Nocturnal asthma

SUTHERLAND, E

doi:10.1016/j.jaci.2005.09.028

Cited by 110 publications

(58 citation statements)

References 34 publications

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“…Although these nocturnal events are considered important in childhood asthma, their significance remains unclear due to a paucity of literature regarding this topic, in part due to the fact that most publications investigating nocturnal asthma have focused on adults (e.g., [2][3][4][5] ). Studies in children have examined the prevalence of nocturnal asthma [6][7][8][9][10][11] , associations with nocturnal asthma and sleep quality 10 and other factors associated with nocturnal asthma 9,[12][13][14][15] , but all of these studies were of short duration (≤7 days) or cross-sectional.…”

Section: Introductionmentioning

confidence: 99%

Most Nocturnal Asthma Symptoms Occur Outside of Exacerbations and Associate with Morbidity

Horner

Mauger

Strunk

et al. 2011

Journal of Allergy and Clinical Immunology

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Section: Introductionmentioning

confidence: 99%

Most Nocturnal Asthma Symptoms Occur Outside of Exacerbations and Associate with Morbidity

Horner

Mauger

Strunk

et al. 2011

Journal of Allergy and Clinical Immunology

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“…Similarly, mortality following pneumococcal infection varies according to time of day (14). In humans, cases of asthma symptoms and rheumatoid arthritis occur more at certain times of the day (15,16). However, the basis for this rhythmic regulation remains unclear.…”

mentioning

confidence: 99%

Circadian Variation of the Response of T Cells to Antigen

Fortier¹,

Rooney²,

Dardente³

et al. 2011

The Journal of Immunology

156

171

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Circadian clocks regulate many important aspects of physiology, and their disturbance leads to various medical conditions. Circadian variations have been found in immune system variables, including daily rhythms in circulating WBC numbers and serum concentration of cytokines. However, control of immune functional responses by the circadian clock has remained relatively unexplored. In this study, we show that mouse lymph nodes exhibit rhythmic clock gene expression. T cells from lymph nodes collected over 24 h show a circadian variation in proliferation after stimulation via the TCR, which is blunted in Clock gene mutant mice. The tyrosine kinase ZAP70, which is just downstream of the TCR in the T cell activation pathway and crucial for T cell function, exhibits rhythmic protein expression. Lastly, mice immunized with OVA peptide-loaded dendritic cells in the day show a stronger specific T cell response than mice immunized at night. These data reveal circadian control of the Ag-specific immune response and a novel regulatory mode of T cell proliferation, and may provide clues for more efficient vaccination strategies.

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“…Numerous mechanisms are implied in nocturnal asthma. (7) Inflammation and airway remodeling result in structural alterations, which seem to explain the permanent reduction in airway diameter. (8)(9)(10) These alterations clinically manifest as fixed airway obstruction.…”

Section: Resultsmentioning

confidence: 99%

Fenótipos clínicos de asma grave

2008

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Objective: To characterize clinical phenotypes of severe asthma. Methods: A total of 111 patients were retrospectively evaluated at a specialized outpatient clinic. A systematic protocol for patient evaluation and follow-up was applied. Treatment compliance and control of the disease at the end of follow-up were defined by clinical and functional data. Patients who did not meet asthma control criteria after six months despite compliance with treatment and correct use of medication were characterized as treatment-resistant. Phenotypes were determined by factorial analysis and compared using various tests. Results: At the end of follow-up, 88 patients were considered treatment compliant and 23 were considered noncompliant. Factorial analysis of the compliant patients identified four phenotypes: phenotype 1 (28 patients) comprised patients who were treatment-resistant, more often presenting nocturnal symptoms and exacerbations, as well as more often using rescue bronchodilators; phenotype 2 (48 patients) comprised patients with persistent airflow limitation, lower ratios of forced expiratory volume in one second/forced vital capacity at baseline, more advanced age and longer duration of symptoms; phenotype 3 (42 patients) comprised patients with allergic rhinosinusitis who were nonsmokers and presented predominantly reversible airflow obstruction; and phenotype 4 (15 patients) comprised cases with a history of aspirin intolerance to acetylsalicylic acid associated with near-fatal asthma. Conclusions: A significant number of patients with severe asthma are noncompliant with treatment. Although many patients with severe asthma have persistent airflow obstruction, the most relevant clinical phenotype comprises patients who are resistant to the typical treatment.Keywords: Asthma; Asthma/prevention & control; Asthma/treatment. ResumoObjetivo: Estabelecer os fenótipos clínicos em portadores de asma grave. Métodos: Foram estudados, retrospectivamente, 111 pacientes em um ambulatório especializado. Os pacientes foram avaliados e acompanhados de maneira sistemática, estabelecendo-se ao final do acompanhamento a adesão e o controle ou não da doença por dados clínicos e funcionais. A resistência ao tratamento foi definida como o não preenchimento, ao final do acompanhamento, por pelo menos seis meses, dos critérios de controle de asma, apesar do uso correto e adesão à medicação. Os fenótipos foram determinados por análise fatorial e comparados por testes diversos. Resultados: Ao final, 88 pacientes foram considerados aderentes e 23 não aderentes. Por análise fatorial do grupo aderente, quatro fenótipos foram determinados: o fenótipo 1 (28 pacientes), formado pelos pacientes resistentes ao tratamento, com maior freqüência de sintomas noturnos, maior número de exacerbações e uso mais freqüente de broncodilatador de resgate; o fenótipo 2 (48 pacientes), formado pelos pacientes com obstrução persistente, com menores valores de relação volume expiratório forçado no primeiro segundo/capacidade vital forçada na avaliação ini...

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Nocturnal asthma

Cited by 110 publications

References 34 publications

Most Nocturnal Asthma Symptoms Occur Outside of Exacerbations and Associate with Morbidity

Most Nocturnal Asthma Symptoms Occur Outside of Exacerbations and Associate with Morbidity

Circadian Variation of the Response of T Cells to Antigen

Fenótipos clínicos de asma grave

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