Mechanisms underlying corticosteroid resistance in patients with asthma: A review of current knowledge
Expert Rev Respir Med. 2023 Sep 1. doi: 10.1080/17476348.2023.2255124. Online ahead of print.ABSTRACTINTRODUCTION: Corticosteroids are the most cost-effective anti-inflammatory drugs available for the treatment of asthma. Despite their effectiveness, several asthmatic patients have corticosteroid resistance or insensitivity and exhibit a poor response. Corticosteroid insensitivity implies a poor prognosis due to challenges in finding alternative therapeutic options for asthma.AREAS COVERED: In this review, we describe asthma phenotypes and endotypes, as well as their differential responsiveness to corticosteroids. In addit...
Source: Expert Review of Respiratory Medicine - September 1, 2023 Category: Respiratory Medicine Authors: Javier Milara Anselm Morell In és Roger Paula Montero Julio Cortijo Source Type: research

Pharmacotherapy for obstructive sleep apnea: targeting specific pathophysiological traits
Expert Rev Respir Med. 2023 Aug 30:1-12. doi: 10.1080/17476348.2023.2241353. Online ahead of print.ABSTRACTINTRODUCTION: The pathophysiology of obstructive sleep apnea (OSA) is multi-factorial and complex. Varying OSA's pathophysiological traits have been identified, including pharyngeal collapsibility, upper airway muscle reactivity, arousal threshold, and regulation of the ventilatory drive. Being CPAP of difficult tolerance and other interventions reserved to specific subpopulations new pharmacological treatments for OSA might be resolutive.AREAS COVERED: Several existing and newly developed pharmacological drugs can im...
Source: Expert Review of Respiratory Medicine - August 30, 2023 Category: Respiratory Medicine Authors: Elisa Perger Simona Bertoli Carolina Lombardi Source Type: research

Severe pediatric asthma endotypes: current limits and future perspectives
Expert Rev Respir Med. 2023 Aug 30. doi: 10.1080/17476348.2023.2254234. Online ahead of print.ABSTRACTINTRODUCTION: Althoughrare, pediatric severe therapy-resistant asthma (STRA) is a highlyheterogeneous, resource-demanding disease that differs significantly fromsevere adult asthma and whose pathogenesis is still poorly understood.AREAS COVERED: This reviewsummarizes the latest ten years of English-written studies defining pediatricSTRA endotypes using lung-specific techniques such as bronchoalveolar lavageand endobronchial biopsy. Results of the studies and limits on the field arediscussed, together with some future persp...
Source: Expert Review of Respiratory Medicine - August 30, 2023 Category: Respiratory Medicine Authors: Beatrice Andrenacci Maria De Filippo Martina Votto Maria Sole Prevedoni Gorone Mara De Amici Stefania La Grutta Gian Luigi Marseglia Amelia Licari Source Type: research

Pharmacotherapy for obstructive sleep apnea: targeting specific pathophysiological traits
Expert Rev Respir Med. 2023 Aug 30:1-12. doi: 10.1080/17476348.2023.2241353. Online ahead of print.ABSTRACTINTRODUCTION: The pathophysiology of obstructive sleep apnea (OSA) is multi-factorial and complex. Varying OSA's pathophysiological traits have been identified, including pharyngeal collapsibility, upper airway muscle reactivity, arousal threshold, and regulation of the ventilatory drive. Being CPAP of difficult tolerance and other interventions reserved to specific subpopulations new pharmacological treatments for OSA might be resolutive.AREAS COVERED: Several existing and newly developed pharmacological drugs can im...
Source: Expert Review of Respiratory Medicine - August 30, 2023 Category: Respiratory Medicine Authors: Elisa Perger Simona Bertoli Carolina Lombardi Source Type: research

