BACKGROUND: Asthma is a common cause of breathing difficulty in children and adults, and is characterized by chronic airway inflammation that is poorly controlled by available treatments. This results in severe disability and applies a huge burden to the public health system. Methane has been demonstrated to function as a therapeutic agent in many diseases. The aim of the present study was to explore the effect of methane-rich saline (MRS) on the pathophysiology of a mouse model of asthma and its underlying mechanism. METHODS: A murine model of ovalbumin (OVA)-induced allergic asthma was applied in this study. Mice were divided into three groups: a control group, an OVA group, and OVA-induced asthmatic mice treated with MRS as the third group. Lung resistance index (RI) and dynamic compliance (Cdyn) were measured to determine airway hyper-responsiveness (AHR). Haematoxylin and eosin (H&E) staining was performed and scored to show histopathological changes. Cell counts of bronchoalveolar lavage fluid (BALF) were recorded. Cytokines interleukin (IL)-4, IL-5, IL-13, tumor necrosis factor α (TNF-α), and C-X-C motif chemokine ligand 15 (CXCL15) from BALF and serum were measured by enzyme-linked immunosorbent assay (ELISA). The oxidative stress indexes, including malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), myeloperoxidase (MPO), and 8-hydroxydeoxyguanosine (8-OHdG), were determined using commercial kits. Apoptosis was evaluated by western blot, quantitative real-time polymerase chain reaction (qRT-PCR), and biochemical examination. RESULTS: MRS administration reversed the OVA-induced AHR, attenuated the pathological inflammatory infiltration, and decreased the cytokines IL-4, IL-5, IL-13, TNF-α, and CXCL15 in serum and BALF. Moreover, following MRS administration, the oxidative stress was alleviated as indicated by decreased MDA, MPO, and 8-OHdG, and elevated SOD and GSH. In addition, MRS exhibited an anti-apoptotic effect in this model, protecting epithelial cells from damage. CONCLUSIONS Methane improves pulmonary function and decreases infiltrative inflammatory cells in the allergic asthmatic mouse model. This may be associated with its anti-inflammatory, antioxidative, and anti-apoptotic properties.
Animals ; Apoptosis/drug effects* ; Asthma/metabolism* ; Bronchial Hyperreactivity/drug therapy* ; Cytokines/analysis* ; Female ; Inflammation/prevention & control* ; Methane/pharmacology* ; Mice ; Mice, Inbred BALB C ; Oxidative Stress/drug effects* ; Saline Solution

BACKGROUND/AIMS: Asthma is characterized by airway hyperresponsiveness, inflammation, and remodeling. Peroxisome proliferator-activated receptors have been reported to regulate inflammatory responses in many cells. In this study, we examined the effects of intranasal rosiglitazone on airway remodeling in a chronic asthma model. METHODS: We developed a mouse model of airway remodeling, including smooth muscle thickening, in which ovalbumin (OVA)-sensitized mice were repeatedly exposed to intranasal OVA administration twice per week for 3 months. Mice were treated intranasally with rosiglitazone with or without an antagonist during OVA challenge. We determined airway inflammation and the degree of airway remodeling by smooth muscle actin area and collagen deposition. RESULTS: Mice chronically exposed to OVA developed sustained eosinophilic airway inflammation, compared with control mice. Additionally, the mice developed features of airway remodeling, including thickening of the peribronchial smooth muscle layer. Administration of rosiglitazone intranasally inhibited the eosinophilic inflammation significantly, and, importantly, airway smooth muscle remodeling in mice chronically exposed to OVA. Expression of Toll-like receptor (TLR)-4 and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kappaB) was increased in the OVA group and decreased in the rosiglitazone group. Co-treatment with GW9660 (a rosiglitazone antagonist) and rosiglitazone increased the expression of TLR-4 and NF-kappaB. CONCLUSIONS: These results suggest that intranasal administration of rosiglitazone can prevent not only air way inf lammation but also air way remodeling associated with chronic allergen challenge. This beneficial effect is mediated by inhibition of TLR-4 and NF-kappaB pathways.
Actins/metabolism ; Administration, Inhalation ; Airway Remodeling/*drug effects ; Animals ; Anti-Asthmatic Agents/*administration & dosage ; Asthma/chemically induced/*drug therapy/metabolism/physiopathology ; Chronic Disease ; Collagen/metabolism ; Disease Models, Animal ; Female ; Lung/*drug effects/metabolism/physiopathology ; Mice, Inbred BALB C ; NF-kappa B/metabolism ; Ovalbumin ; PPAR gamma/agonists/metabolism ; Pneumonia/chemically induced/physiopathology ; Pulmonary Eosinophilia/chemically induced/prevention & control ; Signal Transduction/drug effects ; Thiazolidinediones/*administration & dosage ; Toll-Like Receptor 4/metabolism

