Is there a role for macrolides in severe asthma?

Abstract:

PURPOSE OF REVIEW:Severe asthma is a heterogeneous syndrome, encompassing several distinct clinical phenotypes. Different molecular and cellular pathways or endotypes determine the type of underlying airway inflammation in patients with severe asthma, which can be categorized as eosinophilic asthma (allergic and nonallergic) or noneosinophilic asthma (neutrophilic and paucigranulocytic). In this review, we discuss the potential role of macrolides in the treatment of severe asthma in adults. RECENT FINDINGS:Maintenance treatment with low-dose macrolides such as erythromycin and azithromycin provides clinical benefit in several chronic neutrophilic airway diseases, including cystic fibrosis (CF), non-CF bronchiectasis and exacerbation-prone chronic obstructive pulmonary disease. Although several short-term studies of macrolides in mild-to-moderate asthma have failed to improve lung function, the AzIthromycin in Severe Asthma trial has demonstrated a significant reduction in the rate of exacerbations in patients with exacerbation-prone noneosinophilic severe asthma. As chronic macrolide use is associated with the risks of population antimicrobial resistance, this add-on treatment should be restricted to severe asthma patients at greatest unmet need despite optimal asthma management. SUMMARY:Further clinical, translational and basic research is needed to better phenotype patients with severe asthma, to determine the risk-benefit ratio of macrolide maintenance treatment in neutrophilic severe asthma and to elucidate the principal mechanisms of action of macrolides.

journal_name

Curr Opin Pulm Med

authors

Brusselle GG,Joos G

doi

10.1097/MCP.0000000000000017

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

95-102

issue

1

eissn

1070-5287

issn

1531-6971

journal_volume

20

pub_type

杂志文章,评审
  • Choosing a nebulizer for cystic fibrosis applications.

    abstract::As the number of inhaled drugs available for cystic fibrosis grows, there is increasing awareness of delivery device issues. Current jet and ultrasonic nebulizers are inefficient at delivering drugs to the lower respiratory tract. There are large differences in output characteristics between nebulizers and high inters...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-199711000-00005

    authors: Geller DE

    更新日期:1997-11-01 00:00:00

  • Management of refractory hepatic hydrothorax.

    abstract:PURPOSE OF REVIEW:Treatment of hepatic hydrothorax is challenging because of its rapid symptomatic recurrence. This review will focus on potential therapeutic approaches to hepatic hydrothorax. RECENT FINDINGS:Hepatic hydrothorax is refractory to salt restriction and diuretics in approximately 25% of cases. Primary ma...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0000000000000058

    authors: Porcel JM

    更新日期:2014-07-01 00:00:00

  • Role of video-assisted thoracoscopic surgery and classic thoracotomy in lung cancer management.

    abstract::Lung cancer is the leading cause of cancer-related death worldwide. For patients diagnosed with early-stage lung cancer, complete surgical resection remains the best hope for cure. Limited resections are avoided when possible because of higher recurrence rates and potentially worse long-term survival. Traditionally, a...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-200207000-00007

    authors: Moffatt SD,Mitchell JD,Whyte RI

    更新日期:2002-07-01 00:00:00

  • Proteomic analysis in interstitial lung diseases: a review.

    abstract:PURPOSE OF REVIEW:This article aims to review the most recent proteomic findings in tissue and biological fluids and application of new technologies for the study of interstitial lung diseases. RECENT FINDINGS:New insights into lung cell biology as well as novel pathogenetic pathways of different interstitial lung dis...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e32832ea4f2

    authors: Rottoli P,Bargagli E,Landi C,Magi B

    更新日期:2009-09-01 00:00:00

  • Guidelines for the diagnosis and therapy of diabetes mellitus in cystic fibrosis.

    abstract::Diabetes is a common complication of cystic fibrosis. Because it is associated with increased morbidity and mortality, prompt diagnosis and aggressive management of cystic fibrosis-related diabetes is important. The Cystic Fibrosis Foundation held a consensus conference in 1998 to define the standards of care for pati...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-199911000-00010

    authors: Riggs AC,Seaquist ER,Moran A

    更新日期:1999-11-01 00:00:00

  • Fixed-dose versus adjusted-dose low molecular weight heparin for the initial treatment of patients with deep venous thrombosis.

    abstract::Patients with acute deep vein thrombosis (DVT) were treated with a body-weight independent dosage of 2 x 8000 aXa IU low-molecular-weight heparin (LMWH) Certoparin. After the subcutaneous administration of 8000 IU Certoparin, pharmacodynamic parameters did not differ between patients and healthy volunteers, and the AU...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-200209000-00007

    authors: Harenberg J

    更新日期:2002-09-01 00:00:00

  • Pulmonary physiology in interstitial lung disease: recent developments in diagnostic and prognostic implications.

    abstract::Pulmonary function changes in interstitial lung disease are characterized by loss of lung volume, increase in ratio of forced expiratory volume in 1 second to forced vital capacity, and decrease in carbon monoxide diffusion capacity. Recent developments in the assessment of respiratory mechanics in infiltrative lung d...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-199609000-00005

    authors: Baydur A

    更新日期:1996-09-01 00:00:00

  • Diagnostic and therapeutic challenges of chronic obstructive pulmonary disease in the elderly.

