Mepolizumab in the treatment of bronchial asthma in children

Patients with severe bronchial asthma, which remains uncontrolled despite the optimal basic therapy, carry a significant healthcare burden and require substantial financial investments. Severe asthma is a heterogeneous airway disease with complex pathophysiological mechanisms that can be broadly divided into inflammatory pathways with eosinophilic and non-eosinophilic inflammation.Aim. This study aimed to analyze the literature data on the use of targeted genetic engineering therapy in patients with severe bronchial asthma, as well as to analyze the organization of immunobiological therapy in the Krasnoyarsk Territory. The addition of targeted drugs for severe eosinophilic bronchial asthma based on phenotyping has proven to be effective and is recommended by all current guidelines. Today, several biologics targeting specific endotypes and phenotypes has been approved for the treatment of severe eosinophilic asthma worldwide. These are antibodies binding immunoglobulin E (omalizumab), antagonists of interleukin-5 (mepolizumab, reslizumab) and its receptor (benralizumab), as well as antibodies selectively binding to the IL-4 and IL-13 receptors (dupilumab). Eosinophilic inflammation therapy is a relatively new direction of asthma treatment, and understanding its long-term efficacy and safety is important.Conclusion. It is essential to differentiate patients with severe eosinophilic asthma from the general cohort of asthma patients, timely refer them to specialists who can prescribe this therapy and have experience with it, select the drug correctly, and monitor the patients during the treatment. This article describes organization of biological therapy for patients with severe eosinophilic bronchial asthma in the Krasnoyarsk Territory.

show abstract

Organization of biological therapy for patients with severe eosinophilic bronchial asthma in the Krasnoyarsk region

Demko

Собко

Kraposhina

et al. 2023

Pulʹmonologiâ (Mosk.)

View full text Add to dashboard Cite

show abstract

Natural history of phenotype markers in patients with bronchial asthma (a decade’s observation)

Kamaev

Mizernitsky

Шапорова

2023

Ross. vestn. perinatol. pediatr.

View full text Add to dashboard Cite

Volatility of certain bronchial asthma (BA) phenotype markers is not enough investigated during maturation of pediatric patients. Material and methods. One hundred thirty-one patients with non-severe BA were included; by the age on inclusion date subgroups of “Children” (62 patients aged 6 to 11 years) and “Adolescents” (69 patients aged 12–17 years) were allocated. Every 6 months patients were examined, fulfi d asthma control questionnaires, performed spirometry with salbutamol test, provided hematology results with absolute eosinophil count and height and weight data. Exacerbation and hospitalization numbers, BA severity and controller treatment step were considered. Acquired data were archived; patients’ management was driven by real clinical practice algorithms.Results. Ninety-three patients included (71%) completed at least decade observation. Adolescents and young adults had body mass index higher than 90th percentile by age more often than younger children; some patients had normalized their body mass during observation. BMI and ACT results had moderate reverse correlation (r=–0.64). Eosinophil counts more than 300 cells per microliter conserved longer in older patients: duration median and [Q1; Q3] for “Adolescents” were 11,7 [9,6; 15,3] months and 9.3 [4.8; 11.1] months for “Children” subgroup, difference was significant (р=0.043). Most lung functional parameters were in age normal range. Rare cases of functional obstruction were not stable and did not differ in duration between “Children” 7.3 [6.2; 8.8] months and “Adolescents” 8.4 [6.5; 10.4] months.Conclusion. Phenotype markers of future BA exacerbation risk are quite volatile in pediatric patients and young adults. We recommend repeated evaluation of such markers every 12–18 month of observation to decide on asthma controller change. Simultaneous detection of several markers was quite often but did not lead to more severe asthma course in most patients. Longer duration of elevated BMI or peripheral blood eosinophils were typical for patients with more often BA exacerbations.

show abstract

Using induced sputum method in clinical practice in patients with bronchial asthma

Чулков

Минина

Medvedeva

2022

Acta biomedica scientifica

View full text Add to dashboard Cite

This article presents an overview of modern statements of the induced sputum method; detailed description of the methods and protocols for taking sputum in adults and children, methods for processing the obtained substance. The paper describes in detail the features of the cellular composition of induced sputum in healthy individuals and in patients with bronchial asthma, emphasizes the importance of the eosinophilia level as a prognostic and diagnostic criterion of asthma and also determines the functions of other induced sputum cells such as neutrophils, macrophages, basophils. The article is illustrated with photographs of sputum microscopy. In addition to sputum cytology, we give accent to the possibility of using other research methods such as an identification of viral and bacterial pathogens, genomics, proteomics, lipidomics, metabolomics, determination of the concentration of various mediators in the sputum supernatant. The paper presents the ideas on biochemical inflammatory markers and remodelling of the respiratory tract in asthma, which can be determined in sputum (C3a anaphylatoxin, clusterin, periostin, eosinophil-derived neurotoxin, folliculin). In addition, we summarize the information on inflammatory phenotypes of bronchial asthma, emphasize their variability and modification depending on the period of the disease, prescribed treatment, intercurrent respiratory infections, and smoking. The article also presents detailed characteristics of eosinophilic, neutrophilic, mixed and small granulocyte phenotypes of bronchial asthma, and describes the most frequent correlations of phenotypes with the severity and course of the disease, with lung function parameters and other indicators. The paper gives an account of the possibilities of using the induced sputum method for a comprehensive assessment of the course, asthma controllability and the effectiveness of drug therapy, as well as for a personalized selection of an antiinflammatory drug considering the inflammatory phenotype.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

hi@scite.ai

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Mepolizumab in the treatment of bronchial asthma in children

Cited by 3 publications

References 34 publications

Organization of biological therapy for patients with severe eosinophilic bronchial asthma in the Krasnoyarsk region

Organization of biological therapy for patients with severe eosinophilic bronchial asthma in the Krasnoyarsk region

Natural history of phenotype markers in patients with bronchial asthma (a decade’s observation)

Using induced sputum method in clinical practice in patients with bronchial asthma

Contact Info

Product

Resources

About