Bronchial Asthma Research Papers - Academia.edu (original) (raw)

Objectives: Many studies have attempted to delineate the positive relationship between anxiety and depressive symptomatology in outpatients with bronchial asthma. However, do not exist reports on the relation between the depression,... more

Objectives: Many studies have attempted to delineate the positive relationship between anxiety and depressive symptomatology in outpatients with bronchial asthma. However, do not exist reports on the relation between the depression, anxiety and vital exhaustion in these patients.

An imbalance between oxidative stress and antioxidative capacity may play an important role in the development and progression of bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD). We carried out a study to assess the... more

An imbalance between oxidative stress and antioxidative capacity may play an important role in the development and progression of bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD). We carried out a study to assess the systemic oxidant-antioxidant status during the exacerbation and the stable period in patients with BA and COPD. A total of 33 patients, 16 with BA and 17 with COPD were included in the study. During the exacerbation and the stable periods, levels of malondialdehyde (MDA), activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione reductase (GRd), and catalase (CAT) in erythrocytes and serum melatonin concentrations were investigated. Blood counts, respiratory functions, and blood gases of the patients were also performed. During an exacerbation period of BA, despite the decreases in GSH-Px, GRd and melatonin levels, MDA and CAT levels, and the white blood cell count, the percentage of eosinophils were significantly higher than in the stable period. Also, it was found that FEV 1 /L (where FEV 1 is the forced expiratory volume in 1 s), FVC/L (where FVC is forced vital capacity), PEF/L/s (where PEF is peak expiratory flow), pO 2 (where pO 2 is oxygen pressure) levels increased during the stable period in patients with BA. MDA and SOD values were higher in the exacerbation period than in the stable period although GSH-Px, GRd, melatonin, pH, and pO 2 values were lower in the exacerbation period than in the stable period. The blood counts and the respiratory function tests did not change between the exacerbation and the stable period of patients with COPD significantly. In conclusion, we observed that oxidative stress in the exacerbation period of patients with BA and COPD increased whereas the antioxidant enzymes and melatonin values reduced. The episodes of BA or COPD might be associated with elevated levels of oxidative stress.

Isocyanates are increasingly being used for manufacturing polyurethane foam, elastomers, adhesives, paints, coatings, insecticides, and many other products At present, they are regarded as one of the main causes of occupational asthma The... more

Isocyanates are increasingly being used for manufacturing polyurethane foam, elastomers, adhesives, paints, coatings, insecticides, and many other products At present, they are regarded as one of the main causes of occupational asthma The large number of workers who are exposed to these chemicals have a concentration-dependent risk of developing chronic airway disorders, especially bronchial asthma Different pathophysiologic mechanisms are involved Immunoglobulin E (Ig E)-mediated sensitization and irritative effects have been clearly demonstrated in both exposed subjects and animals Presumably, neural inflammation due to neuropeptide release of capsaicin-sensitive afferent nerves is crucial We collected data on 1780 isocyanate workers who had been examined by our groups Of them 1095 (including subjects from outpatient departments) had work-related symptoms, predominantly of the respiratory tract Specific Ig E antibodies were found in 14 % of the 1095 subjects The methacholine challenge test was shown to be an inadequate predictor of the results of inhalative isocyanate provocation tests in workers and in asthmatic controls. Isocyanate (toluene diisocyanate TDI) air concentrations of 10 ppb (0 07 mg/m 3) and 20 ppb (O 14 mg/m 3), respectively, did not cause significant bronchial obstruction in the majority of previously unexposed asthmatics with bronchial hyperreactivity Ig G-mediated allergic alveolitis, a rare disease among isocyanate workers, was found in These studies were partly supported by the Ministry of Research and Technology, Federal Republic of Germany, grant 07 ALL 16 approximately 1 % of the symptomatic subjects Experimental studies exhibit dose-dependent toxic effects and give evidence for tachykinin-mediated bronchial hyperreactivity after exposure to isocyanates The clinical role of genotoxic effects of isocyanates and their by-products demonstrated here in vitro and in vivo has yet to be clarified. Key words Isocyanates Occupational asthma Bronchial hyperreactivity •Extrinsic allergic alveolitis Hypersensitivity pneumonitis Genotoxicity Neuropeptides Ig E antibodies Ig G antibodies Inhalative challenge test Abbreviations ACH acetylcholine •BALF bronchoalveolar lavage fluid • CGRP calcitonin gene-related peptide • cpm counts per minute • DMSO dimethylsulfoxide EAST enzyme allergo sorbent test FEVI forced expiratory volume in one second •HDI hexamethylene diisocyanate HSA human serum albumin IGV intrahoracic gas volume, measured by bodyplethysmography • IVC inspiratory vital capacity LC 50 lethal concentration for 50 % of tested animals MDI diphenylmethane diisocyanate • PD 50 so (oo PC 5 o (O oo O dose/concentration causing a change of 50 % (100 %) of the parameter indicated • ppb (ppm) parts per billion (million) RAST radio allergo sorbent test Raw airway resistance, measured by bodyplethysmography s Raw specific airway resistance, measured by bodyplethysmography • TDI toluene diisocyanate • TLV threshold limit value

Background: The protective effect of breast-feeding on the development of childhood asthma remains a matter of controversy. We conducted a systematic review of prospective studies that evaluated the association between exclusive... more

Background: The protective effect of breast-feeding on the development of childhood asthma remains a matter of controversy. We conducted a systematic review of prospective studies that evaluated the association between exclusive breast-feeding during the first 3 months after birth and asthma. Study design: We searched the 1966-1999 MEDLINE database and reviewed reference lists of relevant articles to identify 12 prospective studies that met pre-stated inclusion criteria. Methodological aspects of the studies, duration and exclusivity of breast-feeding, and outcomes were assessed. Effect estimates were abstracted by the investigators, using a standardized approach. Results: The summary odds ratio (OR) for the protective effect of breastfeeding was 0.70 (95% CI 0.60 to 0.81). The effect estimate was greater in studies of children with a family history of atopy (OR = 0.52) than in studies of a combined population (OR = 0.73).

