Article
Pharmacology & Pharmacy
Kaveh Ahookhosh, Maysam Saidi, Mousa Mohammadpourfard, Habib Aminfar, Hamed Hamishehkar, Ali Farnoud, Otmar Schmid
Summary: Inhalation therapy is crucial for the management of respiratory diseases, and pressurized metered dose inhalers (pMDIs) are a popular drug delivery device. Computational study on flow structure inside pMDI and deposition of micron-sized particles in human airway model revealed significant impact of inhalation air flow rate and inhaler geometry on deposition patterns.
EUROPEAN JOURNAL OF PHARMACEUTICAL SCIENCES
(2021)
Article
Pharmacology & Pharmacy
Victoria Legh-Land, Allen E. Haddrell, David Lewis, Darragh Murnane, Jonathan P. Reid
Summary: This study investigates the dynamics of particle formation and maturation in pMDI sprays, showing that evaporating aerosol droplets can act as condensation nuclei for water and the rapid vaporization of volatile components is directly correlated to the volume of water taken up by condensation. Droplets with a water activity of 0.98 at inhalation produce markedly different dose deposition profiles compared to those with lower water activities at the point of inspiration.
Article
Cardiac & Cardiovascular Systems
Mona Al-Ahmad, David Webb
Summary: The study in a real-world population in Kuwait showed that switching asthma patients from ICS/LABA DPI to ICS/LABA pMDI can significantly improve lung function and increase asthma control within 12 months.
RESPIRATORY MEDICINE
(2022)
Review
Pharmacology & Pharmacy
Eknath Kole, Krishna Jadhav, Nitin Shirsath, Prashik Dudhe, Rahul K. Verma, Aniruddha Chatterjee, Jitendra Naik
Summary: Pulmonary diseases are a significant global health threat. Recent years have seen the emergence of nanotherapeutics-based approaches to tackle these diseases. Nanomedicine can be used to deliver drugs directly into lung tissue via aerosol or dry powder inhalation, targeting deep lung deposition and enhancing therapeutic efficacy. Particle engineering plays a crucial role in developing inhalable formulations that improve drug delivery and targeting effects.
JOURNAL OF DRUG DELIVERY SCIENCE AND TECHNOLOGY
(2023)
Article
Green & Sustainable Science & Technology
Brett Fulford, Karen Mezzi, Andy Whiting, Simon Aumonier
Summary: The life-cycle assessment of the Breezhaler(R) dry powder inhaler revealed that it has a relatively low environmental impact compared to other inhalation therapies. The device's packaging and raw materials are key contributors to resource depletion, with the 90-day pack showing the lowest overall environmental impact across all categories in the countries studied. Further research is needed to evaluate the impact of active pharmaceutical ingredients and clinical outcomes on the environment.
Article
Medical Informatics
Henock G. Yebyo, Julia Braun, Dominik Menges, Gerben Ter Riet, Mohsen Sadatsafavi, Milo A. Puhan
Summary: The addition of inhaled corticosteroids to long-acting beta 2-agonists and long-acting muscarinic antagonists can provide a net clinical benefit in patients with chronic obstructive pulmonary disease, depending on exacerbation risk, blood eosinophil count, and age. Personalized treatment decisions based on these factors and predicted exacerbation risks may help reduce overtreatment and undertreatment with inhaled corticosteroids.
LANCET DIGITAL HEALTH
(2021)
Article
Pediatrics
Petr Pohunek, Guido Varoli, Yuriy Reznichenko, Svetlana Mokia-Serbina, Jerzy Brzostek, Viktoriya Kostromina, Mykola Kaladze, Annamaria Muraro, Elena Carzana, Silvia Armani, Jadwiga Kaczmarek
Summary: The study demonstrated that CHF1535 pediatric fixed combination was non-inferior to the free combination in pulmonary function in asthmatic children, with a dose-related response trend, indicating high safety of the treatments.
