Asthma is the most common respiratory disease. It has multiple phenotypes thatcan be partially differentiated by measuring the disease's specific characteristics-biomarkers. The pathogenetic ...mechanisms are complex, and it is still a challenge to choose suitable biomarkers to adequately stratify patients, which became especially important with the introduction of biologicals in asthma treatment. Usage of biomarkers and an understanding of the underlying pathobiological mechanisms lead to the definition of endotypes. Asthma can be broadly divided into two endotypes, T2-high and T2-low. The right combination of various biomarkers in different phenotypes is under investigation, hoping to help researchers and clinicians in better disease evaluation since theindividual approach and personalized medicine are imperative. Multiple biomarkers are superior to a single biomarker.
Biologics have been proven efficacious for patients with severe asthma (SA). It is essential to diagnose such individuals correctly. This study was designed to survey pulmonologists to identify ...barriers to early diagnosis and subsequent appropriate use of biologics for SA in Croatia. A pulmonologist group with expertise in SA developed the initial list of questions, with the final questionnaire created according to a 2-round Delphi method. The resulting survey consisted of 23 items consequently divided into 4 domains: 1) Pulmonologists' demographics and professional experiences; 2) Concerns about asthma management; 3) Attitudes toward SA diagnosis; and 4) Beliefs and attitudes regarding the use of biologics in managing SA. The given answers represented the respondents' estimates. Eighty-four surveys were analyzed, with pulmonologists observing that general practitioners often inaccurately diagnose asthma and treat acute exacerbations. Although specialist centers are capably and correctly equipped, the time to diagnose patients with SA is approximately 3.5 months, with initial use of biologics delayed an additional 2 months. The primary indications for prescribing biologics are conventional therapy with oral glucocorticoids (91.7%) and frequent acute exacerbations (82.1%). In addition to improper diagnosis (64.3%), many patients with SA do not receive the indicated biologics owing to strict administrative directives for reimbursement (70.2%) or limited hospital resources (57.1%). Croatian pulmonologists observed that a significant number of patients with SA who are eligible for biologics are not prescribed them, largely because of an inaccurate and/or delayed diagnosis, a delayed referral to a specialist center, highly restrictive criteria for reimbursement, and/or institutional budgetary limitations.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The aim of this study was to establish the impact of air transport on blood samples packaged with and without cooling elements and effect of outdoor temperature on sample quality. Venous samples from ...38 blood donors in winter and 36 in summer were tested for hemolysis and complete blood count. One tube
subject was kept in controlled conditions at +4 °C. Two sets of tubes were sent by plane from Zagreb to Brussels, one with and one without cooling elements, and another two sets were sent to London following the same principle. Packages with cooling elements were stored in controlled warehousing conditions at airports (+2 °C to +8 °C), whereas packages without cooling elements were stored in ambient warehouse conditions. Data loggers were used for temperature monitoring. Our research revealed statistically significant differences in several hematologic parameters when comparing the samples stored in controlled laboratory conditions and those transported by plane. These differences were more pronounced in the samples transported during the summer. Transport conditions without cooling elements had additional negative impact on the sample quality. Transport of samples using cooling elements and controlled warehousing conditions at airports are sometimes not sufficient to maintain laboratory storage conditions.
Astma je najčešća plućna bolest, iako s manjim utjecajem na zbroj izgubljenih godina života zbog preuranjene smrtnosti i godina proživljenih s invaliditetom nego neke druge plućne bolesti, kao što je ...kronična opstruktivna plućna bolest. Budući da se radi o bolesti s velikim javnozdravstvenim utjecajem na radnu sposobnost i kvalitetu života oboljelih, kao i s potrošnjom značajnih zdravstvenih i financijskih resursa, potrebno je primijeniti
kvalitetno i standardizirano liječenje. Osnova liječenja astme – primjena temeljnoga protuupalnog lijeka s najmanjom dozom koja može održati dobru kontrolu – nije se značajno promijenila u odnosu na posljednje hrvatske smjernice za dijagnostiku i liječenje astme u odraslih, objavljene prije petnaestak godina. Međutim, u međuvremenu su se u globalnoj strategiji za upravljanje i prevenciju astme dogodile značajne promjene u stavu
prema kratkodjelujućem bronhodilatatoru salbutamolu, gdje se on više ne primjenjuje samostalno u akutnom bronhospazmu ili pri pojavi tegoba, bez inhalacijskog glukokortikoida. Također, značajan je napredak postignut u biološkoj terapiji teške astme, prepoznat je značaj izrade osobnog plana liječenja astme, kao i pojava novih mogućnosti liječenja (fiksna trojna terapija), što je uključeno u nove hrvatske smjernice za liječenje astme.
