Unconventional Treatment Options in Severe Asthma: An Overivew

Banh, Hoan Linh

doi:10.18433/j37s36

Cited by 8 publications

(5 citation statements)

References 172 publications

(150 reference statements)

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“…However, one study [35] failed to show the effectiveness of HCQ in patients with severe asthma. These data suggest that HCQ might be used as an autophagy-inhibiting, anti-inflammatory agent for the management of SA.…”

Section: Discussionmentioning

confidence: 99%

“…These data suggest that HCQ might be used as an autophagy-inhibiting, anti-inflammatory agent for the management of SA. However, one study [35] failed to show the effectiveness of HCQ in patients with severe asthma. Further studies are required to investigate the potential usefulness of HCQ in the management of severe asthma considering the viral and genetic susceptibility factors that are reportedly associated with autophagy in asthma [4,5,24].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Autophagy mechanisms in sputum and peripheral blood cells of patients with severe asthma: a new therapeutic target

Ban

Pham

Trinh

et al. 2015

Clin Experimental Allergy

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Autophagy mechanisms in sputum and peripheral blood cells of patients with severe asthma: a new therapeutic target

Ban

Pham

Trinh

et al. 2015

Clin Experimental Allergy

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“…If patients with the "overlap syndrome" (asthma and COPD) are included, the numbers of people with refractory disease increases significantly [75]. Of the various novel therapies under consideration for refractory asthma [76], macrolides appear to be one of the most promising. A 2013 metaanalysis of 12 randomized, controlled trials (RCTs) of macrolides for the long term management of asthma in both adults and children found positive effects on peak expiratory flow rate (PEFRa measure of pulmonary function), asthma symptoms, asthma quality of life (AQL), and airway hyper responsiveness (AHR), but not on forced expiratory flow rate in 1 s (FEV1) [77].…”

Section: Treatmentmentioning

confidence: 99%

Infection-mediated asthma: etiology, mechanisms and treatment options, with focus on Chlamydia pneumoniae and macrolides

Webley

Hahn

2017

Respir Res

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Asthma is a chronic respiratory disease characterized by reversible airway obstruction and airway hyperresponsiveness to non-specific bronchoconstriction agonists as the primary underlying pathophysiology. The worldwide incidence of asthma has increased dramatically in the last 40 years. According to World Health Organization (WHO) estimates, over 300 million children and adults worldwide currently suffer from this incurable disease and 255,000 die from the disease each year. It is now well accepted that asthma is a heterogeneous syndrome and many clinical subtypes have been described. Viral infections such as respiratory syncytial virus (RSV) and human rhinovirus (hRV) have been implicated in asthma exacerbation in children because of their ability to cause severe airway inflammation and wheezing. Infections with atypical bacteria also appear to play a role in the induction and exacerbation of asthma in both children and adults. Recent studies confirm the existence of an infectious asthma etiology mediated by Chlamydia pneumoniae (CP) and possibly by other viral, bacterial and fungal microbes. It is also likely that early-life infections with microbes such as CP could lead to alterations in the lung microbiome that significantly affect asthma risk and treatment outcomes. These infectious microbes may exacerbate the symptoms of established chronic asthma and may even contribute to the initial development of the clinical onset of the disease. It is now becoming more widely accepted that patterns of airway inflammation differ based on the trigger responsible for asthma initiation and exacerbation. Therefore, a better understanding of asthma subtypes is now being explored more aggressively, not only to decipher pathophysiologic mechanisms but also to select treatment and guide prognoses. This review will explore infection-mediated asthma with special emphasis on the protean manifestations of CP lung infection, clinical characteristics of infection-mediated asthma, mechanisms involved and antibiotic treatment outcomes.

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“…Therapy was also given to a single patient with amphotericin B and budesonide 15,16,17,86 . Itraconazole is also preferred in patients not responding to oral corticosteroid or if a corticosteroid-sparing treatment approach is required 87,88 . But precaution should be taken while giving itraconazole capsule concomitantly with other drugs which show the pharmacokinetic type of interaction hence serum itraconazole level should be monitored to ascertain adequate absorption of the drug.…”

Section: Diagnosis Of Acute Invasive Fungal Rhinosinusitismentioning

confidence: 99%

Untitled

2018

IJPSR

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Aspergillus produces both airborne and waterborne infections with deadly consequences depending on the species involved and the immune status of patients. Patients may remain asymptomatic for up to 18 months. The severity of aspergillosis is mainly seen in HSCT recipients with mortality up to 90%. Though aspergillosis is primarily opportunistic and lung is the primary site of infection yet deviation observed where the primary site was organs other than lungs. The major reasons behind invasion are prolonged (>3 weeks) high dose corticosteroid therapy, broad-spectrum antibiotics, CMV infection, iron overload, decreased neutrophil count (<500 cells/mm 3), etc. Monoclonal technology in the form of EB-A2 and JF5 antibody can identify fungal antigen much before the appearance of clinical symptoms. Selection of a test and its success to determine fungal invasion depend on associated morbidity as galactomannan assay is more suitable in HSCT recipients rather than solid organ transplant recipients whereas PCR is specific for cancer patients with thrombocytopenia to differentiate between aspergillosis and histoplasmosis. Thorough knowledge about the neutrophil profile is required to interpret the results of CT scan and biopsy. The success of treatment depends on early and correct diagnosis as Aspergillus mimics precancerous conditions and there is considerable overlapping of symptoms between different species of Aspergillus and therapy must be species specific. Mutations in Cyp51A, L98H, M220I, F219C, and G54W are responsible for azole resistance, but the mystery of resistance did not resolve completely as certain fungal isolates show no such mutations but are resistant to antifungals; indicating the need of further research. INTRODUCTION: Fungal invasion arising in the form of aspergillosis may cripple the life of an individual. Aspergillus primarily targets lungs and sinuses but can disseminate to other organs also 1. The portals of entry of Aspergillus are a respiratory tract, damaged skin, operative wounds, cornea and ear 2 .

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Unconventional Treatment Options in Severe Asthma: An Overivew

Cited by 8 publications

References 172 publications

Autophagy mechanisms in sputum and peripheral blood cells of patients with severe asthma: a new therapeutic target

Autophagy mechanisms in sputum and peripheral blood cells of patients with severe asthma: a new therapeutic target

Infection-mediated asthma: etiology, mechanisms and treatment options, with focus on Chlamydia pneumoniae and macrolides

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