Nasal protein profiles in work‐related asthma caused by different exposures

114

In this review, we discuss recent publications on asthma and review the studies that have reported on the different aspects of the prevalence, risk factors and prevention, mechanisms, diagnosis, and treatment of asthma. Many risk and protective factors and molecular mechanisms are involved in the development of asthma. Emerging concepts and challenges in implementing the exposome paradigm and its application in allergic diseases and asthma are reviewed, including genetic and epigenetic factors, microbial dysbiosis, and environmental exposure, particularly to indoor and outdoor substances. The most relevant experimental studies further advancing the understanding of molecular and immune mechanisms with potential new targets for the development of therapeutics are discussed. A reliable diagnosis of asthma, disease endotyping, and monitoring its severity are of great importance in the management of asthma. Correct evaluation and management of asthma comorbidity/ multimorbidity, including interaction with asthma phenotypes and its value for the precision medicine approach and validation of predictive biomarkers, are further detailed. Novel approaches and strategies in asthma treatment linked to mechanisms and endotypes of asthma, particularly biologicals, are critically appraised. Finally, due to the recent pandemics and its impact on patient management, we discuss the challenges, relationships, and molecular mechanisms between asthma, allergies, SARS-CoV-2, and COVID-19.

Section: Molecular Mechanisms In the Development Of Asthmamentioning

confidence: 99%

Advances and recent developments in asthma in 2020

Cevhertas

Öğülür

Maurer

et al. 2020

114

“…Although some NSAIDs hypersensitivity and related phenotypes biomarkers have been proposed, [162][163][164][165] they have not been incorporated into in vitro diagnosis and validation is required. These include serum levels of LTE4 and the ratio LTE4/9a,11b-PGF2, 166 plasma eosinophil-derived neurotoxin, 167 L-plastin, 144 serum sphingosine-1phosphate and urine sphingosine 168 and serum periostin.…”

Section: The S E Arch For B I Omark Er Smentioning

confidence: 99%

Progress in understanding hypersensitivity reactions to nonsteroidal anti‐inflammatory drugs

Doña

Pérez‐Sánchez

Eguiluz‐Gracia

et al. 2019

Nonsteroidal anti‐inflammatory drugs (NSAIDs), the medications most commonly used for treating pain and inflammation, are the main triggers of drug hypersensitivity reactions. The latest classification of NSAIDs hypersensitivity by the European Academy of Allergy and Clinical Immunology (EAACI) differentiates between cross‐hypersensitivity reactions (CRs), associated with COX‐1 inhibition, and selective reactions, associated with immunological mechanisms. Three phenotypes fill into the first group: NSAIDs‐exacerbated respiratory disease, NSAIDs‐exacerbated cutaneous disease and NSAIDs‐induced urticaria/angioedema. Two phenotypes fill into the second one: single‐NSAID‐induced urticaria/angioedema/anaphylaxis and single‐NSAID‐induced delayed reactions. Diagnosis of NSAIDs hypersensitivity is hampered by different factors, including the lack of validated in vitro biomarkers and the uselessness of skin tests. The advances achieved over recent years recommend a re‐evaluation of the EAACI classification, as it does not consider other phenotypes such as blended reactions (coexistence of cutaneous and respiratory symptoms) or food‐dependent NSAID‐induced anaphylaxis. In addition, it does not regard the natural evolution of phenotypes and their potential interconversion, the development of tolerance over time or the role of atopy. Here, we address these topics. A state of the art on the underlying mechanisms and on the approaches for biomarkers discovery is also provided, including genetic studies and available information on transcriptomics and metabolomics.

“…Nasal protein profiles from brush samples were compared between healthy adults and adults with asthma occupationally to protein allergens, isocyanates, or welding fumes. Hierarchical clustering revealed greater differences in asthma related to welding fumes when compared to protein allergen and isocyanate‐related asthma . Proteomic analysis of bronchoalveolar lavage fluid in patients with asthma revealed that approximately 150 distinct proteins were significantly upregulated after exposure to allergens.…”

Section: Framing the Issuementioning

confidence: 99%

Emerging concepts and challenges in implementing the exposome paradigm in allergic diseases and asthma: a Practall document

Agache

Miller

Gern

et al. 2018

Exposome research can improve the understanding of the mechanistic connections between exposures and health to help mitigate adverse health outcomes across the life span. The exposomic approach provides a risk profile instead of single predictors and thus is particularly applicable to allergic diseases and asthma. Under the PRAC- TALL collaboration between the European Academy of Allergy and ClinicalImmunology (EAACI) and the American Academy of Allergy, Asthma, and Immunology (AAAAI), we evaluated the current concepts and the unmet needs on the role of the exposome in allergic diseases and asthma.