The Experts below are selected from a list of 1506 Experts worldwide ranked by ideXlab platform

Alberto Papi - One of the best experts on this subject based on the ideXlab platform.

  • Treatment strategies in Mild Asthma.
    Current opinion in pulmonary medicine, 2009
    Co-Authors: Alberto Papi
    Abstract:

    More than 10 years ago the category of Mild Asthma was split into Mild Intermittent and Mild persistent Asthma and maintenance therapy with low dose inhaled corticosteroids (ICS) was recommended for Mild persistent Asthma. The threshold for instituting regular ICS therapy was arbitrarily chosen, in the absence of clinical studies specifically addressing this issue. The results of recent trials have questioned the assumption that all patients at the Mild end of the Asthma severity spectrum should be committed to regular anti-inflammatory treatment with inhaled corticosteroids. As a consequence, the identification of the relevant outcomes for the treatment of Mild persistent Asthma has become a matter of discussion, which has provided the rationale to test the efficacy and well tolerance of new strategies, other than guidelines-recommended regular low-dose ICS, for the treatment of Mild persistent Asthma. Several approaches have been evaluated with some promising results, to include the combination of ICS and long-acting b2-agonists, oral leukotriene antagonists, and the Intermittent or as-needed use of ICS in the absence of regular treatment. Conversely, little effort has been made to evaluate therapeutic options other than as-needed bronchodilation in Mild Intermittent Asthma.

  • Treatment strategies in Mild Asthma.
    Current opinion in pulmonary medicine, 2009
    Co-Authors: Alberto Papi
    Abstract:

    PURPOSE OF THE REVIEW More than 10 years ago the category of Mild Asthma was split into Mild Intermittent and Mild persistent Asthma and maintenance therapy with low dose inhaled corticosteroids (ICS) was recommended for Mild persistent Asthma. The threshold for instituting regular ICS therapy was arbitrarily chosen, in the absence of clinical studies specifically addressing this issue. RECENT FINDINGS The results of recent trials have questioned the assumption that all patients at the Mild end of the Asthma severity spectrum should be committed to regular anti-inflammatory treatment with inhaled corticosteroids. As a consequence, the identification of the relevant outcomes for the treatment of Mild persistent Asthma has become a matter of discussion, which has provided the rationale to test the efficacy and well tolerance of new strategies, other than guidelines-recommended regular low-dose ICS, for the treatment of Mild persistent Asthma. SUMMARY Several approaches have been evaluated with some promising results, to include the combination of ICS and long-acting b2-agonists, oral leukotriene antagonists, and the Intermittent or as-needed use of ICS in the absence of regular treatment. Conversely, little effort has been made to evaluate therapeutic options other than as-needed bronchodilation in Mild Intermittent Asthma.

Giovanni A. Rossi - One of the best experts on this subject based on the ideXlab platform.

  • Total and allergen‐specific IgE levels in serum reflect blood eosinophilia and fractional exhaled nitric oxide concentrations but not pulmonary functions in allergic Asthmatic children sensitized to house dust mites
    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2003
    Co-Authors: Oliviero Sacco, Michela Silvestri, Federica Sabatini, Maurizio G. Biraghi, Rosa Sale, Laura D. Serpero, Maria E. Raynal, Giovanni A. Rossi
    Abstract:

    Although elevated levels of serum immunoglobulin E (IgE) are considered the hallmark of atopic diseases, their clinical value in evaluating subjects with allergic disorders is under debate. To evaluate possible relationships between serum IgE levels and a variety of clinical parameters, 83 Mild Asthmatic children [10.98-year-old (2.95)], sensitized to house dust mites (HDM) Dermatophagoides pteronyssinus (Dp) or D. farinae (Df), were enrolled. As compared with normal control reference values detected in our laboratory, children with allergic Asthma had higher blood eosinophil counts (expressed both as percentage and as absolute number) and higher fractional exhaled nitric oxide (FeNO) levels but similar values in pulmonary function parameters. In the allergic Asthmatic population, serum levels of total, Dp-specific or Df-specific IgE correlated positively with eosinophil counts (Rho > or = 0.30, p or = 0.33, p 0.1, each correlation). Finally, significant correlations, although moderate, were found in the allergic Asthmatic population between eosinophil counts and FeNO levels (Rho > or = 0.42, p < 0.001, each correlation). Thus, in atopic children sensitized to HDM with Mild Intermittent Asthma, IgE levels in blood appear to reflect systemic (blood eosinophils) and organ-specific (FeNO) markers of allergic inflammation but not pulmonary volumes or the degree of airflow limitation.

