Exhaled TGF-β1 levels before and after an exercise challenge in asthmatic and healthy children, and during exacerbation.

Background: There is conflicting data regarding the role of transforming growth factor-β1 (TGF-β1) in the pathogenesis of airway hyper-reactivity and asthma exacerbation.

Objective: To investigate the role of exhaled-TGF-β1 in exercise-induced bronchospasm (EIB) in asthmatic and nonasthmatic healthy children, and in asthma exacerbation and asthma control.

Methods: The exhaled-TGF-β1 levels of 56 stable asthmatic children and 15 nonasthmatic healthy children were evaluated before and 30 min after an exercise challenge.

Immunologic mechanisms in asthma.

Asthma is a chronic airway disease, which affects more than 300 million people. The pathogenesis of asthma exhibits marked heterogeneity with many phenotypes defining visible characteristics and endotypes defining molecular mechanisms. With the evolution of novel biological therapies, patients, who do not-respond to conventional asthma therapy require novel biologic medications, such as anti-IgE, anti-IL-5 and anti-IL4/IL13 to control asthma symptoms.

Classification of asthma.

Asthma is a chronic inflammatory disorder of the airways that results, physiologically, in hyperreactivity and, clinically, in recurrent episodes of wheezing, chest tightness, or coughing. Airway inflammation, smooth-muscle contraction, epithelial sloughing, mucous hypersecretion, bronchial hyperresponsiveness, and mucosal edema contribute to the underlying pathophysiology of asthma. Diagnostic tests such as methacholine or mannitol challenges or spirometry (pre- and postbronchodilator responses) help to identify such underlying pathophysiology assessments of bronchial hyperreactivity and lung mechanics but are imperfect and, ultimately, must be viewed in the context of a patient's clinical presentation, including response to pharmacotherapy.

Understanding the immunology of asthma: Pathophysiology, biomarkers, and treatments for asthma endotypes.

Asthma is a common disease in paediatrics and adults with a significant morbidity, mortality, and financial burden worldwide. Asthma is now recognized as a heterogeneous disease and emerging clinical and laboratory research has elucidated understanding of asthma's underlying immunology. The future of asthma is classifying asthma by endotype through connecting discernible characteristics with immunological mechanisms.

Anti-oxidant and Anti-inflammatory Effects of Aquatic Exercise in Allergic Airway Inflammation in Mice.

Oxidative stress and inflammation are key pathways responsible for the pathogenesis of asthma. Aquatic exercise (AE) has been proven to elicit a variety of biological activities such as anti-oxidant and anti-inflammatory effects. However, although proper forms of AE provide beneficial health effects, incorrect forms and types of AE are potentially injurious to health.

Does exercise-induced bronchoconstriction affect physical activity patterns in asthmatic children?

Exercise-induced bronchoconstriction (EIB) is a sign of uncontrolled childhood asthma and classically occurs after exercise. Recent research shows that EIB frequently starts during exercise, called breakthrough-EIB (BT-EIB). It is unknown whether this more severe type of EIB forces children to adapt their physical activity (PA) pattern in daily life.

Prevalence of Montelukast Use as an Add-On Therapy among Iraqi Asthmatics on Treatment Attending Al-Kindy Teaching Hospital and Al-Zahraa Center of Asthma and Allergy.

Background: Montelukast (Singulair) is a cysteinyl leukotriene receptor antagonist, used for the maintenance treatment of asthma and to relieve symptoms of seasonal allergic rhinitis and asthma, also used for exercise-induced bronchospasm.

Aim: This study was performed to determine the prevalence of Montelukast use as an add-on therapy among Iraqi asthmatic patients on treatment. Comparing the effectiveness of regimens with and without montelukast.

Update in Pediatric Asthma: Selected Issues.

Asthma is a complex condition that affects 14% of the world's children and the approach to management includes both pharmacologic as well as non-pharmacologic strategies including attention to complex socioeconomic status phenomena. After an historical consideration of asthma, allergic and immunologic aspects of asthma in children and adolescents are presented. Concepts of socioeconomic aspects of asthma are considered along with environmental features and complications of asthma disparities.

Vocal Cord Dysfunction: The Spectrum Across the Ages.

Vocal cord dysfunction (VCD) is an upper airway disorder characterized by exaggerated and transient glottic constriction causing respiratory and laryngeal symptoms. Although the origin of VCD symptoms is in the upper airway, it is frequently misdiagnosed as asthma resulting in significant morbidity. VCD can coexist with asthma or mimic allergic conditions affecting the upper airway.

Ozone effects on blood biomarkers of systemic inflammation, oxidative stress, endothelial function, and thrombosis: The Multicenter Ozone Study in oldEr Subjects (MOSES).

The evidence that exposure to ozone air pollution causes acute cardiovascular effects is mixed. We postulated that exposure to ambient levels of ozone would increase blood markers of systemic inflammation, prothrombotic state, oxidative stress, and vascular dysfunction in healthy older subjects, and that absence of the glutathione S-transferase Mu 1 (GSTM1) gene would confer increased susceptibility. This double-blind, randomized, crossover study of 87 healthy volunteers 55-70 years of age was conducted at three sites using a common protocol.

