T-helper cells and their cytokines in pathogenesis and treatment of asthma

Frontiers in Immunology, Journal Year: 2023, Volume and Issue: 14

Published: June 12, 2023

Prosperous advances in understanding the cellular and molecular mechanisms of chronic inflammation airway remodeling asthma have been made over past several decades. Asthma is a inflammatory disease airways characterized by reversible obstruction that self-resolving or remits with treatment. Around half patients are "Type-2-high" overexpression type 2 pathways elevated cytokines. When stimulated allergens, epithelial cells secrete IL-25, IL-33, TSLP to derive Th2 immune response. First ILC2 followed produces series cytokines such as IL-4, IL-5, IL-13. T

Language: Английский

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Hot topics in allergen immunotherapy, 2023: Current status and future perspective

Allergy, Journal Year: 2023, Volume and Issue: 79(4), P. 823 - 842

Published: Nov. 20, 2023

The importance of allergen immunotherapy (AIT) is multifaceted, encompassing both clinical and quality-of-life improvements cost-effectiveness in the long term. Key mechanisms tolerance induced by AIT include changes memory type allergen-specific T- B-cell responses towards a regulatory phenotype with decreased Type 2 responses, suppression IgE increased IgG

Language: Английский

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Pre-asthma: a useful concept for prevention and disease-modification? A EUFOREA paper. Part 1—allergic asthma

Frontiers in Allergy, Journal Year: 2024, Volume and Issue: 4

Published: Jan. 30, 2024

Asthma, which affects some 300 million people worldwide and caused 455,000 deaths in 2019, is a significant burden to suffers society. It the most common chronic disease children represents one of major causes for years lived with disability. Significant efforts are made by organizations such as WHO improving diagnosis, treatment monitoring asthma. However asthma prevention has been less studied. Currently there concept pre- diabetes allows reduction full blown if diet exercise undertaken. Similar predictive states found Alzheimer's Parkinson's diseases. In this paper we explore possibilities prevention, both at population level also investigate possibility defining state pre-asthma, intensive could reduce progression Since heterogeneous condition, concerned allergic A subsequent will deal late onset eosinophilic

Language: Английский

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Changes in Small Airway Physiology Measured by Impulse Oscillometry in Subjects with Allergic Asthma Following Methacholine and Inhaled Allergen Challenge

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(3), P. 906 - 906

Published: Jan. 30, 2025

Background: Small airway dysfunction (SAD) is associated with impaired asthma control, but small physiology not routinely assessed in clinical practice. Previously, we demonstrated impulse oscillometry (IOS)-defined dual responders (DRs) upon bronchoprovocation various allergens. Aim: To compare lung using spirometry and IOS following methacholine (M) inhaled house dust mite (HDM) extract corticosteroid-naïve asthmatic subjects. Methods: Non-smoking, clinically stable HDM-allergic subjects (18–55 years, FEV1 > 70% of pred.) underwent an M HDM challenge on two separate days. Airway response was measured by spirometry, until a drop ≥ 20% (PC20) from post-diluent baseline (M), up to 8 h post-allergen (HDM). Early (EAR) late (LAR) were defined as ≥20% ≥15% fall during 0–3 3–8 post-challenge, respectively. parameters (Rrs5, Rrs20, Rrs5-20, Xrs5, AX, Fres) compared between mono-responders (MRs: EAR only) (EAR + LAR). Correlations maximal % change after the challenges calculated for both parameters. Results: A total 47 included (11 MRs; 36 DRs). predicted did differ MR DR at baseline, had lower median PC20M (0.84 (range 0.07–7.51) vs. (2.15 (0.53–11.29)); p = 0.036). During LAR, DRs higher values than MRs. For (but FEV1), correlated. inversely correlated Xrs5 LAR (r= −0.443; 0.0018 r= −0.389; 0.0075, respectively). Conclusions: HDM-induced changes can be non-invasively detected are increased hyperresponsiveness challenge. have airways phenotype, which reflects more advanced disease.

Language: Английский

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Expert opinion on gray areas in asthma management: A lesson from the innovative project “revolution in asthma” of the Italian thoracic society (AIPO‐ITS)

Clinical and Translational Allergy, Journal Year: 2025, Volume and Issue: 15(2)

Published: Feb. 1, 2025

Despite the availability of numerous guidelines for asthma management, their recommendations are not consistently implemented in clinical practice. This discrepancy between and real-world practice among Italian healthcare professionals was explored during "Revolution Asthma" training program, which identified "gray areas" barriers preventing clinicians from adopting guideline-based approaches. study aims to analyze key challenges management provide evidence-based solutions improve adherence A group experts Scientific Committee Revolution Asthma project reviewed program's findings, focusing on three main areas management: diagnosis, control, treatment. The summarized clinicians' needs questions each area provided responses practical recommendations. highlights critical treatment, addressing two questions: (a) What possible uses indications short-acting β-agonists patients? (b) How should treatment be initiated adjusted based control? expert panel developed practical, operational tools support general practitioners specialists (pulmonologists allergists) optimizing management. paper serves as a knowledge co-creation initiative, bridging gap daily By offering concrete recommendations, it enhance application professionals.

