| 1. |
- Matabuena, Marcos, et al.
(författare)
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Identification of Asthma Phenotypes in the Spanish MEGA Cohort Study Using Cluster Analysis
- 2023
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Ingår i: Archivos de Bronconeumologia. - : Elsevier BV. - 0300-2896. ; 59:4, s. 223-231
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The definition of asthma phenotypes has not been fully established, neither there are cluster studies showing homogeneous results to solidly establish clear phenotypes. The purpose of this study was to develop a classification algorithm based on unsupervised cluster analysis, identifying clusters that represent clinically relevant asthma phenotypes that may share asthma-related outcomes. Methods: We performed a multicentre prospective cohort study, including adult patients with asthma (N = 512) from the MEGA study (Mechanisms underlying the Genesis and evolution of Asthma). A standardised clinical history was completed for each patient. Cluster analysis was performed using the kernel k-groups algorithm. Results: Four clusters were identified. Cluster 1 (31.5% of subjects) includes adult-onset atopic patients with better lung function, lower BMI, good asthma control, low ICS dose, and few exacerbations. Cluster 2 (23.6%) is made of adolescent-onset atopic asthma patients with normal lung function, but low adherence to treatment (59% well-controlled) and smokers (48%). Cluster 3 (17.1%) includes adult-onset patients, mostly severe non-atopic, with overweight, the worse lung function and asthma control, and receiving combination of treatments. Cluster 4 (26.7%) consists of the elderly-onset patients, mostly female, atopic (64%), with high BMI and normal lung function, prevalence of smokers and comorbidities. Conclusion: We defined four phenotypes of asthma using unsupervised cluster analysis. These clusters are clinically relevant and differ from each other as regards FEV1, age of onset, age, BMI, atopy, asthma severity, exacerbations, control, social class, smoking and nasal polyps.
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| 2. |
- Acevedo-Prado, Antonio, et al.
(författare)
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Association of rhinitis with asthma prevalence and severity
- 2022
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Asthma and rhinitis often co-exist in the same patient. Although some authors observed a higher prevalence and/or greater severity of asthma in patients with rhinitis, this view is not homogeneous and the debate continues. The aim of our study is to describe the prevalence of rhinitis in children and adolescents and to analyse their relationship with the prevalence of asthma. A multicentre study was conducted using the methodology of the International Study of Asthma and Allergies in Childhood (ISAAC). The target population of the study was all those school children aged 6–7 and 13–14 years from 6 of the main health catchment areas of Galicia (1.9 million inhabitants). The schools required were randomly selected, and all children in the targeted age ranges were included. Multiple logistic regression was used to obtain adjusted prevalence odds ratios (OR) between asthma symptoms of the schoolchildren and rhinitis prevalence. The results were adjusted for parental smoking habits, maternal education level, cat and dog exposure, and obesity. A total of 21,420 valid questionnaires were finally obtained. Rhinitis was associated with a significant increase in the prevalence of asthma in both age groups. The highest OR were 11.375 for exercise induced asthma (EIA) for children with recent rhinoconjunctivitis and 9.807 for children with recent rhinitis in 6–7 years old group. The prevalence OR’s are higher in EIA and severe asthmatics. Rhinitis in children and adolescents is associated with a higher prevalence and severity of asthma.
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| 3. |
- Salgado Castro, Francisco Javier, et al.
(författare)
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Proteomic analysis of food allergens
- 2022
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Ingår i: Food Proteomics : Technological Advances, Current Applications and Future Perspectives - Technological Advances, Current Applications and Future Perspectives. - 9780323908900 - 9780323908894 ; , s. 225-300
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Bokkapitel (refereegranskat)abstract
- Food allergies are a growing health problem that generate high costs for health systems. Food allergies have a prevalence of 6-8% in children and 2-3% in adults, which is increasing in the last 10 years due to industrialization. The wide variety of ingredients containing food allergens, in combination with the high number of product formulations and processing methods to produce food makes allergen detection a challenge. It is important to highlight that even trace amounts of allergens are able to elicit allergic reactions and the commercialization of food products with a potential health risk is forbidden (European Union Regulation (EU) 178/2002). Hence, precautionary allergen labeling must be provided in the different food products. In addition, this creates a real need for the development of highly sensitive and reliable techniques that allow the detection and quantification of multiple allergens present in trace amounts. This, together with the possibility to perform new allergen discovery studies (shotgun proteomics), makes Proteomic approaches a widely used methodology in this field. In this chapter we summarize the current knowledge regarding food allergies and the proteomic studies performed for the analysis of the different allergens. We briefly describe immunological processes underlying the different types of food allergies, the causative allergens involved in these processes, as well as the different proteomic approaches developed to identify (e.g., LC-MS/MS) and quantify (e.g., targeted proteomics such as selected/multiple reaction monitoring, SRM/MSM) these allergens in different conditions (e.g., complex mixtures, ultra-processed food, etc). Moreover, we have performed a comprehensive review of the different allergens and proteomic studies carried out in the field of plant food allergies, including gluten related disorders (GRDs), pollen-fruit allergy syndrome (PFAS), legumes allergy, and tree-nuts allergy, as well as animal food allergies, including cow´s milk, red meat, egg, fish, and shellfish allergies.
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| 4. |
- Rodríguez-García, Carlota, et al.
(författare)
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Efficacy of mepolizumab in usual clinical practice and characteristics of responders : Mepolizumab in usual clinical practice
- 2021
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111. ; 187
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Tidskriftsartikel (refereegranskat)abstract
- Background: Severe eosinophilic asthma is a high-burden disease. Mepolizumab has been effective in several randomized clinical trials. However, such success might not be applicable to patients treated in usual clinical practice. The objectives of this article are to evaluate the efficacy of mepolizumab in severe uncontrolled eosinophilic asthma under usual clinical practice, and to determine characteristics associated with the response to this treatment. Methods: We have conducted a retrospective, multicentre study, including all adult patients with severe uncontrolled eosinophilic asthma in Galicia, Spain, on whom mepolizumab treatment was started before June 2020, at least 6 months before the time of inclusion, and had received at least one dose of the drug. Patient characteristics, clinical data, respiratory function and comorbidities were collected at baseline and at the 6-month-follow-up. Responders and super-responders were defined according to clinical response and requirement of systemic corticosteroids. Results: 122 patients (mean age 58 years old) were included. In the follow-up treatment 6 months later, 75.4% of the patients were well-controlled, displaying a significant reduction in blood eosinophil counts (p < 0.001), hospital admissions and disease exacerbations (p < 0.001), and had their systemic glucocorticosteroid dose significantly reduced (p < 0.001). The inhaled corticosteroid dose was also lowered (p < 0.01) after 6 months of treatment. Around two-thirds had a clinically significant increase in FEV1, 95% of the patients were considered responders and 43% super-responders. Conclusion: In routine clinical practice, mepolizumab is effective in patients with severe eosinophilic asthma and it has a good safety profile.
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