Hypersensitivity to inhalant allergen in patients with severe asthma and fixed airway obstruction

2018 ◽  
Author(s):  
Galina  Sergeeva
Keyword(s):  
Airway Obstruction ◽  
Severe Asthma ◽  
Inhalant Allergen

scholarly journals In an Adult Horse With Severe Asthma (Previously Recurrent Airway Obstruction) Does Using Inhaled Corticosteroids Result in an Equal Improvement in Clinical Signs When Compared to Systemic Corticosteroids?

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Natasha A Jocelyn
Keyword(s):  
Open Access ◽  
Airway Obstruction ◽  
Severe Asthma ◽  
Inhaled Corticosteroids ◽  
Clinical Signs ◽  
The Body ◽  
Recurrent Airway Obstruction ◽  
Bottom Line ◽  
Systemic Corticosteroids ◽  
Equine Asthma

<strong>PICO question</strong><br /><p>In an adult horse with severe asthma (previously recurrent airway obstruction (RAO)) does using inhaled corticosteroids result in an equal improvement in clinical signs when compared to systemic corticosteroids?</p><strong>Clinical bottom line</strong><br /><p>The level of confidence in the outcomes from the body of evidence in the 4 papers identified is high. This suggests inhaled corticosteroids (fluticasone and beclomethasone) when used at an appropriate dose can have equivalent effects on severe equine asthma as systemic intravenous dexamethasone. Inhaled corticosteroids can take longer to have the desired effects. </p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" />

Outpatient pulmonary rehabilitation for severe asthma with fixed airway obstruction: Comparison with COPD

2019 ◽  
Vol 56 (12) ◽  
pp. 1325-1333 ◽  
Author(s):  
Agnès Bellocq ◽  
Wanda Gaspard ◽  
Camille Couffignal ◽  
Marie Vigan ◽  
Antoine Guerder ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Severe Asthma ◽  
Pulmonary Rehabilitation

scholarly journals Large endotracheal tumour presenting as severe COPD: flow–volume loop analysis, not always a straightforward diagnostic test

2018 ◽  
pp. bcr-2018-226430
Author(s):  
Iliya P Amaza ◽  
Swan Lee ◽  
Rolando Sanchez
Keyword(s):  
Airway Obstruction ◽  
Severe Asthma ◽  
Standard Therapy ◽  
Chronic Obstructive ◽  
Flow Volume ◽  
Loop Analysis ◽  
Obstructive Pulmonary Disease ◽  
Flow Volume Loop ◽  
Tobacco Abuse ◽  
High Level

The flow–volume loop (FVL) analysis is typically helpful in establishing the diagnosis of airway obstruction caused by endobronchial lesions. In this report, we describe a patient with emphysema and tobacco abuse who presented with chronic dry cough and severe chronic obstructive pulmonary disease (COPD) refractory to standard therapy. The initial FVL showed a relatively normal forced expiratory peak flow shape followed by a smooth flattening of the expiratory curve on spirometry, a pattern consistent with distal airway obstruction as seen in severe asthma or COPD. The patient was later found to have a large endotracheal mass. This atypical presentation, along with the unusual FVL, led to a significant delay in the diagnosis of the tracheal mass. A high level of suspicion is needed to diagnose variable intrathoracic airway obstruction in patients presenting with severe asthma or COPD who fail to improve with standard therapy.

scholarly journals Predictors of reversible airway obstruction with omalizumab in severe asthma: a real-life study

2019 ◽  
Vol 13 ◽  
pp. 175346661984127 ◽  
Author(s):  
Paolo Solidoro ◽  
Filippo Patrucco ◽  
Francesca de Blasio ◽  
Luisa Brussino ◽  
Michela Bellocchia ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Allergic Asthma ◽  
Severe Asthma ◽  
Airway Remodeling ◽  
Real Life ◽  
Forced Expiratory Volume ◽  
Life Study ◽  
Reversible Airway Obstruction ◽  
Number Of Patients ◽  
Severe Allergic Asthma

