Metabolomic Analysis of Serum Glycerophospholipid Levels in Eosinophilic and Neutrophilic Asthma.

Juan Carlos Ivancevich Sunday, 14 April 2019 23:09

Gai XY1, Zhang LJ1, Chang C1, Guo CL1, Abulikemu M1, Li WX1, Wang J1, Yao WZ1, Zhang X2.

Abstract

OBJECTIVE: To compare the serum glycerophospholipid levels in the inflammatory subtypes of asthma by using targeted metabolomicanalysis.

METHODS: Demographic and clinical data were collected from 51 patients with asthma between January 2015 and December 2015. Routine blood and sputum induction tests were performed. Eosinophilic asthma was defined as induced sputum containing ⪖ 3% eosinophils, and neutrophilic asthma, as induced sputum containing ⪖ 71% neutrophils. Serum metabolic glycerophospholipid profile was determined by liquid chromatography-mass spectrometry. Differences in glycerophospholipid levels between eosinophilic and non-eosinophilic asthma and between neutrophilic and non-neutrophilic asthma were analyzed using partial least squares discriminant analysis.

RESULTS: The serum lysophosphatidylglycerol level was significantly higher in the group with ⪖ 3% eosinophils in sputum than in the group with < 3% eosinophils in sputum. The area under the receiver-operating characteristic curve was ⪖ 70%. There was no significant difference in the serum metabolic glycerophospholipid profile between the group with sputum neutrophils ⪖ 71% and the group with sputum neutrophils < 71%.

CONCLUSION: Serum lysophosphatidylglycerol is produced abundantly in eosinophilic asthma and may be a biomarker of eosinophilic asthma. This information is helpful for identifying and tailoring treatment for the common asthma subtypes.

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CME: Severe Uncontrolled Asthma: Assessing Phenotypic-driven Approaches to Treatment

Juan Carlos Ivancevich Friday, 12 April 2019 23:22
MedPageToday CME Education
 
 

Severe Uncontrolled Asthma: Assessing Phenotypic-driven Approaches to Treatment

Released: December 18, 2018 
Valid for credit through: December 17, 2019 
Estimated Time To Complete: 60 minutes 

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Recent Patents in Allergy/Immunology: Use of arginase inhibitors in the treatment of asthma and allergic rhinitis

Juan Carlos Ivancevich Thursday, 11 April 2019 13:27
NEWS AND VIEWS: RECENT PATENTS IN ALLERGY AND IMMUNOLOGY 
 
Open Access
 
 1 COMMENTARY

1.1 Description of invention

Asthma is a chronic inflammatory disease characterized by recurrent airway obstruction, airway hyperresponsiveness (AHR), airway inflammation, and airway remodeling, which is often associated with allergy and allergic rhinitis. Many patients with asthma are poorly controlled by current drug treatment, particularly a subgroup of patients with difficult‐to‐treat severe asthma, characterized by chronic symptoms, severe exacerbations, progressive loss of lung function, and resistance to corticosteroids. New therapeutic options are therefore highly warranted...

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GINA: 2019 updates to the Pocket Guide for Asthma Management and Prevention

Juan Carlos Ivancevich Friday, 12 April 2019 11:42
 

FOR IMMEDIATE RELEASE APRIL 12, 2019                                                                            

Today the Global Initiative for Asthma (GINA) is happy to release the 2019 updates to the Pocket Guide for Asthma Management and Prevention, as well as an updated version (2.0) of the Pocket Guide on “Diagnosis and Management of Difficult-to-treat and Severe Asthma in adolescent and adult patients”. These important resources are now available on the GINA website www.ginasthma.org/reports 

Landmark Changes in the 2019 GINA Asthma Strategy Report

The 2019 GINA strategy report represents the most significant change in asthma management in over 30 years. The key changes in GINA 2019 are first, that for safety, GINA no longer recommends starting treatment of asthma with short-acting beta2-agonist reliever inhalers on their own. Instead, GINA recommends that all adults and adolescents with asthma should receive either symptom-driven (for mild asthma) or daily inhaled anti-inflammatory controller treatment, to reduce their risk of serious exacerbations and to control symptoms. A summary of the changes implemented in 2019, and the evidence and rationale supporting them, can be found starting on page 16 of the GINA 2019 Pocket Guide, or by downloading the “What’s new in GINA 2019?” slide set, also found at  www.ginasthma.org/reports. The full GINA 2019 report, which contains multiple practical resources for clinicians, and the 2019 online Appendix, will be available shortly. 

Prof. Helen Reddel, Chair of the GINA Science Committee and a research leader at the Woolcock Institute of Medical Research in Sydney, Australia, stated “The new GINA recommendations represent the outcome of a 12-year campaign by GINA to obtain evidence for strategies to reduce the risk of serious asthma-related exacerbations and death, including in patients with so-called mild asthma. Our aims were also to avoid establishing a pattern of patient reliance on quick-relief medications early in the course of the disease, and to facilitate consistent messaging about the goals of asthma treatment from the time of first diagnosis.” 

Summary of Changes for Severe Asthma ver 2.0  

The GINA Pocket Guide on the “Diagnosis and Management of Difficult-to-treat and Severe Asthma in adolescent and adult patients” has proved extremely popular in both hard copy and pdf format since it was first published in November 2018. The Pocket Guide provides practical evidence-based advice for clinicians in both low and high income countries about how to assess and treat patients for whom conventional asthma therapies don’t seem to be working, and about how treatment strategies, including biologic therapies if available, can be implemented into patient care. 

The second version of this Pocket Guide includes important additions to the treatment algorithm for severe asthma, including the availability of an additional biologic treatment (dupilumab, an antibody against interleukin-4 receptor alpha), and advice about extension of a treatment trial of biologic therapy to 6-12 months if the initial response is unclear. 

For media requests or interviews, contact Rebecca Decker, GINA Program Director, via Contact Us page within the GINA website https://ginasthma.org/contact-us/

 For bulk ordering of the new GINA resources, please visit the GINA store (please note these are pre-packed in cases of 125 guides) https://store.ginasthma.org/

Omalizumab in patients with severe asthma and persistent sputum eosinophilia

Juan Carlos Ivancevich Thursday, 04 April 2019 10:51
 
Letter to the editor       Open Access
 
Manali MukherjeeMelanie KjarsgaardKatherine RadfordChynna HuangRichard LeighDelbert R. DorscheidCatherine LemiereLouis-Philippe BouletSusan WasermanJames Martin and Parameswaran Nair Email authorView ORCID ID profile

Abstract

Omalizumab, a recombinant humanized monoclonal antibody targeting the IgE molecule, is the first biologic approved for moderate-to-severe allergic asthmatics, who remain uncontrolled despite high dose inhaled corticosteroid and bronchodilators. Steroid-sparing effect of omalizumab has not been demonstrated in asthmatics with persistent airway eosinophilia in a randomised controlled trial till date. From this double-blind, placebo-controlled, multi-centred, randomized parallel group design, we report that omalizumab is possibly inadequate to control sputum eosinophilia, and therefore may not have a steroid-sparing effect, especially in those maintained on oral corticosteroids daily. This needs to be confirmed or refuted in a larger trial, which may be a challenge with respect to recruitment, since there are currently three additional biologics available to prescribe.

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Editor: Juan C. Ivancevich, MD

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