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Corticosteroid resistance

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https://www.readbyqxmd.com/read/29332324/effects-of-macrolide-and-corticosteroid-in-neutrophilic-asthma-mouse-model
#1
Tai Joon An, Chin Kook Rhee, Ji Hye Kim, Young Rong Lee, Jin Young Chon, Chan Kwon Park, Hyoung Kyu Yoon
BACKGROUND: Asthma is a disease of chronic airway inflammation with heterogeneous features. Neutrophilic asthma is corticosteroid-insensitive asthma related to absence or suppression of TH2 process and increased TH1 and/or TH17 process. Macrolides are immunomodulatory drug that reduce airway inflammation, but their role in asthma is not fully known. The purpose of this study was to evaluate the role of macrolides in neutrophilic asthma and compare their effects with those of corticosteroids...
January 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29332144/long-acting-%C3%AE-2-agonists-in-asthma-enantioselective-safety-studies-are-needed
#2
Glenn A Jacobson, Sharanne Raidal, Morten Hostrup, Luigino Calzetta, Richard Wood-Baker, Mark O Farber, Clive P Page, E Haydn Walters
Long-acting β2-agonists (LABAs) such as formoterol and salmeterol are used for prolonged bronchodilatation in asthma, usually in combination with inhaled corticosteroids (ICSs). Unexplained paradoxical asthma exacerbations and deaths have been associated with LABAs, particularly when used without ICS. LABAs clearly demonstrate effective bronchodilatation and steroid-sparing activity, but long-term treatment can lead to tolerance of their bronchodilator effects. There are also concerns with regard to the effects of LABAs on bronchial hyperresponsiveness (BHR), where long-term use is associated with increased BHR and loss of bronchoprotection...
January 13, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29325675/mycophenolate-mofetil-as-a-therapeutic-agent-for-interstitial-lung-diseases-in-systemic-sclerosis
#3
REVIEW
Takahiro Ueda, Takuro Sakagami, Toshiaki Kikuchi, Toshinori Takada
Systemic sclerosis (SSc) is an intractable disease that causes fibrosis in all organs. Approximately 40% of patients with SSc have some degree of interstitial lung disease (ILD). One third of patients with SSc and ILD, approximately 15% of all patients, have pulmonary lesions, which slowly progress to respiratory failure resistant to corticosteroid and other treatments. A randomized controlled trial conducted in the United States indicated that one year of treatment with oral cyclophosphamide in patients with SSc-ILD had a significant but modest beneficial effect on lung function, dyspnea, thickening of the skin, and health-related quality of life...
January 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29321413/remission-of-refractory-ascites-and-discontinuation-of-hemodialysis-after-additional-rituximab-to-long-term-glucocorticoid-therapy-in-a-patient-with-tafro-syndrome
#4
Hanako Tsurumi, Yoshihide Fujigaki, Tadashi Yamamoto, Risa Iino, Kei Taniguchi, Michito Nagura, Shigeyuki Arai, Yoshifuru Tamura, Tatsuru Ota, Shigeru Shibata, Fukuo Kondo, Nozomu Kurose, Yasufumi Masaki, Shunya Uchida
Thrombocytopenia, ascites, myelofibrosis, renal dysfunction, and organomegaly (TAFRO) syndrome is a newly recognized but rare disease, and its treatment has not yet been established. We reported a 50-year-old woman with TAFRO syndrome diagnosed 2 years after the initial symptoms of a fever, fatigue, epigastric pain, edema, ascites, lymphadenopathy, thrombocytopenia and renal insufficiency. The patient showed refractory ascites and required hemodialysis under corticosteroid mono-therapy for suspected immune-mediated disease but was successfully treated with additive rituximab, resulting in improvement in her laboratory data, the withdrawal of hemodialysis and the disappearance of ascites...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29314244/rapid-successful-treatment-of-atopic-dermatitis-recalcitrant-to-topical-corticosteroids
#5
Daniel J Lewis, Steven R Feldman
Atopic dermatitis is responsive to midpotency topical corticosteroids, which are the mainstay of treatment, yet many patients have disease that is "resistant" to triamcinolone prescribed for outpatient use. Such resistance is often due to poor adherence, but patients and caregivers may remain adamant that the steroid was ineffective and assure the physician that it was applied as recommended. We describe the case of a young girl with a 2-year history of atopic dermatitis resistant to triamcinolone whose condition rapidly improved with continued use of triamcinolone...
