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Refractory asthma

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https://www.readbyqxmd.com/read/28314658/management-of-chronic-inducible-urticaria-according-to-the-guidelines-a-prospective-controlled-study
#1
Emek Kocatürk, Pelin Kuteyla Can, Pırıl Etikan Akbas, Mehmet Copur, Ece Nur Degirmentepe, Kübra Kızıltac, Ralfi Singer
BACKGROUND: The recommended treatment approach in chronic inducible urticarias (CIndU) is the same as that for chronic spontaneous urticaria (CSU). But there is a lack of controlled trials assessing efficacy of available treatment options. OBJECTIVE: We aimed to evaluate the efficacy of treatment algorithm recommended by the guidelines and comparison of treatment responses in CIndU vs CSU. METHODS: This prospective parallel group controlled study included 70 CIndU and 66 CSU patients...
March 1, 2017: Journal of Dermatological Science
https://www.readbyqxmd.com/read/28294420/chronic-urticaria-in-the-real-life-clinical-practice-setting-in-sweden-norway-and-denmark-baseline-results-from-the-non-interventional-multicentre-aware-study
#2
S F Thomsen, E C Pritzier, C D Anderson, N Vaugelade-Baust, R Dodge, A-K Dahlborn, C Vestergaard
BACKGROUND: Chronic urticaria (CU) is characterised by the recurrence of itchy hives and/or angioedema for more than six weeks. AWARE (A World-wide Antihistamine-Refractory Chronic Urticaria Patient Evaluation) is a multinational study designed to document the real-life treatment situation, burden of disease, and clinical resource usage of H1-antihistamine refractory CU patients. OBJECTIVE: To examine baseline data from Scandinavian AWARE patients. METHODS: AWARE is a prospective, non-interventional, multinational, umbrella design study, which includes adults (≥18 years) with a confirmed CU diagnosis (>2 months) that is refractory to H1-antihistamines...
March 10, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28267764/ex-vivo-modulation-of-the-foxo1-phosphorylation-state-does-not-lead-to-dysfunction-of-t-regulatory-cells
#3
Kristen Kelley Penberthy, Monica Weaver Buckley, Sanja Arandjelovic, Kodi Ravichandran
Peripheral regulatory CD4+ T cells (Treg cells) prevent maladaptive inflammatory responses to innocuous foreign antigens. Treg cell dysfunction has been linked to many inflammatory diseases, including allergic airway inflammation. Glucocorticoids that are used to treat allergic airway inflammation and asthma are thought to work in part by promoting Treg cell differentiation; patients who are refractory to these drugs have defective induction of anti-inflammatory Treg cells. Previous observations suggest that Treg cells deficient in the transcription factor FoxO1 are pro-inflammatory, and that FoxO1 activity is regulated by its phosphorylation status and nuclear localization...
2017: PloS One
https://www.readbyqxmd.com/read/28263381/obesity-promotes-prolonged-ovalbumin-induced-airway-inflammation-modulating-th1-th2-and-th17-immune-responses-in-balb-c-mice
#4
F M C Silva, E E Oliveira, A C C Gouveia, A S S Brugiolo, C C Alves, J O A Correa, J Gameiro, J Mattes, H C Teixeira, A P Ferreira
Clinical and epidemiological studies indicate that obesity affects the development and phenotype of asthma by inducing inflammatory mechanisms in addition to eosinophilic inflammation. The aim of this study was to assess the effect of obesity on allergic airway inflammation and T helper 2 (Th2) immune responses using an experimental model of asthma in BALB/c mice. Mice fed a high-fat diet (HFD) for 10 weeks were sensitized and challenged with ovalbumin (OVA), and analysis were performed at 24 and 48 hours after the last OVA challenge...
