Practice of oxygenation and respiratory support during fibreoptic bronchoscopy: the OxyFOB study protocol.

Introduction: Flexible bronchoscopy (FB) is widely used for diagnostic and therapeutic procedures in pulmonary medicine. However, FB can cause respiratory and haemodynamic complications, especially in patients with pre-existing lung and/or cardiovascular comorbidities. Despite the range of oxygenation and ventilatory approaches available to prevent these risks, evidence regarding their real-world application and clinical impact is limited.

Patient-derived 3D nasal spheroids reveal epithelial changes following Dupilumab therapy in CRSwNP: a preliminary report.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory disease associated with epithelial dysfunction and impaired mucosal barrier integrity. Dupilumab, an IL-4 receptor alpha antagonist, has shown clinical efficacy, but its cellular effects on nasal epithelium remain poorly understood. Advanced in vitro models such as 3D spheroid cultures may provide insight into epithelial organization under treatment.

Biologic Therapy in Severe Asthma: A Phenotype-Driven and Targeted Approach.

Asthma is a highly heterogeneous respiratory disease that, in its severe forms, is characterized by persistent symptoms, frequent exacerbations, and a significant impact on patients' quality of life. Despite high-dose inhaled corticosteroids and long-acting bronchodilators, a subset of patients remains uncontrolled, necessitating advanced therapeutic strategies. The advent of biologic therapies has revolutionized the management of severe asthma, offering targeted interventions based on the underlying inflammatory endotypes, primarily T2-high and T2-low.

Short-term therapeutic effectiveness of tezepelumab in patients with severe asthma: A real-world study.

Background: Tezepelumab is a fully human monoclonal antibody which specifically binds to thymic stromal lymphopoietin (TSLP), thus effectively inhibiting its pleiotropic pathogenic actions. Tezepelumab has been licensed for add-on biologic therapy of severe asthma, regardless of biomarker levels or phenotype expression.

Objective: The aim of this real-life, retrospective, single-centre investigation has been to evaluate the therapeutic efficacy of tezepelumab in different phenotypes of severe asthma.

Eosinophil-targeted treatment strategies for long-term outcomes in severe eosinophilic asthma.

Background: Airway eosinophilic inflammation is a key pathobiologic trait of severe asthma, a complex chronic disease which affects about 5-10% of asthmatic patients worldwide. Therefore, an in-depth knowledge of the immunopathologic mechanisms underlying severe eosinophilic asthma (SEA) is essential to understand the beneficial effects of currently available, eosinophil-targeted anti-asthma treatments, as well as to develop new therapeutic strategies.

Areas Covered: This narrative review article aims to provide a concise coverage of the pathophysiology of severe eosinophilic asthma, followed by an updated overview of current and newly emerging therapeutic approaches capable of counteracting airway eosinophilic inflammation.

Tissue microRNA dynamics in sinonasal inverted papilloma: implications for pathology and therapy.

Sinonasal inverted papilloma (SNIP) is a benign epithelial neoplasm of the Schneiderian membrane, known for its locally aggressive behavior, high recurrence rates, and potential for malignant transformation into sinonasal squamous cell carcinoma (SNSCC). Emerging evidence emphasizes the role of microRNAs (miRNAs) in the pathogenesis, progression, and clinical management of SNIP. These small non-coding RNAs regulate key cellular pathways, particularly the PTEN/PI3K/AKT axis, which governs tumor growth, apoptosis resistance, and chemoresistance.

Biologicals reduce drug burden and improve physical and mental health in severe eosinophilic asthma.

Objective: This real-world study evaluates the improvement in asthma control, drug burden reduction, and physical and mental health in patients with severe eosinophilic asthma treated with biologicals.

Methods: We enrolled 127 patients with severe eosinophilic asthma from two centers, treating them with add-on biological therapy. The asthma control test (ACT) and the Short-form Health Survey-12 (SF-12), including Physical Component Summary (PCS) and Mental Component Summary (MCS), were used, assessing drug history at baseline (T0) and after 32 weeks of biological therapy (T1).

