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https://www.readbyqxmd.com/read/29766394/treatment-of-eosinophilic-granulomatosis-with-polyangiitis-a-review
#1
Loïc Raffray, Loïc Guillevin
Eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome) is a rare type of anti-neutrophil cytoplasm antibody-associated vasculitis. Nevertheless, eosinophilic granulomatosis with polyangiitis stands apart because it has features of vasculitis and eosinophilic disorders that require targeted therapies somewhat different from those used for other anti-neutrophil cytoplasm antibody-associated vasculitides. Considerable advances have been made in understanding the underlying pathophysiology of eosinophilic granulomatosis with polyangiitis that have highlighted the key role of eosinophils and opened new therapeutic opportunities...
May 15, 2018: Drugs
https://www.readbyqxmd.com/read/29756701/prevalence-of-mycoplasma-pneumoniae-infection-in-pediatric-patients-with-acute-asthma-exacerbation
#2
Elías Kassisse, Hecmary García, Linair Prada, Ixora Salazar, Jorge Kassisse
INTRODUCTION: Mycoplasma pneumoniae may be involved in refractory asthma exacerbation. OBJECTIVE: To determine the prevalence of Mycoplasma pneumoniae infection in patients with acute asthma exacerbation. Material and method. A prospective, crosssectional, observational, case-control study was carried out in patients older than 2 years old and younger than 12. Immunoglobulin M (IgM) antibodies were serologically determined for M. pneumoniae, using the NovaLisa® NovaTec kit for enzyme-linked immunosorbent assay (ELISA)...
June 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29729200/reduction-in-polyamine-catabolism-leads-to-spermine-mediated-airway-epithelial-injury-and-induces-asthma-features
#3
Vaibhav Jain, Shikha Raina, Atish Prabhakar Gheware, Rita Singh, Rakhshinda Rehman, Vinny Negi, Tracy Murray Stewart, Ulaganathan Mabalirajan, Adarsh Kumar Mishra, Robert A Casero, Anurag Agrawal, Balaram Ghosh
BACKGROUND: Airway epithelial injury is a crucial component of acute and severe asthma pathogenesis and a promising target for treatment of refractory asthma. However, the underlying mechanism of epithelial injury remains poorly explored. Though high levels of polyamines, mainly spermine, have been found in asthma and co-morbidity, their role in airway epithelial injury and the cause of their altered levels in asthma has not been explored. METHODS: We measured key polyamine metabolic enzymes in lung samples from normal and asthmatic subjects and in mice with OVA-induced allergic airway inflammation (AAI)...
May 5, 2018: Allergy
https://www.readbyqxmd.com/read/29649887/clinical-effect-of-endoscopic-vidian-neurectomy-on-bronchial-asthma-outcomes-in-patients-with-coexisting-refractory-allergic-rhinitis-and-asthma
#4
Jingang Ai, Zuozhong Xie, Xiang Qing, Wei Li, Honghui Liu, Tiansheng Wang, Guolin Tan
Background The prevalence of both allergic rhinitis and bronchial asthma is high throughout the world; their mutual influence on each other has been documented in many studies. However, studies regarding surgical intervention are limited. Objective To evaluate the clinical significance of endoscopic vidian neurectomy on bronchial asthma outcomes in patients with coexisting refractory allergic rhinitis and asthma. Methods A total of 109 patients with moderate to severe persistent intractable allergic rhinitis and mild/moderate asthma were allocated to the bilateral endoscopic vidian neurectomy group (group 1) or conservative medication group (group 2) according to the patients' self-selection...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29611440/new-biologics-for-allergic-diseases
#5
Laurie A Manka, Michael E Wechsler
Allergic conditions such as asthma and atopic dermatitis have a high prevalence but represent a heterogeneous group of diseases despite similar clinical presentation and underlying pathophysiology. A better understanding of the phenotypes and endotypes of these diseases has driven rapid development of biologic medications targeting many steps of the inflammatory pathways. Areas covered: There are 2 major inflammatory pathways that drive allergic diseases: Type-2 (Th-2) inflammation and non-type 2 inflammation...
April 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29609049/type-2-biomarkers-and-prediction-of-future-exacerbations-and-lung-function-decline-in-adult-asthma
#6
Ruth Semprini, Mathew Williams, Alex Semprini, Alice McDouall, James Fingleton, Cecile Holweg, Mark Weatherall, Richard Beasley, Irene Braithwaite
BACKGROUND: Type 2 biomarkers that predict both likelihood of future severe exacerbations and response to monoclonal antibody therapy in asthma, would be useful clinically in identifying patients both at greater risk of hospitalization, and most likely to benefit from monoclonal antibody therapy. OBJECTIVE: To describe the association between the Type 2 biomarkers, blood eosinophils, FeNO, serum periostin, serum IgE and time to severe exacerbation in a broad asthma population...