The complex role of the serotonin system in respiratory function and inflammatory diseases such as asthma is unclear. Our study investigated platelet serotonin (5-HT) levels and platelet monoamine ...oxidase B (MAO-B) activity, as well as associations with
(rs6314; rs6313)
(rs3813929; rs518147), and
(rs1799836; rs6651806) gene polymorphisms in 120 healthy individuals and 120 asthma patients of different severity and phenotypes. Platelet 5-HT concentration was significantly lower, while platelet MAO-B activity was considerably higher in asthma patients; however, they did not differ between patients with different asthma severity or phenotypes. Only the healthy subjects, but not the asthma patients, carrying the
rs1799836 TT genotype had significantly lower platelet MAO-B activity than the C allele carriers. No significant differences in the frequency of the genotypes, alleles, or haplotypes for any of the investigated
and
gene polymorphisms have been observed between asthma patients and healthy subjects or between patients with various asthma phenotypes. However, the carriers of the
rs518147 CC genotype or C allele were significantly less frequent in severe asthma patients than in the G allele carriers. Further studies are necessary to elucidate the involvement of the serotonergic system in asthma pathophysiology.
Aim
ABO blood group genotypes are established as a genetic factor in pathophysiology of various diseases, such as cardiovascular disorders, cancers, infectious diseases and there is rising evidence ...of their involvement in other conditions. The aim of this study was to determine if ventilatory changes of lung function in asthma, measured by biomarkers/parameters, are connected to certain ABO blood group genotypes in Croatia.
Methods
A case-control study included 149 patients with asthma and 153 healthy individuals (blood donors). ABO genotyping on five main alleles was performed using PCR-SSP method. All patients had spirometry performed and severity of asthma was estimated. Clinical parameters of spirometry (FEV 1 , FEV/FVC, PEF), biomarkers FeNO, IgE and pO2 were measured. The χ 2 test, Fisher's test, Kruskal-Wallis test and Spearman's correlation coefficients with p˂0.05 were used as statistically significant.
Results
There was no determined statistically significant difference in both ABO genotypes and phenotypes between patient and control groups. Comparison of the lung function in different ABO phenotypes in asthmatic patients also did not show any statistically significant differences in FEV1 values, FEV/FVC ratio or PEF. Statistically significant differences in oxygenation between different ABO blood types have not been noticed (p=0.326). Differences in quantitative values of biomarkers (FeNO and IgE) between different ABO blood phenotypes in patients with asthma were not significant, except for IgE that had marginal values (p=0.074).
Conclusion
No correlation was found between certain ABO blood group genotypes and parameters/biomarkers of ventilatory dysfunction in patients with allergic and nonallergic asthma.
Brain-derived neurotrophic factor (BDNF) and its tropomyosin-related kinase B (TrkB) receptor might contribute to normal lung functioning and immune responses; however, their role in asthma remains ...unclear. Plasma BDNF concentrations, as well as
and
(
gene) polymorphisms, were investigated in 120 asthma patients and 120 healthy individuals using enzyme-linked immunosorbent assay and polymerase chain reaction, respectively. The genotype and allele frequencies of
Val66Met (rs6265) and
rs1439050 polymorphisms did not differ between healthy individuals and asthma patients, nor between patients grouped according to severity or different asthma phenotypes. Although plasma BDNF concentrations were higher among healthy subjects carrying the
Val66Met GG genotype compared to the A allele carriers, such differences were not detected in asthma patients, suggesting the influences of other factors. Plasma BDNF concentration was not affected by
rs1439050 polymorphism. Asthma patients had higher plasma BDNF concentrations than control subjects; however, no differences were found between patients subdivided according to asthma severity, or Type-2, allergic, and eosinophilic asthma. Higher plasma BDNF levels were observed in asthma patients with aspirin sensitivity and aspirin-exacerbated respiratory disease. These results suggest that plasma BDNF may serve as a potential peripheral biomarker for asthma, particularly asthma with aspirin sensitivity.
Asthma is a chronic inflammatory disease that is characterized by reversible obstruction of airways, bronchial hyper-reactivity and airway remodeling. The etiology of asthma is multifactorial, with ...inheritance playing an important role. The aim of our study was to investigate the importance of biomarkers of asthma and the role of plasminogen activator inhibitor-1 (PAI-1) gene as a genetic factor that could be involved in the pathogenesis of asthma. The research was conducted at Jordanovac University Department for Lung Diseases and Croatian Institute of Transfusion Medicine. The research included 149 patients with asthma and 89 healthy individuals. We collected demographic data of both study groups, determined asthma severity using GINA guidelines, and the values of biomarkers and PAI-1 by using laboratory techniques. Based on the results, we concluded that patients with allergic phenotype of asthma were younger, had better lung function and higher levels of IgE. By observing FeNO values, we were not able to distinguish asthmatic patients that had been diagnosed with obstruction of airways from asthmatic patients with normal lung function because FeNO indicates the inflammatory component of disease. The 4G/5G polymorphism of PAI-1 gene did not show any statistically significant difference in the distribution of 4G/4G, 4G/5G and 5G/5G between the group of asthmatic patients and control group.
