Article
Biochemistry & Molecular Biology
Priyadarshini Kachroo, Isobel D. Stewart, Rachel S. Kelly, Meryl Stav, Kevin Mendez, Amber Dahlin, Djora I. Soeteman, Su H. Chu, Mengna Huang, Margaret Cote, Hanna M. Knilhtila, Kathleen Lee-Sarwar, Michael McGeachie, Alberta Wang, Ann Chen Wu, Yamini Virkud, Pei Zhang, Nicholas J. Wareham, Elizabeth W. Karlson, Craig E. Wheelock, Clary Clish, Scott T. Weiss, Claudia Langenberg, Jessica A. Lasky-Su
Summary: The application of large-scale metabolomic profiling provides new opportunities for omics-based precision medicine in treating asthma. This study identifies and replicates 17 steroid metabolites that are significantly reduced in individuals with asthma, especially those receiving inhaled corticosteroid (ICS) treatment. The dose-dependent effect of ICS treatment on steroid levels suggests the need for regular cortisol monitoring to minimize the adverse effects of adrenal suppression. The findings highlight the importance of considering the public health implications of adrenal suppression in asthma patients receiving ICS treatment.
Review
Endocrinology & Metabolism
Kay Choong See
Summary: Inhaled corticosteroids (ICS) and intranasal corticosteroids (INS) are commonly used to treat chronic respiratory diseases. While they are generally considered to have fewer systemic side effects compared to oral corticosteroids, their impact on diabetes mellitus (DM) remains controversial. Multiple studies have shown that high doses of ICS are associated with increased incidence and worsened control of DM. Two studies also found a short-term association between INS use and hyperglycemia. More research is needed to evaluate the risk of DM-related adverse events with ICS/INS use, but high doses of ICS/INS should be avoided if possible.
WORLD JOURNAL OF DIABETES
(2023)
Article
Multidisciplinary Sciences
Hyung Jun Park, Jin-Young Huh, Ji Sung Lee, Jae Seung Lee, Yeon-Mok Oh, Sei Won Lee
Summary: The comparative effectiveness of different inhaler therapies for mild-to-moderate asthma was assessed through a systematic review and network meta-analysis. Inhaled corticosteroid/long-acting beta 2-agonist (ICS/LABA) as maintenance and reliever showed the highest effectiveness. Low-dose ICS/LABA had the best lung function improvement. As-needed ICS with LABA or SABA was more effective in preventing asthma exacerbation compared to regular ICS.
SCIENTIFIC REPORTS
(2022)
Article
Biochemistry & Molecular Biology
William Yip, Xuan Li, Graeme J. Koelwyn, Stephen Milne, Fernando Sergio Leitao Filho, Chen Xi Yang, Ana I. Hernandez Cordero, Julia Yang, Cheng Wei Tony Yang, Tawimas Shaipanich, Stephan F. van Eeden, Janice M. Leung, Stephen Lam, Kelly M. McNagny, Don D. Sin
Summary: Changes in the microbiome following inhaled corticosteroid/long-acting beta 2-agonist combination therapy in COPD patients are related to alterations in the host transcriptome in the small airways. This may explain why some COPD patients treated with inhaled corticosteroids may be at an increased risk for airway infections.
Article
Pharmacology & Pharmacy
Peter T. Daley-Yates, Noushin Brealey, Sebin Thomas, Daren Austin, Shaila Shabbir, Tim Harrison, Dave Singh, Neil Barnes
Summary: This study compared the airway potency, systemic activity, and therapeutic index of three inhaled corticosteroids. Fluticasone furoate (FF) showed greater airway potency and less systemic activity compared to fluticasone propionate (FP) and budesonide (BUD), suggesting that FF may provide better protection against airway hyperresponsiveness with a wider therapeutic index.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2021)
Article
Respiratory System
Alberto Papi, Diogenes S. Ferreira, Ioana Agache, Eugenio Baraldi, Richard Beasley, Guy Brusselle, Courtney Coleman, Mina Gaga, Carolina Maria Gotera Rivera, Erik Melen, Ian D. Pavord, Deborah Penate Gomez, Daniel Schuermans, Antonio Spanevello, Thomy Tonia, Florence Schleich
Summary: Recent clinical trials have shown that using as-needed ICS/formoterol could be a potential treatment option for mild asthma. The European Respiratory Society's Task Force has provided evidence-based recommendations, suggesting that adults with mild asthma should use as-needed ICS/formoterol instead of regular ICS maintenance treatment plus as-needed SABA, while adolescents can choose either as-needed ICS/formoterol or ICS maintenance treatment plus as-needed SABA.
