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Severe persistent asthma

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https://www.readbyqxmd.com/read/28421345/long-term-predictors-of-anxiety-and-depression-in-adult-patients-with-asthma
#1
Marina Labor, Slavica Labor, Iva Jurić, Vladimir Fijačko, Sanja Popović Grle, Davor Plavec
BACKGROUND: It is well established that anxiety and depression are associated with asthma, but there is limited evidence about the persistence of anxiety/depression in asthma. The aim of our study was to assess the long-term predictors of anxiety and depression in adult asthmatic patients. METHODS: A total of 90 adult asthma patients (63 women, age 18-50 years) with different levels of disease control (28 uncontrolled and 34 partially controlled) were assessed at baseline and at follow-up after 7 years for anxiety, depression and asthma control...
April 18, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28417624/cow-s-milk-desensitization-in-anaphylactic-patients-a-new-personalized-dose-method
#2
Delara Babaie, Mohammad Nabavi, Saba Arshi, Mehrnaz Mesdaghi, Zahra Chavoshzadeh, Mohammad Hasan Bemanian, Mitra Tafakori, Mehrdad Amirmoini, Hosein Esmailzadeh, Rasoul Molatefi, Mahsa Rekabi, Nadieh Akbarpour, Farimah Masoumi, Morteza Fallahpour
Cow's milk allergy (CMA) is the most frequent food allergy in children and oral immunotherapy (OIT) is a promising approach for treatment of patients. The most challenging cases are anaphylactic with coexisting asthma and proposing safe protocols is crucial especially in high risk groups. Considering that CMA varies among patients, an individualized OIT protocol would be beneficial to achieve a safer and more efficient method of desensitization. 18 children more than 3 years of age with IgE-mediated CMA were enrolled...
February 2017: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/28392707/factors-predicting-persistence-of-early-wheezing-through-childhood-and-adolescence-a-systematic-review-of-the-literature
#3
Carlos E Rodríguez-Martínez, Monica P Sossa-Briceño, Jose A Castro-Rodriguez
BACKGROUND: For the early identification of persistent asthma symptoms among young children with recurrent wheezing, it would be helpful to identify all available studies that have identified at least one factor for predicting the persistence of early wheezing. The objective of the present study was to perform a systematic review of all studies that have identified factors that predict the persistence of symptoms among young patients with recurring wheezing. METHODS: A systematic review of relevant studies was conducted through searching in MEDLINE, EMBASE, CINHAL, and SCOPUS databases up to June 2016...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28392331/maternal-phthalate-exposure-promotes-allergic-airway-inflammation-over-two-generations-via-epigenetic-modifications
#4
Susanne Jahreis, Saskia Trump, Mario Bauer, Tobias Bauer, Loreen Thürmann, Ralph Feltens, Qi Wang, Lei Gu, Konrad Grützmann, Stefan Röder, Marco Averbeck, Dieter Weichenhan, Christoph Plass, Ulrich Sack, Michael Borte, Virginie Dubourg, Gerrit Schüürmann, Jan C Simon, Martin von Bergen, Jörg Hackermüller, Roland Eils, Irina Lehmann, Tobias Polte
BACKGROUND: Prenatal and early postnatal exposures to environmental factors are considered responsible for the increasing prevalence of allergic diseases. Although there is some evidence for allergy-promoting effects in children due to exposure to plasticizers like phthalates, findings of previous studies are inconsistent and lack mechanistic information. OBJECTIVE: We investigated the effect of maternal phthalate exposure on asthma development in the subsequent generations and their underlying mechanisms including epigenetic alterations...
April 6, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28389304/cluster-analysis-on-longitudinal-data-of-patients-with-adult-onset-asthma
#5
Pinja Ilmarinen, Leena E Tuomisto, Onni Niemelä, Minna Tommola, Jussi Haanpää, Hannu Kankaanranta
BACKGROUND: Previous cluster analyses on asthma are based on cross-sectional data. OBJECTIVE: To identify phenotypes of adult-onset asthma by using data from baseline (diagnostic) and 12-year follow-up visits. METHODS: The Seinäjoki Adult Asthma Study is a 12-year follow-up study of patients with new-onset adult asthma. K-means cluster analysis was performed by using variables from baseline and follow-up visits on 171 patients to identify phenotypes...