The aim of this study was to establish the impact of air transport on blood samples packaged with and without cooling elements and effect of outdoor temperature on sample quality. Venous samples from ...38 blood donors in winter and 36 in summer were tested for hemolysis and complete blood count. One tube per subject was kept in controlled conditions at +4 degreesC. Two sets of tubes were sent by plane from Zagreb to Brussels, one with and one without cooling elements, and another two sets were sent to London following the same principle. Packages with cooling elements were stored in controlled warehousing conditions at airports (+2 degreesC to +8 degreesC), whereas packages without cooling elements were stored in ambient warehouse conditions. Data loggers were used for temperature monitoring. Our research revealed statistically significant differences in several hematologic parameters when comparing the samples stored in controlled laboratory conditions and those transported by plane. These differences were more pronounced in the samples transported during the summer. Transport conditions without cooling elements had additional negative impact on the sample quality. Transport of samples using cooling elements and controlled warehousing conditions at airports are sometimes not sufficient to maintain laboratory storage conditions. Key words: Blood sample quality; Transport conditions; Hematologic parameters Cilj ovog istrazivanja bio je utvrditi utjecaj zracnog prijevoza na uzorke krvi pakirane s rashladnim elemenatima i bez njih, kao i utjecaj vanjske temperature na kvalitetu uzorka. U venskim uzorcima 38 darivatelja krvi tijekom zime i njih 36 tijekom ljeta odredeni su stupanj hemolize i kompletna krvna slika. Jedan uzorak po ispitaniku ostavljen je u kontroliranim uvjetima na +4 degreesC. Dva seta uzoraka poslana su zrakoplovom iz Zagreba u Bruxelles, jedan s rashladnim elemenatima i jedan bez njih, a druga dva seta poslana su u London po istom nacelu. Pakovanja s rashladnim elementima cuvana su u kontroliranim skladisnim uvjetima u zracnim lukama (+2 degreesC do +8 degreesC), dok su pakovanja bez rashladnih elemenata cuvana u ambijentnim skladisnim uvjetima. Uredaji za kontinuirano mjerenje temperature koristeni su za nadzor temperature tijekom transporta. Nase istrazivanje otkrilo je statisticki znacajne razlike u nekoliko hematoloskih parametara kada se usporeduju uzorci pohranjeni u kontroliranim laboratorijskim uvjetima i oni koji se transportiraju zracnim prijevozom. Te su razlike bile izrazenije u uzorcima transportiranim tijekom ljeta. Uvjeti transporta bez rashladnih elemenata imali su dodatni negativni utjecaj na kvalitetu uzoraka. Transport uzoraka pomocu rashladnih elemenata i kontrolirani uvjeti skladistenja u zracnim lukama ponekad nisu dovoljni za odrzavanje laboratorijskih uvjeta skladistenja. Kljucne rijeci: Kvaliteta uzoraka krvi; Uvjeti transporta; Hematoloski parametri
Asthma is one of the most common chronic diseases in the world. Obesity is the most common comorbidity of asthma and is connected to incidence and course of the disease. Obesity is associated with ...non-allergic asthma phenotype, but this relation could be influenced by gender. The aim of our study was to determine the relationship between BMI and asthma and to explore possible gender differences.
Study included 149 patients with asthma (examined group) and 153 healthy blood donors (control group). Data from the medical records of patients with asthma were used, and all included subjects had their BMI calculated using standard formula. Data were analyzed using descriptive statistics methods. Data with non-parametric distribution were analysed with Mann-Whitney U test and showed through medians with corresponding interquartile ranges. Statistical significance of BMI differences between non-allergic asthma, allergic asthma and control groups were analyzed by one-way analysis of variance - ANOVA. The results were interpreted at a significance level of P<0.05.
The comparison between median BMI values of two groups shows that examined group of patients with astma has significantly higher median BMI value in comparison with control group (P=0.035). Correlation was stronger for women than men (P=0.002 vs P=0.898). Incresed BMI of the examined group of patients with asthma was not asociated with non-allergic asthma (P=0.085). However, when stratified according to gender, there was a strong association of increased BMI with non-allergic asthma in women (P<0.001).
Patients with asthma in our study have higher BMI in comparison to healthy individuals, which contributes to hypothesis that BMI is a risk factor for development of asthma. We found that possible effect that BMI has on asthma is stronger in women, since there was a strong association between increased BMI and non-allergic asthma only in women.
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