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Showing 13 results for Asthma
Methotrexate in the treatment of steroid dependent asthma
Derakhshan Deilami Gh, Mehrabi S,
Volume 58, Issue 2 (5-2000)
Abstract
Despite the role of oral corticosteroids in management of sever asthma, use of these drugs needs careful awareness of its many side effects. There are controversies about the role of methotrexate in lowering the need for corticosteroides in these patients. In this study an attempt has been made to determine methotrexate effects in corticosteroid dependent asthma. Six patients were entered in a double-blind placebo controlled crossover trial and randomly allocated to two groups. Each group got a 12 weeks course of treatment with 15 milligrams of methotrexate or placebo which thereafter was changed to the other regimen. In comparison with placebo, methotrexate caused a 62.5% less need for oral corticosteroid (P<0.01) and a 20% increase in FEV1 (P<0.05). We concluded that the use of low doses of oral methotrexate results in less need for oral corticosteroid in treatment of corticosteroid dependent asthma.
The effect of influenza vaccination in the prevention of exacerbation of children asthma
Gharagozlou M, Montazeran M, Foroozanfar M, Khalili S,
Volume 64, Issue 11 (10-2006)
Abstract
Background: Influenza epidemies which occur mosthly in cold seasons could be a risk factor for developing exacerbations and acute attacks of asthma. Although influenza vaccination is recommended for the asthmatic patients, there is a lack of sufficient clinical evidence that this annual vaccination prevents asthma exacerbation in children.
Methods: Prospective clinical trial study of 201 children with asthma, where 79 did, and 122 did not receive the influenza vaccine, was done. The two groups were compared with respect to use of bronchodilators, systemic corticosteroids, emergency department (ED) visits and hospitalizations for asthma. In multi variable analysis, adjustment was made for baseline asthma severity and demographic variables.
Results: After adjusting for other variables, the vaccinated group had a significant decreased in exacerbations frequency and duration. Also the frequency of used bronchodilators and the absence days of daycare center or school were lower in the vaccinated group (P<0.05). There was no significant difference between the two groups in relation to used systemic corticosteroids and ED or hospital admissions (P>005).
Conclusion: This study showed that influenza vaccination may be effective in prevention of some asthma exacerbation aspects.
Pet ownership and risk of asthma: a case-controlled study
L Sharifi, Z Pourpak, S Bokaie, A Karimi, M Gharegozloo, M Movahhedi, M Moin,
Volume 66, Issue 5 (8-2008)
Abstract

Background: In the treatment of bronchial asthma, the identification, isolation, and elimination of causative allergens is the most effective part of treatment. With the recent diversification within the pet industry, pet owner exposure to many unknown antigens is on the rise. The results of population studies have been contradictory and some epidemiological studies have failed to confirm this, some indicating that keeping pets might actually reduce the risk of sensitization and asthma. The purpose of this study was to determine the association between pet ownership and asthma.

Methods: This case-control study included 300 asthmatic participants referred to the Children's Medical Center over a two-year period. Participants were asked to fill out a questionnaire regarding pet ownership, pet gender and puberty, the place it was kept, how long the pet was kept and the reason for keeping the pet. The same questions were asked from 300 age- and gender-matched nonasthmatic individuals as the control group. Statistical analysis was performed to calculate odds ratios (OR) of asthma morbidity in individuals who kept pets.

Results: The OR for asthma morbidity in patients who kept pets was 2.59 (CI=1.60-4.21 and p>0.001). Financial aim was the most common reason for keeping a pet and most pets were mature and kept outdoors. No significant correlations for pet genders were observed.

Conclusion: This survey provides evidence that pet ownership is an important risk factor for asthma, therefore we suggest that individuals at risk for asthma (atopic individuals) must avoid contact with pets. However, more research in this field in Iran is necessary.


Childhood asthma prevalence and parents’ daily cigarette smoking: a case - control study
Sharifi L, Pourpak Z, Bokaie S, Karimi A, Movahedi M, Gharaghozlou M, Moin M,
Volume 67, Issue 9 (12-2009)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Asthma prevalence has increased in developed and developing countries in several last decades. Although cigarette smoking is an identified risk factor for many diseases such as coronary Heart disease and chronic obstructive lung disease, its effect on asthma is controversial. The aim of this study was to determine the odds ratio and its confidence interval for asthma morbidity among children referred to the Immunology and Allergy department of children medical center according to their parents' smoking and daily cigarette consumption.
Methods: A case-control study was conducted during two years period on the asthmatic patients who referred to Immunology and Allergy department of children medical center. Demographic information and parents' smoking and daily cigarette consumption assessed by a questionnaire. Healthy children with same age and sex were entered to the study as the control group. Statistical analysis was performed to calculate odds ratio.
Results: Among 215 patients who entered the study 63 patients were exposed the cigarette smoke. Odds ratio for asthma morbidity among children whose parents smoke more than five cigarettes per day in comparison with whose smoke less than five or do not smoke was 2.38 (p<0.01).
Conclusion: Parent's cigarette smoking is a risk factor for childhood asthma and could increase the risk of asthma to 2.38 folds in children whose parents smoke more than five cigarettes. Increasing in parents' knowledge level that probably relate to their education results in cigarette consumption decline.


