The Journal of allergy and clinical immunology
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J. Allergy Clin. Immunol. · Dec 2015
Randomized Controlled Trial Multicenter StudyPreseasonal treatment with either omalizumab or an inhaled corticosteroid boost to prevent fall asthma exacerbations.
Short-term targeted treatment can potentially prevent fall asthma exacerbations while limiting therapy exposure. ⋯ Adding omalizumab before return to school to ongoing guidelines-based care among inner-city youth reduces fall asthma exacerbations, particularly among those with a recent exacerbation.
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J. Allergy Clin. Immunol. · May 2015
Randomized Controlled TrialRandomized trial to evaluate azithromycin's effects on serum and upper airway IL-8 levels and recurrent wheezing in infants with respiratory syncytial virus bronchiolitis.
Respiratory syncytial virus (RSV) bronchiolitis in infancy is a major risk factor for recurrent wheezing and asthma. Because azithromycin attenuated neutrophilic airway inflammation in a murine viral bronchiolitis model, demonstration of similar effects in human subjects might provide a strategy for the prevention of postbronchiolitis recurrent wheezing. ⋯ In this proof-of-concept study azithromycin treatment during RSV bronchiolitis reduced upper airway IL-8 levels, prolonged the time to the third wheezing episode, and reduced overall respiratory morbidity over the subsequent year.
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J. Allergy Clin. Immunol. · Mar 2015
Randomized Controlled TrialVitamin D reduces eosinophilic airway inflammation in nonatopic asthma.
Low levels of vitamin D are associated with asthma severity, airway remodeling, and exacerbation rate increase, especially in nonatopic asthma. Reduced steroid responsiveness or impaired antimicrobial defense might be underlying mechanisms. ⋯ Vitamin D supplementation reduced eosinophilic airway inflammation in patients with nonatopic asthma with severe eosinophilic airway inflammation, but did not affect sputum neutrophils. Also, a small effect on asthma control was observed. These findings suggest that vitamin D might have potential as an add-on treatment option in eosinophilic asthma.
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J. Allergy Clin. Immunol. · Feb 2015
Randomized Controlled TrialIL-1 receptor antagonist reduces endotoxin-induced airway inflammation in healthy volunteers.
Asthma with neutrophil predominance is challenging to treat with corticosteroids. Novel treatment options for asthma include those that target innate immune activity. Recent literature has indicated a significant role for IL-1β in both acute and chronic neutrophilic asthma. ⋯ Anakinra effectively reduced airway neutrophilic inflammation and resulted in no serious adverse events in a model of inhaled LPS challenge. Anakinra is a potential therapeutic candidate for treatment of asthma with neutrophil predominance in diseased populations.