Persistent airway inflammation and high exacerbation rate in asthma that starts at menopause

Balzano, Giovanni; Fuschillo, Salvatore; Angelis, E. De; Gaudiosi, Carlo; Mancini, Alessandro; Caputi, M

doi:10.4081/monaldi.2007.484

Cited by 26 publications

(21 citation statements)

References 19 publications

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“…A total of 22,488 records were retrieved, of which 64 articles (reporting 57 studies) met the criteria to be included in the review. E5 , E10 , E11 , E12 , E13 , E14 , E15 , E16 , E17 , E18 , E19 , E20 , E21 , E22 , E23 , E24 , E25 , E26 , E27 , E28 , E29 , E30 , E31 , E32 , E33 , E34 , E35 , E36 , E37 , E38 , E39 , E40 , E41 , E42 , E43 , E44 , E45 , E46 , E47 , E48 , E49 , E50 , E51 , E52 , E53 , E54 , E55 , E56 , E57 , E58 , E59 , E60 , E61 , E62 , E63 , E64 , E65 , E66 , E67 , E68 , E69 , E70 , E71 , E72 In total, 554,293 participants were analyzed across the included studies. Of the 57 studies, 22 were included in at least ...…”

Section: Resultsmentioning

confidence: 99%

“…Of the 37 studies on endogenous hormones, 9 focused on puberty, E13 , E24 , E28 , E33 , E35 , E53 , E54 , E56 , E67 , E70 22 on menarche, E14 , E21 , E23 , E24 , E25 , E29 , E30 , E31 , E34 , E37 , E38 , E43 , E44 , E45 , E48 , E50 , E53 , E54 , E56 , E57 , E60 , E62 , E63 , E64 , E71 , E72 5 on menstruation, E22 , E25 , E30 , E43 , E44 , E45 , E66 and 11 on menopause. E15 , E17 , E27 , E32 , E36 , E39 , E40 , E42 , E43 , E44 , E45 , E62 , E63 , E64 , E68 , E69 Of the 31 studies on exogenous hormones, 17 focussed on hormonal contraceptives (15 observational E23 , E26 , E29 , E32 , E37 , E42 ...…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Endogenous and exogenous sex steroid hormones in asthma and allergy in females: A systematic review and meta-analysis

McCleary

Nwaru

Nurmatov

et al. 2018

Journal of Allergy and Clinical Immunology

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Endogenous and exogenous sex steroid hormones in asthma and allergy in females: A systematic review and meta-analysis

McCleary

Nwaru

Nurmatov

et al. 2018

Journal of Allergy and Clinical Immunology

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“…However, US Nurses’ Health Study determined postmenopausal women not taking HRT had decreased risk of developing asthma compared to premenopausal women (10), and the ECRHSII cross-sectional study reported increased asthma symptoms in women during the menopause transition (amenorrhea for 6+ months) compared to premenopausal women (41). Further, a new phenotype of asthma with onset after menopause has been recently described for a subset of women (42–44), but the mechanisms that initiate and regulate post-menopausal asthma remain largely unknown.…”

Section: Menopause and Asthmamentioning

confidence: 99%

Mechanisms Driving Gender Differences in Asthma

Fuseini

Newcomb

2017

Curr Allergy Asthma Rep

319

226

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Purpose of Review Many phenotypes of asthma exist, ranging from mild asthma with onset during childhood to severe asthma with later onset, making asthma a broad disease with different pathologies. A gender disparity exists in asthma prevalence. As adults, women have an increased asthma prevalence compared to men. Further, women are more likely to have severe asthma and a later onset of asthma compared to men. Here, we review clinical and animal studies that have defined the role of sex hormones in airway inflammation, smooth muscle contraction, mucus production, and airway mechanics associated with asthma pathogenesis. Recent Findings Clinical evidence shows that increased asthma symptoms occur in females starting at puberty compared to boys. However, after puberty, the role for sex hormones in regulating asthma symptoms during menstruation, pregnancy, and menopause is not as clear. Animal studies have shown that estrogen increases and testosterone decreases Th2-mediated airway inflammation, and that females have increased IL-17A-mediated airway inflammation compared to males. Further, females had increased DC and Mφ function compared to males. However, the mechanisms driving the types of allergic inflammation are not fully elucidated. Summary Overall, ovarian hormones increased and testosterone decreased airway inflammation in asthma, but the mechanisms remain unclear. Delineating these pathways using animal models as well as women and men with various phenotypes of asthma will help determine if women with asthma should take (or avoid) hormonal contraceptives as well as predict changes asthma symptoms during life phases, including pregnancy and menopause, when sex hormones are dramatically changing.