January 4, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29299707/lupus-myocarditis-receiving-the-rituximab-therapy-a-monocentric-retrospective-study
#6
Chrong-Reen Wang, Yi-Shan Tsai, Wei-Ting Li
Despite high-dose corticosteroids alone or with immunosuppressive agents as the standard therapy in lupus myocarditis (LM), an immune complex-mediated critical setting, such management is still associated with resistant disease and even mortality. A retrospective study was performed for the refractory LM patients treated with rituximab (RTX), a very limited experience in English literatures. A retrospective review of the myocarditis manifestation was carried out in hospitalized Han Chinese patients with SLE from February 2007 to January 2017...
January 3, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29297055/pharmacology-of-corticosteroids-for-diabetic-macular-edema
#7
Scott M Whitcup, John A Cidlowski, Karl G Csaky, Jayakrishna Ambati
Purpose: Corticosteroids remain the mainstay of treatment for inflammatory diseases almost 80 years after their first clinical use. Topical ophthalmic formulations of corticosteroids have been available to treat disease of the anterior segment of the eye, but the approval of corticosteroids to treat vitreoretinal diseases, including vein occlusion, diabetic macular edema, and uveitis, has occurred only recently. Although most diseases respond to corticosteroid therapy, some patients are resistant to this therapy and side effects, including cataract and elevated intraocular pressure, can limit their use...
January 1, 2018: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/29289977/anti-pd-1-induced-high-grade-hepatitis-associated-with-corticosteroid-resistant-t-cells-a-case-report
#8
Helen M McGuire, Elena Shklovskaya, Jarem Edwards, Paul R Trevillian, Geoffrey W McCaughan, Patrick Bertolino, Catriona McKenzie, Ralph Gourlay, Stuart J Gallagher, Barbara Fazekas de St Groth, Peter Hersey
Effective treatment or prevention of immune side effects associated with checkpoint inhibitor therapy of cancer is an important goal in this new era of immunotherapy. Hepatitis due to immunotherapy with antibodies against PD-1 is uncommon and generally of low severity. We present an unusually severe case arising in a melanoma patient after more than 6 months uncomplicated treatment with anti-PD-1 in an adjuvant setting. The hepatitis rapidly developed resistance to high-dose steroids, requiring anti-thymocyte globulin (ATG) to achieve control...
December 30, 2017: Cancer Immunology, Immunotherapy: CII
https://www.readbyqxmd.com/read/29288933/targeting-the-renin-angiotensin-system-as-novel-therapeutic-strategy-for-pulmonary-diseases
#9
REVIEW
Wan Shun Daniel Tan, Wupeng Liao, Shuo Zhou, Dan Mei, Wai-Shiu Fred Wong
The renin-angiotensin system (RAS) plays a major role in regulating electrolyte balance and blood pressure. RAS has also been implicated in the regulation of inflammation, proliferation and fibrosis in pulmonary diseases such as asthma, acute lung injury (ALI), chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF) and pulmonary arterial hypertension (PAH). Current therapeutics suffer from some drawbacks like steroid resistance, limited efficacies and side effects. Novel intervention is definitely needed to offer optimal therapeutic strategy and clinical outcome...
December 27, 2017: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29288170/atorvastatin-enhances-bone-marrow-endothelial-cell-function-in-corticosteroid-resistant-immune-thrombocytopenia-patients
#10
Yuan Kong, Xie-Na Cao, Xiao-Hui Zhang, Min-Min Shi, Yue-Yun Lai, Yu Wang, Lan-Ping Xu, Ying-Jun Chang, Xiao-Jun Huang
The pathogenesis of corticosteroid-resistant immune thrombocytopenia (ITP), a clinically challenging condition in which patients exhibit either no response to corticosteroids or are corticosteroid-dependent, remains poorly understood. Murine studies suggest that bone marrow (BM) endothelial progenitor cells (EPCs) play a crucial role in regulating megakaryocytopoiesis. However, little is known regarding the number and function of BM EPCs or how to improve impaired BM EPCs in corticosteroid-resistant ITP patients...