    abstract:PURPOSE OF REVIEW:Chronic obstructive pulmonary disease (COPD) imposes a large burden on the global population and even more so for the elderly who face significant obstacles in the diagnosis, management, and psychosocial effects of the disease. This review describes the current challenges and key points in the managem...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章

    doi:10.1097/MCP.0000000000000750

    authors: Allen B,Aboussouan LS

    更新日期:2021-03-01 00:00:00

  • Improving adherence to asthma therapies.

    abstract:PURPOSE OF REVIEW:Adherence to asthma therapies is poor leading to unnecessary morbidity and increased use of emergency and hospital resources. Strategies to improve adherence have not been successful. RECENT FINDINGS:Asthma adherence disease management is a clinical method to improve adherence for asthma patients. Th...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0000000000000128

    authors: Weinstein AG

    更新日期:2015-01-01 00:00:00

  • Common variable immunodeficiency-associated granulomatous and interstitial lung disease.

    abstract:PURPOSE OF REVIEW:Common variable immunodeficiency (CVID) is the most common primary immunodeficiency characterized by a deficiency of immunoglobulins. Approximately 30% of the patients develop autoimmune and granulomatous disease. Similar to sarcoidosis, granulomatous disease in CVID can potentially affect all organs,...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e3283642c47

    authors: Prasse A,Kayser G,Warnatz K

    更新日期:2013-09-01 00:00:00

  • Experimental treatments for asthma.

    abstract::There has been increased recognition of the importance of inflammatory cells and their products in the pathogenesis of asthma. From this recognition has evolved a number of new approaches to treat the various components of the asthmatic inflammatory response. Nonselective anti-inflammatory agents such as cyclosporine ...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-199701000-00006

    authors: Floreani AA,Rennard SI

    更新日期:1997-01-01 00:00:00

  • Cell apoptosis and granulomatous lung diseases.

    abstract::Apoptosis, also known as activation-induced cell death or programmed cell death, is an active suicide mechanism that is involved in normal tissue turnover during embryogenesis and adult life. There are many examples of apoptosis in the immune system, including programmed cell death of T cells during negative intrathym...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-199809000-00004

    authors: Agostini C,Perin A,Semenzato G

    更新日期:1998-09-01 00:00:00

  • Imaging in lung cancer.

    abstract::The diagnosis, staging, and follow-up of lung cancer is a clinical and therapeutic challenge. Recent radiographic advances are critical to the management of patients with lung cancer. This review focuses on state-of-the-art chest imaging modalities, including plain radiography, computed tomography; magnetic resonance ...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Sarinas PS,Chitkara RK,Rizk NW,Segall GM,Stark P

    更新日期:1996-07-01 00:00:00

  • Comorbidities of chronic facial pain and obstructive sleep apnea.

    abstract:PURPOSE OF REVIEW:This article explains the high comorbidity of craniofacial pain (chronic face pain, temporomandibular disorders, and primary headaches) with obstructive sleep breathing disorders and obstructive sleep apnea (OSA). It is recommended that physicians treating OSA should be aware of the concurrent chronic...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0000000000000325

    authors: Olmos SR

    更新日期:2016-11-01 00:00:00

  • Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    abstract:PURPOSE OF REVIEW:Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients h...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e32834317bb

    authors: Lee R,McNicholas WT

    更新日期:2011-03-01 00:00:00

  • Identification and management of pleural effusions of multiple aetiologies.

    abstract:PURPOSE OF REVIEW:Historically, pleural effusions have been attributed to a single cause. There is growing recognition that a substantial proportion of pleural effusions may have more than one underlying cause. The purpose of this review is to summarise recent findings regarding the diagnosis and treatment of effusions...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0000000000000388

    authors: Walker S,Maskell N

    更新日期:2017-07-01 00:00:00

  • Critical care of patients with pulmonary arterial hypertension.

    abstract:PURPOSE OF REVIEW:Need for intensive care in the patient with pulmonary arterial hypertension is associated with high mortality. This review will provide an overview of causes of ICU admission for patients with pulmonary hypertension and provide guidance on management. RECENT FINDINGS:There is a paucity of evidence-ba...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章

    doi:10.1097/MCP.0000000000000713

    authors: Aryal S,King CS

    更新日期:2020-09-01 00:00:00

  • Pulmonary hypertension in sickle cell disease.

    abstract:PURPOSE OF REVIEW:This review highlights the prevalence of pulmonary hypertension as a chronic complication of sickle cell disease (SCD) and its importance in the prognosis. RECENT FINDINGS:In recent years, the limitations of echocardiogram for the appropriate diagnosis of SCD-associated pulmonary hypertension have be...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0000000000000200

    authors: Fonseca G,Souza R

    更新日期:2015-09-01 00:00:00

  • Pleural disease in patients with AIDS.

    abstract::Patients infected with HIV are at risk of developing a variety of infectious and malignant pleuropulmonary disorders. The three most common causes of AIDS-related pleural effusions are parapneumonic effusions or empyemas, tuberculosis, and Kaposi's sarcoma. However, the relative frequency of these conditions varies fr...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-199707000-00014

    authors: Hamm H,Matthys H

    更新日期:1997-07-01 00:00:00

  • Infectious lung complications in patients with HIV/AIDS.