March 30, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29559484/extracorporeal-membrane-oxygenation-ecmo-for-near-fatal-asthma-refractory-to-conventional-ventilation
#7
Usman Maqsood, Nehal Patel
We describe a case of near-fatal asthma, treated successfully by initiation of extracorporeal membrane oxygenation (ECMO). A 29-year-old woman, known asthmatic on steroid inhalers, inhaled/nebulised bronchodilators, long-term oral prednisolone, theophylline and montelukast, presented with acute shortness of breath. She deteriorated following initial treatment with nebulised bronchodilators and magnesium sulfate requiring intubation and mechanical ventilation. Severe bronchospasm ensued following mechanical ventilation and peak airway pressures remained at 55 cm H2 O with intrinsic positive end expiratory pressure(PEEP) of 14 cm H2 O...
March 20, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29524537/refractory-airway-type-2-inflammation-in-a-large-subgroup-of-asthmatic-patients-treated-with-inhaled-corticosteroids
#8
Michael C Peters, Sheena Kerr, Eleanor M Dunican, Prescott G Woodruff, Merritt L Fajt, Bruce D Levy, Elliot Israel, Brenda R Phillips, David T Mauger, Suzy A Comhair, Serpil C Erzurum, Mats W Johansson, Nizar N Jarjour, Andrea M Coverstone, Mario Castro, Annette T Hastie, Eugene R Bleecker, Sally E Wenzel, John V Fahy
BACKGROUND: Airway type 2 inflammation is usually corticosteroid sensitive, but the role of type 2 inflammation as a mechanism of asthma in patients receiving high-dose inhaled corticosteroids (ICSs) is uncertain. OBJECTIVE: We sought to determine whether airway type 2 inflammation persists in patients treated with ICSs and to evaluate the clinical features of patients with steroid-resistant airway type 2 inflammation. METHODS: We used quantitative PCR to generate a composite metric of type 2 cytokine gene expression (type 2 gene mean [T2GM]) in induced sputum cells from healthy control subjects, patients with severe asthma receiving ICSs (n = 174), and patients with nonsevere asthma receiving ICSs (n = 85)...
March 7, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29453280/elevated-expression-of-il-33-and-tslp-in-the-airways-of-human-asthmatics-in-vivo-a-potential-biomarker-of-severe-refractory-disease
#9
Yan Li, Wei Wang, Zhe Lv, Yun Li, Yan Chen, Kewu Huang, Chris J Corrigan, Sun Ying
The epithelial cytokines IL-33, thymic stromal lymphopoietin (TSLP), and IL-25 have been implicated in asthma pathogenesis because they promote Th2-type cytokine synthesis, but their expression is relatively poorly documented in "real-life" human asthma. Using bronchoalveolar lavage fluid (BALF), we measured airway concentrations of these mediators and compared them with those of Th1- and Th2-type cytokines, airway infiltration of neutrophils and eosinophils, and lung function in a large group of asthmatic patients with a range of disease severity ( n = 70) and control subjects ( n = 30)...
April 1, 2018: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/29438772/lumen-area-change-delta-lumen-between-inspiratory-and-expiratory-multidetector-computed-tomography-as-a-measure-of-severe-outcomes-in-asthmatic-patients
#10
Sung Shine Shim, Mark L Schiebler, Michael D Evans, Nizar Jarjour, Ron L Sorkness, Loren C Denlinger, Alfonso Rodriguez, Sally Wenzel, Eric A Hoffman, Ching-Long Lin, David S Gierada, Mario Castro, Sean B Fain
BACKGROUND: Quantitative computed tomographic (QCT) biomarkers of airway morphology hold potential for understanding and monitoring regional airway remodeling in asthmatic patients. OBJECTIVE: We sought to determine whether the change in airway lumen area between total lung capacity (TLC) and functional residual capacity (FRC) lung volumes measured from CT imaging data was correlated with severe outcomes in asthmatic patients. METHODS: We studied 152 asthmatic patients (90 female and 62 male patients) and 33 healthy subjects (12 female and 21 male subjects) using QCT...