EUROPEAN JOURNAL OF PEDIATRICS
(2021)
Article
Pediatrics
Kesanee Chaicoming, Aroonwan Preutthipan, Anusorn Adirekkittikun, Malinee Nugboon
Summary: During the COVID-19 pandemic, a homemade valved holding chamber (VHC) made of a paper coffee cup and a drinking water bottle was compared to a standard commercial VHC for bronchodilator delivery in children with airway hyperresponsiveness. Both VHCs showed significant improvements in lung function parameters after salbutamol MDI administration, indicating the effectiveness of the homemade VHC as a disposable alternative when commercial options are unavailable.
PEDIATRIC PULMONOLOGY
(2021)
Article
Respiratory System
Jin Sun Kim, Nader Hashweh, Hannah Li, Salik Choudhary, Sadashiv Santosh, Edward Charbek
Summary: Many COPD patients have incorrect pMDI techniques, which can be improved with a short training in the clinic.
BMC PULMONARY MEDICINE
(2021)
Article
Engineering, Chemical
Farnia Dastoorian, Leila Pakzad, Janusz Kozinski, Ehsan Behzadfar
Summary: Inhalation therapy using a pressurized metered-dose inhaler (pMDI) is an effective treatment method for asthma patients. This study developed a computational fluid dynamics model to simulate the aerosol flow from a pMDI into the mouth-throat area. The results showed that the flow patterns and drug deposition behavior were influenced by the air flow rate and cone angle. Increasing the air flow rate reduced the particle diameter, while increasing the cone angle increased mouth-throat deposition.
Article
Allergy
Konstantinos Douros, Dafni Moriki, Olympia Sardeli, Barbara Boutopoulou, Angeliki Galani, Vasiliki Papaevangelou, Kostas N. Priftis
Summary: This study aimed to estimate the risk of hospitalization in children with mild-moderate asthma exacerbation, assessed using the PRAM score and treated with salbutamol via MDI/S. The initial PRAM score was positively associated with admission risk, while improvement in PRAM score was negatively associated with admission risk. Conclusion: PRAM is a reliable tool for assessing asthma exacerbation severity.
ALLERGOLOGIA ET IMMUNOPATHOLOGIA
(2023)
Article
Biophysics
Mahsa Jahed, Janusz Kozinski, Leila Pakzad
Summary: This study used computational fluid dynamics simulations to investigate the effect of two different nozzle types on drug deposition in the mouth-throat region. The study found that the actuator structure significantly impacts the device's efficacy.
BIOMECHANICS AND MODELING IN MECHANOBIOLOGY
(2023)
Article
Biophysics
Mahsa Jahed, Janusz Kozinski, Leila Pakzad
Summary: This study investigated the impact of two different nozzle types on drug deposition in the mouth-throat region, as well as the behavior of aerosol plumes in different environments using computational fluid dynamics simulations. The study revealed that the actuator structure significantly affects the device's efficacy.
BIOMECHANICS AND MODELING IN MECHANOBIOLOGY
(2023)
Article
Respiratory System
Gerard J. Criner, Therese Cole, Kristen A. Hahn, Kari Kastango, James Eudicone, Ileen Gilbert
Summary: The study evaluated the impact of the BreatheMate device on adherence in COPD patients, showing that medication reminders can improve adherence to inhaled therapy, especially in elderly patients.
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
(2021)
Article
Allergy
Erdem Topal, Mustafa Arga, Abdullah Hakan Ozmen, Muhammet Arif Kursun, Omer Adil Ilhan, Mustafa Alici
Summary: This study found that approximately one third of pharmacists were able to correctly demonstrate all steps for proper usage of pMDIs with a spacer device. This suggests that pharmacists should be included in training programs and receive continuous training on the use of pMDIs with a spacer device.
Review
Biotechnology & Applied Microbiology
Maria Gabriella Matera, Luigino Calzetta, Mario Cazzola, Josuel Ora, Paola Rogliani
Summary: No mAb directed against cytokines or chemokines has shown therapeutic impact in COPD patients, except for mAbs targeting the IL-5 pathway which have a weak effect in patients with eosinophilic COPD. This reflects the complexity of COPD where no single cytokine or chemokine plays a dominant role. Therefore, mAbs targeting specific cytokines or chemokines should be evaluated in limited and focused populations.
