Nonrespiratory Comorbidities in Asthma

Cardet, Juan Carlos; Bulkhi, Adeeb; Lockey, Richard F.

doi:10.1016/j.jaip.2021.08.027

Cited by 20 publications

(16 citation statements)

References 141 publications

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“…7 8 Several risk factors for asthma attacks have been described separately in children and adults including female sex, 9 10 11 12 a history of previous asthma-related hospital admissions, 10 13 higher disease severity, 14 older age, 9 12 belonging to an ethnic minority group, 13 15 having a history of inhaled corticosteroid use, 15 and presence of comorbidities such as allergic rhinitis, gastro-oesophageal reflux disease and obesity. 11 16 However, risk factors contributing to asthma attacks have not been studied across paediatric and adult populations simultaneously in a large population representative sample. Furthermore, asthma management guidelines advise stepping up medications to improve control but there is relatively little emphasis on addressing modifiable risk factors and comorbidities at each step of the treatment pathway, highlighting the need for more research focusing on their contribution to the burden of asthma exacerbations.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for asthma-related hospital and intensive care admissions in children, adolescents, and adults: a cohort study using primary and secondary care data

Simms-Williams

Haroon

Nagakumar

et al. 2022

Preprint

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Objectives To assess the association between demographic and clinical risk factors and asthma-related hospital and intensive care admissions in children, adolescents, and adults, and to estimate the proportion of hospital admissions attributable to modifiable risk factors. Design Cohort study using routinely collected primary and secondary care data. Setting A large UK-based primary care database, the Clinical Practice Research Datalink (CPRD) Aurum, and linked Hospital Episode Statistics Admitted Patient Care (HES APC) data. Participants Patients were eligible for the study if they were aged five years and older and had an asthma diagnosis with linked data to the HES APC database. This included 90,989 children aged 5-11 years, 114,927 adolescents aged 12-17 years, and 1,179,410 adults aged 18 years or older. Primary and secondary outcome measures Primary outcome: asthma-related hospital admissions recorded from 1st January 2017 to 31st December 2019. Secondary outcome: asthma-related intensive care unit (ICU) admissions. Incidence rate ratios (IRR) adjusted for demographic and clinical risk factors were estimated using negative binomial models. Population attributable fraction (PAF) amongst those with asthma was estimated for modifiable risk factors that were statistically significantly associated with the primary outcome. Results In children, the risk factors for asthma-related hospital admission were belonging to an ethnic minority group, increasing socioeconomic deprivation, allergies (PAF 11.4%, 95% CI 6.8 to 15.8), and atopic eczema (6.8%, 3.6 to 9.9). In adolescents, the risk factors were being female, belonging to an ethnic minority group, increasing socioeconomic deprivation, former smoking (PAF 6.8%, 0.9 to 12.3), and allergic rhinitis. In adults, the risk factors were younger age, being female, belong to an ethnic minority group, increasing socioeconomic deprivation, being underweight, overweight or obese (PAF 23.3%, 95% CI 20.5 to 26.1 for obesity), current smoking (4.3%, 3.0 to 5.7), depression (11.1%, 9.1 to 13.1), allergies (6.2%, 4.4 to 8.0), gastro-oesophageal reflux disease (2.3%, 1.2 to 3.4), anxiety (2.0%, 0.5 to 3.6), and chronic rhinosinusitis (0.8%, 0.3 to 1.3%). In all age groups, increasing medication burden was associated with an increased risk in the primary outcome. Risk factors for asthma-related ICU admissions in children were black or mixed ethnicity and high levels of socioeconomic deprivation; in adolescents, they were female sex and black ethnicity; and in adults, they were younger age, female sex, black, mixed, or Asian ethnicity, and depression. In all age groups, increasing medication burden was associated with an increased risk in the secondary outcome. Conclusions There are significant sociodemographic inequalities in the rates of asthma-related hospital and ICU admissions. Treating atopic conditions in all age groups should be considered an integral part of asthma management. Adults have a wide range of potentially treatable risk factors that contribute substantially to asthma-related hospital admissions, including obesity, smoking, depression, anxiety and gastro-oesophageal reflux disease. Treating these risk factors could significantly reduce the rate of avoidable hospital admissions. Overall asthma medication burden is an important reflection of disease severity and prognostic marker of asthma outcomes, which should be monitored in all patients.

