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Aspirin-exacerbated respiratory disease (AERD) consists of asthma, chronic rhinosinusitis with polyps, and hypersensitivity to aspirin and/or nonsteroidal anti-inflammatory drugs (NSAIDs). Nasal Lysine Aspirin Challenge is an effective tool for the diagnosis of hypersensitivity to aspirin and/or NSAIDs in patients with AERD. However, there is no unified international consensus version to perform nasal provocation tests (NPTs).To investigate the effect of a leukotriene receptor antagonist (LTRA), montelukast, on the lysine-acetylsalicylate (L-ASA) nasal challenge.We included 86 patients divided into 3 samples: group A (AERD without LTRA), group B (AERD with LTRA), and the control group (NSAID-tolerant asthmatics). NPT with L-ASA was performed with 25 mg of L-ASA every 30 minutes 4 times followed by rhinomanometry and spirometric measurements and evaluation of symptoms using a novel clinical scale.In group A, 94.5% of patients (35 of 37) developed a positive response to NPT (drop40% in total nasal flow), whereas only 46% of group B subjects (13 of 28) showed a positive response to the nasal challenge (P.001). Control subjects did not show any response to the L-ASA challenge. A novel clinical score demonstrated accuracy in classifying the hypersensitivity to aspirin and/or NSAIDs when patients avoid LTRA (33 of 37).Patients with AERD without LTRA showed a greater positive response to the L-ASA challenge than those taking this drug; therefore, LTRA treatment should be discontinued before the challenge for optimal diagnostic accuracy.

Introduction: Subcutaneous allergen-specific immunotherapy (SCIT) is one of the main cornerstones in the treatment of allergic rhinitis in pediatric patients. It has demonstrated symptoms and quality of life improvement, but it is not exempt from adverse reactions (ADVrs). Nevertheless, there are a few reports that have evaluated their safety. Our objective was to evaluate the ADVr to SCIT in pediatric patients. Methods: We reviewed 786 clinical records with SCIT from 2005 to 2018, comparing the clinical characteristics of patients with ADVrs with SCIT versus a group of a similar number of patients who completed SCIT (control group, CG). The analysis of ADVrs was according to the World Allergy Organization (WAO) 2010 grading system by frequency analysis, survival curve, and log rank. Results: Of 786 patients, 106 (13.4%) presented ADVrs, and the patients with ADVr had sensitivity and immunotherapy with at least 2 allergens versus CG p < 0.001, containing a combination of standardized and nonstandardized allergens (p = 0.003). The ADVrs were in the buildup phase (p < 0.001). The survival curve showed that 50% had some reaction at 12 weeks of SCIT. The most frequent ADVr was grade 1 in 73/106 patients (68.8%) and grade 2 in 33/106 (31.1%). The log-rank analysis between the grades of the WAO grading system showed a statistically significant difference (p = 0.02). Conclusions: The SCIT is safe in pediatric patients. The ADVrs are infrequent, grade 1 being the most reported; however, at >12 weeks, the risk of ADVrs that involve 2 organs systems increases.

Asthma is a chronic inflammation of lower airway disease, characterized by bronchial hyperresponsiveness. Type I hypersensitivity underlies all atopic diseases including allergic asthma. However, the role of neurotransmitters (NT) and neuropeptides (NP) in this disease has been less explored in comparison with inflammatory mechanisms. Indeed, the airway epithelium contains pulmonary neuroendocrine cells filled with neurotransmitters (serotonin and GABA) and neuropeptides (substance P[SP], neurokinin A [NKA], vasoactive intestinal peptide [VIP], Calcitonin-gene related peptide [CGRP], and orphanins-[N/OFQ]), which are released after allergen exposure. Likewise, the autonomic airway fibers produce acetylcholine (ACh) and the neuropeptide Y(NPY). These NT/NP differ in their effects; SP, NKA, and serotonin exert pro-inflammatory effects, whereas VIP, N/OFQ, and GABA show anti-inflammatory activity. However, CGPR and ACh have dual effects. For example, the ACh-M3 axis induces goblet cell metaplasia, extracellular matrix deposition, and bronchoconstriction; the CGRP-RAMP1 axis enhances Th2 and Th9 responses; and the SP-NK1R axis promotes the synthesis of chemokines in eosinophils, mast cells, and neutrophils. In contrast, the ACh-α7nAChR axis in ILC2 diminishes the synthesis of TNF-α, IL-1, and IL-6, attenuating lung inflammation whereas, VIP-VPAC1, N/OFQ-NOP axes cause bronchodilation and anti-inflammatory effects. Some NT/NP as 5-HT and NKA could be used as biomarkers to monitor asthma patients. In fact, the asthma treatment based on inhaled corticosteroids and anticholinergics blocks M3 and TRPV1 receptors. Moreover, the administration of experimental agents such as NK1R/NK2R antagonists and exogenous VIP decrease inflammatory mediators, suggesting that regulating the effects of NT/NP represents a potential novel approach for the treatment of asthma.

