The Role of the Body Clock in Asthma and COPD: Implication for Treatment

Krakowiak, Karolina; Durrington, Hannah J.

doi:10.1007/s41030-018-0058-6

Cited by 35 publications

(38 citation statements)

References 88 publications

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“…Growing evidence suggests cigarette smoking severely affects circadian rhythms, which may further contribute to its role in the cause and disease progression of COPD (for review, see Truong et al, 2016;Krakowiak and Durrington, 2018). Although the evidence is not currently well-established, it appears that cigarette smoke targets a multitude of COPD-related symptoms, which normally display their own circadian oscillations and vary in severity throughout the day.…”

Section: Hr Bpmmentioning

confidence: 99%

“…Although the evidence is not currently well-established, it appears that cigarette smoke targets a multitude of COPD-related symptoms, which normally display their own circadian oscillations and vary in severity throughout the day. For example, exacerbation of mucus secretion and excessive coughing at Zeitgeber Time 04:00 h (i.e., early morning) are observed (Barnes, 1985; for review, see Sundar et al, 2015;Krakowiak and Durrington, 2018). Maintaining the coordination between the endogenous circadian clocks and exogenous light/dark cycles is pertinent for optimizing all aspects of mammalian physiology (for review, see Bechtold et al, 2010;Truong et al, 2016).…”

Section: Hr Bpmmentioning

confidence: 99%

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Disruption of Physiological Rhythms Persist Following Cessation of Cigarette Smoke Exposure in Mice

et al. 2020

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Background: Physiological rhythms in mammals are essential for maintaining health, whereas disruptions may cause or exacerbate disease pathogenesis. As such, our objective was to characterize how cigarette smoke exposure affects physiological rhythms of otherwise healthy mice using telemetry and cosinor analysis. Methods: Female BALB/c mice were implanted with telemetry devices to measure body temperature, heart rate, systolic blood pressure (SBP), and activity. Following baseline measurements, mice were exposed to cigarette smoke for approximately 50 min twice daily during weekdays over 24 weeks. Physiological parameters were recorded after 1, 4, 8, and 24 weeks of exposure or after 4 weeks cessation following 4 weeks of cigarette smoke exposure. Results: Acute cigarette smoke exposure resulted in anapyrexia, and bradycardia, with divergent effects on SBP. Long term, cigarette smoke exposure disrupted physiological rhythms after just 1 week, which persisted across 24 weeks of exposure (as shown by mixed effects on mesor, amplitude, acrophase, and goodness-of-fit using cosinor analysis). Four weeks of cessation was insufficient to allow full recovery of rhythms. Conclusion: Our characterization of the pathophysiology of cigarette smoke exposure on physiological rhythms of mice suggests that rhythm disruption may precede and contribute to disease pathogenesis. These findings provide a clear rationale and guide for the future use of chronotherapeutics.

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Section: Hr Bpmmentioning

confidence: 99%

Section: Hr Bpmmentioning

confidence: 99%

Disruption of Physiological Rhythms Persist Following Cessation of Cigarette Smoke Exposure in Mice

et al. 2020

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“…Previous research [42] has shown that the circadian rhythm influences the severity of asthma symptoms. Symptoms tend to be worst around 4:00 am and gradually improve during the day.…”

Section: Discussionmentioning

confidence: 98%

Does immediate smart feedback on therapy adherence and inhalation technique improve asthma control in children with uncontrolled asthma? A study protocol of the IMAGINE I study

