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JOURNAL ARTICLE
Suhas Sondur, Govid Vj, Shakti Prasad Das
The anti-inflammatory and immunosuppressive properties of steroids allow their use in a wide variety of rheumatological diseases, asthma, inflammatory bowel disease, cancer therapy, and severe viral infections. Though life-saving or organ-saving, long-term clinical use leads to a vast array of complications. Osteoporosis is the most common orthopedic side effect of steroid abuse, while osteonecrosis is a rare occurrence. The risk of osteonecrosis appears to be dose and duration dependent, but several patient factors also play a major role and usually affect the femoral head followed by the knee joint...
March 2024: Clinical Medicine & Research
#2
JOURNAL ARTICLE
Charlene Desaintjean, Kaïs Ahmad, Julie Traclet, Mathieu Gerfaud-Valentin, Cecile-Audrey Durel, Jean-Charles Glerant, Arnaud Hot, François Lestelle, Sabine Mainbourg, Mouhamad Nasser, Pascal Seve, Ségolène Turquier, Gilles Devouassoux, Vincent Cottin
INTRODUCTION: Asthma associated with eosinophilic granulomatosis with polyangiitis (EGPA) is often severe and corticosteroid-dependent, leading to significant morbidity. Mepolizumab and benralizumab are humanized monoclonal antibodies targeting interleukin 5 (IL-5) and its receptor, respectively. They have been shown to be effective in steroid-sparing in patients with severe eosinophilic asthma. OBJECTIVE: Our aim was to evaluate the efficacy and safety of mepolizumab and benralizumab prescribed for severe asthma in patients with EGPA under "real-world" conditions...
2024: Frontiers in Medicine
#3
JOURNAL ARTICLE
Antonio Faraone, Alberto Fortini, Vanni Borgioli, Chiara Cappugi, Aldo Lo Forte, Valeria Maria Bottaro, Augusto Vaglio
BACKGROUND: eosinophilic granulomatosis with polyangiitis (EGPA) is a rare multisystem inflammatory disease characterized by asthma, eosinophilia and granulomatous or vasculitic involvement of various organs. While the eye is uncommonly affected in patients with EGPA, multiple ophthalmic manifestations have been reported, which can result in serious visual impairment without timely treatment. CASE REPORT: we report the case of a 79-year-old woman with a history of asthma and nasal polyps who presented with low-grade fever, mild alteration of mental status, and fatigue...
2024: European Journal of Case Reports in Internal Medicine
#4
REVIEW
Rohit Goyal, Amrit K Kamboj, Diana L Snyder
Eosinophilic esophagitis (EoE) is a chronic and progressive immune-mediated esophageal disorder. Given its increasing incidence, it is now a leading cause of dysphagia and food impaction in the United States. Eosinophilic esophagitis is most common in adult White men and has a high concurrence rate with other atopic conditions like allergic rhinitis, bronchial asthma, and eczema. The initial presentation includes symptoms of esophageal dysfunction, classically solid-food dysphagia. Without treatment, inflammation can progress to fibrosis with the formation of strictures, leading to complications such as food impaction...
April 2024: Mayo Clinic Proceedings
#5
Ning Cui, Jingluan Wang, Yanmei Shao, Jingming Zhao, Zhaozhong Cheng
A 27-year-old female visited our hospital with a history of asthma, peripheral blood eosinophilia, increased total IgE, Aspergillus fumigatus specific IgE, reversible mild bronchiectasis, sinusitis, bronchial mucus plugs and cultivation of Aspergillus from BALF. Glucocorticoids therapy is effective. These results met the diagnostic criteria for both allergic bronchopulmonary aspergillosis (ABPM) and eosinophilic granulomatosis with polyangiitis (EGPA). Special attention should be paid to the possibility of both diseases coexisting in the disease process...
