• Sébastien Abad asked a question:
    Do you think that Adult Asthma and PeriOrbital Xanthogranulomas could be part of the spectrum of non-Langerhans histiocytosis ?

    Recently, we described three cases of AAPOX syndrome associated with IgG4-positive plasma cell infiltration. Our findings prompted us to suggest that AAPOX syndrome and IgG4-RD are strongly linked (1).

    Thanks for your help!

    1- London J et al. Medicine (Baltimore) 2015. 94:e1916.

  • Carla Pinheiro added an answer:
    In our lab we are doing differencial cell count in sputum of asmathic children and we found cells that we have not seen before. What are they?

    Attached I send two documents in PDF with photographs of the sample, stained with MGG, another with Pap. Final magnification of 400x.

    + 1 more attachment

    Carla Pinheiro

    Dear Dr. Bart Vrugt, thanks for your answer. That's another good possibility try CD138, thanks :) Best wishes, Carla

  • Tarig Eltoum Yagoub asked a question:
    Any body working on bronchial asthma?

    Any body working on bronchial asthma? "epigenetics field"

  • Khaled Saad added an answer:
    Any clinical trial about mucolytics in children with Asthma?

    Mucolytics in children with Asthma

    Khaled Saad

    Thanks E. Melillo for very good answer

  • Vladimir Dvoryanchikov added an answer:
    Is there an association between sea level and the asthma prevalence?
    I am just wondering whether there is an association between the sea level and asthma prevalence? Or the lower prevalence in Tibet just due to higher childhood mortality or is there better air quality there? What do you think? Thank you!
    • Source
      [Show abstract] [Hide abstract] ABSTRACT: Background It is well known that the prevalence of asthma has been reported to increase in many places around the world during the last decades. Therefore, the aim of this study was to identify and review studies of asthma prevalence among children in China and address time trends and regional variation in asthma. Methods A systematic literature search was performed using PubMed and China National Knowledge Infrastructure (CNKI) databases. Selected articles had to describe an original study that showed the prevalence of asthma among children aged 0−14 years. Results A total of 74 articles met the inclusion criteria. The lifetime prevalence of asthma varied between 1.1% in Lhasa (Tibet) and 11.0% in Hong Kong in studies following the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. The prevalence was 3% or lower in most articles following Chinese diagnostic criteria. One article reported the results from two national surveys and showed that the current average prevalence of asthma for the total study population had increased from 1990 to 2000 (0.9% to 1.5%). The lowest current prevalence was found in Lhasa (0.1% in 1990, 0.5% in 2000). Conclusions The prevalence of childhood asthma was generally low, both in studies following the ISAAC and Chinese diagnostic criteria. Assessment of time trends and regional variations in asthma prevalence was difficult due to insufficient data, variation in diagnostic criteria, difference in data collection methods, and uncertainty in prevalence measures. However, the findings from one large study of children from 27 different cities support an increase in current prevalence of childhood asthma from 1990 to 2000. The lowest current prevalence of childhood asthma was found in Tibet.
      Full-text · Article · Oct 2012 · BMC Public Health
  • Mitch Gersh added an answer:
    Why is it important to understand the differences between diagnoses (i.e., COPD, CHF, ARDS, asthma) when determining appropriate ventilator settings?

    I'm interested in the potential adverse effects when inappropriate settings are made and the challenges clinicians face when making the right choice. Also, how might these decisions change given the particular patient demographic (i.e., neonate, pediatric, adult, geriatric)?

    These questions relate to research I am doing for an article I'm writing for RT: For Decision Makers in Respiratory Care.

    Mitch Gersh

    There are certain guidelines or goals that are universal when managing any patient with respiratory failure and those are ensuring adequate oxygen to the tissues and that is accomplished with adequate hemoglob88 - 90%in and a oxygen saturation of at least 88 - 90%,  There are differences when managing ventilator settings as far as the different pathologies.  We need to understand these to try and prevent barotrauma or make it harder to get our patients off the ventilator.  In Asthma patients we need to remember that these patients have sever airflow obstruction and we may need to allow permissive hypercapnia in order to give them enough time to exhale and ovoid stacking breaths and creating AutoPEEP.  This is also true with severe COPD.  Managing all patients that require mechanical ventilation is improved by being able to assess and adjust the ventilator settings to the individual patient needs.  When you know or can assess the underlying pathology or the reason for mechanical ventilation it does help with initial settings and adjustments.  The other change based on recent literature is that there is danger when giving supplemental oxygen when the SpO2 is greater than 95%.   

