Asthma-OSA Overlap Syndrome: A Distinct Endophenotype?

Purpose: Asthma and obstructive sleep apnea (OSA) are two respiratory diseases that often may coexist, resulting in Alternative Overlap Syndrome (aOVS), which is still underestimated and underdiagnosed.

Objectives: This state-of-art review aims to describe the current evidence on aOVS, including its pathophysiology, clinical, functional and therapeutic implications. A secondary objective is to assess whether aOVS can be identified as a distinct endophenotype needing personalized diagnostic and therapeutic strategies.

Impact of Sex on Lung Function in Adult Langerhans Cell Histiocytosis.

Background: Langerhans Cell Histiocytosis (LCH) is a rare histiocytic hematological disorder that frequently involves the lungs. Due to a lack of data about sex-related differences in LCH, the aim of this study is to evaluate sex-related differences in pulmonary function in a cohort of patients with LCH.

Methods: We retrospectively analyzed data from 79 adult patients diagnosed with LCH.

Real-World Use of MART in Moderate-Severe Asthma: Results from the Italian WAMP Survey among Healthcare Professionals and Patients.

Introduction: Moderate-severe asthma affects a significant proportion of patients and poses challenges in symptom control and exacerbation prevention. The preferred track 1 endorsed by the Global Initiative for Asthma (GINA) recommendations offers a single-inhaler approach combining inhaled corticosteroids and formoterol for both maintenance and symptom relief (maintenance and reliever therapy; MART). However, MART's real-world adoption remains suboptimal and concerns regarding its correct implementation persist.

Daily digital biomarkers in the follow-up and clustering of patients with asthma.

Background And Research Question: We aimed to assess whether levels of digital biomarkers can reflect monthly patterns of asthma control.

Study Design And Methods: We performed a longitudinal study on patients with asthma and comorbid rhinitis who filled ≥26 days of data in a month in the MASK-air® app and who reported at least 1 day of treatment with an inhaled corticosteroid with or without a long-acting β-agonist (ICS ± LABA). We applied k-means cluster analysis to define clusters of months according to daily asthma control and medication use.

Profile of mild/moderate asthma patients: Baseline data from the MANI cohort.

Although 90% of asthmatic patients suffer from mild and moderate disease, little is known about the burden on health status and quality of life, the long-term trajectory of disease severity, and the socio-economic impact. The Mild Moderated Asthma Network of Italy (MANI) is a real-world, cross-sectional, prospective, observational cohort study designed to explore these issues. Here we aimed to provide an identikit of asthmatic patients receiving treatment according to GINA steps 1-4, and enrolled in the centers of excellence participating in the MANI.

Association of Pulmonary Septic Embolism and Pulmonary Arterial Thromboembolism in Lemierre Syndrome: A Case Report and Literature Review.

Lemierre syndrome (LS) is a rapidly progressing disease characterised by a recent oropharyngeal infection, complicated by septic emboli and thrombophlebitis of the internal jugular vein (IJV). We describe a case of a 65-year-old woman who presented to the emergency room with a 14-day history of progressive occipital headache, fever and odynophagia. Radiological investigations showed bilateral IJV thrombophlebitis, multiple cavitated pulmonary nodules suggestive of septic emboli and a subsegmental pulmonary arterial thromboembolism.

Bilateral Spontaneous Hemothorax: A Rare Case of Primary Pleural Angiosarcoma and Literature Review.

Angiosarcomas, rare soft tissue malignancies originating from endothelial cells, represent only 1-2% of all soft tissue sarcomas. Primary pleural angiosarcoma (PPA) is exceptionally rare, with only 43 reported cases since 1943. There are many diagnostic and therapeutic challenges due to the rarity of these tumors.

Small Airways Disease as a Novel Target for Mepolizumab in Asthma-The SASAM Prospective Real-Life Study.

Mepolizumab represents an effective strategy for severe eosinophilic asthma. Small airways disease (SAD) defines a peculiar asthma phenotype related to worse disease control. Limited and indirect findings are currently available on the effect of mepolizumab on SAD.

Exercise Recommendations and Practical Considerations for Asthma Management-An EAACI Position Paper.

Exercise is an important treatment for people with asthma and should be considered alongside pharmacological therapy when developing personalised asthma management plans. Despite this, there remains limited guidance concerning the practicalities of asthma-specific exercise prescription. This European Academy of Allergy and Clinical Immunology task force was therefore established to achieve three fundamental aims: first, to provide an up-to-date perspective concerning the role of exercise for asthma management (i.

Immunity, Inflammation and Airway Dysfunction in Elite Cross-Country Skiers and Ice Hockey Players: A Systematic Review.

Strenuous exercise in elite sports impacts the immune system, leading to high rates of upper respiratory tract infections and airway dysfunction, such as asthma and exercise-induced bronchoconstriction (EIB). Cross-country (XC) skiers and ice hockey (IH) players are particularly affected due to their training environments and sports disciplines. This systematic review (SR) evaluates immune and inflammatory responses and the risk of developing airway dysfunction in these athletes.

Asthma in the Biologics Era: Should Oral Corticosteroid Therapy Be Relegated to History?