2024: Respiratory Medicine Case Reports
#6
JOURNAL ARTICLE
Peter T Daley-Yates, Bhumika Aggarwal, Maximilian Plank
INTRODUCTION: Asthma treatment guidelines classify inhaled corticosteroid (ICS) regimens as low, medium, or high dose. However, efficacy and safety are not independently assessed accordingly. Moreover, differences in ICS duration of action are not considered when a dose regimen is selected. We investigated the efficacy and safety implications of these limitations for available ICS molecules. METHODS: Published pharmacodynamic and pharmacokinetic parameters were used, alongside physiological and pharmacological principles, to estimate the efficacy and safety of available ICS molecules...
March 27, 2024: Advances in Therapy
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JOURNAL ARTICLE
Andrew N Menzies-Gow, Trung N Tran, Brooklyn Stanley, Victoria Ann Carter, Josef S Smolen, Arnaud Bourdin, J Mark Fitzgerald, Tim Raine, Jatin Chapaneri, Benjamin Emmanuel, David J Jackson, David B Price
PURPOSE: Associations between systemic glucocorticoid (SGC) exposure and risk for adverse outcomes have spurred a move toward steroid-sparing treatment strategies. Real-world changes in SGC exposure over time, after the introduction of steroid-sparing treatment strategies, reveal areas of successful risk mitigation as well as unmet needs. PATIENTS AND METHODS: A population-based ecological study was performed from the Optimum Patient Care Research Database to describe SGC prescribing trends of steroid-sparing treatment strategies in primary care practices before and after licensure of biologics in the United Kingdom from 1990 to 2019...
2024: Pragmatic and Observational Research
#8
REVIEW
Willis S Bowman, Rebecca J Schmidt, Gursharan K Sanghar, George R Thompson Iii, Hong Ji, Amir A Zeki, Angela Haczku
BACKGROUND: Wildfires are a global concern due to their wide-ranging environmental, economic, and public health impacts. Climate change contributes to an increase in the frequency and intensity of wildfires making smoke exposure a more significant and recurring health concern for individuals with airway diseases. Some of the most prominent effects of wildfire smoke exposure are asthma exacerbations and allergic airway sensitization. Likely due to the delayed recognition of its health impacts in comparison with cigarette smoke and industrial or traffic-related air pollution, research on the composition, the mechanisms of toxicity, and the cellular/molecular pathways involved is poor or non-existent...
March 7, 2024: International Archives of Allergy and Immunology
#9
JOURNAL ARTICLE
Lexin Chen, Can Li, Hangang Chen, Yangli Xie, Nan Su, Fengtao Luo, Junlan Huang, Ruobin Zhang, Lin Chen, Bo Chen, Jing Yang
UNLABELLED: The study, using data from Chongqing, China, and employing Mendelian randomization along with bioinformatics, establishes a causal link between asthma and osteoporosis, beyond glucocorticoid effects. Asthma may contribute to osteoporosis by accelerating bone turnover through inflammatory factors, disrupting the coupling between osteoblasts and osteoclasts, ultimately leading to osteoporosis. INTRODUCTION: Asthma and osteoporosis are prevalent health conditions with substantial public health implications...
March 2, 2024: Osteoporosis International
#10
JOURNAL ARTICLE
Hui-Hui Guo, Yan-Xing Han, Xiao-Juan Rong, Zhen Shen, Hao-Ran Shen, Ling-Fei Kong, Yun-Dan Guo, Ji-Zhou Li, Bo Xu, Tian-Le Gao, Lu-Lu Wang, Cai Tie, Jian-Dong Jiang
BACKGROUND: Asthma affects 3% of the global population, leading to over 0.25 million deaths. Due to its complexity, asthma is difficult to cure or prevent, and current therapies have limitations. This has led to a growing demand for alternative asthma treatments. We found rosmarinic acid (RosA) as a potential new drug candidate from natural medicine. However, RosA has poor bioavailability and remains mainly in the gastrointestinal tract after oral administration, suggesting the involvement of gut microbiota in its bioactivity...
