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https://www.readbyqxmd.com/read/27909980/omalizumab-in-severe-refractory-vernal-keratoconjunctivitis-in-children-case-series-and-review-of-the-literature
#1
Serge Doan, Flore Amat, Eric Gabison, Sarah Saf, Isabelle Cochereau, Jocelyne Just
INTRODUCTION: Vernal keratoconjunctivis (VKC) is a severe form of pediatric ocular allergy, characterized by acute and chronic corneoconjunctival inflammation that may lead to visual sequelae. Although topical immunosuppressive drugs such as cyclosporine are usually effective, some severe forms may be refractory and require prolonged steroid therapy. Very few papers report the use of omalizumab in VKC in the literature. In the present study, we describe our clinical experience with omalizumab in severe VKC children...
December 1, 2016: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/27879191/replacement-of-sfc-dpi-with-sfc-mdi-exhaled-through-the-nose-improved-eosinophilic-chronic-rhinosinusitis-with-bronchial-asthma%C3%A2
#2
Yoshiki Kobayashi, Mikiya Asako, Takahisa Yamamoto, Hirotaka Yasuba, Koichi Tomoda, Akira Kanda
OBJECTIVE: Eosinophilic chronic rhinosinusitis (ECRS), a subgroup of chronic rhinosinusitis with nasal polyps, is a refractory disease closely associated with bronchial asthma. We recently reported on the efficacy of ultra-fine particle inhaled corticosteroids (ICS) (hydrofluoroalkane-134a-beclomethasone dipropionate: HFA-BDP) exhalation through the nose (ETN) treatment for mild-to-moderate asthmatics with ECRS. However, the effect of HFA-BDP ETN was found to be transient in some cases with severe ECRS and asthma, requiring treatment with higher-dose ICS and long-acting β2-agonists (LABA)...
November 23, 2016: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27864676/anti-ige-and-biologic-approaches-for-the-treatment-of-asthma
#3
Patrick D Mitchell, Amani I El-Gammal, Paul M O'Byrne
Current asthma treatments are effective for the majority of patients with mild-to-moderate disease. However, in those with more severe refractory asthma, agents other than inhaled corticosteroids and beta-agonists are needed both to better manage this group of patients and to avoid the side effects of high-dose corticosteroids and the social and personal hardship endured. Several biological pathways have been targeted over the last 20 years, and this research has resulted in pharmacological approaches to attempt to better treat patients with severe refractory asthma...
November 19, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27849652/polyps-asthma-and-allergy-what-s-new
#4
Dimitrios Terzakis, Christos Georgalas
PURPOSE OF REVIEW: Although chronic rhinosinusitis with nasal polyps, asthma, and allergy share common inflammatory mechanisms, there is no evidence of cause-and-effect relationship. In this review, we present new studies investigating the complex immunology that links these diseases. Advances in new therapies as well as evidence regarding indication and timing of surgery, especially of more complex cases, are highlighted. RECENT FINDINGS: New studies have endotyped patients in an effort to describe the exact inflammatory profile of each phenotype, whereas described cytokines seem to play a significant role in amplification of T2 inflammation, directly or via innate lymphoid cells...
November 15, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27844172/xanthines-and-phosphodiesterase-inhibitors
#5
D Spina, C P Page
Theophylline is an orally acting xanthine that has been used since 1937 for the treatment of respiratory diseases including asthma and chronic obstructive pulmonary disease (COPD). However, in most treatment guidelines, xanthines have now been consigned to third-line therapy because of their narrow therapeutic window and propensity for drug-drug interactions. However, lower than conventional doses of theophylline considered to be bronchodilator are now known to have anti-inflammatory actions of relevance to the treatment of respiratory disease...
November 15, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27814586/exercise-intolerance-and-exercise-induced-bronchoconstriction-in-children
#6
Predrag B Minic, Aleksandar D Sovtic
Respiratory symptoms at rest or during exercise may restrain the physical capabilities required for normal motor and psychosocial development in children. The most frequent cause of exercise intolerance, apart from poor physical fitness, is exercise-induced bronchoconstriction (EIB), which may occur in some healthy children and in children with asthma. It is proposed that hyperventilation during exercise is associated with drying and cooling of airways, which can trigger a proinflammatory response. Several tests are used to confirm EIB, and the exercise-challenge test is the most common...
