Publications by authors named "Papakosta D"

Remission of asthma can occur as part of the natural history of the disease; however, the use of biologics can result in disease remission in some patients. In this post hoc analysis of the RELIght study, we aimed to evaluate clinical remission in real life among patients treated with mepolizumab, to detect possible differences between "remitters" and "nonremitters," and to evaluate possible predictors of remission. Clinical remission was defined as the absence of asthma exacerbations, discontinuation of oral corticosteroids (OCS), achievement of asthma control (Asthma Control Test [ACT] ≥ 20), and stable or improved lung function.

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Background And Aim: There is limited data on the prevalence of SARS-COV-2 in sarcoidosis patients and the underlying parameters linked to severity. We aimed to conduct a national multicenter study to explore the prevalence of SARS-COV-2 in sarcoidosis patients and investigate its impact on hospitalization and infection rates, describe the characteristics of the infected population and assess the role of these characteristics in determining the likelihood of infection or hospitalization.

Methods: We recruited all the adult sarcoidosis patients with who were examined across eight Greek Health Interstitial Lung Disease Referral Centers from the beginning of the pandemic until August 1, 2022.

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Article Synopsis
  • The STEPINCOPD study investigated the factors influencing the escalation or de-escalation of inhaled COPD therapies in clinical practice, especially after updated guidelines were released in 2019 and 2020.
  • Conducted over 12 weeks with 1429 patients from various centers in Greece, the study focused on understanding why patients had changes in their inhaled medication based on GOLD's 2021 recommendations.
  • Findings revealed that reasons for treatment changes included lack of response to previous treatment and COPD exacerbations, with a high adherence rate (over 80%) to the GOLD recommendations among physicians, influenced by factors such as their age and patients' CAT scores.
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Background: Clinical trials and real-world experience have provided evidence for the clinical benefits of mepolizumab, an anti-IL-5 biologic, in severe asthma. However, limited data exist regarding the impact of mepolizumab on airway remodeling.

Objective: We sought to investigate the effect of mepolizumab on airway structural remodeling in patients treated for severe asthma in routine clinical care.

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Background: Electronic cigarettes (ECs) have been promoted as alternatives to traditional cigarettes.

Aim: To investigate ECs' effects on respiratory system, especially in patients with respiratory diseases.

Methods: We randomly selected 25 smokers with stable moderate asthma and matched them with 25 healthy smokers.

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Background: The aim of this present study was to determine serum biomarker levels and their correlation with respiratory function and the clinical course of patients with idiopathic pulmonary fibrosis (IPF).

Materials And Methods: This study included 72 IPF patients, according to the ATS/ERS criteria, in whom antifibrotic treatment was initiated. Blood samples were taken, and serum biomarkers, such as KL-6, SP-D, CCL18, CXCL13, VEGF-A, IL-8, IGFBP-1, IGFBP-2, IGFBP-7 and ICAM-1 were measured using ELISA methodology.

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Purpose: AAntitrypsin deficiency (AATD) pathogenic mutations are expanding beyond the PI*Z and PI*S to a multitude of rare variants.

Aim: to investigate genotype and clinical profile of Greeks with AATD.

Methods: Symptomatic adult-patients with early-emphysema defined by fixed airway obstruction and computerized-tomography scan and lower than normal serum AAT levels were enrolled from reference centers all over Greece.

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Contemporary asthma management requires a proactive and individualized approach, combining precision diagnosis and personalized treatment. The introduction of biologic therapies for severe asthma to everyday clinical practice, increases the need for specific patient selection, prediction of outcomes and monitoring of these costly and long-lasting therapies. Several biomarkers have been used in asthma in disease identification, prediction of asthma severity and prognosis, and response to treatment.

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Background And Objective: There remains a paucity of large databases for patients with idiopathic pulmonary fibrosis (IPF) and lung cancer. We aimed to create a European registry.

Methods: This was a multicentre, retrospective study across seven European countries between 1 January 2010 and 18 May 2021.

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Asthma phenotyping and endotyping are constantly evolving. Currently, several biologic agents have been developed towards a personalized approach to asthma management. This review will focus on different eosinophilic phenotypes and Th2-associated endotypes with eosinophilic inflammation.

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Background: The aim of the present study was the application of the latest phenotype recommendations in Greek patients, in order to identify specific clinical, imaging and spirometric characteristics, at initial diagnosis of sarcoidosis, related to disease phenotypes.

Methods: Our cohort included 147 patients coming from Northern Greece, recruited from the Outpatient Sarcoidosis Clinic, of Aristotle University of Thessaloniki. The observation period was 5 years.

