“As-needed” inhaled corticosteroid therapy for mild asthma – what is the evidence?

Expert Name
Prof. Kaharu Sumino

Several recent studies assessed the benefit of as-needed inhaled corticosteroid (ICS) treatment for mild asthma. An advantage of this approach is the ICS sparing effect, which was evident both in randomised clinical trials and practice studies. The traditional management of persistent asthma consists of a controller medication daily and reliever medication as needed. “This procedure was the guideline´s first choice…

Vaping identified as risk factor for asthma

Expert Name
Prof. Theresa To

An analysis of Canadian survey data found an association between e-cigarette smoking and asthma. Not only did vaping increase the odds for asthma by 19%; those who had asthma were also more prone to exacerbation. Every 2 years, the Canadian Community Health Survey gathers health-related data of Canadian inhabitants at the regional level. The 2019 survey in Ontario reported 23%…

Obesity: A risk factor for new-onset asthma and worse asthma control

Expert Name
Prof. Fernando Holguin

For at least 2 decades, it has been widely recognised that obesity increases asthma incidence, impairs asthma control, diminishes response to therapy with inhaled corticosteroids (ICS), and increases the chances of an asthma exacerbation. Abdominal obesity appears the most important risk factor. Obesity stimulates bronchial hyperresponsiveness and leads to a steeper loss of lung function. “While there are varying degrees…

Tezepelumab – good success rates in various types of severe asthma

Expert Name
Prof. Michael E. Wechsler

Tezepelumab showed convincing results for the treatment of severe asthma. Besides significantly reducing exacerbation rates in many different inflammatory profiles, the first-in-class TSLP blocker also improved asthma control and quality of life. Tezepelumab is a monoclonal antibody with specific inhibition of thymic stromal lymphopoietin (TSLP) resulting in hindering TSLP to cooperate with its receptor thus acting upstream of various cytokines…

Benralizumab lives up to its phase 3 results in real-world findings

Expert Name
Dr Donna Carstens

The efficacy of benralizumab for severe eosinophilic asthma was confirmed in a retrospective cohort trial utilising US claims data. Exacerbation rates and the use of controller medication were significantly diminished with benralizumab treatment. After demonstrating significant results in phase 3 trials, the anti-IL-5 antibody benralizumab has been approved by the EMA as add-on maintenance medication in adult patients with severe…

IL-4/13 blocker successful in treatment of paediatric moderate-to-severe asthma

Expert Name
Prof. Leonhard B. Bacharier

Dupilumab reduced annualised exacerbations in schoolchildren with uncontrolled moderate-to-severe asthma by >50% compared with placebo. The safety profile was similar to that seen in adolescents and adults. These were the results of the VOYAGE trial. Despite optimised standard-of-care therapy, children with moderate-to-severe asthma may continue to have uncontrolled disease. The IL-4/13 blocker dupilumab has previously been shown to be effective…

1-Minute Summary: Eosinophil accumulation in allergic asthma is regulated by the uridine diphosphate–glucose/P2Y14R axis.

Airway hyperresponsiveness (AHR) to allergen exposure induces the production of type 2 cytokines interleukin 5 (IL-5) and IL-3, and the chemokines CCL11/CCL24/CCL26, forming a cytokine/chemokine axis that regulates airway eosinophil accumulation [1]. A recent article demonstrated that this is mediated by the nucleotide sugar UDP-glucose (UDP-G) and the purinergic receptor P2Y14R. Dr. Tadeucz Karcz et al. (National Institute of Environmental…

1-Minute SUMMARY: Biomarkers for Severe Asthma: Lessons From Longitudinal Cohort Studies

Expert Name
Dr Youngsoo Lee, Dr Quang Luu Quoc, Dr Hae-Sim Park

Severe asthma (SA) is a heterogenous disease and the prevalence has increased recently [2]. SA is characterised by uncontrolled symptoms, frequent exacerbations and decline of lung functioning. The disease’s heterogeneity is not only related to airway inflammation and responsiveness to treatment, but also to distinct disease symptoms and comorbidities. Promising type 2 inflammatory biomarkers are immunoglobulin E (IgE), interleukins (IL)-4,…

COVID-19 inflammatory profiles: distinct role for GM-CSF

Expert Name
Prof. Peter Openshaw

Our study in brief: We performed a very large collaborative study within the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) in over 200 different hospitals in the UK. The aim was to identify inflammatory markers in blood which increased within the early stages of COVID-19 in those who went on to become critically ill. We just recently published…

1-Minute Summary: GM-CSF instigates a dendritic cell – T cell inflammatory circuit that drives chronic asthma development.

Expert Name
Dr S.P. Nobs, Dr L. Pohlmeier, Dr F. Li, et al.

Chronic asthma is characterised by the accumulation of neutrophils in the lungs, which are key drivers in chronic lung inflammation [1,2]. Moreover, neutrophil accumulation density correlates with disease severity [3]. The high levels of neutrophils are a result of granulocyte-macrophage colony-stimulating factor (GM-CSF)-signalling, which promotes the development of alveolar macrophages (AM) and lung dendritic cell (DC)-dependent induction of Th2/Th17 cell…