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Asthma endotype phenotype

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https://www.readbyqxmd.com/read/27879060/evidence-of-microbiota-dysbiosis-in-chronic-rhinosinusitis
#1
Michael Hoggard, Kristi Biswas, Melissa Zoing, Brett Wagner Mackenzie, Michael W Taylor, Richard G Douglas
BACKGROUND: Despite considerable research, the pathogenesis of chronic rhinosinusitis (CRS) remains poorly understood. Potential microbial roles in the etiology or progression of CRS have long been hypothesized, yet few specific associations have been identified. In this study we investigate associations between patterns in resident bacterial communities and clinical variants of CRS. METHODS: Bacterial communities were assessed in 94 patients with extensive bilateral CRS undergoing endoscopic sinus surgery (ESS) and 29 controls undergoing ESS for indications other than CRS...
November 23, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27867084/new-concepts-in-asthma-clinical-phenotypes-and-pathophysiological-mechanisms
#2
REVIEW
Andreas R Koczulla, Claus F Vogelmeier, Holger Garn, Harald Renz
Asthma is among the most common chronic inflammatory diseases worldwide. Recent evidence indicates that the pathogenesis shows a high degree of heterogeneity. Patient subsets have been identified that exhibit different cellular and molecular patterns of dysregulation. A prominent example is eosinophilic Th2-driven asthma. These unique and molecular patterns are termed endotypes. Characterization of endotypes has broad implications for therapeutic interventions. Although ∼80% of asthmatic patients respond well to standard anti-inflammatory therapies, the remaining subset particularly consisting of severe patients requires a more specialized endotype-specific approach...
November 17, 2016: Drug Discovery Today
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/27820746/role-of-biologics-targeting-type-2-airway-inflammation-in-asthma-what-have-we-learned-so-far
#5
Amit D Parulekar, Zuzana Diamant, Nicola A Hanania
PURPOSE OF REVIEW: Severe asthma is a heterogeneous syndrome that can be classified into distinct phenotypes and endotypes. In the type 2 (T2)-high endotype, multiple cytokines are produced that lead to eosinophilic inflammation. These cytokines and their receptors are targets for biologic therapies in patients with severe asthma who do not respond well to standard therapy with inhaled corticosteroids. RECENT FINDINGS: In the last decade, an increasing number of biologic therapies have been developed targeting T2 inflammation...
January 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/27820745/role-of-sputum-biomarkers-in-the-management-of-asthma
#6
Sven F Seys
PURPOSE OF REVIEW: Airway inflammation is considered to be a cardinal feature of asthma. However, the type of airway inflammation is heterogeneous and airway inflammation may even be absent. Biomarkers may help to identify the inflammatory phenotype or endotype, especially now the time has come that targeted therapies enter daily practice. RECENT FINDINGS: Sputum biomarkers have increased our insights into the different inflammatory asthma phenotypes, their response to treatment and their association with progression of disease...
January 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/27818326/an-update-on-lymphocyte-subtypes-in-asthma-and-airway-disease
#7
REVIEW
Daniel M Moldaver, Mark Larché, Christopher D Rudulier
Inflammation is a hallmark of many airway diseases. Improved understanding of the cellular and molecular mechanisms of airway disease will facilitate the transition in our understanding from phenotypes to endotypes, thereby improving our ability to target treatments based on pathophysiology. For example, allergic asthma has long been considered to be driven by an allergen-specific Th2 response. However, clinical and mechanistic studies have begun to shed light on the role of other cell subsets in the pathogenesis and regulation of lung inflammation...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27817211/asthma-phenotypes-in-childhood
#8
Matea Deliu, Danielle Belgrave, Matthew Sperrin, Iain Buchan, Adnan Custovic
Asthma is no longer thought of as a single disease, but rather a collection of varying symptoms expressing different disease patterns. One of the ongoing challenges is understanding the underlying pathophysiological mechanisms that may be responsible for the varying responses to treatment. Areas Covered: This review provides an overview of our current understanding of the asthma phenotype concept in childhood and describes key findings from both conventional and data-driven methods. Expert Commentary: With the vast amounts of data generated from cohorts, there is hope that we can elucidate distinct pathophysiological mechanisms, or endotypes...