Oral corticosteroids (OCS) have been used for both maintenance and burst treatment of asthma since the 1950s owing to their beneficial effect on symptoms and exacerbations coupled with a historical lack of alternative therapies. Despite the current availability of well-tolerated and effective treatment with biologics, chronic OCS use remains high. This is of great concern because evidence suggests that a lifetime cumulative exposure even as low as 0.

The role of Fraction Exhaled Nitric Oxide (FeNO) in asthma management: an Italian consensus statement on clinical and economic aspects.

Background: Chronic respiratory diseases cause significant global morbidity and mortality, with asthma being a major contributor. Globally, 461,000 asthma-related deaths and a prevalence of 262 million subjects were estimated in 2019. The objective of this paper is to summarize experts' opinions in the field of asthma to produce evidence on the clinical and economic impact of FeNO test in asthma management, as well as on its standard operational procedures.

ERS Congress 2024: highlights from the Airway Diseases Assembly.

https://bit.ly/4070nNw.

Development and Validation of a Screening Equation for Obstructive Sleep Apnea.

The high prevalence of obstructive sleep apnea (OSA), about 30% of people worldwide over 30 years old, underscores the crucial need for early screening. This study aimed to identify key predictive factors for OSA; use these factors to develop a screening equation for a population at high risk for OSA; and prospectively validate this equation's application. The study included two phases: a retrospective phase examining anthropometric data, the Epworth sleepiness scale (ESS), and the home sleep apnea test (HSAT) from 200 patients referred to the Respiratory Sleep Disorder Center at Policlinico Umberto I, Rome, Italy (January 2020-January 2023) to create a predictive equation for OSA using multivariate analysis (with the most predictive data according to scientific literature).

Proposal of a New Composite Score (DAMADECO) to Simultaneously Evaluate Asthma and CRSwNP Severity in Comorbid Patients.

: Asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) are chronic respiratory conditions that frequently coexist. However, an integrated assessment tool for both conditions is currently lacking. This study aimed to develop and preliminarily evaluate a composite score capable of simultaneously assessing asthma and CRSwNP in comorbid patients.

The Effect of Inhaled Beta-2 Agonists on Heart Rate in Patients With Asthma: Sensor-Based Observational Study.

Background: Beta-2 agonists play an important role in the management of asthma. Inhaled long-acting beta-2 agonists (LABAs) and short-acting beta-2 agonists (SABAs) cause bronchodilation by stimulating adrenoceptors. These receptors are also present in cardiac cells and, as a side effect, could also be stimulated by inhaled beta-2 agonists.

Sinonasal Outcomes Obtained after 2 Years of Treatment with Benralizumab in Patients with Severe Eosinophilic Asthma and CRSwNP: A "Real-Life" Observational Study.

Background/objectives: Benralizumab is a monoclonal antibody that targets the interleukin-5 receptor (IL-5Rα), leading to the rapid depletion of blood eosinophils. RCTs have demonstrated efficacy in patients with severe eosinophilic asthma (SEA). The aim of this study was to assess the efficacy of benralizumab on sinonasal outcomes in a real-life setting in patients with SEA and concomitant chronic rhinosinusitis with nasal polyps (CRSwNP).

Asthma remission one, none and one-hundred thousand: the relevance of the patient's view.

Objective: Achieving remission in severe asthma holds paramount importance in elevating patient quality of life and reducing both individual and societal burdens associated with this chronic condition. This study centers on identifying pivotal patient-relevant endpoints through standardized, reproducible methods, while also developing a patient-centric definition of remission, essential for effective disease management.

Methods: A discrete choice experiment (DCE) was conducted to assess patients' perceptions on the four primary criteria for defining severe asthma remission, as outlined by the SANI survey.

Ventilatory efficiency in long-term dyspnoeic patients following COVID-19 pneumonia.

Background: Long COVID is defined as persistency of symptoms, such as exertional dyspnea, twelve weeks after recovery from SARS-CoV-2 infection.

Objectives: To investigate ventilatory efficiency by the use of cardiopulmonary exercise testing (CPET) in patients with exertional dyspnea despite normal basal spirometry after 18 (T) and 36 months (T) from COVID-19 pneumonia.

Methods: One hundred patients with moderate-critical COVID-19 were prospectively enrolled in our Long COVID program.

Relevance of individual bronchial symptoms for asthma diagnosis and control in patients with rhinitis: A MASK-air study.

Rationale: It is unclear how each individual asthma symptom is associated with asthma diagnosis or control.

Objectives: To assess the performance of individual asthma symptoms in the identification of patients with asthma and their association with asthma control.

Methods: In this cross-sectional study, we assessed real-world data using the MASK-air app.

Recommendations for asthma monitoring in children: A PeARL document endorsed by APAPARI, EAACI, INTERASMA, REG, and WAO.

Monitoring is a major component of asthma management in children. Regular monitoring allows for diagnosis confirmation, treatment optimization, and natural history review. Numerous factors that may affect disease activity and patient well-being need to be monitored: response and adherence to treatment, disease control, disease progression, comorbidities, quality of life, medication side-effects, allergen and irritant exposures, diet and more.