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      Comparable reductions in hyperpnoea-induced bronchoconstriction and markers of airway inflammation after supplementation with 6·2 and 3·1 g/d of long-chain n-3 PUFA in adults with asthma

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          Abstract

          Although high dose n-3 PUFA supplementation reduces exercise- and hyperpnoea-induced bronchoconstriction (EIB/HIB), there are concurrent issues with cost, compliance and gastrointestinal discomfort. It is thus pertinent to establish the efficacy of lower n-3 PUFA doses. Eight male adults with asthma and HIB and eight controls without asthma were randomly supplemented with two n-3 PUFA doses (6·2 g/d (3·7 g EPA and 2·5 g DHA) and 3·1 g/d (1·8 g EPA and 1·3 g DHA)) and a placebo, each for 21 d followed by 14 d washout. A eucapnic voluntary hyperpnoea (EVH) challenge was performed before and after treatments. Outcome measures remained unchanged in the control group. In the HIB group, the peak fall in forced expiratory volume in 1 s (FEV 1) after EVH at day 0 (−1005 ( sd 520) ml, −30 ( sd 18) %) was unchanged after placebo. The peak fall in FEV 1 was similarly reduced from day 0 to day 21 of 6·2 g/d n-3 PUFA (−1000 ( sd 460) ml, −29 ( sd 17) % v. −690 ( sd 460) ml, −20 ( sd 15) %) and 3·1 g/d n-3 PUFA (−970 ( sd 480) ml, −28 ( sd 18) % v. −700 ( sd 420) ml, −21 ( sd 15) %) ( P<0·001). Baseline fraction of exhaled nitric oxide was reduced by 24 % ( P=0·020) and 31 % ( P=0·018) after 6·2 and 3·1 g/d n-3 PUFA, respectively. Peak increases in 9 α, 11 β PGF 2 after EVH were reduced by 65 % ( P=0·009) and 56 % ( P=0·041) after 6·2 and 3·1 g/d n-3 PUFA, respectively. In conclusion, 3·1 g/d n-3 PUFA supplementation attenuated HIB and markers of airway inflammation to a similar extent as a higher dose. Lower doses of n-3 PUFA thus represent a potentially beneficial adjunct treatment for adults with asthma and EIB.

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          Most cited references52

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          An official American Thoracic Society clinical practice guideline: exercise-induced bronchoconstriction.

          Exercise-induced bronchoconstriction (EIB) describes acute airway narrowing that occurs as a result of exercise. EIB occurs in a substantial proportion of patients with asthma, but may also occur in individuals without known asthma. To provide clinicians with practical guidance, a multidisciplinary panel of stakeholders was convened to review the pathogenesis of EIB and to develop evidence-based guidelines for the diagnosis and treatment of EIB. The evidence was appraised and recommendations were formulated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Recommendations for the treatment of EIB were developed. The quality of evidence supporting the recommendations was variable, ranging from low to high. A strong recommendation was made for using a short-acting β(2)-agonist before exercise in all patients with EIB. For patients who continue to have symptoms of EIB despite the administration of a short-acting β(2)-agonist before exercise, strong recommendations were made for a daily inhaled corticosteroid, a daily leukotriene receptor antagonist, or a mast cell stabilizing agent before exercise. The recommendations in this Guideline reflect the currently available evidence. New clinical research data will necessitate a revision and update in the future.
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            New therapies for asthma: is there any progress?

            Current therapy for asthma with inhaled corticosteroids and long-acting inhaled beta(2)-agonists is highly effective, safe and relatively inexpensive, but for many patients, their disease remains poorly controlled. Most advances in asthma therapy have occurred through improving these drug classes, and a major developmental hurdle is to improve existing drug classes. The major unmet needs include better treatment of severe asthma, and curative therapies for mild to moderate asthma. Many new treatments are specific, targeting a single mediator or receptor, and are unlikely to have a major clinical effect, although they might be effective in specific asthma phenotypes. Drugs with more widespread effects, such as kinase inhibitors, might be more effective but have a greater risk of side effects. New treatments targeting the underlying allergic/immune process would treat concomitant allergic diseases. Improved immunotherapy approaches have the prospect of disease modification, although prospects for a cure are currently remote. The most promising therapeutic developments for asthma are discussed in this review. Copyright 2010 Elsevier Ltd. All rights reserved.
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              Determination of reference intervals for serum creatinine, creatinine excretion and creatinine clearance with an enzymatic and a modified Jaffé method.

              The aim of this study was to determine the reference intervals for serum creatinine, the renal creatinine output and the creatinine clearance (CrCl) with two new methods for accurate creatinine determination. The reference population consisted of 252 healthy subjects (127 males and 125 females) at the age between 18 and 74 years, median 27. Urine was collected for exactly 24 h. Creatinine in serum and urine was measured with an enzymatic assay ("Creatinine Plus") and a modification of the kinetic Jaffé reaction, named "Jaffé compensated". Reference values for serum creatinine were almost identical to previously published ones obtained with the same methods: 0.73-1.18 and 0.55-1.02 mg/dl for males and females, respectively, with the enzymatic, 0.72-1.16 and 0.55-0.96 mg/dl with the compensated Jaffé method (Jcomp). CrCl values were normally distributed and showed no gender difference in contrast to some previous studies. The reference interval for the entire group was found to be 66-143 ml/min with the enzymatic assay and 71-151 ml/min with the chemical one. Copyright 2004 Elsevier B.V.
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                Author and article information

                Journal
                British Journal of Nutrition
                Br J Nutr
                Cambridge University Press (CUP)
                0007-1145
                1475-2662
                May 28 2017
                June 13 2017
                May 28 2017
                : 117
                : 10
                : 1379-1389
                Article
                10.1017/S0007114517001246
                28606216
                9c4db592-8faa-4ef9-99b6-066b3e817cb7
                © 2017

                https://www.cambridge.org/core/terms

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