Expert consensus on the use of systemic glucocorticoids for managing eosinophil-related diseases

Background. According to the GOLD guidelines, glucocorticoids (GCs) are recommended for exacerbations of chronic obstructive pulmonary disease (COPD). Bone mineral density (BMD) can be reduced in case of the use of therapeutic doses of GCs. The aim of the study was to determine the influence of GCs on BMD and the frequency of osteoporosis in patients with COPD depending on the prescribed therapy. Materials and methods. We examined 202 patients with COPD (group E) in the acute phase. Group I consisted of 129 patients taking basic dual treatment, group II — 73 patients taking triple therapy with inhaled GCs. During exacerbations, systemic GCs were prescribed at the cumulative dose of 352.94 ± 30.51 mg/year. The bone state was examined using an ultrasound densitometer SONOST-2000. A Speed of Sound (SOS), Broadband Ultrasound Attenuation (BUA), Stiffness index (SI), and T- and Z-scores were determined. Results. Decreases in SI, BUA, T- and Z- scores were established in 43.51 % of the patients from the I group and 83.56 % from the II group (p < 0.05). In the II group, SI was lower by 9.54 %, BUA — by 14.35 %, SOS — by 14.57 %, T- score — by 6.9 %, Z- score — by 25.86 %; in subjects with GOLD 3: BUA — by 40.27 %, SI — by 3.25 %, T- score — by 17.9 %; in patients with GOLD 4: SI — by 19.9 %, BUA — by 77.8 %, T- score — by 5.6 % compared to the I group. Conclusions. Glucocorticoid-induced osteoporosis was diagnosed in 10.71 % of patients from the I group and 20.55 % of the II group. Its frequency depended on the stage of COPD: GOLD 3 — in 22.22 % of patients, GOLD 4 — in 50.0 % of the subjects.

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Navigating the Terrain: Type 2 Cytokines and Biologic Intervention in Severe Eosinophilic Asthma

W.P. Seymour,

A. Seymour,

M. Gilford

2024

Eosinophils and Their Role in Human Health and Disease

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Asthma is a chronic respiratory disease characterized by bronchial hyperreactivity. There are several endotypes of which allergic asthma is the most common. Severe eosinophilic asthma is prevalent in approximately 5% of asthmatics and its phenotype overlaps with allergic asthma and type 2 inflammation. Patients with refractiveness to corticosteroids underline the difficulty in controlling persistent inflammation in severe eosinophilic asthma. The focus of biological therapies is geared towards the understanding of the intricate interplay of the cytokines that drive the eosinophil’s ability to induce chronic inflammation with airway obstruction. This chapter takes the reader down a historical journey of initial studies that were performed using mouse helper T cell clones for reconstitution experiments to unravel the mechanism of the role T helper 2 cytokines play in allergic asthma. We then reviewed the classic in vivo experiments that demonstrated how antibodies to IL5 can down regulate eosinophils in the blood and their progenitors in the bone marrow of mice. We also delve into the complex interaction of the alarmins on the cytokines triggers of allergic inflammation with elevated eosinophils. Finally, we review the clinical literature on the beneficial effects of humanized monoclonal antibodies in use for treatment of patients suffering from severe eosinophilic asthma.

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Expert consensus on the use of systemic glucocorticoids for managing eosinophil-related diseases

Cited by 3 publications

References 83 publications

Safety, pharmacokinetics and pharmacodynamics of SHR-1703, an innovative long-acting anti-interleukin-5 monoclonal antibody, in healthy subjects: a randomized, double-blind, dose-escalation, placebo-controlled phase I study

Safety, pharmacokinetics and pharmacodynamics of SHR-1703, an innovative long-acting anti-interleukin-5 monoclonal antibody, in healthy subjects: a randomized, double-blind, dose-escalation, placebo-controlled phase I study

The influence of glucocorticoids on the bone tissue in patients with chronic obstructive pulmonary disease

Navigating the Terrain: Type 2 Cytokines and Biologic Intervention in Severe Eosinophilic Asthma

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