In siddha system of medicine references are found in literature regarding two routes of drug administration namely Agamarunthu (Internal medicines) and Puramarunthu (External medicines). They are thirty-two each in number. Allergic... more

In siddha system of medicine references are found in literature regarding two routes of drug administration namely Agamarunthu (Internal medicines) and Puramarunthu (External medicines). They are thirty-two each in number. Allergic rhinitis due to inflammation of bronchial mucous membrane is the major cause for the development of bronchial asthma. Administration of Nasiyam reduces the inflammation in the condition of allergic rhinitis in bronchial asthma. This paper concludes the efficacy of Nasiyam, method of application, its probable mechanism of action and also some siddha formulations of Nasiyam in the treatment of allergic rhinitis in Bronchial asthma.

Purpose: Respiration is the evident feature of life which is carried out by Prana vayu. It is a sign of consciousness, provides enthusiasm to human beings. This sole sign of life is affected in this disease Tamaka swasa, causing an... more

Purpose: Respiration is the evident feature of life which is carried out by Prana vayu. It is a sign of consciousness, provides enthusiasm to human beings. This sole sign of life is affected in this disease Tamaka swasa, causing an impendent to the Respiratory function. Public attention in the world recently focuses on asthma because of its rapidly increasing prevalence. Irrespective of the application of advances in modern medicine as well as age old practice of traditional medicines; 100 to 150 million children around the globe suffer from this non-communicable respiratory disease. The international study of asthma and allergy in childhood (ISAAC) estimated asthma prevalence in India to be 6.2%-6.8% in 6-7 years old and 6.4%-6.7% in 12-16 years with more male affected than female. It is chronic disease of paranvaha srotas, in which vitiation of kapha & vata dosha mainly and origin in pitta sthana.Tamaka swasa is characterized by dyspnoea (swasakrichrata), chest tightness (urashula), wheeze (Gurgaruktvamhm) and cough (kasa). The paroxysm attack results in handicapped day & sleepless nights, thus disturbing a normal life style of the child. Childhood asthma is responsible for school absenteeism, restricted activities, social, economic & psychological impact on the family. Even though Tamaka swasa is considered as Yapya vyadhi but it is curable in its initial phase. In today’s scenario we have many anti-asthmatic drugs which can effectively control the various paroxysm attack of asthma but fail to control many adverse effects. Many studies need to be carried out in this perspective to find out a better remedy. Also low-cost asthma management programmers should be developed to ensure asthma care is available and affordable for all socio-economic sectors within the population. Considering all these aspects, the present study has been designed to evaluate the efficacy of two Ayurvedic formulations. The formulation Vasadi Syrup and Satyadi Syrup have been selected owing its Vata-Kaphahara, Swasahara, Rasayana properties.
Method : Symptomatology related to Bala Tamaka swasa, methods of diagnosis, inclusion and exclusion criteria of the patients will be adopted. Essential investigations will be carried out to confirm the diagnosis. A minimum sample of 30 patients in both groups will be assessed during the trial for 30 days with follow up of 15 days. Selected patients will be divided in to two groups. Group A- 15 patients and Group B- 15 patients. The patients will be selected from the OPD of R.G.G.P.G.A. C. Hospital Paprola; Dist. Kangra, (H.P.) 176115.
Result: Both the drugs having an appreciable result in the management of Bala Tamaka swasa symptoms and significant changes in investigations.
Conclusion: Tamaka swasa can be efficiently and effectively managed with Vasadi syrup and Satyadi syrup, the complication is prevented.

Objetivo: Reconocer la relación entre el tipo de lactancia materna y el riesgo de asma bronquial. Métodos: Estudio de casos y controles. Los casos (asmáticos, n= 31) y controles (no asmáticos, n=79) se seleccionaron de una muestra no... more

Objetivo: Reconocer la relación entre el tipo de lactancia materna y el riesgo de asma bronquial. Métodos: Estudio de casos y controles. Los casos (asmáticos, n= 31) y controles (no asmáticos, n=79) se seleccionaron de una muestra no probabilística de tipo accidental. El análisis se realizó por regresión múltiple. Ambiente: Dos comunidades de los Estados Lara y Yaracuy, entre 1998 y 1999. resultados: La lactancia materna complementaria, así como la suplementaria se asociaron a mayor riesgo de presentar el diagnóstico de asma bronquial (razones de posibilidades iguales a 4,5 y 17,8, respectivamente). Conclusiones: La lactancia materna exclusiva parece asociarse a protección contra el asma bronquial, por lo que debe ser promovida en las comunidades.

The cashew tree grows in abundance in the hills and plains of Goa, India. Because of the financial yield, more and more trees are being planted each year. The cashew tree flowers once a year between January and March, but pollination is... more

The cashew tree grows in abundance in the hills and plains of Goa, India. Because of the financial yield, more and more trees are being planted each year. The cashew tree flowers once a year between January and March, but pollination is mostly entomophilous. Objective: For the first time, a study was conducted to establish the possible role of the cashew pollen in triggering allergic asthma.

outcome measures. Results: Participation in FR, GI and FR/GI led to increases in FEV 1 (% predicted) of 7.6 8 13.2, 3.3 8 9.8, and 8.3 8 21.0, respectively, as compared to -1.8 8 11.1 in the CI group at the end of the therapy. After... more

outcome measures. Results: Participation in FR, GI and FR/GI led to increases in FEV 1 (% predicted) of 7.6 8 13.2, 3.3 8 9.8, and 8.3 8 21.0, respectively, as compared to -1.8 8 11.1 in the CI group at the end of the therapy. After follow-up, the increases in FEV 1 were 6.9 8 10.3 in the FR group, 4.4 8 7.3 in the GI and 4.5 8 8.1 in the FR/GI, compared to -2.8 8 9.2 in the CI. Improvements in sR aw (% predicted) were in keeping with the changes in FEV 1 in all groups. Conclusions: Our study confirms a positive effect of FR on respiratory parameters and suggests a clinically relevant long-term benefit from FR as a nonpharmacological and complementary therapy treatment option.

