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https://www.readbyqxmd.com/read/29133975/severe-eosinophilic-asthma-from-the-pathogenic-role-of-interleukin-5-to-the-therapeutic-action-of-mepolizumab
#1
REVIEW
Corrado Pelaia, Alessandro Vatrella, Maria Teresa Busceti, Luca Gallelli, Rosa Terracciano, Rocco Savino, Girolamo Pelaia
Mepolizumab is an anti-interleukin-5 (IL-5) humanized monoclonal antibody that has been recently approved as an add-on biological treatment for severe eosinophilic asthma, by both the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Moreover, mepolizumab is also currently included within the step 5 of the Global Initiative for Asthma guidelines, as an add-on therapy for severe uncontrolled asthma. The relevant therapeutic benefits detectable in patients with refractory eosinophilic asthma receiving mepolizumab depend on the pivotal pathogenic role played by IL-5 in these subjects...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29127369/suppression-of-th17-polarized-airway-inflammation-by-rapamycin
#2
Oana Joean, Anja Hueber, Felix Feller, Adan Chari Jirmo, Matthias Lochner, Anna-Maria Dittrich, Melanie Albrecht
Because Th17-polarized airway inflammation correlates with poor control in bronchial asthma and is a feature of numerous other difficult-to-treat inflammatory lung diseases, new therapeutic approaches for this type of airway inflammation are necessary. We assessed different licensed anti-inflammatory agents with known or expected efficacy against Th17-polarization in mouse models of Th17-dependent airway inflammation. Upon intravenous transfer of in vitro derived Th17 cells and intranasal challenge with the corresponding antigen, we established acute and chronic murine models of Th17-polarised airway inflammation...
November 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29121432/effectiveness-of-alpine-climate-treatment-for-children-with-difficult-to-treat-atopic-dermatitis-results-of-a-pragmatic-randomized-controlled-trial-davos-trial
#3
Karin Fieten, Renske Schappin, Wieneke Zijlstra, Lilian Figee, Jos Beutler, Florine Raymakers, Harmieke van Os-Medendorp, Rebecca Stellato, Maartje Vandewall, Joan Winkelhof, Monica Uniken Venema, Carla Bruijnzeel-Koomen, Lucia Rijssenbeek-Nouwens, Cornelis van der Ent, Els van Hoffen, Yolanda Meijer, Suzanne Pasmans
BACKGROUND: Alpine climate treatment has historically been used in Europe to treat atopic dermatitis (AD), but no randomized trials have been conducted to provide evidence for its effectiveness. OBJECTIVE: To investigate the long-term effectiveness of alpine climate treatment for children with difficult to treat AD. MATERIALS & METHODS: A pragmatic, open, randomized controlled trial was conducted. Children diagnosed with AD that was considered difficult to treat, aged between 8 and 18 years and willing to be treated in Switzerland were randomized to a six week personalized integrative multidisciplinary treatment period in a clinical setting in the alpine climate (Switzerland) or an outpatient setting in moderate maritime climate (Netherlands)...
November 9, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29121247/prediction-of-individual-outcomes-for-asthma-sufferers
#4
B Storlie Curtis, E Branda Megan, R Gionfriddo Michael, D Shah Nilay, A Rank Matthew
We consider the problem of individual-specific medication level recommendation (initiation, removal, increase, or decrease) for asthma sufferers. Asthma is one of the most common chronic diseases in both adults and children, affecting 8% of the US population and costing $37-63 billion/year in the United States of America. Asthma is a complex disease, whose symptoms may wax and wane, making it difficult for clinicians to predict outcomes and prognosis. Improved ability to predict prognosis can inform decision making and may promote conversations between clinician and provider around optimizing medication therapy...
November 6, 2017: Biostatistics
https://www.readbyqxmd.com/read/29103801/guiding-principles-for-use-of-newer-biologics-and-bronchial-thermoplasty-for-patients-with-severe-asthma
#5
Michael S Blaiss, Mario Castro, Bradley E Chipps, Myron Zitt, Reynold A Panettieri, Michael B Foggs
BACKGROUND: Severe asthma poses significant disease-related and economic burdens in the United States. Challenges in practice include how to define "severe asthma" for a given patient, knowing which are the right tests to perform and when, and having a better understanding of a patient's asthma phenotype. Furthermore, current guidelines do not address a clear, practical approach to treatment that is based on a patient's asthma phenotype. OBJECTIVE: To develop a consensus on the definition of severe asthma, the role of biomarkers and phenotyping severe asthma, and the use of newer biologic therapies and bronchial thermoplasty to help guide practicing clinicians...
November 2, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28987810/chronic-rhinosinusitis-in-asia
#6
Yuan Zhang, Elien Gevaert, Hongfei Lou, Xiangdong Wang, Luo Zhang, Claus Bachert, Nan Zhang
Chronic rhinosinusitis (CRS), although possibly overdiagnosed, is associated with a high burden of disease and is often difficult to treat in those truly affected. Recent research has demonstrated that inflammatory signatures of CRS vary around the world, with less eosinophilic and more neutrophilic inflammation found in Asia compared with Europe and North America. Although in the Western world about 80% of nasal polyps carry a type 2 signature, this might be between 20% and 60% in China and Korea or Thailand, respectively...
