDLINE,和WebofScience直到2024年3月5日,以确定相关的人类研究,评估生物多样性的内部和外部层与哮喘风险之间的关系,喘息,或过敏致敏。该协议在PROSPERO(CRD42022381725)中注册。
    总共筛选了2,419项研究,在排除和447项研究的全文回顾之后,82项研究被纳入综合研究,最后审查。29项研究报道了外层生物多样性在哮喘发展中的保护作用,喘息,或过敏致敏。还有16项研究表明外层生物多样性对增加哮喘的影响,喘息,或过敏致敏。然而,没有明确的证据表明内层生物多样性在哮喘发展中的作用,喘息,和过敏性致敏(13项研究报告了保护作用,15项研究报告了风险增加的证据).
    根据文献综述,未来的系统评价可以更具体地关注外层生物多样性和哮喘.与内层生物多样性的关联不太可能有足够的证据进行系统审查。基于这一全面审查,有必要进行基于人群的纵向研究,以确定生命过程中进入成年期的关键暴露期,并更好地了解将环境暴露与微生物组组成变化联系起来的机制,多样性,和/或功能发展为哮喘和过敏性致敏。https://doi.org/10.1289/EHP13948.
    UNASSIGNED: Changes in land use and climate change have been reported to reduce biodiversity of both the environment and human microbiota. These reductions in biodiversity may lead to inadequate and unbalanced stimulation of immunoregulatory circuits and, ultimately, to clinical diseases, such as asthma and allergies.
    UNASSIGNED: We summarized available empirical evidence on the role of inner (gut, skin, and airways) and outer (air, soil, natural waters, plants, and animals) layers of biodiversity in the development of asthma, wheezing, and allergic sensitization.
    UNASSIGNED: We conducted a systematic search in SciVerse Scopus, PubMed MEDLINE, and Web of Science up to 5 March 2024 to identify relevant human studies assessing the relationships between inner and outer layers of biodiversity and the risk of asthma, wheezing, or allergic sensitization. The protocol was registered in PROSPERO (CRD42022381725).
    UNASSIGNED: A total of 2,419 studies were screened and, after exclusions and a full-text review of 447 studies, 82 studies were included in the comprehensive, final review. Twenty-nine studies reported a protective effect of outer layer biodiversity in the development of asthma, wheezing, or allergic sensitization. There were also 16 studies suggesting an effect of outer layer biodiversity on increasing asthma, wheezing, or allergic sensitization. However, there was no clear evidence on the role of inner layer biodiversity in the development of asthma, wheezing, and allergic sensitization (13 studies reported a protective effect and 15 reported evidence of an increased risk).
    UNASSIGNED: Based on the reviewed literature, a future systematic review could focus more specifically on outer layer biodiversity and asthma. It is unlikely that association with inner layer biodiversity would have enough evidence for systematic review. Based on this comprehensive review, there is a need for population-based longitudinal studies to identify critical periods of exposure in the life course into adulthood and to better understand mechanisms linking environmental exposures and changes in microbiome composition, diversity, and/or function to development of asthma and allergic sensitization. https://doi.org/10.1289/EHP13948.
