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  1. Wongsa C, Wongyikul P, Chokevittaya P, Nititammaluk A, Soe KK, Phinyo P, et al.
    J Allergy Clin Immunol Glob, 2025 Feb;4(1):100366.
    PMID: 39649686 DOI: 10.1016/j.jacig.2024.100366
    BACKGROUND: Inhaled corticosteroid (ICS)-containing regimens are the mainstay for treating asthma despite usually being ineffective in noneosinophilic asthma (NEA). Data on the prevalence of NEA versus eosinophilic asthma (EA) in mild-to-moderate asthma are limited.

    OBJECTIVE: We performed a systematic review of the prevalence of mild-to-moderate asthma in adolescents and adults using sputum inflammatory cell analysis and their responses to ICS.

    METHODS: We searched electronic databases (PubMed, Scopus, EMBASE, Cochrane) for studies in adolescents and adults with mild-to-moderate asthma. The primary outcome was the prevalence of asthma subtypes based on sputum inflammatory cell analysis, categorized into EA and NEA. The secondary outcome involved comparing asthma outcomes between different subtypes after ICS therapy. Certainty of evidence was reported for each pooled analysis.

    RESULTS: Eighteen studies involving 3,533 adolescents and adults with mild-to-moderate asthma were reviewed. The pooled prevalence (95% confidence interval) of NEA was estimated at 40.39% (27.54, 53.93) in patients with ICS naive with very low certainty of evidence. On reevaluating sputum cytology, the disease of approximately 20% to 30% of patients initially diagnosed as NEA transitioned to the EA subtype. EA patients showed significant improvements in asthma symptoms after ICS therapy: forced expiratory volume in 1 second (standardized mean difference, 0.79; 95% confidence interval, 0.30, 1.27), and airway hyperresponsiveness (standardized mean difference, 1.34; 95% confidence interval, 0.29, 2.40). NEA patients exhibited limited response.

    CONCLUSION: A high proportion of adolescents and adults with mild-to-moderate asthma were identified with NEA subtype disease, which exhibited a poor response to ICS. A thorough diagnostic evaluation before initiating treatment should be integrated into clinical practice.Registered in PROSPERO (CRD42023484334).

  2. Wee AK, Takayama K, Chua JL, Asakawa T, Meenakshisundaram SH, Onrizal, et al.
    BMC Evol. Biol., 2015 Mar 29;15:57.
    PMID: 25888261 DOI: 10.1186/s12862-015-0331-3
    BACKGROUND: Mangrove forests are ecologically important but globally threatened intertidal plant communities. Effective mangrove conservation requires the determination of species identity, management units, and genetic structure. Here, we investigate the genetic distinctiveness and genetic structure of an iconic but yet taxonomically confusing species complex Rhizophora mucronata and R. stylosa across their distributional range, by employing a suite of 20 informative nuclear SSR markers.

    RESULTS: Our results demonstrated the general genetic distinctiveness of R. mucronata and R. stylosa, and potential hybridization or introgression between them. We investigated the population genetics of each species without the putative hybrids, and found strong genetic structure between oceanic regions in both R. mucronata and R. stylosa. In R. mucronata, a strong divergence was detected between populations from the Indian Ocean region (Indian Ocean and Andaman Sea) and the Pacific Ocean region (Malacca Strait, South China Sea and Northwest Pacific Ocean). In R. stylosa, the genetic break was located more eastward, between populations from South and East China Sea and populations from the Southwest Pacific Ocean. The location of these genetic breaks coincided with the boundaries of oceanic currents, thus suggesting that oceanic circulation patterns might have acted as a cryptic barrier to gene flow.

    CONCLUSIONS: Our findings have important implications on the conservation of mangroves, especially relating to replanting efforts and the definition of evolutionary significant units in Rhizophora species. We outlined the genetic structure and identified geographical areas that require further investigations for both R. mucronata and R. stylosa. These results serve as the foundation for the conservation genetics of R. mucronata and R. stylosa and highlighted the need to recognize the genetic distinctiveness of closely-related species, determine their respective genetic structure, and avoid artificially promoting hybridization in mangrove restoration programmes.

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