Inflammatory Remission in T2 Severe Asthma

Rial, Manuel Jorge; Domínguez‐Ortega, Javier

doi:10.3389/falgy.2022.923083

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…Till now, remission in asthma is classified into several categories. Complete clinical remission is defined by the complete absence of symptoms and no need for medication; partial clinical remission with a significant reduction in symptoms and medication usage [13]; inflammatory remission is characterized by a low concentration or the absence of an inflammatory marker, such as eosinophils, allergen-specific IgE, periostin, FeNO, and eventually airway obstruction; biological Remission with normalization of biological processes related to asthma [14].…”

Section: Clinical Remissionmentioning

confidence: 99%

Clinical remission in severe asthma: lights and shadows on an ambitious goal

Pelaia,

Zannoni,

Paoletti

et al. 2024

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of review The aim of this study was Describe the latest evidence related to the concept of clinical remission in patients with severe asthma, focusing on the lights and shadows of this concept. Recent findings The idea of clinical remission in severe asthma patients brings about a significant shift in the way asthma is treated and managed. Although there has yet to be unanimous agreement among various scientific societies on the precise definition, this concept can be extremely useful in advancing the treatment of the disease. Summary Asthma is a common respiratory condition that affects more than 300 million people globally. It has variable symptoms and severity levels, with about 10% of patients experiencing severe asthma. While there have been advancements in treatment, severe asthma poses significant challenges. Recent approaches have focused on achieving clinical remission, which goes beyond symptom control to address underlying inflammation and biological processes. Clinical remission criteria include the absence of symptoms, reduced medication usage, and normalized inflammatory markers. Various biologic therapies show promise, with some patients achieving remission. However, remission's definition varies globally, hindering standardization and a valid comparison. Standardizing remission criteria and refining predictive factors are crucial for effective asthma management. Overall, achieving clinical remission offers hope for improved long-term outcomes in severe asthma patients.

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Section: Clinical Remissionmentioning

confidence: 99%

Clinical remission in severe asthma: lights and shadows on an ambitious goal

Pelaia,

Zannoni,

Paoletti

et al. 2024

Current Opinion in Allergy &Amp; Clinical Immunology

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“…Применение биологических препаратов блокирует конкретный патогенетический путь, что может обеспечить эффективный контроль воспаления у некоторых пациентов, если этот механизм является основным в данном случае. У других же пациентов могут существовать альтернативные или вторичные патогенетические пути, которые могут быть активированы и не приведут к полной ремиссии БА [10].…”

Section: Chronic Pulmonary Diseasesunclassified

“…Следует отметить, что во всех 3 группах ремиссии наблюдается некоторая степень ремоделирования дыхательных путей, поэтому формально это не может считаться выздоровлением [11]. У взрослых в возрасте до 50 лет курение, аллергическая сенсибилизация, женский пол, пожилой возраст и высокий индекс массы тела (ИМТ) являются факторами риска отсутствия ремиссии или неадекватного контроля БА [10].…”

Section: возможности достижения клинической ремиссии бронхиальной астмыunclassified

The role of anti-IgE therapy in achieving remission of bronchial asthma

Trushenko,

Lavginova,

Stener

et al. 2024

Medicinskij sovet

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Bronchial asthma is one of the most common respiratory diseases, and follows a severe clinical course in 10% of patients. 70–80% of patients with severe asthma have signs of type 2 (T2) inflammation, which is clinically defined as an increase in blood and airways eosinophil counts. The emergence of genetically engineered biological drugs has made it possible to review the purpose of asthma therapy, that is, achieving remission instead of disease control, which includes managing the symptoms, absence of exacerbations, stabilization of functional parameters and normalization of biomarkers in the absence of therapy with systemic glucocorticoids. Clinical studies have shown that therapy with genetically engineered biological drugs can reduce the frequency of asthma exacerbations, decrease the need for maintenance therapy with systemic glucocorticoids, relieve symptoms, improve quality of life, which results in achieving a disease remission in 19.6–31.6% of patients. Predictors of suboptimal response to biological therapy were a high body mass index, admission to the intensive care unit and a history of severe asthma exacerbations, as well as initially more severe clinical manifestations of the disease. The most pronounced effect of omalizumab therapy was observed in patients with atopic severe asthma showing symptoms and exacerbations that are clinically associated with allergic sensitization confirmed by positive results of skin prick testing and (or) identification of serological allergen-specific IgE, elevated levels of T2 biomarkers. This publication presents the latest data on asthma remission: the concept, basic criteria, as well as the role of genetically engineered biological drugs in achieving a remission.

