asthma

Asthma and Allergic rhinitis (AR) are frequently concurrent diseases. Epidemiological, immunological, and clinical studies reported increasing evidence of the links between AR and asthma. Epidemiologically, up to 40% of patients with AR also have asthma, and up to 80% of patients with asthma experience nasal symptoms. Furthermore, patients with AR are at three times the risk of developing asthma compared with those without AR.

This cross-sectional study was carried out during one year from all patients between 0-16 years who were referred to allergy and ENT clinics with symptoms of chronic cough (more than four weeks) or upper respiratory tract symptoms such as sneezing, runny nose, and nasal congestion. Data and diagnosis were classified according to the Global Initiative for Asthma (GINA) and the AR criteria and its Impact on Asthma guidelines (ARIA), respectively.

190 (120 individuals with asthma and 70 individuals with AR) were enrolled in the study. The mean age of patients with asthma was 9.14±3.13, and 43.3% were female. The severity of asthma was classified as mild (20%), moderate (70.8%), and severe (9.2%). The mean age of patients with rhinitis was 10.13±3.45 years, and 35.7% were female. Rhinitis was classified as intermittent (40%) and persistent (60%). The prevalence of AR in the asthma group was 42 individuals (35%). Twenty-nine cases of them (24.2%) had intermittent AR, and 13 (10.8%) cases had persistent AR. The prevalence of asthma in AR was 18 cases (25.7%) 3 cases (4.3%) had mild asthma, 12 cases (17/1%) had moderate asthma, and 3 cases (4.3%) had severe asthma. A significant correlation was found ( P<0.0001) between the severity of AR and asthma.

Based on the findings of our study, there is a significant relationship between the severity of asthma and AR in patients with asthma and AR. The results show that asthma prevalence is high in patients with AR. Also, the frequency of AR in patients with asthma is significantly higher.

Asthma and allergic rhinitis are prevalent respiratory conditions influenced by genetic, environmental, and immunological factors. Understanding the distribution of these conditions and their associated allergens is essential for effective management and prevention strategies.This study aimed to investigate the prevalence of asthma, allergic rhinitis, and their co-occurrence in a specific population, with a focus on allergen sensitivity patterns.

A retrospective analysis was conducted on patients diagnosed with asthma, allergic rhinitis, or both. Allergen sensitivity was assessed using skin prick tests for common environmental allergens, including weeds, mites, cockroaches, and mixed allergens. Data analysis included prevalence rates, allergen distribution, and a heatmap visualization of allergen-patient associations.

Males demonstrated a higher prevalence of asthma (68.8%), allergic rhinitis (64.4%), and combined conditions (67.0%) compared to females. Weeds were the most common allergen among asthma patients (40.0%), while mixed allergens were predominant among allergic rhinitis (45.7%) and coexisting conditions (50.0%). Heatmap analysis revealed strong associations between mites, cockroaches, and respiratory conditions, reinforcing their role as significant allergens. The high prevalence of mixed allergens in patients with both conditions suggests the need for comprehensive allergy management approaches.

This study highlights a male predominance in asthma and allergic rhinitis cases and underscores the role of environmental allergens in disease manifestation. The findings support targeted allergen avoidance and personalized immunotherapy strategies for optimal respiratory disease management.

Adherence to treatment and regular physical activity in individuals with asthma will culminate in favorable clinical outcomes, including an effective disease management and an improved quality of life.

The present study aimed to determine the physical activity level and association with adherence to treatment and quality of life in individuals with asthma.

This cross-sectional study was conducted on 505 individuals referring to the respiratory ward of Vali-e-Asr Hospital in Zanjan, Iran. Participants were selected using a convenience sampling method. Data were collected using the socio-demographic information form, the International Physical Activity Questionnaires (IPAQ), Modanloo Adherence to Treatment Questionnaire (MATQ), and the St. George's Respiratory Questionnaire (SGRQ). Data analysis was performed using descriptive statistics and the Kruskal-Wallis test in SPSS software version 16.