  • Steroid-naive adolescents with Mild Intermittent allergic Asthma have airway hyperresponsiveness and elevated exhaled nitric oxide levels.
    The Journal of asthma : official journal of the Association for the Care of Asthma, 2003
    Co-Authors: Daniela Spallarossa, Michela Silvestri, Elena Battistini, Federica Sabatini, L. Fregonese, Giancarlo Brazzola, Giovanni A. Rossi
    Abstract:

    Although atopic Asthma symptoms often seem to disappear around puberty, subjects in this age group may experience unexpected, often severe, Asthma attacks. This may be related to persistence of untreated airway hyperresponsiveness/inflammation in a life period characterized by low perceptiveness of disease-related symptoms. This study was designed to evaluate the prevalence and the severity of bronchial hyperreactivity and the exhaled nitric oxide (FENO) levels in a group of steroid-naive Asthmatic adolescents. Fifty-two patients with Mild-Intermittent Asthma were studied, ages 12 to 16, sensitized to house dust mites; 22 age-matched controls, were also studied. Asthma patients showed FEV1, FEF25–75%, and FVC values not significantly different from controls, (p>0.05, each comparison). By contrast, although none of the control subjects showed bronchial hyperreactivity, increased airway responsiveness to methacholine (MCh) was demonstrated in the majority of the patients and found to be severe in 36.5% (MCh...

  • Time-dependent changes in orally exhaled nitric oxide and pulmonary functions induced by inhaled corticosteroids in childhood Asthma.
    The Journal of asthma : official journal of the Association for the Care of Asthma, 2001
    Co-Authors: Daniela Spallarossa, Michela Silvestri, Elena Battistini, Federica Sabatini, Maurizio G. Biraghi, Giovanni A. Rossi
    Abstract:

    Exhaled nitric oxide levels are elevated in Asthmatic children and decrease after inhaled steroid treatment. We evaluated the time-dependent changes in fractional exhaled nitric oxide concentration (FENO) and pulmonary function parameters following inhaled steroid therapy. Thirty-nine steroid-naive atopic patients (age 11.92 ± 0.48 years) with Mild Intermittent Asthma and 22 age-matched healthy controls were enrolled in the study; pulmonary functions and FENO levels were measured. Low doses of inhaled steroids were prescribed to all Asthmatic patients who were reevaluated in a second visit (between 10 and 40 days after the beginning of the treatment). At the enrolment, Asthmatic patients had similar forced expiratory volume in 1 sec (FEV1) and forced vital capacity (FVC) values (p > 0.05) but reduced forced expiratory flows at 25–75% of the vital capacity (FEF25–75%) values, as compared to controls (p < 0.05). In addition, FENO levels were significantly higher in Asthmatics with respect to control subject...

  • dissociation between exhaled nitric oxide and hyperresponsiveness in children with Mild Intermittent Asthma
    Thorax, 2000
    Co-Authors: Michela Silvestri, Daniela Spallarossa, Elena Battistini, Vito Brusasco, Giovanni A. Rossi
    Abstract:

