Asthma phenotypes

Hirose, Masahiro; Horiguchi, T.

doi:10.1002/jgf2.7

Cited by 20 publications

(23 citation statements)

References 8 publications

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“…chest tightness, wheeze, cough), the precipitating pathology and corresponding approaches to treatment differ by phenotype. While there is no universal consensus, there appear to be approximately five to seven distinct groups, depending on source 11 . These have been broadly classified into two primary groups: atopic (eosinophilic) and non-atopic (non-eosinophilic) asthma, also commonly referred to as allergic/non-allergic or intrinsic/extrinsic asthma 5 .…”

Section: Genomics Of Asthmamentioning

confidence: 99%

“…There are some exceptions to this rule, and patients with poor response to treatment or suspicion of other asthma look-alikes, such as bronchiectasis, ciliary dyskinesia, or alpha I anti-tripsin disorder, warrant specialty referral and may require further testing 10 . In most circumstances, however, asthma phenotypes can be recognized based on observable characteristics, such as allergic versus non-allergic disease, responsiveness to inhaled steroids, age of onset (pediatric versus adult onset), and comorbid obesity 11 .…”

Section: Genomics Of Asthmamentioning

confidence: 99%

“…Atopic asthma phenotypes are now recognized to be further subdivided into early onset (mild, moderate, and severe), late onset (usually severe), and inflammation predominant, the latter of which presents with fewer symptoms but is associated with mixed eosinophilic and neutrophilic inflammation and heightened pulmonary remodeling 11 . Details on similarities and differences between phenotypes are presented in Table 1.…”

Section: Genomics Of Asthmamentioning

confidence: 99%

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Understanding the genetics of asthma and implications for clinical practice

Mammen

Arcoleo

2019

J Am Assoc Nurse Pract

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Asthma is one of the most common heritable diseases globally, with highly variable clinical expression and response to treatment that is attributed to underlying genetic differences.Hundreds of loci on multiple chromosomes are associated with asthma. Genetic testing is not currently recommended for management, however, recognition of common asthma phenotypes, which are the result of genetic and environmental interactions, can help to guide treatment decisions. Asthma phenotypes are divided into two major categories of atopic and non-atopic disease, with further subdivisions within in each category that are associated with patterns in clinical presentation and responsiveness to treatment. In general, earlier onset, and allergic disease will respond well to traditional therapy with inhaled corticosteroids and leukotrienes, as these medications target corresponding inflammatory pathways for allergic disease. However, patients with late onset, symptom predominant (lacking inflammation) and obese asthma may be resistant to standard therapy and may require treatment modification. These patients are at risk for overuse of inhaled corticosteroids with poor response, and may benefit more by use of long acting beta agonists, long acting muscarinic agonists, weight reduction, and exercise. Research into genetic testing for responsiveness to common asthma medications is early stage, but shows evidence of clinically utility and cost effectiveness.

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Section: Genomics Of Asthmamentioning

confidence: 99%

Section: Genomics Of Asthmamentioning

confidence: 99%

Section: Genomics Of Asthmamentioning

confidence: 99%

See 1 more Smart Citation

Understanding the genetics of asthma and implications for clinical practice

Mammen

Arcoleo

2019

J Am Assoc Nurse Pract

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“…(3,4) We distinguish many asthma phenotypes, and even subphenotypes, based on those factors. (5)(6)(7) Currently, the search for special pathological and molecular features of asthma phenotypes continues, which can become the basis for the development of individual therapy. One of the most common asthma phenotypes is the obesity-asthma phenotype, since obesity affects over a third of the world's population today.…”

Section: Introductionmentioning

confidence: 99%

Clinical Phenotype “Obesity-Asthma” as One of the Main Problems of Personalized Pulmonology

Tribuntceva¹,

Shkatova²,

Авдеев³

et al. 2019

IJBM

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Background: Asthma is a heterogeneous disease comprising different phenotypes. One of the most common asthma phenotypes is the obesity-asthma phenotype, since obesity affects over a third of the world's population today. It is important to continue investigating possible underlying mechanisms of the interaction between asthma and obesity. The purpose of this study was to evaluate levels of leptin, adiponectin, neuropeptide Y (NPY), total oxidative damage (TOD), and total antioxidant status (TAS) in patients with asthma and different body weight (BW), and to analyze their association with spirometry parameters. Materials and Methods: The study included 27 men and 86 women diagnosed with moderate asthma (mean age of 57.81±13.05 years). During the study, all asthma patients were divided into 3 groups. Group 1 included 37 patients with normal BW, Group 2 included 38 overweight patients, and Group 3 included 38 patients with obesity. We analyzed complaints, anamnesis data, objective status data, and laboratory (blood levels of NPY, adiponectin, leptin, total antioxidant status, and total oxidative damage) and instrumental data (spirometry). Two questionnaires were used: Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Test (АСТ). Results: The leptin level was significantly higher in Group 3 compared to Groups 1 and 2 (P=0.000). The NPY level was significantly lower in Group 1 compared to Groups 2 and 3 (P=0.000). The TAS value was significantly higher in Group 1 compared to Groups 2 and 3 (P=0.000) and the TOD value in Group 1 was significantly lower than in Group 3 (P=0.038).The leptin level positively correlated with BMI and waist circumference, and had an inverse correlation with FEV 1 and vital capacity (VC). The adiponectin level had a positive correlation with the Tiffno index, FEF 50 , and peak expiratory flow (PEF). The NPY level had an inverse correlation with VC, FEV 1 , FEF 25 , FVC, Tiffno index, FEF 50 , and PEF. Conclusion: The severity of the clinical course of moderate asthma in obese patients is associated with different factors, including oxidative stress and levels of leptin, adiponectin and NPY.