  • Roberto Calisti added an answer:
    Could pit latrines be the answer to domestic air pollution in developing countries?

    During the recently concluded CAHRD Meeting held in Liverpool (UK), one of the issues discussed was the prospect of reducing domestic air pollution (from burning biomass) and its negative health consequences, which particularly affects women and children.

    I frequently come across papers reporting the success of domestic and public pit latrines designed to double up as bio digesters to produce bio gas for cooking and lighting purposes.

    My questions are: Could this be the way forward for developing countries? How feasible is it to be scaled up?

    Roberto Calisti

    Dear Colleague,

    in the past, in Italy pit latrines were largely (and partly are still now) diffused in the countryside and in any area where sewers didn't exist.

    It deals of an excellent alternative to spreading on the open terrains (that was often used by old farmers in the aim to manure the fields),  a very useful option to avoid pollution  of drinking water sources and of vegetables and to reduce burnings. 

    The simplest kind of pit latrines, known as "black pit", was static and had to be cleared  out at regular intervals.

    A more complex, largely more useful and today still used model of pit latrines is named "IMHOFF PIT"; it  is based upon two sequenced chambers connected by a pipe and having a final drain to remove the cleared sewage. 

    If you are interested in "IMHOFF PITS", I'll send yo some documents (texts and drawings).

    Best regards

    Roberto Calisti

  • Singh Shivakumar added an answer:
    How can I treat acute asthma in a diabetes patient?

    When do we need to use oral steroids to control an acute asthma in a type 2 diabetes patient?

    What dose could we use?

    Do we need to to use insulin at the same time if the diabetes isn't in control?

    Singh Shivakumar

    Acute severe asthma is a life threatening complication & if there is no response to broncho-dilators , steroids must be used . If they can tolerate oral , it is fine ( 0.5 mg/kg of prednisolone ) . If there is vomIting , IV Methyl prednisolone can be used . The blood sugar can be controlled with insulin . The oral steroids would be needed for a short period & can be replaced by Budesonide nebulizers or inhalers .

  • Paula Herke added an answer:
    How many puffs of corticosteroid inhaler are needed to induce systemic side effect in asthmatic patient?

    Asthma, ICS, MDI, Corticosteroid, Pulmonology  How many buffs of corticosteroid inhaler are needed to induce systemic side effect in asthmatic patient?

    Paula Herke

    Dear Collegeau!

    What do you mean on"systemic side effect". I think one thing is the cortisol suppression and other things are the Cushing-syndrome, the osteoporosis or diabetes.  Sorry:The article is in Hungarian language, but you can use the references. Best regards

  • Joanna Morrell added an answer:
    How to get rid of non-specific signals in the staining of immunofluorescent microscopy?
    We are trying to stain mouse lungs in an allergic asthma model for immunofluorescent microscopy. We are blocking the tissue with unlabeled mouse and goat IgGs, 2% BSA, avidin, and biotin. Nevertheless, we still get a strong non-specific signal mainly from the branchial epithelium filled with mucus. I would appreciate any suggestions on how we could get rid of these non-specific signals.
    Joanna Morrell

    Thanks Berislav!

  • Silvia Josefina Venero Fernández added an answer:
    How can I explore the psychological factors which might have an impact on asthma symptoms what would be the appropriate qualitative study design?

    please let me know and give reference to my objective.

    Silvia Josefina Venero Fernández

    I suggestion use the Beck anxiety and depression but you should consider other factors characteristic of their population

  • Ishag Adam added an answer:
    Do premature infants have a better Apgar's score if their asthmatic mothers get ICS?