April 4, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28381320/allergen-specific-immunoglobulin-e-and-allergic-rhinitis-severity
#6
Angelo G Corsico, Mara De Amici, Vanessa Ronzoni, Vania Giunta, Maria Chiara Mennitti, Arianna Viscardi, Gian Luigi Marseglia, Giorgio Ciprandi
BACKGROUND: Allergic rhinitis (AR) is a common disorder. The diagnosis is based on the concordance between allergy sensitization and history. Serum allergen specific immunoglobulin E (sIgE) assessment allows characterization of the relevant sensitizing allergens. Presently, Allergic Rhinitis and its Impact on Asthma (ARIA) classification subdivides AR based on symptoms severity and duration. However, the relationship between sIgE levels and symptom severity is still a matter of debate...
March 1, 2017: Allergy & Rhinology
https://www.readbyqxmd.com/read/28377880/paradoxical-bronchospasm-from-benzalkonium-chloride-bac-preservative-in-albuterol-nebulizer-solution-in-a-patient-with-acute-severe-asthma-a-case-report-and-literature-review-of-airway-effects-of-bac
#7
Mathew George, Saumya Vinod Joshi, Emily Concepcion, Haesoon Lee
Nebulized bronchodilator solutions are available in the United States as both nonsterile and sterile-filled products. Sulfites, benzalkonium chloride (BAC), or chlorobutanol are added to nonsterile products to prevent bacterial growth. Bronchoconstriction from inhaled BAC is cumulative, prolonged, and correlates directly with basal airway responsiveness. The multi-dose dropper bottle of albuterol sulfate solution contains 50 μg BAC per/2.5 mg of albuterol, which may be below or at the lower limit of the threshold dose for bronchoconstriction...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28372806/multiple-immune-disorders-after-natalizumab-discontinuation-after-the-ciris-the-siris
#8
E K Van Obberghen, M Cohen, F Rocher, C Lebrun-Frenay
Natalizumab (NTZ) is an effective treatment for patients with highly active relapsing remitting multiple sclerosis (MS). However, when the therapy must be interrupted, it is important to anticipate the withdrawal to avoid reactivation or disease rebound. Described here is the case of a 35-year-old woman, with a past history of beta thalassemia, bulimia and asthma, who was diagnosed with MS at age 26. She was treated initially with first-line subcutaneous (sc) immunomodulatory treatments. However, due to liver toxicity, interferon beta-1a sc was interrupted and replaced by glatiramer acetate treatment, which was well tolerated and used for several years...
March 31, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28370985/is-bronchial-thermoplasty-cost-effective-as-treatment-for-problematic-asthma-patients-singapore-s-perspective-on-a-global-model
#9
Hai V Nguyen, Saideep Bose, Shweta Mital, Anthony Chau Ang Yii, Shin Yuh Ang, Sean Shao Wei Lam, Devanand Anantham, Eric Finkelstein, Mariko Siyue Koh
BACKGROUND AND OBJECTIVE: Bronchial thermoplasty (BT) has been shown to be effective at reducing asthma exacerbations and improving asthma control for patients with severe persistent asthma but it is also expensive. Evidence on its cost-effectiveness is limited and inconclusive. In this study, we aim to evaluate the incremental cost-effectiveness of BT combined with optimized asthma therapy (BT-OAT) relative to OAT for difficult-to-treat and severe asthma patients in Singapore, and to provide a general framework for determining BT's cost-effectiveness in other healthcare settings...
March 31, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28367537/a-novel-in-vivo-system-to-test-bronchodilators
#10
Kenneth J Addison, John Morse, Annette Robichaud, Michael O Daines, Julie G Ledford
The incidence and severity of asthma continue to rise worldwide. β-agonists are the most commonly prescribed therapeutic for asthma management but have less efficacy for some subsets of asthmatic patients and there are concerns surrounding the side effects from their long-term persistent use. The demand to develop novel asthma therapeutics highlights the need for a standardized approach to effectively screen and test potential bronchoprotective compounds using relevant in vivo animal models. Here we describe a validated method of testing potential therapeutic compounds for their fast-acting efficacy during the midst of an induced bronchoconstriction in a house dust mite challenged animal model...