April 2024: Phytomedicine
#11
REVIEW
Chika V Anekwe, Yoon Ji Ahn, Simar Singh Bajaj, Fatima Cody Stanford
This review aims to summarize pharmacological interventions that may affect adiposity and metabolic equilibrium in individuals with obesity. Pharmacological therapy is frequently used to treat medical conditions that are both directly related to obesity (such as hypertension and type 2 diabetes) and indirectly related to obesity (such as asthma, insomnia, and type 1 diabetes). This pharmacological therapy may result in weight gain and alterations in the metabolic profile. Many medication classes are implicated in the pharmacologic causes of weight gain, including antipsychotics, glucocorticoids, beta-adrenergic blockers, tricyclic antidepressants, antihistamines, insulin, neuropathic agents, sleep agents, and steroids...
February 22, 2024: Annals of the New York Academy of Sciences
#12
JOURNAL ARTICLE
Songsong Yu, Shuang Li, Jie Zhang, Qiuhong Fang
OBJECTIVE OF THE STUDY: Systemic glucocorticoid therapy can improve the outcomes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The study tried to investigate the use of glucocorticoids in AECOPD patients and the factors associated with the physicians' choice. METHODOLOGY: Patients with AECOPD over two periods were divided by the year of 2017 when GOLD and ERS/ATS Guideline for COPD were updated. Data of patients regarding the study was retrieved from medical records...
2024: International Journal of Chronic Obstructive Pulmonary Disease
#13
REVIEW
Junjun Peng, Na Lu, Shucheng Hua, Lei Song, Han Liu
Understanding the pathogenesis of different phenotypes of asthma, including glucocorticoid-dependent and glucocorticoid-resistant asthma, is crucial for the development of effective treatments. Autophagy, a fundamental cellular process involved in cell homeostasis, has been implicated in asthma, although the exact mechanisms remain unclear. Recent studies have identified autophagy activation in eosinophilic, neutrophilic, and paucigranulocytic asthma, providing novel insights into the disease. This comprehensive review examines the role of autophagy in the pathogenesis and treatment of asthma, with a focus on various cell types...
January 18, 2024: Frontiers in Bioscience (Landmark Edition)
#14
REVIEW
Md Mojahidur Hasan, Sehreen Tory
BACKGROUND: Glucocorticoids are the most commonly used anti-inflammatory drugs for a variety of diseases, despite the fact that resistance to them is growing in a number of conditions. There is currently no biomarker that can be used to identify steroid resistance. According to a number of studies, an overexpression of the glucocorticoid receptor beta (GR-β) isoform is associated with steroid-resistant illness. Our goal is to find out whether or not steroid-resistant disorders are associated with an increased level of GR-β expression...
January 2024: Immunity, Inflammation and Disease
#15
MULTICENTER STUDY
Alessandra Bettiol, Maria Letizia Urban, Roberto Padoan, Matthieu Groh, Giuseppe Lopalco, Allyson Egan, Vincent Cottin, Paolo Fraticelli, Claudia Crimi, Stefano Del Giacco, Laura Losappio, Laura Moi, Francesco Cinetto, Marco Caminati, Pavel Novikov, Alvise Berti, Paolo Cameli, Pascal Cathébras, Angelo Coppola, Cécile-Audrey Durel, Marco Folci, Alberto Lo Gullo, Carlo Lombardi, Sara Monti, Paola Parronchi, Carlos Martinez Rivera, Roser Solans, Angelo Vacca, Georgina Espígol-Frigolé, Gabriella Guarnieri, Fulvia Chieco Bianchi, Maria Rita Marchi, Colas Tcherakian, Jean-Emmanuel Kahn, Florenzo Iannone, Vincenzo Venerito, Charlene Desaintjean, Gianluca Moroncini, Santi Nolasco, Giulia Anna Maria Luigia Costanzo, Jan Walter Schroeder, Camillo Ribi, Michelangelo Tesi, Elena Gelain, Irene Mattioli, Federica Bello, David Jayne, Domenico Prisco, Augusto Vaglio, Giacomo Emmi
BACKGROUND: Interleukin-5 (IL-5) inhibitors represent novel therapies for eosinophilic granulomatosis with polyangiitis (EGPA). This study assessed the effectiveness and safety of the IL-5 receptor inhibitor benralizumab in a European cohort of patients with EGPA. METHODS: This retrospective cohort study included patients with EGPA from 28 European referral centres of the European EGPA Study Group across six countries (Italy, France, UK, Russia, Spain, and Switzerland) who received benralizumab as any line of treatment between Jan 1, 2019, and Sep 30, 2022...