Micro- and nanostructures of ZnO co-doped with Er and Li ions have been grown by a catalyst free vapor-solid method under constant N2 flux. Nanowires and nanobelts with lengths of several microns, and thicknesses of a few hundreds of nanometers have been obtained. Scanning Electron Microscopy (SEM), X Ray Microanalysis (EDS) and micro-Raman spectroscopy have been used to characterize the samples. Luminescent emission has been studied by cathodoluminescence (CL). Modifications in the defect structure due to Li incorporation are observed. An increase in the relative intensity of the Er3+ - related 0.8 eV (1.54 µm) emission band in the co-doped samples has been observed. Micro-photoluminescence (µ-PL) has been used to investigate the optical properties of the structures. The establishment of optical resonant modes and wave guiding along both the longitudinal and transversal axes of the structures have been observed.

Background Smoking and smoke from biomass burning (BB) are the main environmental risk factors for COPD. Clinical differences have been described between COPD related to smoking and related to wood smoke, but no studies have shown genetic differences between patients exposed to these two risk factors. Methods To investigate a possible association of tumor necrosis factor (TNF) promoter polymorphisms, we conducted a case-control study. A total of 1,322 subjects were included in four groups: patients with a diagnosis of COPD secondary to smoking (COPD-S, n=384), patients with COPD secondary to biomass burning (COPD-BB, n=168), smokers without COPD (SWOC, n=674), and biomass burning-exposed subjects (BBES n=96). Additionally, a group of 950 Mexican mestizos (MMs) was included as a population control. Three single nucleotide polymorphisms (SNPs) were selected in the TNF gene (rs1800629, rs361525, and rs1800750) and one SNP in the lymphotoxin alpha gene (rs909253). Results Statistically significant differences were found with genotype GA of the rs1800629: COPD-S vs SWOC, (p

Aspirin-exacerbated respiratory disease (AERD) is a clinical entity characterized by hypersensitivity to aspirin leading to asthma and chronic rhinosinusitis with nasosinusal polyposis. The pathophysiology of the disease involves disruption at the level of arachidonic acid metabolism. Therefore, genetic association studies have been focused on the genes coding this pathway. As other mechanisms involved in the genesis of the disease were elucidated, the corresponding genes were also explored.To describe the association reported in the literature between gene polymorphisms involved in the pathophysiology or therapeutic processes of AERD.There is a genetic association between polymorphisms of genes involved in the synthesis of proteins related to arachidonic acid metabolism (LTC4S, ALOX5), antigen presentation (HLA), inflammation (IL5, IL17), and aspirin metabolism (CYP2C19).Genetic association research in AERD has evaluated studies of SNPs in metabolic pathways related to arachidonic acid. Recently, whole genome analysis strategies have allowed the detection of new genetic variants that were previously not considered. Furthermore, these studies have identified SNPs that are associated with inflammatory processes, which could serve as diagnostic markers or predictors of the therapeutic response.

Non-steroidal anti-inflammatory drugs (NSAID) exacerbated respiratory disease (N-ERD) is a disease integrated by asthma, nasal polyps, and hypersensitivity to non-steroidal anti-inflammatory drugs (NSAID). Genetic association studies have explored single nucleotide polymorphisms (SNPs) in genes involved in theoretical pathophysiological mechanisms, but most of these lack replication of findings in second populations. Our objective was to evaluate the association of SNPs in candidate genomic regions described in Asian and European subjects with N-ERD in Mexican-mestizo patients. We designed a replicative study in two stages. We included 381 SNPs selected by fine mapping of associated genes in a microarray, which were tested in three groups: N-ERD (N), asthma (A), and control group (CG), by means of GoldenGate array, positive results by genetic models were validated in the second stage in another population through qPCR with the same methodology. In the allelic model, we identified 11 SNPs in N vs. CG comparison, and five in N vs. A and A vs. CG, respectively. By genetics models, all SNPs in PPARG, rs13239058 in TBXAS1, and rs1554286 and rs1800872 in IL10 were associated in both models. In the second stage, only rs1800872CC showed an association in the dominant model comparing N vs. GC, p = 0.004, OR = 0.44. In conclusion, rs1800872 in IL10 was the only associated with N-ERD in Mexican-mestizo patients.

