Integrating evidence for managing asthma in patients who smoke

Peer reviewedPublisher PD

Freezing of sputum as a way to improve the applicability of sputum studies

Rationale: Sputum examination is a valuable research tool to study airway diseases, but the requirement to process the samples within 2 hours of their collection poses limitations to its wider applicability. A way to bypass this hurdle would be to freeze the sample at the time of collection and to examine it at a later stage.Methods and Subjects: We developed a protocol for freezing of sputum upon collection by adding dimethylsulfoxide to it. We tested the reproducibility of cell counts in frozen samples and in fresh portions from the same sputum specimens. We took sputum from 41 asthmatics (18 males) with different levels of control of their disease: 19 of the samples were spontaneously produced and 22 were induced with hypertonic saline.Results: Significant correlations (p<0.05) were established between the total cell counts, the relative and absolute number of neutrophils, eosinophils and macrophages in the paired fresh and frozen sputum samples. Cell viability in frozen sputum was slightly but consistently lower. Only one frozen sample had viability < 50%. Outcomes in paired samples from induced sputum had better reproducibility than the spontaneous ones.Conclusion: Examination of frozen sputum samples does not change total cell counts and differential cell counts, despite consistently affecting cell viability compared with fresh sputum cellularity. Still cell viability in frozen sputum was above 50% in all but one examined specimens

Parastatistics Algebra, Young Tableaux and the Super Plactic Monoid

The parastatistics algebra is a superalgebra with (even) parafermi and (odd) parabose creation and annihilation operators. The states in the parastatistics Fock-like space are shown to be in one-to-one correspondence with the Super Semistandard Young Tableaux (SSYT) subject to further constraints. The deformation of the parastatistics algebra gives rise to a monoidal structure on the SSYT which is a super-counterpart of the plactic monoid.Comment: Presented at the International Workshop "Differential Geometry, Noncommutative Geometry, Homology and Fundamental Interactions" in honour of Michel Dubois-Violette, Orsay, April 8-10, 200

Hopf Structure and Green Ansatz of Deformed Parastatistics Algebras

Deformed parabose and parafermi algebras are revised and endowed with Hopf structure in a natural way. The noncocommutative coproduct allows for construction of parastatistics Fock-like representations, built out of the simplest deformed bose and fermi representations. The construction gives rise to quadratic algebras of deformed anomalous commutation relations which define the generalized Green ansatz.Comment: 14 pages, final versio

A real – life observational pilot study to evaluate the effects of two-week treatment with montelukast in patients with chronic cough

BACKGROUND: Different conditions make the proximal airways susceptible to tussigenic stimuli in the chronic cough (CC) syndrome. Leukotrienes can be implicated in the inflammatory mechanism at play in it. Montelukast is a selective cysteinyl-leukotriene receptor antagonist with proven effectiveness in patients with asthma. The aim of our real-life pilot study was to use montelukast to relieve cough symptoms in patients with CC allegedly due to the two frequent causes other than asthma – upper airway cough syndrome and gastroesophageal reflux (GER). METHODS: 14 consecutive patients with CC were evaluated before and after 2 weeks of treatment with montelukast 10 mg daily. Cough was assessed by validated cough questionnaire. Questionnaires regarding the presence of gastroesophageal reflux were also completed. Cough reflex sensitivity to incremental doubling concentrations of citric acid and capsaicin was measured. Lung function, airway hyperresponsiveness and exhaled breath temperature (EBT), a non-invasive marker of lower airway inflammation, were evaluated to exclude asthma as an underlying cause. Thorough upper-airway examination was also conducted. Cell counts, eosinophil cationic protein (ECP), lactoferrin, myeloperoxidase (MPO) were determined in blood to assess systemic inflammation. RESULTS: Discomfort due to cough was significantly reduced after treatment (P < 0.001). Cough threshold for capsaicin increased significantly (P = 0.001) but not for citric acid. The values of lactoferrin and ECP were significantly reduced, but those of MPO rose. EBT and pulmonary function were not significantly affected by the treatment. CONCLUSION: Patients with CC due to upper airway cough syndrome or gastroesophageal reflux (GER) but not asthma reported significant relief of their symptoms after two weeks of treatment with montelukast. ECP, lactoferrin, MPO altered significantly, highlighting their role in the pathological mechanisms in CC. Clinical trial ID at Clinicaltrials.gov is NCT01754220

Performance of database-derived severe exacerbations and asthma control measures in asthma : responsiveness and predictive utility in a UK primary care database with linked questionnaire data

Peer reviewedPublisher PD

Real-life biomarker response to anti-IL5 and anti-IgE therapies in severe asthma patients

Funding: This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was partially funded by Optimum Patient Care Global and AstraZeneca Ltd. No funding was received by OPRI for its contribution.Peer reviewedPostprin

Characterization of patients in the International Severe Asthma Registry with high steroid exposure who did or did not initiate biologic therapy

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