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Article Synopsis
  • The study aimed to observe the risks of COVID-19 in patients with severe asthma who are treated with biologics during the pandemic.
  • Data was collected from 591 severe asthmatics across Greece, revealing that only 4.4% tested positive for SARS-CoV-2, with a small number requiring hospitalization.
  • Findings suggest that severe asthma patients on biologics do not have a higher risk of COVID-19 infection or adverse outcomes compared to the general population.
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Introduction And Objective: Left-heart dysfunction and pulmonary vasculopathy are increasingly recognized as contributing factors of exercise capacity limitation in interstitial fibrosing lung disease (IFLD). Moreover, the clinical significance of exercise pulmonary hypertension (ePH) in pulmonary and cardiac diseases has been documented, representing a risk factor for decreased exercise capacity and survival, progression to resting pulmonary hypertension (PH) and overall clinical worsening. We conducted a prospective study aiming at: (a) assessing the prevalence of PH and ePH in a cohort of 40 functionally limited patients with IFLD, (b) determining the post-capillary (postC) or pre-capillary (preC) etiology of either PH or ePH in this cohort, and (c) examining the correlations between invasively and non-invasively measured exercise variables among hemodynamic groups.

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Omalizumab is the first monoclonal antibody that was globally approved as a personalized treatment option for patients with moderate-to-severe allergic asthma. This review summarizes the knowledge of almost two decades of use of omalizumab to answer some important everyday clinical practice questions, concerning its efficacy and safety and its association with other asthma-related and drug-related parameters. Evidence suggests that omalizumab improves asthma control and reduces the incidence and frequency of exacerbations in patients with severe allergic asthma.

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Background And Objective: Data on natural killer (NK)- and natural killer T (NKT)- like cells in the immunopathogenesis of sarcoidosis remain limited. The aim was to assess NK- and NKT-like cells across different stages in bronchoalveolar lavage (BALF) versus peripheral blood (PB) in comparison to controls.

Methods: Forty four patients (32 women and 12 men, mean age 46.

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The PERSEIDS study aimed to estimate incidence/prevalence of interstitial lung diseases (ILDs), fibrosing interstitial lung diseases (F-ILDs), idiopathic pulmonary fibrosis (IPF), systemic sclerosis-associated ILD (SSc-ILD), other non-IPF F-ILDs and their progressive-fibrosing (PF) forms in six European countries, as current data are scarce. This retrospective, two-phase study used aggregate data (2014-2018). In Phase 1, incident/prevalent cases of ILDs above were identified from clinical databases through an algorithm based on codes/keywords, and incidence/prevalence was estimated.

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Background: Monogenic and polygenic inheritances are evidenced for idiopathic pulmonary fibrosis (IPF). Pathogenic variations in surfactant protein-related genes, telomere-related genes (TRGs), and a single-nucleotide polymorphism in the promoter of MUC5B gene encoding mucin 5B (rs35705950 T risk allele) are reported. This French-Greek collaborative study, Gen-Phen-Re-GreekS in inheritable IPF (iIPF), aimed to investigate genetic components and patients' characteristics in the Greek national IPF cohort with suspected heritability.

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Article Synopsis
  • A study conducted in Greece from February to May 2020 analyzed hospitalized COVID-19 patients, revealing that most subjects were male (65.7%) with an average age of 60, predominantly non-smokers (57.2%).
  • The majority received a standard treatment regimen including hydroxychloroquine and azithromycin, with an average hospital stay of 10 days; 13.3% required intubation and 4.2% died.
  • The findings highlighted that higher neutrophil-to-lymphocyte ratios (NLR) and lactate dehydrogenase (LDH) levels were linked to more severe disease, suggesting these markers may help predict disease progression and inform treatment decisions.
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  • Electronic cigarettes (EC) are seen as alternatives to traditional tobacco cigarettes, but their health impacts, especially on asthma patients, are not well-understood.
  • * The review evaluates how ECs may contribute to asthma development, negatively impact lung function, worsen asthma symptoms, and increase inflammation in those who vape.
  • * Evidence indicates that asthma patients who use ECs face more severe symptoms and exacerbations, suggesting they should avoid using them altogether.
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The efficacy and safety of omalizumab in patients with severe allergic asthma have been established in both randomized controlled trials and real-life studies. To evaluate the sustained effectiveness and safety of long-term treatment with omalizumab in a real-world setting. In this retrospective study, we included patients treated with omalizumab for at least 8 years in four asthma clinics in Greece.

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Article Synopsis
  • Idiopathic Pulmonary Fibrosis (IPF) is a chronic lung disease with an unpredictable progression, and this study aimed to assess the prognostic value of complete blood count parameters in patients diagnosed with IPF.
  • The research involved analyzing data from 489 treatment-naïve IPF patients across two cohorts, focusing on monocyte count and red cell distribution width (RDW) to categorize them into high and low groups.
  • Results showed that higher monocyte counts and RDW were linked to significantly poorer lung function and higher mortality rates, with similar findings confirmed in a validation cohort.
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