Language: Английский

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Asthma Phenotypes and Biomarkers

Respiratory Care, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 10, 2025

Asthma experienced by both adults and children is a phenotypically heterogeneous condition. Severe asthma, characterized ongoing symptoms airway inflammation despite high doses of inhaled and/or systemic corticosteroids, the focus research efforts to understand this underlying heterogeneity. Clinical phenotypes in adult pediatric asthma have been determined using supervised definition-driven classification unsupervised data-driven clustering methods. Efforts inflammatory patterns severe led seminal discovery type 2-high versus 2-low development biologics targeted at reduce rates exacerbations. Type upregulation T helper 2 immune pathways including interleukin (IL)-4, IL-5, IL-13 along with eosinophilic inflammation, sometimes allergic sensitization, responsiveness treatment corticosteroids. poorly responsive corticosteroids not as well asthma. limited being defined absence markers. Choosing biologic for involves evaluation panel biomarkers such blood eosinophils, total specific immunoglobulin E/allergic fractional exhaled nitric oxide. In review, we on pathobiology discuss different phenotype-based options or without describe clinical phenotyping approach patients guide out-patient therapy. Finally, end discussion whether exacerbations necessitating admission an ICU constitute their own high-risk phenotype it part other previously subgroups difficult-to-control exacerbation-prone treatment-resistant

Language: Английский

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EUFOREA summit in Brussels 2023: inspiring the future of allergy & respiratory care

Frontiers in Allergy, Journal Year: 2023, Volume and Issue: 4

Published: July 27, 2023

In March 2023, the European Forum for Research and Education in Allergy Airways diseases (EUFOREA) organized its bi-annual Summit Brussels with expert panel members of EUFOREA, representatives EUFOREA patient advisory board, board management teams. Its aim was to define research, educational advocacy initiatives be developed by over next 2 years until 10th anniversary 2025. is an international non-for-profit organization forming alliance all stakeholders dedicated reducing prevalence burden chronic allergic respiratory via education, advocacy. Based on medical scientific core competency, offers evidence-supported platform introduce innovation education healthcare leading optimal care, bridging gap between latest evidence daily practice. Aligned mission improving health panels asthma, rhinitis (AR), rhinosinusitis (CRS) & Position Paper Rhinosinusitis Nasal Polyps (EPOS), allergen immunotherapy (AIT) paediatrics have proposed elaborated a variety activities that correspond major unmet needs allergy field. The current report provides concise overview achievements, ambitions, action plan future, allowing field up-dated inspired join forces Europe beyond.

Language: Английский

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Precision care in the treatment of pediatric asthma

Current Opinion in Pediatrics, Journal Year: 2024, Volume and Issue: 36(3), P. 304 - 309

Published: Feb. 23, 2024

Precision medicine in pediatric asthma involves identification of phenotypes, genetic markers, biomarkers, and biologics that target specific pathways. This review includes a discussion the efficacy currently approved for most recent advances biomarker/phenotype associations affect care.

Language: Английский

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Studying of anti‐inflammatory and antioxidant effects of tectorigenin in ovalbumin‐induced asthma mice models

The Clinical Respiratory Journal, Journal Year: 2024, Volume and Issue: 18(4)

Published: April 1, 2024

Abstract Background Allergic asthma is an important respiratory system problem characterized by airway inflammation, breathlessness, and bronchoconstriction. its outcomes are triggered type 2 allergic immune responses. Tectorigenin a methoxy‐isoflavone with anti‐inflammatory effects. In this study, we investigated the effects of tectorigenin on pathophysiology in animal model. Methods Asthmatic mice were treated tectorigenin. Then hyperresponsiveness (AHR), eosinophil percentage, levels interleukin (IL)‐33, IL‐25, IL‐13, IL‐5, IL‐4, total ovalbumin (OVA)‐specific immunoglobulin (Ig)E, lung histopathology evaluated. Result significantly (P 〈 0.05) reduced infiltration (41 ± 7%) broncho‐alveolar lavage fluid (BALF), serum IL‐5 level 5, pg/mL), bronchial vascular inflammation (scores 1.3 0.2 1.1 0.3, respectively) but had no significant AHR, IL‐33, −25, −13, −4 (403 24, 56 7, 154 11, 89 6 pg/mL, respectively), OVA‐specific IgE (2684 265 264 19 ng/mL, goblet cell hyperplasia, mucus production. Conclusion could control secretion inflammatory mediators asthma, so it can be regarded as potential antiasthma treatment ability to eosinophilia‐related problems.

Language: Английский

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Allergen Immunotherapy for the Prevention and Treatment of Asthma

Clinical & Experimental Allergy, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 4, 2024

Allergic asthma is the predominant phenotype among asthmatics. Although conventional pharmacotherapy a central component in management of asthma, it does not enable control symptoms all patients. In recent decades, some uncontrolled asthmatic patients, especially those with allergic have benefited from biological therapies. However, biologics do address unmet needs left by pharmacotherapy. Furthermore, noteworthy that neither nor therapies disease-modifying properties. this context, allergen immunotherapy (AIT) represents an indispensable therapeutic arsenal against due to its immunological effects. review article, funded AIT manufacturer, we find clinical trials support as only treatment option able both improve and prevent onset worsening condition. For patients severe or other safety concerns, combination offers very promising new modalities for asthma. Trial Registration: clinicaltrials.gov identifier: NCT06027073.

Language: Английский

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