The Role of Endobronchial Biopsies in Evaluating Biologic Therapy Response in Severe Asthma.

Severe asthma imposes a significant burden on public health worldwide, mainly due to its morbidity and high cost. The management of severe asthma has dramatically changed in the past few years with the introduction of biologics. Zero exacerbations, zero systemic corticosteroids, better asthma control, and better lung function are the outcomes that the era of biologics has made attainable in a large proportion of severe asthmatics, ending up in a better quality of life.

Ocular manifestations in COPD patients. An underrecognized comorbidity.

Chronic obstructive pulmonary disease (COPD) is characterized by the presence of comorbidities, such as cardiovascular diseases, that significantly impact symptoms, quality of life and prognosis. Indeed, it is shown that patients with COPD may present with diseases of aging, earlier in life, including eye disorders, such as macular degeneration and cataract. Although underrecognized, cumulative evidence over the last years suggests that COPD is associated with ocular abnormalities, mainly in the posterior segment of the eye, affecting both the microvascular network of the retina and the optic nerve, while structural abnormalities of the choroid and cornea have also been described.

Mepolizumab for severe eosinophilic asthma.

Introduction: Severe eosinophilic asthma is a distinct asthma phenotype that is characterized by elevated blood eosinophils, frequent exacerbations and dependence on treatment with systemic corticosteroids. The development of Mepolizumab, a monoclonal antibody that targets Interleukin 5, has significantly transformed the therapeutic approach of patients with severe eosinophilic asthma.

Areas Covered: This review explores the clinical development, efficacy, effectiveness and safety profile of mepolizumab.

Mepolizumab Effectiveness in Severe Asthma With/Without Chronic Rhinosinusitis With Nasal Polyps: Real-World Pooled Analysis.

Background: Severe asthma with an eosinophilic phenotype (SAEP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are predominantly type 2-driven diseases, characterised by eosinophilic inflammation and substantial disease burden. Mepolizumab, a humanised monoclonal antibody that targets interleukin-5, a key cytokine in type 2 inflammation, is an effective, approved treatment both in SAEP and CRSwNP. We aimed to analyse real-world evidence of mepolizumab effectiveness in patients with comorbid SAEP and CRSwNP.

Biomarker profile and disease burden associated with intermittent and long-term oral corticosteroid use in patients with severe asthma prior to biologic initiation in real-life (STAR).

Background: Asthma characterization using blood eosinophil count (BEC) (among other biomarkers and clinical indices) is recommended in severe asthma (SA), but the masking effect of oral corticosteroids (OCS), makes this challenging.

Aim: Our aim was to explore the effect of OCS use (both intermittent [iOCS] and long-term [LTOCS]) prior to biologic initiation on SA phenotype and biomarker profile in real-life and to characterize the burden of SA among patients prescribed LTOCS by biomarker profile.

Methods: This was a registry-based cohort study, including data from 23 countries collected between 2003 and 2023 and shared with the Internatonal Severe Asthma Registry (ISAR).

The Risk Factors for Post-Bronchoscopy Respiratory Infection in Lung Cancer Patients-A Retrospective Case-Control Study from a Center in Greece.

Flexible bronchoscopy and its new methods have revolutionized the era of the diagnosis, staging, and restaging of lung cancer. A rare late complication is post-bronchoscopy respiratory infection, but it is critical due to treatment delays, treatment cancellation, and death. The aim of this study is to identify risk factors for respiratory tract infection after bronchoscopy in patients with lung cancer.

Monoclonal Antibodies for the Treatment of Chronic Obstructive Pulmonary Disease.

Chronic obstructive pulmonary disease (COPD) is a common and complex disease characterized by persistent airflow limitation and the presence of exacerbations, resulting in significant morbidity and mortality. Although the pathogenesis of COPD is multifactorial, airway inflammation plays a significant role in disease progression. Despite the advantages of non-pharmaceutical and pharmaceutical interventions that have significantly improved the symptom burden and exacerbation frequency in COPD, there is a lack of disease-modifying therapies that target the underlying disease mechanisms.

A Delphi Consensus Project to Capture Greek Experts' Opinion on the Position of Triple Therapies in COPD: Why, When and to Whom.

Background: In recent years, COPD treatment has become more personalized considering specific patient's characteristics.

Aim And Methods: We have performed a DELPHI consensus project to assess the level of consensus among Greek experts on the use of triple therapy in COPD as an initial and follow-up treatment. A three-round Delphi online survey was developed.

T2-low severe asthma clinical spectrum and impact: The Greek PHOLLOW cross-sectional study.

Background: Data on type 2 (T2)-low severe asthma (SA) frequency is scarce, resulting in an undefined unmet therapeutic need in this patient population. Our objective was to assess the frequency and characterize the profile and burden of T2-low SA in Greece.

Methods: PHOLLOW was a cross-sectional study of adult SA patients.

Early Identification of Exacerbations in Patients with Chronic Obstructive Pulmonary Disease (COPD).

Exacerbations of Chronic Obstructive Pulmonary Disease (COPD) have a substantial effect on overall disease management, health system costs, and patient outcomes. However, exacerbations are often underdiagnosed or recognized with great delay due to several factors such as patients' inability to differentiate between acute episodes and symptom fluctuations, delays in seeking medical assistance, and disparities in dyspnea perception. Self-management intervention plans, telehealth and smartphone-based programs provide educational material, counseling, virtual hospitals and telerehabilitation, and help COPD patients to identify exacerbations early.