OBJECTIVETo investigate the status of asthma control in the city and severity of asthma in children and to identify related factors.

METHODThis study was conducted in one children's hospital or tertiary hospital in each of the 29 provinces except Xinjiang and Xizang Autonomous Regions. Totally, 2960 parents with asthmatic children ages 0 to 14 years, and all had been diagnosed with asthma at least 3 months ago and the course was more than 12 months, who visited those hospitals were selected for the knowledge, attitude, and practice (KAP) questionnaire survey, and separated into the controlled asthma group and uncontrolled asthma group according to children's asthma conditions in the past 12 months. Multivariate analysis was carried out based on the answers to 28 tested factors; 2485 of 2960 questionnaires from 29 provinces were valid.

RESULTOf the 2485 valid questionnaires, 66.0% asthmatic children had asthma attacks in the past 12 months, 26.8% asthmatic children had visited the emergency department, 16.2% asthmatic children had been hospitalized. The total cost was significantly higher in the uncontrolled group than in contro group (χ² = 23.14, P < 0.01). Parents' education level, parents' KAP scores, regular visits for asthma control, knowledge of "3 or more times recurrent wheezing suggesting asthma", knowledge of "cough lasting for more than 4 weeks suggesting asthma", knowledge of "cough improved with bronchodilators suggesting asthma", knowledge of "awareness of using short-acting β₂ agonist for acute attack", avoiding contact with plush toys, adhere to use nasal steroid, inhaled corticosteroids/composite preparation, age of children and course of asthma in children are protective factors that affect asthma control and severity of asthma in children. Food allergies, eczema and family history of asthma are risk factors.

CONCLUSIONAsthma in many children was poorly controlled. Factors that affect asthma control and severity include parents' knowledge about asthma, exposure to adverse environment, the compliance with medication and regular visits for asthma control. Awareness and improvement the related factors about asthma control and severity can help leading asthma to a well-controlled status and reducing the severity of asthma.

Age Factors ; Anti-Asthmatic Agents ; administration & dosage ; therapeutic use ; Asthma ; drug therapy ; epidemiology ; prevention & control ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Glucocorticoids ; administration & dosage ; therapeutic use ; Health Knowledge, Attitudes, Practice ; Health Surveys ; Humans ; Male ; Multivariate Analysis ; Parents ; psychology ; Retrospective Studies ; Rhinitis, Allergic, Perennial ; complications ; Risk Factors ; Severity of Illness Index ; Socioeconomic Factors ; Surveys and Questionnaires

OBJECTIVETo verify the clinical efficacy of Xiaochuangao acupoint paste (XAP) in treating asthma in children.

METHODNinety children patients with asthma were randomly assigned to three groups with 30 patients each, being treated with XAP, hormone and XAP combined with hormone, respectively. The changes of the lung function and the recurrence times during one-year follow-up were observed.

RESULTGroup II (Hormone group) saw higher total effective rate (69.2%) than Group I (XAP group) (63.3%) , but with no statistic difference between these two groups. Group llI (XAP and Hormone) saw the highest total effective rate (93.1%), with significant statistic difference from the other two groups (P < 0.05). All three groups saw the significant increase of the levels of FEV1, FEV11/FVC and PEF after the treatments (P < 0.05), while no statistical difference of FEV1, FEV1/FVC, PEF were observed in the three groups before the treatments. After the treatments, statistic differences of FEV1, FEV1/FVC, PEF between Group Ill and Group II were observed (P < 0.05).

CONCLUSIONXAP played a role in preventing the recurrence of asthma in children. Combined with hormone, XAP showed better effects.

