78 results match your criteria: "University Hospital Essen-Ruhrlandklinik[Affiliation]"

Roads to remission: evolving treatment concepts in type 2 inflammatory diseases.

EClinicalMedicine

February 2025

Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, Marburg, Germany.

Unlabelled: Non-communicable diseases (NCDs) characterised by type 2 inflammation, including asthma, allergic rhinitis, chronic rhinosinusitis with nasal polyps, atopic dermatitis, food allergies and eosinophilic esophagitis, are increasing in prevalence worldwide. Currently, there is a major paradigm shift in the management of these diseases, towards the concept of disease modification and the treatment goal remission, regardless of severity and age. Remission as a treatment goal in chronic inflammatory NCDs was first introduced in rheumatoid arthritis, and then adopted in other non-type 2 inflammatory diseases.

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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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Sex Differences in Sleep Profiles and the Effect of Elexacaftor/Tezacaftor/Ivacaftor on Sleep Quality in Adult People with Cystic Fibrosis: A Prospective Observational Study.

Diagnostics (Basel)

December 2024

Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Adult Cystic Fibrosis Center, University of Duisburg-Essen, Tueschener Weg 40, 45329 Essen, Germany.

Background/objectives: Recent studies indicate that sleep and sleep disorders differ between men and women, but corresponding data in people with chronic lung diseases are lacking. This study aims to answer the question of what the sex-specific differences in sleep profiles and responses to elexacaftor/tezacaftor/ivacaftor (ETI) therapy in people with cystic fibrosis (pwCF) are.

Methods: Adult pwCF and a matched control group (adults with suspected sleep-disordered breathing undergoing in-laboratory polysomnography (PSG)) were included.

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Article Synopsis
  • Targeted therapies using biologics for atopic diseases, urticaria, and angioedema are advancing quickly, with several new antibodies developed, tested, and approved for clinical use, like omalizumab and dupilumab.
  • There is ongoing research into combining different biologics for enhanced treatment efficacy, expanding their applications to conditions like food allergies and eosinophilic esophagitis.
  • There are emerging concerns about unexpected side effects and hypersensitivity reactions associated with these therapies, raising important questions about their safety and mechanisms, particularly in specific patient groups like children.
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Cystic fibrosis bone disease (CFBD) is a common comorbidity in adult people with cystic fibrosis (pwCF), resulting in an increased risk of bone fractures. This study evaluated the capacity of artificial intelligence (AI)-assisted low-dose chest CT (LDCT) opportunistic screening for detecting low bone mineral density (BMD) in adult pwCF. In this retrospective single-center study, 65 adult pwCF (mean age 30.

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Host-directed antivirals (HDAs) represent an attractive treatment option and a strategy for pandemic preparedness, especially due to their potential broad-spectrum antiviral activity and high barrier to resistance development. Particularly, dual-targeting HDAs offer a promising approach for antiviral therapy by simultaneously disrupting multiple pathways essential for viral replication. Izumerogant (IMU-935) targets two host proteins, (i) the retinoic acid receptor-related orphan receptor γ isoform 1 (RORγ1), which modulates cellular cholesterol metabolism, and (ii) the enzyme dihydroorotate dehydrogenase (DHODH), which is involved in de novo pyrimidine synthesis.

