scholarly journals Evaluation of inflammation by level of Interleukin 4 in exhaled breath condensate in patients affected by bronchial asthma treated according to GINA guidelines

2011 ◽  
Vol 1 (1) ◽  
pp. 11
Author(s):  
Giuseppe Valerio ◽  
Pierluigi Bracciale ◽  
Fabio Valerio
Keyword(s):  
Asthma Control ◽  
Bronchial Asthma ◽  
Persistent Asthma ◽  
Bronchial Reactivity ◽  
Airways Obstruction ◽  
Severe Persistent Asthma ◽  
Gina Guidelines ◽  
One Year ◽  
Breath Condensate ◽  
Airways Inflammation

GINA guidelines suggest that optimal asthma control can be gained by regular monitoring of symptoms, rescue medication use, airways obstruction and variability upon time of airways flows. Our aim was to check if therapy according to GINA rules is able to lower airways inflammation, measured by the level of IL4 in expired breath condensate (EBC). One hundred patients affected by bronchial asthma in different levels were recruited as they come to the ambulatory ward. They were cured according to GINA guidelines for one year, using inhaled fluthicasone as inhaled steroid. Symptoms were monitored by asthma control test score (ACT), airways obstruction by FEV1, bronchial reactivity by PD20, airways inflammation by IL4 in EBC. ACT showed complete control in the first three GINA levels, improving incompletely in the GINA level 4 (from 20±2 to 21±12; from 17±2 to 22±2; from 14±4 to 18±3; from 10±3 to 14±3 units respectively in the first to fourth levels of asthma). FEV1 improved, but both baseline and after therapy levels were worst in severe persistent asthma (from 96±5 to 96±4; from 92±6 to 93±3; from 74±6 to 83±8; from 45±10 to 60±5% of normal standards respectively from the 1st to 4th level). PD20 and IL4 were fairly normalized by therapy in the s and third levels, improved in the last one (PD20 from 437±329 to 460±269, from 364±308 to >1600, from 436±252 to 890±220; from 45±25 to 60±40 mcg respectively, IL4 in EBC from 60±6 to 40±12, from 65±10 to 41±9, from 72±8 to 45±6, from 78±20 to 52±5 respectively). IL4 and PD20 were significantly related. Experimental data allowed the assessment of the correlation of inflammation with bronchial reactivity and the relevance of addressing therapy upon IL4. Severe persistent asthma behave as a different entity with worst baseline inflammation, partially refractory asthma and persistent inflammation, needing specific immunologic weapons. Bronchial inflammation was fairly reduced but not normalized after one year of therapy.

scholarly journals Assessment of Asthma Control and Severity among Children According to Global Initiative for Asthma Guidelines in Sulaimani City-Iraq

2016 ◽  
Vol 12 (3) ◽  
pp. 160
Author(s):  
Adnan M. H. Hamawandi ◽  
Kosar M Ali ◽  
Ali Z. Naji
Keyword(s):  
Asthma Control ◽  
Objective Assessment ◽  
Asthma Management ◽  
Persistent Asthma ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Global Initiative For Asthma ◽  
Severe Persistent Asthma ◽  
Global Initiative ◽  
Gina Guidelines

Background: Asthma is a common and potentially serious chronic disease that imposes a substantial burden on patients, their families and the community. Objective: Assessment of the level of asthma control and severity in asthmatic children in Sulaimani city according to the global initiative for asthma (GINA) guidelines. Methods: A cross-sectional study of 82 patients who are known cases of asthma, aged 5 – 15 years , from 1st of March 2014 to 1st of August 2014. Results: Out of 82 patients in our study, 20.8%were classified as having intermittent asthma all of them have well controlled asthma, 42.7% of those classified as having mild persistent asthma 65.7% of them have well controlled asthma, 26.8% of those classified as having moderate persistent asthma 54.5% of them have partly controlled asthma, and 9.8%of those classified as having severe persistent asthma the majority of them 87.5% have uncontrolled asthma and none of them reached to the controlled asthma level according to GINA guidelines. Regarding the peak expiratory flow (PFT) we notice that 58.8% of asthmatic children who were classified as having intermittent severity, their PEF measurements ranged between 160- 250 l/min while those with severe persistent asthma 75% of them have readings between 50-150 l/min. Conclusion: Current levels of asthma control in the Sulaimani city fall far short of the goals specified in the GINA guidelines for asthma management. Also there is a strong correlation between PEF measurements and the level of asthma severity,

scholarly journals THE EFFICACY AND SAFETY OF FOSTER IN PATIENTS WITH BRONCHIAL ASTHMA IN ROUTINE CLINICAL PRACTICEon behalf of the Research Group «ESTAFETA» to assess the efficacy and safety of the drug «Foster» in patients with asthma in routine clinical practice