Acupuncture Points ; Asthma ; drug therapy ; physiopathology ; prevention & control ; Child ; Child, Preschool ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Forced Expiratory Volume ; drug effects ; Humans ; Male ; Seasons ; Secondary Prevention

OBJECTIVETo study the clinical efficacy of astragalus's preventing the recurrence and regulatory effects on Th1/Th2 cytokines in asthmatic children during the remission stage.

METHODSNinety asthmatic children during the remission stage were assigned to the astragalus treatment group (Group A), the hormone treatment group (Group B), and the combined group of astragalus and hormone treatment (Group C), 30 in each. Thirty healthy children were set up as the control group. The changes of peak expiratory flow rate (PEFR) before and after treatment and the recurrence times during the one-year follow-up were observed. Peripheral serum contents of immunoreactive fibronectin-gamma (IFN-gamma) and interleukin-4 (IL-4) were detected before and after treatment using ELISA.

RESULTSThe total effective rate was higher in Group B (73.3%) than in Group A (66.7%), but with no statistical difference between the two groups (P>0.05). It was highest in Group C (96.7%), showing significant difference from the other two groups (P<0.05). The levels of PEFR and IFN-gamma significantly increased and IL-4 obviously decreased in the three groups after treatment (P<0.05). No statistical difference of PEFR, IFN-gamma, or IL-4 existed in the three groups before treatment (P>0.05). Statistical difference of PEFR, IFN-gamma, or IL-4 existed between Group C and Group B after treatment (P<0.05).

CONCLUSIONSAstragalus played a role in preventing the recurrence of asthma. The combination of astragalus and hormones showed better effects.

Asthma ; blood ; drug therapy ; pathology ; prevention & control ; Astragalus Plant ; Child ; Child, Preschool ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Male ; Phytotherapy ; Recurrence

Recent clinical evidence indicates that the non-eosinophilic subtype of severe asthma is characterized by fixed airway obstruction, which may be related to emphysema. Transgenic studies have demonstrated that high levels of IFN-gamma in the airways induce emphysema. Fibroblast growth factor 2 (FGF2), which is the downstream mediator of TGF-beta, is important in wound healing. We investigated the role of FGF2 in IFN-gamma-induced emphysema and the therapeutic effects of recombinant FGF2 in the prevention of emphysema in a severe non-eosinophilic asthma model. To evaluate the role of FGF2 in IFN-gamma-induced emphysema, lung targeted IFN-gamma transgenic mice were cross-bred with FGF2-deficient mice. A severe non-eosinophilic asthma model was generated by airway application of LPS-containing allergens twice a week for 4 weeks. To evaluate protective effects of FGF2, recombinant FGF2 (10 microg) was injected subcutaneously during allergen challenge in the severe asthma model. We found that non-eosinophilic inflammation and emphysema induced by transgenic overexpression of IFN-gamma in the airways were aggravated by the absence of FGF2. Airway challenge with LPS-containing allergens induced more inflammation in mice sensitized with LPS-containing allergens compared to challenge with allergens alone. In addition, LPS-induced lung inflammation and emphysema depended on IFN-gamma but not on IL-13. Interestingly, emphysema in the severe asthma model was significantly inhibited by treatment with recombinant FGF2 during allergen challenge, whereas lung inflammation was unaffected. Therefore, our present data suggest that FGF2 may help protect against IFN-gamma-induced emphysema, and that recombinant FGF2 may help lessen the severity of emphysema.
Animals ; Asthma/drug therapy/*prevention & control ; Bronchoalveolar Lavage Fluid ; Disease Models, Animal ; Emphysema/drug therapy/*prevention & control ; Enzyme-Linked Immunosorbent Assay ; Fibroblast Growth Factor 2/deficiency/*metabolism/*therapeutic use ; Flow Cytometry ; Inflammation/immunology ; Interferon-gamma/*biosynthesis/genetics ; Interleukin-13 ; Lipopolysaccharides/administration & dosage/pharmacology ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Pulmonary Eosinophilia ; Recombinant Proteins/administration & dosage/therapeutic use

