Asthma Phenotypes: Nonallergic (Intrinsic) Asthma

Peters, Stephen P.

doi:10.1016/j.jaip.2014.09.006

Cited by 65 publications

(51 citation statements)

References 21 publications

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“…However, we now appreciate that a substantial subset of asthma is predominantly nonallergic or “low type 2” in nature. This phenotype may be characterized by infiltration of neutrophils and is often more severe and difficult to treat, being relatively resistant to corticosteroids [7]. …”

Section: Pathogenesis Of Asthmamentioning

confidence: 99%

Alveolar Macrophages in Allergic Asthma: the Forgotten Cell Awakes

Draijer

Peters‐Golden

2017

Curr Allergy Asthma Rep

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Purpose of Review The role of alveolar macrophages in innate immune responses has long been appreciated. Here, we review recent studies evaluating the participation of these cells in allergic inflammation. Recent Findings Immediately after allergen exposure, monocytes are rapidly recruited from the bloodstream and serve to promote acute inflammation. By contrast, resident alveolar macrophages play a predominantly suppressive role in an effort to restore homeostasis. As inflammation becomes established after repeated exposures, alveolar macrophages can polarize across a continuum of activation phenotypes, losing their suppressive functions and gaining pathogenic functions. Summary Future research should focus on the diverse roles of monocytes/macrophages during various types and phases of allergic inflammation. These properties could lead us to new therapeutic opportunities.

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Section: Pathogenesis Of Asthmamentioning

confidence: 99%

Alveolar Macrophages in Allergic Asthma: the Forgotten Cell Awakes

Draijer

Peters‐Golden

2017

Curr Allergy Asthma Rep

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“…It is increasingly recognized that asthma manifests as multiple phenotypes that can be classified by different factors such as disease severity, predominant inflammatory phenotype (i.e., atopic, non-atopic, eosinophilic and/or neutrophilic), age of onset and response to corticosteroid therapy [8–15]. These phenotypes are regulated by distinct cellular and molecular pathways, thus providing impetus to develop better targeted therapies for distinct subpopulations.…”

Section: Introductionmentioning

confidence: 99%

Syk Regulates Neutrophilic Airway Hyper-Responsiveness in a Chronic Mouse Model of Allergic Airways Inflammation

et al. 2017

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BackgroundAsthma is a chronic inflammatory disease characterized by airways hyper-responsiveness (AHR), reversible airway obstruction, and airway inflammation and remodeling. We previously showed that Syk modulates methacholine-induced airways contractility in naïve mice and in mice with allergic airways inflammation. We hypothesize that Syk plays a role in the pathogenesis of AHR; this was evaluated in a chronic 8-week mouse model of house dust mite (HDM)-induced allergic airways inflammation.MethodsWe used the Sykflox/flox//rosa26CreERT2 conditional Syk knock-out mice to assess the role of Syk prior to HDM exposure, and treated HDM-sensitized mice with the Syk inhibitor, GSK143, to evaluate its role in established allergic airways inflammation. Respiratory mechanics and methacholine (MCh)-responsiveness were assessed using the flexiVent® system. Lungs underwent bronchoalveolar lavage to isolate inflammatory cells or were frozen for determination of gene expression in tissues.ResultsMCh-induced AHR was observed following HDM sensitization in the Syk-intact (Sykflox/flox) and vehicle-treated BALB/c mice. MCh responsiveness was reduced to control levels in HDM-sensitized Sykdel/del mice and in BALB/c and Sykflox/flox mice treated with GSK143. Both Sykdel/del and GSK143-treated mice mounted appropriate immune responses to HDM, with HDM-specific IgE levels that were comparable to Sykflox/flox and vehicle-treated BALB/c mice. HDM-induced increases in bronchoalveolar lavage cell counts were attenuated in both Sykdel/del and GSK143-treated mice, due primarily to decreased neutrophil recruitment. Gene expression analysis of lung tissues revealed that HDM-induced expression of IL-17 and CXCL-1 was significantly attenuated in both Sykdel/del and GSK143-treated mice.ConclusionSyk inhibitors may play a role in the management of neutrophilic asthma.

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“…Two reviewers (YZ and JL) independently assessed the methodological quality of all included studies. An 11‐item checklist which was recommended by the Agency for Healthcare Research and Quality was used for assessing the quality of cross‐sectional studies . An item would be scored “0” if the answer was “No” or “Unclear,” if the answer was “Yes,” the item scored “1.” A total score of 0 to 3 was assessed as low quality; 4 to 7 as moderate quality and 8 to 11 as high quality.…”

Section: Methodsmentioning

confidence: 99%

Mediterranean diet during pregnancy and childhood for asthma in children: A systematic review and meta‐analysis of observational studies

Zhang

Lin

et al. 2019

Pediatric Pulmonology

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Objectives: To evaluate the relationship between high adherence to the Mediterranean diet in pregnancy and childhood and the risk of asthma and wheeze in children. Methods: We conducted searches of PubMed, EMBASE, and Cochrane CentralRegister of Controlled Trials from inception to 30 October 2018. Observational studies providing risk estimates and corresponding confidence intervals on the association of high adherence to the Mediterranean diet in pregnancy or childhood and the risk of asthma or wheeze in childhood were included. The methodological quality of all included studies was assessed. Summary odds ratios (OR) were calculated using a random-effects model.Results: Eighteen observational studies were included in this review. All studies were of moderate to high quality. The pooled data suggested high adherence to the Mediterranean diet during pregnancy was associated with a reduced incidence of wheeze in the first 12 months (OR, 0.92; 95% confidence interval [CI], 0.88-0.95; P < 0.001), and there was an inverse association between the Mediterranean diet during childhood and the incidence of wheeze in the history (OR, 0.51; 95% CI, 0.37-0.70; P = 0.001) and current wheeze (OR, 0.97; 95% CI, 0.95-0.99; P = 0.013).However, there was no significant association between high adherence of the Mediterranean diet in pregnancy and childhood and any of the other meta-analysis end points including diagnosed asthma.Conclusion: High adherence to the Mediterranean diet during pregnancy and childhood may have short-term effects on wheeze in children in early life. However, these findings should be interpreted with caution owing to the heterogeneity of the studies. K E Y W O R D S asthma, children, Mediterranean diet, meta-analysis, wheeze

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Asthma Phenotypes: Nonallergic (Intrinsic) Asthma

Cited by 65 publications

References 21 publications

Alveolar Macrophages in Allergic Asthma: the Forgotten Cell Awakes

Alveolar Macrophages in Allergic Asthma: the Forgotten Cell Awakes

Syk Regulates Neutrophilic Airway Hyper-Responsiveness in a Chronic Mouse Model of Allergic Airways Inflammation

Mediterranean diet during pregnancy and childhood for asthma in children: A systematic review and meta‐analysis of observational studies

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