    Background—Bronchial hyperresponsiveness and airway inflammation are distinctive features of Asthma. Evaluation of nitric oxide (NO) levels in expired air have been proposed as a reliable method for assessing the airway inflammatory events in Asthmatic subjects. A study was undertaken to evaluate whether airway hyperresponsiveness is related to levels of exhaled NO. Methods—Thirty two steroid-naive atopic children with Mild Intermittent Asthma of mean (SD) age 11.8 (2.3) years and 28 age matched healthy controls were studied to investigate whether baseline lung function or airway hyperresponsiveness is related to levels of exhaled NO. Airway responsiveness was assessed as the dose of methacholine causing a 20% decrease in forced expiratory volume in one second (FEV1) from control (PD20 methacholine) and exhaled NO levels were measured by chemiluminescence analysis of exhaled air. Results—At baseline Asthmatic children had significantly higher NO levels than controls (mean diVerence 25.87 ppb (95% CI 18.91 to 32.83); p<0.0001) but there were no significant diVerences in lung function parameters (forced vital capacity (FVC), FEV1 (% pred), and forced expiratory flows at 25‐75% of vital capacity (FEF25‐75%)). In the Asthmatic group exhaled NO levels were not significantly correlated with baseline lung function values or PD20 methacholine. Conclusions—These results suggest that levels of exhaled NO are not accurate predictors of the degree of airway responsiveness to inhaled methacholine in children with Mild Intermittent Asthma. (Thorax 2000;55:484‐488)

  • Dissociation between exhaled nitric oxide and hyperresponsiveness in children with Mild Intermittent Asthma
    Thorax, 2000
    Co-Authors: Michela Silvestri, Daniela Spallarossa, Elena Battistini, Vito Brusasco, Giovanni A. Rossi
    Abstract:

    Background—Bronchial hyperresponsiveness and airway inflammation are distinctive features of Asthma. Evaluation of nitric oxide (NO) levels in expired air have been proposed as a reliable method for assessing the airway inflammatory events in Asthmatic subjects. A study was undertaken to evaluate whether airway hyperresponsiveness is related to levels of exhaled NO. Methods—Thirty two steroid-naive atopic children with Mild Intermittent Asthma of mean (SD) age 11.8 (2.3) years and 28 age matched healthy controls were studied to investigate whether baseline lung function or airway hyperresponsiveness is related to levels of exhaled NO. Airway responsiveness was assessed as the dose of methacholine causing a 20% decrease in forced expiratory volume in one second (FEV1) from control (PD20 methacholine) and exhaled NO levels were measured by chemiluminescence analysis of exhaled air. Results—At baseline Asthmatic children had significantly higher NO levels than controls (mean diVerence 25.87 ppb (95% CI 18.91 to 32.83); p

Christian J. Herold - One of the best experts on this subject based on the ideXlab platform.

  • Bronchial reactivity in hyperresponsive patients and healthy individuals: demonstration with high resolution computed tomography.
    European journal of radiology, 2004
    Co-Authors: G. Schueller, K. Neumann, Thomas H. Helbich, H. Riemer, Werner Backfrieder, K. Sertl, Christian J. Herold
    Abstract:

    Abstract Objective: High resolution computed tomography (HRCT) was used to assess the extent of bronchial reactivity after inhalative bronchoprovocation and dilation in hyperresponsive patients and healthy subjects. Patients and methods: Patients with Mild Intermittent Asthma, 15 with a >20% decrease in FEV1 and a >10 mmHg (PC20+) in PaO2, 12 with a 10 mmHg (PC20−) in PaO2 after provocation, and eight healthy humans were included in the study. Changes in cross-sectional area in a total of 1256 bronchi and in bronchial wall area (792 bronchi) were evaluated after histamine-triggered bronchoprovocation and salbutamol-induced bronchodilation at high lung volumes (FVC 80%). Data were compared with the results of pulmonary function tests (FEV1, PaO2, PaCO2). Results: In all groups, a significant decrease in bronchial cross-sectional area (P 10 mmHg between baseline and provocation were observed. In healthy persons, the PaO2 decrease was 0.05). After histamine provocation, the decrease in FEV1 was measured in the PC20+ group, whereas a

Michela Silvestri - One of the best experts on this subject based on the ideXlab platform.