    If asthmatic mother get inhaled corticosteroids has fewer or no attacs, better oxygienisation. But the absorbed fraction has effect on her baby. We treat pregnant asthmatic women with budesonide based on safety dates. Has this fraction lungselectivity in embryos too? Can it facilitat the maturation of airways? Have somebody dates? Are there any differents between budesonide, cycloserin, BDP and fluticasone -P/F ?

    Ishag Adam

    Unfortunately asthma itself during pregnancy  has  many  effects  on the mother and unborn  baby.  These can  not be dissected from  the effects of its treatment and we can  hardly say  it is due to  the treatment of Asthma 

  • Majid Mirsadraee added an answer:
    What is your opinion about using antihistamines in asthma?
    Drugs such as Loratadine or Zaditen.
    Majid Mirsadraee

    Low effect high sedation good action in limited subjects

  • Randall C Johnson added an answer:
    Synaptotagmin-13 differentiated expressed in asthma (in 2 different datasets), is it biologically consistent?


    I get 2 geo dataset of RNA expression (http://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE43696 and other), same platform same use, and both bronchial epithelial cells, and classes (control, mild moderate asthma, and severe asthma).

    The aim of all of this was to classify as best as i could with supervised methods. Without FSS (feature subset selection), we got bad results. But, when we reduced both datasets we get AUC > 0.75 as overall. So, this filter is consistent and the sondes(genes) we get are important.

    It is true (and biologically consistent) because we get genes like CPA3, WNK4, SCGB1A1.. Although, we find genes like TDRD5 (spermiogenesis), C12orf39 (agoraphobia), PLAC4 (placenta-especific), and syt13.

    What could you say about this? Are they just some random genes? Or it could be logical to find those things?

    If you want more information about the procedure i have a document about it.

    Thanks in advance.

    Randall C Johnson

    That sounds interesting. A meta analysis including additional data sets would be helpful to reduce the likelihood of false positive associations. Gene-gene and gene-environment interactions are complicated enough that it seems one can always find a plausible mechanism or pathway for just about any gene. Sometimes you find something unexpected (and exciting) that pans out, but often they don't.

  • Closed account added an answer:
    Role of magnesium sulfate in acute exacerbation of bronchial asthma and chronic obstructive airway disease: What is the difference and efficacy?

    Which randomised-controlled trial (RCT) and study have been done to explain this?


    Dear Dr Bikash, Thank you for the thorough explanation with evidence-based supports. 

  • Jamal AlKhateeb added an answer:
    Can anyone recommend literature for Asthma and mental health?

    My background is in mental health, however I am new to the study of asthma. What are the key conversations regarding the interaction of these two elements should I get myself up to speed on?

    Jamal AlKhateeb

    I am researching this topic currently. PubMed, ScienceDirect, ERIC, and SpringerLink provide a comprehensive list of studies related to bronchial asthma and mental health (psychosocial aspects). Good luck.

  • Bizaya Malla asked a question:
    Is KL-6 produced in lung bronchial epithelial cells ?

    I am curious to know if KL-6 protein production is diminished in asthma and COPD. I found literatures suggesting that KL-6 is primarily produced by ALVEOLAR epithelial cells type II, but could not find literatures showing if KL-6 is also produced by brochial epithelial cells. Would be glad to know primary cell culture from bronchial biopsies for expression of KL-6.


  • Pal Bela Szecsi added an answer:
    Does a person whose Total IgE test is positive i.e., concentration of IgE is above the normal level, go for a repeat test in the same year?

    Also, do we have separate kits for reagents, conjugate and calibrators for Allergen Specific IgE or the complete thing comes in one kit? 

    Pal Bela Szecsi

    The short answer is NO.

    Total IgE have limited clinical use and even levels of allergen specific IgE do not reflect clinical symptoms.

    So measure total IgE seldom, and certainly not repeatedly.

  • Oscar L. Sierra added an answer:
    Does anyone have treated A549 cell with IL-13 to induce periostin release?

    In many papers it is mentioned that IL-13 can induce periostin release from airway epithelial cells. But I did not find about the A549 cell. Is there any information regarding the release of periostin from A549 cell after IL-13 treatment?

