Asthma ; diagnosis ; pathology ; Humans

Adult ; Asthma ; diagnosis ; pathology ; Dermatitis, Atopic ; diagnosis ; pathology ; Enteritis ; diagnosis ; pathology ; Eosinophilia ; diagnosis ; pathology ; Gastritis ; diagnosis ; pathology ; Humans ; Male

Eosinophilic granulomatosis with polyangiitis(EGPA),also known as Churg-Strauss syndrome,is a clinically rare small-vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCAs) and the hypereosinophilic syndromes (HESs),characterized by asthma,disseminated necrotizing vasculitis,extravascular granulomas,peripheral eosinophilia,and tissue eosinophilia. This article reviews the pathology,imaging,and clinical features of EGPA.
Antibodies, Antineutrophil Cytoplasmic ; Asthma ; Churg-Strauss Syndrome ; diagnosis ; pathology ; Eosinophilia ; Granulomatosis with Polyangiitis ; diagnosis ; pathology ; Humans

Asthma is a chronic inflammatory disorder of the airways causing typical symptoms, and the diagnosis is supported by evidence of airflow obstruction which is variable, reversible or inducible. However, standard assessment of lung function with spirometry does not measure dysfunction in small airways which are < 2 mm in diameter towards the periphery of the lung. These airways make only a small contribution to airway resistance under normal circumstances. Nevertheless, there is mounting evidence that pathology and dysfunction in these small airways are implicated in the pathogenesis and natural history of asthma. Using forced oscillation and the multibreath nitrogen washout techniques, uneven ventilation (ventilation heterogeneity) due to small airways dysfunction has been shown to be an important marker of asthma disease activity, even in the absence of abnormalities in standard spirometric measurements. Recent advances in imaging research, particularly with hyperpolarised gas magnetic resonance imaging, have also given insights into the significance and dynamic nature of ventilation heterogeneity in asthma. The challenge is to integrate these new physiological and imaging insights to further our understanding of asthma and facilitate potential new treatments.
Airway Resistance ; Asthma ; Diagnosis ; Lung ; Magnetic Resonance Imaging ; Natural History ; Nitrogen ; Pathology ; Population Characteristics ; Spirometry ; Ventilation

Tracheobronchopathia osteochondroplastica (TO) is a rare disorder of unknown cause characterized by the presence of multiple submucosal osseous and/or cartilaginous nodules that protrude into the lumen of the trachea and large bronchi. A simultaneous diagnosis of TO and amyloidosis is rarely reported. In this report, a case initially suspected to be asthma bronchiole that could not be treated, was radiologically diagnosed as TO, and also secondary amyloidosis is presented. A 53 years, man patient reported a 3 years history of dyspnea. Pulmonary function tests (PFTs) showed an obstructive pattern. Chest X-rays revealed right middle lobe atelectasis. FOB and CT detected nodular lesions in the trachea and in the anterior and lateral walls of the main bronchi. AA amyloidosis was confirmed by endobronchial biopsy. In the abdominal fat pad biopsy, amyloidosis was not detected. Asthma bronchiole was excluded by PFTs. This case illustrates that it is possible for TO and amyloidosis to masquerade as asthma. TO and amyloidosis should be suspected in patients of older ages with asthma and especially with poorly treated asthmatic patients. Although nodular lesions in the anterior and lateral tracheobronchial walls are typical for TO, a biopsy should be obtained to exclude amyloidosis.
Amyloidosis/complications/*diagnosis/pathology ; Asthma/diagnosis ; Bronchial Diseases/complications/*diagnosis/radiography ; Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Tracheal Diseases/complications/*diagnosis/radiography

