Severe bronchial asthma in children: a review of novel biomarkers used as predictors of the disease

Uwaezuoke, Samuel N; Ayuk, Adaeze C; Eze, Joy N.

doi:10.2147/jaa.s149577

Cited by 17 publications

(15 citation statements)

References 101 publications

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“…[20] Severe asthma consists of multiple phenotypes, such as the inflammatory phenotypes which comprise severe allergic asthma, eosinophilic asthma, and neutrophilic asthma. [21] Neutrophilic inflammation is the hallmark of neutrophilic asthma: a phenotype that can occur with or without eosinophilic inflammation. [22] Induction of neutrophilic inflammation is mediated by type 2 T-helper (Th2) cells.…”

Section: The Non-calcemic Actions Of Calcitriol and Asthma Pathogenesismentioning

confidence: 99%

Vitamin D status and asthma flare-ups in children: a non-systematic review

Uwaezuoke¹

2019

Anatol JFM

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Asthma has assumed global prominence as the most common non-communicable respiratory disease in children. [1] Asthma is now regarded as a heterogeneous disease with several phenotypes and underlying endotypes. [2] Disease heterogeneity is seen in the variable clinical presentations and the nature/extent of airway inflammation and remodeling. Asthma phenotypes and endotypes appear to represent a multitude of the host (gene)-environment reciprocal influences that occur over different periods. [3] Epidemiologic data now indicate that dietary factors, such as hypovitaminosis D, are associated with florid asthma symptoms, asthma flare-ups, decreased lung function and increased drug usage, as well as severe disease. [4] The non-calcemic actions of vitamin D are welldocumented in the medical literature. [5][6][7] Precisely, role of vitamin D in childhood asthma is currently an area of on-going research. The research questions to be addressed should include as follows: First, whether vitamin D supplementation in infancy is protective against viral infections (which could act as triggers to asthma flare-ups). [8] Second, whether vitamin D supplementation could be administered together with inhalational steroid therapy to ameliorate disease flare-ups in school-age children. [8] And third, whether vitamin D supplementation is more effective in populations at risk for hypovitaminosis D. [8] Several studies have highlighted Several non-calcemic actions of vitamin D are well-documented in the literature. Its role in childhood asthma is now an area of on-going research. Studies indicate that the severity of childhood asthma is directly correlated with reduced serum vitamin D levels. This non-systematic review aims to discuss the association of vitamin D status with asthma flare-ups in children. We searched the PubMed database for articles that met the objective of this review. Vitamin D may play a vital role in lung health by inhibiting inflammation, partly by maintaining the regulatory T cells, and by direct induction of innate antimicrobial mechanisms. Vitamin D also inhibits adaptive immunity by delaying the proliferation of T-helper cells. For instance, the neutrophilic asthma phenotype is characterized by neutrophilic inflammation, whose induction is mediated by type 2 T-helper cells. Thus, vitamin D is related to the pathogenesis of asthma based on its ability to block the proliferation of T-helper cells. Predictably, hypovitaminosis D is associated with florid asthma symptoms, asthma flare-ups, decreased lung function, and increased drug usage, as well as severe disease. Several reports have shown a strong relationship between wheezing symptoms/asthma severity in children and low serum 25-hydroxyvitamin D levels. These findings support the use of vitamin D 3 supplementation as a potential strategy for reducing disease flare-ups in children. ABSTRACTSamuel Nkachukwu Uwaezuoke, Adaeze C Ayuk

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Section: The Non-calcemic Actions Of Calcitriol and Asthma Pathogenesismentioning

confidence: 99%

Vitamin D status and asthma flare-ups in children: a non-systematic review

Uwaezuoke¹

2019

Anatol JFM

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“…Recently, McKenzie and colleagues described group 2 lymphoid cells producing these cytokines, defining another pathway which contributes to the T2 high profiling ( Figure 1 ) [ 7 ]. At present, several biomarkers can identify inflammatory characteristics of T2-high endotypes (serum IgE, serum periostin, blood eosinophil, and exhaled nitric oxide eNO) both for adult and in children asthma ( Table 1 ) [ 8 ]. However, the most validated method to assess airway inflammation is currently the sputum cytometry.…”

Section: T2-highmentioning

confidence: 99%

Precision Medicine in Targeted Therapies for Severe Asthma: Is There Any Place for “Omics” Technology?