The majority of participants were male (57.2%) with a mean (standard deviation [SD]) age of 66.35 (15.33) years. The physical activity level of the majority of participants was vigorous (43.4%). The mean (SD) total scores for adherence to treatment and quality of life were 120.83 (8.92) and 35.42 (5.02), respectively. According to the findings, physical activity had no statistically significant association with adherence to treatment (p=0.535) and quality of life (p=0.173).

In the present study, physical activity level was vigorous in asthmatic participants. Adherence to treatment among participants was at a good level, and quality of life was at a moderate level. Therefore, the design of supportive educational interventions is recommended to improve quality of life and promote lifestyle modification in individuals with asthma.

Asthma is one of the most common respiratory diseases. Hyssopus officinalis L. is a medicinal herb that has shown anti-asthmatic effects and has also been recommended in Persian Medicine literature for its treatment. In this study, the efficacy of hyssop in mild to moderate asthma was investigated considering the patients' phenotype (having productive/non-productive cough).

In a randomized triple-blind placebo-controlled trial, 60 mild-to-moderate asthmatic patients were randomized to receive either hyssop syrup (5 ml twice daily containing 6g Hyssopus officinalis L. extract) or plain sugar syrup (5 ml twice daily) for 4 weeks as an adjuvant to routine treatment. Outcome measures were the Asthma Control Test (ACT), pulmonary function tests, Expert Panel Report 3 (EPR3), and wheezing severity.

The patients with productive cough in the hyssop group showed significant improvement in forced expiratory volume in 1 second (FEV1), ACT (at the 4th week), peak expiratory flow (PEF), maximal expiratory flow rate 25-75 (MEF25-75%), and wheezing severity. However, those with dry cough got worse regarding these indices.

Hyssop syrup is effective for asthmatic patients with productive cough and a higher BMI, but it is not suitable for those experiencing a dry cough. It highlights the importance of syndrome differentiation in asthmatic patients and a posteriori subgrouping in data analysis. This approach enhances treatment accuracy and response rates while reducing adverse effects. Future trials are guaranteed to approve this categorization in asthma treatment.

Asthma and Chronic Obstructive Pulmonary Disease (COPD) are prevalent respiratory disorders with significant societal and healthcare impacts. This study will be conducted on the participants of the Persian Cohort study at Mashhad University of Medical Sciences (POCM) to determine the prevalence of asthma and COPD and to explore their relationship with dietary patterns, urban structure, lifestyle, and the severity in Iran.  A comprehensive assessment will be employed in this cohort study, including lifestyle factors, dietary patterns, anthropometry, spirometry, depression and stress levels, sleep quality, and physical activity. Individual-level analysis will utilize multivariate logistic regression to assess associations between outcome variables and potential predictors like air quality, smoking, occupation, socioeconomic status, and nutritional status. Adjustments for gender, age, chronic health conditions, and other potential confounders will be incorporated.  This study will investigate the most closely associated factors influencing the prevalence and severity of asthma and chronic obstructive pulmonary disease.  The final outcomes will delineate the relationship between the prevalence of asthma and COPD and various lifestyle factors, including socioeconomic status, air pollution, and physical activity.

Asthma, a prevalent chronic condition in children, poses significant challenges in management. While conventional treatments like inhaled corticosteroids and beta-agonists are standard, there is increasing interest in the role of herbal medicine and probiotics as complementary therapies. This paper reviews the impact of herbal remedies—such as Butterbur, Ginger, Turmeric, Boswellia, Licorice, and Ephedra—and probiotics on pediatric asthma. Evidence suggests these therapies may reduce inflammation and improve respiratory function, potentially benefiting asthma management. However, variability in product quality and study designs necessitates further research. Future studies should focus on validating these interventions through rigorous clinical trials to better integrate herbal medicine and probiotics into comprehensive asthma care for children.

