Unclear Which Inhaled Steroids Least Affect Growth in Asthmatic Children Unclear Which Inhaled Steroids Least Affect Growth in Asthmatic Children

It's not clear which inhaled corticosteroids and delivery devices have the least adverse impact on growth in children with persistent asthma, a systematic review concludes.Reuters Health Information
Source: Medscape Allergy Headlines - Category: Allergy & Immunology Tags: Pulmonary Medicine News Source Type: news

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AbstractBackgroundBlood eosinophil count (BEC) and fractional exhaled nitric oxide (FeNO) concentration are established biomarkers in asthma, associated particularly with the risk of exacerbations. We evaluated the relationship of BEC and FeNO as complementary and independent biomarkers of severe asthma exacerbations.MethodsThis observational study included data from the Optimum Patient Care Research Database. Asthma patients (18 –80 years) with valid continuous data for 1 year before FeNO reading, ≥ 1 inhaled corticosteroid prescription, and BEC recorded ≤ 5 years bef...
Source: Clinical and Translational Allergy - Category: Allergy & Immunology Source Type: research
Neutrophilic inflammation in asthma is associated with interleukin (IL)-17A, corticosteroid-insensitivity and bronchodilator-induced forced expiratory volume in 1 s (FEV1) reversibility. IL-17A synergises with tumour necrosis factor (TNF)-α in the production of the neutrophil chemokine CXCL-8 by primary bronchial epithelial cells (PBECs). We hypothesised that local neutrophilic inflammation in asthma correlates with IL-17A and TNF-α-induced CXCL-8 production by PBECs from asthma patients. PBECs from most asthma patients displayed an exaggerated CXCL-8 production in response to TNF-α and IL-17A, but n...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Lung biology and experimental studies, Asthma and allergy Original Articles: Basic science and asthma Source Type: research
CONCLUSION: The 16-day desensitization protocol seemed to be safe and effective in the non-immediate type DHRs caused by lenalidomide. PMID: 31400463 [PubMed - as supplied by publisher]
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Ann Allergy Asthma Immunol Source Type: research
Publication date: Available online 30 July 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Kaharu Sumino, Leonard B. Bacharier, Juanita Taylor, Kelley Chadwick-Mansker, Vanessa Curtis, Alison Nash, Shawni Jackson-Triggs, Joseph Moen, Kenneth B. Schechtman, Jane Garbutt, Mario CastroBackgroundSymptom-based adjustment (SBA) of inhaled corticosteroids may be an alternative patient-centered approach in which day-to-day inhaled corticosteroid use is adjusted by symptoms and short-acting β-agonist need.ObjectiveTo evaluate the effectiveness of SBA in the primary care setting.MethodsWe condu...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Appropriate use of and adherence to asthma medications are critical components of controlling pediatric asthma morbidity. Guideline based asthma therapy recommends use of short acting nebulizers or inhalers to provide quick symptom relief and daily use of long term controller therapies, such as inhaled corticosteroids, to prevent inflammation and exacerbations.1 However, children often lack access to controller and rescue therapies or have poor adherence to their therapies, leading to worse asthma control and health outcomes.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Perspective Source Type: research
Asthma control changes over time and many factors contribute to this variability. Environmental exposures such as seasonal allergen fluctuations, second-hand tobacco exposure, and viral upper respiratory tract infections (RTI) are just a few of the known triggers of lability 1. In addition, host factors such as inhaler technique and co-morbid conditions including atopic diseases, obesity, and acid reflux can also contribute to this changeability. During times of lability, overzealous intervention can lead to overuse of oral corticosteroids (OCS) and healthcare visits, while delayed treatment can lead to severe exacerbation...
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Review Source Type: research
AbstractThe use of biologic agents as therapies for atopic diseases such as asthma and atopic dermatitis has increased greatly in recent years. The biological agents used to treat atopic diseases are for the most part monoclonal antibodies that suppress the immune response and reduce inflammation by targeting particular cytokines or other molecules involved in Th1, Th2, or Th17 immune reactions. Various side effects and rare complications have been reported from these agents. In this review, we discuss mechanisms of various adverse effects for the biologic agents currently in use or in development for atopic and inflammato...
Source: Clinical Reviews in Allergy and Immunology - Category: Allergy & Immunology Source Type: research
In contrast to asthma, the inflammatory response induced by human respiratory syncytial virus (RSV) infection is refractory to glucocorticoid treatment1,2 for reasons that are not clear. Reduced corticosteroid responsiveness at the cellular and clinical level is associated with reduced numbers of glucocorticoid receptor (GRs).3,4 We previously showed that RSV infection downregulated GR mRNA and protein levels in RSV-infected A549  cells and in BALB/c mice.5 Other studies showed that downregulated GR levels were associated with an increase in the microRNAs (miRNAs) miR-124-3p, miR-142-3p, and miR-29a.
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Tags: Letter to the Editor Source Type: research
We read with interest the study by Cardet et  al,1 which showed that 38% of asthmatic patients receiving an inhaled corticosteroid (ICS) and a long-acting β-agonist (LABA; ie, fluticasone/salmeterol) experienced loss of bronchoprotection. We believe that their results need to be interpreted in light of the potential interaction between the L ABA moiety and the arginine/glycine genotype at position 16 (Arg16Gly) of the β2-adrenoceptor. For example, a post hoc genotype-stratified pooled analysis of 152 patients from randomized placebo-controlled trials showed that the degree of protection after chronic dosing ...
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Tags: Correspondence Source Type: research
The European Respiratory Biologics Forum gathered participants from 21 countries in Madrid, Spain, to discuss the management and treatment of severe asthma in the era of biologics. The current insights on the pathophysiology of severe asthma were discussed, as well as the role of respiratory biologics in clinical practice and strategies for eliminating chronic use of oral corticosteroids. The participants also highlighted the key challenges in identifying patients with severe asthma based on phenotypes, biomarkers and treatable traits, and the existing problems in patient referral to specialist care. The monitoring of trea...
Source: European Respiratory Review - Category: Respiratory Medicine Authors: Tags: Asthma and allergy Review Source Type: research
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