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Featured Buzz August 5

By Debbie Bunch

July 29, 2024

Gut Molecule Linked to Increased Asthma Risk in Kids

Researchers from Monash University have identified a protective molecule produced in the gut but destroyed by antibiotics that may be responsible for the connection between early antibiotic use and the increased risk of developing asthma. They believe a supplement containing the molecule, which is known as indole-3-propionic acid (IPA), could help lower the risk.

The study was conducted in mice who were prone to asthma. When these mice were given antibiotics early in life, they were more likely to develop allergic airway inflammation triggered by house dust mites, a susceptibility that continued into adulthood even after their gut bacteria and IPA levels had returned to normal.

However, when the mice were given IPA as a dietary supplement during early life, they were protected against developing allergic airway inflammation from house dust mites or asthma, even as adults.

The authors believe the decreased levels of IPA caused by the antibiotics led to long-term changes in cellular stress, metabolism, and mitochondrial respiration in the lung epithelium, leading to the increased risk for asthma.

“The use of antibiotics in the first year of life can have the unintentional effect of reducing bacteria which promote health, and we now know from this research that antibiotics lead to reduced IPA, which we have found is critical early in life as our lung cells mature, making it a candidate for early life prevention of allergic airway inflammation,” said study author Ben Marsland.

The study was published by Immunity. Read Press Release Read Abstract

New Guideline on Central Airway Obstruction

The American College of Chest Physicians has released a new clinical practice guideline aimed at helping clinicians better manage central airway obstruction (CAO).

“Central airway obstruction is associated with a poor prognosis, and the management of CAO is highly variable dependent on the provider expertise and local resources,” said lead author on the guideline Kamran Mahmood, MD, MPH, FCCP. “By releasing this guideline, the panel hopes to standardize the definition of CAO and provide guidance for managing patients to optimize care and improve outcomes.”

In addition to recommending shared decision-making between patients and clinicians and a multidisciplinary approach to management, key components of the guideline include –

  • For patients with symptomatic malignant or nonmalignant CAO, the authors suggest therapeutic bronchoscopy as an adjunct to systemic medical therapy and/or local radiation.
  • For patients with symptomatic malignant or nonmalignant CAO, the authors suggest using rigid bronchoscopy over flexible bronchoscopy for therapeutic interventions.
  • For patients with symptomatic malignant or nonmalignant CAO, the authors suggest the use of general anesthesia/deep sedation over moderate sedation for therapeutic bronchoscopy.
  • For patients with symptomatic malignant or nonmalignant CAO, the authors suggest stent placement if other therapeutic bronchoscopic and systemic treatments have failed and when feasible for the underlying disorder.
  • For patients with nonmalignant CAO, the authors suggest either open surgical resection or therapeutic bronchoscopy.
  • For patients with malignant CAO with endobronchial tumor, the authors suggest either surgical resection or therapeutic bronchoscopy for relief of initial obstruction.

According to Dr. Mahmood, the recommendations in the guideline were developed using GRADE methodology and are based on a thorough evidence review and expert input. However, overall evidence quality is very low, leading the panel to call for well-designed studies and randomized controlled trials to manage CAO.

The guideline was published by CHEST. Read Press Release Read Abstract

The Protective Power of Vitamin E

Can vitamin E protect people against COPD? According to a new study out of China that examined 2013-2018 data from the U.S. National Health and Nutrition Examination Survey (NHANES), the answer may be yes.

The analysis included data from 4,706 adults aged 20 and older. Overall, the average vitamin E intake was 7.10 mg/day for people with COPD vs. 8.72 mg/day for those without. The authors note the recommended daily allowance of vitamin E for adults is 15 mg/day.

When the participants were divided into three groups – lowest vitamin E intake, medium vitamin E intake, and highest vitamin E intake – they found those in the highest intake group had a 43% reduced risk of COPD relative to the group with the lowest vitamin E intake. The finding held true even after it was adjusted to take factors like age, sex, smoking, and cholesterol levels into account.

“After analyzing data based on the NHANES database from 2013-2018, the results showed that vitamin E intake among U.S. adults was well below the recommended levels and that higher vitamin E intake was negatively associated with COPD incidence,” concluded the investigators.

They emphasize, however, that their study was designed only to uncover correlations, not cause and effect, and they believe more research is needed to explore the value of vitamin E in decreasing the risk of COPD. The study was published by Frontiers in Nutrition. Read Article Read Full Paper

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