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  • 文章类型: Journal Article
    背景:颗粒β-葡聚糖(WGP)是在各种生物过程中具有调节作用的天然化合物,包括肿瘤发生和炎症性疾病,如过敏性哮喘。然而,它们对肥大细胞(MC)的影响,哮喘小鼠气道高反应性(AHR)和炎症的贡献者,仍然未知。
    方法:C57BL/6小鼠在没有明矾的情况下反复进行OVA致敏,其次是卵清蛋白(OVA)挑战。小鼠在致敏和攻击前每天口服50或150mg/kg剂量的WGP(OAW)。我们评估了气道功能,肺组织病理学,气道中的肺部炎症细胞成分,以及支气管肺泡灌洗液(BALF)中的促炎细胞因子和趋化因子。
    结果:150mg/kgOAW治疗减轻了OVA诱导的AHR和气道炎症,气道对雾化乙酰甲胆碱(Mch)的反应性降低证明,炎性细胞浸润减少,肺组织杯状细胞增生。此外,OAW阻碍了炎症细胞的募集,包括MC和嗜酸性粒细胞,在肺组织和BALF中。OAW治疗可减弱BALF中的促炎性肿瘤坏死因子(TNF)-α和IL-6水平。值得注意的是,OAW显著下调趋化因子CCL3、CCL5、CCL20、CCL22、CXCL9和CXCL10在BALF中的表达。
    结论:这些结果突出了OAW的强大抗炎特性,提示通过影响炎症细胞浸润和调节气道中的促炎细胞因子和趋化因子治疗MC依赖性AHR和过敏性炎症的潜在益处。
    BACKGROUND: Particulate β-glucans (WGP) are natural compounds with regulatory roles in various biological processes, including tumorigenesis and inflammatory diseases such as allergic asthma. However, their impact on mast cells (MCs), contributors to airway hyperresponsiveness (AHR) and inflammation in asthma mice, remains unknown.
    METHODS: C57BL/6 mice underwent repeated OVA sensitization without alum, followed by Ovalbumin (OVA) challenge. Mice received daily oral administration of WGP (OAW) at doses of 50 or 150 mg/kg before sensitization and challenge. We assessed airway function, lung histopathology, and pulmonary inflammatory cell composition in the airways, as well as proinflammatory cytokines and chemokines in the bronchoalveolar lavage fluid (BALF).
    RESULTS: The 150 mg/kg OAW treatment mitigated OVA-induced AHR and airway inflammation, evidenced by reduced airway reactivity to aerosolized methacholine (Mch), diminished inflammatory cell infiltration, and goblet cell hyperplasia in lung tissues. Additionally, OAW hindered the recruitment of inflammatory cells, including MCs and eosinophils, in lung tissues and BALF. OAW treatment attenuated proinflammatory tumor necrosis factor (TNF)-α and IL-6 levels in BALF. Notably, OAW significantly downregulated the expression of chemokines CCL3, CCL5, CCL20, CCL22, CXCL9, and CXCL10 in BALF.
    CONCLUSIONS: These results highlight OAW\'s robust anti-inflammatory properties, suggesting potential benefits in treating MC-dependent AHR and allergic inflammation by influencing inflammatory cell infiltration and regulating proinflammatory cytokines and chemokines in the airways.
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  • 文章类型: Journal Article
    目的:哮喘,一种具有不同病理机制的慢性炎症性疾病,在开发个性化诊断和治疗方法方面提出了挑战。这篇综述旨在全面概述外泌体的作用,小的细胞外囊泡,并探索其作为诊断生物标志物和治疗工具的潜力。
    方法:进行了文献检索,以确定研究外泌体与哮喘的关系的最新研究。对检索到的文章进行分析,以提取有关外泌体在维持肺微环境稳态中的作用的相关信息。调节炎症反应,以及它们对哮喘的诊断和治疗潜力。
    结果:由各种细胞类型分泌的外泌体,已成为健康和患病条件下细胞间通讯的关键介质。证据表明,外泌体在维持肺微环境稳态中起重要作用,并通过调节炎症反应促进哮喘的发病机理。健康个体和哮喘患者之间的外泌体含量差异有望开发新的哮喘生物标志物。此外,免疫细胞和非免疫细胞分泌的外泌体,以及在生物流体中检测到的那些,表现出促进或调节免疫反应的潜力,使他们有吸引力的候选人设计新的治疗策略,如哮喘。
    结论:外泌体,具有调节免疫反应和提供治疗性货物的能力,在哮喘管理中提供作为靶向治疗工具的潜力。需要进一步的研究和临床试验来充分了解外泌体介导作用的潜在机制,并将这些发现转化为哮喘患者的有效诊断和治疗策略。
    OBJECTIVE: Asthma, a chronic inflammatory disease with diverse pathomechanisms, presents challenges in developing personalized diagnostic and therapeutic approaches. This review aims to provide a comprehensive overview of the role of exosomes, small extracellular vesicles, in asthma pathophysiology and explores their potential as diagnostic biomarkers and therapeutic tools.