2009 ◽  
Vol 7 (5) ◽  
pp. 82-90
Author(s):  
N I Iljina ◽  
K S Pavlova
Keyword(s):  
Asthma Control ◽  
Bronchial Asthma ◽  
Fixed Combination ◽  
Combined Therapy ◽  
Persistent Asthma ◽  
Innovative Technology ◽  
Symptomatic Therapy ◽  
Efficacy And Safety ◽  
Inhaled Steroids ◽  
Long Acting

Background. Evaluation of the efficacy and safety of the drug Foster (fixed combination of beclomethasone di-propionate 100 mcg and formoterol 6 micrograms per single dose) in metered-dose aerosol inhaler technology Modulite® in patients with bronchial asthma (BA). Methods. Prospective non comparative multicenter open observational study. Study group consisted of 120 practicing physicians from the 92 hospitals in 21 cities of Russia. Analyzed 557 case report forms of patients with moderate persistent asthma treated with Foster during 12 weeks who needed to correct the basic therapy (according to asthma control criteria GINA 2006). Results. The effectiveness of treatment with Foster was observed in 555 (99,6%) of 557 patients, who showed improvement in lung function, decreased severity of symptoms, reducing the need for symptomatic therapy compared with baseline and improved asthma control in general. Conclusions. In most cases, control over moderate and severe persistent asthma can be improved by the combined therapy of inhaled steroids (ICS) and в2-agonist long-acting (LABA). In this case, Foster is a drug of choice with a fixed combination of ICS and LABA. Extra-fine form of the drug (thanks to innovative technology Modulite®) is evenly distributed in central and peripheral airways, providing good therapeutic effect of using of low doses of ICS and reducing the likelihood of side effects.

scholarly journals One Year Treatment with Omalizumab Is Effective and Well Tolerated in Japanese Patients with Moderate-to-Severe Persistent Asthma

2010 ◽  
Vol 59 (2) ◽  
pp. 167-174 ◽  
Author(s):  
Ohta Ken ◽  
Manabu Yamamoto ◽  
Norio Sato ◽  
Kimitoshi Ikeda ◽  
Terumasa Miyamoto
Keyword(s):  
Persistent Asthma ◽  
Japanese Patients ◽  
Severe Persistent Asthma ◽  
One Year

scholarly journals Impact of Omalizumab on Poor Asthma Control Events and Medication Utilisation in Patients With Moderate or Severe Persistent Asthma

2014 ◽  
Vol 17 (7) ◽  
pp. A589
Author(s):  
T.C. Yu ◽  
T. Nazareth ◽  
S.J. Turner ◽  
K. Raimundo ◽  
H. Zhou ◽  
...  
Keyword(s):  
Asthma Control ◽  
Persistent Asthma ◽  
Severe Persistent Asthma

scholarly journals Long-term augmentation therapy with Alpha-1 Antitrypsin in an MZ-AAT severe persistent asthma

2016 ◽  
Vol 70 (4) ◽  
Author(s):  
I. Blanco ◽  
H. Canto ◽  
J. Flóres ◽  
C. Camblor ◽  
V. Cárcaba ◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Social Life ◽  
Hospital Admissions ◽  
Persistent Asthma ◽  
Psychological State ◽  
Future Research ◽  
Lung Function Decline ◽  
Severe Persistent Asthma ◽  
Alpha1 Antitrypsin ◽  
Alpha 1 Antitrypsin

A young Caucasian female with severe bronchial asthma and Alpha1-antitrypsin (AAT) deficiency, MZ phenotype, experienced a quick and severe limitation of her physical capacity, which negatively affected her psychological state and social life, though she was under a strong antiasthmatic treatment. Given her declining health status and the significant chronic corticoid administration- related side-effects (including high reduction of muscle mass and bone density), a clinical trial with commercial intravenous AAT was proposed by the patient’s doctors, and accepted by the Spanish Ministry of Health, although it this therapy was not approved for MZ phenotypes yet. This new therapy quickly stopped lung function decline rate, dramatically reduced the number of hospital admissions of the patient, suppressed the oral administration of prednisone, reversed the corticosteroid-related health adverse effects, significantly improving her quality of life. Thus, although AAT replacement therapy is not approved nor indicated for the treatment of bronchial asthma in MZ patients, its favourable effects observed in this isolated case support the hypothesis that bronchial asthma could be due to pathogenic mechanisms related to a protease- antiprotease imbalance, what which could open new perspectives for future research on the field.