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“…The consensus report by Menzies-Gow and colleagues recommends including the absence of AHR as a criterion for complete remission in a research setting but notes that this may not be feasible in routine clinical practice [ 40 ]. In a review by Rial and Domínguez-Ortega, it was noted that some degree of AHR or lung function impairment may be present in patients with asthma without significant symptoms or in those with low or undetectable serum or airway biomarker levels (e.g., FeNO, eosinophils, or allergen-specific immunoglobulin [Ig]E) [ 44 ]. According to these authors, remission in asthma can be defined in three ways: (1) clinical remission, defined as no significant symptoms or the use of corticosteroid medications for ≥ 1 2 months with improved lung function tests; (2) inflammatory remission, defined as very low or undetectable airway or serum biomarker levels (such as eosinophils, allergen-specific IgE, periostin, FeNO); or (3) complete remission, defined as the absence of asthma symptoms without the use of medication.…”

Section: Existing Definitions Of Remission In Type 2 Inflammatory Dis...mentioning

confidence: 99%

“…According to these authors, remission in asthma can be defined in three ways: (1) clinical remission, defined as no significant symptoms or the use of corticosteroid medications for ≥ 1 2 months with improved lung function tests; (2) inflammatory remission, defined as very low or undetectable airway or serum biomarker levels (such as eosinophils, allergen-specific IgE, periostin, FeNO); or (3) complete remission, defined as the absence of asthma symptoms without the use of medication. Only patients with complete remission would no longer show signs of bronchial hyper-responsiveness [ 44 ].…”

Section: Existing Definitions Of Remission In Type 2 Inflammatory Dis...mentioning

confidence: 99%

Remission in Type 2 Inflammatory Diseases: Current Evidence, Unmet Needs, and Suggestions for Defining Remission in Chronic Rhinosinusitis with Nasal Polyps

Caminati,

De Corso,

Ottaviano

et al. 2023

Curr Allergy Asthma Rep

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Purpose of Review The development of biological therapies for type 2 inflammatory diseases raises the possibility of addressing remission in those dis-immune conditions. No consensus exists for a definition of remission in chronic rhinosinusitis with nasal polyps (CRSwNP). This review aims to critically evaluate the published data to provide the basis for defining remission in CRSwNP. Recent Findings The published evidence has yet to provide an unequivocal definition on remission in type 2 inflammatory diseases, in part reflecting differences in approaches to diagnosis and follow-up. A multidimensional evaluation is necessary when considering complete remission, including clinical, inflammatory, and histologic criteria, but how to combine or tailor the three perspectives according to disease severity at baseline or timing of assessment of treatment category is yet to reach consensus. We suggest defining remission starting from the approach taken in asthma and eosinophilic esophagitis, that is, including the resolution of symptoms and improvements in objective parameters of disease severity and/or inflammatory activity. Future studies and consensuses should provide validated criteria with cutoffs for the day-to-day definition of remission. Summary The definition of remission in CRSwNP should include the following criteria, to be verified and maintained for a period of ≥ 12 months: absence of symptoms (nasal obstruction, loss of smell, rhinorrhea as the main ones); no impact of symptoms on quality of life; no need of surgery; no chronic or rescue medications (systemic corticosteroids or antibiotics); and recovery of smell function, possibly evaluated by objective test. Assessment of underlying inflammation should also be considered once accurate and feasible biomarkers are available in clinical practice.

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Inflammatory Remission in T2 Severe Asthma

Cited by 7 publications

References 10 publications

Clinical remission in severe asthma: lights and shadows on an ambitious goal

Clinical remission in severe asthma: lights and shadows on an ambitious goal

The role of anti-IgE therapy in achieving remission of bronchial asthma

Remission in Type 2 Inflammatory Diseases: Current Evidence, Unmet Needs, and Suggestions for Defining Remission in Chronic Rhinosinusitis with Nasal Polyps

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