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https://www.readbyqxmd.com/read/28935455/recent-directions-in-personalised-acute-respiratory-distress-syndrome-medicine
#1
REVIEW
Matthieu Jabaudon, Raiko Blondonnet, Jules Audard, Marianne Fournet, Thomas Godet, Vincent Sapin, Jean-Michel Constantin
Acute respiratory distress syndrome (ARDS) is heterogeneous by definition and patient response varies depending on underlying biology and their severity of illness. Although ARDS subtypes have been identified with different prognoses in past studies, the concept of phenotypes or endotypes does not extend to the clinical definition of ARDS. This has possibly hampered the development of therapeutic interventions that target select biological mechanisms of ARDS. Recently, a major advance may have been achieved as it may now be possible to identify ARDS subtypes that may confer different responses to therapy...
September 18, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28927820/a-novel-role-for-cilia-function-in-atopy-adgrv1-and-dnah5-interactions
#2
Pierre-Emmanuel Sugier, Myriam Brossard, Chloé Sarnowski, Amaury Vaysse, Andréanne Morin, Lucile Pain, Patricia Margaritte-Jeannin, Marie-Hélène Dizier, William O C M Cookson, Mark Lathrop, Miriam F Moffatt, Catherine Laprise, Florence Demenais, Emmanuelle Bouzigon
BACKGROUND: Atopy, an endotype underlying allergic diseases, has a substantial genetic component. OBJECTIVE: Our goal was to identify novel genes associated with atopy in asthma-ascertained families. METHODS: We implemented a three-step analysis strategy in three datasets: The Epidemiological study on the Genetics and Environment of Asthma (EGEA) dataset: 1,660 subjects; The Saguenay-Lac-Saint-Jean (SLSJ) dataset: 1,138 subjects; and The Medical Research Council (MRC) dataset: 446 subjects)...
September 16, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28923762/translating-basic-research-into-clinical-practice-vitamin-d-in-asthma-mechanisms-of-action-and-considerations-for-clinical-trials
#3
REVIEW
Paul E Pfeffer, Catherine M Hawrylowicz
There is increasing interest in the therapeutic utility of vitamin D in asthma, supported by a significant body of evidence on epidemiological associations between vitamin D insufficiency and worse asthma control. In support of a causal relationship, vitamin D beneficially modulates diverse immunological pathways in heterogeneous asthma endotypes, regulating the actions of lymphocytes, mast cells, antigen-presenting cells and structural cells to dampen excessive inflammatory responses. Allergic asthma is characterised by a failure of immune tolerance, and development of pathological responses to inhaled aeroallergens, and vitamin D has been extensively shown to support immune regulation...
September 15, 2017: Chest
https://www.readbyqxmd.com/read/28919788/innovative-treatments-for-severe-refractory-asthma-how-to-choose-the-right-option-for-the-right-patient
#4
REVIEW
Francesco Menzella, Carla Galeone, Francesca Bertolini, Claudia Castagnetti, Nicola Facciolongo
The increasing understanding of the molecular biology and the etiopathogenetic mechanisms of asthma helps in identification of numerous phenotypes and endotypes, particularly for severe refractory asthma. For a decade, the only available biologic therapy that met the unmet needs of a specific group of patients with severe uncontrolled allergic asthma has been omalizumab. Recently, new biologic therapies with different mechanisms of action and targets have been approved for marketing, such as mepolizumab. Other promising drugs will be available in the coming years, such as reslizumab, benralizumab, dupilumab and lebrikizumab...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28918658/the-role-of-upper-airway-pathology-as-a-co-morbidity-in-severe-asthma
#5
Amelia Licari, Ilaria Brambilla, Maria De Filippo, Dimitri Poddighe, Riccardo Castagnoli, Gian Luigi Marseglia
Severe asthma is a complex heterogeneous disease that is refractory to standard treatment and is complicated by multiple co-morbidities and risk factors. Several co-morbidities may contribute to worsen asthma control and complicate diagnostic and therapeutic management of severe asthmatic patients. Areas covered: A prevalent cluster of chronic upper airway co-morbid diseases is recognized in severe asthma. Evaluation for these disorders should always be considered in clinical practice. The aim of this review is to provide an updated overview of the prevalence, the pathogenetic mechanisms, the clinical impact and the therapeutic options for upper airway pathology in severe asthma, focusing on chronic rhinosinusitis and allergic rhinitis...
September 16, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28913985/asthma-biomarkers-do-they-bring-precision-medicine-closer-to-the-clinic
#6
REVIEW
Ioana Agache, Liliana Rogozea
Measurement of biomarkers has been incorporated within clinical research of asthma to characterize the population and to associate the disease with environmental and therapeutic effects. Regrettably, at present, there are no specific biomarkers, none is validated or qualified, and endotype-driven choices overlap. Biomarkers have not yet reached clinical practice and are not included in current asthma guidelines. Last but not least, the choice of the outcome upholding the value of the biomarkers is extremely difficult, since it has to reflect the mechanistic intervention while being relevant to both the disease and the particular person...
