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Inhaled corticosteroids and asthma

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https://www.readbyqxmd.com/read/28724478/the-stoppa-twin-study-explains-the-exhaled-nitric-oxide-and-asthma-link-by-genetics-and-sensitization
#1
Björn Nordlund, Cecilia Lundholm, Vilhelmina Ullemar, Marianne van Hage, Anne K Örtqvist, Catarina Almqvist
BACKGROUND: The link between asthma and exhaled nitric oxide (FENO) is not completely understood. The aim of this study was to estimate the association between FENO and asthma, taking genetics, sensitization, and inhaled corticosteroids (ICS) into account. METHODS: A total of 681 twins (53% monozygotic [MZ] and 47% dizygotic [DZ]) from the population-based STOPPA study (mean age 12.6 years) were recruited and information on FENO (parts per billion), parental report of current asthma, sensitization to airborne allergens (Phadiatop; IgE ≥0...
August 2017: Twin Research and Human Genetics: the Official Journal of the International Society for Twin Studies
https://www.readbyqxmd.com/read/28722791/treatment-evaluation-using-lung-sound-analysis-in-asthmatic-children
#2
Chizu Habukawa, Katsumi Murakami, Mitsuru Endoh, Noriaki Horii, Yukio Nagasaka
BACKGROUND AND OBJECTIVE: Non-invasive assessment of treatment and prediction of attacks in asthmatic children do not yet exist. Lung sound analysis can non-invasively evaluate airway obstruction. We used a recently developed technology for analysing lung sounds using ic700 (index of the chest wall at 700 Hz, sound intensity at 700 Hz) to evaluate response to inhaled corticosteroid (ICS) in asthmatic children. METHOD: Seventy asthmatic children, including infants, underwent lung sound recording in the asymptomatic state prior to and 1, 2, 4, 6 and 8 weeks after ICS treatment, and asthma control was assessed at 10 weeks...
July 19, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28721208/new-perspectives-on-the-regulation-of-type-ii-inflammation-in-asthma
#3
REVIEW
Mireya Becerra-Díaz, Marsha Wills-Karp, Nicola M Heller
Asthma is a chronic inflammatory disease of the lungs which has been thought to arise as a result of inappropriately directed T helper type-2 (Th2) immune responses of the lungs to otherwise innocuous inhaled antigens. Current asthma therapeutics are directed towards the amelioration of downstream consequences of type-2 immune responses (i.e. β-agonists) or broad-spectrum immunosuppression (i.e. corticosteroids). However, few approaches to date have been focused on the primary prevention of immune deviation...
2017: F1000Research
https://www.readbyqxmd.com/read/28721202/defining-the-inflammatory-signature-of-human-lung-explant-tissue-in-the-presence-and-absence-of-glucocorticoid
#4
Tracy L Rimington, Emily Hodge, Charlotte K Billington, Sangita Bhaker, Binaya K C, Iain Kilty, Scott Jelinsky, Ian P Hall, Ian Sayers
BACKGROUND:  Airway inflammation is a feature of many respiratory diseases and there is a need for newer, more effective anti-inflammatory compounds. The aim of this study was to develop an ex vivo human lung explant model which can be used to help study the mechanisms underlying inflammatory responses and which can provide a tool to aid drug discovery for inflammatory respiratory diseases such as asthma and COPD. METHOD:  Parenchymal lung tissue from 6 individual donors was dissected and cultured with two pro-inflammatory stimuli, lipopolysaccharide (LPS) (1 µg/ml) and interleukin-1 beta (IL-1β) (10 ng/ml) in the presence or absence of dexamethasone (1 µM)...
2017: F1000Research
https://www.readbyqxmd.com/read/28719697/diagnosis-and-management-of-asthma-in-adults-a-review
#5
Jennifer L McCracken, Sreenivas P Veeranki, Bill T Ameredes, William J Calhoun
Importance: Asthma affects about 7.5% of the adult population. Evidence-based diagnosis, monitoring, and treatment can improve functioning and quality of life in adult patients with asthma. Observations: Asthma is a heterogeneous clinical syndrome primarily affecting the lower respiratory tract, characterized by episodic or persistent symptoms of wheezing, dyspnea, and cough. The diagnosis of asthma requires these symptoms and demonstration of reversible airway obstruction using spirometry...