January 1, 2017: Frontiers in Bioscience (Elite Edition)
https://www.readbyqxmd.com/read/27807906/activin-a-and-follistatin-in-patients-with-asthma-does-severity-make-the-difference
#7
Anastasia Papaporfyriou, Petros Bakakos, Konstantinos Kostikas, Georgios Papatheodorou, Georgios Hillas, Rodoula Trigidou, Patroklos Katafigiotis, Nikolaos G Koulouris, Spyros A Papiris, Stelios Loukides
BACKGROUND AND OBJECTIVE: Activin A is a pleiotropic cytokine holding a fundamental role in inflammation and tissue remodelling. Follistatin can modulate the bioactivity of activin. We aimed to measure activin A and follistatin in sputum supernatants and bronchoalveolar lavage (BAL) of asthmatic patients and to determine the possible associations with severity as well as with inflammatory and remodelling indices. METHODS: A total of 58 asthmatic patients (33 with severe refractory asthma (SRA)) and 10 healthy controls underwent sputum induction for % cells, activin A, follistatin, eosinophilic cationic protein (ECP), transforming growth factor beta 1 (TGF-β1), IL-13 and IL-8 measurements...
November 2, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27803792/mepolizumab-for-severe-refractory-eosinophilic-asthma-evidence-to-date-and-clinical-potential
#8
REVIEW
Francesco Menzella, Mirco Lusuardi, Carla Galeone, Sofia Taddei, Nicola Facciolongo, Luigi Zucchi
Severe asthma is characterized by major impairment of quality of life, poor symptom control and frequent exacerbations. Inflammatory, clinical and causative factors identify different phenotypes and endotypes of asthma. In the last few years, new treatment options have allowed for targeted treatments according to the different phenotypes of the disease. To accurately select a specific treatment for each asthmatic variant, the identification of appropriate biomarkers is required. Eosinophilic asthma is a distinct phenotype characterized by thickening of the basement membrane and corticosteroid responsiveness...
November 2016: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/27801958/nasal-obstructive-disorders-induce-medical-treatment-failure-in-pediatric-persistent-allergic-rhinitis-the-nodpar-study
#9
Franklin S Mariño-Sánchez, Meritxell Valls-Mateus, Karen Ruiz-Echevarría, Isam Alobid, Paulina Cardenas-Escalante, Rosa Jiménez-Feijoo, Jaime Lozano-Blasco, María T Giner-Muñoz, Jesús Rodríguez-Jorge, Oliver Haag, Ana M Plaza-Martin, Joaquim Mullol
BACKGROUND: Allergic rhinitis (AR) is the most common chronic disease among children. To characterize the disease, a modified classification of severity (m-ARIA) has recently been validated in AR children. When medical treatment fails, surgery for nasal obstructive disorders (NOD) may be a therapeutic option. Our objective was to assess the prevalence of NOD and their influence in medical treatment response among children with persistent AR (PER). METHODS: In a prospective, real-life study, 130 pediatric PER patients (13...
November 1, 2016: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/27796795/interleukin-5-antagonists-usher-in-a-new-generation-of-asthma-therapy
#10
REVIEW
Matthew P Giannetti, Juan C Cardet
Asthma is the most common chronic respiratory disease in the USA. A subset of patients with asthma have refractory symptoms, persistent eosinophilic inflammation, and recurrent exacerbations despite maximal medical therapy. The monoclonal antibodies targeting the IL-5 pathway are a new class of medications designed to target severe eosinophilic asthma. There are two medications clinically available: mepolizumab and reslizumab, both of which target IL-5. A third medication, benralizumab, is currently under development and targets the IL-5 receptor...
