Triggers in adult asthma: are patients aware of triggers and doing right?

Göksel, Özlem; Çelik, Gülfem; Erkekol, Ferda Öner; Güllü, Emine; Mungan, Dilşad; Mısırlıgil, Zeynep

doi:10.1016/s0301-0546(09)71723-9

Cited by 15 publications

(25 citation statements)

References 29 publications

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“…3 Our study also parallels the findings of another study from Turkey with 131 ambulatory patients in an allergy clinic. 15 In the Turkish study, the mean number of triggers per patient was 12, the most common being environmental irritants, dust, emotional stress, and infections, and there were few associations with demographic and clinical characteristics except that more women reported stress as a trigger. Similar to our findings, more severe asthma was associated with emotional stress, weather, environmental irritants and aspirin-related triggers.…”

Section: Discussionmentioning

confidence: 94%

“…2,3,14,15 In a study of 205 ambulatory patients in the Epidemiological Study on the Genetics and Environment of Asthma, of 22 possible triggers, the most frequently cited triggers were exercise, smoke, emotional stress and dust. 14 When dichotomized into subgroups based on skin testing, patients with a negative skin test more often reported environmental irritants and patients with a positive test more often reported dust and pollen.…”

Section: Discussionmentioning

confidence: 99%

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History of Symptom Triggers in Patients Presenting to the Emergency Department for Asthma

et al. 2012

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Objective Understanding triggers is important for managing asthma particularly for patients who seek emergency department (ED) care for exacerbations. The objectives of this analysis were to delineate self-reported triggers in ED patients and to assess associations between triggers and asthma knowledge, severity, and quality of life. Methods At the time of an ED visit, 296 patients were asked what were their usual asthma triggers based on a checklist of 25 potential items, and what they thought specifically precipitated their current ED visit. Using standardized scales, patients also were asked about asthma knowledge, severity and quality of life. Results Mean age was 44 years and 72% were women. Patients cited a mean of 12 triggers; most patients had diverse triggers spanning respiratory infections, environmental irritants, emotions, allergens, weather, and exercise. Patients with more triggers were more likely to be women (OR 2.0, CI 1.3, 3.2, p=.002), obese (OR 1.7, CI 1.1, 2.5, p=.01), and to not have a smoking history (OR 1.9, CI 1.3, 2.9, p=.001). There were no associations between number of triggers and current age, age at diagnosis, education, socioeconomic status or race/ethnicity. Patients who cited more triggers had more frequent flares (OR 1.1, CI 1.1, 1.2, p<.0001), worse quality of life scores (OR 1.6, CI 1.1, 2.4, p=.02), and were more likely to have been previously hospitalized for asthma (OR 1.9, CI 1.3, 2.9, p=.003) and to have previously required oral corticosteroids (OR 2.9, CI 1.6, 5.1, p=.003). There was little clustering of specific triggers according to the variables we considered except for more frequent animal allergy in patients diagnosed at a younger age (OR 2.8, CI 1.7, 4.5, p<.0001) and worse quality of life in patients citing emotional stress as a trigger (OR 2.5, CI 1.5, 4.0, p=.0002). Patients attributed their current ED visit to multiple precipitants, particularly respiratory infections and weather, and these were concordant with what they reported were known triggers. Conclusions Patients presenting to the ED for asthma reported multiple triggers spanning diverse classes of precipitants and having more triggers was associated with worse clinical status. ED patients should be instructed that although it may not be possible to eliminate all triggers, mitigating even some triggers can be helpful. (ClinicalTrials.gov NCT00110409)

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

History of Symptom Triggers in Patients Presenting to the Emergency Department for Asthma

et al. 2012

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“…Demographic variables appear to moderate asthma trigger reports. Consistently, female patients report more asthma triggers than male asthma patients . Higher education levels are associated with the report of fewer asthma triggers , although the latter association is not always found .…”

