Patient perspectives in the management of asthma: improving patient outcomes through critical selection of treatment options

Asthma is a chronic inflammatory disorder of the airways that requires long-term treatment, the goal of which is to control clinical symptoms for extended periods with the least possible amount of drugs. International guidelines recommend the addition of an inhaled long-acting beta2-agonist (LABA) to a low- to medium-dose inhaled corticosteroid (ICS) when low doses of ICS fail to control asthma symptoms. The fixed combined administration of ICS/LABA improves patient compliance, reducing the risk of therapy discontinuation. The relative deposition pattern of the inhaled drug to the target site is the result of a complex interaction between the device used, the aerosol formulation and the pat…

The impact of age on allergen responsiveness in allergic rhinitics and asthmatics in the coastal area of southern Italy

Additional benefits of beclomethasone/formoterol extrafine combination treatment on small airways function in asthma

Effects on Small Airways of Two Different Combination Treatments for Asthma.

Chronic Renal Failure

Background To the best of our knowledge, the association between COPD and chronic renal failure (CRF) has never been assessed. Lean mass is frequently reduced in COPD, and the glomerular filtration rate (GFR) might be depressed in spite of normal serum creatinine (concealed CRF). We investigated the prevalence and correlates of both concealed and overt CRF in elderly patients with COPD. Methods We evaluated 356 consecutive elderly outpatients with COPD enrolled in the Extrapulmonary Consequences of COPD in the Elderly Study and 290 age-matched outpatients free from COPD. The GFR was estimated using the Modification of Diet in Renal Disease Study Group equation. Patients were categorized as …

Role of chronic exposure to cigarette smoke on endoglin/CD105 expression in airway epithelium

Dysregulation of airway epithelium function related to cigarette smoke exposure plays an important role in the pathophysiology of COPD and is associated to tissue damage and disease severity. CD105 is a component of the receptor complex of TGF-β, a pleiotropic cytokine involved in cellular proliferation, differentiation and migration. CD105 regulates the expression of different components of the extracellular matrix suggesting a role of CD105 in cellular transmigration and remodeling processes. The aim of the present study was to investigate the expression of endoglin/CD105 in airway epithelium of COPD patients and its involvement in tissue remodeling and COPD progression. We evaluated the …

The mini nutritional assessment is associated with the perception of dyspnoea in older subjects with advanced COPD

Role of chronic exposure to cigarette smoke on Oct-4/CD146 imbalance in human bronchial epithelial cells

Causes of Allergic Rhinitis and Asthma

Ageing and COPD affect different domains of nutritional status: the ECCE study

Chronic obstructive pulmonary disease (COPD) and ageing may contribute to malnutrition. We aimed to explore whether COPD and ageing determine malnutrition in different manners. 460 stable COPD outpatients (376 males and 84 females) from the Extrapulmonary Consequences of COPD in the Elderly (ECCE) study database were investigated (age 75.0±5.9 yrs; forced expiratory volume in 1 s 54.7±18.3% predicted). Nutritional status was evaluated using the Mini Nutritional Assessment® (MNA) questionnaire. From the MNA, three scores exploring the domains of the nutritional status were calculated: body composition, energy intake and body functionality scores. Global Initiative for Chronic Obstructive Lun…

The mini nutritional assessment (MNA) and the perception of dyspnea in elderly subjects with COPD. The MINUTRA project

The Risk of Malnutrition Correlates with Perception of Dyspnea in COPD

Il punteggio MNA come correlato indipendente della dispnea nell'anziano con BPCO

Cigarette smoke alters primary human bronchial epithelial cell (PBEC) differentiation atAir-Liquid Interface (ALI): role of Oct-4, CD146 and CD105

The airway epithelium is a dynamic tissue that undergoes slow but constant renewal. Dysregulation of airway epithelial cell function related to cigarette smoke (CS) exposure plays an important role in the pathophysiology of COPD. Oct-4 is the crucial POU domain transcription factor responsible for maintaining cellular self-renewal and regeneration, and CD146 and CD105 are adhesion molecule involved in cellular proliferation, differentiation, epithelial-mesenchymal transition and tissue remodelling. Bronchial biopsy specimens (BBs) were obtained from 9 healthy controls (C) and 9 COPD. ALI cultures of PBEC from C were exposed to CS extract (CSE) for 7, 14, 21 days. Oct-4, CD105 and CD146 expr…

Cigarette smoke alters primary human bronchial epithelial cell (PBEC) differentiation at air-liquid interface (ALI) and induces expression of CD105 and CD146

Dys-regulation of airway epithelial cell function related to cigarette smoke exposure plays an important role in the pathophysiology of COPD. CD105, a component of TGF-β complex, and CD146, an epithelial-mesenchymal transition inducer, are adhesion molecules involved in cellular proliferation, differentiation, transmigration and tissue remodelling. After validation of an ex vivo ALI culture of PBEC, we assessed the effect of long-term cigarette smoke extract (CSE) exposure on epithelium regeneration and differentiation. Endobronchial biopsy specimens (EBBs) were obtained from 8 controls (C) and 9 COPD. ALI cultures from EBBs of C were exposed to CSE for 7, 14, 21 days. Transepithelial Elect…

Il questionario nutrizionale MNA è un predittore migliore della performance fisica rispetto al BMI in soggetti anziani con BPCO - progetto MINUTRA

Concealed renal failure in COPD. The extrapulmonary consequences of COPD in the elderly (ECCE) study

Effects of extra-fine inhaled beclomethasone/formoterol on both large and small airways in asthma

Background: Airway inflammation in asthma involves both large and small airways, and the combination of inhaled corticosteroids (ICS) and long acting beta-2 agonists (LABA) is the mainstay of therapy. Available inhaled combinations differ in terms of drug delivery to the lung and the ability to reach small airways. Aim: To evaluate whether treatment with an extra-fine inhaled combination provides additional effects vs a nonextra-fine combination on airway function. Methods: After a 1- to 4-week run-in period, patients with asthma were randomized to a double blind, double dummy, 12-week treatment with either extra-fine beclomethasone/formoterol (BDP/F) 400/24 lg daily or fluticasone propiona…

Aging and COPD affect different domains of nutritional status – The ECCE study.

C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) as inflammation markers in elderly patients with stable chronic obstructive pulmonary disease (COPD)

Erythrocyte sedimentation rate (ESR) might represent a less expensive alternative to C-reactive protein (CRP) as a marker of systemic inflammation in stable chronic obstructive pulmonary disease (COPD). We tried to verify this hypothesis in 223 consecutive outpatients aged 65 years or more with stable COPD enrolled in a multicenter observational study. Patients were grouped according to normal/increased ESR/CRP values and groups were compared with regard to clinical and laboratory characteristics. Correlations between CRP, ESR and selected variables of interest were assessed by Spearman's ζ-test and multivariate linear regression analysis. CRP was weakly and inversely correlated with the fo…