October 4, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28877019/severe-and-difficult-to-treat-asthma-in-adults
#7
REVIEW
Elliot Israel, Helen K Reddel
New England Journal of Medicine, Volume 377, Issue 10, Page 965-976, September 2017.
September 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28840001/bronchial-hyperreactivity-in-perimenstrual-asthma-is-associated-with-increased-th-2-response-in-lower-airways
#8
Szymon Skoczynski, Aleksandra Semik-Orzech, Ewa Sozanska, Wojciech Szanecki, Krzysztof Kołodziejczyk, Igor Radziewicz-Winnicki, Andrzej Witek, Władysław Pierzchała, Adam Barczyk
BACKGROUND: Perimenstrual asthma (PMA) is a commonly observed, usually difficult-to-treat asthma phenotype. The mechanisms underlying this phenomenon remain unexplained. The aim of the study was to assess the degree of airway hyperresponsiveness and its relationship to proinflammatory cytokines concentration in lower airways of PMA compared to non-PMA patients. METHODS: Premenopausal women with regular menstrual cycles diagnosed as: PMA (n=12), non-PMA asthmatics (n=9), and healthy controls (n=10) were prospectively followed for 10 weeks over two consecutive menstrual cycles...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28807925/what-is-the-evidence-for-different-management-options-for-difficult-to-treat-severe-asthma
#9
(no author information available yet)
No abstract text is available yet for this article.
August 14, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28803186/asthma-exacerbations-and-triggers-in-children-in-tenor-impact-on-quality-of-life
#10
Bradley E Chipps, Tmirah Haselkorn, Karin Rosén, David R Mink, Benjamin L Trzaskoma, Allan T Luskin
BACKGROUND: Data examining associations between asthma exacerbations, triggers, and asthma-related quality of life (QOL) in children with severe/difficult-to-treat asthma are unavailable. OBJECTIVE: To evaluate real-world data on relationships between asthma exacerbations, triggers, and QOL in children using data from TENOR (The Epidemiology and Natural History of Asthma Outcomes and Treatment Regimens), a 3-year observational study of patients with severe/difficult-to-treat asthma, including those aged 6 to 12 years...
August 9, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28797732/more-than-a-decade-follow-up-in-patients-with-severe-or-difficult-to-treat-asthma-the-epidemiology-and-natural-history-of-asthma-outcomes-and-treatment-regimens-tenor-ii
#11
Bradley E Chipps, Tmirah Haselkorn, Brandee Paknis, Benjamin Ortiz, Eugene R Bleecker, Farid Kianifard, Aimee J Foreman, Stanley J Szefler, Robert S Zeiger
BACKGROUND: The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR I) study demonstrated high morbidity in patients with severe or difficult-to-treat asthma despite standard-of-care treatment. OBJECTIVE: We sought to determine the long-term natural history of disease and outcomes in patients in TENOR I after more than a decade. METHODS: TENOR I was a multicenter observational study (2001-2004) of 4756 patients with severe or difficult-to-treat asthma...
August 7, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28780940/diagnosis-and-management-of-anaphylaxis-in-precision-medicine
#12
REVIEW
Mariana Castells
Anaphylaxis is the most severe and frightening of the allergic reactions, placing patients at high risk and demanding prompt recognition and immediate management by health care providers. Yet because its symptoms imitate those of other diseases, such as asthma and urticaria, current data suggest that its diagnosis is often missed, with underuse of tryptase measurement; its treatment is delayed, with little use of epinephrine; and its underlying cause or causes are poorly investigated. Deaths from anaphylaxis are difficult to investigate because of miscoding...
August 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28646903/human-adipose-tissue-mesenchymal-stromal-cells-and-their-extracellular-vesicles-act-differentially-on-lung-mechanics-and-inflammation-in-experimental-allergic-asthma
#13
Ligia Lins de Castro, Debora Gonçalves Xisto, Jamil Zola Kitoko, Fernanda Ferreira Cruz, Priscilla Christina Olsen, Patricia Albuquerque Garcia Redondo, Tatiana Paula Teixeira Ferreira, Daniel Jay Weiss, Marco Aurélio Martins, Marcelo Marcos Morales, Patricia Rieken Macedo Rocco
BACKGROUND: Asthma is a chronic inflammatory disease that can be difficult to treat due to its complex pathophysiology. Most current drugs focus on controlling the inflammatory process, but are unable to revert the changes of tissue remodeling. Human mesenchymal stromal cells (MSCs) are effective at reducing inflammation and tissue remodeling; nevertheless, no study has evaluated the therapeutic effects of extracellular vesicles (EVs) obtained from human adipose tissue-derived MSCs (AD-MSC) on established airway remodeling in experimental allergic asthma...