    METHODS: A literature search was conducted to identify recent studies investigating the involvement of exosomes in asthma. The retrieved articles were analyzed to extract relevant information on the role of exosomes in maintaining lung microenvironment homeostasis, regulating inflammatory responses, and their diagnostic and therapeutic potential for asthma.
    RESULTS: Exosomes secreted by various cell types, have emerged as crucial mediators of intercellular communication in healthy and diseased conditions. Evidence suggest that exosomes play a significant role in maintaining lung microenvironment homeostasis and contribute to asthma pathogenesis by regulating inflammatory responses. Differential exosomal content between healthy individuals and asthmatics holds promise for the development of novel asthma biomarkers. Furthermore, exosomes secreted by immune and nonimmune cells, as well as those detected in biofluids, demonstrate potential in promoting or regulating immune responses, making them attractive candidates for designing new treatment strategies for inflammatory conditions such as asthma.
    CONCLUSIONS: Exosomes, with their ability to modulate immune responses and deliver therapeutic cargo, offer potential as targeted therapeutic tools in asthma management. Further research and clinical trials are required to fully understand the mechanisms underlying exosome-mediated effects and translate these findings into effective diagnostic and therapeutic strategies for asthma patients.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    由于疾病的异质性和复杂性,评估哮喘患者的COVID-19风险具有挑战性。我们假设COVID-19的潜在危险因素在哮喘年龄组之间可能不同,一起研究时阻碍了重要的见解。
    我们纳入了来自瑞典国家气道登记机构(SNAR)的哮喘患者人群队列,并与来自多个国家健康登记机构的数据相关联。COVID-19结果包括感染,住院治疗,从2020年1月至2021年2月死亡。哮喘患者按年龄12-17、18-39、40-64和≥65岁分组。将具有不同COVID-19结局的哮喘患者的特征与相应年龄的各自来源人群的特征进行比较。
    在研究的201,140名哮喘患者中,11.2%的人年龄在12-17岁之间,26.4%18-39岁,37.6%40-64岁,24.9%≥65岁。我们观察到18,048(9.0%)COVID-19感染,2172(1.1%)住院,336例(0.2%)COVID-19死亡。死亡仅发生在≥40岁的患者中。当按年龄比较COVID-19病例和来源哮喘人群时,潜在风险因素出现了巨大差异,主要是因为COVID-19住院和死亡。对于12-17岁的人,这些包括教育,employment,自身免疫,精神病学,和抑郁状态,以及使用短效β-激动剂(SABA)和吸入性皮质类固醇(ICS)。在18-39岁年龄段,最大的差异是年龄,婚姻状况,呼吸衰竭,焦虑,和体重指数。40-64岁的性别表现出明显的差异,出生区域,癌症,口服皮质类固醇,抗组胺药,和吸烟。对于年龄≥65岁的人,心血管合并症的差异最大,1型糖尿病,慢性阻塞性肺疾病,过敏状况,和特定的哮喘治疗(ICS-SABA,ICS-长效支气管扩张剂(LABA))。哮喘控制和肺功能在所有年龄组都很重要。
    我们发现不同年龄的哮喘患者在COVID-19相关危险因素方面存在明显差异。这些信息对于评估哮喘患者的COVID-19风险以及相应地定制患者护理和公共卫生策略至关重要。
    为什么要进行这项研究?哮喘患者可能更容易受到COVID-19结果的影响。哮喘影响所有年龄段,与COVID-19相关的危险因素可能随年龄而变化。调查导致COVID-19感染的因素,住院治疗,和不同年龄组哮喘患者的死亡率可以更全面地了解COVID-19风险的年龄特异性细微差别。研究人员做了什么和发现了什么?我们分析了社会人口统计学特征,合并症,处方药,不同年龄组COVID-19哮喘患者的临床特征,并与相应年龄来源的哮喘人群进行比较。COVID-19的潜在危险因素及其结果因年龄组而异。对于12-17岁的儿童,这些包括教育,employment,自身免疫,精神病学,和抑郁状态,以及使用短效β-激动剂(SABA)和吸入性皮质类固醇(ICS)。在18-39岁年龄段,最大的差异是年龄,婚姻状况,呼吸衰竭,焦虑,和体重指数。40-64岁的性别表现出明显的差异,出生区域,癌症,口服皮质类固醇,抗组胺药,和吸烟。对于年龄≥65岁的人,心血管合并症的差异最大,1型糖尿病,慢性阻塞性肺疾病,过敏性哮喘,和特定的哮喘治疗(ICS-SABA,ICS-长效支气管扩张剂(LABA))。哮喘控制和肺功能在所有年龄组都很重要。这些结果意味着什么?这些结果强调了在因果分析中认识到导致COVID-19风险的特定年龄模式的重要性。研究结果还强调了在临床和公共卫生干预措施中采用年龄特异性方法来管理哮喘患者的COVID-19的必要性。
    UNASSIGNED: Assessing COVID-19 risk in asthma patients is challenging due to disease heterogeneity and complexity. We hypothesized that potential risk factors for COVID-19 may differ among asthma age groups, hindering important insights when studied together.
    UNASSIGNED: We included a population-based cohort of asthma patients from the Swedish National Airway Register (SNAR) and linked to data from several national health registers. COVID-19 outcomes included infection, hospitalization, and death from Jan 2020 until Feb 2021. Asthma patients were grouped by ages 12-17, 18-39, 40-64, and ≥65 years. Characteristics of asthma patients with different COVID-19 outcomes were compared with those in their age-corresponding respective source population.