Lepidium sativum commonly called ‘‘Garden Cress’’ is a polymorphic species. Despite its great medicinal value, L. sativum has not received the attention it deserves. The garden cress is an annual herb belonging to the family... more

Lepidium sativum commonly called ‘‘Garden Cress’’ is a polymorphic species. Despite its great medicinal value, L. sativum has not received the attention it deserves. The garden cress is an annual herb belonging to the family Brassicaceae (Cruciferae) growing in Middle East Countries, Europe and USA. Its common names are Garden Cress, Pepper Grass, Garden Pepper, Cress, Water Cress, and Pepper Wort. In different provinces of Iran it has been different names, for example in Mazandaran called (TareTizak) and in other provinces of Iran called (Shahi). The consumption of (SHAHI) or Garden cress returned to past Centuries in Iran. The parts of the plant which are used are the roots, leaves and seeds. The seeds of L. sativum are bitter and find applications in a wide range of biological functions and
diseases such as leprosy, skin diseases and as a diuretic. The roots are bitter and acrid and have been used in treating secondary syphilis and tenesmus. The leaves are antibacterial and useful in treating scurvy and
hepatopathy. The effectiveness of this plant in the treatment of bronchial asthma, hiccups, cough with expectoration and bleeding piles has been reported. Also Iranian scientists have been worked on its different
properties. For example, Iranians investigate on Shahi phytoremediation against Soils contaminated with cadmium, or of the therapeutic properties, positive results were obtained about liver disorders, reduce fat
and cholesterol and antimicrobial properties. It seems to be that Shahi (L. sativum) is feature rich undiscovered.

Frequent administration of nebulized ~2 agonist at the onset of an acute asthmatic attack has been reported to be more effective. 1,2 However, even with this aggressive approach some residual obstruction is left which is unresponsive to... more

Frequent administration of nebulized ~2 agonist at the onset of an acute asthmatic attack has been reported to be more effective. 1,2 However, even with this aggressive approach some residual obstruction is left which is unresponsive to ~2 agonist. 3-6 Various drug combinations ...

A case report was carried out in two asthmatic patients treated with a new health natural product named Vimang®, an aqueous extract of Mangifera indica L stem bark, which has been registered as antioxidant and anti-inflammatory. A 39... more

A case report was carried out in two asthmatic patients treated with a new health natural product named Vimang®, an aqueous extract of Mangifera indica L stem bark, which has been registered as antioxidant and anti-inflammatory. A 39 years-old female with persistent moderated asthma and a 43 years-old male with persistent severe asthma were treated orally with Vimang® (capsule 300 mg, one every 8 h) during three months. Respiratory functional tests and determination of total serum immunoglobulin E (IgE), eosinophil cationic protein (ECP) and metalloproteinase-9 (MMP-9) activity were done at times 0, 6 and 12 weeks, respectively. An improvement in the volume of force expiration (FEV1) was observed for both patients. The values of IgE, ECP and the enzymatic activity of MMP-9 decreased also for both patients. These results could open the way to further clinical researches about the use of Vimang® as an alternative for the treatment of bronchial asthma.

A rare case of primary pulmonary neoplasm is reported. The patient was a 38-year-old woman presenting with obstructive pneumonia. Fiberoptic bronchoscopy revealed an endobronchial mass obstructing the left main bronchus: a reddish... more

A rare case of primary pulmonary neoplasm is reported. The patient was a 38-year-old woman presenting with obstructive pneumonia. Fiberoptic bronchoscopy revealed an endobronchial mass obstructing the left main bronchus: a reddish polypoid mass which bled on contract that was suggestive of bronchial adenoma. The patient also had a long-standing history of bronchial asthma and hemoptysis and the delay in establishing the eventured diagnosis was caused by the minor symptoms mimicking those of asthma. A persistent restrictive lung and the presentation of obstructive pneumonia were important clues which warranted further investigation by computed tomography (CT) scan and bronchoscopy. The patient underwent rigid bronchoscopy with CO2-laser ablation under general anesthesia. Histopathology confirmed a bronchial adenoma. The clinical response was excellent. Bronchial adenoma should be considered in young patients presenting with asthma, hemoptysis and obstructive pneumonia. Bronchoscopic ...

Bronchial asthma is a stress disease that may be induced by various stressors. Psychosocial stressors, working through the central nervous system as an inducing factor, cause disorders in the autonomous nervous system, the endocrine... more

Bronchial asthma is a stress disease that may be induced by various stressors. Psychosocial stressors, working through the central nervous system as an inducing factor, cause disorders in the autonomous nervous system, the endocrine system, and the immune system, and affect the onset and process of asthma. The disease tends to become serious and difficult to cure unless stressors are properly dealt with. The involvement, or lack of, psychosocial stressors, and the psychological state of the patients, are mainly diagnosed from interviews with them and observation of their behavior. With the premise that somatic medical treatments are fully carried out, the patients are encouraged to become aware by themselves of the relationship between stressors and asthma. If depression or anxiety is observed, the patients are treated with an antidepressant or an antianxiety agent. If asthma is not relieved by the continued practice of ordinary psychosomatic medicine, or if it is desired to reduce the levels of anti-asthmatics or to stop the medication, then other therapies can also be utilized. These include autogenic training, bio-feedback therapy based on respiratory resistance value, and fasting therapy.

