Asthma ; drug therapy ; epidemiology ; physiopathology ; prevention & control ; Humans ; Pediatrics ; Singapore ; epidemiology

OBJECTIVETo study the effects of alltrans retinoic acid (ATRA) on airway responsiveness, airway remodeling and expression of matrix metalloproteinase-9 (MMP-9) protein in rats with asthma.

METHODSForty rats were randomly divided into five groups: asthma model, normal saline (control), ATRA treatment, cotton oil treatment and budesonide treatment (n=8 each). Asthma was induced by ovalbumin sensitization and challenge in the asthma model, and the ATRA, cotton oil or budesonide treatment groups. ATRA (50 μg/kg), cotton oil (1 mL) or budesonide (0.32 mg/kg) was administered before ovalbumin challenge in the three treatment groups. Airway responsiveness was assessed. The lung tissues were sampled to detect airway remodeling and the expression of MMP-9 protein by immunohistochemistry.

RESULTSThe expression of MMP-9 in lung tissues in the ATRA treatment group was significantly higher than that in the control group, but the airway responsiveness in the ATRA treatment group was not significantly different from that in the control group. The airway responsiveness and the expression of MMP-9 in lung tissues were significantly reduced in the ATRA treatment group compared with the asthma model group. The airway remodeling was significantly improved in the ATRA treatment group compared with the asthma model group.

CONCLUSIONSATRA may alleviate airway hyperresponsiveness and airway remodeling possibly through decreasing the protein expression of MMP-9 in rats with asthma.

Airway Remodeling ; drug effects ; Animals ; Asthma ; drug therapy ; pathology ; physiopathology ; Bronchi ; drug effects ; pathology ; physiopathology ; Lung ; enzymology ; Matrix Metalloproteinase 9 ; analysis ; Rats ; Rats, Sprague-Dawley ; Tretinoin ; pharmacology

OBJECTIVETo investigate the effects of obesity on response to therapy and pulmonary function in children with asthma who receive inhaled corticosteroid (ICS) treatment.

METHODSA total of 129 children with asthma were divided into two groups according to their body mass index: normal weight group (n=64) and obese group (n=65). The asthma control status and pulmonary function were compared between the two groups after one year of ICS treatment. The pulmonary function was expressed as percent forced expiratory volume in 1 second (FEV1%), percent predicted forced vital capacity (FVC%), peak expiratory flow (PEF), peak expiratory flow at 25% of vital capacity (PEF25), and peak expiratory flow at 50% of vital capacity (PEF50). The asthma control status was expressed as complete control rate, partial control rate, and uncontrolled rate. Sixty-eight healthy children were selected as the healthy control group.

RESULTSThere were significant differences in the indices of pulmonary function between the three groups before treatment (P<0.01); the healthy control group had the best values of pulmonary function, while the obese group had the worst values. After 1 year of treatment, the normal weight group showed significantly more improvements in FEV1% and FVC% than the obese group (P<0.01). However, there were no significant differences in improvements in PEF, PEF25, and PEF50 between the two groups. The complete control rate, partial control rate, and uncontrolled rate in the normal weight group were 72%, 19%, and 9%, respectively, while the rates in the obese group were 28%, 51%, and 22%, respectively; the normal weight group had a significantly better asthma control status than the obese group (P<0.01).

CONCLUSIONSThe asthmatic children with obesity have a significantly less improvement in large airway function and a poorer asthma control status after ICS treatment than those with the normal weight.

Administration, Inhalation ; Adrenal Cortex Hormones ; administration & dosage ; Asthma ; drug therapy ; physiopathology ; Child ; Child, Preschool ; Female ; Forced Expiratory Volume ; Humans ; Lung ; physiopathology ; Male ; Obesity ; physiopathology

Animals ; Asthma ; drug therapy ; immunology ; metabolism ; physiopathology ; Child, Preschool ; Humans ; Infant ; Leukotrienes ; immunology ; metabolism ; pharmacology ; Respiratory Sounds ; drug effects ; immunology ; physiopathology

Anti-Asthmatic Agents ; therapeutic use ; Asthma ; physiopathology ; prevention & control ; therapy ; virology ; Child ; China ; Chronic Disease ; Cough ; physiopathology ; virology ; Drug Therapy, Combination ; Humans ; Respiratory Sounds ; drug effects ; physiopathology ; Respiratory Syncytial Virus Infections ; complications ; physiopathology ; prevention & control

OBJECTIVETo study the changes in pulmonary function and fractional exhaled nitric oxide in exhaled breath (FeNO) in asthmatic children who have different responses to regular treatment.

METHODSA total of 52 asthmatic children who had a good compliance with regular stepped control treatment were selected as subjects. They were followed up every three months to evaluate the asthma control level, pulmonary ventilation function, and FeNO for 9 months. Besides, medications for asthma control were recorded.

RESULTSAt three follow-up points (months 3, 6, and 9), the percentage of asthmatic children who used the first or the second level of control treatment in the stable group (with stable response to the treatment) was significantly higher than in the unstable group (with unstable response to the treatment) (P<0.05), while the percentage of asthmatic children who used the third level of control treatment in the stable group was significantly lower than in the unstable group (P<0.05). At the three follow-up points, the stable group had a significantly higher ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) than the unstable group (P<0.05); at the 3-month and 9-month follow-up points, the stable group had a significantly higher percentage of predicted maximum mid-expiratory flow (MMEF%) than the unstable group (P<0.05); at the initial evaluation and 3-month follow-up point, the stable group had a significantly higher FeNO than the unstable group (P<0.05).