For the past three decades, a large number of genetic studies have been performed to examine genetic variants associated with asthma and its subtypes in hopes of gaining better understanding of the mechanisms underlying disease pathology and to identify genetic biomarkers predictive of disease outcomes. Various methods have been used to achieve these objectives, including linkage analysis, candidate gene polymorphism analysis, and genome-wide association studies (GWAS); however, the degree to which genetic variants contribute to asthma pathogenesis has proven to be much less significant than originally expected. Subsequent application of GWAS to well-defined phenotypes, such as occupational asthma and non-steroidal anti-inflammatory drugexacerbated respiratory diseases, has overcome some of these limitations, although with only partial success. Recently, a combinatorial analysis of single nucleotide polymorphisms (SNPs) identified by GWAS has been used to develop sets of genetic markers able to more accurately stratify asthma subtypes. In this review, we discuss the implications of the identified SNPs in diagnosis of asthma and its subtypes and the progress being made in combinatorial analysis of genetic variants.
Anti-Inflammatory Agents, Non-Steroidal ; Aspirin ; Asthma* ; Asthma, Occupational ; Biomarkers ; Diagnosis* ; Genetic Association Studies ; Genetic Markers ; Genetic Techniques ; Genome-Wide Association Study ; Hope ; Pathology ; Phenotype ; Polymorphism, Single Nucleotide*

OBJECTIVEBy observing body surface temperature variation of the intermediate structures of the Lung (Fei) and Large Intestine (Dachang) exterior-interior relationship in asthmatic patients, to investigate the pathological response on the pathway of channels and to substantiate the objective existence of the intermediary structures.

METHODSThe study included 60 subjects meeting the bronchial asthma inclusion criteria (experimental group) and 60 healthy subjects (normal control group). ATIR-M301 infrared thermal imaging device was used for detecting body surface temperature of the subjects and collecting the infrared thermal images. The temperature values of the intermediate structures of Lung and Large Intestine exterior-interior relationship [throat, Quepen, elbow, nose, Lieque (LU 7), Pianli (LI 6)], control areas (0.2 cm lateral to the above structures) and Yintang (EX-HN 3) were measured on the infrared thermal image by infrared imaging system. Then, the above temperature values were compared and analyzed within and between two groups.

RESULTSThere were insignificant differences between the temperature on the left and right sides of the intermediate structures (Quepen, elbow, LU 7, LI 6) in normal control group (P>0.05). Except for that of Quepen, there were insignifificant differences between the temperature of the intermediate structures and their corresponding control areas in normal control group (P>0.05). In the experimental group, the temperature on the left and right sides of the intermediate structures (Quepen, elbow, LU 7, LI 6) showed statistically signifificant differences (P<0.05 or P<0.01); the temperature difference between intermediate structure (throat, Quepen, elbow, nose, LI 6) and their respective control areas were also significant (P<0.05 or P<0.01). The temperature of the intermediate structures (throat, Quepen, elbow, LU7, LI 6) between the experimental group and normal control group showed signifificant differences (P<0.05 or P<0.01).

CONCLUSIONSThis study is an initial step to validate the objective existence of Lung and Large Intestine exterior-interior relationship intermediate structures, as described in the Chinese classical medical literatures, through the functional imaging angle. The intermediate structures are the pathological reaction areas of the bronchial asthmatic patients.

Asthma ; diagnosis ; pathology ; Biomedical Research ; Case-Control Studies ; Diagnostic Imaging ; Female ; Humans ; Infrared Rays ; Intestine, Large ; pathology ; Lung ; pathology ; Male ; Middle Aged ; Temperature ; Thermography ; methods

OBJECTIVETo explore the biomarkers and inflammatory characteristics for microcosmic syndrome differentiation of cold-phlegm syndrome (CPS) and heat-phlegm syndrome (HPS) in patients with bronchial asthma.

METHODSPatients with bronchial asthma of chronic persistent condition were distributed into three groups according syndrome differentiation, the CPS group (27 patients), the HPS group (32 patients) and the non-cold/heat-phlegm syndrome group (NP group, 31 patients), besides, a control group was setup with 33 healthy persons. Percentages of neutrophils and eosinophils (NEU, EOS) in sputum sample (collected by induction) and peripheral blood were counted; and levels of interleukin-8, -5, and -4 (IL-8, IL-5 and IL-4), interferon-gamma (IFN-gamma), leukotriene B4 (LT-B4), eosinophil cationic protein (ECP), and C-reactive protein (CRP) in sputum supernatant and serum were determined by enzyme-linked immunosorbent assay.

