Toll-like receptors (TLRs) act as receptors for numerous stimuli of immune cells, including bacterial cell wall constituents (lipopolysaccharide [LPS] from Gram-negative bacteria and lipopeptides from Gram-positive species), plasma proteins and extracellular matrix breakdown products. TLR2 and TLR4 bind lipopeptide and LPS respectively, mediating responses of alveolar macrophages and other immune cells to bacterial infection in the lungs. Exposure of lungs to LPS leads to pro-inflammatory responses of a number of cell types, including airway smooth muscle, which secretes a number of cytokines involved in leucocyte recruitment and the Th2 polarization of immune responses. Human airway smooth muscle cells were cultured with LPS in the absence and presence of peripheral blood mononuclear cells to determine direct and leucocyte-dependent TLR-mediated responses. (more…)
One especially favored target for immune recognition is bacterial lipopolysaccharide (LPS). This macromolecule is found only in ...
Airway hyper-responsiveness in asthma may involve smooth muscle growth, a manifestation of airway remodelling. The involvement ...
Innate immunity depends on both resident and recruited leukocytes. The macrophage without doubt plays an import- ant role in the de ...
Acetylcholine is a neurotransmitter of the nerve vagus, the functional effects mediated by binding to muscarinic receptors. Results ...
Eosinophil infiltration of the mucosa is a feature of asthmatic airways. Their adhesion to bronchial epithelial cells has been ...
A role for Leukotriene B4 in the induction of airway hyper-responsiveness was explored through the use of transgenic mice deficient in the BLT1 receptor for LTB4 . Ovalbumin challenge of sensitized wild-type mice resulted in the usual features of experimental asthma, including goblet cell hyperplasia, hyper-responsiveness to inhaled methacholine and elevated BAL fluid concentrations of the Th2 cytokine IL-13. In contrast, BLT1 –/– mice (i.e. genetically modified mice lacking the gene coding for the BLT1 receptor) exhibited significantly lower responses. BLT1 –/– mice also exhibited lower numbers of IL-13-positive T lymphocytes of both the helper (CD4 T Cells) and cytotoxic/suppressor (CD8 + ) types. (more…)
Vascular Endothelial Growth Factor (VEGF), originally described as a vascular permeability factor generating tissue oedema, has be ...
Airway hyper-responsiveness in asthma may involve smooth muscle growth, a manifestation of airway remodelling. The involvement ...
IgE plays an important role in allergic asthma. Reducing IgE in the airway mucosa should reduce airway inflammation. Omalizumab has ...
Some features seem to be common to severe asthma and Chronic Obstructive Pulmonary Disease with reversibility of airflow limita ...
Antihistamines have been shown to be effective in seasonal allergic rhinitis and chronic idiopathic urticaria. They improve qua ...
Despite optimum drug delivery and good compliance with inhaled corticosteroids, many patients experience symptoms and exacerbations. Dose–response studies using inhaled corticosteroids have generally been unable to demonstrate any significant difference between individual doses of inhaled corticosteroids. For example, a metaanalysis evaluated eight studies (2324 asthmatics) where the effects of at least two doses of inhaled fluticasone were measured. (more…)
Current internationally recognized guidelines indicate that symptomatic asthmatics using a low to medium inhaled corticosteroid ...
Leukotrienes can be found in the airway and urine following both spontaneous exacerbations of asthma and acute exposure to bron ...
Treating allergic rhinitis may have a downstream effect on concomitant asthma and this may be due to attenuation of the underlying ...
The guidelines for asthma management recommend the use of regular inhaled corticosteroid in patients with mild persistent asthma, b ...
This study was similar to the study of Harrison and colleagues, which looked at doubling the dose of inhaled corticosteroid dur ...
Allergen-specific immunotherapy is highly effective in the treatment of IgE-mediated allergy diseases such as rhinitis, conjunctivitis, asthma, and venom allergy hypersensitivity. It is the only treatment that leads to lifelong tolerance against previously disease-causing allergens due to restoration of the normal immunity. (more…)
Allergen-specific immunotherapy aims to correct the underlying immune imbalance associated with specific immunotherapy allergic rhi ...