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Section: Introductionmentioning

confidence: 99%

Risk factors for asthma-related hospital and intensive care admissions in children, adolescents, and adults: a cohort study using primary and secondary care data

Simms-Williams

Haroon

Nagakumar

et al. 2022

Preprint

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“…Asthma is a chronic heterogeneous inflammatory disease of the airway characterized by airway hyper-responsiveness [ 87 ]. With the changes of living environment in the 21st century, the sensitizing factors of asthma are becoming more and more complex, and the prevalence of asthma is increasing worldwide [ 88 ].…”

Section: Application Of Pcls Technology In Various Respiratory Inflam...mentioning

confidence: 99%

Application of Precision-Cut Lung Slices as an In Vitro Model for Research of Inflammatory Respiratory Diseases

Liu

Wang

et al. 2022

Bioengineering

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The leading cause of many respiratory diseases is an ongoing and progressive inflammatory response. Traditionally, inflammatory lung diseases were studied primarily through animal models, cell cultures, and organoids. These technologies have certain limitations, despite their great contributions to the study of respiratory diseases. Precision-cut lung slices (PCLS) are thin, uniform tissue slices made from human or animal lung tissue and are widely used extensively both nationally and internationally as an in vitro organotypic model. Human lung slices bridge the gap between in vivo and in vitro models, and they can replicate the living lung environment well while preserving the lungs’ basic structures, such as their primitive cells and trachea. However, there is no perfect model that can completely replace the structure of the human lung, and there is still a long way to go in the research of lung slice technology. This review details and analyzes the strengths and weaknesses of precision lung slices as an in vitro model for exploring respiratory diseases associated with inflammation, as well as recent advances in this field.

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“…Bronchial asthma is the most frequent inflammatory non-communicable condition affecting the airways worldwide [ 1 ]. It is commonly associated with concomitant conditions, which substantially contribute to its burden, whether they involve the lung or other districts [ 1 , 2 ]. The most recent research has highlighted a number of pathobiological interactions between asthma and other organs in the view of a shared immunological background underling different diseases.…”

Section: Introductionmentioning

confidence: 99%

Hidden Comorbidities in Asthma: A Perspective for a Personalized Approach

Maule

Olivieri

Guarnieri

et al. 2023

JCM

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Bronchial asthma is the most frequent inflammatory non-communicable condition affecting the airways worldwide. It is commonly associated with concomitant conditions, which substantially contribute to its burden, whether they involve the lung or other districts. The present review aims at providing an overview of the recent acquisitions in terms of asthma concomitant systemic conditions, besides the commonly known respiratory comorbidities. The most recent research has highlighted a number of pathobiological interactions between asthma and other organs in the view of a shared immunological background underling different diseases. A bi-univocal relationship between asthma and common conditions, including cardiovascular, metabolic or neurodegenerative diseases, as well as rare disorders such as sickle cell disease, α1-Antitrypsin deficiency and immunologic conditions with hyper-eosinophilia, should be considered and explored, in terms of diagnostic work-up and long-term assessment of asthma patients. The relevance of that acquisition is of utmost importance in the management of asthma patients and paves the way to a new approach in the light of a personalized medicine perspective, besides targeted therapies.

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Nonrespiratory Comorbidities in Asthma

Cited by 20 publications

References 141 publications

Risk factors for asthma-related hospital and intensive care admissions in children, adolescents, and adults: a cohort study using primary and secondary care data

Risk factors for asthma-related hospital and intensive care admissions in children, adolescents, and adults: a cohort study using primary and secondary care data

Application of Precision-Cut Lung Slices as an In Vitro Model for Research of Inflammatory Respiratory Diseases

Hidden Comorbidities in Asthma: A Perspective for a Personalized Approach

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