Prominent blood and tissue eosinophilia is clinically manifested in a number of inflammatory states, particularly in allergic diseases. Corticosteroids are the most effective anti-inflammatory drugs used in the treatment of eosinophilic... more

Prominent blood and tissue eosinophilia is clinically manifested in a number of inflammatory states, particularly in allergic diseases. Corticosteroids are the most effective anti-inflammatory drugs used in the treatment of eosinophilic disorders, including bronchial asthma. Their beneficial effects result, among others, from (i) the suppression of the synthesis and the effects of eosinophil survival factors, (ii) the direct induction of eosinophil apoptosis and (iii) the stimulation of their engulfment by professional phagocytic cells. Failure of steroids to propagate apoptotic signals and to promote eosinophil clearance may explain the corticoresistance observed in a proportion of asthmatic patients. Accordingly, studies on the intracellular mechanisms involved in eosinophil corticosensitivity and resistance may provide a valuable tool for identifying new and selective molecular targets to therapeutically resolve otherwise persistent eosinophilic inflammation. In this review, the ...

Background: Angiogenesis is a feature of airway remodeling in bronchial asthma. The mechanism responsible for this angiogenesis is unknown. Vascular endothelial growth factor (VEGF) is a potent inducer of endothelial cells, which may... more

Background: Angiogenesis is a feature of airway remodeling in bronchial asthma. The mechanism responsible for this angiogenesis is unknown. Vascular endothelial growth factor (VEGF) is a potent inducer of endothelial cells, which may contribute to chronic inflammation and angiogenesis. Objective: We sought to investigate the molecular mechanisms underlying increased vascularity, and we examined the mRNA expression of VEGF and its receptors (flt-1 and flk-1) within bronchial biopsy specimens from asthmatic patients and normal control subjects. Methods: Endobronchial biopsy specimens were examined immunocytochemically by staining with anti-type IV collagen mAb to evaluate vessel density by using computer-assisted image analysis. Specimens were also analyzed for the presence of the mRNAs of VEGF and its receptors with in situ hybridization. Results: The extent of airway vascularity was increased in asthmatic subjects compared with that in control subjects (P < .01). Asthmatic subjects exhibited a greater expression of VEGF, flt-1, and flk-1 mRNA + cells in the airway mucosa compared with that in control subjects (P < .001 for each comparison). The degree of vascularity was associated with the number of VEGF, flt-1, and flk-1 mRNA + cells. Numbers of cells expressing VEGF mRNA inversely correlated with airway caliber (r = -0.83, P < .01) and airway hyperresponsiveness (r = -0.97, P < .001). Colocalization studies showed that macrophages, eosinophils, and CD34 + cells were the major sources of VEGF; CD34 + cells, macrophages, and T cells expressed both flt-1 and flk-1. Conclusion: These findings provide evidence that VEGF may play an important role in angiogenesis and subsequent airway remodeling in bronchial asthma. (J Allergy Clin Immunol 2001;107:1034-8.)

A large population world over is affected with allergic diseases and asthma. Pharmacotherapy for allergic diseases and asthma is effective in controlling symptoms but on discontinuation of medication, symptoms reoccur. In contrast,... more

A large population world over is affected with allergic diseases and asthma. Pharmacotherapy for allergic diseases and asthma is effective in controlling symptoms but on discontinuation of medication, symptoms reoccur. In contrast, immunotherapy modifies and corrects the underlying pathological immune responses in an antigenspecific manner. Immunotherapy shows an increase in IgG (blocking antibody) that competes with IgE for allergen, inhibiting the release of inflammatory mediators. Recent studies suggest that immunotherapy acts by modifying CD4+ T-cell responses either by immune deviation, T-cell anergy and/or both. Current immunological approaches for management of allergies and asthma involve immunization with native allergen, modified allergen, peptides/ cDNA of allergen, anti-IgE, adjuvants coupled allergen, including immunostimulatory DNA sequences, cytokines, and bacterial products. These approaches modulate the immune response and are intended to give long-term benefit.

Tumor necrosis factor-alpha (TNFα) antagonists including antibodies and soluble receptors have shown remarkable efficacy in various immune-mediated inflammatory diseases (IMID). As experience with these agents has matured, there is an... more

Tumor necrosis factor-alpha (TNFα) antagonists including antibodies and soluble receptors have shown remarkable efficacy in various immune-mediated inflammatory diseases (IMID). As experience with these agents has matured, there is an emerging need to integrate and critically assess

Background: Corona virus disease 2019 (COVID-19) is a public health emergency of international concern. The global population lacks immunity to COVID-19 and is generally susceptible. Underlying conditions, especially chronic respiratory... more

Background: Corona virus disease 2019 (COVID-19) is a public health emergency of international concern. The global population lacks immunity to COVID-19 and is generally susceptible. Underlying conditions, especially chronic respiratory diseases, may affect progression, treatment and prognosis of COVID-19. The majority of people who exposed to COVID-19 suffer only mild respiratory symptoms like cough, cold, difficulty in breathing, etc and these symptoms were correlated with Kaba Suram in the Siddha literature. Case Summary: Siddha Clinical Research Unit, New Delhi (CCRS), Ministry of AYUSH, Govt. of India had reported a patient with confirmed COVID-19 by RT-PCR with bronchial asthma as a comorbid condition. Recovery time from disease onset to negative test for COVID-19 was 19 days. Conclusion: Since the patient residing in Dwaraka, New Delhi has bronchial asthma as a co-morbid condition, both air pollution and the winter season are likely to increase the severity of the disease. But it was observed that the patient's condition did not deteriorate, so it could be presumed that the management of COVID-19 with the given Siddha internal medicines and external therapies as a standalone treatment ceased the progress of the disease to a severe stage.