Histamine is a low-molecular-weight monoamine that binds to four different G-protein-coupled receptors, and has recently been d ...
The precise mechanisms underlying the effects of Specific Immunotherapy are not well understood but several studies have shown ...
Treg cells or regulatory T cells constitute a large population of cellular infiltrate in atopic/allergic inflammation and a dys ...
The immunologic mechanisms of sublingual immunotherapy are less established. In Cochrane analysis, the authors concluded that t ...
A variety of proinflammatory cells, mediators, and cytokines orchestrate the development of airway hyperresponsiveness, which results in the episodic airflow obstruction characteristic of asthma. As a consequence, modulation of the underlying disease process with antii-nflammatory agents is firmly established as being the cornerstone of successful management. Inhaled corticosteroids are the most potent antiinflammatory agents available and satisfactorily suppress underlying airway inflammation in most individuals. (more…)
The cysteinyl leukotrienes (LTC 4 , LTD 4 and LTE 4 ) are lipid mediators produced from an arachidonic acid precursor following ...
Antihistamines have been shown to be effective in seasonal allergic rhinitis and chronic idiopathic urticaria. They improve qua ...
In the UK, Europe and the USA, montelukast is licensed for once-daily oral administration in adults and is also available as a ...
Leukotrienes can be found in the airway and urine following both spontaneous exacerbations of asthma and acute exposure to bron ...
Despite optimum drug delivery and good compliance with inhaled corticosteroids, many patients experience symptoms and exacerbat ...
Normally present at very low levels in plasma, antibodies of the immunoglobulin E (IgE) isotype were first discovered in 1967, decades after the description of IgA, IgG, and IM. IgE antibodies are produced primarily by plasma cells in mucosal-associated lymphoid tissue and their levels are uniformly elevated in patients suffering from atopic conditions like allergic rhinitis, asthma and atopic dermatitis. Production of allergen-specific IgE in atopic individuals is driven both by a genetic predisposition to the synthesis of this isotype as well as by environmental factors, including chronic allergen exposure. (more…)
The precise mechanisms underlying the effects of Specific Immunotherapy are not well understood but several studies have shown ...
Our current knowledge for trigger factor and food allergy intolerance is still in it infancy level. We already known that the aller ...
Treatment with omalizumab has been shown to reduce serum free IgE concentrations and to have beneficial effects on allergic airway ...
A paradigm of immune development underlies allergy development and progression in early childhood. Briefly, the immune system o ...
IgE plays an important role in allergic asthma. Reducing IgE in the airway mucosa should reduce airway inflammation. Omalizumab has ...
This study was similar to the study of Harrison and colleagues, which looked at doubling the dose of inhaled corticosteroid during an asthma exacerbation. This study investigated whether doubling the dose of budesonide inhalation in patients on regular inhaled budesonide would be beneficial during an asthma exacerbation. (more…)
The management of asthma in the community involves patient education to avoid the triggers, doubling the dose of inhaled steroi ...
The guidelines for asthma management recommend the use of regular inhaled corticosteroid in patients with mild persistent asthma, b ...
Asthma control is improved by combining inhaled corticosteroids with long acting beta-agonists but patients still require relie ...
This study evaluated budesonide formoterol efficacy and safety of a novel asthma management strategy for both maintenance and s ...
The role of oral and inhaled corticosteroids in the management of acute asthma is well known. This study compared the effects of in ...
Maintenance of asthma control by once-daily inhaled ciclesonide nasal spray in adults with persistent asthma. Ciclesonide is an inhaled corticosteroid that is converted to an active metabolite, desisobutyryl ciclesonide, in the lungs, thereby minimizing effects on endogenous cortisol inflammation. The goal of finding newer, safer corticosteroids for the management of asthma has led to the development of this inhaled corticosteroid.
