Nutriovia

Using real data of 1,600 patients, available via a database created to accelerate research and innovation, the team also found that its reliability differs considerably in winter compared to autumn.

Asthma is a common pulmonary condition which can cause whistling breathing and shortness of breath, sometimes severe. About 6.5% of people over six years old in the United Kingdom are affected by the condition. Treatments include the use of inhalers or nebulizers to transport medication in the lungs.

The majority of asthma attacks occur at night or early in the morning. Although this can partly be due to the cooler night air and exposure to mites and allergens, this also suggests that circadian rhythms – our “bodily clocks” – probably play a role.

Researchers from the Victor Phillip Dahdaleh Heart and Lung Research Institute, a collaboration between the University of Cambridge and the Royal Papworth Hospital Trust (RPH), wanted to explore whether these circadian rhythms can also have an impact on our ability to diagnose asthma, using clinical tests carried out regularly.

As a rule, people suspected of asthma will be offered a Spirometry test, which implies resuming a deep inspiration, then to expire hard and quickly as long as possible in a tube to assess the pulmonary function. They will then be administered the salbutamol medication via a inhaler or a nebulizer, and shortly after, will resume the Spirometry test.

Salbutamol works by opening the respiratory tract, therefore a positive test result – that is to say a difference in the readings between the initial and monitoring spirometry tests – means that the airways must have been narrower or obstructed to start, suggesting that the patient could have asthma.

Cambridge University Hospitals NHS Foundation Trust (CUH) has recently set up the Electronic Research and Innovation Database of Patients (ERIN) so that researchers can access patient data in a secure environment to help their research and accelerate patient improvements to patients.

Using this resource, the Cambridge team analyzed the data of 1,600 patients referred to CUH between 2016 and 2023, adjusted for factors such as age, sex, body mass index (BMI), the history of smoking and the severity of the initial disability of the pulmonary function.

In the results published today in ThoraxThe researchers noted that from 8:30 am, with all hours spending during the working day, the chances of a positive response to the test – in other words, the patient’s lungs responding to the treatment, suggesting that they could have asthma – reduced by 8%.

Dr. Ben Knox-Brown, respiratory physiologist of research at the head of RPH, said: “Given what we know about how the risk of an asthma crisis changes between night and day, we expected to find a difference in the way people responded to the pulmonary function test, but even, we were surprised by the size of the effect.

“This has potentially important implications. Make the test in the morning would give a more reliable representation of a patient’s response to the drug than doing so in the afternoon, which is important when confirming a diagnosis such as asthma.”

The researchers also discovered that individuals were 33% less likely to have a positive result if they were tested during the fall compared to those tested during the winter.

Dr. Akhilesh Jha, a medical research council clinician at the University of Cambridge and honorary consultant in respiratory medicine in Cuh, said there could be a combination of factors behind this difference.

“Our bodies have natural rhythms – our bodily clocks,” said JHA. “Throughout the day, different hormones levels in our body increase and descend and our immune systems work differently, for example. All these factors can affect the way people react to the pulmonary function test.

“The idea that the hour of the day, or the season of the year, affects our health and how we react to treatments is something that we see growing evidence. We know, for example, that people react differently to vaccinations depending on whether they are administered in the morning or afternoon. The results of our study still support this idea and can be taken into account when interpreting the tests.”

Using real data of 1,600 patients, available via a database created to accelerate research and innovation, the team also found that its reliability differs considerably in winter compared to autumn.

Asthma is a common pulmonary condition which can cause whistling breathing and shortness of breath, sometimes severe. About 6.5% of people over six years old in the United Kingdom are affected by the condition. Treatments include the use of inhalers or nebulizers to transport medication in the lungs.

The majority of asthma attacks occur at night or early in the morning. Although this can partly be due to the cooler night air and exposure to mites and allergens, this also suggests that circadian rhythms – our “bodily clocks” – probably play a role.

Researchers from the Victor Phillip Dahdaleh Heart and Lung Research Institute, a collaboration between the University of Cambridge and the Royal Papworth Hospital Trust (RPH), wanted to explore whether these circadian rhythms can also have an impact on our ability to diagnose asthma, using clinical tests carried out regularly.

As a rule, people suspected of asthma will be offered a Spirometry test, which implies resuming a deep inspiration, then to expire hard and quickly as long as possible in a tube to assess the pulmonary function. They will then be administered the salbutamol medication via a inhaler or a nebulizer, and shortly after, will resume the Spirometry test.

Salbutamol works by opening the respiratory tract, therefore a positive test result – that is to say a difference in the readings between the initial and monitoring spirometry tests – means that the airways must have been narrower or obstructed to start, suggesting that the patient could have asthma.

Cambridge University Hospitals NHS Foundation Trust (CUH) has recently set up the Electronic Research and Innovation Database of Patients (ERIN) so that researchers can access patient data in a secure environment to help their research and accelerate patient improvements to patients.

