Effect of Oral Methyl Prednisolone on Different Radiological Patterns of Hypersensitivity Pneumonitis

Tony, Fatma; Soliman, Youssef; Salem, Hoda A.

doi:10.2147/jaa.s299939

Cited by 6 publications

(6 citation statements)

References 35 publications

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“…On the other hand, 6MWD and DSP also increased in the non-responders. The only paper concerning treatment-related changes of 6MWT parameters in HP was published by Tony et al, who found a significant increase in 6MWD in non-fibrotic HP patients after eight weeks of treatment with methylprednisolone [ 26 ]. The increase of 6MWD after therapy is not always combined with less desaturation.…”

Section: Discussionmentioning

confidence: 99%

New 6-Minute-Walking Test Parameter—Distance/Desaturation Index (DDI) Correctly Diagnoses Short-Term Response to Immunomodulatory Therapy in Hypersensitivity Pneumonitis

Lewandowska

Sobiecka

Boros³

et al. 2023

Diagnostics

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The six-minute-walking test (6MWT) is an easy-to-perform, cheap and valuable tool to assess the physical performance of patients. It has been used as one of the endpoints in many clinical trials investigating treatment efficacy in pulmonary arterial hypertension and idiopathic pulmonary fibrosis. However, the utility of 6MWT in patients diagnosed with hypersensitivity pneumonitis (HP) is still under investigation. The aim of the present retrospective study was to assess the value of different 6MWT parameters, including the newly developed distance-desaturation index (DDI), to evaluate immunomodulatory treatment outcomes in HP patients. Methods: 6MWT parameters (distance, initial saturation, final saturation, desaturation, distance-saturation product (DSP), and DDI) were analyzed at baseline and after 3 to 6 months of treatment with corticosteroids alone or in combination with azathioprine. Results: 91 consecutive HP patients diagnosed and treated in a single pulmonary unit from 2005 to 2017 entered the study. There were 44 (48%) males and 52 (57%) patients with fibrotic HP (fHP). Sixty-three patients (69%) responded to treatment (responders) and 28 (31%) did not respond (non-responders). In the responders group, all parameters assessed during 6MWT significantly improved, whereas in non-responders, they worsened. Medians (95% CI) of best indices were post-treatment DDI/baseline DDI—1.67 (1.85–3.63) in responders versus 0.88 (0.7–1.73) in non-responders (p = 0.0001) and change in walking distance–51 m (36–72 m) in responders, versus 10.5 m (−61.2–27.9) in non-responders (p = 0.0056). The area under the curve (AUC) of receiver operating characteristics (ROC) for post-treatment DDI/baseline DDI was 0.74 and the optimal cut-off was 1.075, with 71% of specificity and 71% of sensitivity. Conclusions: 6MWT may be used as a tool to assess and monitor the response to immunomodulatory therapy in HP patients, especially if indices incorporating both distance and desaturation are used. Based on the present study results, we recommend 6MWD and DDI use, in addition to FVC and TL,co, to monitor treatment efficacy in patients with interstitial lung diseases.

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Section: Discussionmentioning

confidence: 99%

New 6-Minute-Walking Test Parameter—Distance/Desaturation Index (DDI) Correctly Diagnoses Short-Term Response to Immunomodulatory Therapy in Hypersensitivity Pneumonitis

Lewandowska

Sobiecka

Boros³

et al. 2023

Diagnostics

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“…All subjects who received treatment experienced the improvement in FVC%pred., whereas untreated patients declined [ 9 ]. Another study by Tony et al also showed post-treatment improvement in lung function and exercise performance in both non-fibrotic and fibrotic HP patients [ 10 ]. In fibrotic HP, the increase in FVC, FEV1, and oximetry before and after 6MWT and 6MWD were less expressed but also significant [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another study by Tony et al also showed post-treatment improvement in lung function and exercise performance in both non-fibrotic and fibrotic HP patients [ 10 ]. In fibrotic HP, the increase in FVC, FEV1, and oximetry before and after 6MWT and 6MWD were less expressed but also significant [ 10 ]. Morisset et al retrospectively analyzed the effect of azathioprine or mycophenolate mofetil added to a small dose of prednisone in patients with HP and found significant improvements in TL, co, but not FVC after a year of treatment [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

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Factors Predictive for Immunomodulatory Therapy Response and Survival in Patients with Hypersensitivity Pneumonitis—Retrospective Cohort Analysis