EUROPEAN RESPIRATORY JOURNAL
(2023)
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
Medicine, Research & Experimental
Peter Daley-Yates, Bhumika Aggarwal, Zrinka Lulic, Sourabh Fulmali, Alvaro A. Cruz, Dave Singh
Summary: This study compared different dosing regimens of inhaled corticosteroids (ICS) in mild asthma to assess their bronchoprotective effects and benefit/risk profiles. Results showed that all ICS regimens provided sustained bronchoprotective efficacy when used regularly with high adherence. Longer-acting ICS molecules were more likely to provide sustained protection and better therapeutic index compared to shorter duration of action molecules.
ADVANCES IN THERAPY
(2022)
Article
Medicine, General & Internal
Michiel A. G. E. Bannier, Sophie Kienhorst, Quirijn Jobsis, Kim D. G. van de Kant, Frederik-Jan Van Schooten, Agnieszka Smolinska, Edward Dompeling
Summary: Exhaled breath analysis has the potential to diagnose various respiratory and non-respiratory diseases. This study found that inhaled corticosteroids can influence the volatile organic compounds in the exhaled breath of wheezing preschool children. Furthermore, the exhaled volatile organic compounds can predict the response to corticosteroid treatment in these children.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Allergy
Ahmed Edris, Emmely W. de Roos, Michael J. McGeachie, Katia M. C. Verhamme, Guy G. Brusselle, Kelan G. Tantisira, Carlos Iribarren, Meng Lu, Ann Chen Wu, Bruno H. Stricker, Lies Lahousse
Summary: Genetic variants in CRHR1 and TBXT genes were found to be associated with poor and improved ICS response in adults with asthma, respectively. These associations may indicate specific endotypes that could potentially predict exacerbation risk and response to ICS treatment.
CLINICAL AND EXPERIMENTAL ALLERGY
(2022)
Review
Medicine, General & Internal
Irene Karampela, Natalia G. Vallianou, Dimitrios Tsilingiris, Gerasimos-Socrates Christodoulatos, Giovanna Muscogiuri, Luigi Barrea, Giovanni Vitale, Maria Dalamaga
Summary: This article discusses the therapeutic role of inhaled and systemic corticosteroids in the treatment of COVID-19. It provides evidence that inhaled corticosteroids may lead to early clinical improvement and lower hospitalization rate in patients with mild COVID-19.
Review
Pharmacology & Pharmacy
Jieon Lee, Kairui Feng, Denise S. Conti, Ross Walenga, Michael Wientjes, Hezhen Wang, Bryan Newman, Liangfeng Han, Sneha Dhapare, Elizabeth Bielski, Andrew Babiskin, Fang Wu, Mark Donnelly, Myong-Jin Kim, Wenlei Jiang, Markham C. Luke, Lanyan Fang, Liang Zhao
Summary: In this article, the US FDA's current thinking, challenges, and opportunities for comparative clinical endpoint bioequivalence studies of orally inhaled drug products (OIDPs) are presented. The FDA uses an aggregate weight-of-evidence approach to demonstrate the bioequivalence of generic OIDPs to their reference listed drug. This approach includes comparative clinical endpoint studies, pharmacokinetic studies, and in vitro studies, as well as the assessment of formulation sameness and device similarity. Challenges arise in the use of forced expiratory volume in the first second (FEV1) as a clinical endpoint due to its variability and relatively flat dose-response relationship. The FDA is striving to develop alternative methods to make the bioequivalence assessment of OIDPs more efficient.
CLINICAL PHARMACOLOGY & THERAPEUTICS
(2022)
Review
Medicine, General & Internal
Kayleigh M. Kew, Ella Flemyng, Bradley S. Quon, Clarus Leung
Summary: This article compares the clinical effectiveness and safety of increased versus stable doses of inhaled corticosteroids (ICS) for home management of asthma exacerbations. The results suggest that increasing the dose does not have a significant impact on reducing the need for oral steroids, but other clinically important benefits and potential harms cannot be ruled out due to limitations in the trials.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2022)
Article
Allergy
Scott P. Ginebaugh, Matthias Hagner, Anuradha Ray, Serpil C. Erzurum, Suzy A. A. Comhair, Loren C. Denlinger, Nizar N. Jarjour, Mario Castro, Prescott G. Woodruff, Stephanie A. Christenson, Eugene R. Bleecker, Deborah A. Meyers, Annette T. Hastie, Wendy C. Moore, David T. Mauger, Elliot Israel, Bruce D. Levy, Sally E. Wenzel, Matthew J. Camiolo
Summary: This study investigated the transcriptional response of bronchial epithelial cells to inhaled corticosteroids. It was found that a subset of asthma patients with poor hormone treatment response had worse lung function and quality of life. Furthermore, the response to hormone treatment could be predicted using blood samples.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
(2023)
Article
Respiratory System
Paul M. O'Byrne, Helen K. Reddel, Richard Beasley
Summary: ICS-containing reliever medication is superior to SABA as reliever alone and equivalent to maintenance ICS and SABA as reliever, particularly in reducing risks of severe asthma exacerbations, in studies comparing these reliever options.
