0000000000284307
AUTHOR
Alessio Piraino
Why small particle fixed dose triple therapy? An excursus from COPD pathology to pharmacological treatment evolution
Although bronchodilators are the cornerstone in chronic obstructive pulmonary disease (COPD) therapy, the treatment with a single-agent bronchodilator may not provide adequate symptoms control in COPD. The combination of drugs with different mechanisms of action may be more effective in inducing bronchodilation and preventing exacerbations, with a lower risk of side-effects in comparison with the increase of the dose of a single molecule. Several studies comparing the triple therapy with the association of long-acting ß2 agonist (LABA)/inhaled corticosteroid (ICS) or long-acting muscarinic antagonist (LAMA)/LABA reported improvement of lung function and quality of life. A significant reduc…
Day and Night Control of COPD and Role of Pharmacotherapy: A Review
Abstract The topic of 24-hour management of COPD is related to day-to-night symptoms management, specific follow-up and patients’ adherence to therapy. COPD symptoms strongly vary during day and night, being worse in the night and early morning. This variability is not always adequately considered in the trials. Night-time symptoms are predictive of higher mortality and more frequent exacerbations; therefore, they should be a target of therapy. During night-time, in COPD patients the supine position is responsible for a different thoracic physiology; moreover, during some sleep phases the vagal stimulation determines increased bronchial secretions, increased blood flow in the bronchial circ…
Extracorporeal shock waves increase markers of cellular proliferation in primary bronchial fibroblasts of COPD patients
COPD is due to a remodeling of small airways and destruction of the lung parenchyma with loss of the alveolar attachment as a result of pulmonary emphysema. Treatment of connective tissue fibroblasts with extracorporeal shock waves (ESW) increases their cellular proliferation and differentiation. To date no studies are available on ESW treatment of human primary bronchial fibroblasts from COPD and control subjects. Primary bronchial fibroblasts were obtained from bronchial biopsies from three patients with mild/moderate COPD and 3 control smokers with normal lung function. After stabilization for 24h, 1 ml of cell suspension (106 cells) from COPD and controls was treated in 2 ml tubes with …
Extracorporeal Shock Waves Increase Markers of Cellular Proliferation in Bronchial Epithelium and in Primary Bronchial Fibroblasts of COPD Patients
Chronic obstructive pulmonary disease (COPD) is due to structural changes and narrowing of small airways and parenchymal destruction (loss of the alveolar attachment as a result of pulmonary emphysema), which all lead to airflow limitation. Extracorporeal shock waves (ESW) increase cell proliferation and differentiation of connective tissue fibroblasts. To date no studies are available on ESW treatment of human bronchial fibroblasts and epithelial cells from COPD and control subjects. We obtained primary bronchial fibroblasts from bronchial biopsies of 3 patients with mild/moderate COPD and 3 control smokers with normal lung function. 16HBE cells were also studied. Cells were treated with a…
<p>Day and Night Control of COPD and Role of Pharmacotherapy: A Review</p>
The topic of 24-hour management of COPD is related to day-to-night symptoms management, specific follow-up and patients' adherence to therapy. COPD symptoms strongly vary during day and night, being worse in the night and early morning. This variability is not always adequately considered in the trials. Night-time symptoms are predictive of higher mortality and more frequent exacerbations; therefore, they should be a target of therapy. During night-time, in COPD patients the supine position is responsible for a different thoracic physiology; moreover, during some sleep phases the vagal stimulation determines increased bronchial secretions, increased blood flow in the bronchial circulation (…