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Article Synopsis
  • Regular disease monitoring in cystic fibrosis patients is essential, and this study compared low-dose high-resolution (LD-HR) CT scans using photon-counting CT (PCCT) versus energy-integrating detector system CT (EID-CT).
  • The results showed that PCCT reduced radiation exposure by about 42% and had superior image quality and sharpness compared to EID-CT.
  • Ultimately, PCCT proved to be a more advantageous method for monitoring cystic fibrosis due to its lower radiation dose and improved imaging capabilities.
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  • Elexacaftor/tezacaftor/ivacaftor (ETI) treatment for cystic fibrosis can lead to liver-related side effects, particularly in patients with Gilbert's syndrome, a genetic condition that elevates bilirubin levels.
  • A case series involving six cystic fibrosis patients revealed that Gilbert's syndrome was often unmasked after starting ETI, causing varying degrees of hepatic dysfunction but allowing most to continue treatment, some at adjusted dosages.
  • Physicians should recognize that while Gilbert's syndrome may seem like a risk factor for liver issues during ETI therapy, it is not a reason to stop treatment, and patients can still benefit from ETI despite liver-related complications.
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  • Primary ciliary dyskinesia (PCD) is a rare genetic disorder that affects ciliary function, leading to airway clearance issues and sometimes organ positioning defects (laterality defects), with a study conducted across 19 countries to analyze gene defects and their clinical implications.
  • The study involved 1236 individuals with a variety of pathogenic DNA variants and found significant geographical differences in PCD genotypes, with varying rates of laterality defects and distinct genetic characteristics linked to different countries.
  • Results revealed that individuals with PCD often have lower lung function (measured by forced expiratory volume) and that the presence of certain genetic variants can correlate with more severe clinical outcomes, highlighting the importance of genetic understanding in diagnosing
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Article Synopsis
  • Poor nutritional status negatively impacts lung function and survival in people with cystic fibrosis (pwCF).
  • A study using deep-learning analyzed body composition changes in 66 adults with CF before and after elexacaftor/tezacaftor/ivacaftor (ETI) therapy, finding significant increases in adipose tissue but only minimal improvements in muscle ratio.
  • The results indicate that ETI therapy mainly influences fat tissue, particularly in underweight patients, which may inform future nutritional strategies for managing CF.
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Article Synopsis
  • International guidelines emphasize the importance of airway clearance management in treating bronchiectasis, yet its actual usage across Europe remains unclear.
  • A study involving 16,723 patients from 28 countries showed that 52% reported using regular airway clearance, with significant variation in techniques and usage between countries.
  • Patients using airway clearance tended to have more severe disease and symptoms, and access to specialized respiratory physiotherapy was notably low, especially in Eastern Europe.
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Gene editing in allergic diseases: Identification of novel pathways and impact of deleting allergen genes.

J Allergy Clin Immunol

July 2024

Department of Pediatrics, Division of Cell Biology, National Jewish Health, Denver, Colo. Electronic address:

Article Synopsis
  • * This technology can create gene knockouts and identify disease-causing genes, helping to pinpoint allergens and reduce their harmful effects.
  • * Despite some limitations in precision and possible off-target effects, new methods are being developed to better understand gene functions and reduce allergenicity in diseases like peanut allergies and asthma.
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Article Synopsis
  • A case was reported of a 39-year-old male living with HIV who developed hypercalcemia and acute kidney damage due to immune reconstitution inflammatory syndrome (IRIS) and disseminated Mycobacterium avium infection.
  • The patient experienced significant weight loss, muscle weakness, and had laboratory findings confirming high serum calcium levels and kidney damage despite being on antiretroviral therapy and other medications.
  • Treatment involving diuretics, bisphosphonates, and calcitonin successfully normalized calcium levels and improved kidney function, highlighting the rare but critical nature of hypercalcemia linked to IRIS in HIV patients.
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Background: Monoclonal antibodies (biologics) drastically changed severe asthma therapy. Mepolizumab (anti-interleukin (IL) 5), benralizumab (anti-IL5 receptor alpha), and dupilumab (anti-IL4/13) are the most used biologics in this context. While all biologics are efficient individually, the choice of biologic is complicated by insufficient data on their comparative long-term treatment efficacy.

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Article Synopsis
  • Maintaining physical fitness is crucial for adults with cystic fibrosis (pwCF), but there is limited data on how new therapies like ETI affect their fitness levels over time.
  • A study tracked 28 adult pwCF for about 5.6 years, measuring various physical fitness components and health indicators like BMI and FEV1, finding significant improvements in BMI and some health-related fitness measures after starting ETI therapy.
  • While ETI therapy showed some positive effects, the overall impact on fitness was small, suggesting that other factors also play a role in achieving high physical fitness in pwCF.
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Article Synopsis
  • Habitual physical activity and exercise training are crucial for improving health and quality of life in people with cystic fibrosis (pwCF), particularly with the advent of new CFTR modulator therapies like Elexacaftor/Tezacaftor/Ivacaftor (ETI).
  • A study was conducted to evaluate the effects of ETI on habitual physical activity, measuring steps per day and intensity among adult pwCF over time, with a focus on data collected during the post-pandemic period.
  • Results showed that pwCF on ETI increased daily steps by 25%, while those not receiving ETI saw a slight decline; however, changes in lung function were significant for those on
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Microbes little helpers and suppliers for therapeutic asthma approaches.

