Objective To observe the eotaxin expression of rat airway smooth muscle cells ( ASMCs) induced by serum from asthmatic rats, and explore the possible mechanism. Methods ASMCs isolated fromrat tracheas were cultured in vivo. Then they were treated with serum from asthmatic rats, or treated with serum and dexamethasone simultaneously. The level of eotaxin protein in supernatant and eotaxin mRNA in ASMCs were measured by ELISA and reverse transcription-polymerase chain reaction. The expression of cAMP in ASMCs was examined by radioimmunoassay. Results After the treatment with sensitized serum, the eotaxin level in supernatant and mRNA expression in ASMCs were significantly higher [ ( 107. 09 ±7. 12) ng/L vs. ( 0. 63 ±0. 56) ng/L, P lt; 0. 05; 1. 39 ±0. 04 vs. 0. 05 ±0. 01, P lt;0. 05] , and the level of cAMP in ASMCs was significantly lower compared with the control group [ ( 17. 58 ±3. 62) ng/L vs. ( 32. 39 ±3. 36) ng/L, P lt; 0. 05] . After intervened by the sensitized serum and dexamethasone simultaneously, the protein and mRNA expressions of eotaxin were lower compared with those intervened by sensitized serumalone [ ( 64. 18 ±4. 04) ng/L and 0. 77 ±0. 19] . The level of eotaxin in supernatant was negatively correlated with cAMP level in ASMCs ( r = - 0. 788, P lt; 0. 01) . Conclusions There is anautocrine function in ASMCs as inflammatory cells after stimulation with sensitized serum. Eotaxin may play an important roll in the pathogenesis of asthma via a cAMP-dependent pathway.
ObjectiveTo explore the clinical features of atypical bronchial asthma with chief complaint of palpitations. MethodsTwelve cases with unexplained palpitations diagnosed by asthma were analyzed retrospectively. ResultsThe patients were diagnosed with asthma through bronchodilation test,skin prick tests,fractional exhaled nitric oxide (FeNO) and diagnostic treatment.The ratio of male to female cases was 1:5. The ventilation lung function of all patients was in normal range. The median time of misdiagnosis was 13.5(3-120) months. 41.6% of cases had dust mite positive skin prick test. The median value of FeNO was 32.75(18-54) ppb. The symptoms of all patients were relieved completely after standard treatment. ConclusionPalpatation may be a specific presentation of asthma characterized with eosinophilic airway inflammation which may be misdiagnosed as other diseases for a long time,especially in elder women. To improve the knowledge of this kind of atypical asthma,detailed medical history, experimental examinations and diagnostic treatment response are important to confirm the diagnosis in time.
Objective To assess the systematic reviews of magnesium sulfate used to treat severe asthma. Methods An electronic search was performed in The Cochrane Library (Issue 2, 2008), ACP Journal Club (1991 to June 2008), MEDLINE (1990 to June 2008), Chinese Journal Full-text Database (1979 to June 2008), Chinese Scientific and Technological Periodical Databases (VIP) (1980 to June 2008), and Chinese Bio-medicine Database (CBM) (1980 to June 2008) to collect systematic reviews of magnesium sulfate treatment for severe asthma. The retrieved systematic reviews were reassessed, and then we adopted the evidence for clinical practice. Results Nine systematic reviews were included, and all of them included 14.1 ± 2.9 items of QUOROM (the quality of reporting of Meta-analyses) on average. In general, the included systematic reviews had comparatively high quality. Evidence illustrated that intravenous infusion of magnesium sulfate could improve pulmonary function and reduce hospital admission without any serious side effects. However, no evidence could verify that patients with asthma can benefit from aerosolized and oral magnesium sulfate. In a specific case with severe asthma, we used magnesium sulfate via intravenous infusion which helped the control of symptoms with no adverse reactions. Conclusion Magnesium sulfate via intravenous infusion can improve pulmonary function and reduce hospital admission rates. Due to its effectiveness, safety, and low cost, it deserves widespread application in patients with severe asthma.