Objective: The aim of this study is to examine the efficacy of progressive muscle relaxation (PMR) on change in blood pressure, lung parameters and heart rate in female adolescent asthmatics. Method: In a prospective, randomized,... more

Objective: The aim of this study is to examine the efficacy of progressive muscle relaxation (PMR) on change in blood pressure, lung parameters and heart rate in female adolescent asthmatics. Method: In a prospective, randomized, double-blind, controlled study, adolescent female asthmatics (n =31) were tested to find out how the systolic blood pressure (SBP), forced expiratory volume in the first second (FEV 1 ), peak expiratory flow (PEF) and heart rate change after PMR. The control group (CG; n = 30) received a placebo intervention. Results: A significant reduction in SBP and a significant increase in the FEV 1 and PEF were observed after PMR. The heart rate showed a significant increase in the coefficient of variation (CV), root-mean-square of successive differences (RMSSD) and at the high frequency (HF) range, in addition to a significant reduction at the low and middle frequency (LF and MF, respectively) ranges. Conclusion: PMR appears to be effective in improvement of blood pressure, lung parameter and heart rate in adolescent female asthmatics. D

Objectives: During the course of Helicobacter pylori infection, increased oxidative stress plays an important role in the pathogenesis of gastroduodenal mucosal inflammation, which can cause gastric mucosal atrophy that characterized by... more

Objectives: During the course of Helicobacter pylori infection, increased oxidative stress plays an important role in the pathogenesis of gastroduodenal mucosal inflammation, which can cause gastric mucosal atrophy that characterized by the replacement of the gastric mucosal glands by collagen fibers. In the present study, we aimed to determine serum prolidase activity and oxidative status, and to find out if there is any association between serum prolidase activity and oxidative status in H. pylori infection.

A large population world over is affected with allergic diseases and asthma. Pharmacotherapy for allergic diseases and asthma is effective in controlling symptoms but on discontinuation of medication, symptoms reoccur. In contrast,... more

A large population world over is affected with allergic diseases and asthma. Pharmacotherapy for allergic diseases and asthma is effective in controlling symptoms but on discontinuation of medication, symptoms reoccur. In contrast, immunotherapy modifies and corrects the underlying pathological immune responses in an antigen-specific manner. Immunotherapy shows an increase in IgG (blocking antibody) that competes with IgE for allergen, inhibiting the release of inflammatory mediators. Recent studies suggest that immunotherapy acts by modifying CD4+ T-cell responses either by immune deviation, T-cell anergy and/or both. Current immunological approaches for management of allergies and asthma involve immunization with native allergen, modified allergen, peptides/cDNA of allergen, anti-IgE, adjuvants coupled allergen, including immunostimulatory DNA sequences, cytokines, and bacterial products. These approaches modulate the immune response and are intended to give long-term benefit.

Acute asthma is the third commonest cause of pediatric emergency visits at PGIMER. Typically, it presents with acute onset respiratory distress and wheeze in a patient with past or family history of similar episodes. The severity of the... more

Acute asthma is the third commonest cause of pediatric emergency visits at PGIMER. Typically, it presents with acute onset respiratory distress and wheeze in a patient with past or family history of similar episodes. The severity of the acute episode of asthma is judged clinically and categorized as mild, moderate and severe. The initial therapy consists of oxygen, inhaled beta-2 agonists (salbutamol or terbutaline), inhaled budesonide (three doses over 1 h, at 20 min interval) in all and ipratropium bromide and systemic steroids (hydrocortisone or methylprednisolone) in acute severe asthma. Other causes of acute onset wheeze and breathing difficulty such as pneumonia, foreign body, cardiac failure etc. should be ruled out with help of chest radiography and appropriate laboratory investigations in first time wheezers and those not responding to 1 h of inhaled therapy. In case of inadequate response or worsening, intravenous infusion of magnesium sulphate, terbutaline or aminophylline may be used. Magnesium sulphate is the safest and most effective alternative among these. Severe cases may need ICU care and rarely, ventilatory support.

Intelligent systems are transforming the world, as well as our healthcare system. We propose a deep learning-based cough sound classification model that can distinguish between children with healthy versus pathological coughs such as... more

Intelligent systems are transforming the world, as well as our healthcare system. We propose a deep learning-based cough sound classification model that can distinguish between children with healthy versus pathological coughs such as asthma, upper respiratory tract infection (URTI), and lower respiratory tract infection (LRTI). In order to train a deep neural network model, we collected a new dataset of cough sounds, labelled with clinician's diagnosis. The chosen model is a bidirectional longshort term memory network (BiLSTM) based on Mel Frequency Cepstral Coefficients (MFCCs) features. The resulting trained model when trained for classifying two classes of coughs-healthy or pathology (in general or belonging to a specific respiratory pathology), reaches accuracy exceeding 84% when classifying cough to the label provided by the physicians' diagnosis. In order to classify subject's respiratory pathology condition, results of multiple cough epochs per subject were combined. The resulting prediction accuracy exceeds 91% for all three respiratory pathologies. However, when the model is trained to classify and discriminate among the four classes of coughs, overall accuracy dropped: one class of pathological coughs are often misclassified as other. However, if one consider the healthy cough classified as healthy and pathological cough classified to have some kind of pathologies, then the overall accuracy of four class model is above 84%. A longitudinal study of MFCC feature space when comparing pathologicial and recovered coughs collected from the same subjects revealed the fact that pathological cough irrespective of the underlying conditions occupy the same feature space making it harder to differentiate only using MFCC features.

