Publications by authors named "Skowasch D"

Background: Clinical studies of biologics in severe asthma exclude smokers or ex-smokers (ExS) with over 10 pack-years (py). Thus, the effectiveness of this therapy in ex-smokers with severe asthma is not well understood.

Objectives: To assess the impact of smoking on clinical efficiency of biologics in patients with severe asthma from the German Asthma Net (GAN), a comprehensive international registry.

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Automated tools for quantification of idiopathic pulmonary fibrosis (IPF) can aid in ensuring reproducibility, however their complexity and costs can differ substantially. In this retrospective study, two automated tools were compared in 45 patients with biopsy proven (12/45) and imaging-based (33/45) IPF diagnosis (mean age 74 ± 9 years, 37 male) for quantification of pulmonary fibrosis in CT. First, a tool that identifies multiple characteristic lung texture features was applied to measure multi-texture fibrotic lung (MTFL) by combining the amount of ground glass, reticulation, and honeycombing.

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Objectives: To longitudinally assesses pulmonary involvement in newly diagnosed rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients over a 12-months follow-up. To identify biomarkers and establish a diagnostic algorithm for monitoring pulmonary changes.

Methods: Newly diagnosed RA and PsA patients were examined with clinical and laboratory assessments, pulmonary function tests (PFT), and chest radiography (CXR) at three-months intervals for one year.

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Background: Patients with severe asthma (SA) benefit from biologic therapy substantially. However, the impact of smoking-related comorbidities remains unclear due to the exclusion of patients with ≥10 pack-years from asthma studies. Our aim was to examine the effects of emphysema on biologic treatment response in SA in this retrospective cohort study.

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Purpose: Asthma is affecting 4-5% of all adults (10% of children) in Germany, ≥ half are inadequately controlled. In 2019 up to 54 thousand patients suffered from severe uncontrolled asthma, 52% were treated/co-treated by pneumonologists. 45% of them had continuous oral corticosteroid (OCS)- and short-acting β2-agonist (SABA) overuse for ≥2 years.

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Background: The use of online information and communication is globally increasing in the healthcare sector. In addition to known benefits in other medical fields, possible specific potentials of eHealth lie in the monitoring of oncological patients undergoing outpatient therapy. Specifically, the treatment with immune checkpoint inhibitors (ICI) requires intensive monitoring due to various possible negative side effects.

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Article Synopsis
  • - The study investigates the relationship between eosinophils and changes in arteries among asthma patients, given that both conditions are linked to inflammation but previous mediators weren't well understood.
  • - A total of 100 asthma patients were assessed, comparing those with low (< 300/µl) and high (≥ 300/µl) eosinophil blood counts, with findings showing that high eosinophil counts correlated with more severe asthma symptoms and increased arterial stiffness.
  • - Results indicated that higher eosinophil levels were associated with reduced radial strain in the carotid arteries, suggesting potential support for the idea that eosinophils could play a role in the development of atherosclerosis.
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Background: The optimal use of steroids in COVID-19 patients remains challenging. Current S3-guidelines "Recommendations for patients with COVID-19" recommend dexamethasone (DEX) for patients requiring respiratory support, remdesivir (RD) in the early disease phase and azythromycin (AZ) is no longer recommended. We investigated effects of DEX, RD and AZ in a lipopolysaccharide induced inflammation in lung cells in vitro and analyzed publicly available datasets with a focus on the Angiotensin-converting enzyme 2 (ACE2) to better understand drugs' mechanisms of action.

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Introduction: Asthma patients with a smoking history are usually excluded from asthma trials to exclude smoking-related comorbidities like chronic obstructive pulmonary disease (COPD). Therefore, little is known about the efficacy of biologic therapy in asthma patients with reduced diffusing capacity of the lungs for carbon monoxide (DLCO).

Methods: This study aimed to assess the response to biologic therapy in asthma patients with reduced DLCO.

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Iron deficiency (ID) is common in patients with pulmonary arterial hypertension and has been associated with increased morbidity and mortality. We aimed to evaluate the therapeutic effects of iron supplementation in iron deficient patients with group 1 to 4 pulmonary hypertension (PH). A total of 85 PH patients (mean age 69.

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Objectives: This cross-sectional study aimed to determine the prevalence, manifestation, and risk factors of pulmonary involvement in newly diagnosed, untreated rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients, and to evaluate the efficacy of various diagnostic tools in screening for pulmonary involvement.

Methods: Untreated, newly diagnosed patients with RA and PsA underwent an extensive multimodal diagnostic approach including clinical and laboratory assessment, pulmonary function tests, and chest radiography.