November 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28913336/anti-interleukin-5-il-5-and-il-5ra-biological-drugs-efficacy-safety-and-future-perspectives-in-severe-eosinophilic-asthma
#7
REVIEW
Diego Bagnasco, Matteo Ferrando, Gilda Varricchi, Francesca Puggioni, Giovanni Passalacqua, Giorgio Walter Canonica
The definition of asthma has changed considerably in recent years, to the extent that asthma is no longer considered a single disease but a heterogeneous disorder that includes several phenotypes and, possibly, endotypes. A more detailed analysis of the immunological mechanisms underlying the pathogenesis of asthma shows interleukin 5 (IL-5) to be a crucial cytokine in several asthma phenotypes. In fact, IL-5 exerts selective action on eosinophils, which, in turn, sustain airway inflammation and worsen asthma symptoms and control...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28910134/eosinophilic-and-non-eosinophilic-asthma
#8
Tara F Carr, Amir A Zeki, Monica Kraft
Asthma can be subdivided into eosinophilic or non-eosinophilic phenotypes based on the inflammatory cellular patterns seen in sputum, blood, and airway tissue compartments. However, this level of stratification does not always produce robust clinical phenotypes as there is considerable overlap across these phenotypes when viewed from the perspective of "eosinophilia". Multiple proposed subphenotypes of asthma have instead been described within both the eosinophilic and non-eosinophilic groups. An endotype is the mechanism driving a subphenotype including those associated with eosinophilia such as early-onset allergic asthma, with and without obesity, aspirin sensitive asthma and late-onset eosinophilic asthma, allergic bronchopulmonary mycosis, and exercise-induced asthma...
September 14, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28904279/endotypes-of-neutrophilic-airway-inflammation
#9
Nobuyuki Hizawa
No abstract text is available yet for this article.
2017: Arerugī, [Allergy]
https://www.readbyqxmd.com/read/28879503/asthma-phenotypes-and-endotypes-implications-for-personalised-therapy
#10
Katrina Dean, Robert Niven
Asthma is increasingly recognised as a heterogeneous group of diseases with similar clinical presentations rather than a singular disease entity. Asthma was historically categorised by clinical symptoms; however, newer methods of subgrouping, describing and categorising the disease have sub-defined asthma. These sub-definitions are intermittently called phenotypes or endotypes, but the real meanings of these words are poorly understood. Novel treatments are currently and increasingly available, partly in the monoclonal antibody environment, and also some physical therapies (bronchial thermoplasty), but additionally small molecules are not far away from clinical practice...
September 6, 2017: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
https://www.readbyqxmd.com/read/28872030/what-does-endotyping-mean-for-treatment-in-chronic-obstructive-pulmonary-disease
#11
REVIEW
Alvar Agustí, Bartolome Celli, Rosa Faner
Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disease, both at the clinical and biological level. However, COPD is still diagnosed and treated according to simple clinical measures (level of airflow limitation, symptoms, and frequency of previous exacerbations). To address this clinical and biological complexity and to move towards precision medicine in COPD, we need to integrate (bioinformatics) and interpret (clinical science) the vast amount of high-throughput information that existing technology provides (systems biology and network medicine) so diagnosis, stratification, and treatment of patients with COPD can occur on the basis of their pathobiological mechanism (ie, endotypes)...
September 2, 2017: Lancet
https://www.readbyqxmd.com/read/28866644/functional-phenotypes-determined-by-fluctuation-based-clustering-of-lung-function-measurements-in-healthy-and-asthmatic-cohort-participants
#12
Edgar Delgado-Eckert, Oliver Fuchs, Nitin Kumar, Juha Pekkanen, Jean-Charles Dalphin, Josef Riedler, Roger Lauener, Michael Kabesch, Maciej Kupczyk, Sven-Eric Dahlen, Erika von Mutius, Urs Frey
RATIONALE: Asthma is characterised by inflammation and reversible airway obstruction. However, these features are not always closely related. Fluctuations of daily lung function contain information on asthma phenotypes, exacerbation risk and response to long-acting β-agonists. OBJECTIVES: In search of subgroups of asthmatic participants with specific lung functional features, we developed and validated a novel clustering approach to asthma phenotyping, which exploits the information contained within the fluctuating behaviour of twice-daily lung function measurements...
September 2, 2017: Thorax
https://www.readbyqxmd.com/read/28864057/the-road-to-precision-medicine-in-sepsis-blood-transcriptome-endotypes
#13
Carlos Flores, Jesus Villar
No abstract text is available yet for this article.
August 29, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28864056/classification-of-patients-with-sepsis-according-to-blood-genomic-endotype-a-prospective-cohort-study
#14
Brendon P Scicluna, Lonneke A van Vught, Aeilko H Zwinderman, Maryse A Wiewel, Emma E Davenport, Katie L Burnham, Peter Nürnberg, Marcus J Schultz, Janneke Horn, Olaf L Cremer, Marc J Bonten, Charles J Hinds, Hector R Wong, Julian C Knight, Tom van der Poll
BACKGROUND: Host responses during sepsis are highly heterogeneous, which hampers the identification of patients at high risk of mortality and their selection for targeted therapies. In this study, we aimed to identify biologically relevant molecular endotypes in patients with sepsis. METHODS: This was a prospective observational cohort study that included consecutive patients admitted for sepsis to two intensive care units (ICUs) in the Netherlands between Jan 1, 2011, and July 20, 2012 (discovery and first validation cohorts) and patients admitted with sepsis due to community-acquired pneumonia to 29 ICUs in the UK (second validation cohort)...