March 2017: Journal of Infectious Pulmonary Diseases
https://www.readbyqxmd.com/read/28366480/biologic-and-new-therapies-in-asthma
#11
REVIEW
Farnaz Tabatabaian, Dennis K Ledford, Thomas B Casale
Several biologics are currently FDA approved for asthma that target Th2 high patients. Unfortunately, 50% of patients with severe asthma do not fit this phenotype of disease and have fewer effective therapeutic options. In the clinical setting, total IgE, FeNO and peripheral blood eosinophils are important tools in defining Th2 high patients with asthma. However, precise biomarkers to predict better response to one specific Th2 high asthma therapy versus another is lacking. It is important to recognize that none of the current medications targeting the Th2 pathway induces persistent immunomodulation or remission...
May 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/28364469/chronic-rhinosinusitis-impairs-sleep-quality-results-of-the-ga2len-study
#12
Caroline Bengtsson, Eva Lindberg, Lars Jonsson, Mats Holmström, Fredrik Sundbom, Jan Hedner, Andrei Malinovschi, Roelinde Middelveld, Bertil Forsberg, Christer Janson
Study objectives: To analyze the prevalence of sleep problems in subjects with Chronic rhinosinusitis (CRS) and to determine whether the disease severity of CRS affects sleep quality. Methods: Questionnaires were sent to a random sample of 45 000 adults in four Swedish cities. Questions on CRS, asthma, allergic rhinitis, co-morbidities, tobacco use, educational level, and physical activity were included. CRS was defined according to the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) epidemiological criteria...
January 1, 2017: Sleep
https://www.readbyqxmd.com/read/28362801/exposure-to-secondhand-smoke-and-asthma-severity-among-children-in-connecticut
#13
Jessica P Hollenbach, Elizabeth D Schifano, Christopher Hammel, Michelle M Cloutier
OBJECTIVE: To determine whether secondhand smoke (SHS) exposure is associated with greater asthma severity in children with physician-diagnosed asthma living in CT, and to examine whether area of residence, race/ethnicity or poverty moderate the association. METHODS: A large childhood asthma database in CT (Easy Breathing) was linked by participant zip code to census data to classify participants by area of residence. Multinomial logistic regression models, adjusted for enrollment date, sex, age, race/ethnicity, area of residence, insurance type, family history of asthma, eczema, and exposure to dogs, cats, gas stove, rodents and cockroaches were used to examine the association between self-reported exposure to SHS and clinician-determined asthma severity (mild, moderate, and severe persistent vs...
2017: PloS One
https://www.readbyqxmd.com/read/28347734/rhinovirus-induced-first-wheezing-episode-predicts-atopic-but-not-non-atopic-asthma-at-school-age
#14
Minna Lukkarinen, Annamari Koistinen, Riitta Turunen, Pasi Lehtinen, Tytti Vuorinen, Tuomas Jartti
BACKGROUND: Persistent childhood asthma is mainly atopy-driven. However, limited data exist on the risk factors for childhood asthma phenotypes. OBJECTIVE: To identify risk factors at the first severe wheezing episode for the current asthma 7 years later, and separately for atopic and non-atopic asthma. METHODS: One hundred and twenty-seven steroid-naive children with the first severe wheezing episode (90% hospitalized/10% emergency room treated) were followed for 7 years...
March 24, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28341820/il-23-gene-and-protein-expression-in-childhood-asthma
#15
Soheila Alyasin, Reza Amin, Ali Fazel, Mohammad Hossein Karimi, Seyed Hesamedin Nabavizadeh, Hossein Esmaeilzadeh, Maryam Babaei
BACKGROUND: Asthma is the chronic inflammation of airways characterized by eosinophilic infiltration, mucus overproduction, airway hyper-responsiveness and airway remodeling. These changes are induced mostly by cytokines which are produced by T helper (Th) 2 cells. Recently, the role of interleukin-23 (IL-23) in the pathogenesis of adult allergic asthma has been studied. OBJECTIVE: To explore IL-23 serum levels and its expression in persistent asthma compared with healthy children younger than five years old...