The effects of aerobic and strength exercises on pulmonary function tests and quality of life in asthmatic patients
Fesharaki M, Omolbanin Paknejad Smj, Kordi R,
Volume 68, Issue 6 (9-2010)
Abstract

Background: Asthma is a major health condition in Iran. This randomized clinical trial was aimed for the comparison of the effects of two exercise protocols (aerobic and aerobic-strength) on the pulmonary indices and quality of life of asthmatic patients.

Methods: The study was conducted in pulmonary ward of Dr Shariati Hospital in Tehran, and Research Center of Exercise Medicine of Tehran in 2009. Fifty six asthmatic patients were selected and after two weeks of education, their spirometric parameters were recorded and the St George's respiratory questionnaire was completed. Then patients were randomly assigned to two groups of A and B. For ten weeks group A did the aerobic-strength exercises and group B did only the aerobic ones at home. At the end, again their spirometric parameters were recorded and the questionnaire was completed. Finally 42 patients completed the study.

Results: After the intervention, FEV1 and FVC but not FEV1/FVC increased in group A. There were no changes in these parameters in group B. In addition, post-intervention FEV1 and FVC were significantly higher in group A than group B. All scores of St George's respiratory questionnaire were significantly improved in both groups but they were not different between them.

Conclusions: Our findings showed that regular aerobic exercises, individually or concomitant with strength exercises, could improve vital signs and quality of life of mild to moderate asthmatic patients. However, only aerobic exercises with strength ones improve spirometric parameters. Therefore, a combination of both aerobic and strength exercises could be considered in treatment protocols of asthmatic patients.


The association between methacholine challenge test and respiratory symptoms: a study on 146 patients
Paknejad O, Hojjati Sa, Pazoki M,
Volume 68, Issue 11 (2-2011)
Abstract

Background: Asthma is a life-threatening disease that can cause death due to bronchospasm. In addition to clinical symptoms such as wheezing, acute paroxysmal dyspnea, chronic cough after exposure to cold air or cough after exercise, spirometry is also necessary for the diagnosis of asthma. The association between respiratory symptoms and a positive methacholine challenge test (MCT) is still controversial. The aim of this study was to determine the association between methacholine test results and respiratory symptoms and allergy.

Methods: One hundred and forty-six patients with respiratory symptoms and normal baseline pulmonary function tests were enrolled in this cross-sectional study. The participants were divided into two groups according to their positive or negative response to MCT. The association between MCT and the clinical symptoms and allergy was later evaluated statistically.

Results: Out of 146 participants of the study 59 (40.4%) were female and 87 (59.6%) were male. The mean age of the participants was 33.8±13.8 years. Sixty-one patients (41.8%) had positive results for the test. There was an association between a history of allergy, wheezing and age with positive MCT results. The other clinical signs had no association with the test.

Conclusion: Methacholine challenge test is the best diagnostic test for ruling out asthma in patients with normal pulmonary function tests in whom we cannot definitely rule out asthma based solely on clinical symptoms. Nevertheless, in adults with a history of allergy, wheezing and also in patients below 30, the probability for a positive MCT is high.