Plastic bronchitis (PB) is a rare but potentially life-threatening condition characterized by the formation of bronchial casts, leading to airway obstruction. It is associated with several underlying conditions, including congenital heart disease, respiratory infections, and asthma. Due to its non-specific symptoms, PB is often misdiagnosed or underdiagnosed. We present a case of a 10-year-old boy with a one-year history of recurrent productive cough, dyspnea, and fever, unresponsive to albuterol treatment. Chest X-rays revealed atelectasis of the left lower lung, which persisted despite airway clearance techniques. High-resolution computed tomography (HRCT) showed collapse consolidation of the left lung. Bronchoscopy revealed bronchial obstruction by a rubbery cast, which was successfully removed. Pathologic analysis of the cast showed eosinophils, neutrophils, and Charcot-Leyden crystals. The patient was treated with inhaled corticosteroids and short-acting beta-agonists, leading to complete resolution of symptoms. Follow-up after six months showed no recurrence of symptoms. This case highlights the importance of considering PB in patients with recurrent respiratory symptoms and atelectasis, particularly when foreign body aspiration or common respiratory diseases have been ruled out. Early diagnosis and management, including cast removal and treatment of underlying conditions, are crucial to preventing complications.

Asthma is a chronic respiratory disease and a major public health problem globally. This study aimed to determine the prevalence of asthma and related symptoms in schoolchildren in Dezful city, southwest Iran.

In this cross-sectional descriptive analytical study, the prevalence of asthma symptoms was measured using a randomized cluster sampling method among 2,978 schoolchildren aged 6-14 years. A validated questionnaire from the International Study of Asthma and Allergies in Childhood (ISAAC) was used from January to February 2020. The chi-square test was used to determine the relationship between variables, which were expressed as percentages, with a p‐value <0.05 considered statistically significant.

The overall prevalence of asthma was 4.7% (CI=3.98 - 5.54), significantly higher among 13-14-year-olds compared to the 6-7-year-old age group (6.4% vs. 3.1%, p<0.001) and in males versus females (6.9% vs. 2.5%, p<0.001). The total prevalence of wheezing in the last year, the main symptom of asthma, was 7.2% (CI=6.31 - 8.20), significantly higher among 13-14-year-olds (8.4% vs. 6.1%, p<0.009) and male schoolchildren (9.6% vs. 4.7%, p<0.001).

According to our findings, and compared to the previous ISAAC study in Iran, the prevalence of asthma symptoms was relatively low among Dezful schoolchildren. Further epidemiological studies are needed to investigate factors affecting this disease, such as indoor and outdoor environments, as well as their effects on gene expression over time.

Asthma is a prevalent chronic inflammatory disorder in children, and poor therapeutic response in asthmatic children could result from various factors related to the doctor, patient, disease, and treatment. This study aimed to evaluate the most important causes of failure in asthma control. One hundred three children referred to the Children’s Medical Center in Tehran, Iran, participated in this study in 2017. A specific questionnaire was organized and completed by telephone interviews with parents. The mean age of participants was 10.30 years, and 68.9% were male. More action plans (45/53) were received from hospitalized patients in the asthma and allergy ward than from hospitalized patients in the emergency department (13/46). Moreover, 85% of admitted patients in the asthma and allergy ward were visited by a specialist compared with 50% in the emergency department (23/46). Hospitalization in the asthma and allergy ward resulted in receiving more action plans, spirometry tests, and visits by an allergist after discharge compared with admission to the emergency department.

