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Advances in Asthma
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Advances in Asthma

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 April 2023) | Viewed by 15788

Special Issue Editors

Dr. Gianenrico Senna

E-Mail Website
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
Dr. Hiroki Kabata

E-Mail Website
Guest Editor
Department of Internal Medicine (Pulmonary Medicine), Keio University School of Medicine, Tokyo 160-0016, Japan
Interests: asthma; IL-33; TSLP; ILC2 (group 2 innate lymphoid cells)
Dr. Marco Caminati

E-Mail Website
Guest Editor
Department of Medicine, University of Verona, Verona University Hospital, 37134 Verona, Italy
Interests: allergy and clinical immunology; bronchial asthma; severe asthma; immunodeficiencies; biologic drugs
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Bronchial asthma is currently a very 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 been a great step forward in the treatment of severe asthma, leading to a significant reduction of exacerbations and the use of oral steroids. However, from unsuccessful cases we are learning the need for more specific biomarkers and the careful clinical evaluation of each individual 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 schedules of treatment, would increase the low adherence to the treatment. In summary, the management of asthma is still a “work in progress” despite the significant progress that has been made in its pharmacological treatment.

Dr. Gianenrico Senna
Dr. Hiroki Kabata
Dr. Marco Caminati
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bronchial asthma
  • biologic inflammation
  • asthma
  • management

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Published Papers (5 papers)

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Editorial

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2 pages, 160 KiB  
Editorial
Severe Asthma in the Era of Biologics: Continuous Challenges
by Pinelopi Schoini, Petros Bakakos and Stelios Loukides
J. Clin. Med. 2023, 12(11), 3857; https://doi.org/10.3390/jcm12113857 - 5 Jun 2023
Viewed by 1079
Abstract
Asthma is a heterogenous disease characterized by different phenotypes and endotypes [...] Full article
(This article belongs to the Special Issue Advances in Asthma)

Research

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13 pages, 1000 KiB  
Article
Effect of Obesity on the Expression of Genes Associated with Severe Asthma—A Pilot Study
by Marina Bantulà, Ebymar Arismendi, Valeria Tubita, Jordi Roca-Ferrer, Joaquim Mullol, Ana de Hollanda, Joaquín Sastre, Antonio Valero, Selene Baos, Lucía Cremades-Jimeno, Blanca Cárdaba and César Picado
J. Clin. Med. 2023, 12(13), 4398; https://doi.org/10.3390/jcm12134398 - 29 Jun 2023
Cited by 2 | Viewed by 1459
Abstract
Asthma is a complex condition resulting from the interaction of genes and environment. Obesity is a risk factor to develop asthma and contributes to poor response to asthma therapy and severity. The aim of the study was to evaluate the effect of obesity [...] Read more.
Asthma is a complex condition resulting from the interaction of genes and environment. Obesity is a risk factor to develop asthma and contributes to poor response to asthma therapy and severity. The aim of the study was to evaluate the effect of obesity on the expression levels of genes previously associated with severe asthma. Three groups of subjects were studied: non-obese asthmatics (NOA), obese asthma patients (OA), and non-asthmatic obese subjects (O). Previously reported overexpressed (IL-10, MSR1, PHLDA1, SERPINB2, and CD86) and underexpressed genes (CHI3L1, CPA3, IL-8, and PI3) in severe asthma were analyzed by RT-qPCR in peripheral blood mononuclear cells (PBMCs). In the overexpressed genes, obesity significantly decreased the expression of MSR1 and PHLDA1 and had no effects on CD86, IL-10, and SERPINB2. In underexpressed genes, obesity did not affect PI3, CHI3L1, and IL-8 and significantly reduced CPA3 expression. The results of this study show that obesity should be included among the known factors that can contribute toward modifying the expression of genes associated with asthma and, in particular, severe asthma. Full article
(This article belongs to the Special Issue Advances in Asthma)
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7 pages, 520 KiB  
Communication
Benralizumab Efficacy in Late Non-Responders to Mepolizumab and Variables Associated with Occurrence of Switching: A Real-Word Perspective
by Marco Caminati, Alessandro Marcon, Gabriella Guarnieri, Jessica Miotti, Diego Bagnasco, Giovanna Elisiana Carpagnano, Girolamo Pelaia, Rachele Vaia, Matteo Maule, Andrea Vianello and Gianenrico Senna
J. Clin. Med. 2023, 12(5), 1836; https://doi.org/10.3390/jcm12051836 - 24 Feb 2023
Cited by 7 | Viewed by 2241
Abstract
Overlapping eligibility to different biologics for severe asthma is still challenging, especially when addressing the same target. We aimed to characterize severe eosinophilic asthma patients according to their maintained or reduced response to mepolizumab over time and to explore baseline variables significantly associated [...] Read more.
Overlapping eligibility to different biologics for severe asthma is still challenging, especially when addressing the same target. We aimed to characterize severe eosinophilic asthma patients according to their maintained or reduced response to mepolizumab over time and to explore baseline variables significantly associated with the occurrence of switching to benralizumab. We performed a multicentre retrospective observational study evaluating OCS reduction, exacerbation rate, lung function, exhaled nitric oxide levels (FeNO), Asthma control test (ACT), and blood eosinophil concentrations at baseline and before and after switching occurrence among 43 female and 25 male patients with severe asthma aged 23 to 84 years. Younger age, higher OCS daily dose and lower blood eosinophils at baseline were associated with a significantly higher risk (odds) for switching occurrence. All the patients showed an optimal response to mepolizumab, up to six months. The need for switching, according to the above-mentioned criterion, occurred for 30 out of 68 patients after a median time of 21 months (Q1–Q3: 12–24) from mepolizumab initiation. At the follow-up time-point after the switch (median time: 31 months, Q–Q3: 22–35), all the outcomes substantially improved and no cases of poor clinical response to benralizumab were detected. Although the small sample size and the retrospective design represent major limitations, to our knowledge, our study provides the first real-word focus on clinical variables potentially predicting a better response to anti IL-5r in patients fully eligible for both mepolizumab and benralizumab and suggests that in late non responder patients to mepolizumab, more robustly targeting the IL-5 axis may be effective. Full article
(This article belongs to the Special Issue Advances in Asthma)
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Review