    UNASSIGNED: Among 201,140 asthma patients studied, 11.2% were aged 12-17 years, 26.4% 18-39, 37.6% 40-64, and 24.9% ≥65 years. We observed 18,048 (9.0%) COVID-19 infections, 2172 (1.1%) hospitalizations, and 336 (0.2%) COVID-19 deaths. Deaths occurred only among patients aged ≥40. When comparing COVID-19 cases to source asthma populations by age, large differences in potential risk factors emerged, mostly for COVID-19 hospitalizations and deaths. For ages 12-17, these included education, employment, autoimmune, psychiatric, and depressive conditions, and use of short-acting β-agonists (SABA) and inhaled corticosteroids (ICS). In the 18-39 age group, largest differences were for age, marital status, respiratory failure, anxiety, and body mass index. Ages 40-64 displayed notable differences for sex, birth region, cancer, oral corticosteroids, antihistamines, and smoking. For those aged ≥65, largest differences were observed for cardiovascular comorbidities, type 1 diabetes, chronic obstructive pulmonary disease, allergic conditions, and specific asthma treatments (ICS-SABA, ICS-long-acting bronchodilators (LABA)). Asthma control and lung function were important across all age groups.
    UNASSIGNED: We identify distinct differences in COVID-19-related risk factors among asthma patients of different ages. This information is essential for assessing COVID-19 risk in asthma patients and for tailoring patient care and public health strategies accordingly.
    Why was the study done? Asthma patients may be more susceptible to COVID-19 outcomes. Asthma affects all ages, and COVID-19-related risk factors may vary with age. Investigating factors that contribute to COVID-19 infection, hospitalization, and mortality within distinct age groups of asthma patients can yield a more comprehensive understanding of the age-specific nuances of COVID-19 risk. What did the researchers do and find? We analyzed sociodemographic characteristics, comorbidities, prescribed medications, and clinical characteristics of asthma patients with COVID-19 in different age groups and compared them with their age-corresponding source asthma populations. Potential risk factors for COVID-19 and its outcomes differed by age group For ages 12-17, these included education, employment, autoimmune, psychiatric, and depressive conditions, and use of short-acting β-agonists (SABA) and inhaled corticosteroids (ICS). In the 18-39 age group, largest differences were for age, marital status, respiratory failure, anxiety, and body mass index. Ages 40-64 displayed notable differences for sex, birth region, cancer, oral corticosteroids, antihistamines, and smoking. For those aged ≥65, largest differences were observed for cardiovascular comorbidities, type 1 diabetes, chronic obstructive pulmonary disease, allergic asthma, and specific asthma treatments (ICS-SABA, ICS-long-acting bronchodilators (LABA)). Asthma control and lung function were important across all age groups. What do these results mean? These results emphasize the importance of recognizing age-specific patterns contributing to COVID-19 risk for consideration in causal analyses. The findings also highlight the necessity for age-specific approaches in both clinical and public health interventions in managing COVID-19 in asthma patients.