    abstract:PURPOSE OF REVIEW:The aim of this article is to review recent observations in the area of infectious lung complications in individuals with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Since the immunodeficiency was first characterized, it has been associated with enhanced susceptibilit...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.mcp.0000156992.53246.f8

    authors: Boyton RJ

    更新日期:2005-05-01 00:00:00

  • Renal sarcoidosis: approach to diagnosis and management.

    abstract:PURPOSE OF REVIEW:The purpose of this article is to provide understanding of renal sarcoidosis, the different types of renal sarcoidosis, disease burden of renal involvement, and treatment options. RECENT FINDINGS:The frequency of renal involvement seems to be underestimated, but renal sarcoidosis represents a relevan...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0000000000000504

    authors: Bergner R,Löffler C

    更新日期:2018-09-01 00:00:00

  • The Sleep Heart Health Study: a progress report.

    abstract:PURPOSE OF REVIEW:The Sleep Heart Health Study began in 1994 as a prospective cohort study of cardiovascular disease. The results of longitudinal analysis are not yet available, but numerous analyses of cross-sectional data have been published. This review provides an overview of study results so far. RECENT FINDINGS:...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e328312ed61

    authors: Gottlieb DJ

    更新日期:2008-11-01 00:00:00

  • The use of macrolide antibiotics in patients with cystic fibrosis.

    abstract:PURPOSE OF REVIEW:There has been much recent interest in the use of macrolide antibiotics as chronic suppressive therapy in patients with cystic fibrosis. Three recent randomized, placebo-controlled trials have been conducted. RECENT FINDINGS:All three trials used similar regimens of azithromycin, and lung function im...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.mcp.0000142101.53084.f0

    authors: Saiman L

    更新日期:2004-11-01 00:00:00

  • Applied clinical immunology in sarcoidosis.

    abstract::Staging of sarcoidosis needs a synthesis of clinical features, histology, radiology, biochemical changes, and immunologic aberrations to distinguish this disease from nonspecific sarcoid-tissue reactions. The main aim of this report is to offer readers an overview on immunologic markers that have been evaluated in the...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-200209000-00017

    authors: Semenzato G,Bortoli M,Agostini C

    更新日期:2002-09-01 00:00:00

  • Pediatric sleep disorders: new developments and evolving understanding.

    abstract::Disorders of sleep in children are distinctly different from sleep disorders in adults. Since children are forced to constantly learn and adapt, the effects of disordered sleep may be more profound. This paper reviews the disorders of sleep that are most significant in each of the stages of development from infancy to...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-200011000-00007

    authors: Anstead M

    更新日期:2000-11-01 00:00:00

  • Management of chronic obstructive pulmonary disease.

    abstract::Chronic obstructive pulmonary disease is the fourth leading cause of death in the United States, affecting approximately 10% of all adults. Several articles published during the past year contributed significantly to our understanding of the complicated management of this disease. New information concerning bronchodil...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-199603000-00011

    authors: Navin DM,Gross NJ

    更新日期:1996-03-01 00:00:00

  • Animal models of malignant pleural effusion.

    abstract:PURPOSE OF REVIEW:Malignant pleural effusion (MPE) poses a common and significant clinical problem. Its pathogenesis is poorly understood and therapeutic options are limited. Herein are summarized animal models of MPE and their contributions in unveiling new aspects of the pathobiology of the condition. RECENT FINDING...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e32832af07c

    authors: Stathopoulos GT,Kalomenidis I

    更新日期:2009-07-01 00:00:00

  • Bronchoscopic interventions in the management of chronic obstructive pulmonary disease.

    abstract:PURPOSE OF REVIEW:In the past few years, there have been exciting developments in bronchoscopic efforts at attaining lung volume reduction (LVR), given real and perceived risks of surgical LVR. The purpose of this review is to discuss these techniques, with special emphasis on what we have learnt in the past 1-2 years....

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e32835cfd59

    authors: Taneja A

    更新日期:2013-03-01 00:00:00

  • Viral infections in obstructive airway diseases.

    abstract::The most common syndromes associated with obstructive lung disease are asthma and chronic obstructive pulmonary disease (COPD). Evidence for a viral etiology of asthmatic exacerbations is well known, but evidence for a role for viruses in COPD exacerbation is just emerging. Viruses may cause chronic infection in both ...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-200303000-00004

    authors: Seemungal TA,Wedzicha JA

    更新日期:2003-03-01 00:00:00

  • Clinical relevance of distal deep vein thrombosis.

    abstract:PURPOSE OF REVIEW:To discuss pros and cons of anticoagulant treatment in the presence of symptomatic distal deep vein thrombosis. RECENT FINDINGS:Available data are responsible for a lack of consensus regarding treatment of distal deep vein thrombosis. SUMMARY:One standard diagnostic approach of suspected deep vein t...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e32830460ea

    authors: Righini M,Bounameaux H

    更新日期:2008-09-01 00:00:00