CONCLUSIONSContinuously monitoring FEV1/FVC, MMEF% and FeNO is useful in the early evaluation of the responses to treatment in children with asthma.

Adolescent ; Asthma ; drug therapy ; physiopathology ; Breath Tests ; Child ; Female ; Forced Expiratory Volume ; Humans ; Male ; Nitric Oxide ; analysis ; Vital Capacity

OBJECTIVEThe efficacy of bronchodilator in asthmatoid bronchitis remains controversial. This study was designed to investigate the effects of bronchodilators, salbutamo and ipraopium bromide, on the pulmonary function in young children with this disease.

METHODSPulmonary function tests were performed in 20 children with asthmatoid bronchitis (2 months-2.5 years of age) before and 30, 60, and 120 minutes after salbutamo and ipratropium bromide inhalation. The indexes of pulmonary function measured included tidal breathing flow volume (TBFV) loop, percent of tidal volume to peak tidal expiratory flow (%V-PF), terminal flows per peak expiratory flow (25/PF), peak tidal expiratory flow (PTEF), rate of mid-expiratory to mid-inspiratory flow (ME/MI), respiratory rate (RR) and tidal volume per kilogram (TV/kg).

RESULTSBefore drug inhalation, the descending branch of the TBFV loop was depressed. The PTEF shifted forward and %V-PF (0.19 +/- 0.04) and 25/PF (0.42 +/- 0.11) decreased. These changes did not improve and the remaining indexes, RR, ME/MI and TV/kg, 30, 60, and 120 minutes after drug inhalation also remained similar to before inhalation.

CONCLUSIONSSalbutamo and ipratropium bromide inhalation did not improve the airway resistance and ventilation function in children with asthmatoid bronchitis. This suggests that the efficacy of bronchodilator in the treatment of this disease is doubtful.

Administration, Inhalation ; Albuterol ; administration & dosage ; Asthma ; drug therapy ; physiopathology ; Bronchitis ; drug therapy ; physiopathology ; Bronchodilator Agents ; administration & dosage ; Child, Preschool ; Female ; Humans ; Infant ; Ipratropium ; administration & dosage ; Lung ; drug effects ; physiopathology ; Male

OBJECTIVETo probe a better therapy for chronic persistent asthma.

METHODSThirty-six cases of chronic persistent asthma were randomly divided into a beat-sensitive moxibustion group (17 cases) and a western medication group (19 cases). In heat-sensitive moxibustion group, the sensitization points between Feishu (BL 13) and Geshu (BL 17) were selected with heat-sensitive moxibustion; in western medication group, Seretide inhalant was applied. The patients of both groups were continuously treated for 3 months and the therapeutic effects were evaluated by clinical symptom scores and pulmonary ventilation function test.

RESULTSAfter treatment, the effective rate of 88.2% (15/17) in heat-sensitive moxibustion group was superior to that of 47.4% (9/19) in western medication group (P < 0.05); the clinical symptom scores and pulmonary ventilation function were obviously improved in the two groups, and the heat-sensitive moxibustion group was superior to the western medication group (all P < 0.05).

CONCLUSIONFor chronic persistent bronchial asthma, heat-sensitive moxibustion can improve the clinical symptoms and the pulmonary ventilation function, and it is better than Seretide inhalant.

Adolescent ; Adult ; Aged ; Albuterol ; analogs & derivatives ; therapeutic use ; Androstadienes ; therapeutic use ; Asthma ; drug therapy ; physiopathology ; therapy ; Chronic Disease ; therapy ; Drug Combinations ; Female ; Fluticasone-Salmeterol Drug Combination ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Moxibustion ; Pulmonary Ventilation ; Treatment Outcome ; Young Adult

Most studies on the effects of ambient ozone on asthmatics have been based on ozone concentration measurements taken by air monitors in downtown areas. Using a passive ozone sampler, we investigated the effects of on-site ozone concentrations on the pulmonary function and symptoms of asthmatics. Twenty moderate to severe asthmatics who had been managed for at least 2 months without changes of their medication were enrolled from 3 June to 18 July 2005. Respiratory, nasal and ocular symptoms, peak expiratory flow (PEF), which was measured twice a day, and medication use were recorded on a daily basis during the study period. Data for 17 subjects were analyzed. The average ozone exposure level was 28.2+/-23.6 ppb (3.4-315.3 ppb). There was no significant correlation between PEF and ozone concentration (p>0.05) on the same day or 1-, 2-, or 3-day lags. Interestingly, the degree of asthma symptoms was influenced by the ozone concentration (rho=0.303, p<0.001), even at concentrations less than 80 ppb (p=0.298, p<0.001), but the correlation between ozone exposure and the frequency of reliever medication use was not statistically significant (p=0.99). Our results suggest that exposure to relatively low concentrations of ozone influences the symptoms of moderate to severe asthmatics regardless of changes in pulmonary function or medication use.
Ozone/analysis/*toxicity ; Nebulizers and Vaporizers ; Middle Aged ; Male ; Lung/*physiopathology ; Humans ; Female ; Asthma/drug therapy/*etiology/physiopathology ; Air Pollution/*adverse effects ; Aged ; Adult

Anti-Asthmatic Agents ; therapeutic use ; Asthma ; drug therapy ; physiopathology ; Chronic Disease ; Humans ; Long-Term Care ; Lung ; physiopathology ; Respiratory Function Tests ; Severity of Illness Index ; Treatment Outcome