Viral Infections and Associated Factors That Promote Acute Exacerbations of Asthma

Kim, Chang Keun; Callaway, Zak; Gern, James E.

doi:10.4168/aair.2018.10.1.12

Cited by 51 publications

(36 citation statements)

References 67 publications

(73 reference statements)

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“…The major cause of asthma exacerbations is respiratory infection with rhinovirus (RV) accounting for up to 80% of all exacerbations (8). Viral-induced exacerbations in asthma are associated with increased levels of interleukin (IL)-6, the neutrophil chemoattractant CXCL8 and neutrophilic inflammation (9,10). There are some studies that have reported bacterial infection to also be related to asthma exacerbations (11,12), however this relationship is less evident.…”

Section: Introductionmentioning

confidence: 99%

Dietary Fatty Acids Amplify Inflammatory Responses to Infection through p38 MAPK Signaling

Rutting

Zakarya

Bozier

et al. 2019

Am J Respir Cell Mol Biol

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Obesity is an important risk factor for severe asthma exacerbations, which are mainly caused by respiratory infections. Dietary fatty acids, which are increased systemically in obese patients and are further increased after high fat meals, affect the innate immune system and may contribute to dysfunctional immune responses to respiratory infection. This study investigated the effects of dietary fatty acids on immune responses to respiratory infection in pulmonary fibroblasts and a bronchial epithelial cell line (BEAS-2B). Cells were challenged with BSA-conjugated fatty acids (ω-6 PUFAs, ω-3 PUFAs or SFAs) +/-the viral mimic polyinosinic:polycytidylic acid (PolyI:C) or bacterial compound lipoteichoic acid (LTA) and release of pro-inflammatory cytokines was measured. In both cell types, challenge with arachidonic acid (AA) (ω-6 PUFA) and PolyI:C or LTA led to substantially greater IL-6 and CXCL8 release than either challenge alone, demonstrating synergy. In epithelial cells, palmitic acid (SFA) combined with PolyI:C also led to greater IL-6 release. The underlying signaling pathways of AA and PolyI:C-or LTAinduced cytokine release were examined using specific signaling inhibitors and immunoblotting. Cytokine production in pulmonary fibroblasts was prostaglandin-dependent, and synergistic upregulation occurred via p38 MAP kinase signaling, whereas cytokine production in BEAS2Bs was mainly mediated through JNK and p38 MAPK signaling. We confirmed these findings using rhinovirus infection, demonstrating that AA enhances rhinovirus-induced cytokine release. This study suggests that during respiratory infection, increased levels of dietary ω-6 PUFAs and SFAs may lead to more severe airway inflammation and may contribute to and/or increase the severity of asthma exacerbations.

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Section: Introductionmentioning

confidence: 99%

Dietary Fatty Acids Amplify Inflammatory Responses to Infection through p38 MAPK Signaling

Rutting

Zakarya

Bozier

et al. 2019

Am J Respir Cell Mol Biol

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“…As rhinovirus is known to be the main cause of acute asthma exacerbations, rhinovirus was unsurprisingly detected in the majority of our subjects . The EBT is known to increase with viral infections .…”

Section: Discussionmentioning

confidence: 81%

“…20,22 As rhinovirus is known to be the main cause of acute asthma exacerbations, rhinovirus was unsurprisingly detected in the majority of our subjects. [29][30][31] The EBT is known to increase with viral infections. 6 However, we did not detect a difference in the PLET between virally infected children and those without evidence of a viral illness.…”

Section: Discussionmentioning

confidence: 99%

Exhaled breath temperature as a tool for monitoring asthma control after an attack in children