February 10, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29437007/blood-eosinophils-as-biomarkers-to-drive-treatment-choices-in-asthma-and-copd
#11
Konstantinos Kostikas, Caterina Brindicci, Francesco Patalano
Both asthma and COPD are complex, heterogeneous conditions comprising a wide range of phenotypes, some of which are refractory to currently available treatments. Elucidation of these phenotypes and identification of biomarkers with which to recognize them and guide appropriate treatment remains a priority. This review describes the utility of blood eosinophils as a surrogate biomarker of eosinophilic airway inflammation, a common feature of specific asthma and COPD phenotypes. The role of blood eosinophils in airway disease is described, as is their relevance in reflecting airway eosinophilia...
February 12, 2018: Current Drug Targets
https://www.readbyqxmd.com/read/29434524/the-control-of-allergic-rhinitis-in-real-life-a-multicenter-cross-sectional-italian-study
#12
Federica Gani, Carlo Lombardi, Laura Barrocu, Massimo Landi, Erminia Ridolo, Massimo Bugiani, Giovanni Rolla, Gianenrico Senna, Giovanni Passalacqua
Background: Allergic Rhinitis (AR) is a high-prevalence disease. In Europe about 25% of the general population is affected, and in Italy the prevalence is estimated to be 19.8%. The Allergic Rhinitis and its Impact on Asthma (ARIA) international document underlined that the prevalence of severe or refractory or overlapping rhinitis is increasing and represents a non-negligible socio-economic burden. In general, despite the social healthcare costs, allergic rhinitis remains underestimated, not sufficiently controlled and often undertreated...
2018: Clinical and Molecular Allergy: CMA
https://www.readbyqxmd.com/read/29408386/tiotropium-attenuates-refractory-cough-and-capsaicin-cough-reflex-sensitivity-in-patients-with-asthma
#13
Kensuke Fukumitsu, Yoshihiro Kanemitsu, Takamitsu Asano, Norihisa Takeda, Hiroya Ichikawa, Jennifer Maries Go Yap, Satoshi Fukuda, Takehiro Uemura, Osamu Takakuwa, Hirotsugu Ohkubo, Ken Maeno, Yutaka Ito, Tetsuya Oguri, Atsushi Nakamura, Masaya Takemura, Akio Niimi
BACKGROUND: Asthmatic cough is often refractory to standard treatments such as inhaled corticosteroids (ICS) and long-acting β2 agonists (LABA). Tiotropium may modulate cough reflex sensitivity of acute viral cough, but its efficacy in asthmatic cough remains unknown. OBJECTIVE: To evaluate whether tiotropium improves cough and cough reflex sensitivity in patients with asthma refractory to ICS/LABA. METHODS: Seventeen consecutive patients with asthma with chronic cough despite the use of ICS/LABA (13 women; 43...
February 3, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29404272/type-i-kounis-syndrome-variant-a-case-report-and-literature-review
#14
Abdullah Haddad, Triston Smith, Aneel Bole, Moneal Shah, Mithun Chakravarthy
Kounis syndrome defined as the occurrence of acute coronary syndrome in the setting of allergic reaction due to mast cells activation and inflammatory mediators release that induces coronary vasospasm, plaque erosion, or even stent thrombosis. A 25-year-old postpartum female with asthma and recurrent episodes of chest pain was admitted with ST-segment elevation myocardial infarction in the setting of coronary artery spasms. The patient was started on calcium channel blockers and nitrite-based medication with no improvement...
January 2018: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/29331328/pilot-clinical-trial-of-high-flow-oxygen-therapy-in-children-with-asthma-in-the-emergency-service
#15
Yolanda Ballestero, Jimena De Pedro, Nancy Portillo, Otilia Martinez-Mugica, Eunate Arana-Arri, Javier Benito
OBJECTIVES: To assess the efficacy of high-flow nasal cannula (HFNC) oxygen therapy and safety in children with asthma and moderate respiratory failure in the emergency department (ED). STUDY DESIGN: This was a prospective randomized pilot trial of children (aged 1-14 years) presenting to a tertiary academic pediatric ED with moderate-to-severe asthma exacerbations between September 2012 and December 2015. Patients with a pulmonary score (PS) ≥6 or oxygen saturation <94% with a face mask despite initial treatment (salbutamol/ipratropium bromide and corticosteroids) were randomized to HFNC or to conventional oxygen therapy...