This 12-week, double-blind, randomized, parallel-group, placebo-controlled study evaluated the efficacy and safety of ciclesonide in adults with persistent asthma. Efficacy was monitored with asthma symptom scores, rescue medication use, morning and evening peak expiratory flow rate (PEF) measurements, spirometry, and the probability of study completion without experiencing lack of efficacy. It was concluded that ciclesonide (160 or 640 µg) once daily in the morning maintains asthma control effectively, does not affect cortisol levels, and has an adverse event profile comparable with that of placebo in adults with primarily mild to moderate asthma.
It has been reported previously that, compared with fluticasone, ciclesonide possesses equivalent anti-inflammatory efficacy, through pulmonary activation, with a significantly improved safety profile. Since it has low bioavailability because it is metabolized by the lung, it is believed to cause minimal systemic adverse effects. It was found that the morning peak expiratory flow rate (PEF) and FEV 1 values from patient diaries decreased significantly in patients switched from their usual inhaled corticosteroids therapy to placebo but remained stable in patients switched to either dose of ciclesonide (160 or 640 µg). Furthermore, in patients switched to placebo there were significant increases in daily asthma symptoms and the use of rescue medication, with no significant changes from baseline in patients switched to either dose of ciclesonide. Mean changes from baseline in serum and urinary cortisol levels were not statistically significant in any of the treatment groups. Adverse effects were mild, with no reported cases of oral candidiasis.
In conclusion, once-daily inhaled ciclesonide nasal spray (160 or 640 µg) was superior to placebo in the maintenance of asthma control in adult patients previously treated with moderate doses of inhaled corticosteroids, without any significant adverse effects.
The new corticosteroid ciclesonide has been evaluated in various studies to assess its efficacy and adverse effect profile in a ...
This study was similar to the study of Harrison and colleagues, which looked at doubling the dose of inhaled corticosteroid dur ...
The guidelines for asthma management recommend the use of regular inhaled corticosteroid in patients with mild persistent asthma, b ...
Roflumilast is an oral, once-daily PDE4 inhibitor with antiinflammatory activity in development for the treatment of asthma. Ro ...
Patients with severe persistent asthma who are inadequately controlled despite Global Initiative for Asthma (GINA) 2002 step 4 ther ...
Roflumilast is an oral, once-daily inhibitor of phosphodiesterase type 4 (PDE4) that prevents the breakdown of cyclic adenosine monophosphate (cAMP) levels, leading to inhibition of pro-inflammatory signalling. This study investigated the effects of repeated doses of 250 or 500 µg of roflumilast on airway asthma responses to allergen. (more…)
Roflumilast is an oral, once-daily PDE4 inhibitor with antiinflammatory activity in development for the treatment of asthma. Ro ...
Marimastat is a synthetic broad-spectrum matrix metalloproteinase (MMP) inhibitor. This study assessed the anti-inflammatory effect ...
Treating allergic rhinitis may have a downstream effect on concomitant asthma and this may be due to attenuation of the underlying ...
Tumour Necrosis Factor is a pro-inflammatory cytokine implicated in the pathogenesis of asthmatic airway inflammation, hyper-react ...
Despite optimum drug delivery and good compliance with inhaled corticosteroids, many patients experience symptoms and exacerbat ...
Tumour Necrosis Factor is a pro-inflammatory cytokine implicated in the pathogenesis of asthmatic airway inflammation, hyper-reactivity and remodelling. The primary aim of the trial was to assess whether TNF antagonism, using a soluble Tumour Necrosis Factor receptor (TNFR:Fc etanercept, Enbrel ® ), can attenuate eosinophilic airway inflammation in patients with mild to moderate allergic asthma. (more…)
Tumour necrosis factor alpha (TNF-a) is a major therapeutic target in a range of chronic inflammatory disorders involving neutr ...
Marimastat is a synthetic broad-spectrum matrix metalloproteinase (MMP) inhibitor. This study assessed the anti-inflammatory effect ...
Roflumilast is an oral, once-daily inhibitor of phosphodiesterase type 4 (PDE4) that prevents the breakdown of cyclic adenosine ...
IgE plays an important role in allergic asthma. Reducing IgE in the airway mucosa should reduce airway inflammation. Omalizumab has ...
Vascular Endothelial Growth Factor (VEGF), originally described as a vascular permeability factor generating tissue oedema, has be ...