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  • 文章类型: Journal Article
    肺功能检测对马哮喘(EA)的诊断至关重要,马呼吸道疾病的重要原因,但是它的临床应用仍然难以捉摸,不幸的是,由于参考方法的复杂性,食管球囊/气相色谱(EBP)和强制振荡力学(FOM),所以我们寻求一种非侵入性的,通过快速中断气流以平衡肺泡压力与近端气道压力在马匹中使用的便携式方法,称为流量中断(FI)。阻力(RINT)被计算为中断之前和之后立即的鼻子处的压力变化与中断之前立即的流量之间的关系。使用EBP和FI对5种健康的大学拥有的动物进行的初步研究表明,两种方法之间具有良好的对应关系:RINT(0.33/-0.05cmH2O/l/s)和RL(0.31/-0.06cmH2O/l/s)。在两个不同的客户拥有的马群中,将方法随机分配给FIvEBP(n=8),RINT与马匹的RL表现出良好的相关性,(rs=.995,p=.0002),符合RL,RINT和RL之间没有显着差异。使用FOM(n=12),RINT(0.67+/-0.31cmH2O/l/s)与FOM测量的RRS具有良好的相关性(r=.834,p=.0001),但始终小于RRS(0.74+/-0.33cmH2O/l/s)。在这些马中的一部分中进行了组胺支气管激发(HBP):FI将6中的一匹马分类为反应性比EBP低,FI将7匹马归类为反应性比FOM低。
    Pulmonary function testing is critical to the diagnosis of equine asthma (EA), an important cause of respiratory disease in the horse, but its clinical use has remained elusive, unfortunately, due to the complexity of reference methods, esophageal balloon/pneumotachography (EBP) and forced oscillatory mechanics (FOM), so we sought a non-invasive, portable method for use in horses through rapid interruption of airflow for equilibration of alveolar pressure with proximal airway pressure, termed flow interruption (FI). Resistance (RINT) was computed as the relationship between the change in pressure at the nose before and immediately after interruption and flow immediately before interruption. A pilot study in 5 healthy university-owned animals using EBP and FI showed good correspondence between the two methods: RINT (0.33 +/- 0.05 cm H2O/l/s) and RL (0.31 +/- 0.06 cm H2O/l/s). In 2 separate populations of client-owned horses, with random assignment of methods to FI v EBP (n = 8), RINT showed good correlation with RL in horses, (rs =.995, p = .0002) and accords with RL, with no significant difference between RINT and RL. Using FOM (n = 12), RINT (0.67 +/- 0.31 cmH2O/l/s) has good correlation with RRS measured with FOM (r =.834, p = .0001), but is consistently smaller than RRS (0.74 +/- 0.33 cmH2O/l/s) . Histamine bronchoprovocation (HBP) was performed in a subset of these horses: FI classified one horse in 6 as less reactive than did EBP, and FI classified one horse in 7 as less reactive than did FOM.