Role of the immune cells, mediators and cytokines in pathogenesis of asthma: a review article
Sedigheh Bahrami Mahne, Seyed Alireza Mahdaviani , Nima Rezaei ,
Volume 72, Issue 5 (8-2014)
Abstract
Asthma is a chronic inflammatory disorder of the airways, associated with airway re-modeling and hyperresponsiveness. It is expressed that asthma influences about 300 million people around the world, which is estimated to increase to about 400 million by 2025. The prevalence rate is 15 to 20 percent in children and 5 to 10 percent in adults, while its trend is still increasing. Inflammation plays an important role in the patho-physiology of asthma, which involves an interaction of different types of the immune cells and mediators. It leads to a number of pathophysiology changes, including bron-chial inflammation, airway obstruction, and clinical episodes such as cough, wheeze and shortness of breath. Asthma is now greatly being introduced as a heterogeneous disorder and it is pointed out to the role of T cells, including Th1, Th2, Th17, and regu-latory T cells. Other immune cells, especially neutrophils, macrophages and dendritic cells, as well structural cells such as epithelial and airway smooth muscle cells also pro-duce disease-associated cytokines in asthma. Increased levels of these immune cells and cytokines have been recognized in clinical samples and mouse models of asthma. Different cytokines, including pro-inflammatory cytokines (such as TNFα, IL-1, and IL-6), T helper 2 cytokines (such as IL-4, IL-5, IL-9, IL-13), and growth factors (such as GM-CSF, PDGF) play a role in the pathogenesis of asthma. Indeed chemokines (such as MPC-1, RANTES , MIP-1) and the chemokine receptors (such as CCR3, CCR4, CCL11, CCL24, and CCL26) play an important role in the recruitment of circu-lating inflammatory cells into the airways in asthmatic patients and also is related with increased T helper 2 cytokines after inhaled allergens. Among new approaches, treat-ment of asthma with anti-cytokine drugs such as antibodies blocking IL-4, IL-5, IL-9 could reduce recruitment inflammatory cells into the airways and remodeling. The final perspective of asthma treatments would be to alter from the symptomatic treatments to disease modifying.
Evaluation of IL-17 gene expression in peripheral blood and sputum of asthma patients and healthy individuals
Reza Yazdani , Mazdak Ganjalikhani Hakemi, Roya Sherkat , Abbas Rezaei , Rahim Farahani , Behrouz Beiranvand ,
Volume 72, Issue 9 (12-2014)
Abstract
Background: Asthma as an airway disease is identified by increase network respon-siveness of the trachea and bronchus to a specific stimulus. Th17 cells through produc-tion of IL-17 have important role in inflammation and autoimmune diseases .In some studies has been shown which IL-17 as major cytokine of Th17 probably has im-portant role in the pathogenesis of allergy and asthma. Methods: Total mRNA extracted from whole blood samples and sputum of 23 asthma patients and 23 normal controls. Then, total RNA was converted into cDNA according to the manufacturer’s instructions. Finally, the transcript levels of IL-17 were quanti-fied by the real-time quantitative PCR. Twenty-three patients with asthma were diag-nosed and selected according to the global initiative for asthma (GINA) and none of the patients had taken the medication at least three week before sampling. Healthy in-dividuals did not have any history of allergy, asthma and other inflammatory diseases at the time of sampling. All of experiments have done in Isfahan University of Medical Sciences, Iran during May to February, 2013. Results: This study showed a significant increase in transcript levels of IL-17 in the blood (287±79 versus 1/18±0/13) and sputum samples of the patients (64±28 versus 0/9±0/1) in comparison with normal individuals (P= 0.000, P= 0.029 respectively). It al-so revealed that the expression levels of the cytokines in the serum samples of the asthmatics were significantly more than their levels in patient’s sputum samples (P= 0.000). However, there was no significant difference between the cytokines expression levels in serum samples and sputum samples of the controls (P> 0.05). Conclusion: In this study, we showed which the expression of IL-17 was increased in serum and sputum of asthmatic patients compared to healthy controls, this could re-sult in elevation of neutrophils population and activation of pulmonary neutrophil.
Effect of mesenchymal stem cells on allergic asthma in mouse model
Reza Habibian , Nowruz Delirezh , Amir Abbas Farshid ,
Volume 73, Issue 5 (8-2015)
Abstract
Background: Allergic Asthma is an inflammatory disease of the respiratory system that is well known by increased inflammatory cells in the airways and causes difficulty in respiration. The prevalence of allergic asthma is increasing worldwide, and it has become a significant cause of health challenge especially in developed countries. Inhaled β2-agonists and Inhaled or oral corticosteroids are common medications for treating the disease, but they cannot be used for long periods of time because of frequently occurring side effects and they can’t change the main pathogenesis of the problem. Deficiency in regulatory system against inflammation could be an important factor in allergic asthma. Mesenchymal stem cells (MSCs) have potential of cellular immunosuppressive therapy of inflammatory disorders. The aim of present study was to evaluate the effects of MSC therapy on mechanisms of allergic asthma in mice model. Methods: This experimental study was conducted from August 2014 to March 2015. The animals were housed and maintained in Biotechnology Center of Urmia University, Iran. Mice were sensitized by intra-peritoneal injection of ovalbumin (OVA) and aluminum hydroxide emulsion and then were challenged intra-nasally with OVA. Before allergen challenge on day 14, experimental mice received tail vein injection of MSCs in PBS. Regulatory T cells of spleen, cytokines and IgE analysis were carried out using lungs wash as well as serum samples. Results: Our results showed that MSCs significantly reduced total cells and eosinophilia, serum OVA-specific IgE concentration in OVA-sensitized and challenged mice. Also results showed that MSCs markedly inhibited expressions of Th2 cytokines and elevated levels of Treg cells and Treg cytokines. Conclusion: In the present study, we demonstrated the inhibitory effect of MSCs on airway inflammation using mice model of allergic asthma. The mice were sensitized with OVA and compared to the results of dexamethasone administration. Our results demonstrated that administration of MSCs could be used as a potential therapeutic approach for the allergic asthma.
A review on the relation between obesity and vitamin D with pediatric asthma, and a report of a pilot study in Tehran, Iran: review article
Mansoureh Shariat, Ezoddin Rostamian, Heshmat Moayeri, Mamak Shariat, Laleh Sharifi,
Volume 78, Issue 5 (8-2020)
Abstract
Asthma is an inflammatory and chronic disease that affects about 300 million people globally. The disease is more common in developed countries. The increase in the prevalence of asthma is not only due to genetic factors, but also to many environmental factors related to urbanization and type of nutrition. It has been reported that obesity is an independent risk factor for asthma and obese children are at higher risk of asthma. The researchers found that many of the common phenotypes of obesity and asthma are due to genetic effects and some genetic component is common to asthma and obesity. Genetic data suggest that there are areas of genetic overlap between the obesity and asthma genes. These children experience more severe asthma and have a poor treatment outcome. On the other hand, there is an association between vitamin D deficiency in the earlier stages of life and incidence of asthma in the following years. Interestingly, obesity is a common risk factor for both asthma and vitamin D deficiency. Therefore, study on the interaction of asthma, obesity, and vitamin D deficiency may play an important role in unraveling the intricate nature of asthma. Prevalence of Pediatric asthma in 6-7 and 13-14 years-old children has been reported more than 10% in Iran. In this review we aimed to assess the latest findings about pediatric asthma and its association with obesity and vitamin D in Iran and the other countries. In addition, the results of a pilot study that has examined the frequency of overweight and obesity, as well as vitamin D deficiency in children with asthma in Tehran, are briefly presented. Enrolling a national study on obesity and vitamin D levels in children with asthma, can provide excellent information on the effects of obesity and vitamin D deficiency on asthma in Iranian children. Also the results could provide a basis for ecological studies to measure correlation between pediatric asthma and Sunlight and food and cultural habits in different parts of the country. Also, it is recommended that for a better understanding of the subject, experimental studies examine the effect of vitamin D supplementation and vitamin D-rich diets on the prevention and treatment of pediatric asthma in different age groups as well as different ethnicities of Iran.