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“…1 There are multiple phenotypes of asthma each with its own pathological mechanism. 2,3 There is no permanent cure for asthma. Response to treatment is assessed by decrease in symptoms, absence of nocturnal attacks, non-interference with day time activities and diurnal variation of PEFR less than 20%.…”

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confidence: 99%

A Prospective Comparative Study on Efficacy of Two Combinations Formoterol/Budesonide and Salmeterol/Fluticasone as Dpi and Mdi in Patients With Bronchial Asthma in a Tertiary Care Centre

Rachakonda¹,

Padarthi²,

Jupalli³

et al. 2019

jebmh

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BACKGROUND Bronchial asthma is a very common illness causing considerable mortality and morbidity. Long acting beta 2 agonists in combination with inhalation steroid is useful for reducing the severity of asthma. We have attempted to compare the efficacy of formoterol/budesonide and salmeterol/fluticasone combinations among patients of bronchial asthma. We wanted to compare the efficacy of Formoterol/Budesonide combination and Salmeterol/Fluticasone combination as Dry Powder Inhaler and Metered Dose Inhaler in patients with Bronchial Asthma in terms of asthma control and improvement in pulmonary function as assessed by FVC (%), FEV1 (%), FEV1/FVC (%), PEFR and Asthma Control Test (ACT) Score. METHODS This is a prospective, observational, non-interventional study conducted in Bronchial Asthma patients attending outpatient Respiratory Medicine Department of NRI General Hospital, Guntur. A total of 100 patients were included in the study. All the patients who were diagnosed with Asthma and who met the inclusion criteria and are prescribed with either Formoterol/Budesonide as DPI or MDI or Salmeterol/Fluticasone as DPI or MDI were reviewed for the efficacy of treatment. These different groups were created based on block randomization method. Initially base line PFT was performed and asthma control scores were obtained before treatment using GINA Guidelines. Reversibility of bronchoconstriction is assessed within 15 minutes of nebulization with 0.05% Salbutamol. After 15 days of PFT values and Asthma Control Scores were again obtained and compared with the base line values. Data analysis was conducted using paired ANOVA and t-test. RESULTS Of these 100 patients, 25 (25%) patients belong to Group-IA, 26 (26%) belong to Group-IB, 24 (24%) patients belong to Group-IIA and 25 (25%) patients belong to Group-IIB. After 2 weeks of treatment, PFT was repeated and asthma control scores were obtained. These obtained values were compared to baseline values. The improvement in lung function and the level of asthma control was assessed by performing PFTs and using Asthma Control Test Questionnaire. The corresponding Mean of FVC, FEV1, FEV1/FVC, PEFR and Asthma Control Score in the sample population using Formoterol/Budesonide DPI is more when compared to those using Formoterol/Budesonide MDI after 15 days of treatment with significant p-value of <0.05%. The corresponding Mean of FVC, FEV1, FEV1/FVC, PEFR and Asthma Control in the sample population using Salmeterol/Fluticasone DPI is more when compared to those using Salmeterol/Fluticasone MDI after 15 days of treatment with significant p-value of <0.05%. When sample population using Formoterol/Budesonide DPI is compared with sample population using Salmeterol/Fluticasone, the mean of FVC, FEV1, FEV1/FVC, PEFR and asthma control were significantly improved with a p-value of <0.05%. Pharmacoeconomic analysis showed that Group-IA (Formoterol/Budesonide DPI) is more effective with lesser cost of therapy when compared to other groups. This study reveals that Group-IA (Formoterol/Budeso...

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Asthma phenotypes

Cited by 20 publications

References 8 publications

Understanding the genetics of asthma and implications for clinical practice

Understanding the genetics of asthma and implications for clinical practice

Clinical Phenotype “Obesity-Asthma” as One of the Main Problems of Personalized Pulmonology

A Prospective Comparative Study on Efficacy of Two Combinations Formoterol/Budesonide and Salmeterol/Fluticasone as Dpi and Mdi in Patients With Bronchial Asthma in a Tertiary Care Centre

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