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Severe Asthma Research - September 2015

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

Microbial ligand costimulation drives neutrophilic steroid-refractory asthma

This paper describes the effects of LPS and β-glucan on the pathogenesis of allergic and non-allergic respiratory responses to house dust mite allergen. The authors found that challenging non-allergic mice with both LPS and β-glucan resulted in neutrophilic inflammation involving the β-glucan receptor, Dectin-1, and TLR-4. The authors then went on to determine that while challenging OVA-sensitized mice resulted in eosinophilic inflammation, challenge with OVA, LPS, and β-glucan resulted in neutrophilic inflammation, an observation that was translated to a model of dustmite sensitized mice. These results demonstrate that the microbial components, LPS and β-glucan, alter the pulmonary inflammatory response in a mouse model. Interestingly, the pulmonary responses in these models were also steroid resistent, similar to patients with severe asthma.

Source: Hadebe S, Kirstein F, Fierens K, Chen K, Drummond RA et al. Microbial ligand costimulation drives neutrophilic steroid-refractory asthma. PLoS One 2015; 10(9). (doi:10:1371/journal.pone/0137945)

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Effectiveness of vitamin D3 in severe persistent asthmatic patients: A double blind, randomized, clinical study

In this double-blind study, 161 adults with severe asthma were randomized to receive 1,000 IU of vitamin D3 daily in addition to a combination inhaler or a combination inhaler only. Of those randomized, 141 completed the 6 month study with similar drop out between the two groups. Symptom score, activity score, impact score and total scores of SGRQ improved during the study in both groups.  The treatment group had a statistically significant improvement in symptom score only. FEV1 was also improved at the end of the study for both groups; however, no statistically significant difference between the two groups was seen. This study fails to provide evidence compelling enough to recommend routine supplement of vitamin D3 in severe asthmatics; however, a quick assessment to ensure adequate nutritional vitamin D3 intake is endorsed.

Source: Rajanandh MG, Nageswari AD, Prathiksha G. Effectiveness of vitamin D3 in severe persistent asthmatic patients: A double blind, randomized, clinical study. Journal of Pharmacololgy and Pharmacotherapeutics 2015; 6(3): 142-146. (doi:10.4103/0976-500X.162022)

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