Airway Eosinophilia in Children with Severe Asthma

Lex, Christiane; Ferreira, Flavia de Aguiar; Zacharasiewicz, Angela; Nicholson, Andrew G.; Haslam, P L; Wilson, Nicola; Hansel, Trevor T.; Payne, Donald; Bush, Andrew

doi:10.1164/rccm.200603-352oc

Cited by 141 publications

(92 citation statements)

References 20 publications

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“…This inflammation has been categorised into eosinophilic, neutrophilic, and/or paucigranulocytic [14,18,[45][46][47]. The concomitant presence of both eosinophils and neutrophils (mixed cellularity) has been reported to be associated with the most severe disease [48].…”

Section: Inflammation and Adaptive Immunitymentioning

confidence: 99%

International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

et al. 2013

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Severe or therapy-resistant asthma is increasingly recognised as a major unmet need. A Task Force, supported by the European Respiratory Society and American Thoracic Society, reviewed the definition and provided recommendations and guidelines on the evaluation and treatment of severe asthma in children and adults.A literature review was performed, followed by discussion by an expert committee according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach for development of specific clinical recommendations.When the diagnosis of asthma is confirmed and comorbidities addressed, severe asthma is defined as asthma that requires treatment with high dose inhaled corticosteroids plus a second controller and/or systemic corticosteroids to prevent it from becoming “uncontrolled” or that remains “uncontrolled” despite this therapy. Severe asthma is a heterogeneous condition consisting of phenotypes such as eosinophilic asthma. Specific recommendations on the use of sputum eosinophil count and exhaled nitric oxide to guide therapy, as well as treatment with anti-IgE antibody, methotrexate, macrolide antibiotics, antifungal agents and bronchial thermoplasty are provided.Coordinated research efforts for improved phenotyping will provide safe and effective biomarker-driven approaches to severe asthma therapy.

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Section: Inflammation and Adaptive Immunitymentioning

confidence: 99%

International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

et al. 2013

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“…The most extensively studied biomarker is FeNO, which has been reported to reflect both airway and tissue eosinophilia [142][143][144]. FeNO can be measured in a noninvasive standardised way and is an attractive technique for use in children, usually from school age onwards [144][145][146].…”

Section: Fenomentioning

confidence: 99%

Monitoring asthma in children

et al. 2015

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The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist in various combinations in different individuals, to date there is limited evidence on how to integrate these for optimal monitoring of children with asthma. The aims of this ERS Task Force were to describe the current practise and give an overview of the best available evidence on how to monitor children with asthma.22 clinical and research experts reviewed the literature. A modified Delphi method and four Task Force meetings were used to reach a consensus.This statement summarises the literature on monitoring children with asthma. Available tools for monitoring children with asthma, such as clinical tools, lung function, bronchial responsiveness and inflammatory markers, are described as are the ways in which they may be used in children with asthma. Management-related issues, comorbidities and environmental factors are summarised.Despite considerable interest in monitoring asthma in children, for many aspects of monitoring asthma in children there is a substantial lack of evidence. @ERSpublications ERS statement summarising and discussing the available literature on monitoring children with asthma

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“…Cytokines may enhance the attraction, activation and survival of these inflammatory cells within the submucosa and promote their migration through the epithelium into the bronchial lumen. In the bronchial submucosa, if the number of eosinophils is increased in endobronchial biopsies [31] and in the BAL fluid of asthmatic children [34,37], there is no significant correlation between tissue and BAL eosinophils indicating a compartmentalisation of the eosinophils traffic.…”

Section: Bronchial Epithelium In Childrenmentioning

confidence: 99%

Bronchial epithelium in children: a key player in asthma

et al. 2016

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Bronchial epithelium is a key element of the respiratory airways. It constitutes the interface between the environment and the host. It is a physical barrier with many chemical and immunological properties. The bronchial epithelium is abnormal in asthma, even in children. It represents a key component promoting airway inflammation and remodelling that can lead to chronic symptoms. In this review, we present an overview of bronchial epithelium and how to study it, with a specific focus on children. We report physical, chemical and immunological properties from ex vivo and in vitro studies. The responses to various deleterious agents, such as viruses or allergens, may lead to persistent abnormalities orchestrated by bronchial epithelial cells. As epithelium dysfunctions occur early in asthma, reprogramming the epithelium may represent an ambitious goal to induce asthma remission in children. @ERSpublications Bronchial epithelium is a morphological and functional dysregulated gatekeeper in asthmatic children http://ow.ly/Y4MaM

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Airway Eosinophilia in Children with Severe Asthma

Abstract: There was moderate agreement between both Fe(NO) and sputum eosinophils and BAL eosinophils. There was good NPV, but only poor PPV for these markers for mucosal eosinophilia.

Cited by 141 publications

References 20 publications

International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

Monitoring asthma in children

Bronchial epithelium in children: a key player in asthma

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