RESULTSPercentage of NEU in sputum of HPS group was higher than that in the other three groups (P < 0.05); while percentages of EOS in serum and sputum of CPS group were higher than that in the other three groups (all P < 0.01). Level of ECP (a parameter closely associated with EOS) also was high in the CPS group, but IL-8 (a parameter closely associated with NEU) showed no significant difference in various groups (P > 0.05). Moreover, the CPS group showed a higher serum IL-4 (P < 0.05) but a lower IFN-gamma/IL-4 level as compared with those in the NP group (P < 0.01).

CONCLUSIONPhlegm, which is considered by Chinese medicine as an inveterate root of asthma, might be closely related with the inflammation in modern medicine. The inflammatory characteristics of asthma in patients with CPS partially present as increase of EOS, possibly show Th2 dominant trend, similar to that presented in eosinophilic asthma. Asthma with HPS embodies increase of NEU in respiratory tract. EOS and ECP might be the important markers for microcosmic syndrome differentiation of CPS, and NEU might be that for HPS.

Adolescent ; Adult ; Aged ; Asthma ; complications ; diagnosis ; pathology ; Biomarkers ; metabolism ; Case-Control Studies ; Diagnosis, Differential ; Eosinophil Cationic Protein ; metabolism ; Eosinophils ; pathology ; Female ; Humans ; Inflammation ; complications ; diagnosis ; pathology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Neutrophils ; pathology ; Young Adult

I n some patients, eosinophilic gastroenteritis(EG) occurs in those with food allergy. We experienced a non-atopic asthmatic who had an EG associated with food allergy to fish and eggs, and blood eosinophilia. A skin prick test and RAST to causative food allergens showed a negative result. A fiber-optic endoscopic biopsy from the gastric mucosa showed an intense eosinophilic infiltration. We could find symptomatic improvement and a disappearance of eosinophilic infiltration in gastric mucosa after complete avoidance from the causative food and oral cortcosteroid. It was suggested that fiber-optic endoscopic biopsy might be needed to identify coexisting EG if an allergic patient with blood eosinophilia complains of severe gastrointestinal symptoms.
Adrenal Cortex Hormones/therapeutic use ; Asthma/*complications/drug therapy ; Case Report ; Endoscopy ; Eosinophilia/*complications ; Food Hypersensitivity/*complications ; Gastric Mucosa/pathology ; Gastroenteritis/*complications/diagnosis/pathology ; Human ; Male ; Middle Age

OBJECTIVETo explore the role of eotaxin in the pathogenesis of bronchial asthma and the clinical value in the diagnosis of asthma.

METHODSSerum eotaxin were measured by ELISA in 38 patients with asthma, 28 patients with non-asthma allergy, and 30 healthy controls.

RESULTSThe levels of serum eotaxin in the asthma group were higher than those in the non-asthma allergic and control group (P<0.01). Furthermore, eotaxin levels in patients with acute asthma were significantly higher than those in patients with stable asthma (P<0.001). It was also found that the eotaxin levels of the acute asthma group were positively correlated to the amounts of eosinophils in peripheral blood (r=0.4196, P<0.001), and inversely correlated to the forced expiratory volume in one second (FEV1) (r=-0.3746, P<0.001).

CONCLUSIONIt suggests that eotaxin may play a crucial pathogenic role in the asthmatic process possibly by activating the allergic inflammatory cells and controlling the recruitment of eosinophils from blood to bronchial epithelium of the airway. The concentration of eotaxin is significantly associated with the attack of acute asthma and its severity. Eotaxin may be a potential therapeutic target in patients with asthma.

Adult ; Asthma ; diagnosis ; physiopathology ; Cell Count ; Chemokine CCL11 ; Chemokines, CC ; blood ; physiology ; Eosinophilia ; pathology ; Female ; Forced Expiratory Volume ; Humans ; Male ; Middle Aged