BACKGROUND:Adhesion molecules such ICAM-1 and VCAM have been show to play important roles in allergic inflammation. The aim of our study was to evaluate the serum soluble levels of ICAM-1 and VCAM in pts with allergic bronchial asthma... more

BACKGROUND:Adhesion molecules such ICAM-1 and VCAM have been show to play important roles in allergic inflammation. The aim of our study was to evaluate the serum soluble levels of ICAM-1 and VCAM in pts with allergic bronchial asthma (ABA) and allergic rhinitis (AR) to HDM. MATERIAL AND METHOD: 11 pts with ABA and AR were compare to 10 nonatopic controls (C) match for sex and age. Fasting serum levels of ICAM-1 and VCAM were measured by ELISA (R&D Systems).

Respiratory diseases place a considerable burden on global health. Bronchial asthma describes many heterogeneous clinical phenotypes that result in chronic bronchial inflammation. Chronic obstructive pulmonary disease (COPD) is one of the... more

Respiratory diseases place a considerable burden on global health. Bronchial asthma describes many heterogeneous clinical phenotypes that result in chronic bronchial inflammation. Chronic obstructive pulmonary disease (COPD) is one of the most common adult respiratory disorders characterized by chronic airflow limitation that is not fully reversible and is associated with an abnormal inflammatory response of the lungs to noxious particles and gases. Recognition of the global importance and rising prevalence of these diseases and the absence of effective treatments has led to concerted efforts to improve the efficacy of the existing drugs and develop new ones that target cellular and molecular mechanisms that underlie disease pathogenesis. The transcription factor nuclear factor kappa B (NF-B) regulates the expression of a wide array of genes that are involved in the molecular pathobiology of the lung by regulating cellular immune responses, cell adhesion, differentiation, proliferation, angiogenesis and apoptosis.

Tumor necrosis factor (TNF) is a proinflammatory cytokine that is eminently important in the pathogenesis of bronchial asthma. Bronchial asthma is a frequent respiratory disease characterized by variable airflow obstruction, inflammation... more

Tumor necrosis factor (TNF) is a proinflammatory cytokine that is eminently important in the pathogenesis of bronchial asthma. Bronchial asthma is a frequent respiratory disease characterized by variable airflow obstruction, inflammation of the airways, and bronchial hyper-responsiveness (BHR). In an effort to find out the polymorphism(s) in genes whose variant(s) have been implicated in asthma phenotypes, we examined the genetic

Up to now alpha 1-antitrypsin (AAT) augmentation therapy has been approved only for commercial use in selected adults with severe AAT deficiency-related pulmonary emphysema (i.e. PI*ZZ genotypes as well as combinations of Z, rare and null... more

Up to now alpha 1-antitrypsin (AAT) augmentation therapy has been approved only for commercial use in selected adults with severe AAT deficiency-related pulmonary emphysema (i.e. PI*ZZ genotypes as well as combinations of Z, rare and null alleles expressing AAT serum concentrations <11 μmol/L). However, the compassionate use of augmentation therapy in recent years has proven outstanding efficacy in small cohorts of patients suffering from uncommon AAT deficiency-related diseases other than pulmonary emphysema, such as fibromyalgia, systemic vasculitis, relapsing panniculitis and bronchial asthma. Moreover, a series of preclinical studies provide evidence of the efficacy of AAT augmentation therapy in several infectious diseases, diabetes mellitus and organ transplant rejection. These facts have generated an expanding number of medical applications and patents with claims for other indications of AAT besides pulmonary emphysema. The aim of the present study is to compile and analyze both clinical and histological features of the aforementioned published case studies and reports where AAT augmentation therapy was used for conditions other than pulmonary emphysema. Particularly, our research refers to ten case reports and two clinical trials on AAT augmentation therapy in patients with both AAT deficiency and, at least, one of the following diseases: fibromyalgia, vasculitis, panniculitis and bronchial asthma. In all the cases, AAT was successfully applied whereas previous maximal conventional therapies had failed. In conclusion, laboratory studies in animals and humans as well as larger clinical trials should be, thus, performed in order to determine both the strong clinical efficacy and security of AAT in the treatment of conditions other than pulmonary emphysema.

Peripheral blood mononuclear cells (PBMC) were isolated from seven normal subjects, eight asthmatic subjects clinically sensitive to corticosteroids (CS), and eight asthmatic subjects clinically resistant to corticosteroids (CR). PBMC... more

Peripheral blood mononuclear cells (PBMC) were isolated from seven normal subjects, eight asthmatic subjects clinically sensitive to corticosteroids (CS), and eight asthmatic subjects clinically resistant to corticosteroids (CR). PBMC were cul- tured at 370C for 24 h in the absence or ...

Actinomycosis has been known to involve virtually every anatomic site in the body. Although actinomycosis has been identified in resected tonsils, its possible role in adeno-tonsillar disease has received little attention. A... more

Actinomycosis has been known to involve virtually every anatomic site in the body. Although actinomycosis has been identified in resected tonsils, its possible role in adeno-tonsillar disease has received little attention. A clinicopathological study of 302 patients who had adeno-tonsillar surgery is presented. Tonsillar actinomycosis was present in 86 (28.5%) patients. The statistical analysis revealed a significant association (P B 0.0001) of actinomycosis and tonsillar hypertrophy (56.8%) compared to only 10.3% in the recurrent tonsillitis group. A statistically significant association (P B0.0001) of tonsillar actinomycosis and sickle cell anaemia, beta thalassaemia, bronchial asthma and beta haemolytic streptococcal infections was also seen. This data supports a predisposition of the above conditions to tonsillar actinomycosis and adeno-tonsillar hypertrophy and a possible etiopathologic role of this organism in adeno-tonsillar hypertrophy and disease. Although the clinical association of actinomycosis and tonsillar hypertrophy and beta haemolytic streptococcal infection has been described before the association of actinomycosis with sickle cell anaemia, beta thalassaemia and bronchial asthma is being observed for the first time in literature.