July 18, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28708950/a-real-life-study-on-height-in-prepubertal-asthmatic-children-receiving-inhaled-steroids
#6
Elpis Hatziagorou, Fotis Kirvassilis, Eleana Kouroukli, Vasiliki Avramidou, Dafni Papanikolaou, Despoina Terzi, Maria Karailidou, John Tsanakas, Maria Papagianni, Demosthenes Panagiotakos
INTRODUCTION: Asthma is the most common chronic respiratory disease in children and inhaled corticosteroids (ICS) constitute the first line of treatment for these patients. However, the potential growth-inhibiting effect of ICS has often been a cause of concern for both caregivers as well as physicians, and there still remains conflict regarding their safety profile. OBJECTIVE: To assess whether the administration of ICS in low or medium doses is associated with height reduction in prepubertal children...
July 14, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28704107/asthma-medication-use-among-adults-with-current-asthma-by-work-related-asthma-status-asthma-call-back-survey-29-states-2012-2013
#7
Katelynn E Dodd, Jacek M Mazurek
OBJECTIVE: Asthma severity is defined as the intensity of treatment required to achieve good control of asthma symptoms. Studies have shown that work-related asthma (WRA) can be associated with poorer asthma control and more severe symptoms than non-WRA. Associations between asthma medications and WRA status were assessed using data from the 2012-2013 Asthma Call-back Survey among ever-employed adults (≥18 years) with current asthma from 29 states. METHODS: Persons with WRA had been told by a physician that their asthma was work-related...
July 13, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28696809/effects-of-aspergillus-fumigatus-on-glucocorticoid-receptor-and-%C3%AE-2-adrenergic-receptor-expression-in-a-rat-model-of-asthma
#8
Xia Zhou, Ya-Jie Dang, Gui-Fang Wang, Xian-Qiao Jin
PURPOSE: Conventional inhaled corticosteroids or β2-adrenergic receptor agonists do not work well in some asthmatic populations while empirical antifungal therapy has obvious impact on those patients. The study was designed to investigate whether short-term exposure to Aspergillus fumigatus (A. fumigatus) could decrease glucocorticoid receptor (GCR) and β2-adrenergic receptor (ADRB2) expression in lung tissue of asthmatic rats. MATERIALS AND METHODS: A rat model of chronic asthma was first established by ovalbumin sensitization and challenge...
July 11, 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/28696803/thai-pediatricians-current-practice-toward-childhood-asthma
#9
Harutai Kamalaporn, Pongpan Chawalitdamrong, Aroonwan Preutthipan
BACKGROUND: Childhood asthma is a substantial health burden in Thailand. Due to a lack of pediatric respiratory specialists (pediatric pulmonologists and allergists; RS), most Thai children are cared for by general pediatricians (pediatric primary care providers (PCP)). OBJECTIVES: We investigated whether current practices of Thai pediatricians complied with asthma guidelines and compared practices (diagnosis and treatments) provided by PCP and RS. METHODS: A cross-sectional study was conducted using electronic surveys including four case scenarios of different asthma phenotypes distributed to Thai pediatricians...
July 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28696794/the-effects-of-asthma-medications-on-reactive-oxygen-species-production-in-human-monocytes
#10
Ming-Kai Tsai, Yi-Ching Lin, Ming-Yii Huang, Min-Sheng Lee, Chang-Hung Kuo, Po-Lin Kuo, Ching-Hsiung Lin, Chih-Hsing Hung
OBJECTIVE: Asthma is a chronic inflammatory airway disease induced by many environmental factors. The inhalation of allergens and pollutants promote the reactive oxygen species (ROS) production leading to airway inflammation, hyper-responsiveness and remodeling in allergic asthma. The effects of asthma medications on ROS production are unclear. The present study investigated the anti-ROS effects of current asthma medications including inhaled corticosteroid (ICS; budesonide and fluticasone), leukotriene receptor antagonist (LTRA; montelukast), long acting β2 agonists (LABAs; salmeterol and formoterol) and a new extra-LABA (indacaterol)...