Using this resource, the Cambridge team analyzed the data of 1,600 patients referred to CUH between 2016 and 2023, adjusted for factors such as age, sex, body mass index (BMI), the history of smoking and the severity of the initial disability of the pulmonary function.

In the results published today in ThoraxThe researchers noted that from 8:30 am, with all hours spending during the working day, the chances of a positive response to the test – in other words, the patient’s lungs responding to the treatment, suggesting that they could have asthma – reduced by 8%.

Dr. Ben Knox-Brown, respiratory physiologist of research at the head of RPH, said: “Given what we know about how the risk of an asthma crisis changes between night and day, we expected to find a difference in the way people responded to the pulmonary function test, but even, we were surprised by the size of the effect.

“This has potentially important implications. Make the test in the morning would give a more reliable representation of a patient’s response to the drug than doing so in the afternoon, which is important when confirming a diagnosis such as asthma.”

The researchers also discovered that individuals were 33% less likely to have a positive result if they were tested during the fall compared to those tested during the winter.

Dr. Akhilesh Jha, a medical research council clinician at the University of Cambridge and honorary consultant in respiratory medicine in Cuh, said there could be a combination of factors behind this difference.

“Our bodies have natural rhythms – our bodily clocks,” said JHA. “Throughout the day, different hormones levels in our body increase and descend and our immune systems work differently, for example. All these factors can affect the way people react to the pulmonary function test.

“The idea that the hour of the day, or the season of the year, affects our health and how we react to treatments is something that we see growing evidence. We know, for example, that people react differently to vaccinations depending on whether they are administered in the morning or afternoon. The results of our study still support this idea and can be taken into account when interpreting the tests.”

Using real data of 1,600 patients, available via a database created to accelerate research and innovation, the team also found that its reliability differs considerably in winter compared to autumn.

Asthma is a common pulmonary condition which can cause whistling breathing and shortness of breath, sometimes severe. About 6.5% of people over six years old in the United Kingdom are affected by the condition. Treatments include the use of inhalers or nebulizers to transport medication in the lungs.

The majority of asthma attacks occur at night or early in the morning. Although this can partly be due to the cooler night air and exposure to mites and allergens, this also suggests that circadian rhythms – our “bodily clocks” – probably play a role.

Researchers from the Victor Phillip Dahdaleh Heart and Lung Research Institute, a collaboration between the University of Cambridge and the Royal Papworth Hospital Trust (RPH), wanted to explore whether these circadian rhythms can also have an impact on our ability to diagnose asthma, using clinical tests carried out regularly.

As a rule, people suspected of asthma will be offered a Spirometry test, which implies resuming a deep inspiration, then to expire hard and quickly as long as possible in a tube to assess the pulmonary function. They will then be administered the salbutamol medication via a inhaler or a nebulizer, and shortly after, will resume the Spirometry test.

Salbutamol works by opening the respiratory tract, therefore a positive test result – that is to say a difference in the readings between the initial and monitoring spirometry tests – means that the airways must have been narrower or obstructed to start, suggesting that the patient could have asthma.

Cambridge University Hospitals NHS Foundation Trust (CUH) has recently set up the Electronic Research and Innovation Database of Patients (ERIN) so that researchers can access patient data in a secure environment to help their research and accelerate patient improvements to patients.

Using this resource, the Cambridge team analyzed the data of 1,600 patients referred to CUH between 2016 and 2023, adjusted for factors such as age, sex, body mass index (BMI), the history of smoking and the severity of the initial disability of the pulmonary function.

In the results published today in ThoraxThe researchers noted that from 8:30 am, with all hours spending during the working day, the chances of a positive response to the test – in other words, the patient’s lungs responding to the treatment, suggesting that they could have asthma – reduced by 8%.

Dr. Ben Knox-Brown, respiratory physiologist of research at the head of RPH, said: “Given what we know about how the risk of an asthma crisis changes between night and day, we expected to find a difference in the way people responded to the pulmonary function test, but even, we were surprised by the size of the effect.

“This has potentially important implications. Make the test in the morning would give a more reliable representation of a patient’s response to the drug than doing so in the afternoon, which is important when confirming a diagnosis such as asthma.”

The researchers also discovered that individuals were 33% less likely to have a positive result if they were tested during the fall compared to those tested during the winter.

Dr. Akhilesh Jha, a medical research council clinician at the University of Cambridge and honorary consultant in respiratory medicine in Cuh, said there could be a combination of factors behind this difference.

“Our bodies have natural rhythms – our bodily clocks,” said JHA. “Throughout the day, different hormones levels in our body increase and descend and our immune systems work differently, for example. All these factors can affect the way people react to the pulmonary function test.

“The idea that the hour of the day, or the season of the year, affects our health and how we react to treatments is something that we see growing evidence. We know, for example, that people react differently to vaccinations depending on whether they are administered in the morning or afternoon. The results of our study still support this idea and can be taken into account when interpreting the tests.”