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Asthma therapy

Justin C Chia, P Régine Mydlarski
PURPOSE: Omalizumab is a recombinant humanized monoclonal antibody that inhibits the binding of IgE to the high-affinity IgE receptor (FceRI) on the surface of mast cells and basophils. Omalizumab has been approved for use in asthma, and new reports show promise in a variety of dermatologic diseases. Herein, we review the literature on omalizumab in dermatology and discuss the safety, efficacy and mechanisms of action for this emerging therapy. MATERIALS AND METHODS: PubMED, MEDLINE, and Embase databases were searched for the period January 1, 1990, to September 1, 2016...
October 19, 2016: Journal of Dermatological Treatment
Gabriella Di Lascio, Edvin Prifti, Elmi Messai, Adriano Peris, Guy Harmelin, Roland Xhaxho, Albana Fico, Guido Sani, Massimo Bonacchi
INTRODUCTION: Status asthmaticus is a life-threatening condition characterized by progressive respiratory failure due to asthma that is unresponsive to standard therapeutic measures. We used extracorporeal membrane oxygenation (ECMO) to treat patients with near-fatal status asthamticus who did not respond to aggressive medical therapies and mechanical ventilation under controlled permissive hypercapnia. MATERIALS AND METHODS: Between January 2011 and October 2015, we treated 16 adult patients with status asthmaticus (8 women, 8 men, mean age: 50...
October 6, 2016: Perfusion
Engi F Attia, Robert F Miller, Rashida A Ferrand
PURPOSE OF REVIEW: The incidence of pulmonary infections has declined dramatically with improved access to antiretroviral therapy (ART) and cotrimoxazole prophylaxis, but chronic lung disease (CLD) is an increasingly recognized but poorly understood complication in adolescents with perinatally acquired HIV. RECENT FINDINGS: There is a high prevalence of chronic respiratory symptoms, abnormal spirometry and chest radiographic abnormalities among HIV-infected adolescents in sub-Saharan Africa, wherein 90% of the world's HIV-infected children live...
October 7, 2016: Current Opinion in Infectious Diseases
Bo Chen, Shuai Feng, Xiao-Wen Yin
OBJECTIVE: To study the effect of obesity on the treatment outcome of asthma predictive index (API)-positive infants and young children with wheezing. METHODS: A total of 208 API-positive infants and young children with wheezing were enrolled. According to the Kaup index, the patients were divided into an obese group (n=93) and a non-obese group (n=115). The patients were given multimodality therapy in an acute episode of wheezing and aerosol inhalation of inhaled corticosteroid (ICS) budesonide suspension in the remission stage...
October 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Tarig Ali-Dinar, Jason E Lang
Obesity is a major risk factor for several conditions including atherosclerotic disease, metabolic syndrome, and upper airway dysfunction. However, the purported link between obesity and asthma has remained more difficult to define, in part due to limitations in past epidemiologic studies and the inherent challenge in accurately defining asthma in children. It is possible that obesity leads to asthma only in the presence of a mediating variable such as an obesity-related conditions such as esophageal reflux or insulin resistance...
October 17, 2016: Pediatric Pulmonology
Cecilia K Andersson, Alexandra Adams, Prasad Nagakumar, Cara Bossley, Atul Gupta, Daphne De Vries, Afiqah Adnan, Andrew Bush, Sejal Saglani, Clare M Lloyd
BACKGROUND: Neutrophils and IL-17A have been linked mechanistically in models of allergic airways disease and have been associated with asthma severity. However, their role in paediatric asthma is unknown. OBJECTIVES: To investigate the role of neutrophils and the IL-17A pathway in mediating paediatric severe therapy resistant asthma (STRA). METHODS: Children with STRA (n=51, age 12.6 (6 -16.3) years) and non-asthmatic controls (n=15, age 4...
October 13, 2016: Journal of Allergy and Clinical Immunology
Patricia D Freitas, Palmira G Ferreira, Aline G Silva, Rafael Stelmach, Regina M Carvalho-Pinto, Frederico L A Fernandes, Marcio C Mancini, Maria N Sato, Milton A Martins, Celso R F Carvalho
RATIONALE: Clinical control is difficult to achieve in obese patients with asthma. Bariatric surgery has been recommended for weight-loss and to improve asthma control; however, the benefits of nonsurgical interventions have been poorly investigated. OBJECTIVE: To examine the effect of exercise training in a weight-loss program on asthma control, quality of life, inflammatory biomarkers and lung function. METHODS: Fifty-five obese patients with asthma were randomly assigned to either a weight-loss program + exercise (WL+E group, n=28) or a weight-loss program + sham (WL+S group, n=27) group, where the weight-loss program included nutrition (caloric restriction) and psychological therapies...