Sportel

Wolcherink

Palen

et al. 2020

Trials

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Background Many asthmatic children suffer from uncontrolled asthma with frequent exacerbations, despite an optimal treatment plan using inhalation medication. Studies have shown that therapy adherence and inhalation technique are often suboptimal in asthmatic children, but these have traditionally been hard to measure. A novel device functioning as an add-on to the inhaler has been developed to measure both aspects by recording vibration patterns during inhalation. This data can be converted to smart feedback and provided to patients immediately via a mobile application. The aim of this study is to improve asthma control in children between 6 and 18 years old by providing immediate smart feedback on the intake of inhalation medication. Asthma control will be measured by forced expiratory volume in 1 s, (Childhood) Asthma Control Test ((c-)ACT) score, and lung function variability and reversibility. Methods The study will be performed in Medisch Spectrum Twente (Enschede, The Netherlands). The goal is to include 68 uncontrolled moderate to severe asthmatic children between 6 and 18 years old who receive controller inhalation medication through the Nexthaler®, Ellipta®, or Spiromax®. The study consists of three phases. Phase 1 is observational and will last 4 weeks to observe the baseline adherence and inhalation technique as monitored by the add-on device. A randomised controlled trial lasting 6 weeks will be performed in phase 2. Patients in the intervention group will receive immediate smart feedback about the performed inhalations via a mobile application. In the control group, adherence and inhalation technique will be monitored, but patients will not receive feedback. In phase 3, also lasting 6 weeks, the feedback will be ceased for all children and revision of current therapy may occur, depending on the findings in phase 2. Asthma control can be assessed by means of spirometry (both at home and in the hospital) and (c-)ACT questionnaires. Discussion Immediate smart feedback may improve therapy adherence and inhalation technique, and thus asthma control in children and prevent unnecessary switches to targeted biologics. Performing this study in children is desired, since they are known to react differently to feedback and medication than adults. Trial registration Dutch Trial Register NL7705. Registered on 29 April 2019

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“…This finding is consistent with asthma diurnal variation and should be taken into consideration when defining the time of at home measurements. Circadian variation in asthma causes lower spirometry measurements in the early morning hours when the disease is at its nadir 6 . A larger difference between mSpirometry and clinic measurements observed in the morning compared to afternoon/evening suggests the impact of FEV 1 diurnal variation rather than suboptimal efforts by…”

Section: Discussionmentioning

confidence: 99%

“…Asthma is characterized by airflow obstruction which displays a diurnal pattern. Diurnal variation is observed in lung function in healthy individuals 5 and is greater in asthma patients 6 . The lowest FEV 1 measurements are observed in early morning hours coinciding with increased symptoms and airway inflammation 7 .…”

Section: Introductionmentioning

confidence: 99%

Remote FEV1 Monitoring in Asthma Patients: A Pilot Study

Huang¹,

Izmailova²,

Jackson

et al. 2020

Clinical Translational Sci

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Forced expiratory volume in one second (FEV 1) is a critical parameter for the assessment of lung function for both clinical care and research in patients with asthma. While asthma is defined by variable airflow obstruction, FEV 1 is typically assessed during clinic visits. Mobile spirometry (mSpirometry) allows more frequent measurements of FEV 1 , resulting in a more continuous assessment of lung function over time and its variability. Twelve patients with moderate asthma were recruited in a single-center study and were instructed to perform pulmonary function tests at home twice daily for 28 days and weekly in clinic. Daily and mean subject compliance was summarized. The agreement between clinic and mobile FEV 1 was assessed using correlation and Bland-Altman analyses. The test-retest reliability for clinic and mobile spirometry was assessed by inter-class correlation coefficient (ICC). Simulation was conducted to explore if mSpirometry could improve statistical power over clinic counterparts. The mean subject compliance with mSpirometry was 70% for twice-daily and 85% for at least once-daily. mSpirometry FEV 1 were highly correlated and agreed with clinic ones from the same morning (r=0.993) and the same afternoon (r=0.988) with smaller mean difference for the afternoon (0.0019L) than morning (0.0126L) measurements. The test-retest reliability of mobile (ICC=0.932) and clinic (ICC=0.942) spirometry were comparable. Our simulation analysis indicated greater power using dense mSpirometry than sparse clinic measurements. Overall, we have demonstrated good compliance for repeated at-home mSpirometry, high agreement and comparable test-retest reliability with clinic counterparts, greater statistical power, suggesting a potential for use in asthma clinical research.

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The Role of the Body Clock in Asthma and COPD: Implication for Treatment

Cited by 35 publications

References 88 publications

Disruption of Physiological Rhythms Persist Following Cessation of Cigarette Smoke Exposure in Mice

Disruption of Physiological Rhythms Persist Following Cessation of Cigarette Smoke Exposure in Mice

Does immediate smart feedback on therapy adherence and inhalation technique improve asthma control in children with uncontrolled asthma? A study protocol of the IMAGINE I study

Remote FEV1 Monitoring in Asthma Patients: A Pilot Study

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