Sol

Kim

et al. 2019

Pediatric Pulmonology

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Background Exhaled breath temperature (EBT) has been suggested as a non‐invasive marker of airway inflammation in asthma. There have been no studies examining longitudinal changes in EBT following asthma attacks. Objective To investigate changes in EBT during and after an asthma attack and to relate these changes to changes in respiratory physiological measurements. Methods We evaluated 38 hospitalized children aged 5‐18 years diagnosed with an asthma attack. Spirometry was performed upon hospitalization. During hospitalization, EBT, peak expiratory flow rate (PEFR), and asthma score were measured daily. These tests were repeated 1 week and 1 month after discharge. The overall PEFR change, temporal changes in plateau values at the end of expiration, and time‐dynamic associations were evaluated using linear mixed models. Results FEV1 was lower at admission than at discharge (63.3 ± 24 vs 99.5 ± 14 percent of predicted, P < 0.001). The EBT was higher at admission than at 1 week after discharge (34.1°C [range: 33.9‐34.8°C] vs 33.6°C [range: 33.0‐34.2°C], P = 0.007); overall, EBTs decreased over time (P = 0.007). Among individual subjects, decreased EBT was correlated with increased PEFR over time. Furthermore, plateau values at the end of expiration had a time‐dependent, dynamic association with the PEFR during hospitalization (P = 0.005) and between asthma attack onset and asthma status stabilization (P = 0.032). Conclusions The EBT was elevated during asthma attacks and gradually decreased until asthma was well controlled. The EBT may be a useful, non‐invasive tool for monitoring asthma control in children.

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“…All patients in this study were also tested for virus infection as it is well known that respiratory viral infection is the major cause of asthma exacerbation in children. 27 We detected virus in about half of the treated subjects and reduction in sEDN levels was significantly larger in the virus-negative subgroup of the MONT group, indicating that virus infection may have hindered the effect of montelukast ( Supplementary Fig. S1 ).…”

Section: Discussionmentioning

confidence: 87%

Montelukast Reduces Serum Levels of Eosinophil-Derived Neurotoxin in Preschool Asthma

Kim

Callaway

Park

et al. 2018

Allergy Asthma Immunol Res

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PurposeSeveral markers for eosinophilic inflammation have been proposed to predict response to asthma treatment. However, definitive criteria for treatment decisions have not yet been established. We investigate a potentially useful relatively non-invasive biomarker, eosinophil-derived neurotoxin (EDN), to predict favorable responses to budesonide or montelukast, common treatment for children with asthma.MethodsYoung children (1 to 6 years old) were enrolled in this randomized, parallel, 2-group, open-label trial. Criteria for eligibility included: 1) being symptomatic during the run-in period; and 2) having a serum EDN (sEDN) level ≥ 53 ng/mL, with positive specific immunoglobulin E to house dust mite. Eligible patients were randomly placed into 2 groups: the BIS group received budesonide inhalation suspension (BIS) 0.5 mg once daily; the MONT group received montelukast 4 mg once daily. Ineligible patients were invited to receive montelukast 4 mg once daily (OBS group). Treatment period was 12 weeks.ResultsAsthma control days increased significantly in the BIS and MONT groups (P < 0.000) over the 12-week study period. There was no significant change in sEDN in the BIS group but there was a significant decrease in the MONT group (P < 0.000). Patients in the OBS group with high EDN levels (< 53 ng/mL) showed a significant decrease due to MONT treatment (P = 0.023). Rescue medication usage significantly decreased in the BIS and MONT groups (P < 0.000).ConclusionsEDN is a useful relatively non-invasive biomarker for predicting responses to montelukast and budesonide treatment of preschool children with beta2-agonist responsive recurrent wheeze and multiple-trigger wheeze (Trial registry at UMIN Clinical Trials Registry, UMIN000008335).

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Viral Infections and Associated Factors That Promote Acute Exacerbations of Asthma

Cited by 51 publications

References 67 publications

Dietary Fatty Acids Amplify Inflammatory Responses to Infection through p38 MAPK Signaling

Dietary Fatty Acids Amplify Inflammatory Responses to Infection through p38 MAPK Signaling

Exhaled breath temperature as a tool for monitoring asthma control after an attack in children

Montelukast Reduces Serum Levels of Eosinophil-Derived Neurotoxin in Preschool Asthma

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