November 2016: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/27742523/glucagon-for-refractory-asthma-exacerbation-a-case-series
#11
Jillian M Cavallari, Tara S Jawaro, Nadia I Awad, Patrick J Bridgeman
Glucagon, a hormone secreted by pancreatic alpha cells, causes bronchial smooth muscle relaxation by activating the synthesis of cyclic adenosine monophosphate. It was studied in the 1980s and 1990s as a treatment option for the management of asthma but has since not been evaluated. Data to support its use are limited, but it may serve as a last-line agent for refractory asthma exacerbation. Here we describe 4 cases in which intravenous glucagon was used to manage severe, refractory asthma exacerbation in the emergency department...
September 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27717421/omalizumab-in-the-treatment-of-chronic-inducible-urticaria
#12
P Chicharro, P Rodríguez, D de Argila
Omalizumab is a recombinant humanized monoclonal antibody that inhibits immunoglobulin E. It has been approved for the treatment of severe asthma and chronic spontaneous urticaria refractory to other treatments. Its use in the management of chronic inducible urticaria (a type triggered by certain stimuli) is still considered off-label, although this use has been discussed in some consensus papers. This review brings together case reports and case series describing the use of omalizumab to treat chronic inducible urticaria...
October 5, 2016: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/27667784/treatment-of-eosinophilic-otitis-media-with-pegylated-interferon-%C3%AE-2a-and-2b
#13
Brian A Neff, Stephen G Voss, Matthew L Carlson, Erin K O'Brien, Joseph H Butterfield
OBJECTIVE/HYPOTHESIS: Eosinophilic otitis media (EOM) is a variant of chronic otitis media that is characterized by the development of thick mucoid middle ear effusion, adult onset bronchial asthma, sinonasal polyposis, and aspirin sensitivity. EOM is typically refractory to corticosteroid therapy and surgical intervention. Pegylated interferon (PEG-IFN) has effectively treated hypereosinophilic syndrome in clinical trials; however, the efficacy of this medication for EOM treatment remains undefined...
September 26, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27624865/airway-and-peripheral-urokinase-plasminogen-activator-receptor-is-elevated-in-asthma-and-identifies-a-severe-nonatopic-subset-of-patients
#14
M A Portelli, C Moseley, C E Stewart, D S Postma, P Howarth, J A Warner, J W Holloway, G H Koppelman, C Brightling, I Sayers
RATIONALE: Genetic polymorphisms in the asthma susceptibility gene, urokinase plasminogen activator receptor (uPAR/PLAUR) have been associated with lung function decline and uPAR blood levels in asthma subjects. Preliminary studies have identified uPAR elevation in asthma; however, a definitive study regarding which clinical features of asthma uPAR may be driving is currently lacking. OBJECTIVES: We aimed to comprehensively determine the uPAR expression profile in asthma and control subjects utilizing bronchial biopsies and serum, and to relate uPAR expression to asthma clinical features...
October 5, 2016: Allergy
https://www.readbyqxmd.com/read/27609656/effectiveness-of-bronchial-thermoplasty-in-patients-with-severe-refractory-asthma-clinical-and-histopathological-correlations
#15
Marina Pretolani, Anders Bergqvist, Gabriel Thabut, Marie-Christine Dombret, Dominique Knapp, Fatima Hamidi, Loubna Alavoine, Camille Taillé, Pascal Chanez, Jonas S Erjefält, Michel Aubier
BACKGROUND: The effectiveness of bronchial thermoplasty (BT) has been reported in severe asthma, yet its impact on the different bronchial structures remains unknown. OBJECTIVE: To examine the effect of BT on bronchial structures and to explore their association with clinical outcome in severe refractory asthmatics. METHODS: Bronchial biopsies (n = 300) were collected from 15 severe uncontrolled asthmatics before and 3 months after BT. Immunostained sections were assessed for airway smooth muscle (ASM) area, sub-epithelial basement membrane thickness, nerve fibers and epithelium neuroendocrine cells...
