Asthma Control Test (ACT): Comparison with Clinical, Functional, and Biological Markers of Asthma Control

Melosini, Lorenza; Dente, Federico L.; Bacci, Elena; Bartoli, Maria Laura; Cianchetti, Silvana; Costa, Francesco; Franco, Antonella Di; Malagrinò, Laura; Novelli, Federica; Vagaggini, Barbara; Paggiaro, Pierluigi

doi:10.3109/02770903.2012.661008

Cited by 48 publications

(49 citation statements)

References 27 publications

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“…The weekly mean of the 3 highest exhalations (mean PEFR) was recorded in their diaries as well as asthma symptoms (cough, dyspnea and wheezing). To evaluate disease control, ACT was assessed at baseline and at week 16 [20,21]. …”

Section: Methodsmentioning

confidence: 99%

Omalizumab Attenuates Airway Inflammation and Interleukin-5 Production by Mononuclear Cells in Patients with Severe Allergic Asthma

Takaku

Soma

Nishihara

et al. 2013

Int Arch Allergy Immunol

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Background: Omalizumab, an anti-immunoglobulin E monoclonal antibody, has shown an inhibitory effect on airway inflammation, which may be associated with clinical improvement of severe asthma. This study evaluated changes in airway inflammation and cytokine release by the peripheral blood mononuclear cells (PBMCs) of Japanese patients with severe asthma after administration of omalizumab. Methods: Sixteen Japanese patients with severe asthma who were allergic to house-dust mites were enrolled in this study. Eight received omalizumab every 2 or 4 weeks for 16 weeks, and 8 control subjects were treated with conventional drug treatment. Changes in clinical scores for sputum eosinophils and levels of fraction of exhaled nitric oxide (FeNO) were measured at the time of enrollment and at week 16. Cytokines from PBMCs stimulated by house-dust mite (Dermatophagoides farinae) or ionomycin/phorbol myristate acetate (PMA) were measured at baseline and at week 16. Results: In the omalizumab-treated group, decreases in sputum eosinophils and FeNO were observed following treatment. Furthermore, the ex vivo production of interleukin (IL)-5 by PBMCs in response to both mite allergen and ionomycin/PMA decreased significantly. In contrast, interferon (IFN)-γ production was unchanged. There were no changes in any of the parameters observed in the control group. Conclusion: Omalizumab exerts inhibitory effects on airway inflammation in Japanese patients with severe allergic asthma. This treatment attenuates production of IL-5 by PBMCs stimulated with both a specific allergen and a nonspecific activator. Reduction of the Th2 inflammatory cascade likely contributes to clinical benefits; however, further studies are required to clarify these results due to the small sample size in this study.

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Section: Methodsmentioning

confidence: 99%

Omalizumab Attenuates Airway Inflammation and Interleukin-5 Production by Mononuclear Cells in Patients with Severe Allergic Asthma

Takaku

Soma

Nishihara

et al. 2013

Int Arch Allergy Immunol

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“…There is a huge controversy about the role of eosinophils as a key player in asthma severity [10][11][12][13][14][15][16][17][18][19][20][21]. Some studies have looked at airway eosinophils in bronchoalveolar lavage (BAL) [21], induced sputum [11,12,14,[16][17][18] and bronchial biopsies [19,20], while others focused on systemic inflammation through blood eosinophil count measurement [20].…”

Section: Introductionmentioning

confidence: 99%

Importance of concomitant local and systemic eosinophilia in uncontrolled asthma

et al. 2014

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Systemic and airway eosinophilia are recognised features of asthma. There are, however, patients who exhibit discordance between local and systemic eosinophilia. In this study, we sought to determine the prevalence and characteristics of patients with concordant and discordant systemic and bronchial eosinophilia.We conducted a retrospective study on 508 asthmatics with successful sputum induction. We assessed the relationship between blood and sputum eosinophils by breaking down the population into four groups according to blood (o400 cells per mm 3 ) and sputum (o3%) eosinophils. Then, we prospectively reassessed the link between eosinophils and asthma control (Asthma Control Questionnaire (ACQ)) and exacerbation rate in a new cohort of 250 matched asthmatics.In our retrospective cohort, asthmatics without eosinophilic inflammation were the largest group (49%). The group with isolated sputum eosinophilia (25%) was, compared with noneosinophilic asthma, associated with lower forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity ratio and higher bronchial hyperresponsiveness and exhaled nitric oxide fraction (FeNO). Asthmatics exhibiting isolated systemic eosinophilia (7%) had similar characteristics as noneosinophilic asthmatics. The group with concordant systemic and airway eosinophilia (19%) showed remarkable male predominance, and had the lowest airway calibre, asthma control and quality of life, and the highest bronchial hyperresponsiveness, FeNO and exacerbation rate. The prospective cohort confirmed the different subgroup proportions and the higher ACQ and exacerbation rates in cases of diffuse eosinophilia compared with noneosinophilic asthmatics.Concomitant systemic and bronchial eosinophilic inflammation contribute to poor asthma control.@ERSpublications Concomitant systemic and bronchial eosinophilic inflammation contributes to poor asthma control

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“…14 In contrast, moderate to low correlations were observed between the ACT score and FEV 1 , F ENO , and specialists' rating of control according to NAEPP EPR-3 guidelines. 9,15,16 The substantially low correlations between the ACT scores and physiologic measures of asthma, such as FEV 1 values and F ENO , support the notion that asthma control cannot be inferred from physiologic measures alone. 14,17 Furthermore, the ACT has been validated in many languages [18][19][20][21][22][23] and in different settings, including in asthma specialist consultations, 9 in primary care, 13 in pharmacies, 24 by mail, 25 by speech-recognition telephone calls, 26 and over the internet.…”

Section: Validitymentioning

confidence: 88%

Asthma Control Assessment Tools

Alzahrani

Becker

2015

Respir Care

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, and they emphasize periodic assessment of asthma control once treatment is established. Accurate assessment of asthma control is difficult due to the complexity of asthma control and due to the limitations in the traditional methods of assessment, such as lung function tests, physician assessment, and patients' self-assessment. Relying solely on the role of lung function tests is insufficient to reflect the status of asthma control, since patients with asthma may have normal spirometry between exacerbations. Clinicians often overestimate the level of asthma control. Similarly, it is not uncommon for patients to overestimate how well their asthma is controlled, and, therefore, they under-report asthma symptoms and fail to recognize the impact that asthma has on their daily life. As a result, several tools have been developed to quantify the level of asthma control, identify patients at risk, and evaluate the effect of asthma management. This review examines the commonly 106RESPIRATORY CARE • JANUARY 2016 VOL 61 NO 1 used asthma control assessment tools in terms of content, psychometric properties, methods of administration, limitations, and ability to reflect the overall status of asthma control, which can aid clinicians in selecting the most appropriate tool for their needs.

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Asthma Control Test (ACT): Comparison with Clinical, Functional, and Biological Markers of Asthma Control

Cited by 48 publications

References 27 publications

Omalizumab Attenuates Airway Inflammation and Interleukin-5 Production by Mononuclear Cells in Patients with Severe Allergic Asthma

Omalizumab Attenuates Airway Inflammation and Interleukin-5 Production by Mononuclear Cells in Patients with Severe Allergic Asthma

Importance of concomitant local and systemic eosinophilia in uncontrolled asthma

Asthma Control Assessment Tools

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