Modulating nasal barrier function and tissue remodeling in inflammatory diseases: the role of ginseng and its bioactive compounds.

Ginseng, a well-known herbal supplement, is widely recognized for its pharmacological properties, including anti-inflammatory, antioxidant, and immune-modulatory effects. This review explores the potential therapeutic benefits of ginseng, particularly its active compounds, ginsenosides, in promoting nasal mucosa health. The nasal mucosa plays a crucial role in respiratory defense, acting as a barrier to pathogens and particulate matter, while also orchestrating immune responses.

Emerging biological treatments for asthma.

Introduction: Severe asthma is a chronic airway disease characterized by many pathomechanisms known as endotypes. Biological therapies targeting severe asthma endotypes have significantly improved the treatment of this disease, thus remarkably bettering patient quality of life.

Areas Covered: This review aims to describe current biological therapies for severe asthma, highlighting emerging ones.

Connections and Unmet Needs: Severe Asthma Biologics and Osteoporosis.

Asthma is a chronic inflammatory disease with the main anti-inflammatory drugs for better disease control being steroids or corticosteroids. The use of steroids in asthma patients, in particular in uncontrolled asthma patients, is associated with an increased risk of osteoporosis and fragility fractures. A single oral corticosteroid course increases the risk of osteoporosis and the continual use of inhaled corticosteroids is correlated over time to an increased risk for both bone conditions.

Pre-biologic FeNO might predict anti-IL-5/IL-5Rα response to treatment in severe asthmatics.

Objective: It remains unclear whether baseline FeNO levels can predict response to anti-IL5/5R biologic treatment in patients with severe asthma.

Methods: We recruited 104 patients with severe eosinophilic asthma treated with anti-IL5/anti-IL5R for at least one year who had measured FeNO values before the beginning of anti-eosinophilic treatment. Population was divided into subjects with FeNO < 25 and ≥25 ppb.

Real-World Evaluation of Dupilumab in the Long-Term Management of Eosinophilic Chronic Rhinosinusitis with Nasal Polyps: A Focus on IL-4 and IL-13 Receptor Blockade.

: Chronic rhinosinusitis (CRS) is a complex inflammatory condition of the nasal passages that severely impairs quality of life. Type 2 CRS is characterized by eosinophilic inflammation, driven by cytokines like IL-4, IL-5, and IL-13. These cytokines are key to CRS pathogenesis and contribute to a heavy disease burden, especially with comorbidities.

Effects of Continuous Positive Airway Pressure Treatment on Vascular Function in a Real-Life Cohort of Elderly Patients with Obstructive Sleep Apnoea Syndrome.

Background: Obstructive sleep apnoea syndrome (OSAS) is an independent risk factor for cardiovascular morbidity and mortality and has a detrimental effect on vascular function, in particular on arterial stiffness and endothelial function. Continuous positive airway pressure (CPAP) is the gold-standard therapy for OSAS and its effects on arterial stiffness and endothelial function have been demonstrated in non-elderly patients.

Objectives: The objective of this study was to evaluate the effect of one year of CPAP treatment on arterial stiffness, through assessment of carotid-femoral pulse wave velocity (cf-PWV), and on endothelial function, through the reactive hyperaemia index (RHi), in a real-life cohort of elderly patients with moderate-to-severe OSAS and several comorbidities.

Interleukin 33: a suitable target for biological therapies of COPD?

https://bit.ly/3USJCUP.

Long-Term Clinical and Sustained REMIssion in Severe Eosinophilic Asthma Treated With Mepolizumab: The REMI-M Study.

Background: Biological therapies, such as mepolizumab, have transformed the treatment of severe eosinophilic asthma. Although mepolizumab's short-term effectiveness is established, there is limited evidence on its ability to achieve long-term clinical remission.

Objective: To evaluate the long-term effectiveness and safety of mepolizumab, explore its potential to induce clinical and sustained remission, and identify baseline factors associated with the likelihood of achieving remission over 24 months.

