Asthma and COPD have characteristic symptoms, yet patients with both are prevalent. Despite this, there is currently no globally accepted definition for the overlap between asthma and COPD, commonly referred to as asthma–COPD overlap (ACO). Generally, ACO is not considered a distinct disease or symptom from either clinical or mechanistic perspectives. However, identifying patients who present with both conditions is crucial for guiding clinical therapy. Similar to asthma and COPD, ACO patients are heterogeneous and presumably have multiple underlying disease processes. The variability of ACO patients led to the establishment of multiple definitions describing the condition’s essential clinical, physiological, and molecular characteristics. ACO comprises numerous phenotypes, which affects the optimal medication choice and can serve as a predictor of disease prognosis. Various phenotypes of ACO have been suggested based on host factors including but not limited to demographics, symptoms, spirometric findings, smoking history, and underlying airway inflammation. This review provides a comprehensive clinical guide for ACO patients to be used in clinical practice based on the available limited data. Future longitudinal studies must evaluate the stability of ACO phenotypes over time and explore their predictive powers to facilitate a more precise and effective management approach.

This research aimed to evaluate the effects of high-dose cholecalciferol (VD₃) supplements (50,000 IU/week) on selected circulating cytokines associated with cytokine storms in adults with vitamin D deficiency. This clinical trial, based in Jordan, included 50 participants receiving vitamin D₃ supplements (50,000 IU/week) for 8 weeks; the exact number was assigned to the control group. Interleukin-6 (IL-6), interleukin-1β (IL-1β), interleukin-10 (IL-10), tumor necrotic factor-α (TNF-α), and leptin were measured in serum at baseline and 10 weeks (wash out: 2 weeks). Our results revealed that vitamin D₃ supplementation significantly increased the serum levels of 25OHD, IL-6, IL-10, IL-1β, and leptin compared with baseline. In contrast, the serum level of TNF-α insignificantly increased in the group receiving vitamin D₃ supplementation. Although the observations of this trial may refer to a potential negative effect of VD₃ supplementation during cytokine storms, further trials are required to clarify the potential benefits of VD₃ supplement during cytokine storms.

Background: To identify stress associated factors for vitamin D deficiency (VDD) in healthy Jordanian people based on serum 25(OH)D levels. Design: Prospective cohort study. Methods: Three hundred and seventy-one Jordanian men and women aged 17–52 years, who were identified as VD deficient 25(OH)D <30 ng/mL, were eligible to participate in the study. Serum vitamin 25(OH) D was measured using chemiluminescent immunoassay. Cortisol, parathyroid hormone, calcium, phosphate, fasting lipid profile, and blood glucose were also analyzed. Questionnaires were used to collect lifestyles parameters. Anthropometric parameters including: body mass index (BMI), waist (W) and hip (H) circumferences, W/H ratio (WHR) were also calculated. Results: The vast majority (91%) of the participants had vitamin D deficiency (25- (OH) D <30 ng/mL). Positive correlations were observed between vitamin D deficiency and the following anthropometric parameters in all study sample; gender (P=0.010), height (P=0.22), height/hip ratio (P=0.015) and waist/hip ratio (P=0.013). Lifestyle parameters that indicated very weak positive correlations with VDD were number of family members (P=0.011) and insufficient exposure to sunlight (P=0.023). The following clinical parameters showed weak or very weak correlations with VDD; serum cortisol (r=0.318), low density lipoprotein (r=0.246) and total cholesterol (r=0.133). Skin color and water pipe tobacco smoking were added to the multivariable stepwise regression analyses as they have been weakly correlated with VDD. These predictors together explained only 12.2% of the variance in serum cortisol levels in the VDD study sample. Conclusion: A weak positive association between VDD and elevated serum cortisol was observed in this study. Subcutaneous changes may be involved in that association but further studies are needed to clarify a potential role for adrenocorticotropic hormone (ACTH).

This study aims to investigate the anti-hyperlipidaemic effect of ethanolic leaf extract of Equisetum ramosissimum. 2,2-Diphenyl-1- picrylhydrazyl assay for antioxidants, Folin-Ciocalteu, AlCl₃, and UHPLC-MS/MS analysis, focusing on phenols and flavonoid content were performed. Anti-hyperlipidemic effect of the extract on lipid profile and body weight was evaluated alone or in combination with Atorvastatin in rats. The extract was shown to contain phenols (0.032±0.001 µg/g, equivalent to gallic acid), flavonoids (0.044±0.003 mg/g, equivalent to quercetin), and antioxidant IC₅₀ value of (1000.00±0.78 µg/mL). UHPLC-MS/MS analysis revealed the presence of 8 different phenols and flavonoids. An in vivo study on healthy standard diet-fed animals and an induced hyperlipidaemic model showed a significant (P < 0.05) reducing effect of the extract alone and in combination with Atorvastatin on serum lipid profile. These findings revealed the potential advantages of the extract alone and in combination with statins for preventing or treating hyperlipidaemia, but need to be further explored.

Purpose This randomized clinical trial (RCT) was created to assess the influence of 1,25-dihydroxyvitamin D (VD₃), omega−3 fatty acids (n-3FA), and their combination (D+) on glycated hemoglobin (A1c) levels in Jordanian peoples with vitamin D deficiency (VDD). Participants and Methods This RCT was designed to examine the follow-up (2 months) effect of either 50,000 IU VD₃, 300 mg n-3FA, or the combination of the two supplements on glycated Hemoglobin (A1c) levels in 146 Jordanian women and men with VDD, aged from 25 to 55 years. The eligible participants were randomized into 4 groups: Control (C); VD₃ supplementation (50,000 IU of VD₃ was taken weekly) (D₃); n-3FA supplementation (300 mg of Omega-3FA was taken daily) (n-3FA); VD₃ and omega 3 supplementation group (D+) with the same protocol as the previous two groups. Results The combination therapy (n-3FA plus VD3) for 8 weeks significantly increased A1c levels (5.79±0.34 vs. 5.41±0.33, P<0.001). Tukey test for post-hoc comparisons of A1c at follow-up showed that the A1c mean levels were remarkably higher in the D+ study group comparing to the control group (5.78 vs. 5.38). Conclusion The intervention of n-3FA alone or in combination with high doses of VD₃ may lead to negative effects on glycemic control or accelerate the insulin resistance’s development in susceptible people for diabetes mellitus (type 2).

This research aims to determine acute bronchiolitis’ causative virus(es) and establish a viable protocol to classify the Human Rhinovirus (HRV) species. During 2021–2022, we included children 1–24 months of age with acute bronchiolitis at risk for asthma. The nasopharyngeal samples were taken and subjected to a quantitative polymerase chain reaction (qPCR) in a viral panel. For HRV-positive samples, a high-throughput assay was applied, directing the VP4/VP2 and VP3/VP1 regions to confirm species. BLAST searching, phylogenetic analysis, and sequence divergence took place to identify the degree to which these regions were appropriate for identifying and differentiating HRV. HRV ranked second, following RSV, as the etiology of acute bronchiolitis in children. The conclusion of the investigation of all available data in this study distributed sequences into 7 HRV-A, 1 HRV-B, and 7 HRV-C types based on the VP4/VP2 and VP3/VP1 sequences. The nucleotide divergence between the clinical samples and the corresponding reference strains was lower in the VP4/VP2 region than in the VP3/VP1 region. The results demonstrated the potential utility of the VP4/VP2 region and the VP3/VP1 region for differentiating HRV genotypes. Confirmatory outcomes were yielded, indicating how nested and semi-nested PCR can establish practical ways to facilitate HRV sequencing and genotyping.