The purpose of this study was to assess the characteristics of the clinical course of asthma in patients with metabolic syndrome (MetS) and to analyze the influence of the MetS components on the course of asthma, control of asthma symptoms, and the the quality of life (QL) of patients with asthma. Materials and Methods:We examined 95 asthma patients aged from 18 to 60 years. The patients were divided into 2 groups. Group 1 included 35 patients without MetS (24/68.6% women and 11/31.4% men; mean age, 49.81±0.77 years), and Group 2 included 60 patients with MetS (45/75.0% women and 15/25.0% men; mean age, 49.82±0.77 years). The asthma diagnosis was based on the integral assessment of symptoms, medical history, health status, and spirometry values according to the Global Strategy for Asthma Management and Prevention (2017). MetS was diagnosed according to the IDF consensus criteria (2006).Results: The MetS components, such as central obesity, high blood pressure, dyslipidemia, carbohydrate metabolism disorder, cause a more serious and unfavorable course of asthma, with frequent exacerbations, calls to emergency service and hospital admissions, severe asthma symptoms, uncontrolled asthma symptoms, low spirometry results, and low level of QL in the physical and psychological domains.
Aim. To study in real clinical practice extrapulmonary personalized factors in patients with asthma depending on the presence or absence of obesity and to build a model of asthma control based on them. Materials and methods. Cross-sectional study was performed in 7 outpatient centers and included 237 adult patients with bronchial asthma (mean age 52.6 ± 1.3 years). The patients were divided in groups according to body mass index (BMI): without obesity (BMI < 30 kg/m2) – 128 patients, with obesity (BMI ≥ 30 kg/m2) – 109 patients. Asthma control was assessed by Asthma Control Questionnaire-5, physical activity – by the motor activity questionnaire (ODA23+), physical activity motivation – by data from the questionnaire. A linear regression model was built with the inclusion of sex, smoking, BMI, physical activity to predict the level of asthma control. Elasticity coefficient Ej, β- and Δ-coefficients and their ranks were calculated. Results. The distribution of patients according to the degree of asthma control differed statistically significantly in the groups: controlled, partially controlled and uncontrolled were 25.8 %, 60.2 %, 14 % and 0 %, 33.9 %, 66.1 %, respectively, in groups without obesity and obese (p < 0.001). High or moderate physical activity was present in 88 % of non-obese and 47% of obese patients (p < 0.05). No differences were found in the motivation for physical activity: 41% with obesity and 42 % without obesity belonged to the category of “thinking about or trying to exercise”. In the regression model, the ranks were distributed as follows (the sum of the ranks of the coefficients Ej, β, and Δ is calculated) rank 1 – BMI (0.8857, 0.4163, 0.5429), rank 2 – level of physical activity (0.6489, 0.3497, 0.4467), rank 3 – smoking status (0.0339, 0.1333, 0.0047). The coefficient of the model was not significant for sex. Conclusion. Obesity and low physical activity are the main personalized extrapulmonary factors that affect control of asthma. A significant part of the patients are motivated to modify their level of physical activity.
The objective of this study was to evaluate levels of leptin, adiponectin, IL-4, IL-6, TNF-α, oxidative damage, and antioxidant status in patients with bronchial asthma (BA), compared to patients who suffer from both BA and osteoarthritis (OA), and analyze the quality of life in such patients. Methods and Results: The study included 103 patients (34 men and 69 women) diagnosed with moderate asthma aged from 30 to 70 years (mean age of 58.52±7.14 years). The levels of IL-4, IL-6, TNF-α, adiponectin, leptin, total antioxidant status (TAS), and total oxidative damage (TOD) were measured. Two questionnaires were used in this study: Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Test (АСТ). The levels of leptin, TNF-α, and Il-6 were significantly higher in Group 2 than in Group 1. On the contrary, the IL-4 level was higher in Group 1 than in Group 2. The TAS value was significantly higher in Group 1 than in Group 2 (P=0.0001). The TOD value was significantly higher in Group 2 than in Group 1 (P=0.0000). The domains of AQLQ(S) activity, symptoms, and emotions were decreased in patients of Group 2. The values of the ACT test were 18.0±2.61 points and 16.78±1.92 points in Group 1 and Group 2, respectively (P=0.0077). Conclusion: In patients with both asthma and osteoarthritis, levels of inflammatory cytokines, such as leptin, IL-6, and TNF-α, are significantly elevated as well as values of total oxidative status, which correlate with poorer asthma control and quality of life.
One of the most important areas of modern medicine is the search for molecular biomarkers that open up new possibilities in fundamental research of pathological processes, allowing to diagnose human diseases with high accuracy and to implement a personalized approach to prescribe effective therapy. Currently, one of the promising molecular biomarkers in respiratory medicine is club cell protein (CC16, or secretory globulin SCGB1A1). Club-shaped cells are known to be involved in pulmonary homeostasis and regulate the progression of acute and chronic inflammatory processes in the bronchopulmonary system. Immunomodulation and regulation of inflammation by club-shaped cells is mediated by secretion of CC16 protein, which has pronounced anti-inflammatory, anti-allergic, and anti-tumor properties.The aim of the review is to collect and analyze data from recent domestic and foreign studies on the role of club-shaped cells and their CC16 protein in physiological and pathological processes in the airways.Conclusion. Based on the data of domestic and foreign studies presented in the review, it can be concluded that club-shaped cells and their secretory globulin SCGB1A1 play an important role in the physiological and pathological processes in the respiratory tract. Thus, club cell protein may serve as a molecular biomarker for diagnosing and monitoring the progression of certain bronchopulmonary diseases, for individual assessment of the treatment efficacy, and as a basis for the development of new therapies in respiratory medicine.
Background: Asthma is a heterogeneous disease comprising different phenotypes. One of the most common asthma phenotypes is the obesity-asthma phenotype, since obesity affects over a third of the world's population today. It is important to continue investigating possible underlying mechanisms of the interaction between asthma and obesity. The purpose of this study was to evaluate levels of leptin, adiponectin, neuropeptide Y (NPY), total oxidative damage (TOD), and total antioxidant status (TAS) in patients with asthma and different body weight (BW), and to analyze their association with spirometry parameters. Materials and Methods: The study included 27 men and 86 women diagnosed with moderate asthma (mean age of 57.81±13.05 years). During the study, all asthma patients were divided into 3 groups. Group 1 included 37 patients with normal BW, Group 2 included 38 overweight patients, and Group 3 included 38 patients with obesity. We analyzed complaints, anamnesis data, objective status data, and laboratory (blood levels of NPY, adiponectin, leptin, total antioxidant status, and total oxidative damage) and instrumental data (spirometry). Two questionnaires were used: Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Test (АСТ). Results: The leptin level was significantly higher in Group 3 compared to Groups 1 and 2 (P=0.000). The NPY level was significantly lower in Group 1 compared to Groups 2 and 3 (P=0.000). The TAS value was significantly higher in Group 1 compared to Groups 2 and 3 (P=0.000) and the TOD value in Group 1 was significantly lower than in Group 3 (P=0.038).The leptin level positively correlated with BMI and waist circumference, and had an inverse correlation with FEV 1 and vital capacity (VC). The adiponectin level had a positive correlation with the Tiffno index, FEF 50 , and peak expiratory flow (PEF). The NPY level had an inverse correlation with VC, FEV 1 , FEF 25 , FVC, Tiffno index, FEF 50 , and PEF. Conclusion: The severity of the clinical course of moderate asthma in obese patients is associated with different factors, including oxidative stress and levels of leptin, adiponectin and NPY.
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