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Severe persistent asthma

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https://www.readbyqxmd.com/read/27913032/intervention-studies-of-inhaled-corticosteroids-combined-with-long-acting-theophylline-or-long-acting-%C3%AE-2-agonists-in-patients-with-moderate-to-severe-asthma-a-randomized-controlled-study
#1
Yan Wang, Ping Chen, Anna Dai, Shengyun Shang, Lingfei Kong
PURPOSE: To evaluate and contrast the therapeutic effect and safety of fluticasone aerosol combined with theophylline tablets in patients with moderate to severe asthma, compared with salmeterol/fluticasone propionate aerosol. METHODS: After a screening period, patients meeting the inclusion criteria were randomly assigned to the experiment group (fluticasone aerosol combined with theophylline tablets) or the control group (salmeterol/fluticasone aerosol combined with placebo tablets) for 12 weeks of treatment...
November 29, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27912982/should-recommendations-about-starting-inhaled-corticosteroid-treatment-for-mild-asthma-be-based-on-symptom-frequency-a-post-hoc-efficacy-analysis-of-the-start-study
#2
Helen K Reddel, William W Busse, Søren Pedersen, Wan C Tan, Yu-Zhi Chen, Carin Jorup, Dan Lythgoe, Paul M O'Byrne
BACKGROUND: Low-dose inhaled corticosteroids (ICS) are highly effective for reducing asthma exacerbations and mortality. Conventionally, ICS treatment is recommended for patients with symptoms on more than 2 days per week, but this criterion has scant evidence. We aimed to assess the validity of the previous symptom-based cutoff for starting ICS by establishing whether there was a differential response to budesonide versus placebo for severe asthma exacerbations, lung function, and asthma symptom control across subgroups identified by baseline asthma symptom frequency...
November 29, 2016: Lancet
https://www.readbyqxmd.com/read/27909980/omalizumab-in-severe-refractory-vernal-keratoconjunctivitis-in-children-case-series-and-review-of-the-literature
#3
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/27906698/ige-and-eosinophils-as-therapeutic-targets-in-asthma
#4
Tanvi R Patel, Sanjiv Sur
PURPOSE OF REVIEW: Asthma is a chronic inflammatory disorder characterized by reversible airflow obstruction, which is being more widely recognized as a broad-spectrum disease that encompasses multiple patient characteristics and pathophysiologic mechanisms. Suboptimal asthma control leads to increasing burden of healthcare costs and loss of productivity to society. Biologic therapies targeted at IgE and eosinophils can be used in poorly controlled allergic and eosinophilic asthma, respectively...
November 30, 2016: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27900996/suppression-of-immunotherapy-on-group-2-innate-lymphoid-cells-in-allergic-rhinitis
#5
Da-Chuan Fan, Xiang-Dong Wang, Cheng-Shuo Wang, Yang Wang, Fei-Fei Cao, Luo Zhang
BACKGROUND: Group 2 innate lymphoid cells (ILC2s) are regarded as a novel population of lineage-negative cells that induce innate Type 2 responses by producing the critical Th2-type cytokines interleukin (IL)-5 and IL-13. ILC2s as key players in the development of allergic rhinitis (AR) have been proved, however, the effect of subcutaneous immunotherapy (SCIT) with dermatophagoides pteronyssinus extract (Der p-SCIT) on ILC2s in AR patients is not clear. This study aimed to investigate the response of ILC2s of peripheral blood in house dust mites (HDM)-sensitized Chinese patients with AR who received SCIT with Der P extract...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27888645/olfaction-in-patients-with-allergic-rhinitis-an-indicator-of-successful-mp-azeflu-therapy
#6
Ludger Klimek, Sophia C Poletti, Annette Sperl, Magdalena Spielhaupter, Cornel Bardenhewer, Joaquim Mullol, Karl Hörmann, Thomas Hummel
BACKGROUND: The purpose of this study was to investigate the effect of MP-AzeFlu on olfaction and the interaction between severity of allergic rhinitis and olfactory improvement after therapy. METHODS: A prospective, multicenter, observational study was performed on 47 patients with persistent allergic rhinitis. Duration and severity of allergic rhinitis was diagnosed and classified using the modified Allergic Rhinitis and its Impact on Asthma (ARIA) criteria and the proof of allergen sensitization from positive skin-prick tests, specific immonoglobulin E (IgE) in serum, and nasal provocation response...
November 26, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27886391/estimate-of-the-total-costs-of-allergic-rhinitis-in-specialized-care-based-on-real-world-data-the-ferin-study
#7
C Colás, M Brosa, E Antón, J Montoro, A Navarro, M T Dordal, I Dávila, B Fernández-Parra, M D P Ibáñez, M Lluch-Bernal, V Matheu, C Rondón, M C Sánchez, A Valero
BACKGROUND: Despite the socioeconomic importance of allergic rhinitis (AR), very few prospective studies have been performed under conditions of routine clinical practice and with a sufficiently long observation period outside the clinical trial scenario. We prospectively estimated the direct and indirect costs of AR in patients attending specialized clinics in Spain. METHODS: Patients were recruited at random from allergy outpatient clinics in 101 health centers throughout Spain over 12 months...