Galeone¹,

Scelfo²,

Bertolini

et al. 2018

BioMed Research International

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According to the current guidelines, severe asthma still represents a controversial topic in terms of definition and management. The introduction of novel biological therapies as a treatment option for severe asthmatic patients paved the way to a personalized approach, which aims at matching the appropriate therapy with the different asthma phenotypes. Traditional asthma phenotypes have been decomposing by an increasing number of asthma subclasses based on functional and physiopathological mechanisms. This is possible thanks to the development and application of different omics technologies. The new asthma classification patterns, particularly concerning severe asthma, include an increasing number of endotypes that have been identified using new omics technologies. The identification of endotypes provides new opportunities for the management of asthma symptoms, but this implies that biological therapies which target inflammatory mediators in the frame of specific patterns of inflammation should be developed. However, the pathway leading to a precision approach in asthma treatment is still at its beginning. The aim of this review is providing a synthetic overview of the current asthma management, with a particular focus on severe asthma, in the light of phenotype and endotype approach, and summarizing the current knowledge about “omics” science and their therapeutic relevance in the field of bronchial asthma.

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“…1 Currently, inhaled and oral corticosteroids, inhaled short-acting and long-acting β 2 agonists, and leukotrienereceptor antagonists are commonly used as therapeutic drugs for asthma; 7 however, some patients show completely refractory responses to these treatments. 8,9 Even worse, side effects, including osteoporosis, immunosuppression, mood changes, and hypothalamic-pituitary-adrenal axis suppression, have been found to be associated with corticosteroid intake at high doses or prolonged use of inhaled corticosteroids. 10 As a multifaceted disease, asthma is influenced by interactions among multiple genetic, epigenetic, and environmental factors.…”

Section: Introductionmentioning

confidence: 99%

<p>Urinary Metabolomic Profiling Reveals Biological Pathways and Predictive Signatures Associated with Childhood Asthma</p>

Liu

Zhou

et al. 2020

JAA

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Background Despite considerable efforts, the pathogenic mechanisms of asthma are still incompletely understood, due to its heterogeneous nature. However, metabolomics can offer a global view of a biological system, making it a valuable tool for further elucidation of mechanisms and biomarker discovery in asthma. Methods GC-MS–based metabolomic analysis was conducted for comparison of urine metabolic profiles between asthmatic children (n=30) and healthy controls (n=30). Results An orthogonal projections to latent structures discriminant–analysis model revealed a clear separation of the asthma and control groups ( R 2 x =0.137, R 2 y =0.947, Q 2 =0.82). A total of 20 differential metabolites were identified as discriminant factors, of which eleven were significantly increased and nine decreased in the asthma group compared to the control group. Pathway-enrichment analysis based on these differential metabolites indicated that sphingolipid metabolism, protein biosynthesis, and citric acid cycle were strongly associated with asthma. Among the identified metabolites, 2-hydroxybutanoic acid showed excellent discriminatory performance for distinguishing asthma from healthy controls, with an AUC of 0.969. Conclusion Our study revealed significant changes in the urine metabolome of asthma patients. Several perturbed pathways (eg, sphingolipid metabolism and citric acid cycle) may be related to asthma pathogenesis, and 2-hydroxybutanoic acid could serve as a potential biomarker for asthma diagnosis.

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Severe bronchial asthma in children: a review of novel biomarkers used as predictors of the disease

Cited by 17 publications

References 101 publications

Vitamin D status and asthma flare-ups in children: a non-systematic review

Vitamin D status and asthma flare-ups in children: a non-systematic review

Precision Medicine in Targeted Therapies for Severe Asthma: Is There Any Place for “Omics” Technology?

<p>Urinary Metabolomic Profiling Reveals Biological Pathways and Predictive Signatures Associated with Childhood Asthma</p>

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