August 29, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28859704/an-update-on-the-epidemiology-of-aspirin-exacerbated-respiratory-disease
#15
Andrew A White
BACKGROUND: Aspirin-exacerbated respiratory disease (AERD) is a disorder of nasal polyposis, asthma, and hypersensitivity respiratory reactions when on systemic cyclooxygenase 1 blockade. METHODS: AERD warrants specific evaluation as an endotype of asthma and chronic sinus disease due to unique therapeutic opportunities. Currently, aspirin therapy is uniquely beneficial as an anti-inflammatory therapy in AERD, with multiple additional therapies currently in early to late clinical studies, which might also show exceptional benefit in AERD...
September 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28852271/potential-biomarkers-for-nsaid-exacerbated-respiratory-disease
#16
REVIEW
Hanki Park, Youngwoo Choi, Chang-Gyu Jung, Hae-Sim Park
Asthma is a common chronic disease with several variant phenotypes and endotypes. NSAID-exacerbated respiratory disease (NERD) is one such endotype characterized by asthma, chronic rhinosinusitis (CRS) with nasal polyps, and hypersensitivity to aspirin/cyclooxygenase-1 inhibitors. NERD is more associated with severe asthma than other asthma phenotypes. Regarding diagnosis, aspirin challenge tests via the oral or bronchial route are a standard diagnostic method; reliable in vitro diagnostic tests are not available...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28840844/increased-serum-il-17a-and-th2-cytokine-levels-in-patients-with-severe-uncontrolled-asthma
#17
Takehiro Hasegawa, Hitoshi Uga, Akio Mori, Hirokazu Kurata
Asthma is a syndrome of chronic bronchial inflammation and airway remodelling. Initially, asthma has been categorized into atopic and nonatopic types, based on antigen-specific IgE levels. Moreover, recently, asthma has been classified into different endotypes based on its pathophysiology, leading to the selection of the most optimal and effective therapies. Although T helper cell type 2 (Th2) cytokines were proven to play critical roles in atopic asthma, IL-17A has been reported to be involved in severe refractory asthma...
March 1, 2017: European Cytokine Network
https://www.readbyqxmd.com/read/28837221/tailored-interventions-based-on-sputum-eosinophils-versus-clinical-symptoms-for-asthma-in-children-and-adults
#18
REVIEW
Helen L Petsky, Albert Li, Anne B Chang
BACKGROUND: Asthma severity and control can be measured both subjectively and objectively. Sputum analysis for evaluation of percentage of sputum eosinophilia directly measures airway inflammation, and is one method of objectively monitoring asthma. Using sputum analysis to adjust or tailor asthma medications is potentially superior to traditional methods based on symptoms and spirometry. OBJECTIVES: To evaluate the efficacy of tailoring asthma interventions based on sputum analysis in comparison to traditional methods (usually symptom-based with or without spirometry/peak flow) for asthma-related outcomes in children and adults...
August 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28833810/features-of-asthma-which-provide-meaningful-insights-for-understanding-the-disease-heterogeneity
#19
Matea Deliu, Tolga S Yavuz, Matthew Sperrin, Danielle Belgrave, Umit M Sahiner, Cansin Sackesen, Omer Kalayci, Adnan Custovic
BACKGROUND: Data-driven methods such as hierarchical clustering (HC) and principal component analysis (PCA) have been used to identify asthma subtypes, with inconsistent results. OBJECTIVE: To develop a framework for the discovery of stable and clinically meaningful asthma subtypes. METHODS: We performed HC in a rich dataset from 613 asthmatic children, using 45 clinical variables (Model 1), and after PCA dimensionality reduction (Model 2)...
August 22, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28814353/pre-and-postoperative-blood-neutrophil-to-lymphocyte-and-eosinophil-to-lymphocyte-ratios-in-patients-with-sinonasal-polyps-a-preliminary-investigation
#20
Giuseppe Brescia, Umberto Barion, Claudia Zanotti, Daniela Parrino, Gino Marioni
BACKGROUND: Identifying specific endotypes within the broad picture of chronic rhinosinusitis with nasal polyps (CRSwNP), by using biomarkers for instance, remains a challenge. The prognostic role of the neutrophil-to-lymphocyte ratio (NLR) and the eosinophil-to-lymphocyte ratio (ELR) as potential markers of inflammation has already been discussed. OBJECTIVE: The aim of the present study was to compare NLR and ELR before and after endoscopic sinus surgery (ESS) and nasal mometasone furoate for CRSwNP by stratifying patients by their clinical and histologic features...
September 1, 2017: Allergy and Asthma Proceedings:
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