ObjectiveTo explore the predictive value of fractional exhaled nitric oxide (FeNO) in the treatment response of adult asthmatic patients. Methods64 adult outpatients with asthma from Peking Union Hospital between March and September 2013 were recruited in the study. All patients completed asthma control test (ACT) together with exhaled nitric oxide (FeNO) and pulmonary function test. Then the patients were classified into a higher FeNO group (n=33) and a normal FeNO group (n=31) according to FeNO level. All patients accepted regular inhaled ICS/LABA treatment (salmeterol and fluticasone 50/250). Three months later all patients reaccepted ACT,FeNO and pulmonary function test. ResultsThe ACT score increased in all patients,and was significantly higher in the higher FeNO group than that in the normal FeNO group[22.07±5.49 vs. 19.23±5.48,t=2.893,P<0.05]. The complete control rate of the higher FeNO group was higher than that in the normal FeNO group (42.42% vs. 19.35%,χ2=3.960,P<0.05). The FEV1 and FEV1%pred of two groups both increased significantly (P<0.05),but there was no significant difference between two groups (P>0.05). Correlation analysis showed that FeNO and the declined rate of FeNO was negatively correlated with the ACT score(r=-0.302,P<0.05;r=0.674,P<0.01) and positively correlated with the improvement of ACT score (r=0.514,P<0.01;r=0.674,P<0.01). No significant correlation was found between FeNO and FEV1 or FEV1%pred. ConclusionThe effect of ICS/LABA therapy is better for asthma patients with higher FeNO. FeNO can be used for predicting the response to ICS/LABA therapy in patients with asthma and guiding the treatment.
Objective To evaluate the status of asthma control in asthmatic outpatients.Methods We performed an investigation by a questionnaire in a face-to-face setting from Feb 2006 to May 2006 in asthmatic outpatients of China-Japan Friendship Hospital.Results A total of 101 asthmatic patients were investigated with a mean age of 47±14.8 years and course of disease of 9.1±12.8 years.80.2% of the asthmatic patients had various social insurance.40.6% of the respondents had visited emergency department because of asthma exacerbation.The percentage of adults with lost workdays caused by asthma was 61.7% (29/47)，and which of children with lost schooldays was 75% (3/4).37.6% of asthmatic patients were completely controlled.Approximately three fourth of respondents (75.2%) was either well or completely controlled.72.3% of respondents had undergone a lung-function test during the past year.The one third of respondents (36.6%) owned oneself peak flowmeter.Only 12.9% reported kept regular use of peak flowmeter.87.1% of patients use inhaled corticosteroids (ICS) regularly.Conclusion With the implementation of patient education program and asthma guideline，the asthma control level has been further improved.
Objective To investigate the depression status，score of asthma control test (ACT) and quality of life in asthma patients before and after health care education according to Global Initiative for Asthma guidelines.Methods 59 enrolled outpatients with asthma were asked to self-administer the CES-D (center for epidemiologic studies-depression) scale，ACT scale and the quality of life (QOL) questionnaire respectively.All the patients were educated and treated by health care professionals under the guidance of GINA 2004.After average of 2.5 months ± 15 days，they were asked to self-administer all the scales and questionnaire mentioned above once again on return visit.The data was collected and analyzed statistically based on whether or not the patient had depression according to the CES-D score and the data before and after the education was compared statistically.Results （A）40.7% (24/59) of the patients had depression emotion before guided treatment，and after that the percentage significantly decreased to 13.6% (8/59) (Plt;0.05).（B）Comparing the depressive and non-depressive groups，there was significant difference in 3 of 5 domains in QOL excluding limitation of activity and self concern about health (Plt;0.05) before guided treatment.While on return visit 3 domains in QOL excluding limitation of activity and psychologic status had shown a significant difference (Plt;0.05).There was no significant difference in ACT score before guided treatment，while wise versa after that (Plt;0.05).（C）Before guided treatment the depression status was inversely correlated with 3 in 5 domains of QOL (symptoms of asthma，psychologic status and response to irritant)，as well as QOL as a whole (Plt;0.05)，but not with the other two domains of QOL scale and ACT score.After guided treatment，the depression status had inverse correlation with QOL and 3 in 5 domains of QOL scale (excluding limitation of activity and psychologic status) (Plt;0.05)，as well as ACT score (Plt;0.05).Conclusions The symptoms of asthma and response to irritants are common factors that influence the depressive emotion in asthma population.While psychologic status and self concern about health are both important factors that can not be overlooked.Health care education is important for asthma patients in view of appropriate treatment，symptom control and relief of depression emotion.