Background Red oak pollen is an important cause of allergic respiratory disease and it is widely distributed in North America and central Europe. To date, however, red oak pollen allergens have not been identified. Here, we describe the allergenic protein profile from red oak pollen. Methods Total proteins were extracted from red oak pollen using a modified phenolic extraction method, and, subsequently, proteins were separated by two-dimensional gel electrophoresis (2DE) for both total protein stain (Coomassie Blue) and immunoblotting. A pool of 8 sera from red oak sensitive patients was used to analyze blotted proteins. Protein spots were analyzed by Mass Spectrometry. Results Electrophoretic pattern of total soluble proteins showed higher intensity bands in the regions of 26–40 and 47–52 kDa. Two dimensional immunoblots using pool sera from patients revealed four allergenic proteins spots with molecular masses in the range from 50 to 55 kDa. Mass spectrometry analysis identified 8 proteins including Enolase 1 and Enolase 1 chloroplastic, Xylose isomerase (X1 isoform), mitochondrial Aldehyde dehydrogenase, UTP-Glusose-1-phosphate uridylyltransferase, Betaxylosidase/alpha-l-arabinofuranosidase and alpha- and beta subunits of ATP synthase. Conclusions This study has identified for first time 8 IgE binding proteins from red oak pollen. These findings will pave the way towards the development of new diagnostic and therapeutic modalities for red oak allergy.

Lithium-doped ZnO structures with sizes in the micro- and nano-scale and different morphologies were obtained by vapor–solid growth method. Two different precursors, lithium oxide and lithium carbonate, were used as the lithium source in order to study the influence on the morphology and optical properties of the obtained structures. Scanning electron microscopy, cathodoluminescence, photoluminescence, X-ray diffraction, energy dispersive X-ray microanalysis and Raman spectroscopy were used to characterize their structure, morphology, composition and optical properties. Depending on the lithium content present, changes in the crystalline quality and the luminescent intensity of the samples were observed. Optical resonant cavity behavior was also observed in some of the nano-structures.

Aspirin-exacerbated respiratory disease (AERD) refers to the combination of asthma rhinosinusitis and poliposis; ingestion of aspirin or other non-steroid anti-inflammatory drugs exacerbate asthma-like symptoms. The pathogenesis of AERD is unknown, and genetic and environmental factors contribute to the disease. Our objective is identifying polymorphisms associated with susceptibility in a Mexican mestizo population. Primarily we performed custom Illumina goldengate array-based genotyping of 1512 SNPs, carefully selected from a variety of acute/chronic inflammatory lung conditions previously reported. Four SNPs in TRPM3 gene showed the lowest p-values (rs10780946, rs7025694, rs1889915, and rs7047645). We further selected rs10780946 and rs7025694 for validation using Taqman genotyping (n = 743; 288 AERD, 272 ATA, and 183 HC). rs10780946 showed association when compared between AERD and ATA groups under co-dominant (p = 0.006), dominant (p = 0.002), overdominant (p = 0.01), and log-additive (p = 0.03) genetic models. AERD showed increased heterozygous TC (rs10780946–rs7025694) haplotype compared to ATA and HC (p

Aim: To evaluate the association of three single nucleotide polymorphisms in TNF and one in LTA in Mexican patients with aspirin-exacerbated respiratory disease (AERD) and the correlation of those single nucleotide polymorphisms with serum levels of TNF-α. Patients & methods: Case–control study including 133 patients with AERD, 135 patients with asthma (aspirin-tolerant asthmatics) and 182 healthy subjects. Results: GA genotype of rs1800629 in TNF was found to be associated with the risk of developing AERD (p

This paper presents an application of an artificial neural network model in forecasting urban water demand using MATLAB software. Considering that in any planning process, the demand forecast plays a fundamental role, being one of the premises to organize and control a set of activities or processes. The versatility of the short, medium and long-term prediction that is provided to the company that offers the water distribution service to determine the supply capacity, maintenance activities, and system improvements as a strategic planning tool. Shown to improve network performance by using time series water demand data, the model can provide excellent fit and forecast without relying on the explicit inclusion of climatic factors and number of consumers. The excellent accuracy of the model indicates the effectiveness of forecasting over different time horizons. Finally, the results obtained from the Artificial Neural Network are compared with traditional statistical models.