November 25, 2016: Allergy
https://www.readbyqxmd.com/read/27881779/allergic-inflammation-leads-to-neuropathic-pain-via-glial-cell-activation
#8
Ryo Yamasaki, Takayuki Fujii, Bing Wang, Katsuhisa Masaki, Mizuho A Kido, Mari Yoshida, Takuya Matsushita, Jun-Ichi Kira
: Allergic and atopic disorders have increased over the past few decades and have been associated with neuropsychiatric conditions, such as autism spectrum disorder and asthmatic amyotrophy. Myelitis presenting with neuropathic pain can occur in patients with atopic disorder; however, the relationship between allergic inflammation and neuropathic pain, and the underlying mechanism, remains to be established. We studied whether allergic inflammation affects the spinal nociceptive system...
November 23, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27877033/combination-therapy-of-inhaled-steroids-and-long-acting-beta2-agonists-in-asthma-copd-overlap-syndrome
#9
Suh-Young Lee, Hye Yun Park, Eun Kyung Kim, Seong Yong Lim, Chin Kook Rhee, Yong Il Hwang, Yeon-Mok Oh, Sang Do Lee, Yong Bum Park
BACKGROUND: The efficacy of inhaled corticosteroids (ICSs)/long-acting beta2-agonist (LABA) treatment in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) compared to patients with COPD alone has rarely been examined. This study aimed to evaluate the clinical efficacy for the improvement of lung function after ICS/LABA treatment in patients with ACOS compared to COPD alone patients. METHODS: Patients with stable COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27826964/comorbidities-and-phenotypes-of-rhinitis-in-korean-children-and-adolescents-a-cross-sectional-multicenter-study
#10
Kyung Suk Lee, Hye Yung Yum, Youn Ho Sheen, Yong Mean Park, Yong Ju Lee, Bong Seok Choi, Hye Mi Jee, Sun Hee Choi, Hyun Hee Kim, Yang Park, Hyo Bin Kim, Yeong Ho Rha
PURPOSE: Rhinitis is a nasal inflammatory disease in children and adolescents. However, little is known about the phenotypes and characteristics of allergic rhinitis (AR) in Korean children and adolescents. The objective of this study was to analyze the symptoms and comorbidities of rhinitis, to compare AR to non-allergic rhinitis (NAR), and to reveal the phenotypes and features of AR in a Korean pediatric population. METHODS: Patients under 18 years of age with rhinitis symptoms were recruited from January 2013 to January 2015 by pediatric allergists...
January 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/27826962/asthma-severity-and-the-controller-prescription-in-children-at-12-tertiary-hospitals
#11
Dong In Suh, Hyeon Jong Yang, Bong Seong Kim, Youn Ho Shin, So Yeon Lee, Geunhwa Park, Woo Kyung Kim, Hyo Bin Kim, Heysung Baek, Ja Kyoung Kim, Jin Tack Kim, Dae Hyun Lim
PURPOSE: Guidelines need to be tailored to where they are applied. We aimed to describe the distinctive asthma severity profile and the pattern of controller prescription in Korean children. METHODS: Twelve pediatric allergists from tertiary medical centers reviewed medical records of all asthmatic children who visited their clinics between September 1 and November 30 of 2013. Controller prescriptions were re-classified into 4 categories, then the prevalence of each asthma severity category and the controller prescription patterns according to asthma severity assessed by a Western (Global Initiative for Asthma, GINA) and an Asia-Pacific (Japanese Pediatric GuideLine, JPGL) guideline were evaluated...
January 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/27826957/development-of-new-therapies-for-severe-asthma
#12
REVIEW
Merritt L Fajt, Sally E Wenzel
Persistent asthma has long been treated with inhaled corticosteroids (CSs), as the mainstay of therapy. However, their efficacy in patients with more severe disease is limited, which led to the incorporation of poor response to ICSs (and thereby use of high doses of ICS) into recent definitions of severe asthma. Several studies have suggested that severe asthma might consist of several different phenotypes, each with ongoing symptoms and health care utilization, despite the use of high doses of ICS, usually in combination with a second or third controller...
January 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/27826098/a-randomized-multicenter-study-evaluating-xolair%C3%A2-persistency-of-response-after-long-term-therapy-xport
#13
Dennis Ledford, William Busse, Benjamin Trzaskoma, Theodore A Omachi, Karin Rosén, Bradley E Chipps, Allan T Luskin, Paul G Solari
BACKGROUND: Few data are available to assist clinicians with decisions regarding long-term use of asthma therapies, including omalizumab. OBJECTIVE: To evaluate the benefit and persistency of response in subjects continuing or withdrawing from long-term omalizumab treatment. METHODS: Evaluating the Xolair® Persistency Of Response After Long-Term Therapy (XPORT) was a randomized, double-blind, placebo-controlled withdrawal study that included subjects with moderate-to-severe persistent asthma receiving long-term omalizumab...