March 6, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28260352/extra-esophageal-presentation-of-gerd-new-understanding-in-a-new-era
#5
Irene Martinucci, Eleonora Albano, Santino Marchi, Corrado Blandizzi
Associations of gastroesophageal reflux disease (GERD) with extraesophageal manifestations, such as chronic cough, asthma, and laryngitis, are reported frequently, and there is a strong evidence of biological plausibility in support of this relationship. On the other hand, extraesophageal reflux disease (EERD) is usually multifactorial in nature with reflux being just one of the several potential contributing cofactors. Moreover, the accuracy of currently available diagnostic tests for EERD is suboptimal, and therefore the causal relationship between GERD and EERD remains far from being conclusively proven...
March 3, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28248008/can-biomarkers-help-us-hit-targets-in-difficult-to-treat-asthma
#6
REVIEW
Michael Fricker, Liam G Heaney, John W Upham
Biomarkers may be a key foundation for the precision medicine of the future. In this article, we review current knowledge regarding biomarkers in difficult-to-treat asthma and their ability to guide the use of both conventional asthma therapies and novel (targeted) therapies. Biomarkers (as measured by tests including prednisolone and cortisol assays and the fractional exhaled nitric oxide (NO) suppression test) show promise in the assessment and management of non-adherence to inhaled and oral corticosteroids...
April 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28208047/targeted-therapy-for-chronic-respiratory-disease-a-new-paradigm
#7
Peter G Gibson, Matthew J Peters, Claire E Wainwright
Targeted therapy has emerged as a highly effective treatment approach for chronic respiratory diseases. Many of these conditions have dismal outcomes; however, targeted therapy shows great results for the subgroup who respond. This represents a new way to approach these conditions and offers great promise as a future treatment direction. In severe eosinophilic asthma, therapy that targets the interleukin-5 pathway with monoclonal antibodies leads to a 50% reduction in asthma exacerbations in previously refractory disease...
February 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28197221/factors-leading-to-refractory-asthma-in-patients-from-saudi-arabia
#8
Amal M Al-Moamary, Mohamed S Al-Hajjaj, Mohamed S Al Moamary
AIM: The aim of this study was to study the clinical characteristic of patient with refractory asthma (RA) from Saudi Arabia. METHODS: This paper prospectively studied in a university hospital factors leading to RA in a cohort of patients who have inadequately controlled asthma or with frequent exacerbations despite optimum controller therapy. It also studied patients with asthma that requires extended periods of oral steroids to control. RESULTS: The mean age was 45...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28194434/corticosteroids-inhibit-anti-ige-activities-of-specialized-proresolving-mediators-on-b-cells-from-asthma-patients
#9
Nina Kim, Thomas H Thatcher, Patricia J Sime, Richard P Phipps
Specialized proresolving mediators (SPMs) promote the resolution of inflammation and exert beneficial effects in animal models of chronic inflammatory diseases, including asthma. Previously, we have shown that certain SPMs reduce IgE production in B cells from healthy individuals, which has a critical role in allergic asthma. Here, we investigated the effects of SPMs on B cell IgE production in asthma patients. Peripheral blood mononuclear cells from asthma patients were treated with 17-HDHA or RvD1, and IgE levels were measured...
February 9, 2017: JCI Insight
https://www.readbyqxmd.com/read/28187115/clinical-course-of-enterovirus-d68-in-hospitalized-children
#10
Jennifer E Schuster, Rangaraj Selvarangan, Ferdaus Hassan, Kayla B Briggs, Lindsay Hays, Jenna O Miller, Barbara Pahud, Henry T Puls, Mary Ann Queen, Marita T Thompson, Gina Weddle, Mary Anne Jackson
BACKGROUND: Enterovirus D68 (EV-D68) has been sporadically reported as a cause of respiratory tract infections. In 2014, an international outbreak of EV-D68 occurred and caused severe respiratory disease in the pediatric population. METHODS: A retrospective chart review was performed of children admitted to Children's Mercy Hospital from August 1, 2014, to September 15, 2014, with positive multiplex polymerase chain reaction testing for EV/rhinovirus (RV). Specimens were subsequently tested for EV-D68, and clinical data were obtained from the medical records...
