Excessive Dynamic Airway Collapse: Large Airway Function During Exercise.

Large airway collapse on expiration is an increasingly recognized cause of airway centric symptoms. The 2 primary conditions are tracheobronchomalacia and excessive dynamic airway collapse, the latter a common comorbidity in those with underlying lung disease. The exertional dyspnea associated with these conditions is complex and exercise intolerance is a key clinical feature, despite the fact that the precise relationship is not fully understood.

The Supraglottic Index: An indicator of response to laryngopharyngeal reflux therapy in asthma.

Background: Laryngopharyngeal reflux (LPR) is associated with gastroesophageal reflux and is known to cause poor asthma control. Moreover, LPR and asthma frequently coexist in the same individual. Controlling LPR could be associated with improved asthma control.

Characteristics and outcomes of ambulatory patients with suspected COVID-19 at a respiratory referral center.

Rationale: SARS-CoV-2 continues to cause a global pandemic and management of COVID-19 in outpatient settings remains challenging.

Objective: We sought to describe characteristics of patients with chronic respiratory disease (CRD) experiencing symptoms consistent with COVID-19, who were seen in a novel Acute Respiratory Clinic, prior to widely available testing, emergence of variants, COVID-19 vaccination, and post-vaccination (breakthrough) SARS-CoV-2 infections.

Methods: Retrospective electronic medical record data were analyzed from 907 adults with presumed COVID-19 seen between March 16, 2020 and January 7, 2021.

Refractory neutrophilic asthma and ciliary genes.

Background: Refractory asthma (RA) remains poorly controlled, resulting in high health care utilization despite guideline-based therapies. Patients with RA manifest higher neutrophilia as a result of increased airway inflammation and subclinical infection, the underlying mechanisms of which remain unclear.

Objective: We sought to characterize and clinically correlate gene expression differences between refractory and nonrefractory (NR) asthma to uncover molecular mechanisms driving group distinctions.

Efficacy and safety of reslizumab in the treatment of eosinophilic granulomatosis with polyangiitis.

Background: Eosinophilic granulomatosis with polyangiitis (EGPA), a rare vasculitis with substantial morbidity, is characterized by asthma, eosinophilia, sinusitis, pulmonary infiltrates, neuropathy, positivity for antineutrophil cytoplasmic antibody, and multiorgan vasculitis. Although treatment options previously included corticosteroids and immunosuppressants, anti-interleukin 5 therapies have gained interest in EGPA treatment. Mepolizumab was approved for and recently benralizumab was found to have safety and efficacy in EGPA.

Benralizumab as a Steroid-Sparing Treatment Option in Eosinophilic Granulomatosis with Polyangiitis.

Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a vasculitis associated with significant morbidity and mortality that has historically been treated with systemic corticosteroids and immunosuppressants. The IL-5 antagonist mepolizumab was Food and Drug Administration approved in 2017 after demonstrating safety and efficacy in EGPA. We hypothesized that benralizumab, an IL-5 receptor antagonist approved for eosinophilic asthma, would demonstrate safety and efficacy in EGPA.

Selecting the right biologic for your patients with severe asthma.

Objective: Severe asthma affects 5% to 10% of the adult asthma population and is associated with increased morbidity, mortality, and consumption of health care resources. Recently, several biologic medications have been approved for use in severe asthma. These medications target the type 2 inflammatory pathway, which is characterized by activation of cytokines, including interleukin (IL)-4, IL-5, and IL-13, which results in eosinophilia, high FeNO, and atopic features.

New biologics for allergic diseases.

Allergic conditions such as asthma and atopic dermatitis have a high prevalence but represent a heterogeneous group of diseases despite similar clinical presentation and underlying pathophysiology. A better understanding of the phenotypes and endotypes of these diseases has driven rapid development of biologic medications targeting many steps of the inflammatory pathways. Areas covered: There are 2 major inflammatory pathways that drive allergic diseases: Type-2 (Th-2) inflammation and non-type 2 inflammation.