November 18, 2016: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/27803792/mepolizumab-for-severe-refractory-eosinophilic-asthma-evidence-to-date-and-clinical-potential
#9
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/27798418/t2-low-asthma-current-approach-to-diagnosis-and-therapy
#10
Konstantinos Samitas, Eleftherios Zervas, Mina Gaga
PURPOSE OF REVIEW: Asthma is a heterogeneous disease not only on a clinical but also on a mechanistic level. For a long time, the molecular mechanisms of asthma were considered to be driven by type 2 helper T cells (Th2) and eosinophilic airway inflammation; however, extensive research has revealed that T2-low subtypes that differ from the dominant T2 paradigm are also common. RECENT FINDINGS: Research into asthma pathways has led to the recognition that some asthma phenotypes show absence of T2 inflammation or alternate between T2 and non-T2 responses...
January 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/27677224/addressing-the-misdiagnosis-of-asthma-in-adults-where-does-it-go-wrong
#11
Jenna MacNeil, Robyn H Loves, Shawn D Aaron
Asthma is diagnosed based on patients' respiratory symptoms of wheeze, cough, chest tightness and/or dyspnea together with physiologic evidence of variable and reversible expiratory airflow limitation. A high prevalence of overdiagnosis, underdiagnosis and misdiagnosis of adult asthma has been reported in the literature. Areas covered: Misdiagnosis of asthma in adults can occur in the community due to physicians' failure to confirm airflow limitation using spirometry, the relatively poor sensitivity of spirometry to absolutely rule in asthma, the complexity of multiple asthma phenotypes and endotypes, and the inherent day to day variability of asthma symptoms and airflow limitation...
October 8, 2016: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/27665382/systemic-corticosteroid-responses-in-children-with-severe-asthma-phenotypic-and-endotypic-features
#12
Anne M Fitzpatrick, Susan T Stephenson, Milton R Brown, Khristopher Nguyen, Shaneka Douglas, Lou Ann S Brown
BACKGROUND: Severe asthma in children is a heterogeneous disorder associated with variable responses to corticosteroid treatment. Criterion standards for corticosteroid responsiveness assessment in children are lacking. OBJECTIVE: This study sought to characterize systemic corticosteroid responses in children with severe asthma after treatment with intramuscular triamcinolone and to identify phenotypic and molecular predictors of an intramuscular triamcinolone response...
September 21, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27651322/evaluating-the-role-of-leukotriene-modifying-drugs-in-asthma-management-are-their-benefits-losing-in-translation
#13
Kanchan Pyasi, Ellen Tufvesson, Subhabrata Moitra
Leukotrienes (LTs) initiate a cascade of reactions that cause bronchoconstriction and inflammation in asthma. LT-modifying drugs have been proved very effective to reduce inflammation and associated exacerbation however despite some illustrious clinical trials the usage of these drugs remains overlooked because the evidence to support their utility in asthma management has been mixed and varied between studies. Although, there are plenty of evidences which suggest that the leukotriene-modifying drugs provide consistent improvement even after just the first oral dose and reduce asthma exacerbations, the beneficial effect of these drugs has remained sparse and widely debated...
September 17, 2016: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27613654/biomarkers-of-airway-type-2-inflammation-and-integrating-complex-phenotypes-to-endotypes-in-asthma
#14
REVIEW
Michael C Peters, Michelle-Linh T Nguyen, Eleanor M Dunican
PURPOSE OF REVIEW: Over the past decade, the most important advance in the field of asthma has been the widespread recognition that asthma is a heterogeneous disease driven by multiple molecular processes. RECENT FINDINGS: The most well-established molecular mechanism in asthma is increased airway type-2 inflammation, and consequently, non-invasive biomarkers of increased airway type-2 inflammation, such as blood eosinophil counts or blood periostin levels, have proven important in stratifying asthma patients in clinical trials of type-2 cytokine inhibitors...