March 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28187065/clinical-course-of-enterovirus-d68-in-hospitalized-children
#11
Jennifer E Schuster, Rangaraj Selvarangan, Ferdaus Hassan, Kayla B Briggs, Lindsay Hays, Jenna O Miller, Barbara Pahud, Henry T Puls, Mary Ann Queen, Marita T Thompson, Gina Weddle, Mary Anne Jackson
BACKGROUND: Enterovirus D68 (EV-D68) has been sporadically reported as a cause of respiratory tract infections. In 2014, an international outbreak of EV-D68 occurred and caused severe respiratory disease in the pediatric population. METHODS: A retrospective chart review was performed of children admitted to Children's Mercy Hospital from August 1-September 15, 2014 with positive multiplex PCR testing for enterovirus/rhinovirus (EV/RV). Specimens were subsequently tested for EV-D68, and clinical data were obtained from the medical records...
December 13, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28169009/role-of-adenoidectomy-in-chronic-nasal-obstruction-after-nasal-steroid-therapy-failure
#12
Peter J Ciolek, Allen Xu, Samantha Anne, Katie Geelan-Hansen
OBJECTIVE: To identify clinical characteristics of pediatric patients that failed nasal steroid therapy for management of chronic nasal obstruction and to evaluate the efficacy of adenoidectomy in this subset of patients. DESIGN: Retrospective chart review. SETTING: Tertiary care academic center. SUBJECTS: Analysis was performed on children that underwent adenoidectomy between 2011 and 2015 for chronic nasal obstruction refractory to nasal steroids...
February 2, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28163052/airway-and-serum-biochemical-correlates-of-refractory-neutrophilic-asthma
#13
Rafeul Alam, James Good, Donald Rollins, Mukesh Verma, HongWei Chu, Tuyet-Hang Pham, Richard J Martin
BACKGROUND: Despite progress in the diagnosis and management of asthma, many patients have poorly controlled or refractory asthma (RA). The mechanism of this RA is not well understood. OBJECTIVE: We sought to explore the relationship between neutrophils and other biomarkers of RA. METHOD: Sixty patients with RA, 30 patients with nonrefractory asthma (NRA), and 20 healthy subjects were enrolled. We performed a comprehensive characterization of these study subjects, which included laboratory and pulmonary function studies, chest computed tomography, and bronchoscopy with bronchoalveolar lavage (BAL)...
February 3, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28160338/h1-antihistamine-refractory-chronic-spontaneous-urticaria-it-s-worse-than-we-thought-first-results-of-the-multicenter-real-life-aware-study
#14
M Maurer, P Staubach, U Raap, G Richter-Huhn, A Bauer, F Ruëff, T Jakob, A S Yazdi, V Mahler, N Wagner, U Lippert, U Hillen, A Schwinn, M Pawlak, N Behnke, K Chaouche, N Chapman-Rothe
BACKGROUND: Most data on chronic spontaneous urticaria (CSU) originate from highly selected patient populations treated at specialized centres. Little is known about CSU patient characteristics and the burden of CSU in routine clinical practice. AWARE (A World-wide Antihistamine-Refractory chronic urticaria patient Evaluation) is an ongoing global study designed to assess chronic urticaria in the real-life setting. OBJECTIVE: To describe the baseline characteristics of the first 1539 German AWARE patients with H1-antihistamine-refractory CSU...
February 4, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28145942/clinical-pathologic-correlation-of-sarcoidosis-associated-multifocal-chorioretinitis-in-an-elderly-patient
#15
Mohamed G A Saleh, John L OʼDonnell, Ronald P Davis, David Wilson, Phoebe Lin
BACKGROUND/PURPOSE: To describe a case of histopathologic clinical correlation of sarcoidosis-related multifocal chorioretinitis in an elderly individual. METHODS: This is a single case report and review of the pertinent literature. A 72-year-old white woman with a history of asthma was referred with bilateral asymmetric low-grade chronic panuveitis with advancing peripheral punched-out chorioretinal lesions despite systemic corticosteroid treatment. RESULTS: Coalescent chorioretinal punched-out lesions on fundus examination in the more severely affected right eye did not respond to corticosteroid treatment, and the refractory nature resulted in a suspicion of intraocular lymphoma despite a previous inconclusive diagnostic vitrectomy result...
