CommentSevere childhood asthma: a common international approach?
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Considering biomarkers in asthma disease severity
2022, Journal of Allergy and Clinical ImmunologyCitation Excerpt :There may be different reasons for poor control among patients on maximum treatment, ranging from the wrong diagnosis,7 to nonadherence with prescribed treatments,8 and genuine resistance to current asthma therapies.9 In pediatric severe asthma, Bush et al10 proposed to use the term “problematic severe asthma” for children with perceived lack of response to high doses of medications. Once other diagnoses are excluded, patients with problematic severe asthma may have either difficult asthma (DA, characterized by modifiable and actionable factors such as poor adherence,11 adverse environmental exposures, and psychosocial factors12), “asthma plus” (asthma with comorbidities), or severe therapy-resistant asthma (STRA), comprising patients who do not respond to standard therapies, such as systemic corticosteroids administered either as intramuscular injections or as oral direct observed therapy, and need different therapeutic approaches, including biologics.13,14
Advanced human-relevant in vitro pulmonary platforms for respiratory therapeutics
2021, Advanced Drug Delivery ReviewsCitation Excerpt :In contrast, dexamethasone was found to be ineffective using the same protocol. These in vitro results were consistent with the clinical observation that pediatric asthmatic patients often fail to respond to inhalation therapy with dexamethasone [180]. Finally, Nawroth et al. [181] used a commercially-available chip (Emulate) to create a micro-engineered model of fully-differentiated human mucociliary airway epithelium.
Eosinophilic airway inflammation is a main feature of unstable asthma in adolescents
2019, Respiratory MedicineCitation Excerpt :According to GINA criteria, we assumed 400–800 mcg as a mean dose of ICS (as an equivalent to Budesonide DP) and >800–1600 mcg as a high dose. The unstable group also contained a subgroup of patients with severe problematic asthma (SPA), which was defined as persistent asthma symptoms (occurring more than twice a week) occurring for at least 3 months, treated with high doses of ICS (exceeding 800 mcg daily recalculated into budesonide), combined with long-acting beta2-agonists (LABA) and exacerbations requiring the use of systemic corticosteroids [9]. The study consisted of a 3-month observation period, and study procedures were performed during three visits, in 4–6 week intervals.
Advanced Microengineered Lung Models for Translational Drug Discovery
2018, SLAS DiscoverySevere asthma: looking beyond the amount of medication
2017, The Lancet Respiratory MedicineAssessment of corticosteroid response in pediatric patients with severe asthma by using a multidomain approach
2016, Journal of Allergy and Clinical Immunology