    Oscar L. Sierra

    The best approach is to have at least two types of cell cultures: 1-regular submerged cells attached to plastic or collagen coated multiwell plates and treat with a known dose of IL-13 and harvest cells at different times for RNA and Western blot. 2-Differentiate cells in air-liquid interfase cultures and do a likewise treatment. If IL-13 does not stimulate periostin mRNA synthesis or protein accumulation then it's unlikely that you'll figure out the proper conditions.

  • Marlina Lovett added an answer:
    When do you use Theophylline in pediatric patients?

    Theophylline in pediatric patients

    Marlina Lovett

    I have seen Aminophylline used for very sick bronchospastic patients.  The times in which I have seen it used, are patients that are either intubated or on high BiPAP settings with a large amount of bronchodilators already being used (continuous albuterol, magnesium, atrovent, IV steroids, +/- ketamine).  But, when it is used, levels are followed quite frequently.

  • Sailesh Palikhe added an answer:
    Does anyone have any idea about cytokines that can induce periostin release?

    I want know whether there are cytokines besides IL-13, that can induce periostin from airway epithelial cells.

    Sailesh Palikhe

    Thank you all for your answers.

    I was looking for cytokines other than IL-13 and IL-4.

    I will try with TNFα and IL-17 to induce periostin release from airway epithelial cells.



  • Michael Rostagno-Lasky added an answer:
    In a metacholine challenge test - I have observed that some patients overcome the challenge test, while some don't - why is it so?

    What is the ratio of negative positive patients passing the induced asthma test even though asthma is duly induced during the test and reversed if proven detrimental?

    Michael Rostagno-Lasky

    Bronchospasm exists on a continuum.  Asymptomatic patients (on days of testing) may pass an MCT on one occasion and fail on another (20% decline in FEV-1).  Some patients who test + on MCT will decline asthma medications stating (to the effect) that their breathing does not improve, and their breathing is fine as is.  Patients on the lower end of normal for FVC will be affected clinically far more by any given degree of bronchospasm than those at the high end (the variability in my experience is that FVC varies from 70 - 169% of predicted, in the absence of any detectable pulmonary pathology (~10,000 patients).  A patient whose FVC was 140% of predicted, & an FEV-1 decline of 35% during MCT, had notable expiratory wheezing, and declared that he felt fine, and had routinely run up many flights of stairs feeling exactly this way in his capacity as a firefighter.  He reacted as expected to albuterol.   I'd expect that had his FVC been 80% of predicted, his clinical appearance and subjective experience during MCT would have been more severe.  Physical exhaustion as the MCT proceeds can bias the test, while remaining repeatable.  Some patients show a sharp decline in FEV-1 on the first FVC, & a considerable increase on trials 2 and 3.  If trials 2 & 3 are used, being repeatable, and trial 1 is discarded, it may miss those patients who rapidly improve post methacholine exposure.  Never under estimate biochemical diversity.  Clinically, choosing whether to treat using only MCT results, may not be optimal for all patients.  

  • Rhonda Vosmus added an answer:
    What percent of asthma in the US is considered moderately persistent, utilizing NHLBI Guidelines?

    I am looking for percent of each severity class (per NHLBI Guidelines)  generally seen in Primary care.  

    Rhonda Vosmus

    helpful.;....thank you......

  • MOHAMMAD Nabavi added an answer:
    Do you consider Bronchial asthma and Hay fever are atopy associations or a collective term for a group of diseases?

    The word ‘atopy’ was introduced by Coca in 1923 as a convenient collective term for a group of diseases, chief among which are asthma and hay fever, which occur spontaneously in individuals who have a family history of susceptibility.

    MOHAMMAD Nabavi

    allergic rhino-sino-tonsilo-adeno-bronchitis is  the correct name of these two condition. in fact you can not manage asthma without considering underlying allergic inflammation of the upper airways and vice verca. Hence the unified airway theory or principle is the correct terminology.

  • Amy C. Paulson added an answer:
    How could we generate an asthma warning system through monitoring environmental factors?