Daclizumab Improves Asthma Control in Patients with Moderate to Severe Persistent Asthma

2008 ◽  
Vol 178 (10) ◽  
pp. 1002-1008 ◽  
Author(s):  
William W. Busse ◽  
Elliot Israel ◽  
Harold S. Nelson ◽  
James W. Baker ◽  
B. Lauren Charous ◽  
...  
Keyword(s):  
Asthma Control ◽  
Persistent Asthma ◽  
Severe Persistent Asthma

scholarly journals Growth velocity and weight gain in prepubertal asthmatic children

2017 ◽  
Vol 63 (3) ◽  
pp. 236-241 ◽  
Author(s):  
Larissa Celiberto Renosto ◽  
Carla Acatauassu ◽  
Itana Andrade ◽  
Marina Rafael Neto ◽  
Talita Lemos Paulino ◽  
...  
Keyword(s):  
Weight Gain ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Persistent Asthma ◽  
Overweight And Obesity ◽  
Z Score ◽  
Asthmatic Children ◽  
Severe Persistent Asthma ◽  
One Year

Summary Objective: To evaluate the stature growth rate (GR) and the weight gain of prepubertal asthmatic children. Method: A retrospective cohort study evaluating medical records of 85 children diagnosed with asthma, aged less than 9 years, of both sexes, with at least one year of follow-up in the allergy outpatient clinic. The data on the disease, weights and heights were collected through a standardized questionnaire on two occasions, with an interval of one year. The curves proposed by Tanner were applied for the analysis of the GR, and the Z-score of the GR (ZGR) was calculated. Results: Excess weight (risk for overweight, overweight and obesity) was observed in 31.8% (27/85) of the patients, but there was no association with the severity of asthma. Low GR (ZGR < -2) was found in 13.9% (11/79) of patients, most frequently among children with moderate/severe persistent asthma compared to persistent mild and intermittent forms (7/11 - 63.6% vs. 21/68 - 30.2%, respectively, p=0.047). Use of steroids (dose, type and time of use) was not associated with GR. Conclusion: GR was most affected in children with moderate/severe asthma.

Successful Treatment of Previously Uncontrolled Adult Asthma with Budesonide Inhalation Suspension: Five-Year Case Histories

2007 ◽  
Vol 41 (10) ◽  
pp. 1728-1733 ◽  
Author(s):  
Sandra M Gawchik
Keyword(s):  
Asthma Control ◽  
Oral Corticosteroid ◽  
Inhaled Corticosteroids ◽  
Case Reports ◽  
Persistent Asthma ◽  
Urgent Care ◽  
Severe Persistent Asthma ◽  
Before And After ◽  
Valuable Treatment ◽  
Poor Outcomes

Objective: To determine whether nebulized budesonide inhalation suspension (BIS) is effective in treating adults with asthma that has been uncontrolled by inhaled therapies. Case Summaries: Three adults with severe persistent asthma were switched to BIS after poor outcomes with other controller medications, including inhaled corticosteroids (ICSs). BIS dosages were initiated with 1 mg twice daily. Based on physician discretion as symptoms improved, dosages were decreased to 0.5 mg twice daily (2 pts.) or once daily (1 pt.). Patients were instructed to self-manage their asthma, increasing their dosages during periods of asthma worsening. Peak expiratory flow (PEF) was assessed before and after the initiation of BIS. The number of healthcare visits and oral corticosteroid courses recorded in patient medical records during the 3 years before and 5 years after initiation of BIS therapy were compared. In all 3 cases, BIS improved asthma control. BIS consistently increased PEF and reduced the number of urgent care visits and oral corticosteroid courses. All patients reported satisfaction with BIS therapy. Discussion: Despite proven effectiveness of ICSs for persistent asthma, some patients fail to respond optimally to treatment administered via an inhaler. These 3 case reports suggest that BIS is effective in treating adults with severe persistent asthma who fail to respond optimally to treatment with other ICS preparations. Failure to use inhalers properly, previous poor adherence in 1 case, or patient preference for the nebulizer might explain why nebulized BIS was more effective than other inhaler therapies. Conclusions: Switching adults with uncontrolled asthma to BIS therapy may be a valuable treatment option for those who are unable to achieve optimal asthma control, despite asthma education and training on inhaler technique.

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