Allergic asthma is a chronic inflammatory disease characterized by airway remodeling, hyperresponsiveness, and exacerbated inflammation. While most patients respond well to current treatments, a small subset remains resistant necessitating new therapeutic strategies. Due to their immunomodulatory properties, stem cells have been proposed as a promising treatment option for asthma. Stem cells can reduce airway inflammation and restore immune balance, demonstrating positive outcomes, particularly in cases of steroid-resistant asthma. However, the mechanisms underlying lung tissue repair are not clearly defined. On the other hand, there are limitations in using these cells and for clinical use of mesenchymal stem cells, which must be produced in accordance with Good Manufacturing Practice. This review article discusses the mechanisms by which stem cells may aid in asthma treatment and addresses and explores the challenges associated with their use. By addressing these areas, we can better understand the potential and limitations of stem cell therapy in asthma and develop more effective strategies to harness their therapeutic benefits for patients with uncontrolled asthma.

To evaluate the risk factors associated with asthma in children hospitalized at Hospital Belen de Trujillo.

An analytical study of retrospective cases and controls was carried out in which 258 clinical histories of children between 5 to 14 years of age who were hospitalized in the Hospital Belen de Trujillo (HBT) during the period 2015-2019 were included, which were grouped into 129 histories of children who had been hospitalized for asthma (cases) and 129 histories of children hospitalized for a different cause (controls). The frequency distribution will be calculated, the Chi-square statistical test will be used, the odds ratio will be obtained and the 95% confidence interval will be calculated; finally, a multivariate analysis will be performed by means of logistic regression to determine whether the influence of other variables generates a greater risk of developing asthma in children.

The multivariate analysis showed that the factors: cesarean delivery, non-exclusive breastfeeding, history of bronchiolitis, obesity and maternal age together predict 92. 0% of the cases of asthma; however, taking the influence of all the factors at the same time, it was found that the cesarean delivery route, non-exclusive breastfeeding, obesity and maternal age are significant for the regression (p<0.05), while the factor history of bronchiolitis is not significant (p>0.05). Likewise, when the bivariate analysis of the five variables studied was performed and the Chi-square test was applied, it was found that all five factors were significant (p<0.05) for asthma in children at Hospital Belen de Trujillo.

The factors cesarean delivery route, non-exclusive breastfeeding, history of bronchiolitis, obesity and maternal age are associated with asthma in children hospitalized at HBT.

Asthma is a complex inflammatory disorder with the infiltration of inflammatory cells in the lung airways. Saffron’s active component, crocin, has been proven to possess anti-inflammatory and anti-oxidant effects. The objective of this current study was to explore the impact of crocin on NF-kB and nuclear erythroid 2-related factor 2 (Nrf2)/ heme oxygenase-1 (HO-1) signaling pathways in ovalbumin (OVA)-sensitized mice, aiming to understand its mechanism.

Four different groups were formed by dividing forty male BALB/C mice: control group, OVA-sensitized group (OVA), OVA combined with crocin 30 mg/kg (OVA-Cr30), and the OVA combined with crocin 60 mg/kg (OVA-Cr60). In order to determine the total number of WBC and inflammatory cells infiltrating the lung, we utilized the bronchoalveolar lavage fluid for counting purposes. The mRNA and protein levels of Nrf2, HO-1, IL-17, and NF-κB in lung tissue were assessed through real-time PCR and western blot techniques. 

Crocin significantly prevented the increase of total WBC and inflammatory cells in the lung tissue (P<0.001 for all) and histopathological changes in OVA-sensitized mice. Furthermore, crocin displayed suppressive effects on the enhancement of NF-kB (P<0.01) and IL-17 (P<0.05) mRNA and protein levels in OVA-sensitized mice while preserving Nrf2 (P<0.01) and HO-1 (P<0.05) expression levels. Crocin effects became increasingly apparent when utilized at high concentrations.

Crocin decreased airway inflammation, partially by inhibiting NF-κB and IL-17 and up-regulating Nrf2/HO-1 mRNA and protein expression levels.