    Asthma is a serious issue. Early warnings for asthmatic are very important. In many countries pollen count or its covering area, pollutants, dust are monitored, but there is a need for combined efforts to minimize the triggers.

    Amy C. Paulson

    We definitely see seasonal variations and geographical variations in asthma exacerbations.  Where I am located is one of the worst places for people who have asthma to live.  It's a combination of factors - long, warm wet growing season; pollen and mold rich environment; and, significant pollution from industry, ports and traffic corridors.  You might take a look at this - I believe they used a modeling approach to determine which areas are the "worst" when multiple factors are considered together.


  • George Christoff added an answer:
    Who knows about ongoing studies of vitamin D as a possible adjunct to standard therapy in paediatric asthma?

    I have published recently about the association between asthma exacerbation and hours of sunlight exposure in UK children. I am interested in undertaking a large study of vitamin D versus placebo to see whether this reduces asthma admissions. Obviously I am aware of the Majak study but does anyone know what active research is going on?

    George Christoff

    This could be of some help as well: http://www.waojournal.org/content/7/1/27

  • George Christoff added an answer:
    How useful are asthma action plans for pediatric asthma patients?

    I am looking into the compliance rate of asthma action plans in the pediatric patient population. How useful are they. Are there results from focus groups regarding asthma action plans?

    George Christoff

    Asthma action plans are the corner stone of modern asthma management. So their usefulness is beyond question. On the other hand it depends to a great extend on patients' compliance. A prerequisite for a high compliance with an asthma action plan is it being tailored to the specific characteristics of the patient group. If you need further information on asthma action plans in different focus groups I suggest you try a search in the medical databases available.

  • Emanuele Cauda added an answer:
    Who should I contact if I wanted a "bronchodilator inhaler" charged with solid spherical microparticles?

    I need to find a company/facility that is interested in loading a drug inhaler cartridge (something generally used for asthmatic people) with monodisperse microsize particles. These are solid spheres in the range of 1-10 um. I want a cheap and quick way to create an aerosol using this inhaler for the testing of samplers. Any suggestion and contacts are very welcome.

    Emanuele Cauda


    Thanks for the suggestion. I searched hard-shell capsules and they might be good for my application. I need to discover though if each capsule can be used only once. If so, this could be problematic considering the cost of the microsphere and the fact I would need few micrograms in the each capsule.


    I am very familiar with cascade impactors and I don't think is what I need for this idea.Thanks

  • Isra Dmour added an answer:
    Any guidelines on dosing with a MDI(metered dose inhaler)in a BE study?

    Any ideas on minimizing inconsistency of dose delivery with MDI's in bio studies. Eg contamination, statics and ?inspirational flow rate? Is this at all necessary?

    Isra Dmour

    I think you may benifit from this:

    Guideline on the Requirements for clinical documentation for Orally Inhaled products (OIP) Including the Requirements for demonstration of therapeutic equivalence between two inhaled products for use in the treatment of ASTHMA and Chronic Obstructive Pulmonary disease (COPD) in Adults and For use in the treatment of Asthma in children and adolescents  CPMP/EWP/4151/00Rev1, 22 January 2009 European Commission, Brussels, ENTR/CT 3, Detailed guidance on the collection, verification and presentation of adverse reaction reports arising from clinical trials on medicinal products for human use, Revision 2, April 2006

    ot this :

    Guideline On The Investigation Of Bioequivalence. Committee For Medicinal Products For Human Use (Chmp), European Medicines Agency (ema), Doc. Ref.: CPMP/EWP/QWP/1401/98 Rev. 1/ Corr, London, 20 January 2010.

                Available at: http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2010/01/WC500070039.pdf

About Asthma

A form of bronchial disorder with three distinct components: airway hyper-responsiveness (RESPIRATORY HYPERSENSITIVITY), airway INFLAMMATION, and intermittent AIRWAY OBSTRUCTION. It is characterized by spasmodic contraction of airway smooth muscle, WHEEZING, and dyspnea (DYSPNEA, PAROXYSMAL).

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