March 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29301919/a-randomised-clinical-trial-of-feedback-on-inhaler-adherence-and-technique-in-patients-with-severe-uncontrolled-asthma
#16
Imran Sulaiman, Garrett Greene, Elaine MacHale, Jansen Seheult, Matshediso Mokoka, Shona D'Arcy, Terence Taylor, Desmond M Murphy, Eoin Hunt, Stephen J Lane, Gregory B Diette, J Mark FitzGerald, Fiona Boland, Aoife Sartini Bhreathnach, Breda Cushen, Richard B Reilly, Frank Doyle, Richard W Costello
In severe asthma, poor control could reflect issues of medication adherence or inhaler technique, or that the condition is refractory. This study aimed to determine if an intervention with (bio)feedback on the features of inhaler use would identify refractory asthma and enhance inhaler technique and adherence.Patients with severe uncontrolled asthma were subjected to a stratified-by-site random block design. The intensive education group received repeated training in inhaler use, adherence and disease management...
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29301585/a-randomised-pragmatic-trial-of-corticosteroid-optimization-in-severe-asthma-using-a-composite-biomarker-algorithm-to-adjust-corticosteroid-dose-versus-standard-care-study-protocol-for-a-randomised-trial
#17
Catherine E Hanratty, John G Matthews, Joseph R Arron, David F Choy, Ian D Pavord, P Bradding, Christopher E Brightling, Rekha Chaudhuri, Douglas C Cowan, Ratko Djukanovic, Nicola Gallagher, Stephen J Fowler, Tim C Hardman, Tim Harrison, Cécile T Holweg, Peter H Howarth, James Lordan, Adel H Mansur, Andrew Menzies-Gow, Sofia Mosesova, Robert M Niven, Douglas S Robinson, Dominick E Shaw, Samantha Walker, Ashley Woodcock, Liam G Heaney
BACKGROUND: Patients with difficult-to-control asthma consume 50-60% of healthcare costs attributed to asthma and cost approximately five-times more than patients with mild stable disease. Recent evidence demonstrates that not all patients with asthma have a typical type 2 (T2)-driven eosinophilic inflammation. These asthmatics have been called 'T2-low asthma' and have a minimal response to corticosteroid therapy. Adjustment of corticosteroid treatment using sputum eosinophil counts from induced sputum has demonstrated reduced severe exacerbation rates and optimized corticosteroid dose...
January 4, 2018: Trials
https://www.readbyqxmd.com/read/29300536/autoimmune-polyendocrine-syndrome-type-2-in-patient-with-severe-allergic-asthma-treated-with-omalizumab
#18
Anna Rams, Marek Żółciński, Weronika Zastrzeżyńska, Stanisław Polański, Agnieszka Serafin, Joanna Wilańska, Jacek Musiał, Stanisława Bazan-Socha
Asthma therapy with monoclonal antibodies is a promising and effective approach for those with a severe and refractory type of disease. Although such a targeted therapy is considered to be safe, unusual complications may occur. We present a case of a 45 year-old female patient with severe allergic asthma and chronic spontaneous urticaria, who developed autoimmune polyendocrine syndrome type 2 (APS-2) after 26 months of omalizumab administration. The patient was diagnosed with primary adrenal insufficiency (Addison's disease) and Hashimoto's thyroiditis accompanied by autoimmune atrophic gastritis...
January 4, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29288573/omalizumab-treats-chronic-rhinosinusitis-with-nasal-polyps-and-asthma-together-a-real-life-study
#19
T Bidder, J Sahota, C Rennie, V J Lund, D S Robinson, H H Kariyawasam
INTRODUCTION: Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma often coexist and thus treating both with one intervention is an attractive strategy. OBJECTIVE: To prospectively evaluate whether treatment with the monoclonal antibody against IgE Omalizumab for severe allergic asthma also effectively treats co-existent CRSwNP. METHODS: SNOT-22 and the ACQ-7 scores were recorded at 4 and 16 weeks of treatment in a cohort of patients with both CRSwNP and severe refractory allergic asthma treated with Omalizumab (n=13) according to UK guidelines for their severe asthma...
March 1, 2018: Rhinology
https://www.readbyqxmd.com/read/29229196/impact-of-allergy-on-phenotypic-and-endotypic-profiles-of-nasal-polyposis
#20
G Mortuaire, I Gengler, M Balden, M Capron, G Lefèvre
OBJECTIVES: To assess the impact of allergy on clinical presentations (phenotypes) and inflammatory patterns (endotypes) of chronic rhinosinusitis with nasal polyps (CRSwNP). METHODS: A single-center prospective study was conducted over an 18-month period. Fifty-seven patients with refractory CRSwNP were included. The diagnosis of allergy was based on concordant skin prick tests and symptoms. Phenotypes were determined on symptom severity score, polyp size classification and Lund-Mackay CT staging...
December 8, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
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