The purpose of this study is to investigate the effect of air pollutants and noise on the prevalence of childhood asthma in Tehran, Iran.
The standardized questionnaire was completed by one of the parents of children aged 6–7 years or by adolescents aged 13–14 years.
The asthma prevalence in ages 6-7 and 13–14 was found to be 8.8% and 17.44%, respectively. A significant positive association was observed between “ever wheezing” and monoxide carbon (CO) concentration (OR=1.84, 1.05-3.25 in 13–14 years), the occurrence of 4 to 12 wheezing attacks and sulfur dioxide (SO2) concentration (Odds Ratio (OR)=1.39, 1.04-1.91) and particulate matter less than 2.5 micron (PM2.5) concentration (OR=1.38, 1.05-1.98 and OR=1.13, 0.98-1.39 in 6-7 and 13–14 years, respectively), as well as one night per week of sleep disturbances and nitrogen dioxide (NO2) concentration (OR=1.09, 1.03-1.16 in 6–7 years, respectively). It was also found that there was a significant interaction between the noise level and particulate matter less than 10 micron (PM10) level.
Based on the findings, exposure to certain outdoor air pollutants and noise can affect prevalence of asthma symptoms in residence of Tehran. The simultaneous presence of air pollutants and noise has an aggravating effect on the prevalence of asthma symptoms. Therefore, controlling sources of pollutants for reducing asthma symptoms is suggested.

Allergies impact nearly 30% of the world's population, with fungi being remarkable contributors to allergic sensitivity. Exposure to fungi allergens can trigger allergic reactions and severe asthma has been linked to hypersensitivity to fungi such as Aspergillus and Alternaria spp. Alternaria alternata, a common allergen in respiratory allergic diseases, releases proteases that initiate Th2 responses, causing inflammatory cytokine production.

Given the anti-inflammatory properties of Pomegranate Seed Oil (PSO) and the potential of Nano-emulsions (NEs) to enhance drug delivery, this study investigates the impact of PSO-loaded NEs on TLR2 and TLR4 gene expression in A549 cells sensitized with A. alternata extract (ALT).

A. alternata (ATCC 6663) was cultured and processed to obtain a cytosolic extract, with protein content measured using the Bradford method. Using a Soxhlet apparatus, PSO was extracted from cleaned, dried seeds and analyzed by gas chromatography. Alginate nanospheres containing PSO were prepared through a modified water-in-oil emulsification method and characterized for particle size, polydispersity index, and zeta potential. A549 cells were cultured and treated with various ALT, PSO, and PSO-loaded NEs combinations. Following treatment, RNA was extracted, and real-time RT-PCR was conducted to analyze TLR2 and TLR4 gene expression.

All treatment groups showed an increase in TLR2 gene expression compared to the control, with the ALT combined with PSO (P+ALT) causing the highest increase at 4.82-fold. Free PSO (P) and free NEs (NP) resulted in 3.92-fold and 2.93-fold increases, respectively, while the ALT and PSO-loaded NEs (NP+ALT) led to 2.26-fold and 2.50-fold increases. For TLR4 gene expression, the ALT treatment increased expression by 2.29-fold, but treatments containing PSO (P, P+ALT, NP+ALT) reduced TLR4 expression, with P+ALT and NP+ALT causing 0.45-fold and 0.61-fold decreases.

The study confirms that herbal extracts like PSO selectively upregulate TLR2 and downregulate TLR4, suggesting targeted therapeutic potential in inflammation and immune modulation. PSO-loaded NEs demonstrated superior anti-inflammatory effects, supporting their development for treating inflammatory diseases and warranting further research into their molecular mechanisms and therapeutic applications.

Limited data exists regarding the association between dietary patterns and asthma. This study aims to determine the relationship between empirically derived dietary patterns and the likelihood of asthma among a large population of children and adolescents living in central Iran.

A total of 7667 of male and female students aged 6-14 from 48 public and private schools in YAZD urban areas entered the current cross-sectional study. Data on dietary intakes, as well as asthma symptoms and other possible confounders, were collected using a self-administered questionnaire filled by parents. Factor analysis was applied to find major dietary patterns. Multivariate logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for asthma development across quintiles of dietary patterns.

