Trajectory of the response to bronchodilator and respiratory outcomes in adults with asthma-like symptoms Daniel Gimenez da Rocha, Monique Olivia Burch, Luciana Aparecida Teixeira Soares, Jessica Regina Bertolino, Ana Lúcia Bergamasco Galastri, et al. Monaldi Archives for Chest Disease, 2026 In the real world, health professionals need to care for individuals with asthma-like symptoms who have a persistently negative bronchodilator response (BDR). Little is known about the evolution of symptoms and lung function of these individuals because they are usually excluded from studies on asthma. The aim of this study was to evaluate whether individuals with asthma-like symptoms but with a persistently negative BDR have a different evolution of symptoms and lung function compared to individuals with asthma proven by positive BDR. This prospective cohort study included adults with asthma-like symptoms. Individuals participated in two visits, 12 months apart. They responded to questionnaires and underwent a spirometry test. In individuals without airway obstruction in the first visit, those with asthma-like symptoms and persistently negative BDR were less likely to lose forced expiratory volume in the first second during follow-up or progress to airway obstruction at the final visit compared to individuals with asthma proven by positive BDR. Among individuals with airway obstruction at baseline, those with asthma-like symptoms and persistently negative BDR were less likely to resolve the airway obstruction during follow-up compared to individuals with asthma proven by positive BDR. In individuals with proven asthma, the emergence or persistence of positive BDR during follow-up was accompanied by a worsening of asthma outcomes compared to the remission of positive BDR. Thus, BRD is an accessible marker of disease progression in individuals with asthma-like symptoms. In individuals with asthma proven by positive BDR, the trend in BDR was associated with the evolution of symptoms and lung function.
Body weight trajectory of non-obese asthmatics: Relationship with inhaled corticosteroids maintenance therapy Monique Olivia Burch, Daniel Gimenez Rocha, Leticia Belleze, Marcos Jose Oliveira Da Silva, Renata Pletsch Assuncao, et al. Allergy and Asthma Proceedings, 2025 Background: It is unclear whether the continuous use of a high dose of inhaled corticosteroids (ICS) could contribute to an unfavorable trajectory in body weight. Objectives: The objective was to evaluate whether a high dose of ICS used continuously for maintenance therapy increases the risk of an unfavorable body weight trajectory in individuals with asthma and who are not obese. Methods: We screened consecutive individuals with chronic respiratory symptoms suggestive of asthma who underwent a medical consultation in any of the 42 public health facilities in the municipality of Jundiaí, Brazil. We included individuals with proven asthma who were ≥ 20 years of age and who had a body mass index (BMI) < 30 kg/m2 on the day of screening for the study. Individuals participated in two study visits 12 months apart, named V1 and V2. Between study visits, individuals had one intermediate consultation with their referring physician. Results: Ninety-nine individuals used a high dose of ICS during the study and 294 used a low-medium dose. The individual with asthma and no obesity and who used a high dose of ICS had a similar risk of having obesity at V2 compared with those who used a low-medium dose (adjusted odds ratio 1.18 [95% confidence interval, 0.46‐3.04]). The probability of gaining weight was similar between the two groups. Conclusion: The use of a high dose of ICS for 1 year does not increase the risk of obesity among individuals with asthma and who are not obese, nor is it associated with an unfavorable body weight trajectory compared with individuals with asthma who were using a low-medium dose of ICS. This information may help reduce fears about using ICS.
Association between Chronic Obstructive Pulmonary Disease and Hearing Loss with Impaired Speech Recognition: A Cross-Sectional Study Leticia Belleze, Monique Olivia Burch, Luciana Aparecida Teixeira Soares, Viviane Cristina Martori Pandini, Raquel Prestes, et al. Audiology and Neurotology, 2024 Introduction: Studies have identified a greater risk of sensory neural hearing loss in individuals with chronic obstructive pulmonary disease (COPD) compared to healthy individuals, but it is unclear whether they are at increased risk of hearing loss with impaired speech recognition. The aim of this study was to assess whether COPD is associated with hearing loss that affects speech recognition. Methods: This is a case-control study. We screened individuals from health facilities in the municipality of Jundiai. We enrolled a test group of individuals with COPD and an age-matched control group composed of individuals with asthma. The selected individuals attended an appointment with a chest physician, responded to questionnaires, and underwent tonal and speech audiometry. Adjusted binary logistic regression analysis evaluated whether COPD was associated with reduced speech recognition. Results: We enrolled 36 individuals with COPD and 72 with asthma. Individuals with COPD were more likely to have a reduced speech recognition compared to asthmatic individuals (reduced recognition of three-syllable words: adjusted OR 3.72, 95 CI [1.38–10.02]) (reduced recognition of monosyllable words: adjusted OR 4.74, 95 CI [1.52–14.76]). Conclusion: We conclude that individuals with COPD from primary and secondary healthcare facilities have at least 38% greater risk of hearing loss with reduced speech recognition compared to an age-matched control group of individuals with asthma recruited from the same facilities. We recommend that longitudinal studies evaluate whether regular screening could contribute to the prevention or early treatment of hearing loss in individuals with moderate-severe COPD.
White piedra on pediatric scalp: A case report Julia Brigagão de Carvalho Sugai, Nayara Pelizaro Di Rito, Alexandre Lourenço, Ronei Luciano Mamoni, Ana Carolina Da Mota Falleiros, et al. Idcases, 2024
Ethanol modulates the effector functions of human monocyte-derived macrophages in response to Paracoccidioides brasiliensis yeast cells Lívia Furquim de Castro, Kamila de Araújo Mathias, Júlia Vieira Nunes, Ana Lúcia Bergamasco Galastri, Dennis Henrique Leandro da Silva, et al. Medical Mycology, 2021 We aimed to investigate the effects of ethanol and its metabolites (β-hydroxybutyrate and sodium acetate) in the effector functions of macrophages in response to Paracoccidioides brasiliensis yeast cells and to determine their influence in the development of the adaptive response. Purified peripheral blood monocytes were differentiated into macrophages and were treated with ethanol, β-hydroxybutyrate, and sodium acetate, and stimulated with P. brasiliensis yeast cells and evaluated for their phenotypic characteristics, functional activity, and capability to induce T cells activation/differentiation. We found that the ethanol treatment diminished the expression of HLA-AB, HLA-DR, CD80, and CD86, modulating the expression of dectin-1, as well as Syk phosphorylation. The ethanol treatment increased the phagocytic activity, expression of CD206, and IL-10 production; however, reduced ROS production, fungicidal activity, caspase-1 cleavage, and IL-1β and IL-6 production. Our data also showed that the presence of ethanol reduced the differentiation of Th1 and Th17 cells and increased the frequency of Th2 cells. Our results indicated that ethanol exposure could suppress effector function of macrophages, possibly leading to the polarization of M2 macrophages. The ethanol modulates the expression of costimulatory and antigen-presentation molecules and interferes with the NLRP3 inflammasome. Altogether, these alterations affect the development of the adaptive response, decreasing the frequency of IL-17, IL-22, and IFN- γ producing cells, and increasing the frequency of IL-4 producing cells. Therefore, exposure to ethanol can impair the capability of macrophages to exert their effector functions and activate the acquired response related to resistance to P. brasiliensis infection.
Cytokines in recurrent pregnancy loss Silvia Daher, Kátia de Arruda Geraldes Denardi, Maria Heloı́sa Souza Lima Blotta, Ronei Luciano Mamoni, Ana Paula Monteiro Reck, et al. Journal of Reproductive Immunology, 2004