January 31, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28143691/changing-paradigms-in-the-treatment-of-severe-asthma-the-role-of-biologic-therapies
#16
Rohit K Katial, Greg W Bensch, William W Busse, Bradley E Chipps, Joshua L Denson, Anthony N Gerber, Joshua S Jacobs, Monica Kraft, Richard J Martin, Parameswaran Nair, Michael E Wechsler
Cytokine antagonists are monoclonal antibodies that offer new treatment options for refractory asthma but will also increase complexity because they are effective only for patients with certain asthma subtypes that remain to be more clearly defined. The clinical and inflammatory heterogeneity within refractory asthma makes it difficult to manage the disease and to determine which, if any, biologic therapy is suitable for a specific patient. The purpose of this article is to provide a data-driven discussion to clarify the use of biologic therapies in patients with refractory asthma...
January 28, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28137226/management-of-status-asthmaticus-in-children
#17
Kam-Lun E Hon, Alexander K C Leung
BACKGROUND: Status asthmaticus is an acute exacerbation of asthma that is persistent and intractable and remains unresponsive to initial treatment with bronchodilators and systemic corticosteroids and that can result in hypoxemia, hypercarbia, and secondary respiratory failure. METHOD: We reviewed treatment and recent patents on management of status asthmaticus. CONCLUSIONS: Supplemental oxygen should be given to maintain an oxygen saturation of ≥92% in room air...
January 30, 2017: Recent Patents on Inflammation & Allergy Drug Discovery
https://www.readbyqxmd.com/read/28127050/hmscs-suppress-neutrophil-dominant-airway-inflammation-in-a-murine-model-of-asthma
#18
Gyong Hwa Hong, Hyouk-Soo Kwon, Kyoung Young Lee, Eun Hee Ha, Keun-Ai Moon, Seong Who Kim, Wonil Oh, Tae-Bum Kim, Hee-Bom Moon, You Sook Cho
Although chronic eosinophilic inflammation is a common feature in patients with asthma, some patients have neutrophil-dominant inflammation, which is known to be associated with severe asthma.Human mesenchymal stem cells (hMSCs) have shown promise in treating various refractory immunological diseases. Thus, hMSCs may represent an alternative therapeutic option for asthma patients with neutrophil-dominant inflammation, in whom current treatments are ineffective. BALB/c mice exposed to ovalbumin and polyinosinic:polycytidylic acid (Poly I:C) to induce neutrophilic airway inflammation were systemically treated with hMSCs to examine whether the hMSCs can modulate neutrophilic airway inflammation...
January 27, 2017: Experimental & Molecular Medicine
https://www.readbyqxmd.com/read/28101292/is-allergic-sensitization-relevant-in-severe-asthma-which-allergens-may-be-culprit
#19
REVIEW
Carlo Lombardi, Eleonora Savi, Erminia Ridolo, Giovanni Passalacqua, Giorgio Walter Canonica
Severe asthma is a major health concern. The allergic (IgE-mediated) form of asthma is well known from a pathogenic viewpoint. We searched the available literature to identify which allergens are most frequently associated with severe, refractory or life threatening asthma. According to the results, molds, pet dander, cockroach and ragweed were more frequently responsible for severe asthma. Thunderstorm asthma, in addition, represents a special association between allergic sensitization and an external climatic factor...
2017: World Allergy Organization Journal
https://www.readbyqxmd.com/read/28041760/response-to-glucagon-for-refractory-asthma-exacerbation-friend-or-foe
#20
Jillian M Cavallari, Tara S Jawaro, Nadia I Awad, Patrick J Bridgeman
No abstract text is available yet for this article.
December 23, 2016: American Journal of Emergency Medicine
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