December 2023: Lancet Rheumatology
#16
JOURNAL ARTICLE
Naomi J Patel, David R W Jayne, Peter A Merkel, Pirow Bekker, Yuqing Zhang, P Jane McDowell, Joslin Johal, Liam G Heaney, Dedee Murrell, Martha N Stone, Huibin Yue, John H Stone
BACKGROUND: Quantifying glucocorticoid toxicity is crucial to efforts to reduce it. The Glucocorticoid Toxicity Index (GTI) measures toxicity effectively in clinical trials by calculating two scores: the cumulative worsening score (CWS) and the aggregate improvement score (AIS). However, in clinical practice, high patient volumes limit the time available for standardised assessments. We aimed to compare the GTI with an abbreviated version of the GTI, the GTI-Metabolic Domains (GTI-MD), which could help to address this issue by using data that are collected easily at routine visits and do not require additional effort from clinicians...
July 2023: Lancet Rheumatology
#17
JOURNAL ARTICLE
Hayato Shimora, Masaya Matsuda, Naoki Takemoto, Miku Nomura, Junpei Hamaguchi, Ryogo Terakawa, Miki Inaba, Kazuyuki Kitatani, Takeshi Nabe
Between 5 and 10% of asthma patients do not respond to glucocorticoid therapy. Experimental animal models are indispensable for investigating the pathogenesis of steroid-resistant asthma; however, the majority of murine asthma models respond well to glucocorticoids. We previously reported that multiple intratracheal administration of ovalbumin (OVA) at a high dose (500 µg/animal) induced steroid-insensitive airway eosinophilia and remodeling with lung fibrosis, whereas a low dose (5 µg/animal) caused steroid-sensitive responses...
2024: Biological & Pharmaceutical Bulletin
#18
JOURNAL ARTICLE
Peixv Chen, Yali Yu, Li He, Chunyi Zhang, Yiting Li, Di Wu, Ying Chen, Ran Wang, Guopeng Xu, Chao Cao
Despite conventional glucocorticoid and antifungal therapy, acute exacerbation and hospitalization occur frequently in patients with allergic bronchopulmonary aspergillosis (ABPA). Whether omalizumab is an effective and safe treatment for adult patients with ABPA complicating asthma. Patients with ABPA complicating asthma who were treated with omalizumab from October 2019 to May 2023 were collected from five tertiary hospitals and evaluated. The frequencies of acute exacerbation and hospitalization; the number of eosinophils; the total IgE levels; and the average monthly medical dosages after 3, 6, and 12 months of omalizumab treatment were analysed, and the data before and after treatment (up to one year) were compared...
January 19, 2024: Clinical and Experimental Medicine
#19
Ryu Sekiya, Tomoyuki Soma, Kazuyuki Nakagome, Makoto Nagata
Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis accompanied by granulomas and eosinophilic inflammation, exhibiting marked peripheral blood eosinophiliaandasthma. Neuropathy is a difficult-to-treat common manifestation that frequently remains after achieving clinical remission with current therapy in a subpopulation of patients with EGPA with or without life-threatening organ involvement. Refractory neuropathy regularly reduces the quality of life and requires glucocorticoids (GCs) and/or immunosuppressants for a long time...
January 2024: Curēus
#20
JOURNAL ARTICLE
Alexander Malik, Benjamin Douglas Liu, Liangru Zhu, David Kaelber, Gengqing Song
BACKGROUND: We explored inflammatory bowel disease (IBD) and eosinophilic esophagitis (EoE) coexistence using a global dataset. Investigating their epidemiology, risks, and impact, we aimed to enhance the understanding of concurrent diagnoses and patient outcomes. METHODS: A retrospective population-based cohort study was conducted using deidentified patient data from the TriNetX database (2011-2022). We estimated the incidence and prevalence of EoE in patients with IBD, including both Crohn's disease (CD) and ulcerative colitis (UC), and vice versa...
January 13, 2024: Digestive Diseases and Sciences
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