Weight loss interventions in asthma: EAACI evidence-based clinical practice guideline (part I).

Background: Asthma and obesity are chronic multifactorial conditions that are associated with gene-environment interaction and immune function. Although the data are not fully consistent, it seems that obesity increases the risk of asthma and compromises asthma control.

Objective: To investigate the impact that weight changes have on asthma.

Management of hypersensivity pneumonitis.

Hypersensitivity pneumonitis (HP) is an interstitial lung disease due to a combined type III and IV reaction with a granulomatous inflammation, caused by cytotoxic delayed hypersensitivity lymphocytes, in a Th1/Th17 milieu, chaperoned by a deficient suppressor function of T regulatory cells. Skewing toward a Th2 phenotype is reported for chronic HP. Phenotypic expression and severity depends on environmental and/or host genetic and immune co-factors.

Research needs in allergy: an EAACI position paper, in collaboration with EFA.

In less than half a century, allergy, originally perceived as a rare disease, has become a major public health threat, today affecting the lives of more than 60 million people in Europe, and probably close to one billion worldwide, thereby heavily impacting the budgets of public health systems. More disturbingly, its prevalence and impact are on the rise, a development that has been associated with environmental and lifestyle changes accompanying the continuous process of urbanization and globalization. Therefore, there is an urgent need to prioritize and concert research efforts in the field of allergy, in order to achieve sustainable results on prevention, diagnosis and treatment of this most prevalent chronic disease of the 21st century.

Predictive value of lung function trend and FeNO for difficult asthma in children.

Objective: The aim of this study was to evaluate the predictive value of lung function and fraction of exhaled nitric oxide (FeNO) for difficult asthma in children.

Patients And Methods: Children with asthma referred to an asthma clinic for uncontrolled persistent asthma on inhaled corticosteroids (ICSs) alone or in combination with a long-acting beta2-agonist and/or a leukotriene receptor antagonist were followed in a prospective 1-year study to identify difficult asthma. At the end of the study period, difficult asthma was considered for children with persistent asthma symptoms and/or frequent moderate/severe asthma exacerbations despite regular intake of ICSs (beclomethasone or equivalent) > 800 microg/d for at least 3 months, after correcting for adherence to treatment, inhalation technique, and comorbidities and after implementing an individualized treatment plan.

Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs.

Allergic rhinitis (AR) and asthma represent global health problems for all age groups. Asthma and rhinitis frequently coexist in the same subjects. Allergic Rhinitis and its Impact on Asthma (ARIA) was initiated during a World Health Organization workshop in 1999 (published in 2001).

Dysfunctional breathing phenotype in adults with asthma - incidence and risk factors.

Background: Abnormal breathing patterns may cause characteristic symptoms and impair quality of life. In a cross-sectional survey 29% of adults treated for asthma in primary care had symptoms suggestive of dysfunctional breathing (DB), more likely to be female and younger, with no differences for severity of asthma. No clear risk factors were demonstrated for DB in asthma, nor the impact of asthma medication was evaluated.

Untangling asthma phenotypes and endotypes.

Asthma phenotypes have been developed to address the complexities of the disease. However, owing to a lack of longitudinal studies, little is known about the onset as well as the stability of phenotypes. Distinguishing phenotypes with regard to the severity or duration of the disease is essential.

Severe chronic allergic (and related) diseases: a uniform approach--a MeDALL--GA2LEN--ARIA position paper.

Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up.

Risk factors and asthma phenotypes in children and adults with seasonal allergic rhinitis.

Background: There are few data on asthma risk factors and phenotypes in patients with seasonal allergic rhinitis (SAR).

Methods: Thirty-three children (mean age, 8.27 ± 1.

Viruses and bacteria in acute asthma exacerbations--a GA² LEN-DARE systematic review.

A major part of the burden of asthma is caused by acute exacerbations. Exacerbations have been strongly and consistently associated with respiratory infections. Respiratory viruses and bacteria are therefore possible treatment targets.

Development and implementation of guidelines in allergic rhinitis – an ARIA-GA2LEN paper.

The links between asthma and rhinitis are well characterized. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines stress the importance of these links and provide guidance for their prevention and treatment. Despite effective treatments being available, too few patients receive appropriate medical care for both diseases.

Increased serum IL-17 is an independent risk factor for severe asthma.

Background: IL-17 expression was found to be associated with many inflammatory diseases in humans, such as rheumatoid arthritis, asthma, systemic lupus erythematosus and allograft rejection and many in vitro studies have indicated a proinflammatory function for IL-17.

Objective: Prognostic value of increased serum IL-17 in asthma patients.

Methods: Serum IL-17 (ELISA) was measured in 85 asthma patients (pts), mean age 46.

Efficacy and safety of bilastine 20 mg compared with cetirizine 10 mg and placebo for the symptomatic treatment of seasonal allergic rhinitis: a randomized, double-blind, parallel-group study.

Background: Bilastine is a new non-sedative H(1) receptor antagonist, indicated for the treatment of allergic rhinitis (AR) (seasonal and perennial).

Objective: To assess and compare the efficacy and safety of bilastine 20 mg vs. cetirizine 10 mg and placebo in relieving the symptoms of seasonal allergic rhinitis (SAR).

Antinuclear antibodies in asthma patients- a special asthma phenotype?

Several studies reported the appearance of asthma and autoimmune conditions in the same patient, but the clinical significance of this association was not yet assessed. One hundred asthmatic patients were observed for one year evolution with death, severe exacerbations, intake of > 1000 micrograms of beclometasone or equivalent (high ICS) and FEV1 decline >100 ml, in relation with ANA (ELISA), sputum and blood eosinophilia (EO), NSAID intolerance, BMI >25, chronic rhinosinusitis, smoking status and FEV1 <30% predicted (low FEV1). After 1 year of observation, there were 5 deaths, 28 severe asthma exacerbations requiring hospitalisations, 24 cases requiring high inhaled corticosteroid intake, and 19 patients with fast FEV1 decline (>100 ml/year).

A 12-week placebo-controlled study of rupatadine 10 mg once daily compared with cetirizine 10 mg once daily, in the treatment of persistent allergic rhinitis.

Background: With the current increasing incidence of allergies worldwide, new treatments showing efficacy and long term safety are needed for chronic conditions such as persistent allergic rhinitis (PER). New generation H1-antihistamines have demonstrated anti-allergic properties, which could possibly enhance their effectiveness in long-term periods of treatment.

Objective: To investigate the efficacy of rupatadine, in controlling symptoms of PER over a 12-week period.

Platelet activation in patients with systemic scleroderma--pattern and significance.

Unlabelled: The vasooclusive features of scleroderma are attributed to the vessel wall anomalies, while platelet's intervention is less studied.

Aim: platelet activation markers (PAM) pattern and significance in systemic sclerosis.

Design: 20 scleroderma patients with severe Raynaud phenomenon, under aspirin treatment, were evaluated by quantitative flow-cytometry for PAM (P-selectin, GPIIbIIIa, CD40L) in correlation with scleroderma activity and severity, systemic endothelial dysfunction (flow-mediated vasodilatation), systemic inflammation (serum CRP and IL-6) and cold-provocation test.

Rovamycine as add-on treatment in unstable angina and 4 year evolution with major cardiovascular events.

Background: Major antibiotic trials targeting Chlamydia Pneumoniae or the pathogen burden in acute coronary syndromes reported conflicting data. Only a minor impact of antibiotic treatment on major cardiovascular events (MACE) incidence was demonstrated in some studies.

Methods And Results: 109 unstable angina patients were randomised in: group C receiving conventional treatment, group R treated with Rovamycine 12 days 4.