Abstract:
An inflammatory illness of the airways, asthma is influenced by neurological and psychological variables. The purpose of the current review is to examine the connection between brain processes, neurobiological modifications, and asthma symptoms. This study`s objective is to assess in real-world settings the prevalence of psychological distress, anxiety, depressive symptoms, and suicidal ideation in asthma patients with severe asthma receiving biological treatments (Benralizumab, Mepolizumab, Omalizumab), while also taking into account the impact of the Covid-19 epidemic. This study`s initial premise is that using biologicals to treat severe asthma patients will reduce their chance of experiencing psychological distress, anxiety, sadness, and suicidal thoughts. Consequently, our research serves as the first observational study on the risk of psychological stress, anxiety, depression, and suicide in patients with severe asthma who are receiving treatment with the biological medication benralizumab. The study involved 90 patients (32 males, 58 females; aged 53.92 ± 15.92) (Table 1) suffering from severe asthma and treated with the following biological drugs: Benralizumab, Mepolizumab and Omalizumab. These patients were enrolled between the second half of 2020 and the first half of 2021 at two Italian centres during Covid-19 pandemic. The first centre is the G.O.I. of Allergology, Business Centre for Allergic and Immunological Diseases and Psocare/Atopic Dermatitis Business Centre, of the U.O.C. of Internal Medicine of the P.O. of Battipaglia, ASL Salerno and the second centre is the U.O.C. of Pneumology of the Mater Domini University Hospital of Catanzaro. Clinicians made the choice of the type of drug treatment at their discretion. The sample comprises 33 patients (12 males, 21 females and aged 52.24 ± 20.05) treated with Omalizumab at a dose of 2 vials of 150 mg subcutaneously (SC) every 4 weeks, 30 patients (12 males, 18 females and aged 55.67 ± 11.53) receiving Benralizumab at a dose of 30 mg subcutaneously (SC) every 4 weeks for the first three doses, then every 8 weeks thereafter and 27 patients (8 males, 19 females aged 54.04 ± 14.73) having Mepolizumab at a dose of 100 mg subcutaneously (SC) every 4 weeks. There was a subsequent collection of data on physical and psychological parameters at baseline (T0) and after 16 weeks of treatment with biologics (T1) for all patients that started their treatment with biologics before the SARS-CoV-2 pandemic and completed 16 weeks of treatment during the pandemic. We developed a qualitative interview based on 4 questions which was administered to the same patients during psychological counselling to explore the impact of Covid-19 on asthma. If someone is stressed, anxious, or depressed, their asthma symptoms, such as coughing, breathing difficulty, and mucus production, worsen. In reaction to stress and psychological disorders, the insula, anterior cingulate cortex, and hypothalamic-pituitary-adrenal axis shift in function; the neuroendocrine system then releases stress hormones, which worsen asthma. According to the research, psychological treatments or neurological rehabilitation decrease inflammation through altering the activity of neural networks and the operation of brain regions associated with asthma. In addition, the neurotrophins and neuropeptides, which the airway nerves secrete in response to brain signals, are the primary mediators in the neuro-immune interactions and may be the focus of numerous future asthma treatments. In addition to providing useful ideas and strategies on neural networks to reduce airway inflammation and asthma severity, this review sheds light on the critical role that the central and peripheral nervous systems play in the onset and exacerbation of asthma.
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Journal: Abstract Book on 9th Annual Neuroscience Conference (ANC-23) August 12-13, 2023 , Volume: 0, Issue: 0, Year: 2023