June 24, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28508234/surgical-treatment-of-extraesophageal-manifestations-of-gastroesophageal-reflux-disease
#14
REVIEW
Feroze Sidwa, Alessandra L Moore, Elaine Alligood, P Marco Fisichella
OBJECTIVE: To review the current literature on the role of antireflux surgery (ARS) for the treatment of extraesophageal manifestations of GERD. The extraesophageal manifestations of gastroesophageal reflux disease (GERD) include chronic cough, laryngopharyngeal reflux, and asthma. They are responsible for significant morbidity in affected patients and a high economic burden on healthcare resources. We recently published a larger review on the symptoms, diagnosis, medical, and surgical treatment of the extraesophageal manifestations of GERD...
May 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28434014/prospective-open-label-evaluation-of-long-term-low-dose-doxycycline-for-difficult-to-treat-chronic-rhinosinusitis-with-nasal-polyps
#15
RANDOMIZED CONTROLLED TRIAL
A C Pinto Bezerra Soter, T F Bezerra, R Pezato, T R Teles Abdo, R M Pilan, F R Pinna, P Gevaert, T van Zele, C Bachert, R L Voegels
BACKGROUND: This study aimed to assess clinical outcomes of long-term low-dose oral doxycycline therapy in difficult-to-treat chronic rhinosinusitis with polyps (CRSwNP). METHODS: This was a prospective, open-label study of 60 patients with difficult-to-treat CRSwNP who had undergone endoscopic sinus surgery. Patients were divided into two groups: 28 received nasal steroids, saline irrigation, and doxycycline (200 mg on the first day, followed by 100 mg once daily) for 12 weeks, while 30 received only nasal steroids and saline irrigation...
June 1, 2017: Rhinology
https://www.readbyqxmd.com/read/28424691/increased-autophagy-related-5-gene-expression-is-associated-with-collagen-expression-in-the-airways-of-refractory-asthmatics
#16
Audrey H Poon, David F Choy, Fazila Chouiali, Rakhee K Ramakrishnan, Bassam Mahboub, Severine Audusseau, Andrea Mogas, Jeffrey M Harris, Joseph R Arron, Catherine Laprise, Qutayba Hamid
BACKGROUND: Fibrosis, particularly excessive collagen deposition, presents a challenge for treating asthmatic individuals. At present, no drugs can remove or reduce excessive collagen in asthmatic airways. Hence, the identification of pathways involved in collagen deposition would help to generate therapeutic targets to interfere with the airway remodeling process. Autophagy, a cellular degradation process, has been shown to be dysregulated in various fibrotic diseases, and genetic association studies in independent human populations have identified autophagy-related 5 (ATG5) to be associated with asthma pathogenesis...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28400693/ludwig-s-angina-a-nightmare-worsened-by-adverse-drug-reaction-to-antibiotics
#17
Mohamed Hisham, Mundilipalayam N Sivakumar, R S Senthil Kumar, P Nandakumar
A 52-year-old obese gentleman presented to the hospital with complaints of fever and shortness of breath for 10 days. He was admitted in the ward and treated for acute exacerbation of asthma. He was shifted to the Intensive Care Unit (ICU) for persistent fever, neck swelling, airway obstruction and desaturation. Ludwig's angina was suspected and computed tomography of neck confirmed it. A difficult airway was anticipated and preceded with surgical tracheostomy. The patient had hypersensitivity reactions to piperacillin/tazobactam; hence, he was treated with clindamycin and metronidazole...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28388228/clinical-management-of-severe-therapy-resistant-asthma
#18
REVIEW
Kian Fan Chung
Severe therapy-resistant asthma is an area where there has been recent advances in understanding that is percolating into improvements in management. Areas covered: This review covers the recent definition and approach to the diagnosis of severe asthma and its differentiation from difficult-to-treat asthma. The recent advances in phenotyping severe asthma and in ensuing changes in management approaches together with the introduction of new therapies are covered from a review of the recent literature. Expert commentary: After ascertaining the diagnosis of severe asthma, patients need to be treated adequately with existing therapies...
May 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28370985/is-bronchial-thermoplasty-cost-effective-as-treatment-for-problematic-asthma-patients-singapore-s-perspective-on-a-global-model
#19
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...
August 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28347832/the-genus-achyranthes-a-review-on-traditional-uses-phytochemistry-and-pharmacological-activities
#20
REVIEW
Xirui He, Xiaoxiao Wang, Jiacheng Fang, Yu Chang, Ning Ning, Hao Guo, Linhong Huang, Xiaoqiang Huang
ETHNOPHARMACOLOGICAL RELEVANCE: Achyranthes L. (Amaranthaceae), also known as Chaff Flower and Niuxi/, mainly includes two famous medicinal species namely A. bidentata and A. aspera. A. bidentata has been widely used as blood-activating and stasis-resolving medicine for the treatment of various diseases including amenorrhea, dysmenorrhea, lumbago, gonalgia, paraplegia, edema, stranguria, headache, dizziness, odontalgia, oral ulcer, hematemesis, and epistaxis. A. aspera has been widely used to treat various diseases, including gynecological disorder, asthma, ophthalmia, odontalgia, haemorrhoids, and abdominal tumor, and has been applied to difficult labour, wound healing, insect and snake bites...
May 5, 2017: Journal of Ethnopharmacology
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