EXPERT OPINION ON BIOLOGICAL THERAPY
(2023)
Review
Pharmacology & Pharmacy
Josuel Ora, Luigino Calzetta, Chiara Frugoni, Ermanno Puxeddu, Paola Rogliani
Summary: Long-COVID, characterized by persistent symptoms after 4 weeks of initial infection, affects 1 in 5 individuals and its underlying mechanisms are yet to be fully understood. This article provides an overview of current and ongoing therapies for long-COVID syndrome, with a focus on clinical trials and underlying mechanisms. Despite the lack of established treatments, pharmacological research is exploring drugs that target systemic inflammation and rehabilitation appears to be a safe option. Further research and trials are needed to better understand the pathogenesis and develop effective treatments.
EXPERT OPINION ON PHARMACOTHERAPY
(2023)
Article
Immunology
Luigino Calzetta, Alfredo Chetta, Marina Aiello, Annalisa Frizzelli, Josuel Ora, Enrico Melis, Francesco Facciolo, Lorenzo Ippoliti, Andrea Magrini, Paola Rogliani
Summary: The study investigated the acute impact of BNT162b2 in a human ex vivo model of severe eosinophilic asthma. The results showed that BNT162b2 increased resting tone and response to histamine, as well as enhanced the response to electrical field stimulation, possibly due to the excipients used.
Review
Pharmacology & Pharmacy
Rossella Laitano, Luigino Calzetta, Francesco Cavalli, Mario Cazzola, Paola Rogliani
Summary: This article evaluates the potential role of delivering monoclonal antibodies (mAbs) via inhalation in the treatment of asthma and chronic obstructive pulmonary disease (COPD) through a systematic review of randomized control trials (RCTs). Compared to systemic administration, delivering mAbs via inhalation offers faster onset of action, greater efficacy at lower doses, minimal systemic exposure, and lower risk of adverse events. However, the delivery of mAbs via inhalation remains challenging and controversial, and further well-designed RCTs are needed to assess their potential role in asthma and COPD treatment.
EXPERT OPINION ON DRUG DELIVERY
(2023)
Review
Biochemistry & Molecular Biology
Maria Gabriella Matera, Paola Rogliani, Giuseppe Novelli, Mario Cazzola
Summary: This narrative review discusses the possible impact of genetic variations on bronchodilator response. Studies have mainly focused on three SNPs in the ADRB2 gene, and other uncommon variants may also contribute to individual variability in salbutamol response. There is also evidence of a link between SNPs and ethnic/age profiles regarding bronchodilator response. However, replication of pharmacogenetic results is limited and often the observed response does not match the expected outcome based on SNP identification. Further research integrating multi-omics approaches and epigenetic factors is needed.
EXPERT OPINION ON DRUG METABOLISM & TOXICOLOGY
(2023)
Review
Pharmacology & Pharmacy
Maria Gabriella Matera, Josuel Ora, Luigino Calzetta, Paola Rogliani, Mario Cazzola
Summary: IL-13 is an important cytokine in the development of asthma and other eosinophilic disorders. Current attempts to directly neutralize IL-13 or block its receptors have not shown significant efficacy in treating severe asthma. We suggest considering the use of anti-IL-13 drugs before GINA step 5.
EXPERT OPINION ON INVESTIGATIONAL DRUGS
(2023)
Article
Respiratory System
Paola Rogliani, Rossella Laitano, Josuel Ora, Richard Beasley, Luigino Calzetta
Summary: This study investigated the strength of association between comorbidities and asthma. It found that allergic rhinitis, allergic conjunctivitis, bronchiectasis, hypertensive cardiomyopathy, and nasal congestion were strongly associated with asthma, while COPD and other chronic respiratory diseases were very strongly associated with asthma. Stronger associations were detected between comorbidities and severe asthma.