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16 pages, 1149 KiB  
Review
Pathobiology of Type 2 Inflammation in Asthma and Nasal Polyposis
by Corrado Pelaia, Giulia Pelaia, Angelantonio Maglio, Caterina Tinello, Luca Gallelli, Nicola Lombardo, Rosa Terracciano and Alessandro Vatrella
J. Clin. Med. 2023, 12(10), 3371; https://doi.org/10.3390/jcm12103371 - 9 May 2023
Cited by 12 | Viewed by 6405
Abstract
Asthma and nasal polyposis often coexist and are frequently intertwined by tight pathogenic links, mainly consisting of the cellular and molecular pathways underpinning type 2 airway inflammation. The latter is characterized by a structural and functional impairment of the epithelial barrier, associated with [...] Read more.
Asthma and nasal polyposis often coexist and are frequently intertwined by tight pathogenic links, mainly consisting of the cellular and molecular pathways underpinning type 2 airway inflammation. The latter is characterized by a structural and functional impairment of the epithelial barrier, associated with the eosinophilic infiltration of both the lower and upper airways, which can be driven by either allergic or non-allergic mechanisms. Type 2 inflammatory changes are predominantly due to the biological actions exerted by interleukins 4 (IL-4), 13 (IL-13), and 5 (IL-5), produced by T helper 2 (Th2) lymphocytes and group 2 innate lymphoid cells (ILC2). In addition to the above cytokines, other proinflammatory mediators involved in the pathobiology of asthma and nasal polyposis include prostaglandin D2 and cysteinyl leukotrienes. Within this context of ‘united airway diseases’, nasal polyposis encompasses several nosological entities such as chronic rhinosinusitis with nasal polyps (CRSwNP) and aspirin-exacerbated respiratory disease (AERD). Because of the common pathogenic origins of asthma and nasal polyposis, it is not surprising that the more severe forms of both these disorders can be successfully treated by the same biologic drugs, targeting many molecular components (IgE, IL-5 and its receptor, IL-4/IL-13 receptors) of the type 2 inflammatory trait. Full article
(This article belongs to the Special Issue Advances in Asthma)
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20 pages, 1065 KiB  
Review
Baseline Characteristics of Patients Enrolled in Clinical Trials of Biologics for Severe Asthma as Potential Predictors of Outcomes
by Francesco Menzella
J. Clin. Med. 2023, 12(4), 1546; https://doi.org/10.3390/jcm12041546 - 15 Feb 2023
Cited by 5 | Viewed by 3467
Abstract
(1) Background: Over the past 20 years, monoclonal antibodies have been developed for the treatment of severe asthma, with numerous randomised controlled trials (RCTs) conducted to define their safety and efficacy. The growing availability of biologics, which until now have only been available [...] Read more.
(1) Background: Over the past 20 years, monoclonal antibodies have been developed for the treatment of severe asthma, with numerous randomised controlled trials (RCTs) conducted to define their safety and efficacy. The growing availability of biologics, which until now have only been available for T2-high asthma, has been further enriched by the arrival of tezepelumab. (2) Methods: This review aims to evaluate the baseline characteristics of patients enrolled in RCTs of biologics for severe asthma to understand how they could potentially predict outcomes and how they can help differentiate between available options. (3) Results: The studies reviewed demonstrated that all biologic agents are effective in improving asthma control, especially with regard to reducing exacerbation rates and OCS use. As we have seen, in this regard, there are few data on omalizumab and none yet on tezepelumab. In analysing exacerbations and average doses of OCSs, pivotal studies on benralizumab have enrolled more seriously ill patients. Secondary outcomes, such as improvement in lung function and quality of life, showed better results—especially for dupilumab and tezepelumab. (4) Conclusion: Biologics are all effective, albeit with important differences. What fundamentally guides the choice is the patient’s clinical history, the endotype represented by biomarkers (especially blood eosinophils), and comorbidities (especially nasal polyposis). Full article
(This article belongs to the Special Issue Advances in Asthma)
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