March 2017: Iranian Journal of Immunology: IJI
https://www.readbyqxmd.com/read/28331346/control-of-moderate-to-severe-asthma-with-randomized-ciclesonide-doses-of-160-320-and-640-%C3%AE-g-day
#16
Søren E Pedersen, Niyati Prasad, Udo-Michael Goehring, Henrik Andersson, Dirkje S Postma
BACKGROUND: The inhaled corticoteroid (ICS) ciclesonide (Cic), controls asthma symptoms in the majority of patients at the recommended dose of 160 µg/day. However, the relationship between the level of asthma control and increasing doses of Cic is unknown. This study investigated whether long-term treatment with higher doses of Cic would further improve asthma symptoms in patients with uncontrolled asthma despite ICS use. PATIENTS AND METHODS: In a double-blind, randomized, parallel-group study, 367 patients were allocated to one of three treatment arms (Cic 160, 320 and 640 µg/day)...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28301050/addition-of-anti-leukotriene-agents-to-inhaled-corticosteroids-for-adults-and-adolescents-with-persistent-asthma
#17
REVIEW
Bhupendrasinh F Chauhan, Maya M Jeyaraman, Amrinder Singh Mann, Justin Lys, Ahmed M Abou-Setta, Ryan Zarychanski, Francine M Ducharme
BACKGROUND: Asthma management guidelines recommend low-dose inhaled corticosteroids (ICS) as first-line therapy for adults and adolescents with persistent asthma. The addition of anti-leukotriene agents to ICS offers a therapeutic option in cases of suboptimal control with daily ICS. OBJECTIVES: To assess the efficacy and safety of anti-leukotriene agents added to ICS compared with the same dose, an increased dose or a tapering dose of ICS (in both arms) for adults and adolescents 12 years of age and older with persistent asthma...
March 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28295424/long-term-future-risk-of-severe-exacerbations-distinct-5-year-trajectories-of-problematic-asthma
#18
Anthony C A Yii, Jessica H Y Tan, Therese S Lapperre, Adrian K W Chan, Su Y Low, Thun H Ong, Keng L Tan, Sanjay H Chotirmall, Peter J Sterk, Mariko S Koh
BACKGROUND: Assessing future risk of exacerbations is an important component of asthma management. Existing studies have investigated short-, but not long-term risk. Problematic asthma patients with unfavorable long-term disease trajectory and persistently frequent severe exacerbations need to be identified early to guide treatment. METHODS: Severe exacerbation rates over five years for 177 "problematic asthma" patients presenting to a specialist asthma clinic were tracked...
March 11, 2017: Allergy
https://www.readbyqxmd.com/read/28294591/letter-to-the-editor-can-dog-allergen-immunotherapy-reduce-concomitant-allergic-sensitization-to-other-furry-animals-a-preliminary-experience
#19
G Liccardi, L Calzetta, A Salzillo, L Billeri, G Lucà, P Rogliani
It has been shown that allergen immunotherapy (AIT) is effective in reducing symptoms of allergic asthma and rhinitis. Data on the efficacy are less convincing with regard to AIT for allergens of common pets (cats/dogs). We describe a case of dog allergy in which we explored if dog AIT (DAI) could reduce a concomitant allergic sensitization to other allergens of furry animals. Our case demonstrates the efficacy of sublingual DAI on SPTs, symptom score, and spirometric responses despite persistent exposure to dog allergens at home in a patient sensitized, but not exposed, to several other furry animals...
March 2017: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28284319/longterm-clinical-outcomes-of-omalizumab-therapy-in-severe-allergic-asthma-study-of-efficacy-and-safety
#20
Adel H Mansur, Sapna Srivastava, Verity Mitchell, Julie Sullivan, Ismail Kasujee
Omalizumab has been shown to be an effective add-on therapy for patients with uncontrolled severe persistent allergic asthma. There has been a steady accumulation of evidence on the long-term effectiveness of omalizumab; however, data on real-life outcomes beyond one year of treatment is limited. In this study, we report on long-term outcomes of omalizumab treatment. We collected data from our severe asthma registry on hospitalisations, exacerbations, corticosteroid sparing, asthma control, lung function, biomarkers and side effects, to determine if the benefit was sustained and treatment was safe on the long term...
March 2017: Respiratory Medicine
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