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“…Thus, the onset of asthma is characterized by absence of atopy, absence of a family history and associations with urticaria and/or recurrent sinusitis of high severity. 23 Balzano et al 55 showed that eosinophil levels were higher in the induced sputum of menopausal asthmatics, but Foschino Barbaro et al reported that there were high sputum levels of neutrophils and exhaled interleukin (IL)-6 in women with menopausal asthma. 50 Few studies have explored the link between the menopause and asthma.…”

Section: Crosssectionalmentioning

confidence: 99%

Association between asthma and female sex hormones

Baldaçara

Silva

2017

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: The relationship between sex hormones and asthma has been evaluated in several studies. The aim of this review article was to investigate the association between asthma and female sex hormones, under different conditions (premenstrual asthma, use of oral contraceptives, menopause, hormone replacement therapy and pregnancy). DESIGN AND SETTING: Narrative review of the medical literature, Universidade Federal do Tocantins (UFT) and Universidade Federal de São Paulo (Unifesp). METHODS:We searched the CAPES journal portal, a Brazilian platform that provides access to articles in the MEDLINE, PubMed, SciELO, and LILACS databases. The following keywords were used based on Medical Subject Headings: asthma, sex hormones, women and use of oral contraceptives. RESULTS:The associations between sex hormones and asthma remain obscure. In adults, asthma is more common in women than in men. In addition, mortality due to asthma is significantly higher among females. The immune system is influenced by sex hormones: either because progesterone stimulates progesterone-induced blocking factor and Th2 cytokines or because contraceptives derived from progesterone and estrogen stimulate the transcription factor GATA-3. CONCLUSIONS:The associations between asthma and female sex hormones remain obscure. We speculate that estrogen fluctuations are responsible for asthma exacerbations that occur in women. Because of the anti-inflammatory action of estrogen, it decreases TNF-α production, interferon-γ expression and NK cell activity. We suggest that further studies that highlight the underlying physiopathological mechanisms contributing towards these interactions should be conducted. RESUMO CONTEXTO E OBJETIVO:A relação entre os hormônios sexuais e a asma tem sido investigada em diversos estudos. Esta revisão tem como objetivo descrever a relação entre hormônios sexuais (endógenos e exó-genos) e a inflamação nas vias aéreas, especialmente na asma, em eventos diferentes (na asma pré-menstrual, durante o uso de anticoncepcionais, na menopausa, no uso de terapia hormonal e na gestação). TIPO DE ESTUDO E LOCAL:Revisão narrativa da literatura médica, Universidade Federal do Tocantins (UFT) e Universidade Federal de São Paulo (Unifesp). MÉTODO: Pesquisamos o Portal de Periódicos Capes, uma plataforma brasileira que fornece acesso a artigos nas bases de dados MEDLINE, PubMed, SciELO e LILACS. Os descritores utilizados foram asma, hormônios sexuais, mulheres e uso de anticoncepcionais, com base no "Medical Subject Headings". RESULTADOS: As associações entre hormônios sexuais e asma ainda permanecem obscuras. Em adultos, a asma é mais frequente em mulheres do que em homens. Além disso, a mortalidade por asma é significativamente maior no sexo feminino, destacando-se que o sistema imunológico sofre influência de hormônios sexuais, seja porque a progesterona estimula o fator bloqueador induzido pela progesterona e citocinas Th2 ou porque contraceptivos derivados de progesterona e estrógeno estimulam o fator de transcriç...

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Persistent airway inflammation and high exacerbation rate in asthma that starts at menopause

Abstract: The eosinophilic airway inflammation present in women with menopausal asthma is poorly responsive to anti-inflammatory treatment with corticosteroids and predisposes to frequent severe exacerbations. Airway inflammation should be monitored in women with menopausal asthma.

Cited by 26 publications

References 19 publications

Endogenous and exogenous sex steroid hormones in asthma and allergy in females: A systematic review and meta-analysis

Endogenous and exogenous sex steroid hormones in asthma and allergy in females: A systematic review and meta-analysis

Mechanisms Driving Gender Differences in Asthma

Association between asthma and female sex hormones

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