December 29, 2017: Blood
https://www.readbyqxmd.com/read/29287833/corticosteroid-treatment-in-sydenham-s-chorea
#11
C Fusco, C Spagnoli
Sydenham's chorea (SC) is an immune-mediated hyperkinetic movement disorder, developing after group A Beta-hemolytic streptococcal (GABHS) infection. Aside from conventional symptomatic treatment (carbamazepine, valproate, neuroleptics), the use of steroids has also been advocated, mainly in severe, drug-resistant cases or if clinically disabling side effects develop with first line therapies. Based on the description of 5 cases followed in the Child Neurology Unit of Santa Maria Nuova Hospital in Reggio Emilia and on the available medical literature on this topic, we propose considering the use of corticosteroids therapy in children with SC, with the administration of IV methyl-prednisolone followed by oral deflazacort in severe cases and of oral deflazacort alone in mild and moderate degrees of involvement...
December 16, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29249126/dyspareunia-in-vulvar-lichen-sclerosus-an-overview-of-a-distressing-symptom
#12
Monica Corazza, Annarosa Virgili, Sara Minghetti, Alessandro Borghi
BACKGROUND: Dyspareunia is a symptom of vulvar lichen sclerosus (VLS). This study specifically addressed prevalence and severity of dyspareunia in patients affected with VLS as well as the factors that can influence its occurrence. Changes in the severity of dyspareunia with treatment were also explored. METHODS: In this retrospective, cohort study we included VLS patients who had undergone any topical treatment for 12 weeks, between January 2011 and March 2016, at our Vulva Unit; demographics, history and clinical features recorded at baseline and at treatment completion were elaborated...
December 15, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/29246256/effect-of-oral-glycine-on-the-clinical-spirometric-and-inflammatory-status-in-subjects-with-cystic-fibrosis-a-pilot-randomized-trial
#13
Mario H Vargas, Rosangela Del-Razo-Rodríguez, Amando López-García, José Luis Lezana-Fernández, Jaime Chávez, María E Y Furuya, Juan Carlos Marín-Santana
BACKGROUND: Patients with cystic fibrosis (CF) have airway inflammation that contributes to symptoms and to pulmonary function derangement. Current drugs used to diminish airway inflammation improve the clinical and spirometric status of patients with CF, but their use is limited due to their undesired side effects, for example, glucose intolerance, growth retardation, and cataracts with corticosteroids, gastrointestinal toxicity with ibuprofen, and macrolide resistance with azythromycin...
December 15, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29229321/the-role-of-aspirin-heparin-and-other-interventions-in-the-prevention-and-treatment-of-fetal-growth-restriction
#14
REVIEW
Katie M Groom, Anna L David
Fetal growth restriction and related placental pathologies such as preeclampsia, stillbirth, and placental abruption are believed to arise in early pregnancy when inadequate remodeling of the maternal spiral arteries leads to persistent high-resistance and low-flow uteroplacental circulation. The consequent placental ischaemia, reperfusion injury, and oxidative stress are associated with an imbalance in angiogenic/antiangiogenic factors. Many interventions have centered on the prevention and/or treatment of preeclampsia with results pertaining to fetal growth restriction and small-for-gestational-age pregnancy often included as secondary outcomes because of the common pathophysiology...
December 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29228331/clinical-characteristics-and-outcomes-of-patients-with-chronic-disseminated-candidiasis-who-need-adjuvant-corticosteroid-therapy
#15
Young-Rock Jang, Min-Chul Kim, Taeeun Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo, Jung Yong Hong, Dok Hyun Yoon, Cheolwon Suh, Jung-Hee Lee, Je-Hwan Lee, Kyoo-Hyung Lee, Sung-Han Kim
We performed a retrospective study involving 21 patients with chronic disseminate candidiasis (CDC) and 38 patients with candidemia. Neutropenia of >2 weeks' duration was more common in those with CDC (71%) than in those with candidemia (26%, P < .001), and the azole-resistant rate in patients with CDC (5%) was lower than that in those with candidemia (29%, P = .03). Of the 21 patients with CDC, five (24%) needed adjuvant corticosteroid therapy due to persistent debilitating fever (median, 19 days). Rapid defervescence (median, 5 days) occurred after adjuvant corticosteroid therapy...