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  • 文章类型: Journal Article
    研究中国荨麻疹患者合并症的患病率,并评估不同年龄段(6-11岁,12-17年,18岁以上),在健康数据库中192,647例荨麻疹患者中进行了一项回顾性队列研究.1:1倾向评分匹配后,166921人分为荨麻疹组和对照组,并在2年内收集随访数据。在12个月和24个月的随访期内,确定的显著合并症包括过敏性鼻炎和哮喘,在不同年龄段观察到不同的模式。慢性荨麻疹患者常出现并发症,如过敏性鼻炎,上呼吸道感染,口咽感染,和龋齿。该研究强调了在荨麻疹管理中需要针对年龄的治疗策略。
    To examine the prevalence of comorbidities in Chinese urticaria patients and assess medication use patterns across different ages (6-11 years, 12-17 years, above 18 years), a retrospective cohort study was performed in 192,647 urticaria patients within the Health Database. After 1:1 propensity score matching, 166,921 people were divided into the urticaria group and the control group, and the follow-up data were collected within 2 years. During the 12-month and 24-month follow-up period, significant comorbidities identified included allergic rhinitis and asthma, with distinct patterns observed across age groups. Chronic urticaria patients often have complications, such as allergic rhinitis, upper respiratory infection, oropharyngeal infection, and dental caries. The study underscores the need for age-specific treatment strategies in urticaria management.
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  • 文章类型: Journal Article
    背景:生育三烯酚表现出抗氧化和抗炎活性。RhoA,一种小的GTPase蛋白,在调节气道平滑肌(ASM)的收缩性中起着至关重要的作用。先前的研究已经证明γ-生育三烯酚通过抑制RhoA的活化来减少ASM增殖和迁移。在本研究中,我们研究了另一种维生素E亚型的作用,β-生育三烯酚,血小板衍生生长因子-BB(PDGF-BB)刺激的人ASM细胞增殖和迁移。
    方法:在用PDGF-BB刺激之前,用β-生育三烯酚预处理人ASM细胞以诱导ASM细胞增殖和迁移。使用比色和transwell迁移测定评估PDGF-BB诱导的人ASM细胞的增殖和迁移。细胞内ROS测定试剂盒用于定量人ASM细胞中的活性氧(ROS)。此外,我们探讨了β-生育三烯酚对PDGF-BB诱导的ASM增殖和迁移的信号通路的影响。
    结果:β-生育三烯酚通过减少RhoA活化和ROS产生抑制PDGF-BB诱导的ASM细胞增殖和迁移。然而,在本研究中,β-生育三烯酚不影响与细胞周期蛋白D1、磷酸化Akt1和ERK1/2相关的信号通路。
    结论:结论:β-生育三烯酚对RhoA活化和ROS产生的抑制作用,导致人类ASM增殖和迁移的减少,提示其作为哮喘气道重塑治疗的潜力。
    BACKGROUND: Tocotrienols exhibit antioxidant and anti-inflammatory activities. RhoA, a small GTPase protein, plays a crucial role in regulating contractility in airway smooth muscle (ASM). Previous studies have demonstrated that γ-tocotrienols reduce ASM proliferation and migration by inhibiting the activation of RhoA. In this present study, we investigate the effect of another vitamin E isoform, β-tocotrienols, on human ASM cell proliferation and migration stimulated by platelet-derived growth factor-BB (PDGF-BB).
    METHODS: Human ASM cells were pre-treated with β-tocotrienol prior to being stimulated with PDGF-BB to induce ASM cell proliferation and migration. The proliferation and migration of PDGF-BB-induced human ASM cells were assessed using colorimetric and transwell migration assays. The intracellular ROS assay kit was employed to quantify reactive oxygen species (ROS) in human ASM cells. Additionally, we explored the effect of β-tocotrienols on the signaling pathways involved in PDGF-BB-induced ASM proliferation and migration.
    RESULTS: β-tocotrienol inhibited PDGF-BB-induced ASM cell proliferation and migration by reducing RhoA activation and ROS production. However, in this present study, β-tocotrienol did not affect the signaling pathways associated with cyclin D1, phosphorylated Akt1, and ERK1/2.
    CONCLUSIONS: In conclusion, the inhibition of RhoA activation and ROS production by β-tocotrienol, resulting in the reduction in human ASM proliferation and migration, suggests its potential as a treatment for asthma airway remodeling.
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