July 19, 2016: American Journal of Respiratory and Critical Care Medicine
Ritesh Agarwal, Inderpaul S Sehgal, Sahajal Dhooria, Ashutosh N Aggarwal
Allergic bronchopulmonary aspergillosis (ABPA) is a complex pulmonary disorder characterized by recurrent episodes of wheezing, fleeting pulmonary opacities and bronchiectasis. It is the most prevalent of the Aspergillus disorders with an estimated five million cases worldwide. Despite six decades of research, the pathogenesis, diagnosis and treatment of this condition remains controversial. The International Society for Human and Animal Mycology has formed a working group to resolve the controversies around this entity...
October 17, 2016: Expert Review of Respiratory Medicine
Steven Maltby, Peter G Gibson, Heather Powell, Vanessa M McDonald
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) are common airway diseases. Individuals with overlapping asthma and COPD experience increased health impairment and severe disease exacerbations. Efficacious treatment options are required for this population. Omalizumab (anti-IgE) therapy is effective in patients with severe, persistent asthma, but limited data are available on efficacy in populations with overlapping asthma and COPD. METHODS: Data from the Australian Xolair Registry (AXR) was used to compare treatment responses in individuals with asthma-COPD overlap to severe asthma alone...
October 11, 2016: Chest
Ariel Brandwein, Kavita Patel, Myriam Kline, Peter Silver, Sandeep Gangadharan
OBJECTIVES: Patients with obstructive airway disease have varying degrees of pulsus paradoxus that correlate with illness severity. Pulsus paradoxus can be measured using plethysmography. We investigated whether plethysmograph (pleth) variability on admission to the pediatric emergency department (ED) could predict patient disposition. We hypothesized that patients with a larger pleth variability would have a higher likelihood of being admitted to a general pediatrics unit or the intensive care unit (ICU)...
October 6, 2016: Pediatric Emergency Care
Rakesh Pore, Swati Biswas, Srirupa Das
PURPOSE: The aim of the survey was to understand the prevailing practice pattern for the management of dry cough among primary care physicians in Indian clinical setting. MATERIAL AND METHODS: This single visit, cross-sectional, non-interventional, interview based physician survey was conducted over a period of 3 months where 500 registered physicians with at least 6 months of clinical practice and willing to participate in the survey were interviewed in their clinic or hospital from June to August 2015...
June 2016: Journal of the Association of Physicians of India
Manon Belhassen, Anjan Nibber, Eric Van Ganse, Dermot Ryan, Carole Langlois, Francis Appiagyei, Derek Skinner, Laurent Laforest, Joan B Soriano, David Price
Against recurrent controversies around the safety of short- and long-acting β2-agonists (SABA and LABA), and the National Review of Asthma Deaths inquiry in the United Kingdom, we investigated the prevalence of inappropriate therapy in asthma. Our study aimed to determine the prevalence of inappropriate use of asthma therapy in the United Kingdom and in France. Two interval, parallel, population-based cohorts (2007 and 2013) were developed in each country by using the UK OPCRD and the French EGB databases...
October 13, 2016: NPJ Primary Care Respiratory Medicine
José Serrano-Pariente, Vicente Plaza, Joan B Soriano, Mercè Mayosc, Antolín López-Viña, César Picado, Laura Vigil
BACKGROUND: Continuous positive airway pressure (CPAP) in asthma patients with concomitant obstructive sleep apnea syndrome (OSAS) seems to have a favorable impact on asthma, but data are inconsistent due to methodological limitations of previous studies METHODS: Prospective, multicenter study. We examined asthma outcomes after six months of CPAP in 99 adult asthma patients (mean age 57 years) with OSAS (respiratory disturbance index ≥20). Asthma control and quality of life were assessed with the Asthma Control Questionnaire (ACQ) and the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), respectively...
October 12, 2016: Allergy
David B Price, Gene Colice, Elliot Israel, Nicolas Roche, Dirkje S Postma, Theresa W Guilbert, Willem M C van Aalderen, Jonathan Grigg, Elizabeth V Hillyer, Victoria Thomas, Richard J Martin
Asthma management guidelines recommend adding a long-acting β2-agonist (LABA) or increasing the dose of inhaled corticosteroid (ICS) as step-up therapy for patients with uncontrolled asthma on ICS monotherapy. However, it is uncertain which option works best, which ICS particle size is most effective, and whether LABA should be administered by separate or combination inhalers. This historical, matched cohort study compared asthma-related outcomes for patients (aged 12-80 years) prescribed step-up therapy as a ≥50% extrafine ICS dose increase or add-on LABA, via either a separate inhaler or a fine-particle ICS/LABA fixed-dose combination (FDC) inhaler...