EUROPEAN RESPIRATORY REVIEW
(2023)
Article
Medicine, General & Internal
Josuel Ora, Paola Rogliani, Federica Ferron, Marilisa Vignuoli, Letizia Valentino, Giancarlo Pontoni, Francesca Di Ciuccio, Roberto Ferrara, Tommaso Sciarra
Summary: This study evaluated the impact of SARS-CoV-2 infection on pulmonary function, exercise tolerance, and muscle strength in healthy middle-aged military outpatients. It found that the infection had a more severe effect on pulmonary function, exercise tolerance, and muscle strength during the initial waves compared to the later ones. Additionally, more recent infections were associated with symptoms related to upper respiratory tract infection.
Review
Respiratory System
Daiana Stolz, Maria Gabriella Matera, Paola Rogliani, Maarten van den Berge, Eleni Papakonstantinou, Reinoud Gosens, Dave Singh, Nicola Hanania, Mario Cazzola, Anke-Hilse Maitland -van der Zee, Laura Fregonese, Alexander G. Mathioudakis, Jurgen Vestbo, Maia Rukhadze, Clive P. Page
Summary: Pharmacological management of airway obstructive diseases is a rapidly evolving field with advances in understanding disease mechanisms and drug action pathways. However, clinical translation of in vitro results remains challenging. This research seminar held by the European Respiratory Society focused on current and future developments in respiratory medication, including drug mechanisms, biomarkers, and pharmacogenomics.
Article
Respiratory System
Mario Cazzola, Clive P. Page, Maria Gabriella Matera, Paola Rogliani, Nicola A. Hanania
Summary: Current guidelines and strategies for asthma treatment primarily focus on improving lung function and reducing symptoms. However, they fail to address the underlying mechanisms of this heterogeneous disease. It is necessary to re-evaluate the current one-size-fits-all approach and develop more personalized asthma management.
EUROPEAN RESPIRATORY JOURNAL
(2023)
Review
Pharmacology & Pharmacy
Maria Gabriella Matera, Luigino Calzetta, Barbara Rinaldi, Mario Cazzola, Paola Rogliani
Summary: Inhalation is a desirable method for delivering mAbs to individuals with lung disorders, but there are challenges in terms of aerosol technology and formulation.
EXPERT OPINION ON DRUG DELIVERY
(2023)
Article
Pharmacology & Pharmacy
Maria Gabriella Matera, Josuel Ora, Paola Rogliani, Mario Cazzola
Summary: This article focuses on the significant role of TSLP in the development of asthma and how tezepelumab can target it for treatment. Clinical trials have shown that tezepelumab can significantly improve key endpoints in patients with severe asthma, regardless of the type 2 endotype. It may be the first biologic to effectively treat asthma exacerbations in patients with low eosinophil levels.
EXPERT OPINION ON DRUG DISCOVERY
(2023)
Review
Pharmacology & Pharmacy
Luigino Calzetta, Elena Pistocchini, Alfredo Chetta, Paola Rogliani, Mario Cazzola
Summary: This study used artificial intelligence and machine learning models to predict the clinical development of investigational drugs for COPD, and found that only a few drugs have a possibility of being approved in the future.
EXPERT OPINION ON INVESTIGATIONAL DRUGS
(2023)
Review
Respiratory System
Gian Marco Manzetti, Josuel Ora, Arianna Sepiacci, Mario Cazzola, Paola Rogliani, Luigino Calzetta
Summary: The aim of this study was to investigate the impact of aging on clinically important deterioration (CID) in patients with Chronic Obstructive Pulmonary Disease (COPD). Data from a large number of COPD patients were analyzed, and the findings suggest that inhaled therapy can effectively reduce the risk of CID in COPD patients, although this protective effect may be compromised in older patients with impaired lung function. Further research is needed to confirm these results.
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
(2023)
Editorial Material
Respiratory System
Mario Cazzola, Paola Rogliani, Francesco Blasi
Summary: The complexity of COPD calls for the identification of patient groups with similar characteristics and needs. Different clinical phenotypes and endotypes have been studied, but a new taxonomic classification based on causes has been proposed. The tractable traits approach is a simpler method, but lacks validation through large randomized controlled trials. Despite its application following the GOLD strategy, there are challenges in identifying and prioritizing treatable traits.
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
(2023)