Advances in Asthma: Volume II

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: closed (25 May 2024) | Viewed by 1128

Special Issue Editors


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Guest Editor
Department of Internal Medicine, University of Verona, 37100 Verona, Italy
Interests: allergic rhinitis; asthma; antihistamines; nasal steroids; complementary medicine; anaphylaxis
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Asthma Center and Allergy Unit, Center for Hypereosinophilic Dysimmune Conditions, University of Verona, Verona University Hospital, 37126 Verona, Italy
Interests: allergy and clinical immunology; severe asthma; immunoterapy; biologic drugs; hyperesoinophilic dysimmune conditions
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is the 2nd edition of "Advances in Asthma" (https://www.mdpi.com/journal/jcm/special_issues/Frontiers_Asthma).

Bronchial asthma is an intriguing topic. The definition of several different endotypes/phenotypes has led to a more personalized approach, mainly based on different types of biologic inflammation. The development of many biologics has improved the treatment of severe asthma, leading to a significant reduction of exacerbated cases and the use of oral steroids. However, we need to identify more specific biomarkers and carefully clinically evaluate each case. Moreover, despite the availability of very effective drugs for any level of severity, the lack of asthma control is still a major problem in the management of the disease. The support of digital medicine, as well as easier treatments, would improve adherence to the treatment. In summary, the management of asthma is still a “work in progress”, despite significant progress that has been made in its pharmacological treatment.

Dr. Gianenrico Senna
Dr. Marco Caminati
Guest Editors

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Keywords

  • bronchial asthma
  • biologic inflammation
  • asthma
  • management

Published Papers (1 paper)

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18 pages, 1283 KiB  
Article
Asthma Inflammatory Phenotypes: How Can We Distinguish Them?
by Aleksandra Plavsic, Branka Bonaci Nikolic, Branislava Milenkovic, Rada Miskovic, Natasa Kusic, Milan Dimitrijevic, Snezana Arandjelovic, Katarina Milosevic, Ivana Buha and Vesna Tomic Spiric
J. Clin. Med. 2024, 13(2), 526; https://doi.org/10.3390/jcm13020526 - 17 Jan 2024
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Abstract
Background and objectives: induced sputum is used to assess different inflammatory phenotypes in asthma, but is not used routinely. We aimed to determine the proportion of inflammatory asthma phenotypes based on induced sputum, to find biomarkers that can discriminate between phenotypes, and to [...] Read more.
Background and objectives: induced sputum is used to assess different inflammatory phenotypes in asthma, but is not used routinely. We aimed to determine the proportion of inflammatory asthma phenotypes based on induced sputum, to find biomarkers that can discriminate between phenotypes, and to evaluate biomarkers in patients with and without biological therapy in different inflammatory asthma phenotypes. Materials and Methods: this cross-sectional study investigated clinical characteristics, asthma control tests, skin prick test, impulse oscillometry (IOS), spirometry, induced sputum, biomarkers (IgE, eosinophils, fractional exhaled nitric oxide (FeNO), serum periostin, IL-5, IL-6, IL-8, IL-17A, IL-33) in 80 asthmatics. A total of 17/80 patients were treated with biologics (10 with omalizumab, 7 with benralizumab). Results: a total of 31% of patients had eosinophilic asthma (EA), 30% had mixed granulocytic asthma (MGA), 24% had paucigranulocytic asthma (PGA), and 15% had neutrophilic asthma (NA). The difference was found in blood eosinophils (p = 0.002), the highest observed in EA. The cut-off ≥ 240/μL eosinophils, with 64% sensitivity and 72.7% specificity, identified EA (AUC = 0.743, p = 0.001). A higher IL-8 level was associated with NA (p = 0.025). In 63 non-biologic asthma group, eosinophils were higher in EA than in NA, MGA, and PGA (p = 0.012, p = 0.028, and p = 0.049, respectively). A higher IL-17A was associated with EA without biologics (p = 0.004). A significantly higher IL-5 was found in EA treated with biologics, in comparison with EA without biologics (p = 0.043). The number of leucocytes and neutrophils was higher in MGA without biologics (p = 0.049, p = 0.019), while IL-5, IL-6, and IL-8 levels were higher in MGA treated with biologics (p = 0.012, p = 0.032, p = 0.038, respectively). Conclusions: EA and MGA were the most prevalent asthma phenotypes. Blood eosinophils can identify EA, both in patients with and without biologics. Apart from the clinical profile, a broad spectrum of biomarkers for assessing inflammatory phenotypes is necessary for an adequate therapy approach to patients with asthma. Full article
(This article belongs to the Special Issue Advances in Asthma: Volume II)
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