Severe Asthma

Lommatzsch, Marek; Virchow, C

doi:10.3238/arztebl.2014.0847

Cited by 62 publications

(43 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Inhaled β 2 -agonists and anticholinergics are also accepted treatments for the management of asthma [ 107 , 108 ]. Long-acting β 2 -agonists (LABA) are used for moderate/severe asthma [ 109 ].…”

Section: Diagnostic Criteria and Therapeutic Interventions In The Eldmentioning

confidence: 99%

Characterization and redox mechanism of asthma in the elderly

2016

View full text Add to dashboard Cite

Asthma is a chronic disease characterized by reversible airflow limitation, coughing, bronchial constriction, and an inflammatory immune response. While asthma has frequently been categorized as emerging in childhood, evidence has begun to reveal that the elderly population is certainly susceptible to late-onset, or even long-standing asthma. Non-atopic asthma, most commonly found in elderly patients is associated with elevated levels of serum and sputum neutrophils and may be more detrimental than atopic asthma. The mortality of asthma is high in the elderly since these patients often possess more severe symptoms than younger populations. The redox mechanisms that mediate inflammatory reactions during asthma have not been thoroughly interpreted in the context of aging. Thus, we review the asthmatic symptoms related to reactive oxygen species (ROS) and reactive nitrogen species (RNS) in seniors. Moreover, immune status in the elderly is weakened in part by immunosenescence, which is broadly defined as the decline in functionality of the immune system that corresponds with increasing age. The effects of immunosenescence on the expression of biomarkers potentially utilized in the clinical diagnosis of asthma remain unclear. It has also been shown that existing asthma treatments are less effective in the elderly. Thus, it is necessary that clinicians approach the diagnosis and treatment of asthmatic senior patients using innovative methods. Asthma in the elderly demands more intentional diagnostic and therapeutic research since it is potentially one of the few causes of mortality and morbidity in the elderly that is largely reversible.

show abstract

Section: Diagnostic Criteria and Therapeutic Interventions In The Eldmentioning

confidence: 99%

Characterization and redox mechanism of asthma in the elderly

2016

View full text Add to dashboard Cite

show abstract

“… 4 These patients with severe asthma constitute <10% of asthma patients but consume a large proportion of medical resources because of their high mortality and morbidity. 5 , 6 , 7 , 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

The role of autophagy in allergic inflammation: a new target for severe asthma

et al. 2016

View full text Add to dashboard Cite

Autophagy has been investigated for its involvement in inflammatory diseases, but its role in asthma has been little studied. This study aimed to explore the possible role of autophagy and its therapeutic potential in severe allergic asthma. BALB/c mice were sensitized with ovalbumin (OVA) on days 0 and 14, followed by primary OVA challenge on days 28–30. The mice received a secondary 1 or 2% OVA challenge on days 44–46. After the final OVA challenge, the mice were assessed for airway responsiveness (AHR), cell composition and cytokine levels in bronchoalveolar lavage fluid (BALF). LC3 expression in lung tissue was measured by western blot and immunofluorescence staining. Autophagosomes were detected by electron microscopy. 3-Methyladenine (3-MA) treatment and Atg5 knockdown were applied to investigate the potential role of autophagy in allergic asthma mice. AHR, inflammation in BALF and LC3 expression in lung tissue were significantly increased in the 2% OVA-challenged mice compared with the 1% OVA-challenged mice (P<0.05). In addition, eosinophils showed prominent formation of autophagosomes and increased LC3 expression compared with other inflammatory cells in BALF and lung tissue. After autophagy was inhibited by 3-MA and Atg5 shRNA treatment, AHR, eosinophilia, interleukin (IL)-5 levels in BALF and histological inflammatory findings were much improved. Finally, treatment with an anti-IL-5 antibody considerably reduced LC3 II expression in lung homogenates. Our findings suggest that autophagy is closely correlated with the severity of asthma through eosinophilic inflammation, and its modulation may provide novel therapeutic approaches for severe allergic asthma.

show abstract

“…We did not specifically measure patient adherence in this study and cannot exclude noncompliance as a confounder in disease classification. Also, there is no gold standard for the assessment of asthma severity (37,38). We did not evaluate dupilumab, the anti-IL4/13 receptor monoclonal antibody, as it was not an approved therapy and therefore had no label at the time of conducting our analyses.…”

Section: Discussionmentioning

confidence: 99%

Severe asthma and eligibility for biologics in a Brazilian cohort

et al. 2020

View full text Add to dashboard Cite

Objective: This study aims to describe the eligibility for biologic therapies for severe asthma (SA) in a cohort of patients attending the Program for Control of Asthma (ProAR) in Bahia, Brazil. Methods: Data from SA patients (!18 years old) attending the ProAR, that were included in a case-control study conducted from 2013 to 2015, were used to reassess patients according to a modified ERS/ATS 2014 SA criteria. Patients were then classified according to the eligibility for SA biological therapy based on current prescription labels. Results: From 544 patients in the cohort, 531 (97.6%) were included and 172 (32.4%) were identified as SA patients according to the ERS/ATS 2014 modified criteria. Of these 172 patients, 69 (40.1%) were ineligible for any of the biologicals approved for asthma (omalizumab, mepolizumab, reslizumab and benralizumab), 60 (34.9%) patients were eligible for one of the biological therapies, and 10 (5.8%) patients were eligible for all biological therapies. Conclusions: More than half of patients with SA were eligible for biologic therapy in our study, but none of them received this form of treatment. Almost half of them were not eligible to any of the approved biologics, however. The variability and overlap in patients' eligibility highlight the importance of evaluating each patient individually for a more personalized treatment approach. While there is a need to increase access for some of those eligible that may really need a biologic treatment, continuous efforts are required to develop alternatives to those who are not eligible.

show abstract

Severe Asthma

Abstract: The diagnosis and treatment of severe asthma is time consuming and requires special experience. There is a need for competent treatment centers, continuing medical education, and research on the prevalence of severe asthma.

Cited by 62 publications

References 41 publications

Characterization and redox mechanism of asthma in the elderly

Characterization and redox mechanism of asthma in the elderly

The role of autophagy in allergic inflammation: a new target for severe asthma

Severe asthma and eligibility for biologics in a Brazilian cohort

Contact Info

Product

Resources

About