The prevalence of respiratory allergens in patients with asthma and allergic rhinitis in Ardabil province
Rasool Molatefi, Adel Ahadi, Hossein Salehzadeh, Elham Safarzadeh, Hadi Abbasi,
Volume 78, Issue 8 (11-2020)
Abstract
Background: Because of geographic variation and regional types of allergens, it is recommended that allergists identify common allergens in their area of activity. In the present study, the prevalence of respiratory allergens in patients with asthma and allergic rhinitis was investigated.
Methods: This study is descriptive and retrospective. The required data of this study were extracted from the records of 661 patients who were referred to the Asthma and Allergy Clinic of Ardabil University of Medical Sciences (Ardabil province, Northwest of Iran) from April 2016 to March 2017. After confirmation of allergic asthma or rhinitis by the asthma and allergy specialist, these patients were subjected to a prick test with allergen extracts. In the group of grasses the extract of nine grasses, in trees the extract of 11 Tree mix, in weeds the extract of Common weed mix, in animal allergens the three extracts of Standard cat, Dog epithelia, Cockroach mix, in weeds the Mite mix and in fungi, three extracts of Mold mix1, Alternaria and Aspergillus mix were used. All the data were analyzed using SPSS software, version 25.
Results: According to results, of the 661 patients who were studied, 462 ones had positive and 273 had significant prick test results. The grasses group with 293 positive (44.3%) and weeds group with 259 positive results (39.2%) were more common than the other categories. Among the significant positive tests, these two categories with 161 and 142 significant positive tests were indicated as the most common allergens. Respiratory allergens were also more common in patients with a family history of allergies in weeds and trees categories, but there was no significant difference in sensitization pattern according to the history of tonsillectomy.
Conclusion: Patients in Ardabil with allergic rhinitis and asthma were more sensitized to weeds and grass mixtures. It is recommended to provide preventive recommendations to allergic patients and the development of localized skin testing packages and additional studies should be conducted focusing on these two categories of allergens.

