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Severe Asthma Research - January 2016

Christina E Ciaccio, MD, MSc

Christina E Ciaccio, MD, MSc
Allergist/Immunologist
Assistant Professor of Pediatrics
University of Chicago Medicine
Comer Children’s Hospital
Chicago, Illinois, United States

Prothrombotic state in patients with severe and prednisolone-dependent asthma

Those with severe asthma have an increased risk of pulmonary embolism. This study sought to determine if, therefore, severe asthmatics are prothrombotic by comparing coagulation and fibrinolysis between healthy subjects and those with asthma. The investigators enrolled 126 adults (33 control, 31 mild asthma, 32 severe asthma, 30 steroid dependent asthma) for blood draw. Endogenous thrombin potential (ETP), plasmin-α2-antiplasmin complex, plasminogen activator inhibitor-1 (PAI-1) and von Willebrand factor (vWF) were increased in asthmatics compared to controls.  While ETP, PAI-1, and vWF increased with worsening asthma severity. This study highlights the need to always consider pulmonary embolism when a severe asthmatics presents with acute worsening of shortness of breath.

Sneeboer MM, Majoor CJ, de Kievit A, Meijers JC, van der Poll T, Kamphuisen PW, Bel EH. Prothrombotic state in patients with severe and prednisolone-dependent asthma. Journal of Allergy and Clinical Immunology 2015; Article in press, published online ahead of print, December 20. (doi:10.1016/j.jaci.2015.10.038)

Abstract

Increased Protease-Activated Receptor-2 (PAR-2) Expression on CD14++CD16+ Peripheral Blood Monocytes of Patients with Severe Asthma

Protease-Activated Receptor-2 (PAR-2) expression is upregulated in asthma airway epithelium and plays a role in the development of allergic airway inflammation. This study sought to determine if expression on immune cells in asthmatics is also increased. The investigators recruited 36 adults with asthma (12 severe and 24 mild/moderate) for blood draw and found that those with severe asthma and those with asthma exacerbation in the last year had higher PAR-2 expression on monocytes compared to those with mild/moderate asthma. The authors conclude that PAR-2 expression on monocytes may also play a role in asthma pathogenesis.

Palikhe NS, Nahirney D, Laratta C, Gandhi VD, Vethanayagam D et al. Increased Protease-Activated Receptor-2 (PAR-2) Expression on CD14++CD16+ Peripheral Blood Monocytes of Patients with Severe Asthma. PLoS One 2015; 10(12): e0144500. (doi:10.1371/journal.pone.0144500)

Full Text, Open Access