Results: We recruited 50 arthritis patients (26 RA, 24 PsA) and 26 control subjects.

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Article Synopsis
  • Pseudoxanthoma elasticum (PXE) is a rare genetic condition that causes skin lesions, vision loss, and early atherosclerosis, leading to peripheral artery disease (PAD) with varying severity among individuals.
  • A study assessed the lipid profiles of 52 PXE patients and found a significant link between elevated Lipoprotein(a) (Lp[a]) levels and PAD severity, while other lipid fractions showed no significant impact.
  • The findings suggest that measuring Lp(a) levels early in PXE could help identify patients at higher risk for rapid disease progression and possibly guide interventions like increased exercise training.
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Background: Tezepelumab is a novel biologic blocking thymic stromal lymphopoetin, approved for severe asthma irrespective of biomarker levels or phenotype.

Objective: To characterize a real-world tezepelumab patient cohort and the efficacy among various asthma phenotypes.

Methods: We performed a retrospective, multicenter study on patients with severe asthma initiating tezepelumab.

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Article Synopsis
  • * Recent studies have demonstrated that inhaled triple therapy (combining corticosteroids and dual bronchodilators) significantly reduces exacerbations and mortality, particularly in patients with higher eosinophil levels in their blood.
  • * For patients with exacerbations and high eosinophil counts, inhaled triple therapy is recommended, while dupilumab shows promise for treating eosinophilic COPD, indicating a shift towards eosinophil-guided treatment approaches.
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Objectives: This cross-sectional study aimed to determine the prevalence and risk factors for sleep-related breathing disorders (SRBD) in newly diagnosed, untreated rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients, and to develop a screening algorithm for early detection.

Methods: We evaluated newly diagnosed RA or PsA patients using the Epworth Sleepiness Scale (ESS) questionnaire, cardiorespiratory polygraphy (RPG), and clinical and laboratory assessments. Sleep apnea syndrome (SAS) was diagnosed based on pathological RPG findings excessive daytime sleepiness, defined as ESS score above 10.

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Background: Among patients with pulmonary arterial hypertension (PAH), acute vasoreactivity testing during right heart catheterization may identify acute vasoresponders, for whom treatment with high-dose calcium channel blockers (CCBs) is recommended. However, long-term outcomes in the current era remain largely unknown. We sought to evaluate the implications of acute vasoreactivity response for long-term response to CCBs and other outcomes.

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Introduction: A multitude of findings from cell cultures and animal studies are available to support the anti-cancer properties of cannabidiol (CBD). Since CBD acts on multiple molecular targets, its clinical adaptation, especially in combination with cancer immunotherapy regimen remains a serious concern.

Methods: Considering this, we extensively studied the effect of CBD on the cytokine-induced killer (CIK) cell immunotherapy approach using multiple non-small cell lung cancer (NSCLC) cells harboring diverse genotypes.

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Article Synopsis
  • Interstitial lung diseases (ILD) are diverse, chronic conditions affecting the lungs, with up to 50% of patients experiencing progression associated with higher mortality rates.
  • The EXCITING-ILD registry analyzed disease trajectories, categorizing progression levels based on forced vital capacity (FVC) changes and identifying risk factors for progression through statistical models.
  • Out of 601 patients, 50.6% showed progression, with median survival after diagnosis at 15.5 years, while reduced baseline FVC and older age were identified as key predictors of disease progression and shorter survival times.
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Allergic bronchopulmonary aspergillosis (ABPA) is a regular occurrence in everyday pneumology. ABPA should be considered in patients with severe asthma, in mould allergic patients with very high serum IgE levels and in patients with cystic fibrosis. The aim should be to make the diagnosis as early as possible in the course of the disease to avoid late complications such as bronchiectasis and fibrotic lung remodelling.

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The present recommendations on the therapy of sarcoidosis of the German Respiratory Society (DGP) was written in 2023 as a German-language supplement and update of the international guidelines of the European Respiratory Society (ERS) from 2021. It contains 5 PICO questions (Patients, Intervention, Comparison, Outcomes) agreed in the consensus process, which are explained in the background text of the four articles: Confirmation of diagnosis and monitoring of the disease under therapy, general therapy recommendations, therapy of cutaneous sarcoidosis, therapy of cardiac sarcoidosis.

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Background: Interstitial lung disease (ILD) comprises a wide variety of pulmonary parenchymal disorders within which progressive fibrosing ILD (PF-ILD) constitutes a phenotypic subset. By use of speckle tracking-based strain analysis we aimed to evaluate the degree of left ventricular (LV) dysfunction in progressive vs. non-progressive fibrosing ILD (non-PF-ILD).

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