Real-Life Response to Biologics in Severe Asthma with Nasal Polyposis: Insights from the Belgian Severe Asthma Registry.

Background: Nasal polyposis (NP) is a comorbidity of type 2 severe asthma (SA) which could influence response to SA biologics.

Methods: We evaluated (super-) response in SA patients with (NP +) and without NP (NP-) enrolled in the Belgian Severe Asthma Registry (BSAR).

Results: 914 patients, of whom 31% NP + , were included.

Anti-Interleukin-5 Therapy Is Associated with Attenuated Lung Function Decline in Severe Eosinophilic Asthma Patients From the Belgian Severe Asthma Registry.

Background: Asthmatics have accelerated lung function decline over time compared with healthy individuals.

Objective: To evaluate risk factors for accelerated lung function decline.

Methods: In a longitudinal analysis on severe asthmatics enrolled in the Belgian Severe Asthma Registry with at least 2 visits a minimum of 12 months apart, we compared characteristics of patients with and without decline (loss of post-bronchodilation forced expiratory volume in 1 s [FEV] (% predicted)/y greater than zero) over time.

Chronic oral corticosteroids use and persistent eosinophilia in severe asthmatics from the Belgian severe asthma registry.

Background: Severe asthma (SA) may require frequent courses or chronic use of oral corticosteroids (OCS), inducing many known side effects and complications. Therefore, it is important to identify risk factors of chronic use of OCS in SA, considering the heterogeneity of clinical and inflammatory asthma phenotypes. Another aim of the present analysis is to characterize a subpopulation of severe asthmatics, in whom blood eosinophil counts (BEC) remain elevated despite chronic OCS treatment.

Secondary organizing pneumonia associated with sertraline: A case report.

Cryptogenic organizing pneumonia is a rare idiopathic interstitial lung disease, with a well-defined clinical-radiological and pathological entity. It may also be secondary to several causes. Rapid clinical and imaging improvement is usually obtained with corticosteroid therapy.

Executive dysfunctions as a good predictor of misuse of respiratory inhalers among hospitalized patients: a prospective survey.

The objectives of the study are to determine the prevalence and potential risk factors of misuse of respiratory inhalers among hospitalized patients admitted at the CHU UcL Namur, site Godinne. Using a cross-sectional design, patients using respiratory inhalers since more than 7 days were recruited from a database established by the hospital pharmacy. Inhaler technique was assessed using a standardised check-list and graded misuse as major or minor errors using previously published criteria.

Nonallergic airway hyperresponsiveness and allergen-specific IgE levels are the main determinants of the early and late asthmatic response to allergen.

Background: Conflicting results have been reported in studies of predictive factors for airway responsiveness to allergens during bronchial challenges.

Objective: The aim of this study was to assess determinants of airway responsiveness to 3 different allergens during standardized bronchial challenges.

Methods: Data were collected from asthmatic patients who participated in allergen challenge trials between 2000 and 2006 (cat, n = 37; house dust mite [HDM], n = 35; grass pollen, n = 27).

Indoor dust and air concentrations of endotoxin in urban and rural environments.

Rural dairy farming is associated with high exposure to indoor endotoxins as compared to rural nonfarming houses and urban houses. The time spent on the mattress (7 h for an adult) and of the proximity of the contaminated source should be taken into account with the other causes of exposure. Studies in European children from a farming background have shown that these children have a reduced risk of asthma and atopic sensitization compared to their urban counterparts.

Presence in sputum of functional dust mite-specific IgE antibodies in intrinsic asthma.

Rationale: Intrinsic asthma was described by Rackemann as asthma without allergy. Local IgE production has been documented in intrinsic asthma, but antigen specificity of this response remains elusive.

Objectives: We investigated (1) the presence of dust mite-specific IgE in sputum of patients with intrinsic asthma, (2) their clinical/immunological relevance, and (3) their functionality.

Low-dose endotoxin in allergic asthmatics: effect on bronchial and inflammatory response to cat allergen.

Background: Endotoxin was proposed to increase the severity of asthma. Endotoxin levels greatly differ according to settings. In domestic environments, airborne concentrations may be dramatically low compared with levels reported in occupational settings.

[Critical analysis of hypotheses explaining the increase in respiratory allergens].

There are three hypotheses to explain the relation between allergens and other factors and the onset of atopy: the hygiene hypothesis, the TH2 like hypothesis and the allergenic hypothesis. None of them have been confirmed. It seems necessary to wait for the results of prospective studies before giving recommendations for primary prevention of respiratory allergic diseases.

Acute exacerbation of chronic obstructive pulmonary disease and antibiotics: what studies are still needed?

The use of antibiotics in acute exacerbations of chronic bronchitis (AECBs) remains the subject of controversy despite considerable medical and socioeconomic implications. First, the contribution of bacterial infection to AECBs is difficult to assess in patients with chronic obstructive pulmonary disease (COPD) who are chronically colonized with respiratory pathogens. In addition, several studies suggest a major role of viral infections in AECBs.

Occupational asthma in symptomatic workers exposed to natural rubber latex: evaluation of diagnostic procedures.

Background: Natural rubber latex (NRL) has been increasingly identified as a cause of occupational asthma (OA).

Objective: We sought to examine the accuracy of the clinical history, immunologic tests, and assessment of nonspecific bronchial hyperresponsiveness in diagnosing OA caused by latex compared with that of the specific inhalation challenge (SIC).

Methods: Forty-five consecutive patients referred for investigation of possible OA caused by latex underwent a diagnostic protocol, including an open medical questionnaire, skin prick testing against latex, measurement of bronchial responsiveness to histamine, and inhalation challenge with latex gloves.