Type 2 severe asthma: pathophysiology and treatment with biologics.

Introduction: The hallmark of most patients with severe asthma is type 2 inflammation, driven by innate and adaptive immune responses leading to either allergic or non-allergic eosinophilic infiltration of airways. The cellular and molecular pathways underlying severe type 2 asthma can be successfully targeted by specific monoclonal antibodies.

Areas Covered: This review article provides a concise overview of the pathophysiology of type 2 asthma, followed by an updated appraisal of the mechanisms of action and therapeutic efficacy of currently available biologic treatments used for management of severe type 2 asthma.

Long-term inhaled corticosteroid treatment in patients with chronic obstructive pulmonary disease, cardiovascular disease, and a recent hospitalised exacerbation: The ICSLIFE pragmatic, randomised controlled study.

Introduction: Patients with chronic obstructive pulmonary disease (COPD) frequently have cardiovascular comorbidities, increasing the risk of hospitalised COPD exacerbations (H-ECOPDs) or death. This pragmatic study examined the effects of adding an inhaled corticosteroid (ICS) to long-acting bronchodilator(s) (LABDs) in patients with COPD and cardiac comorbidities who had a recent H-ECOPD.

Methods: Patients >60 years of age with COPD and ≥1 cardiac comorbidity, within 6 months after discharge following an H-ECOPD, were randomised to receive LABD(s) with or without ICS, and were followed for 1 year.

Sustained remission induced by 2 years of treatment with benralizumab in patients with severe eosinophilic asthma and nasal polyposis.

Background And Objective: Several randomized controlled trials (RCTs) have shown that benralizumab is characterized by a good profile of efficacy and safety, thereby being potentially able to elicit clinical remission on-treatment of severe eosinophilic asthma (SEA). The main goal of this multicentre observational study was to verify the effectiveness of benralizumab in inducing a sustained remission on-treatment of SEA in patients with or without comorbid chronic rhinosinusitis with nasal polyps (CRSwNP).

Methods: Throughout 2 years of treatment with benralizumab, a four-component evaluation of sustained remission of SEA was performed, including the assessment of SEA exacerbations, use of oral corticosteroids (OCSs), symptom control and lung function.

Effect of SGLT2-Inhibitors on Polygraphic Parameters in Elderly Patients Affected by Heart Failure, Type 2 Diabetes Mellitus, and Sleep Apnea.

Obstructive sleep apneas (OSAs) and central sleep apneas (CSAs) are the most common comorbidities in Heart Failure (HF) that are strongly associated with all-cause mortality. Several therapeutic approaches have been used to treat CSA and OSA, but none have been shown to significantly improve HF prognosis. Our study evaluated the effects of a 3-months treatment with sodium-glucose cotransporter type 2 inhibitor (SGLT2i) on polygraphic parameters in patients with sleep apnea (SA) and HF, across the spectrum of ejection fraction, not treated with continuous positive air pressure (CPAP).

Clinical remission in severe asthma: lights and shadows on an ambitious goal.

Purpose Of Review: The aim of this study was Describe the latest evidence related to the concept of clinical remission in patients with severe asthma, focusing on the lights and shadows of this concept.

Recent Findings: The idea of clinical remission in severe asthma patients brings about a significant shift in the way asthma is treated and managed. Although there has yet to be unanimous agreement among various scientific societies on the precise definition, this concept can be extremely useful in advancing the treatment of the disease.

Assessment of cephalometric parameters and correlation with the severity of the obstructive sleep apnea syndrome.

Background: In individuals diagnosed with obstructive sleep apnea syndrome (OSAS), variations in craniofacial structure have been inconsistently documented, showing differing degrees of alteration between obese and nonobese patients. In addition, sleep disturbance has also been shown to induce disequilibrium in this population of patients. This pilot observational study aimed to assess craniofacial values in obese and nonobese subpopulations of patients with OSAS and their correlation and association with the severity of OSAS.