Section: Perceived Triggers Of Asthma: Measurement Structure and Assmentioning

confidence: 85%

“…Patients with a higher number of asthma triggers report less quality of life . Furthermore, a higher number of self‐reported asthma triggers is correlated with physician ratings of more severe asthma , more exacerbations, and a higher frequency of oral corticosteroid use . Self‐reported asthma triggers are also associated with more primary care visits and emergency room visits, as well as a higher rate of hospitalization .…”

Section: Perceived Triggers Of Asthma: Measurement Structure and Assmentioning

confidence: 99%

“…The number of asthma triggers that is reported by patients in different studies varies widely, ranging from 4 to 12 . Differences in the number of triggers reported across studies may be a function of the questions that are used to elicit personal trigger reports, with the number of triggers being evaluated ranging from 9 to 32 . To assess asthma triggers in a standardized form, studies have attempted to develop measures to probe patients’ trigger perceptions.…”

Section: Perceived Triggers Of Asthma: Measurement Structure and Assmentioning

confidence: 99%

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Perceived triggers of asthma: key to symptom perception and management

Janssens

Ritz

2013

Clin Experimental Allergy

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Adequate asthma management depends on an accurate identification of asthma triggers. A review of the literature on trigger perception in asthma shows that individuals vary in their perception of asthma triggers and that the correlation between self-reported asthma triggers and allergy tests is only modest. In this paper, we provide an overview of psychological mechanisms involved in the process of asthma triggers identification. We identify sources of errors in trigger identification and targets for behavioral interventions that aim to improve the accuracy of asthma trigger identification and thereby enhance asthma control.

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Acute Oral Ethanol Exposure Triggers Asthma In Cockroach Allergen–Sensitized Mice

Bouchard

Kim

Beal

et al. 2012

The American Journal of Pathology

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Asthma may be triggered by multiple mediators, including allergen-IgE cross-linking and non-IgE mechanisms. Several clinical studies have shown acute ethanol consumption exacerbates asthma, yet no animal model exists to study this process. We developed a model of ethanol-triggered asthma in allergen-sensitized mice to evaluate the mechanisms of ethanol inducing asthma-like responses. Outbred mice were exposed to cockroach allergens on Days 0 and 14; and on Day 21, mice received ethanol by oral gavage. Tracer studies confirmed alcohol aspiration did not occur. Within 30 minutes, alcohol induced degranulation of over 74% of mast cells, and multiple parameters of asthma-like pulmonary inflammation were triggered. Ethanol-gavaged mice had a fivefold increased production of eotaxin-2 (534 pg/mL) and a sevenfold increase in bronchoalveolar eosinophils (70,080 cells). Ethanol induced a 10-fold increase in IL-13, from 84 pg/mL in sensitized mice to 845 pg/mL in ethanol-gavaged sensitized mice. In cockroach allergen-sensitized mice, ethanol triggered asthma-like changes in respiratory physiology and a significant fivefold increase in airway mucin production. Importantly, none of these asthmatic exacerbations were observed in normal mice gavaged with ethanol. Cromolyn sodium effectively stabilized mast cells, yet increased mucin production and bronchoalveolar eosinophil recruitment. Together, these data show a single oral alcohol exposure will trigger asthma-like pulmonary inflammation in allergen-sensitized mice, providing a novel asthma model.

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Triggers in adult asthma: are patients aware of triggers and doing right?

Abstract: Adult patients are vulnerable to several triggers regardless from underlying severity of the illness. Insufficient compliance to the major preventive measures indicates that new strategies are needed to prevent asthma attacks caused by modifiable triggers.

Cited by 15 publications

References 29 publications

History of Symptom Triggers in Patients Presenting to the Emergency Department for Asthma

History of Symptom Triggers in Patients Presenting to the Emergency Department for Asthma

Perceived triggers of asthma: key to symptom perception and management

Acute Oral Ethanol Exposure Triggers Asthma In Cockroach Allergen–Sensitized Mice

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