Respir Res

January 2024

Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany.

Bronchial asthma is a prevalent and increasingly chronic inflammatory lung disease affecting over 300 million people globally. Initially considered an allergic disorder driven by mast cells and eosinophils, asthma is now recognized as a complex syndrome with various clinical phenotypes and immunological endotypes. These encompass type 2 inflammatory endotypes characterized by interleukin (IL)-4, IL-5, and IL-13 dominance, alongside others featuring mixed or non-eosinophilic inflammation.

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Background: The influence of habitual physical activity and exercise capacity on health-related quality of life (HRQoL) in people with cystic fibrosis (pwCF) is poorly characterized. This study investigated the influence of habitual physical activity, exercise capacity, lung function, and body mass index (BMI) on HRQoL in adolescent and adult pwCF.

Method: Subjects were fitted with an accelerometer to determine habitual physical activity (steps/day), including time spent at different intensities, for up to 4 weeks.

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Article Synopsis
  • * A 53-year-old man with an ileum neuroendocrine tumor and liver metastases developed Hedinger syndrome, experiencing worsening shortness of breath and severe low oxygen levels because of a patent foramen ovale.
  • * Diagnostic imaging, including 99mTc-MAA lung perfusion scintigraphy and 68Ga-FAPI-46 PET/CT, helped identify the right-left blood shunting and the characteristic thickening of heart valves linked to serotonin's effects on fibro
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Article Synopsis
  • Cystic fibrosis (CF) is characterized by immune dysregulation and chronic inflammation, and this study focused on the effects of the CFTR modulator therapy elexacaftor/tezacaftor/ivacaftor (ETI) on associated inflammation in patients with CF.
  • Researchers analyzed plasma samples from 51 patients before, three months, and six months after starting ETI therapy, measuring various pro-inflammatory chemokines.
  • Results showed significant improvements in lung function and decreases in specific inflammatory markers, particularly those linked to neutrophilic inflammation, indicating ETI's anti-inflammatory effects.
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DGAKI and PEI in dialogue 2023: Diagnostics and allergen immunotherapy.

Allergol Select

December 2023

Allergology and Immunology, Department of Dermatology, Venereology and Allergology, Charité -Universitätsmedizin Berlin, Berlin, Germany.

A roundtable discussion on February 10, 2023 between the German Society for Allergology and Clinical Immunology (DGAKI) and the Paul-Ehrlich-Institut (PEI) aimed to discuss in detail current aspects of allergen immunotherapy (AIT), its regulatory framework under the transitional provision of the Therapy Allergen Ordinance (TAO), and the consequences for the planned guideline work of the DGAKI, regulatory challenges in the approval of AIT products for children and adolescents as well as allergy diagnostics. The content and discussion points of this dialogue are summarized and are set in context with the current literature.

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Article Synopsis
  • The study examines the impact of the Elexacaftor/Tezacaftor/Ivacaftor (ETI) therapy on health-related quality of life (HRQoL) in adults with cystic fibrosis (pwCF) over a period of about 5.6 years, comparing those who received ETI to those who did not.
  • It found that ETI significantly improved several HRQoL domains, while pwCF not on ETI saw little improvement in psychosocial factors and decline in physical health over time.
  • The findings suggest ETI therapy enhances both HRQoL and clinical outcomes, but disease progression appears to affect physical health more negatively than psychological aspects; however
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Article Synopsis
  • The Severe Asthma Registry, started in 2011 by the German Asthma Net, collects data on severe asthma patients in Germany, Austria, and Switzerland, focusing here on Austrian participants' initial characteristics.
  • Analysis included 214 patients from six Austrian centers between 2013 and 2022, revealing an average age of 53.7 years, with significant daily asthma symptoms and a high percentage classified as uncontrolled.
  • Compared to international data, Austrian patients showed better asthma control and fewer exacerbations, highlighting a distinct profile within this registry context.
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