July 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28696336/perspectives-on-exhaled-nitric-oxide
#11
Fabio Luigi Massimo Ricciardolo, Philip E Silkoff
The history of nitric oxide (NO) in respiratory field dates back to the beginning of '90s with the ancestral study by Lars Gustafsson et al. describing the presence of endogenous NO in the exhaled breath of human beings. Soon after, independent studies showed that exhaled NO concentrations (FENO) is higher in asthmatics than in normal subjects. Not all asthmatics demonstrate a high FENO reflecting heterogeneity of asthma. High values of FENO are associated with over-expression of corticosteroid-sensitive iNOS isoform and allergic/eosinophilic inflammation...
July 11, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28694695/relationship-between-blood-eosinophils-clinical-characteristics-and-mortality-in-patients-with-copd
#12
Maeva Zysman, Gaëtan Deslee, Denis Caillaud, Pascal Chanez, Roger Escamilla, Isabelle Court-Fortune, Pascale Nesme-Meyer, Thierry Perez, Jean-Louis Paillasseur, Christophe Pinet, Gilles Jebrak, Nicolas Roche, Pierre-Régis Burgel
In patients with COPD, there is controversy regarding the association of blood eosinophil (Eos) levels with 1) exacerbation frequency and 2) the effect of inhaled corticosteroids for prevention of exacerbations. To determine whether Eos define subgroups of patients exhibiting attributes of COPD clinical phenotypes, we compared clinical features and mortality rates in COPD patients from the Initiatives BPCO French cohort categorized using different thresholds of blood Eos levels. The following data were collected at inclusion: medical and smoking history, occupational exposures, dyspnea, cough and sputum production, exacerbations in the previous year, history of allergy and asthma, nasal symptoms, body mass index, St George Respiratory Questionnaire (SGRQ) total score, post-bronchodilator spirometry, comorbidities, and medications...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28692144/toll-like-receptor-1-and-10-gene-polymorphisms-are-linked-to-post-bronchiolitis-asthma-in-adolescence
#13
Sari Törmänen, Matti Korppi, Eero Lauhkonen, Petri Koponen, Johanna Teräsjärvi, Juho Vuononvirta, Merja Helminen, Qiushui He, Kirsi Nuolivirta
AIM: Toll-like receptors (TLR) are innate immunity molecules and our previous studies found that TLR1 gene polymorphism was associated with post-bronchiolitis asthma at 1-6 years of age, as was TLR10 at 5-7 years of age. This study examined any associations at 11-13 years of age. METHODS: This prospective follow-up study was part of an on-going evaluation of children admitted to Tampere University Hospital Finland for bronchiolitis in 2001-2004 at less than six months of age...
July 10, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28689840/severe-asthma-phenotypes-how-should-they-guide-evaluation-and-treatment
#14
Anne M Fitzpatrick, Wendy C Moore
Although patients with "severe" asthma tend to be characterized by ongoing symptoms and airway inflammation despite treatment with high doses of inhaled and systemic corticosteroids, there is increasing recognition of marked phenotypic heterogeneity within affected patients. Although "precision medicine" approaches for patients with severe asthma are needed, there are many hurdles that must be overcome in daily practice. The National Heart, Lung and Blood Institute's Severe Asthma Research Program (SARP) has been at the forefront of phenotype discovery in severe asthma for the past decade...
July 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28687413/effect-of-azithromycin-on-asthma-exacerbations-and-quality-of-life-in-adults-with-persistent-uncontrolled-asthma-amazes-a-randomised-double-blind-placebo-controlled-trial
#15
Peter G Gibson, Ian A Yang, John W Upham, Paul N Reynolds, Sandra Hodge, Alan L James, Christine Jenkins, Matthew J Peters, Guy B Marks, Melissa Baraket, Heather Powell, Steven L Taylor, Lex E X Leong, Geraint B Rogers, Jodie L Simpson
BACKGROUND: Exacerbations of asthma cause a substantial global illness burden. Adults with uncontrolled persistent asthma despite maintenance treatment require additional therapy. Since macrolide antibiotics can be used to treat persistent asthma, we aimed to assess the efficacy and safety of oral azithromycin as add-on therapy in patients with uncontrolled persistent asthma on medium-to-high dose inhaled corticosteroids plus a long-acting bronchodilator. METHODS: We did a randomised, double-blind, placebo controlled parallel group trial to determine whether oral azithromycin decreases the frequency of asthma exacerbations in adults (≥18 years) with symptomatic asthma despite current use of inhaled corticosteroid and long-acting bronchodilator, and who had no hearing impairment or abnormal prolongation of the corrected QT interval...