Severe pediatric asthma endotypes: current limits and future perspectives
Expert Rev Respir Med. 2023 Aug 30. doi: 10.1080/17476348.2023.2254234. Online ahead of print.ABSTRACTINTRODUCTION: Althoughrare, pediatric severe therapy-resistant asthma (STRA) is a highlyheterogeneous, resource-demanding disease that differs significantly fromsevere adult asthma and whose pathogenesis is still poorly understood.AREAS COVERED: This reviewsummarizes the latest ten years of English-written studies defining pediatricSTRA endotypes using lung-specific techniques such as bronchoalveolar lavageand endobronchial biopsy. Results of the studies and limits on the field arediscussed, together with some future persp...
Source: Expert Review of Respiratory Medicine - August 30, 2023 Category: Respiratory Medicine Authors: Beatrice Andrenacci Maria De Filippo Martina Votto Maria Sole Prevedoni Gorone Mara De Amici Stefania La Grutta Gian Luigi Marseglia Amelia Licari Source Type: research

Pharmacotherapy for obstructive sleep apnea: targeting specific pathophysiological traits
Expert Rev Respir Med. 2023 Aug 30:1-12. doi: 10.1080/17476348.2023.2241353. Online ahead of print.ABSTRACTINTRODUCTION: The pathophysiology of obstructive sleep apnea (OSA) is multi-factorial and complex. Varying OSA's pathophysiological traits have been identified, including pharyngeal collapsibility, upper airway muscle reactivity, arousal threshold, and regulation of the ventilatory drive. Being CPAP of difficult tolerance and other interventions reserved to specific subpopulations new pharmacological treatments for OSA might be resolutive.AREAS COVERED: Several existing and newly developed pharmacological drugs can im...
Source: Expert Review of Respiratory Medicine - August 30, 2023 Category: Respiratory Medicine Authors: Elisa Perger Simona Bertoli Carolina Lombardi Source Type: research

Severe pediatric asthma endotypes: current limits and future perspectives
Expert Rev Respir Med. 2023 Aug 30. doi: 10.1080/17476348.2023.2254234. Online ahead of print.ABSTRACTINTRODUCTION: Althoughrare, pediatric severe therapy-resistant asthma (STRA) is a highlyheterogeneous, resource-demanding disease that differs significantly fromsevere adult asthma and whose pathogenesis is still poorly understood.AREAS COVERED: This reviewsummarizes the latest ten years of English-written studies defining pediatricSTRA endotypes using lung-specific techniques such as bronchoalveolar lavageand endobronchial biopsy. Results of the studies and limits on the field arediscussed, together with some future persp...
Source: Expert Review of Respiratory Medicine - August 30, 2023 Category: Respiratory Medicine Authors: Beatrice Andrenacci Maria De Filippo Martina Votto Maria Sole Prevedoni Gorone Mara De Amici Stefania La Grutta Gian Luigi Marseglia Amelia Licari Source Type: research

How can we improve our use of allergen immunotherapy as a treatment option for asthma and severe asthma?
Expert Rev Respir Med. 2023 Aug 29:1-9. doi: 10.1080/17476348.2023.2251403. Online ahead of print.ABSTRACTINTRODUCTION: In patients suffering from allergic asthma, especially in the pediatric age-group, allergen immunotherapy (AIT) could be of benefit and has the potential of long-term disease modification.AREAS COVERED: We reviewed the evidence for a beneficial effect of AIT in allergic asthma. A correct selection of the possible candidates for AIT is crucial. We define the comprehensive allergic asthma diagnosis: confirming asthma, confirming allergic sensitization and having symptoms on exposure to the relevant allergen...
Source: Expert Review of Respiratory Medicine - August 29, 2023 Category: Respiratory Medicine Authors: D ésirée Larenas-Linnemann Blanca Mar ía Morfin Maciel Source Type: research

Procalcitonin as a biomarker to guide treatments for patients with lower respiratory tract infections
Expert Rev Respir Med. 2023 Aug 28:1-11. doi: 10.1080/17476348.2023.2251394. Online ahead of print.ABSTRACTINTRODUCTION: Lower respiratory tract infections are amongst the main causes for hospital/intensive care unit admissions and antimicrobial prescriptions. In order to reduce antimicrobial pressure, antibiotic administration could be optimized through procalcitonin-based algorithms.AREAS COVERED: In this review, we discuss the performances of procalcitonin for the diagnosis and the management of community-acquired and ventilator-associated pneumonia. We provide up-to-date evidence and deliver clear messages regarding th...
Source: Expert Review of Respiratory Medicine - August 28, 2023 Category: Respiratory Medicine Authors: Ouriel Saura Charles-Edouard Luyt Source Type: research