Objective To explore the effects of Aspergillus fumigatus（A. fumigatus） spores on airway inflammation and responsiveness in asthmatic rats.Methods Seventy male Wistar rats were randomly divided into Ⅰ and Ⅱ groups（n=35 in each group），then Group Ⅰ and Group Ⅱ were subdivided into a normal control group（n=5），an asthma group（n=10），a spores-treated control group（n=10），and a spores-treated asthma group（n=10）.The rats were sensitized to ovalbumin（OVA） and challenged with aerosol OVA to establish the asthma model.The effects of A. fumigatus spores on asthmatic rats before and after OVA aerosol challenging were investigated in Group Ⅰ and Group Ⅱ，respectively.The parameters associated with bronchial epithelial damage were observed by total protein concentration in BALF measured by BCA method.Total and differential cell counts in BALF were also counted.The airway resistance and airway responsiveness were calculated by transpulmonary pressure and gas flow rate.Results In Group Ⅰ，the total protein in BALF in the asthma group treated with A. fumigatus spores before OVA challenging（Group CA） was increased remarkably compared to the asthma group（Group A1）[（1.125±0.254）μg/mL vs（0.825±0.173）μg/mL，Plt;0.01].The nonspecific airway resistances induced by different concentration of acetylcholine in Group CA ［（0.997±0.196）cm H2O•mL-1•s-1，（1.123±0.142）cm H2O•mL-1•s-1，（1.130±0.197）cm H2O•mL-1•s-1］were increased significantly compared to Group A1 [（0.655±0.089）cm H2O•mL-1•s-1，（0.687±0.048）cm H2O•mL-1•s-1，（0.821±0.043）cm H2O•mL-1•s-1]（all Plt;0.05）.In Group Ⅱ，however，the above parameters in the asthma group treated with A. fumigatus spores after OVA challenging（Group AC） were not dramatically increased compared with the asthma group（Group A2）（all Pgt;0.05）.The differences in the total and differential cell counts in BALF in Group CA were not remarkable compared to other subgroups in Group Ⅰ（all Pgt;0.05）.But the BALF neutrophil count in Group AC was increased obviously compared to Group A2 ［（2.488±0.420）×106 vs （0.936±0.459）×106，Plt;0.05］.Conclusion These data indicate that exposure to A. fumigatus spores before challenging causes aggravated epithelial damage and increased airway resistance in an asthma rat model.
Objectives To investigate the frequency of LTC4S A-444C polymorphism in Chinese Han population in Beijing and to evaluate its association with susceptibility to asthma，asthma severity and clinical response to leukotriene receptor antagonist.Methods The LTC4S A-444C polymorphism was analyzed in 101 patients with asthma and 105 healthy controls.Then 18 asthmatics were recruited，and a 2-week prospective，open trial of montelukast was performed in addition to the previous medications.Results In the asthma group，the frequencies of A and C allele at -444 locus of LTC4S gene were 81.0% and 19.0%，respectively，and genotype frequencies of AA，AC and CC were 65.4%，30.5% and 3.8%，respectively.There was no significant difference in LTC4S A-444C polymorphism between the asthmatics and healthy controls（Pgt;0.05）.The asthmatics with the C-444 allele had significantly lower forced expiratory volume in one second（FEV1） than wild-type A homozygotes [（58.6±21.6）% predicted vs （70.3±22.4）% predicted，Plt;0.05）].A correlation was observed between the variant C-444 allele and asthma severity（Plt;0.05）.After administered montelukast 1 week，the A-444 allele homozygotes（n=9） responded better than the C（-444） allele carriers（n=7）[（10.8±10.2）% vs （–9.8±16.2）% improvement of FEV1，Plt;0.05].After 2 weeks，the A-444 allele hemozygotes also responded better，although there was no statistical difference（Pgt;0.05）.Conclusion In Chinese Han population LTC4S A-444C polymorphism is associated with asthma severity and probably contributes to the clinical response to leukotriene receptor antagonists.
Objective To investigate the changes of stem cell factor（SCF） level in serum of asthma patients before and after acute exacerbation.Methods The serum SCF was detected in 30 asthma patients respectively in the onset period and catabasis by ELISA.The SCF levels were also determined in 20 normal subjects as control.Results the content of serum SCF of the asthma patients during the acute attack was increased significantly than normal subjects [（156.8±82.6）pmol/L vs （61.5±15.4）pmol/L，Plt;0.001]，and decreased significantly in remission [（66.2±15.8）pmol/L，Plt;0.001].Conclusions SCF may participate in the pathogenesis of asthma.
Objective To investigate the role of urotensin Ⅱ(UⅡ) in the pathogenesis of asthma.Methods Lung function，differential cell count and level of UⅡin induced sputum were studied in 26 asthmatic patients in acute exacerbation and in clinical remission.Results Induced sputum UⅡ level from acute asthma was higher than that of remissed asthma [(58.88±47.38)pg/mL vs (12.69±12.78)pg/mL，Plt;0.01].Induced sputum UⅡ levels of asthma patients in acute exacerbation had a tendency to increase as disease deteriorated，which negatively correlated with FEV1% predicted (r=-0.326，Plt;0.05)，but did not with sputum total cell and neutrophil counts(Pgt;0.05).No significant difference of induced sputum UⅡ levels was found between male and female，smokers and non-smokers.Conclusion UⅡ may play a role in acute exacerbation of asthma