Long-Term Lung Sequelae in Survivors of Severe/Critical COVID-19 Pneumonia: The "Non-Steroid", "Non-Interventional" Approach.

: Long-term lung sequelae in severe COVID-19 survivors, as well as their treatment, are poorly described in the current literature. : To investigate lung fibrotic sequelae in survivors of severe/critical COVID-19 pneumonia and their fate according to a "non-interventional" approach. : Prospective study of the above COVID-19 survivors after hospital discharge from March 2020 to October 2022.

Clinical remission in patients with severe eosinophilic asthma treated with mepolizumab: A analysis of RELIght study.

Remission of asthma can occur as part of the natural history of the disease; however, the use of biologics can result in disease remission in some patients. In this post hoc analysis of the RELIght study, we aimed to evaluate clinical remission in real life among patients treated with mepolizumab, to detect possible differences between "remitters" and "nonremitters," and to evaluate possible predictors of remission. Clinical remission was defined as the absence of asthma exacerbations, discontinuation of oral corticosteroids (OCS), achievement of asthma control (Asthma Control Test [ACT] ≥ 20), and stable or improved lung function.

Εosinophilic Chronic Obstructive Pulmonary Disease. What Do We Know So Far?

The latest advances in asthma treatment have highlighted the significance of eosinophilia and the possible role of some pro-eosinophilic mediators, like interleukins (IL) IL-5, IL-4/IL-13, and IL-33 in the disease's pathogenesis. Considering that a subgroup of patients with chronic obstructive pulmonary disease (COPD) may have blood eosinophilia akin to that seen in asthma, numerous studies in the last decade have suggested that eosinophilic COPD is a separate entity. While the exact role of blood eosinophils in the pathophysiology of COPD remains unclear, eosinophilia seems to increase the effectiveness of corticosteroid therapy.

Investigating a middle‑step COVID‑19 unit in Greece.

During the coronavirus disease-19 (COVID-19) pandemic, there was an unprecedented requirement for hospital bed availability. The present study aimed to examine the characteristics and outcomes of patients hospitalized in a COVID-19 unit that operated as a novel middle-step unit in Greece. The present study aimed to determine whether the middle-step unit supported the central general hospitals; thus, highlighting the potential of these models in future pandemics.

Effect of mepolizumab in airway remodeling in patients with late-onset severe asthma with an eosinophilic phenotype.

Background: Clinical trials and real-world experience have provided evidence for the clinical benefits of mepolizumab, an anti-IL-5 biologic, in severe asthma. However, limited data exist regarding the impact of mepolizumab on airway remodeling.

Objective: We sought to investigate the effect of mepolizumab on airway structural remodeling in patients treated for severe asthma in routine clinical care.

Sensitization to Staphylococcus Enterotoxin: Relationship with Aspects of Disease Severity.

: Sensitization to specific IgE enterotoxins (SEs) is associated with an increased risk for severe asthma development. Limited data exist regarding the association of seropositivity for specific IgE SEs and the different aspects of severe asthma. We aimed to determine whether the presence of SEs is associated with asthma-related parameters such as inflammatory cells in the airways, features of airway remodeling, and other variables relating to asthma assessment and severity.

Adherence to Mediterranean diet and asthma control. Results from a small study among asthmatic patients in Greece.

Objectives: Current variations in asthma prevalence and clinical characteristics suggest that lifestyle choices including dietary habits, may affect the pathogenesis and/or clinical expression of the disease. The purpose of this study is to evaluate the association between adherence to Mediterranean diet (MD) and asthma control, considering disease severity.

Methods: Adherence to MD was assessed through a questionnaire, the MD Adherence Screener (MEDAS), previously validated in Mediterranean populations.

Effects of menopause and fat mass in asthmatic inflammation.

Introduction: Female hormones and obesity have an impact on women with asthma. We aimed to describe how these components affect asthma inflammatory processes.

Methods: Sex hormones [FSH, LH, estradiol (E2), estrone (E1), testosterone and Δ4 androstenedione (A4)] and serum IL1β, IL13, IL17a, IL-5, IL6, TNF-a were measured from 11 to18 pre- and postmenopausal women with asthma.

Mortality prevention as the centre of COPD management.

COPD is a major healthcare problem and cause of mortality worldwide. COPD patients at increased mortality risk are those who are more symptomatic, have lower lung function and lower diffusing capacity of the lung for carbon monoxide, decreased exercise capacity, belong to the emphysematous phenotype and those who have concomitant bronchiectasis. Mortality risk seems to be greater in patients who experience COPD exacerbations and in those who suffer from concomitant cardiovascular and/or metabolic diseases.

Endotyping Eosinophilic Inflammation in COPD with ELAVL1, ZfP36 and HNRNPD mRNA Genes.

: Chronic obstructive pulmonary disease (COPD) is a common disease characterized by progressive airflow obstruction, influenced by genetic and environmental factors. Eosinophils have been implicated in COPD pathogenesis, prompting the categorization into eosinophilic and non-eosinophilic endotypes. This study explores the association between eosinophilic inflammation and mRNA expression of ELAVL1, ZfP36, and HNRNPD genes, which encode HuR, TTP and AUF-1 proteins, respectively.