OBJECTIVEChronic inflammation of airway in bronchial asthma is caused by many complicated elements. Recently, a close attention has been paid to the neurogenic inflammation in airway which is mediated by sensory neuropeptides secreted by sensory nerve in the lung. Neurokinin A (NKA) is an important sensory neuropeptide leading to neurogenic inflammation in airway. Experimental studies showed that NKA has a close relation to asthma. The purpose of the present study was to investigate the changes of NKA in plasma of asthmatic children and possible relationship between sensory neuropeptides and asthma in children.

METHODSThirty-five children with bronchial asthma were studied; 16 of the cases were < 3 yrs and 19 were >or= 3 yrs. Eighteen of the cases had severe asthma and 16 had mild asthma. None of the subjects was treated with glucocorticoid within 3 days before the study started; 15 healthy children without history of asthma or family history of asthma were enrolled as control subjects. Plasma was collected from each case during acute attack of asthma and their clinical remission of the asthmatic children. After purifying with SEP-pak C(18), NKA content was detect by enzyme-linked immunosorbent assay (ELISA) as instructed by the manufacturer of the NKA Kit (NKA unit: ng/L).

RESULTS(1) The content of plasma NKA of asthmatic children was significantly higher at the asthma attack (256 +/- 153) than that at their clinical remission stage (70 +/- 66; q = 9.497, P < 0.01) and than that of the normal control group (38 +/- 6; q = 8.599, P < 0.01); no significant difference in plasma NKA was found between the clinical remission stage and the normal control group (q = 1.245, P > 0.05). (2) There was a significant positive correlation between the asthmatic clinical state and the levels of plasma NKA; the contents of plasma NKA at the stage of acute attack in severe asthma (296 +/- 170) were significantly higher than those of the mild asthmatic children (190 +/- 99; q = 3.77, P < 0.05).

CONCLUSIONSThe contents of plasma NKA were significantly higher during the asthma attack stage of children, and the higher was the level of NKA, the more severe the attack.; with asthma remission, the contents of plasma NKA decreased to normal; the contents of plasma NKA has a close relation to the asthmatic children.

Asthma ; blood ; Child ; Child, Preschool ; Humans ; Infant ; Neurokinin A ; blood

BACKGROUND & OBJECTIVES: The pathogenic mechanism of aspirin-sensitive asthma (ASA-BA) remains to be further defined. To evaluate the role of circulating immune complex (CIC) in ASA-BA. SUBJECTS & METHODS: We measured IgG- and IgA-IC level by ELISA using anti-C3 antibody in 33 ASA-BA patients whose sensitivity was confirmed by lysine-aspirin bronchoprovocation test, and compared with those of 14 allergic, 14 intrinsic asthma patients and 7 healthy controls. RESULTS: There was no significant difference in IgG-IC level among the four groups (p > 0.05), while IgA-IC levels of aspirin-sensitive asthma were higher than those of other groups (p = 0.0035). Patients with nasal polyp had significantly higher IgG-IC than those without it (p = 0.02). No differences were found according to medication and symptom scores, and presence of atopy, rhino-sinusitis, urticaria or concurrent sensitivity to sulfite (p > 0.05). Insignificant correlation was found between IgG-IC level and asthma duration, total IgE level, or circulating eosinophil count. CONCLUSION: These findings suggest a possible contribution of IgG-IC to the development of nasal polyp in ASA-BA. Further study will be needed to clarify the role of IgA-IC in the pathogenesis of ASA-BA.
Adult ; Aged ; Antigen-Antibody Complex/blood* ; Aspirin/adverse effects* ; Asthma/immunology* ; Asthma/etiology* ; Asthma/complications ; Case-Control Studies ; Human ; IgA/blood ; IgG/blood ; Middle Age ; Nasal Polyps/etiology

To explore the expression of heme oxygenase-1 (HO-1) in the peripheral blood mononuclear cells (PBMCs) and its relationship with pulmonary ventilation function in asthmatic patients, 18 asthmatic patients and 18 healthy subjects were selected. HO-1 protein and mRNA levels in PBMCs were measured by immunohistochemical staining and reverse transcription-polymerase chain reaction (RT-PCR), respectively. Blood carbon monoxide Hb (COHb), serum total IgE and pulmonary ventilatory function were observed. Our results showed that the percentage of cells positive for immunohistochemical staining of HO-1 were significantly higher in asthmatic patients (41.72 +/- 7.44) % than that in with healthy subjects (10.45 +/- 4.36) % (P < 0.001) and the optical density of PBMC HO-1 mRNA was higher in asthmatic patients (26.05 +/- 4.14) than that in healthy subjects (10. 82 +/- 4.26) (P < 0.001). The relation analysis showed that PBMC HO-1 protein and mRNA levels had significantly negative relation with FEV1%, PEFR, MEFR50%, respectively (r = -0.51-0.89, P < 0.05-0.001, respectively) and a positive relation with COHb and serum total IgE (r = 0.48-0. 85, 0.05-0.001, respectively). It is concluded that the expression of PBMC HO-1 protein and mRNA increased significantly in asthmatic patients, and HO-1 may play a significant role in the pathogenesis of asthma. The expression of HO-1 may bear a relation with severity of asthma.
Asthma/blood ; Asthma/*enzymology ; Carbon Monoxide/blood ; Heme Oxygenase-1/*biosynthesis ; Heme Oxygenase-1/blood ; Immunoglobulin E/*blood ; Leukocytes, Mononuclear/*enzymology ; RNA, Messenger/blood

Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. Chronic inflammation is associated with airway hyper-responsiveness, which leads to various airway symptoms. Approaches to asthma treatment have been changing because our knowledge about the pathogenesis and treatment of asthma is continually evolving. Until recently, the stepwise approach to the treatment of asthma was based on a patient's asthma severity. However, new international guidelines have recommended that treatment should be adjusted in a continuous cycle driven by the patient's asthma-control status. If asthma is not controlled on the current treatment regimen, treatment should be stepped up until control is achieved. When control is maintained for at least 3 months, treatment can be stepped down. Ongoing monitoring is essential to maintain control and to establish the lowest step and dose of treatment to minimize cost and maximize safety. However, the stepwise approach and recommended treatments are meant to assist, not replace, the clinical decision making necessary to determine the most appropriate treatment to meet the individual patient's needs and circumstances. This article is a review of the stepwise approach to the treatment of asthma recommended by the Global Initiative for Asthma 2009 and Expert Panel Report 3 of National Heart, Lung, and Blood Institute 2007.
Asthma ; Decision Making ; Inflammation ; National Heart, Lung, and Blood Institute (U.S.)

Antigen Presentation ; Asthma ; blood ; etiology ; therapy ; Eosinophils ; physiology ; Humans

OBJECTIVETo study the changes and clinical significance of serum levels of 25-(OH)D(3) and total IgE in children with asthma.

METHODSThirty children with asthma, 40 children with asthmatic bronchitis, and 40 healthy children were enrolled. Double-antibody radioimmunoassay was used to detect the levels of serum 25-(OH)D(3) and total IgE.

RESULTSSerum 25-(OH)D(3) levels (18±3 ng/Ml)decreased significantly in the asthmatic group compared with those in the asthmatic bronchitis group (43±3 ng/mL) and the control group (43±3 ng/mL) (P<0.01). In contrast, serum total IgE levels (192±16 IU/mL) increased significantly in the asthmatic group compared with those in the asthmatic bronchitis group (123±14 IU/mL) and the control group (118±15 IU/mL) (P<0.01). Serum 25-(OH)D(3) levels were negatively correlated with serum total IgE levels in asthmatic children (r=-0.783, P<0.01). There were no correlation between serum 25-(OH)D(3) levels and serum total IgE level in the asthmatic bronchitis and the control groups.

CONCLUSIONS25-(OH)D(3) may play an important role in the pathogenesis of asthma. The increased serum 25-(OH)D(3) level may inhibit total IgE expression, suggesting that increasing serum 25-(OH)D(3) level might be a new option for the prevention and treatment of asthma.

Asthma ; blood ; etiology ; Calcifediol ; blood ; Child ; Child, Preschool ; Female ; Humans ; Immunoglobulin E ; blood ; Infant ; Male

Adolescent ; Asthma ; blood ; Bronchitis ; blood ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Uteroglobin ; blood

Adolescent ; Asthma ; blood ; Child ; Child, Preschool ; Cough ; blood ; Eosinophil Cationic Protein ; blood ; Female ; Humans ; Immunoglobulin E ; blood ; Infant ; Male

OBJECTIVETo study the association of vitamin D level with asthma control and pulmonary function in children with asthma.

METHODSA total of 150 children with asthma were enrolled as observation group, and 55 healthy children were enrolled as control group. According to the level of asthma control, the children were divided into good control group, partial control group, and non-control group. Chemiluminescence microparticle immunoassay was used to measure the serum level of 25-hydroxyvitamin D [25(OH)D] for all groups. According to the level of 25(OH)D, the asthmatic children were divided into normal vitamin D group, vitamin D insufficiency group, and vitamin D deficiency group. Pulmonary function was measured for all asthmatic children.

RESULTSThe observation group had a significantly lower serum level of 25(OH)D than the control group (25± 7 ng/mL vs 29± 4 ng/mL; P<0.05). The normal vitamin D group had the highest asthma control rate, followed by the vitamin D insufficiency group and the vitamin D deficiency group (P<0.05). There was no significant difference in pulmonary function among the three groups (P>0.05).

CONCLUSIONSAsthmatic children have a lower serum level of 25(OH)D than healthy children. The serum level of 25(OH)D is associated with the level of asthma control and has no association with pulmonary function.

Asthma ; blood ; physiopathology ; Child ; Child, Preschool ; Female ; Humans ; Lung ; physiopathology ; Male ; Vitamin D ; blood

The relationship of stress perception and frequency of stressors with serum total Ig E level was investigated in 54 outpatients with bronchial asthma. The GARS (global assessment of recent stress) scale and SRRS (social readjustment rating scale) were used to measure the degree of stress perception and frequency of stressors during a one-year period Total serum Ig E was measured by the PRIST method. 56% of the patients were found to have psychosomatic disorders, but there was no significant difference in stress perception and frequency of stressors between psychosomatic and non-psychosomatic groups. A considerable number of patients (63%) rated their symptoms as severe, but no significant correlation was found between severity of symptoms and stress perception. Severity of stress perception and frequency of stressors did not correlate with serum total Ig E level. Multiple regression analysis revealed that female patients were significantly higher in stress perception than male ones, and that chronicity of illness was more likely to increase stress perception. Extrinsic asthmatics had significantly more negative stressors than intrinsic ones. In conclusion, serum Ig E is considered a stable indicator of allergy not influenced by stress. It was also indicated that patients with bronchial asthma were more likely to perceive physical symptoms than psychological stress.
Adolescent ; Adult ; Asthma/*blood/*psychology ; Female ; Human ; Immunoglobulin E/*blood ; Male ; Middle Age ; Stress/*blood ; Support, Non-U.S. Gov'