December 8, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29227717/quercetin-restores-corticosteroid-sensitivity-in-cells-from-patients-with-chronic-obstructive-pulmonary-disease
#16
Akihisa Mitani, Aishah Azam, Chaitanya Vuppusetty, Kazuhiro Ito, Nicolas Mercado, Peter J Barnes
Corticosteroid resistance is a major barrier to the effective treatment of chronic obstructive pulmonary disease (COPD). Oxidative stress from cigarette smoke and chronic inflammation is likely to induce this corticosteroid insensitivity. Quercetin is a polyphenol that has been reported to be an active oxygen scavenger as well as a functional adenosine monophosphate-activated protein kinase (AMPK) activator. The aim of this study was to investigate the effect of quercetin on corticosteroid responsiveness in COPD cells...
December 11, 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/29225917/role-of-p-glycoprotein-on-cd69-cd4-cells-in-the-pathogenesis-of-proliferative-lupus-nephritis-and-non-responsiveness-to-immunosuppressive-therapy
#17
Shizuyo Tsujimura, Tomoko Adachi, Kazuyoshi Saito, Yoshiya Tanaka
Introduction: P-glycoprotein (P-gp) expression on activated lymphocytes in systemic lupus erythematosus (SLE) plays a role in active efflux of intracellular drugs, resulting in drug resistance. The role of P-gp-expressing lymphocytes in the pathogenesis of SLE remains unclear. The aim of this study was to determine the importance of P-gp+CD4+ cells in organ manifestations in refractory SLE. Methods: The proportion of P-gp+CD4+ cells was determined by flow cytometry in peripheral blood of patients with SLE (n=116) and healthy adults (n=10)...
2017: RMD Open
https://www.readbyqxmd.com/read/29223724/vasoplegia-after-cardiovascular-procedures-pathophysiology-and-targeted-therapy
#18
REVIEW
Shahzad Shaefi, Aaron Mittel, John Klick, Adam Evans, Natalia S Ivascu, Jacob Gutsche, John G T Augoustides
Vasoplegic syndrome, characterized by low systemic vascular resistance and hypotension in the presence of normal or supranormal cardiac function, is a frequent complication of cardiovascular surgery. It is associated with a diffuse systemic inflammatory response and is mediated largely through cellular hyperpolarization, high levels of inducible nitric oxide, and a relative vasopressin deficiency. Cardiopulmonary bypass is a particularly strong precipitant of the vasoplegic syndrome, largely due to its association with nitric oxide production and severe vasopressin deficiency...
October 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29218062/preliminary-study-regarding-the-association-between-tumor-necrosis-factor-alpha-gene-polymorphisms-and-childhood-idiopathic-nephrotic-syndrome-in-romanian-pediatric-patients
#19
Ioana Tieranu, Monica I Dutescu, Constantin Bara, Cristian G Tieranu, Mihaela Balgradean, Olivia M Popa
Background: Childhood idiopathic nephrotic syndrome (INS) is one of the most common glomerular diseases, characterized by heavy proteinuria, hypoalbuminemia, dyslipidemia and generalized edema. Although some progresses were made regarding the pathogenesis of this disease, there are a lot of questions still left unanswered. Some of them involve the implications of several cytokines, including tumor necrosis factor alpha (TNF-alpha), in the development and clinical course of INS. Objective: Our objective was to analyze the role of two single nucleotide polymorphisms of TNF-alpha gene in the development of pediatric INS and their implication in the response to corticosteroid therapy...
September 2017: Mædica
https://www.readbyqxmd.com/read/29215565/a-miniaturized-impedimetric-immunosensor-for-the-competitive-detection-of-adrenocorticotropic-hormone
#20
Nan Li, Egor M Larin, Kagan Kerman
Adrenocorticotropic hormone (ACTH) plays an essential role in regulating corticosteroid hormone production, which has important functions in a myriad of critical physiological functions. In this proof-of-concept study, a miniaturized immunosensor was developed for the highly sensitive detection of ACTH using electrochemical impedance spectroscopy (EIS) in connection with disposable screen-printed gold electrodes (SPGEs). A film of 3,3'-dithiobis[sulfosuccinimidylpropionate] (DTSSP) was prepared to immobilize anti-ACTH antibodies covalently on the nanostructured SPGE surface...
December 7, 2017: Sensors
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