Lewandowska

Barańska²,

Sobiecka

et al. 2022

Diagnostics

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Hypersensitivity pneumonitis (HP) is one of the interstitial lung diseases with clearly established diagnostic criteria. Nevertheless, pharmacologic treatment recommendations are still lacking. Most specialists use steroids as first-line drugs, sometimes combined with an immunosuppressive agent. Aim: The aim of the present retrospective study was to establish predictive factors for treatment success and survival advantage in HP patients. Methods: We analyzed the short-term treatment outcome and overall survival in consecutive HP patients treated with prednisone alone or combined with azathioprine. Results: The study group consisted of 93 HP patients, 54 (58%) with fibrotic HP and 39 (42%) with non-fibrotic HP. Mean (± SD) VCmax % pred. and TL,co % pred. before treatment initiation were 81.5 (±20.8)% and 48.3 (±15.7)%, respectively. Mean relative VCmax and TL,co change after 3–6 months of therapy were 9.5 (±18.8)% and 21.4 (±35.2)%, respectively. The short-term treatment outcomes were improvement in 49 (53%) patients, stabilization in 16 (17%) patients, and progression in 28 (30%) patients. Among those with fibrotic HP, improvement was noted in 19 (35%) cases. Significant positive treatment outcome predictors were fever after antigen exposure, lymphocyte count in broncho-alveolar lavage fluid (BALF) exceeding 54%, RV/TLC > 120% pred., and ill-defined centrilobular nodules in high-resolution computed tomography (HRCT). An increased eosinophil count in BALF and fibrosis in HRCT were significant negative treatment outcome predictors. The presence of fibrosis in HRCT remained significant in a multivariate analysis. A positive response to treatment, as well as preserved baseline VCmax (% pred.) and TLC (% pred.), predicted longer survival, while fibrosis in HRCT was related to a worse prognosis. Conclusion: Immunomodulatory treatment may be effective in a significant proportion of patients with HP, including those with fibrotic changes in HRCT. Therefore, future trials are urgently needed to establish the role of immunosuppressive treatment in fibrotic HP.

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“…Hormones are a class of widely used and significantly therapeutic drugs. In clinical applications, hormones have anti-inflammatory, anti-allergic, anti-viral, and anti-shock effects, which have been used in the treatment of rhinitis, asthma, and lung disease [ 9 , 10 , 11 , 12 , 13 ]. In the treatment of skin diseases, they are generally used to relieve skin problems, such as psoriasis and eczema.…”

Section: Introductionmentioning

confidence: 99%

Advances on Hormones in Cosmetics: Illegal Addition Status, Sample Preparation, and Detection Technology

Wang

et al. 2023

Molecules

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Owing to the rapid development of the cosmetic industry, cosmetic safety has become the focus of consumers’ attention. However, in order to achieve the desired effects in the short term, the illegal addition of hormones in cosmetics has emerged frequently, which could induce skin problems and even skin cancer after long-term use. Therefore, it is of great significance to master the illegal addition in cosmetics and effectively detect the hormones that may exist in cosmetics. In this review, we analyze the illegally added hormone types, detection values, and cosmetic types, as well as discuss the hormone risks in cosmetics for human beings, according to the data in unqualified cosmetics in China from 2017 to 2022. Results showed that although the frequency of adding hormones in cosmetics has declined, hormones are still the main prohibited substances in illegal cosmetics, especially facial masks. Because of the complex composition and the low concentration of hormones in cosmetics, it is necessary to combine efficient sample preparation technology with instrumental analysis. In order to give the readers a comprehensive overview of hormone analytical technologies in cosmetics, we summarize the advanced sample preparation techniques and commonly used detection techniques of hormones in cosmetics in the last decade (2012–2022). We found that ultrasound-assisted extraction, solid phase extraction, and microextraction coupled with chromatographic analysis are still the most widely used analytical technologies for hormones in cosmetics. Through the investigation of market status, the summary of sample pretreatment and detection technologies, as well as the discussion of their development trends in the future, our purpose is to provide a reference for the supervision of illegal hormone residues in cosmetics.

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Effect of Oral Methyl Prednisolone on Different Radiological Patterns of Hypersensitivity Pneumonitis

Cited by 6 publications

References 35 publications

New 6-Minute-Walking Test Parameter—Distance/Desaturation Index (DDI) Correctly Diagnoses Short-Term Response to Immunomodulatory Therapy in Hypersensitivity Pneumonitis

New 6-Minute-Walking Test Parameter—Distance/Desaturation Index (DDI) Correctly Diagnoses Short-Term Response to Immunomodulatory Therapy in Hypersensitivity Pneumonitis

Factors Predictive for Immunomodulatory Therapy Response and Survival in Patients with Hypersensitivity Pneumonitis—Retrospective Cohort Analysis

Advances on Hormones in Cosmetics: Illegal Addition Status, Sample Preparation, and Detection Technology

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