Aspirin exacerbated respiratory disease (AERD) is characterized by chronic hyperplastic rhinosinusitis, nasal polyposis, asthma, and aspirin sensitivity. The mechanisms which produce these manifestations of intolerance are not fully defined, current research focuses on cyclooxygenase 1 (COX-1) inhibition, metabolism of arachidonic acid, and the COX pathway to the lipoxygenase (LO) route, inducing increased synthesis of leukotrienes (LT). The biological plausibility of this model has led to the search for polymorphisms in genes responsible for proinflammatory cytokines synthesis, such as IL1B and IL8. We performed a genetic association study between IL8-251 (rs4073) and IL1B-511 (rs16944) polymorphisms in AERD, aspirin-tolerant asthma (ATA), and healthy control subjects. Using allelic discrimination by real-time PCR, we found statistically nonsignificant associations between AERD, ATA, and healthy control subjects for the GG and GA genotypes of IL1B (rs16944). Interestingly, the AA genotype showed an increased frequency in the AERD patients versus the ATA group (GF = 0.19 versus 0.07, , OR 2.98, and 95% CI 1.17–7.82). This is the first observation that IL1B polymorphisms are involved in AERD. Thus, future studies must investigate whether interleukin-1 is released in the airways of AERD patients and whether it relates to genetic polymorphisms in the IL1B gene.

ObjetivoConocer los hábitos alimentarios y su distanciamiento de la dieta mediterránea.DiseñoEstudio descriptivo, transversal.EmplazamientoABS Gavà 2. Barcelona.ParticipantesSe incluyó a 614 pacientes obtenidos aleatoriamente de los pacientes que acudían al centro. La población fue estratificada en 3 franjas de edad (15-35, 36-64 y>64 años).Mediciones principalesCuestionario validado del consumo por grupos de alimentos en la última semana. Posteriormente se comparó con los valores estándar de dieta mediterránea.ResultadosSe observa un 60% de consumo insuficiente de hidratos de carbono, un 70,7% de consumo insuficiente de verduras, frutas y hortalizas, un 75% de consumo óptimo de legumbres, un 64% de consumo deficiente de lácteos, un 66% de consumo óptimo de pescado, un 73,8% de consumo óptimo de huevos, un 71,2% de consumo adecuado de carne blanca, y un 64,2% de consumo excesivo de carne roja y embutidos, que llega a ser del 86,6% a los 15-35 años. Se observó un IMC>25 en el 59% de las mujeres y el 63% de los valores; la obesidad fue más frecuente en mujeres y en>64 años.ConclusionesLa población estudiada consume un exceso de alimentos con alto contenido en grasas saturadas, especialmente los jóvenes. Hay un déficit en la ingesta de hidratos de carbono de absorción lenta y un consumo inferior al ideal de frutas, verdures y hortalizas, más acusado también en jóvenes. El consumo de lácteos es inferior al aconsejado. La ingesta de legumbres, pescado y carne blanca se aproxima a los niveles correctos.Este patrón difiere del ideal, lo que supone un mayor riesgo de enfermedades crónicas prevalentes.ObjectiveTo discover people's nutritional habits and their distance from the Mediterranean diet.DesignCross-sectional, descriptive study.SettingGavà 2 Health District, Barcelona, Spain.Participants614 obtained at random from patients attending the centre. Stratified in 3 age groups (15-35, 36-64, and over 64).Main measurementsValidated questionnaire of the consumption by groups of food over the previous week. Then figures were compared with the standard values of the Mediterranean diet.ResultsOutstanding results were: 60% insufficiency in consumption of carbohydrates; 70.7% insufficiency in green vegetables, fruit and root vegetables; 75% of optimum consumption of pulses; 64% deficient consumption of milk products; 66% optimum consumption of fish; 73.8% optimum consumption of eggs; 71.2% proper intake of white meat; 64.2% excessive consumption of red meat and processed meats, which reached 86.6% among 15-35 year olds. There was a BMI over 25 in 59% of women and 63% of men, with obesity being most common among women and people over 64 years old.ConclusionsThe population studied consumed an excessive amount of food with high contents of saturated fat, especially young people. There is a deficit in the intake of slowly absorbed carbohydrates and a less than ideal consumption of fruit, green vegetables and root vegetables, which was more marked among the young. The consumption of milk products was below the recommended amount. Pulses, fish and white meat were close to the right levels. This pattern is far from ideal and leads to higher risk of prevalent chronic illnesses.