Objective: The aim of the study was to assess the therapeutic efficacy of Justicia tranquebariensis (Thavasu murungai) in bronchial asthma. Materials and Methods: 40 asthmatics were enrolled for the clinical trial. The... more

Objective: The aim of the study was to assess the therapeutic
efficacy of Justicia tranquebariensis (Thavasu murungai) in
bronchial asthma.
Materials and Methods: 40 asthmatics were enrolled for the clinical
trial. The patients were selected according to the patient subjective
assessment scale, objective parameters and WHO GINA guideline.
The patients with severe diseases such as AIDS, Malignancy, TB,
Renal and CVS disorders were excluded from the study. This open
labeled study was conducted at Government Siddha Medical College
Hospital, Chennai-106. All the patients were administered 30 ml leaf
juice of Justicia tranquebariensis for the period of 3 months. Clinical
trial usually focuses on asthma control as measured by pulmonary
function test (FEV1, FVC, PEFR, Breath holding time and FVR),
symptom scores and medication requirement. The study infers
improvement on subjective and objective parameters of bronchial
asthma. During the trial period, 4 patients were discontinued from the
study due to need for parenteral and inhalation therapy. 36 patients
were completed the study.
Results: There was a significant improvement in all parameters
compared at each follow up visit. Based on the result out of 36 cases
29 had marked response, 5 had moderate response and only 2 cases
had fair response. No side effects have been observed during the
study period.
Conclusion: Thus we concluded that Justicia tranquebariensis
(Thavasu murungai) is effective for the treatment of bronchial
asthma.

Eightynine patients completed the study of which 61.8% were male. There was no significant difference between Ventolin and Butalin concerning the average of Ln transformed records for the FEV1 and PEF, and the AUFC0-1h for the 100 and 200... more

Eightynine patients completed the study of which 61.8% were male. There was no significant difference between Ventolin and Butalin concerning the average of Ln transformed records for the FEV1 and PEF, and the AUFC0-1h for the 100 and 200 µg were (96.89-101.07) and ( ...

Background: Two major acute-phase proteins were identified in human, C-reactive protein and serum amyloid A. There are 3 types of C-reactive protein assays: conventional C-reactive protein, high sensitivity C-reactive protein and cardiac... more

Background: Two major acute-phase proteins were identified in human, C-reactive protein and serum amyloid A. There are 3 types of C-reactive protein assays: conventional C-reactive protein, high sensitivity C-reactive protein and cardiac C-reactive protein. High sensitivity C-reactive protein assays can detect minor inflammatory changes that could be missed by other indices of inflammation. Induced sputum cell counts are relatively non-invasive, safe and reliable method for identifying the presence and type of airway inflammation in asthmatic patients. Purpose of the work: This study was designed to detect the role of serum levels of high sensitivity C-reactive protein in asthmatic patients with or without inhaled corticosteroids treatment. Also to determine the relationship of serum high sensitivity C-reactive protein levels to clinical indices of asthma and inflammatory cell counts in induced sputum. Subjects & Methods: Serum high sensitivity C-reactive protein level, pulmonary function tests, body mass index and induced sputum cell counts were estimated in 50 asthmatic patients (26 steroid inhaled and 24 steroid naïve). Fifteen healthy volunteers, who matched in age and sex with the other groups, were used as a control group. Results: There was an increase of high sensitivity C-reactive protein in asthmatic patients among both steroid inhaled and steroid naïve patients compared to the healthy controls. Serum high sensitivity C-reactive protein correlated negatively with pulmonary function tests and positively with sputum eosinophil % in both inhaled steroid and steroid naïve groups. Conclusion: High sensitivity C-reactive protein is one of the markers of systemic inflammation that can be indirectly reflecting the degree of severity of airway inflammation in bronchial asthma. ª

Aim of the study: We investigated the efficacy of Viola mandshurica W. Becker (VM) ethanolic (EtOH) extract in the treatment of bronchial asthma in an ovalbumin (OVA)-induced asthmatic BALB/c mouse model. Materials and methods: Female... more

Aim of the study: We investigated the efficacy of Viola mandshurica W. Becker (VM) ethanolic (EtOH) extract in the treatment of bronchial asthma in an ovalbumin (OVA)-induced asthmatic BALB/c mouse model. Materials and methods: Female BALB/c mice were sensitized with intraperitoneal (i.p.) ovalbumin (OVA) on days 0 and 14, and were next given intranasal OVA on days 28-30. Randomized treatment groups of sensitized mice received VM EtOH extract, dexamethasone, or placebo, orally, from days 28 to 30. Results: VM EtOH extract significantly inhibited increases in total immunoglobulin E (IgE) and cytokines IL-4 and IL-13 levels in serum and bronchoalveolar lavage fluid (BALF), and also effectively suppressed airway hyperresponsiveness (AHR), eosinophilia, and mucus hypersecretion, in mice with OVA-induced asthma.

Through a house-to-house survey, 1325 people aged 11+ years registered at 2 primary health care centres (1 at high altitude and 1 at sea level) in Asir region, Saudi Arabia, were interviewed and examined for weight, height and peak... more

Through a house-to-house survey, 1325 people aged 11+ years registered at 2 primary health care centres (1 at high altitude and 1 at sea level) in Asir region, Saudi Arabia, were interviewed and examined for weight, height and peak expiratory flow rate. The prevalence of bronchial asthma at sea level (19.5%) was significantly higher than at high altitude (6.9%). Illiteracy, low income, use of coal and wood for heating, having a mud or tent house, lack of electricity inside dwellings and presence of sheep were also significant risk factors for bronchial asthma. In multivariate logistic regression, only altitude was found to be significantly associated with bronchial asthma (adjusted odds ratio = 3.94).