November 5, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27812635/staphylococcal-superantigen-specific-ige-antibodies-degree-of-sensitization-and-association-with-severity-of-asthma
#14
José Elabras, Fernanda Carvalho de Queiroz Mello, Omar Lupi, Blanca Elena Rios Gomes Bica, José Angelo de Souza Papi, Alfeu Tavares França
Objective: To determine the presence of staphylococcal superantigen-specific IgE antibodies and degree of IgE-mediated sensitization, as well as whether or not those are associated with the severity of asthma in adult patients. Methods: This was a cross-sectional study involving outpatients with asthma under treatment at a tertiary care university hospital in the city of Rio de Janeiro, Brazil. Consecutive patients were divided into two groups according to the severity of asthma based on the Global Initiative for Asthma criteria: mild asthma (MA), comprising patients with mild intermittent or persistent asthma; and moderate or severe asthma (MSA)...
September 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/27812543/duox1-mediates-persistent-epithelial-egfr-activation-mucous-cell-metaplasia-and-airway-remodeling-during-allergic-asthma
#15
Aida Habibovic, Milena Hristova, David E Heppner, Karamatullah Danyal, Jennifer L Ather, Yvonne M W Janssen-Heininger, Charles G Irvin, Matthew E Poynter, Lennart K Lundblad, Anne E Dixon, Miklos Geiszt, Albert van der Vliet
Chronic inflammation with mucous metaplasia and airway remodeling are hallmarks of allergic asthma, and these outcomes have been associated with enhanced expression and activation of EGFR signaling. Here, we demonstrate enhanced expression of EGFR ligands such as amphiregulin as well as constitutive EGFR activation in cultured nasal epithelial cells from asthmatic subjects compared with nonasthmatic controls and in lung tissues of mice during house dust mite-induced (HDM-induced) allergic inflammation. EGFR activation was associated with cysteine oxidation within EGFR and the nonreceptor tyrosine kinase Src, and both amphiregulin production and oxidative EGFR activation were diminished by pharmacologic or genetic inhibition of the epithelial NADPH oxidase dual oxidase 1 (DUOX1)...
November 3, 2016: JCI Insight
https://www.readbyqxmd.com/read/27801958/nasal-obstructive-disorders-induce-medical-treatment-failure-in-pediatric-persistent-allergic-rhinitis-the-nodpar-study
#16
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/27799385/mast-cells-are-associated-with-exacerbations-and-eosinophilia-in-children-with-severe-asthma
#17
Guillaume Lezmi, Louise Galmiche-Rolland, Sabine Rioux, Francis Jaubert, Isabelle Tillie-Leblond, Pierre Scheinmann, Philippe Gosset, Jacques de Blic
The role of mast cells in the pathogenesis of childhood asthma is poorly understood. We aimed to estimate the implication of airway mucosal mast cells in severe asthma and their relationship with clinical, functional, inflammatory and remodelling parameters.Bronchial biopsies were performed in 36 children (5-18 years) with severe asthma: 24 had frequent severe exacerbations and/or daily symptoms in the previous year (symptomatic group), and 12 had few symptoms and a persistent obstructive pattern (paucisymptomatic group)...
November 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27798419/novel-targets-of-omalizumab-in-asthma
#18
Caroline Sattler, Gilles Garcia, Marc Humbert
PURPOSE OF REVIEW: Omalizumab is a recombinant humanized anti-IgE monoclonal antibody approved in the US for moderate to severe persistent allergic asthma (severe persistent asthma in the European Union), uncontrolled despite treatment with inhaled corticosteroids and long-acting beta2 agonists. It reduces asthma exacerbations, symptoms, oral corticosteroid doses, and improves quality of life. RECENT FINDINGS: Omalizumab may have an antiviral effect when used as a preventive therapy for fall exacerbations in children and teenagers...
January 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/27796795/interleukin-5-antagonists-usher-in-a-new-generation-of-asthma-therapy
#19
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/27783268/fixed-dose-combination-inhalers
#20
Mario Cazzola, Maria Gabriella Matera
In asthma and chronic obstructive pulmonary disease (COPD), an important step in simplifying management and improving adherence with prescribed therapy is to reduce the dose frequency to the minimum necessary to maintain disease control. Fixed-dose combination (FDC) therapy might enhance compliance by decreasing the number of medications and/or the number of daily doses. Furthermore, they have the potential for enhancing, sensitizing, and prolonging the effects of monocomponents. Combination therapy with an inhaled corticosteroid (ICS) and a long-acting β-agonist (LABA) is considered an important approach for treating patients with asthma and patients with severe COPD who have frequent exacerbations...
October 26, 2016: Handbook of Experimental Pharmacology
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