Based on ZhangShi YiTong written by ZHANG Lu of Qing dynasty, and the record that external application of Baijiezi (seeds of Brassica Alba) for treating asthma of cold syndrome, retrospective study is conducted to modern literature of treating winter diseases in summer with acupoint sticking therapy for preventing and treating chronic cough and asthma. Learning from thoughts and methods of evidence-based medicine, and according to subject characteristics of TCM and acupuncture, acupoints and point-selecting discipline of prescription for preventing and treating chronic cough and asthma in summer with acupoint sticking are analyzed. The results show that the top ten common acupoints used for acupoint sticking therapy of treating winter diseases in summer are Feishu (BL 13), Dingchuan (EX-B 1), Xinshu (BL 15), Geshu (BL 17), Danzhong (CV 17), Shenshu (BL 23), Gaohuang (BL 43), Dazhui (GV 14), Pishu (BL 20), Tiantu (CV 22), most of which belong to the Bladder Meridian of Foot-Taiyang, Conception Vessel and Governor Vessel or extra-meridian points. It refers that the core acupoints of acupoint sticking therapy are Feishu (BL 13), Dingchuan (EX-B 1), Xinshu (BL 15), Geshu (BL 17), Danzhong (CV 17), and adjunct points can be selected by syndrome, disease different stage, disease or symptoms.
Acupuncture Points ; Asthma ; drug therapy ; prevention & control ; Clinical Trials as Topic ; Cough ; drug therapy ; prevention & control ; Drug Prescriptions ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Seasons

INTRODUCTIONThe Singapore National Asthma Program (SNAP) was launched in 2001 to address the high burden of asthma in Singapore. One component of the SNAP was directed at improving asthma control in the community by promoting preventive treatment with inhaled corticosteroids. This paper describes the program on prescription patterns of preventor and reliever medication for asthma in the polyclinics.

MATERIALS AND METHODSWe monitored the prescription pattern for asthma as the preventor-reliever (PR) drug ratio. The PR ratio was employed both as a positive feedback tool and as a key performance indicator (KPI) for the program. Individual clinics were encouraged to implement locally relevant and effective initiatives to increase the KPI and facilitate this process. The different methods included chronic care models, multidisciplinary teams, enhanced primary care clinics, pre-counselling screening, decision support tools, self-management support, a patient information system and community education.

RESULTSIn the course of the program, the case load for asthma in the polyclinics increased by 31%. During the same period, the average PR ratio increased significantly from 0.68 to 1.80 (P <0.001).

CONCLUSIONSA simple audit and positive feedback program based on PR ratios, accompanied by sustained local quality improvement cycles has been associated with a significant shift in the drug treatment of asthma away from episodic quick relief medication towards long-term daily preventive treatment with inhaled steroids in polyclinics.

Administration, Inhalation ; Adrenal Cortex Hormones ; administration & dosage ; therapeutic use ; Ambulatory Care Facilities ; Asthma ; drug therapy ; prevention & control ; Drug Prescriptions ; Feedback ; Humans ; Medical Audit ; Program Evaluation ; Singapore

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

OBJECTIVETo assess the value of immunoregulants in improving the prognosis of infants with wheezing.

METHODSForty-three infants with wheezing with given oxygen support, injection or inhalation of glucocorticosteroids or bronchodilatator to relieve the symptoms. Of these infants, 24 received immunoregulant treatment with bronchovaxom at the daily dose of 3.5 mg for 10 days every a month for a treatment course of 3 months. The other 19 infants were managed with budesonide aerosol at 200 microg once or twice daily for 3 months (basic treatment group). All the infants were followed up for 1 year to record the number of wheezing episode and infections. Ten healthy infants were also included in this study as the control group.

RESULTSIn infants with bronchovaxom treatment, 25% reported more than 3 wheezing episodes within the 1-year follow-up, a rate significantly lower than that in the control group (63.2%, Chi(2)=6.344, P<0.05). The episodes of respiratory infection were similar between bronchovaxom group and the healthy control group (t=0.72, P>0.05), but significantly higher in the basic treatment group than in bronchovaxom and the healthy control group (t=3.11 and 3.92, respectively. P<0.05).

CONCLUSIONSBronchovaxom can effectively reduce the recurrence of wheezing and respiratory infections in the infants with wheezing attack to reduce the risks of asthma development.

Asthma ; diagnosis ; drug therapy ; prevention & control ; Bacteria ; Cell Extracts ; administration & dosage ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Immunologic Factors ; therapeutic use ; Infant ; Male ; Prognosis ; Respiratory Sounds ; drug effects