Evaluating as-needed inhaled corticosteroid strategies in asthma: expanding the benefits to mild asthma
Expert Rev Respir Med. 2023 Aug 21:1-12. doi: 10.1080/17476348.2023.2247973. Online ahead of print.ABSTRACTINTRODUCTION: Adherence to regular anti-inflammatory treatment is commonly low, and short-acting β2 agonist (SABA) overuse is common in patients with asthma, leading to an increased risk of asthma-related adverse events.AREAS COVERED: Given the pivotal role of inflammation in asthma, multiple as-needed inhaled corticosteroid (ICS)-containing therapies have been developed, leading to a reduction in asthma exacerbations and improvement in symptom control. Currently, as-needed ICS/formoterol is one of the most commonly ...
Source: Expert Review of Respiratory Medicine - August 14, 2023 Category: Respiratory Medicine Authors: Tommaso Bigoni Franco Alfano Federico Baraldi Marco Contoli Alberto Papi Source Type: research

Diagnosis and management of pulmonary veno-occlusive disease
Expert Rev Respir Med. 2023 Aug 21:1-15. doi: 10.1080/17476348.2023.2247989. Online ahead of print.ABSTRACTINTRODUCTION: Pulmonary veno-occlusive disease (PVOD) is an orphan disease and uncommon etiology of pulmonary arterial hypertension (PAH) characterized by substantial small pulmonary vein and capillary involvement.AREAS COVERED: PVOD, also known as 'PAH with features of venous/capillary involvement' in the current ESC/ERS classification.EXPERT OPINION: In recent years, particular risk factors for PVOD have been recognized, including genetic susceptibilities and environmental factors (such as exposure to occupational o...
Source: Expert Review of Respiratory Medicine - August 14, 2023 Category: Respiratory Medicine Authors: Sabina Solinas Ath énaïs Boucly Antoine Beurnier Mithum Kularatne Julien Grynblat M élanie Eyries Peter Dorfm üller Olivier Sitbon Marc Humbert David Montani Source Type: research

Evaluating as-needed inhaled corticosteroid strategies in asthma: expanding the benefits to mild asthma
Expert Rev Respir Med. 2023 Aug 21:1-12. doi: 10.1080/17476348.2023.2247973. Online ahead of print.ABSTRACTINTRODUCTION: Adherence to regular anti-inflammatory treatment is commonly low, and short-acting β2 agonist (SABA) overuse is common in patients with asthma, leading to an increased risk of asthma-related adverse events.AREAS COVERED: Given the pivotal role of inflammation in asthma, multiple as-needed inhaled corticosteroid (ICS)-containing therapies have been developed, leading to a reduction in asthma exacerbations and improvement in symptom control. Currently, as-needed ICS/formoterol is one of the most commonly ...
Source: Expert Review of Respiratory Medicine - August 14, 2023 Category: Respiratory Medicine Authors: Tommaso Bigoni Franco Alfano Federico Baraldi Marco Contoli Alberto Papi Source Type: research

Diagnosis and management of pulmonary veno-occlusive disease
Expert Rev Respir Med. 2023 Aug 21:1-15. doi: 10.1080/17476348.2023.2247989. Online ahead of print.ABSTRACTINTRODUCTION: Pulmonary veno-occlusive disease (PVOD) is an orphan disease and uncommon etiology of pulmonary arterial hypertension (PAH) characterized by substantial small pulmonary vein and capillary involvement.AREAS COVERED: PVOD, also known as 'PAH with features of venous/capillary involvement' in the current ESC/ERS classification.EXPERT OPINION: In recent years, particular risk factors for PVOD have been recognized, including genetic susceptibilities and environmental factors (such as exposure to occupational o...
Source: Expert Review of Respiratory Medicine - August 14, 2023 Category: Respiratory Medicine Authors: Sabina Solinas Ath énaïs Boucly Antoine Beurnier Mithum Kularatne Julien Grynblat M élanie Eyries Peter Dorfm üller Olivier Sitbon Marc Humbert David Montani Source Type: research