  • Total and allergen‐specific IgE levels in serum reflect blood eosinophilia and fractional exhaled nitric oxide concentrations but not pulmonary functions in allergic Asthmatic children sensitized to house dust mites
    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2003
    Co-Authors: Oliviero Sacco, Michela Silvestri, Federica Sabatini, Maurizio G. Biraghi, Rosa Sale, Laura D. Serpero, Maria E. Raynal, Giovanni A. Rossi
    Abstract:

    Although elevated levels of serum immunoglobulin E (IgE) are considered the hallmark of atopic diseases, their clinical value in evaluating subjects with allergic disorders is under debate. To evaluate possible relationships between serum IgE levels and a variety of clinical parameters, 83 Mild Asthmatic children [10.98-year-old (2.95)], sensitized to house dust mites (HDM) Dermatophagoides pteronyssinus (Dp) or D. farinae (Df), were enrolled. As compared with normal control reference values detected in our laboratory, children with allergic Asthma had higher blood eosinophil counts (expressed both as percentage and as absolute number) and higher fractional exhaled nitric oxide (FeNO) levels but similar values in pulmonary function parameters. In the allergic Asthmatic population, serum levels of total, Dp-specific or Df-specific IgE correlated positively with eosinophil counts (Rho > or = 0.30, p or = 0.33, p 0.1, each correlation). Finally, significant correlations, although moderate, were found in the allergic Asthmatic population between eosinophil counts and FeNO levels (Rho > or = 0.42, p < 0.001, each correlation). Thus, in atopic children sensitized to HDM with Mild Intermittent Asthma, IgE levels in blood appear to reflect systemic (blood eosinophils) and organ-specific (FeNO) markers of allergic inflammation but not pulmonary volumes or the degree of airflow limitation.

  • Steroid-naive adolescents with Mild Intermittent allergic Asthma have airway hyperresponsiveness and elevated exhaled nitric oxide levels.
    The Journal of asthma : official journal of the Association for the Care of Asthma, 2003
    Co-Authors: Daniela Spallarossa, Michela Silvestri, Elena Battistini, Federica Sabatini, L. Fregonese, Giancarlo Brazzola, Giovanni A. Rossi
    Abstract:

    Although atopic Asthma symptoms often seem to disappear around puberty, subjects in this age group may experience unexpected, often severe, Asthma attacks. This may be related to persistence of untreated airway hyperresponsiveness/inflammation in a life period characterized by low perceptiveness of disease-related symptoms. This study was designed to evaluate the prevalence and the severity of bronchial hyperreactivity and the exhaled nitric oxide (FENO) levels in a group of steroid-naive Asthmatic adolescents. Fifty-two patients with Mild-Intermittent Asthma were studied, ages 12 to 16, sensitized to house dust mites; 22 age-matched controls, were also studied. Asthma patients showed FEV1, FEF25–75%, and FVC values not significantly different from controls, (p>0.05, each comparison). By contrast, although none of the control subjects showed bronchial hyperreactivity, increased airway responsiveness to methacholine (MCh) was demonstrated in the majority of the patients and found to be severe in 36.5% (MCh...

  • Time-dependent changes in orally exhaled nitric oxide and pulmonary functions induced by inhaled corticosteroids in childhood Asthma.
    The Journal of asthma : official journal of the Association for the Care of Asthma, 2001
    Co-Authors: Daniela Spallarossa, Michela Silvestri, Elena Battistini, Federica Sabatini, Maurizio G. Biraghi, Giovanni A. Rossi
    Abstract:

    Exhaled nitric oxide levels are elevated in Asthmatic children and decrease after inhaled steroid treatment. We evaluated the time-dependent changes in fractional exhaled nitric oxide concentration (FENO) and pulmonary function parameters following inhaled steroid therapy. Thirty-nine steroid-naive atopic patients (age 11.92 ± 0.48 years) with Mild Intermittent Asthma and 22 age-matched healthy controls were enrolled in the study; pulmonary functions and FENO levels were measured. Low doses of inhaled steroids were prescribed to all Asthmatic patients who were reevaluated in a second visit (between 10 and 40 days after the beginning of the treatment). At the enrolment, Asthmatic patients had similar forced expiratory volume in 1 sec (FEV1) and forced vital capacity (FVC) values (p > 0.05) but reduced forced expiratory flows at 25–75% of the vital capacity (FEF25–75%) values, as compared to controls (p < 0.05). In addition, FENO levels were significantly higher in Asthmatics with respect to control subject...