Two main dietary patterns were established. A “traditional diet” was determined by meat, fish, fruits, cooked vegetable, raw vegetable, legumes, cereals, bread, macaroni, rice, margarine, butter, olive oil, milk, yogurt, egg, nuts, potato, and a “western-like diet” was characterized by high intakes of simple sugars, fast food(hamburger), fast food (pizza), soft drinks, jelly, chocolate and biscuits of cocoa, ice cream, and sauce. After adjusting for potential confounders, individuals in the top quintile of traditional diet were 0.31 times less likely to have asthma than those in the lowest quintile (OR=0.69; 95% CI: 0.47-1.00). Moreover, individuals in the top quintile of traditional diet were 0.43 times less likely to have wheezing compared with those in the lowest quintile (OR=0.57, 95% CI: 0.46-0.70). However, individuals in the top quintile of the western diet were 0.35 times more likely to have wheezing than those in the lowest quintile (OR=1.35, 95% CI: 1.10-1.66).

According to the results, a traditional diet might be associated with lower odds of asthma; however, a western-like diet might be adversely associated with asthma symptoms.

Asthma is a common and major allergic disease in the world. We aimed to investigate the impact of supplements with vitamin D, folic acid, selenium, zinc, and copper in patients with moderate to severe asthma.

In this clinical trial study 70 patients above six years old with moderate to severe asthma, were divided into two groups, randomly; one group received daily Asmavit syrup, 10 ml (Asmavit, Vitabiotics Ltd, London, UK), and the other group received daily 1000 IU vitamin D3 drops (Asmavit, Vitabiotics Ltd, London, UK) for two months along with ordinary treatment for asthma. Clinical and physical examinations, immunological and biochemical tests were carried out for each patient before and after the treatment.

The mean age of patients was 39.9± 14.7 years old, and the mean disease duration was 8.8 ± 9.8 years. A significant increase in lung function, asthma control, and quality of life score tests was observed in both groups after the treatment (P< 0.05). There was no significant difference in cytokines expression levels before and after the treatment with vitamin D3 or Asmavit (P> 0.05). Serum levels of selenium and folic acid before treatment were correlated with disease severity, while post-treatment vitamin D levels significantly increased FEV1 (P> 0.05). Oxidative stress levels reduced in both groups, with greater reduction in the vitamin D group (P< 0.05).

Supplements, particularly vitamin D, when combined with standard asthma treatment, may effectively improve clinical symptoms and enhance the quality of life for asthmatic patients.

Asthma is a chronic respiratory disease characterized by bronchospasm, airway inflammation. The occurrence of microbial infections is related to the severity of asthma symptoms; thus, their development can be prevented by controlling microbial agents. This study aims to determine the relationship of asthma symptoms severity with Haemophilus influenzae type A infection in patient with asthma compared to healthy people.

In this case-control study, sputum samples of 31 patients with asthma (16men and 15 women; mean age=58.58±14.13) and 31 healthy individuals (16 men and 15 women; mean age=52.03±14.72 years) who referred to a hospital were collected. DNA extraction was done using the kit (Cinnagen Co.). The prevalence of H. influenzae type A was investigated using the bexA gene primer by real-time PCR method. The collected data were analyzed in Excel and SPSS software, version 20.

24 sputum samples (77.4%) from patients and 13 samples (41.9%) from healthy people were positive for H. influenzae type A. The increase in the severity of asthma symptoms, cough and shortness of breath showed that the severity of the infection decreased with the increase in asthma symptoms. Also, in terms of the asthma control test (ACT) score, spirometry indices, fractional exhaled nitric oxide index, and percentages of lymphocytes, macrophages, neutrophils and eosinophils, there was a significant difference between patients and healthy people (P=0.0001).

Further studies are needed to determine the role of H. influenzae type A in the development of lung diseases, including asthma.