Background: Omalizumab may modulate airway remodeling in severe asthma. Using forced expiratory volume in 1 second (FEV1) as a surrogate of airway remodeling, we aimed to investigate if an omalizumab add-on in severe allergic asthma may lead to a persistent reversal of airway obstruction and to evaluate the potential biomarkers of airway obstruction reversibility. Methods: Data were collected before (T0) and after omalizumab add-on for 1 year (T1, 32 patients), 2 years (T2, 26 patients) and 4 years (T4, 13 patients). All patients had baseline FEV1 below 80 % predicted (60.5 ± 12.5 %). After omalizumab, 18 patients showed FEV1 normalization (reversible airway obstruction; RAO+) already at T1 (88.7 ± 14.9 %, p < 0.0001) that persisted up to T4 (83.2 ± 7.9, p < 0.01), while 14 patients (RAO−) had FEV1 persistently decreased, from T1 (65.2 ± 8.4%, p < 0.05) up to T4 (61.4 ± 6.2%, not significant). Both groups had significant improvement of symptoms and exacerbations after omalizumab at T1, which persisted up to T4. The comparison between pretreatment characteristics of the two groups showed that RAO+ patients, had higher values of circulating eosinophils, exhaled nitric oxide (FENO), prevalence of rhinitis and nasal polyps, need of oral corticosteroids, shorter asthma duration, higher FEV1 and response to albuterol test. The optimal cut-off points predicting FEV1 normalization after omalizumab add-on were 30.5 ppb for FENO and 305 cells/µl for eosinophils. Conclusions: This study suggests that omalizumab add-on contributes to the persistent reversal of airway obstruction in a consistent number of patients with severe allergic asthma, and this beneficial effect is predicted by elevated pretreatment FENO and circulating eosinophils.

Fixed airway obstruction in patients with severe asthma

2018 ◽  
Author(s):  
Galina Sergeeva ◽  
Alexander Emelyanov ◽  
Evgenia Leshenkova ◽  
Antonina Znakhurenko ◽  
Nana Asatiani
Keyword(s):  
Airway Obstruction ◽  
Severe Asthma

Risk factors associated with irreversible airway obstruction in nonsmoking adult patients with severe asthma

2014 ◽  
Vol 35 (5) ◽  
pp. 72-79 ◽  
Author(s):  
Maciej Ciebiada ◽  
Mateusz Domagała ◽  
Małgorzata Gorska-Ciebiada ◽  
Paweł Gorski
Keyword(s):  
Risk Factors ◽  
Airway Obstruction ◽  
Severe Asthma ◽  
Adult Patients ◽  
Factors Associated ◽  
Irreversible Airway Obstruction

scholarly journals Lung function in adults with stable but severe asthma: air trapping and incomplete reversal of obstruction with bronchodilation

2008 ◽  
Vol 104 (2) ◽  
pp. 394-403 ◽  
Author(s):  
Ronald L. Sorkness ◽  
Eugene R. Bleecker ◽  
William W. Busse ◽  
William J. Calhoun ◽  
Mario Castro ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Severe Asthma ◽  
Forced Expiratory Volume ◽  
Pathological Process ◽  
Airflow Limitation ◽  
Care Utilization ◽  
Air Trapping ◽  
Asthma Phenotype ◽  
Blood Institute ◽  
National Heart Lung

Five to ten percent of asthma cases are poorly controlled chronically and refractory to treatment, and these severe cases account for disproportionate asthma-associated morbidity, mortality, and health care utilization. While persons with severe asthma tend to have more airway obstruction, it is not known whether they represent the severe tail of a unimodal asthma population, or a severe asthma phenotype. We hypothesized that severe asthma has a characteristic physiology of airway obstruction, and we evaluated spirometry, lung volumes, and reversibility during a stable interval in 287 severe and 382 nonsevere asthma subjects from the National Heart, Lung, and Blood Institute Severe Asthma Research Program. We partitioned airway obstruction into components of air trapping [indicated by forced vital capacity (FVC)] and airflow limitation [indicated by forced expiratory volume in 1 s (FEV1)/FVC]. Severe asthma had prominent air trapping, evident as reduced FVC over the entire range of FEV1/FVC. This pattern was confirmed with measures of residual lung volume/total lung capacity (TLC) in a subgroup. In contrast, nonsevere asthma did not exhibit prominent air trapping, even at FEV1/FVC <75% predicted. Air trapping also was associated with increases in TLC and functional reserve capacity. After maximal bronchodilation, FEV1 reversed similarly from baseline in severe and nonsevere asthma, but the severe asthma classification was an independent predictor of residual reduction in FEV1 after maximal bronchodilation. An increase in FVC accounted for most of the reversal of FEV1 when baseline FEV1 was <60% predicted. We conclude that air trapping is a characteristic feature of the severe asthma population, suggesting that there is a pathological process associated with severe asthma that makes airways more vulnerable to this component.

Fixed airway obstruction in severe asthma

2011 ◽  
pp. 147-159 ◽  
Author(s):  
E.H. Bel ◽  
A. ten Brinke ◽  
R.L. Sorkness
Keyword(s):  
Airway Obstruction ◽  
Severe Asthma
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