  • dissociation between exhaled nitric oxide and hyperresponsiveness in children with Mild Intermittent Asthma
    Thorax, 2000
    Co-Authors: Michela Silvestri, Daniela Spallarossa, Elena Battistini, Vito Brusasco, Giovanni A. Rossi
    Abstract:

    Background—Bronchial hyperresponsiveness and airway inflammation are distinctive features of Asthma. Evaluation of nitric oxide (NO) levels in expired air have been proposed as a reliable method for assessing the airway inflammatory events in Asthmatic subjects. A study was undertaken to evaluate whether airway hyperresponsiveness is related to levels of exhaled NO. Methods—Thirty two steroid-naive atopic children with Mild Intermittent Asthma of mean (SD) age 11.8 (2.3) years and 28 age matched healthy controls were studied to investigate whether baseline lung function or airway hyperresponsiveness is related to levels of exhaled NO. Airway responsiveness was assessed as the dose of methacholine causing a 20% decrease in forced expiratory volume in one second (FEV1) from control (PD20 methacholine) and exhaled NO levels were measured by chemiluminescence analysis of exhaled air. Results—At baseline Asthmatic children had significantly higher NO levels than controls (mean diVerence 25.87 ppb (95% CI 18.91 to 32.83); p<0.0001) but there were no significant diVerences in lung function parameters (forced vital capacity (FVC), FEV1 (% pred), and forced expiratory flows at 25‐75% of vital capacity (FEF25‐75%)). In the Asthmatic group exhaled NO levels were not significantly correlated with baseline lung function values or PD20 methacholine. Conclusions—These results suggest that levels of exhaled NO are not accurate predictors of the degree of airway responsiveness to inhaled methacholine in children with Mild Intermittent Asthma. (Thorax 2000;55:484‐488)

  • Dissociation between exhaled nitric oxide and hyperresponsiveness in children with Mild Intermittent Asthma
    Thorax, 2000
    Co-Authors: Michela Silvestri, Daniela Spallarossa, Elena Battistini, Vito Brusasco, Giovanni A. Rossi
    Abstract:

    Background—Bronchial hyperresponsiveness and airway inflammation are distinctive features of Asthma. Evaluation of nitric oxide (NO) levels in expired air have been proposed as a reliable method for assessing the airway inflammatory events in Asthmatic subjects. A study was undertaken to evaluate whether airway hyperresponsiveness is related to levels of exhaled NO. Methods—Thirty two steroid-naive atopic children with Mild Intermittent Asthma of mean (SD) age 11.8 (2.3) years and 28 age matched healthy controls were studied to investigate whether baseline lung function or airway hyperresponsiveness is related to levels of exhaled NO. Airway responsiveness was assessed as the dose of methacholine causing a 20% decrease in forced expiratory volume in one second (FEV1) from control (PD20 methacholine) and exhaled NO levels were measured by chemiluminescence analysis of exhaled air. Results—At baseline Asthmatic children had significantly higher NO levels than controls (mean diVerence 25.87 ppb (95% CI 18.91 to 32.83); p

Wilmore C. Webley - One of the best experts on this subject based on the ideXlab platform.

  • Chlamydia pneumoniae-Specific IgE Is Prevalent in Asthma and Is Associated with Disease Severity
    PloS one, 2012
    Co-Authors: David L. Hahn, Allison Schure, Katir K. Patel, Tawanna S. Childs, Eduard Drizik, Wilmore C. Webley
    Abstract:

    Results: Of 66 Asthma subjects (mean age 40.9 years, range 5–75, 59% male, 45% ever-smokers) 33 (50%) were Cp IgE positive and 16 (24%) were Cp DNA positive (P=0.001 for association of Cp IgE and DNA). Cp IgE was detected in 21% of Mild Intermittent Asthma v 79% of severe persistent Asthma (test for trend over severity categories, P=0.002). Cp IgE detection was significantly (P=0.001) associated with Asthma when compared to healthy blood donor controls but not when compared to clinic controls. Conclusions: Half of this sample of community Asthma patients had detectable IgE against C. pneumoniae. Cp IgE was strongly and positively associated with Asthma severity and with Asthma when healthy blood donor controls were used. These results support the inclusion of Cp IgE as a biomarker in future studies of infectious contributions to Asthma pathogenesis.