Prevalence of asthma in iranian children: a meta-analysis and meta-regression
Seyed Vahid Jasemi, Maryam Janatolmakan, Masoud Mohammadi, Alireza Khatony,
Volume 79, Issue 6 (9-2021)
Abstract
Background: Asthma is the most prevalent chronic disease in childhood and has been growing globally over the last three decades. Studies in this regard indicate different and irrelevant results in Iran. Different prevalence of asthma has been reported in industrialized countries, prevalence of 25.9% in the United Kingdom, 12.8% in Spain and 31% in Australia. This study aimed to evaluate asthma in Iranian children through systematic review and meta-analysis.
Methods: This study was performed as a systematic review and meta-analysis from January 2001 to December 2018. Related articles to the reviewed subject were obtained through searches of Scopus, ScienceDirect, Magiran, SID, Medline (PubMed), and Google Scholar databases. Cross-sectional studies were selected for inclusion in the study and observational studies as well as review studies were excluded from the study. Searches on Google search engine and the inspection of sites related to the topic were also incorporated to examine the grays literature. Duplicate articles and articles that were similar and obtained from the same source were removed through the EndNote software. The total number of articles was 896. Subsequently, the number of articles and studies that met the requirements of the first stage was 274. Ultimately after the elimination of 236 irrelevant articles and the elimination of 5 articles in the secondary examination, eventually 33 articles were added to the final stage. By the I2 index, the heterogeneity of the studies was investigated and reported.
Results: In a survey of 33 studies and 97205 participants in the age range of (3-18) years, the general prevalence of asthma in this study based on meta-analysis was 5.1% (CI95%: 4-6.5%). The highest prevalence of asthma was among children from Babol which was 19% (CI95%: 17.8% -20.3%) in 2014 and the lowest prevalence of asthma was among children from Isfahan with 0.7% of prevalence (CI95%: 0.5-1.1) in 2001. Also, with the increase of research years and overall sample size in each study, asthma in children shows increasing and decreasing levels, respectively; and the differences were statistically significant.
Conclusion: Based on what was reported in this study, the prevalence of asthma among Iranian children is lower compared to children of developed countries.

Two asthma control test for children and asthma control questionnaire in pediatric asthma patients referred to taleghani hospial clinics, Gorgan
Mohsen Ebrahimi, Zahra Valipour Moghadam , Seyed Ali Aghapour, Azam Rashidbaghan,
Volume 81, Issue 7 (10-2023)
Abstract
Background: Asthma is a chronic inflammatory disease of the airways. Various tests and questionnaires are designed to monitor the severity of asthma and help the therapist and the health system prescribe the best treatment to control it. This study was designed to compare two methods Asthma Control Questionnaires (ACQ) and Asthma Control test-child (ACT-CHILD) in children with asthma.
Methods: This descriptive cross-sectional study was conducted on 92 children with asthma referred to the Taleghani hospital, Gorgan, in 2022-2023. Patients were in a range of age 4-16 years. Asthma control was evaluated and compared by two methods ACT-CHILD and ACQ. ACT-CHILD included one version for 4-11-year patients completed by their parents and another one for 12-16 –year patients completed by the patients. The clinical symptoms, age, gender and the parents' records related to asthma were completed during the clinical interview. Data was analyzed using Chi-square and Spearman correlation tests. The degree of agreement between two questionnaires was determined using the Kappa coefficient.
Results: 84 children aged 4-11 years (91.3%) and 8 children aged 12-16 years (8.7%) were included in the study. According to the ACT-CHILD, 40.2% of children (n=37) had controlled asthma, 44.6% (n=41) had partially controlled asthma, and 15.2% (n=14) had uncontrolled asthma. Based on the ACQ, controlled asthma was observed in 18.5% (n=17), partially controlled asthma in 35.8% (n=33), and uncontrolled asthma in 45.7% (n=42) of children. Asthma control results based on two questionnaires were significantly different from each other (P<0.001). The agreement between the ACT-CHILD and ACQ methods in evaluating children's asthma was at a weak level (P=0.014, κ=0.157), however, a significant negative correlation was observed between the scores of the ACT-CHILD and ACQ questionnaires (r=-0.588, P>0.001) which after categorizing based on age group, this correlation was confirmed only in children aged 4-11 years (r=-0.627, P>0.001).
Conclusion: Our findings showed that there is a poor agreement between ACT-CHILD and ACQ results in the assessment of asthma control. Further studies are recommended.

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