September 5, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27578470/effects-of-older-age-and-age-of-asthma-onset-on-clinical-and-inflammatory-variables-in-severe-refractory-asthma
#16
Rekha Chaudhuri, Charles McSharry, Liam G Heaney, Robert Niven, Christopher E Brightling, Andrew N Menzies-Gow, Christine Bucknall, Adel H Mansur, Waiting Lee, Malcolm Shepherd, Mark Spears, Douglas C Cowan, Holger Husi, Neil C Thomson
BACKGROUND: Asthma in the elderly as well as asthma of adult-onset has been associated with increased morbidity, but little is known specifically about the effects of age on clinical and inflammatory outcomes in severe refractory asthma. The aims of the study were to examine the effects of age [<65 versus ≥65 years] and age of onset of asthma [childhood-onset, <18 versus adult-onset, ≥18 years] on clinical and inflammatory variables in patients with severe asthma. METHODS: In 1042 subjects with refractory asthma recruited to the British Thoracic Society Severe Asthma Registry, we compared patient demographics, disease characteristics and biomarkers of inflammation in patients aged <65 years (n = 896) versus ≥65 years (n = 146) and onset at age <18 years (n = 430) versus ≥18 years (n = 526)...
September 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27574788/efficacy-and-safety-of-a-cxcr2-antagonist-azd5069-in-patients-with-uncontrolled-persistent-asthma-a-randomised-double-blind-placebo-controlled-trial
#17
Paul M O'Byrne, Hristo Metev, Margareta Puu, Kai Richter, Christina Keen, Mohib Uddin, Bengt Larsson, Marie Cullberg, Parameswaran Nair
BACKGROUND: Airway neutrophilic inflammation is a pathological feature in some patients with severe asthma. Stimulation of the chemokine receptor CXCR2 mediates neutrophil migration into the airways. We investigated the safety and efficacy of AZD5069, a CXCR2 antagonist, as an add-on therapy in patients with uncontrolled severe asthma. METHODS: In this multicentre, randomised, double-blind, placebo-controlled, dose-finding trial, we enrolled patients aged 18 years or older with uncontrolled asthma despite combination therapy with long-acting β2 agonists and medium-dose or high-dose inhaled corticosteroids...
October 2016: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/27546969/refractory-asthma-an-old-disorder-novel-approaches-for-effective-control
#18
REVIEW
B N B M Prasad
Bronchial asthma is an inflammatory disorder of airways characterized by hyper-responsiveness to a wide range of triggers and is associated with variable airflow obstruction that remits spontaneously or with the treatment. Several phenotype of asthma not responding to the currently acceptable standard therapy of high dose inhaled gluco-corticosteroids along with along acting β2 agonists come under the purview of refractory asthma. This condition is a heterogeneous and complex disease that requires a multi-disciplinary approach to identify accurately various sub-phenotypes to enable improved understanding of the pathogenesis and development of effective management strategies including use of novel methods and targeted therapy...
July 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27528798/a-review-of-omalizumab-for-the-management-of-severe-asthma
#19
REVIEW
Ching-Hsiung Lin, Shih-Lung Cheng
Despite the expansion of the understanding in asthma pathophysiology and the continual advances in disease management, a small subgroup of patients remain partially controlled or refractory to standard treatments. Upon the identification of immunoglobulin E and other inflammatory mediators, investigations and developments of targeted agents have thrived. Omalizumab is a humanized monoclonal antibody that specifically targets the circulating immunoglobulin E, which in turn impedes and reduces subsequent releases of the proinflammatory mediators...
2016: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/27511920/atomic-structure-of-a-rhinovirus-c-a-virus-species-linked-to-severe-childhood-asthma
#20
Yue Liu, Marchel G Hill, Thomas Klose, Zhenguo Chen, Kelly Watters, Yury A Bochkov, Wen Jiang, Ann C Palmenberg, Michael G Rossmann
Isolates of rhinovirus C (RV-C), a recently identified Enterovirus (EV) species, are the causative agents of severe respiratory infections among children and are linked to childhood asthma exacerbations. The RV-C have been refractory to structure determination because they are difficult to propagate in vitro. Here, we report the cryo-EM atomic structures of the full virion and native empty particle (NEP) of RV-C15a. The virus has 60 "fingers" on the virus outer surface that probably function as dominant immunogens...
August 9, 2016: Proceedings of the National Academy of Sciences of the United States of America
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