Background: T cells play an important role in bronchial asthma. Although airway CD4+ T cells have been extensively studied previously, there are hardly any studies relating CD8+ T cell activation and disease symptoms. Objectives: The aim... more

Background: T cells play an important role in bronchial asthma. Although airway CD4+ T cells have been extensively studied previously, there are hardly any studies relating CD8+ T cell activation and disease symptoms. Objectives: The aim of this study was to analyse the association between T cell activation in induced sputum T cells and asthma severity and control; and to evaluate T cell subpopulations in the same subgroups. Methods: Fifty allergic asthmatic patients were recruited and lung function testing was performed. Airway cells were obtained by sputum induction via inhalation of hypertonic saline solution. CD3, CD4, CD8, CD28, CD25 and CD69 were studied by flow cytometry in whole induced sputum and peripheral blood cells. Results: Total induced sputum T cells and CD8+ T cells had a higher relative percentage of the activation markers CD25 and CD69 in comparison with peripheral blood. In sputum, the relative percentage of CD25 was higher in CD4+ T cells when compared to CD8+ T cells and the reverse was true regarding CD69. However, neither disease severity nor control were associated with the relative percentage of CD25 or CD69 expression on T cells in sputum. Conclusions: Both CD4+ and CD8+ T cells are activated in the lungs and peripheral blood of asthmatic patients. However, with the possible exception of CD69+ CD8+ T lymphocytes in the sputum, there is no association between T cell activation phenotype in the target organ and disease severity or control.

Previous studies have shown that human T h 2 cells, unlike their murine counterparts, retain the ability to produce IFN-y upon activation in the presence of exogenous IL-12. Here we first extended this notion by showing that T h 2-like... more

Previous studies have shown that human T h 2 cells, unlike their murine counterparts, retain the ability to produce IFN-y upon activation in the presence of exogenous IL-12. Here we first extended this notion by showing that T h 2-like cell clones (T h 2C) are also capable of inducing IL-12 production by physiological antigen-presenting cells (APC); we next showed that these cells may express several distinct cytokine profiles depending upon the activation signal and the type of APC with which they interact. We have analyzed the production of IL-4, IL-5 and IFN-y by T h 2C stimulated by either anti-CD3 mAb or exogenous IL-2, using peripheral blood monocytes or dendritic cells (DC) as accessory cells. We found that: (i) DC but not monocytes released IL-12 and promoted IL-12-dependent IFN-y production upon interaction with anti-CD3-or IL-2-stimulated T h 2C and (ii) ligation of CD3 was required for the production of IL-4 but not of IL-5 or IFN-y. Thus, depending upon the type of APC with which they interacted and the mode of activation, T h 2C, expressed four distinct cytokine profiles: (i) IL-4 + IL-5, in response to anti-CD3 + monocytes; (ii) IL-4, IL-5 + IFN-Y, in response to anti-CD3 + DC; (iii) IL-5-I-IFN-y, in response IL-2 + DC; and (iv) IL-5 alone, in response to IL-2 + monocytes. The ability of human T h 2-like cells to induce IL-12 production and to release the proinflammatory cytokines IFN-y and IL-5 upon IL-2-driven interactions with APC may contribute to explain how local infection exacerbates T h 2-mediated diseases, like bronchial asthma and atopic dermatitis.

Periostin is a secreted protein that shares structural homology with the insect axon guidance protein fasciclin 1. Periostin is expressed predominantly in collagen-rich fibrous connective tissues that are subjected to constant mechanical... more

Periostin is a secreted protein that shares structural homology with the insect axon guidance protein fasciclin 1. Periostin is expressed predominantly in collagen-rich fibrous connective tissues that are subjected to constant mechanical stresses. We have shown previously that periostin is a novel component of subepithelial fibrosis in bronchial asthma. Here, we investigated the relationship between periostin and bone marrow (BM) fibrosis. Periostin was expressed in the stroma and stromal cells of BM fibrosis specimens and to a great extent its expression levels correlated closely to the grade of fibrosis, as estimated by silver staining. However, in the present study, we found no relationship between plasma periostin levels and the extent of BM fibrosis. We also demonstrated that periostin is secreted by human BM hTERT stromal cells and that its secretion is enhanced by TGF-b, a cytokine produced by clonal proliferation of megakaryocytes and/or monocytes. These results indicate that periostin is a component of BM fibrosis and that it may play a role in the disease progression.

The mechanisms of sustained overproduction of eosinophils in the idiopathic hypereosinophilic syndrome and in some human immunodeficiency virus (HIV)-l-infected individuals are largely unknown. We hypothesized that T cells may release... more

The mechanisms of sustained overproduction of eosinophils in the idiopathic hypereosinophilic syndrome and in some human immunodeficiency virus (HIV)-l-infected individuals are largely unknown. We hypothesized that T cells may release soluble products that regulate eosinophi]ia in these patients, as has been previously shown in bronchial asthma. We identified one patient with idiopathic hypereosinophilic syndrome and one HIV-l-infected individual with associated hypereosinophilia who demonstrated high numbers of CD4-CD8-T cells in peripheral blood. CD4-CD8-T cells from both patients, although highly activated, did not express functional Fas receptors. In one case, the lack of functional Fas receptors was associated with failure ofFas mR.NA and protein expression, and in another, expression of a soluble form of the Fas molecule that may have antagonized normal signaling ofFas ligand. In contrast to the recently described lymphoproliferative/autoimmune syndrome, which is characterized by accumulation of CD4-CD8-T cells and mutations within the Fas gene, this study suggests somatic variations in Fas expression and function quite late in life. Both genetic and somatic abnormalities in regulation of the Fas gene are therefore associated with failures to undergo T cell apoptosis. Furthermore, the expanded population of CD4-CD8-T cells from both patients elaborated cytokines with antiapoptotic properties for eosinophils, indicating a major role of these T ceils in the development of eosinophilia. Thus, this study demonstrates a sequential dysregulation ofapoptosis in different cell types.