Effect of CPAP on airway reactivity and airway inflammation in children with moderate –severe asthma

ABSTRACTBackground and objectiveAsthma is characterized by airway hyperreactivity and airway inflammation. We previously demonstrated that adults with mild well ‐controlled asthma exhibited a marked decrease in airway reactivity (PC20 increased>2 ‐fold) after using nocturnal continuous positive airway pressure (CPAP) for 1 week. If CPAP produces a similar suppression of airway reactivity in children with moderate–severe asthma, who require chronic use of corticosteroids, then this non‐pharmacological therapy might provide a beneficia l alternative or supplemental therapy in these subjects.MethodsChildren aged 8 –17 years with moderate–severe asthma were treated with 4 weeks of nocturnal CPAP (8–10 cm H2O) or sham CPAP (
Source: Respirology - Category: Respiratory Medicine Authors: Tags: Original Article Source Type: research

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We examined which patients respond to systematic assessment and whether oral corticosteroid burden can be decreased independent of monoclonal biologic use.MethodsSpecialist-referred patients are assessed systematically for difficult asthma at our centre. We undertook a responder analysis for improvements in the domains of symptom control, quality of life, exacerbations and airflow obstruction, assessed six months after initial assessment. Multivariate analyses were performed for each domain to identify predictors of response. Changes in oral corticosteroid burden were also measured, stratified by monoclonal biologics comme...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Publication date: Available online 15 January 2020Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Yong Suk Jo, Yong Il Hwang, Kwang Ha Yoo, Tae-Hyung Kim, Myung Goo Lee, Sang Haak Lee, Kyeong-Cheol Shin, Kwang Ho In, Hyoung Kyu Yoon, Chin Kook Rhee, Korean Asthma Research Group &KOCOSS cohortAbstractBackgroundFew reports have investigated the efficacy of using inhaled corticosteroid (ICS)-containing inhalers to treat patients with asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO).ObjectiveTo investigate the effect of ICS treatment on patients with ACO using five sets ...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Conclusion: Targeted biologic therapies have revolutionized the treatment of uncontrolled severe asthma by reducing or even eliminating the need for OCS and improving other major outcomes. Novel agents are now rapidly increasing the therapeutic armamentarium, but additional efforts are needed to optimize referral pathways in order to ensure sustainable access to these therapies. PMID: 31928102 [PubMed - as supplied by publisher]
Source: Journal of Asthma - Category: Respiratory Medicine Tags: J Asthma Source Type: research
CONCLUSIONS: Limited evidence support that a macrolide trial could be considered in children with acute asthma or recurrent wheezing exacerbation. PMID: 31939108 [PubMed - as supplied by publisher]
Source: Paediatric Drugs - Category: Pediatrics Authors: Tags: Paediatr Drugs Source Type: research
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Source Type: research
ConclusionsLimited evidence support that a macrolide trial could be considered in children with acute asthma or recurrent wheezing exacerbation.
Source: Pediatric Drugs - Category: Pediatrics Source Type: research
A 49-year-old female with history of daily inhaled corticosteroid use for asthma presented to a concussion clinic 7 wk after sport-related head injury with headache, visual blurring, dizziness, nausea, fatigue, polydipsia, and polyuria. Examination reveale...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Economics of Injury and Safety, PTSD, Injury Outcomes Source Type: news
In conclusion, this literature review provides an up-to-date overview of the efficacy and safety of LABAs, LTRAs and LAMAs as add-on to ICS in children and adolescents with asthma. Overall, tiotropium and LABAs have similar efficacy, and provide greater improvements in lung function than montelukast as add-on to ICS. All three controller options have comparable safety profiles. PMID: 31931792 [PubMed - in process]
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Respir Res Source Type: research
Authors: Murphy J, McSharry J, Hynes L, Matthews S, Van Rhoon L, Molloy GJ Abstract Objective: Adherence to inhaled corticosteroids (ICS) is an essential part of asthma management throughout the lifespan, however this may be particularly challenging during the transition into adulthood. This systematic review aimed to determine the prevalence and predictors of adherence to ICS in emerging adulthood.Data sources: MEDLINE, PsycINFO, EMBASE, Scopus and CINAHL were searched with search terms for asthma, ICS, adherence, young adults and predictors combined.Study selection: Studies with participants with diagnosed asthma...
Source: Journal of Asthma - Category: Respiratory Medicine Tags: J Asthma Source Type: research
Abstract While the term "asthma" has long been known to describe heterogeneous groupings of patients, only recently have data evolved which enable a molecular understanding of the clinical differences. The evolution of transcriptomics (and other 'omics platforms) and improved statistical analyses in combination with large clinical cohorts opened the door for molecular characterization of pathobiologic processes associated with a range of asthma patients. When linked with data from animal models and clinical trials of targeted biologic therapies emerging distinctions arose between patients with and withou...
Source: Physiological Reviews - Category: Physiology Authors: Tags: Physiol Rev Source Type: research
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