A Trigger Reduction Approach to Treatment of Paradoxical Vocal Fold Motion Disorder in the Pediatric Population.

Objectives: Paradoxical vocal fold motion disorder (PVFMD), or induced laryngeal obstruction (ILO), is a clinical phenomenon characterized by inappropriate adduction of the true vocal folds during inspiration. The resultant episodes of acute respiratory distress marked by exercise-induced cough, inspiratory stridor, throat tightness, and shortness of breath are often misattributed to asthma despite normal pulmonary function testing results. Although the pathogenesis of the disease remains unclear, the etiology is likely multifactorial with an inflammatory, neurological, and psychiatric basis.

Exercise-induced laryngeal obstruction: Quality initiative to improve assessment and management.

Introduction: Exercise-induced laryngeal obstruction (EILO) affects 2-3% of the general population and 5.1% of elite athletes. Symptoms arise during high-intensity exercise and resolve at rest.

Exercise-induced laryngeal obstruction (EILO) in children and young adults: From referral to diagnosis.

Objective: To identify different presentations, referral patterns, comorbidities, and laryngoscopy findings in children and young adults with exercise-induced laryngeal obstruction (EILO).

Methods: We performed a retrospective chart review of 112 patients, age <26 years, with EILO between 2013 and 2016.

Results: Of the 112 patients who met criteria, 91 were female and 21 were male.

Can EVH Results Predict Post-Exercise Changes in FEV Following Interval and Continuous Exercise?

The eucapnic voluntary hyperpnea (EVH) challenge is used to determine the presence of exercise-induced bronchoconstriction (EIBC) by monitoring changes in forced expiratory volume in 1 s (FEV). However, the predictability of the post-EVH decline in FEV on post-exercise FEV remains unclear. Participants completed an EVH challenge to confirm EIBC and completed a continuous exercise (CONT; n = 21), high-intensity interval exercise (HI; n = 13), and sprint interval exercise (SPRT; n = 8) sessions on separate days.

The Visual Analog Scale detects exercise-induced bronchoconstriction in children with asthma.

Exercise-induced bronchoconstriction (EIB) is a specific morbidity of childhood asthma and an important sign of uncontrolled asthma. The occurrence of EIB is insufficiently identified by the Childhood Asthma Control Test (C-ACT) and Asthma Control Test (ACT). This study aimed to (1) evaluate the Visual Analog Scale (VAS) for dyspnea as a tool to detect EIB in asthmatic children and (2) assess the value of combining (C-)ACT outcomes with VAS scores.

Air pollution and DNA methylation: effects of exposure in humans.

Air pollution exposure is estimated to contribute to approximately seven million early deaths every year worldwide and more than 3% of disability-adjusted life years lost. Air pollution has numerous harmful effects on health and contributes to the development and morbidity of cardiovascular disease, metabolic disorders, and a number of lung pathologies, including asthma and chronic obstructive pulmonary disease (COPD). Emerging data indicate that air pollution exposure modulates the epigenetic mark, DNA methylation (DNAm), and that these changes might in turn influence inflammation, disease development, and exacerbation risk.

Common Pulmonary Conditions in Sport.

Respiratory symptoms and infections are common among athletes. Viral upper respiratory infection symptoms may precede dyspneic symptoms seen in asthmatics or worsen symptoms of exercise-induced bronchoconstriction Knowing how to instruct an athlete on use of inhalers and having an asthma action plan are critical in management of these athletes. Other life-threatening conditions that may be seen are pneumothorax and laryngeal/pharyngeal perforation.

Severe Exercise-Induced Laryngeal Obstruction Treated With Supraglottoplasty.

Exercise induced laryngeal obstruction (EILO) is relatively common in adolescents, with symptoms often confused with exercise induced asthma. EILO often starts with medial or inward rotation of supraglottic structures of the larynx, whereas glottic adduction appears as a secondary phenomenon in a majority. Therefore, surgical treatment (supraglottoplasty) is used in thoroughly selected and highly motivated patients with pronounced symptoms and severe supraglottic collapse.

Association of air humidity with incidence of exercise-induced bronchoconstriction in children.

Background: The effects of humidity and temperature on results of free running test in children are not known.

Objective: Assess the relation of outdoor air temperature, relative humidity (RH), and absolute humidity (AH) to airway obstruction in children after free running exercise test.

Methods: We analyzed all exercise challenge tests with impulse oscillometry in children between January 2012 and April 2015 in the Tampere University Hospital.

Cold air exercise screening for exercise induced bronchoconstriction in cold weather athletes.

Exercise Induced Bronchoconstriction (EIB) prevalence in cold weather athletes is high. Currently, no standardized cold air exercise provocation test exists. Thus we aimed to determine EIB prevalence using a Cold Air Test (CAT; 5 km outdoor running; -15 °C) compared to the most common EIB screen the Eucapnic Voluntary Hyperpnea (EVH) test in cold weather athletes.