July 4, 2017: Lancet
https://www.readbyqxmd.com/read/28684905/a-retrospective-study-to-assess-clinical-characteristics-and-time-to-initiation-of-open-triple-therapy-among-patients-with-chronic-obstructive-pulmonary-disease-newly-established-on-long-acting-mono-or-combination-therapy
#16
Douglas Mapel, François Laliberté, Melissa H Roberts, Susan R Sama, Devi Sundaresan, Dominic Pilon, Patrick Lefebvre, Mei Sheng Duh, Jeetvan Patel
INTRODUCTION: An incremental approach using open-triple therapy may improve outcomes in patients with chronic obstructive pulmonary disease (COPD). However, there is little sufficient, real-world evidence available identifying time to open-triple initiation. METHODS: This retrospective study of patients with COPD, newly initiated on long-acting muscarinic antagonist (LAMA) monotherapy or inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combination therapy, assessed baseline demographics, clinical characteristics, and exacerbations during 12 months prior to first LAMA or ICS/LABA use...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28677351/positioning-of-long-acting-muscarinic-antagonists-in-the-management-of-asthma
#17
REVIEW
René Aalbers, Hae Sim Park
Despite a range of efficacious therapies for asthma, including inhaled corticosteroids (ICS) and long-acting β₂-agonists (LABA), a significant proportion of patients have poor asthma control and retain a risk of future worsening of their symptoms. Long-acting muscarinic antagonist (LAMA) bronchodilators offer a well-tolerated, efficacious, and cost-effective add-on to a patient's treatment. Of the LAMAs currently under investigation or available for the treatment of asthma, evidence from a comprehensive clinical trial program in adults and children shows that once-daily treatment with tiotropium provides benefits for patients with uncontrolled asthma despite the use of ICS and LABAs...
September 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28670116/treatment-trends-in-patients-with-asthma-copd-overlap-syndrome-in-a-copd-cohort-findings-from-a-real-world-survey
#18
Bo Ding, Mark Small
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is an increasingly recognized phenotype. Few randomized clinical trials have been conducted in patients with ACOS; therefore, scientific evidence concerning ACOS is scarce and a therapeutic approach remains unclear. The aim of this study was to evaluate current treatment trends for patients with ACOS, identified as those with a dual definition of asthma and COPD, in a real-world COPD cohort. METHODS: Data were analyzed from patients with asthma and COPD in the USA, France, Germany, Italy, Spain, and the UK who participated in the 2012 and 2013 Adelphi Respiratory Disease Specific Programmes (DSPs)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28665534/bronchoprotective-tolerance-with-indacaterol-is-not-modified-by-concomitant-tiotropium-in-persistent-asthma
#19
Sunny Jabbal, Arvind Manoharan, Brian Lipworth
BACKGROUND: Tiotropium is a long acting antimuscarinic (LAMA), licenced as triple therapy with inhaled corticosteroid and long acting beta-agonist (ICS/LABA). There may be a synergistic benefit between LAMA and LABA as a consequence of receptor cross-talk, which in turn could modify beta-2 receptor down-regulation and associated tolerance induced by LABA. OBJECTIVE: We hypothesise this mechanism may result in a reduction of airway hyperresponsiveness (AHR) when using triple therapy...
June 30, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28663549/determinants-of-initial-inhaled-corticosteroid-use-in-patients-with-gold-a-b-copd-a-retrospective-study-of-uk-general-practice
#20
James D Chalmers, Abigail Tebboth, Alicia Gayle, Andrew Ternouth, Nick Ramscar
Initial use of inhaled corticosteroid therapy is common in patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) A or B chronic obstructive pulmonary disease, contrary to GOLD guidelines. We investigated UK prescribing of inhaled corticosteroid therapy in these patients, to identify predictors of inhaled corticosteroid use in newly diagnosed chronic obstructive pulmonary disease patients. A cohort of newly diagnosed GOLD A/B chronic obstructive pulmonary disease patients was identified from the UK Clinical Practice Research Datalink (June 2005-June 2015)...
June 29, 2017: NPJ Primary Care Respiratory Medicine
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