October 2016: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/27612492/the-clinical-profile-of-benralizumab-in-the-management-of-severe-eosinophilic-asthma
#15
Francesco Menzella, Mirco Lusuardi, Carla Galeone, Nicola Facciolongo, Luigi Zucchi
Despite several therapeutic choices, 10-20% of patients with severe uncontrolled asthma do not respond to maximal best standard treatments, leading to a healthcare expenditure of up to 80% of overall costs for asthma. Today, there are new important therapeutic strategies, both pharmacological and interventional, that can result in improvement of severe asthma management, such as omalizumab, bronchial thermoplasty and other biological drugs, for example, mepolizumab, reslizumab and benralizumab. The availability of these new treatments and the increasing knowledge of the different asthmatic phenotypes and endotypes makes correct patient selection increasingly complex and important...
September 9, 2016: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27512723/identification-of-asthma-subtypes-using-clustering-methodologies
#16
Matea Deliu, Matthew Sperrin, Danielle Belgrave, Adnan Custovic
Asthma is a heterogeneous disease comprising a number of subtypes which may be caused by different pathophysiologic mechanisms (sometimes referred to as endotypes) but may share similar observed characteristics (phenotypes). The use of unsupervised clustering in adult and paediatric populations has identified subtypes of asthma based on observable characteristics such as symptoms, lung function, atopy, eosinophilia, obesity, and age of onset. Here we describe different clustering methods and demonstrate their contributions to our understanding of the spectrum of asthma syndrome...
2016: Pulm Ther
https://www.readbyqxmd.com/read/27477800/low-grade-disease-activity-in-early-life-precedes-childhood-asthma-and-allergy
#17
Bo Lund Krogsgaard Chawes
Asthma and allergies are today the most common chronic diseases in children and the leading causes of school absences, chronic medication usage, emergency department visits and hospitalizations, which affect all members of the family and represent a significant societal and scientific challenge. These highly prevalent disorders are thought to originate from immune distortion in early childhood, but the etiology and heterogeneity of the disease mechanisms are not understood, which hampers preventive initiatives and makes treatment inadequate...
August 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27468754/the-puzzle-of-immune-phenotypes-of-childhood-asthma
#18
REVIEW
Katja Landgraf-Rauf, Bettina Anselm, Bianca Schaub
Asthma represents the most common chronic childhood disease worldwide. Whereas preschool children present with wheezing triggered by different factors (multitrigger and viral wheeze), clinical asthma manifestation in school children has previously been classified as allergic and non-allergic asthma. For both, the underlying immunological mechanisms are not yet understood in depth in children. Treatment is still prescribed regardless of underlying mechanisms, and children are not always treated successfully...
December 2016: Molecular and Cellular Pediatrics
https://www.readbyqxmd.com/read/27401628/traditional-therapies-for-severe-asthma
#19
REVIEW
Eileen Wang, Flavia C L Hoyte
Severe asthma is a complex and heterogeneous disease. The European Respiratory Society and American Thoracic Society guidelines define severe asthma for patients 6 years or older as "asthma which requires treatment with high-dose inhaled corticosteroids…plus a second controller or systemic corticosteroids to prevent it from becoming 'uncontrolled' or which remains 'uncontrolled' despite this therapy." This article reviews available traditional therapies, data behind their uses in severe asthma, and varying recommendations...
August 2016: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27393773/aspirin-or-nonsteroidal-anti-inflammatory-drug-exacerbated-chronic-rhinosinusitis
#20
Dennis K Ledford, Richard F Lockey
Aspirin (ASA)-exacerbated respiratory disease (AERD) is characterized by upper airway congestion due to eosinophilic inflammation of the nasal and sinus membranes and nasal polyposis, associated with increased leukotriene production that is further accentuated by ASA or other nonsteroidal anti-inflammatory drug (NSAID) ingestion. It occurs in 5% to 10% of subjects with chronic rhinosinusitis (CRS) and in 15% to 40% of those with nasal polyposis. Although AERD with CRS is usually associated with asthma, this is not always the case...
July 2016: Journal of Allergy and Clinical Immunology in Practice
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