Lung penetration and patient adherence considerations in the management of asthma: role of extra fine formulations

2013

The mainstay of management in asthma is inhalation therapy at the target site, with direct delivery of the aerosolized drug into the airways to treat inflammation and relieve obstruction. Abundant evidence is available to support the concept that inflammatory and functional changes at the level of the most peripheral airways strongly contribute to the complexity and heterogeneous manifestations of asthma. It is now largely accepted that there is a wide range of clinical phenotypes of the disease, characterized primarily by small airways involvement. Thus, an appropriate diagnostic algorithm cannot exclude biological and functional assessment of the peripheral airways. Similarly, achievement…

Effects of exercise training on airway closure in asthmatics

2012

We previously reported that responsiveness to methacholine (Mch) in the absence of deep inspiration (DI) decreased in healthy subjects after a short course of exercise training. We assessed whether a similar beneficial effect of exercise on airway responsiveness could occur in asthmatics. Nine patients (male/female: 3/6; mean age ± SD: 24 ± 2 yr) with mild untreated asthma [forced expiratory volume in 1 s (FEV1): 100 ± 7.4% pred; FEV1/vital capacity (VC): 90 ± 6.5%] underwent a series of single-dose Mch bronchoprovocations in the absence of DI in the course of a 10-wk training rowing program (6 h/wk of submaximal and maximal exercise), at baseline ( week 0), and at week 5 and 10. The singl…

The Effect of Intranasal Corticosteroids on Asthma Control and Quality of Life in Allergic Rhinitis with Mild Asthma

2011

BACKGROUND: The mechanisms through which rhinitis affects asthma have not been completely elucidated. We explored whether the effect of nasal treatment on asthma control and respiratory-related quality of life (HRQoL) is mediated by inflammatory changes of the upper and lower airways. METHODS: Allergic rhinitics with mild asthma were randomized to a 14-day treatment period with either nasal budesonide 100 mug, 1 puff per nostril twice a day, or placebo. Clinical, functional, and biological evaluations were performed before and after treatment. RESULTS: Twenty subjects (M/F: 10/10; age: 31 +/- 15 years; mean +/- SD) were enrolled, and a total of 17 individuals completely participated in the …

How Effective and Safe Is Bronchial Thermoplasty in “Real Life” Asthmatics Compared to Those Enrolled in Randomized Clinical Trials?

2016

There is limited information on the efficacy and safety of bronchial thermoplasty (BT) inreal life. We evaluated the outcomes of the randomized clinical trials for BT in severe asthmatics, in whom the exclusion criteria were not strictly controlled. A case series of seven asthmatics (M/F: 4/3; age:54.6±2.9years) is reported. Subjects had a statistically significant improvement in AQLQ (from a mean of3.96±1.1to4.5±1.2and5.5±0.6after 6 and 12 months of treatment;p=0.0007) and in the ACQ score (from2.77±0.8to1.83±1.2and1.5±0.8after 6 and 12 months;p<0.001). In the year after BT, severe exacerbations, salbutamol use, and OCS use were significantly lower compared with the 1-yr pretreatment pe…

Clinical and anti-inflammatory effects of ultra-short preseasonal vaccine to Parietaria in asthma

2013

Objective: The ultra-short course preseasonal allergy vaccine, containing the adjuvant monophosphoryl lipid A (MPL), is effective in treating allergic symptoms; however, the efficacy in controlling asthmatics symptoms has not been fully demonstrated. We aimed at evaluating whether the ultra-short preseasonal course of immunotherapy contributes to asthma control. Methods: Four subcutaneous injections of the active product (Pollinex Quattro) were administered, before the pollen season, to 20 Parietaria-sensitive mild, untreated asthmatics (M/F: 12/8; age: 38 ± 14 years). After the screening visit (visit 1), asthma control was assessed by the Asthma Control Test (ACT) immediately before the fi…

Exhaled nitric oxide is associated with cyclic changes in sexual hormones

2013

Abstract Background We hypothesized that changes in the levels of sexual hormones during the menstrual cycle influence the concentration of nitric oxide in the exhaled air (FeNO) and alveolar exhaled nitric oxide (CANO). Methods Twelve healthy, non allergic women in their reproductive age (age range 25–37 years) were recruited. Subjects were studied, on alternate days, over the course of their menstrual cycle. At each visit, measurements of FeNO and CANO were performed. Progesterone and 17-β-estradiol concentrations were measured in salivary samples. Results Eight subjects completed the study. The levels of FeNO and CANO were 13 ± 4.7 pbb and 3.5 ± 1.9 pbb, respectively (mean ± SD). The mea…

Effetti di un programma di esercizio fisico sul grado di reattività bronchiale negli asmatici

2012

EFFETTI DI UN PROGRAMMA DI ESERCIZIO FISICO SUL GRADO DI REATTIVITÀ BRONCHIALE NEGLI ASMATICI N. Scichilone 1, G. Morici 2, D. Zangla 3, R. Arrigo 1, I. Cardillo 1, V. Bellia 1, M.R. Bonsignore 1 1 DIBIMIS, Università degli Studi di Palermo, 2 BIONEC, Università degli Studi di Palermo, 3 DISMOT, Università degli Studi di Palermo SCOPO DEL LAVORO: Il nostro gruppo ha recentemente dimostrato che il grado di reattività bronchiale in assenza di respiri profondi si riduce negli individui sani in seguito ad un intenso programma di allenamento. Nello studio corrente, abbiamo valutato se un simile effetto benefico dell’esercizio fisico potesse realizzarsi negli asmatici. MATERIALI E METODI: Nove as…

Effects of rowing training on airway responsiveness in asthmatics

2012

We previously reported that after a short course of rowing training the responsiveness to methacholine (Mch) in the absence of deep inspiration (DI) decreased in healthy subjects. We assessed whether a similar beneficial effect of exercise on airway responsiveness could occur in asthmatics. Nine patients (M/F: 3/6; mean age±SD: 24±2 yrs) with mild untreated asthma (FEV(1): 100±7.4% pred, FEV(1)/VC 90±6.5%) underwent a series of single dose Mch bronchoprovocations in the absence of DI in the course of a indoor rowing training consisted of two to three sessions per week for 10 weeks (total 28 sessions). Each session included a warm-up period for 20 min (running and stretching), and a specific…

Corticosteroid-induced changes in nasal allergic inflammation are associated with better asthma control

2011