April 2016: ERJ Open Research
Denis Vinnikov, Abdullah Khafagy, Paul D Blanc, Nurlan Brimkulov, Craig Steinmaus
We used meta-analysis to measure the effect of high-altitude climate therapy (HACT) on lung function outcomes in asthma, and systematically searched PubMed, Embase and for publications appearing from 1970 to mid-2015. We included studies carried out with children or adults with an exposure of up to 12 weeks at an altitude of ≥1500 m above sea level. Changes in forced expiratory volume in 1 s (FEV1), FEV1/vital capacity ratio or peak expiratory flow rate as the HACT intervention outcomes were analysed...
April 2016: ERJ Open Research
Yu Lin Tsai, Wang-Sheng Ko, Jung-Lung Hsiao, Hsin-Hung Pan, Ya-Ling Chiou
INTRODUCTION: In the pathogenesis of asthma, an imbalance between helper T (Th) 1/Th2 and Th17/Treg cells is believed to play a key role in asthmatic inflammatory responses. Some studies indicated that zinc deficiency increases inflammatory factor production and worsens asthma. However, the effects of zinc on T cell profiles to reduce inflammatory response remain unclear Objectives: We investigated the beneficial effects of zinc on isolated cell populations and cytokine levels from patients with asthma...
October 11, 2016: Clinical Respiratory Journal
Alberto Francesco Cereda, Patrizia Pedrotti, Lucio De Capitani, Cristina Giannattasio, Alberto Roghi
BACKGROUND: Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis characterized by hypereosinophilia. EGPA typically develops in three clinical phases, beginning with asthma, followed by tissue eosinophilia and finally systemic vasculitis. Cardiac involvement is the most important predictor of mortality; it occurs in approximately 15-60% of EGPA patients, a significant proportion of whom are asymptomatic and have normal electrocardiogram (ECG) and echocardiogram...
October 7, 2016: European Journal of Internal Medicine
Janine Margarita Dizon, Karen Grimmer, Shingai Machingaidze, Pam McLaren, Quinette Louw
BACKGROUND: Little is known about allied health (AH) clinical practice guideline (CPG) activity in South Africa, and particularly in relation to primary health care (PHC). This paper reports on a scoping study undertaken to establish a reference framework, from which a comprehensive maximum variation sample could be selected. This was required to underpin robust sampling for a qualitative study aimed at understanding South African primary care AH therapy CPG activities. This paper builds on findings from the South African Guidelines Evaluation (Project SAGE) Flagship grant...
October 10, 2016: Health Research Policy and Systems
Ronen Bar-Yoseph, Nir Kugelman, Galit Livnat, Michal Gur, Fahed Hakim, Vered Nir, Lea Bentur
BACKGROUND AND OBJECTIVES: Asthma is a chronic inflammatory disorder requiring intermittent or continuous anti-inflammatory therapy. Patients often turn to alternative treatments as complements or replacements to conventional treatments. We aimed to evaluate the effect of salt room chambers (halotherapy) on bronchial hyper-responsiveness (BHR), fractional exhaled nitric oxide (FeNO), and quality of life in children with asthma. PATIENTS AND METHODS: Children aged 5-13 years with a clinical diagnosis of mild asthma not receiving anti-inflammatory therapy...
October 10, 2016: Pediatric Pulmonology
Engin Baturcam, Natale Snape, Tiong Han Yeo, Johanna Schagen, Emma Thomas, Jayden Logan, Sally Galbraith, Natasha Collinson, Simon Phipps, Emmanuelle Fantino, Peter D Sly, Kirsten M Spann
Asthmatics are highly susceptible to respiratory viral infections, possibly due to impaired innate immunity. However, the exact mechanisms of susceptibility are likely to differ amongst viruses. Therefore, we infected primary nasal epithelial cells (NECs) from adults with mild-to-moderate asthma, with respiratory syncytial virus (RSV) or human metapneumovirus (hMPV) in vitro and investigated the antiviral response. NECs from these asthmatics supported elevated hMPV but not RSV infection, compared to non-asthmatic controls...
October 11, 2016: Journal of Innate Immunity
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