EUROPEAN RESPIRATORY JOURNAL
(2021)
Article
Pediatrics
Mariana Mazzuca Reimberg, Jessyca Rodrigues Selman Pachi, Rebeca Souza Scalco, Andrey Jorge Serra, Leandro Fernandes, Fabiano Politti, Gustavo Falbo Wandalsen, Dirceu Sole, Simone Dal Corso, Fernanda Cordoba Lanza
JORNAL DE PEDIATRIA
(2020)
Article
Allergy
Andrea Angel, Gustavo Falbo Wandalsen, Dirceu Sole, Fernanda C. Lanza, Carolina L. N. Cobra, Cintia Johnston, Josefina Aparecida Pellegrini Braga
ALLERGOLOGIA ET IMMUNOPATHOLOGIA
(2020)
Review
Environmental Sciences
Jose Laerte Boechat, Gustavo Falbo Wandalsen, Fabio Chigres Kuschnir, Luis Delgado
Summary: Children with asthma may not be at higher risk for COVID-19, possibly due to factors like lower IFN-alpha production, protective role of eosinophils in the airway, and antiviral properties of inhaled steroids. In childhood asthma-obesity phenotype, the atopic Th2 pattern could still be a protective factor. Return to school activities should consider asymptomatic children as potential disease spreaders.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2021)
Article
Pediatrics
Wellington Fernando da Silva Ferreira, Denise Siqueira de Carvalho, Gustavo Falbo Wandalsen, Dirceu Sole, Emanuel Savio Cavalcante Sarinho, Decio Medeiros, Ana Carolina Cavalcanti Dela Bianca Melo, Elaine Xavier Prestes, Paulo Augusto Moreira Camargos, Karin Regina Luhm, Luis Garcia-Marcos, Javier Mallol, Nelson Augusto Rosario, Herberto Jose Chong-Neto
Summary: There are differences in associated factors for recurrent wheezing (RW) between male and female infants, which could be useful for the approach and management of RW in babies.
JORNAL DE PEDIATRIA
(2021)
Article
Respiratory System
Elida Pereira Silva, Bruno Alvarenga Soares, Mariana M. Reimberg, Raphael Ritti-Dias, Karina Silva Nascimento, Fabiana Silvia Anjos, Gustavo Falbo Wandalsen, Dirceu Sole, Simone Dal Corso, Fernanda Cordoba Lanza
Summary: The study revealed that asthmatic children and adolescents have delayed heart rate recovery after functional capacity testing compared to their peers, suggesting that asthma leads to autonomic nervous system imbalance.
BMC PULMONARY MEDICINE
(2021)
Letter
Allergy
Anna Clara Rabha, Fatima Rodrigues Fernandes, Dirceu Sole, Leonard Benjamin Bacharier, Gustavo Falbo Wandalsen
PEDIATRIC ALLERGY AND IMMUNOLOGY
(2021)
Article
Pediatrics
Bianca M. C. Dias, Fernanda C. Lanza, Jenifer dos Santos, Carolina S. Aranda, Dirceu Sole, Ana Maria Martins, Gustavo F. Wandalsen
Summary: This study evaluated the functional capacity of MPS patients compared to healthy controls, finding that MPS patients performed significantly worse on the SST and ISWT tests.
PEDIATRIC PULMONOLOGY
(2022)
Article
Pediatrics
Mariana M. Reimberg, Raphael Ritti-Dias, Jessyca P. Selman, Rebeca S. Scalco, Gustavo F. Wandalsen, Dirceu Sole, Erik J. Hulzebos, Tim Takken, Simone Dal Corso, Fernanda C. Lanza
Summary: The study found that the modified shuttle test (MST) elicits maximal physiological response in children and adolescents with asthma, demonstrating convergent validity with the cardiopulmonary exercise test (CPET) and can be used as an alternative method for evaluating exercise capacity.
PEDIATRIC PULMONOLOGY
(2022)
Review
Allergy
Fausto Yoshio Matsumoto, Tessa Rachel Tranquillini Goncalves, Dirceu Sole, Gustavo Falbo Wandalsen
Summary: This systematic review focused on local allergic rhinitis (LAR) in children and adolescents. The prevalence rates of LAR varied among different regions, with higher rates observed in Western countries compared to Eastern countries. No specific clinical characteristics have been identified to differentiate LAR from other childhood rhinitis phenotypes. Longitudinal studies are needed to assess the clinical characteristics and stability of LAR in the pediatric age group.
ALLERGOLOGIA ET IMMUNOPATHOLOGIA
(2022)
Review
Allergy
Georgia Veras de Araujo Gueiros Lira, Giselia Alves Pontes da Silva, Gustavo Falbo Wandalsen, Emanuel Savio Cavalcanti Sarinho
Summary: In the assessment of childhood asthma, identifying the risk factors associated with exacerbations and considering the impact of psychological stress on asthma onset and control provide a new perspective on this biopsychosocial disease.
ALLERGOLOGIA ET IMMUNOPATHOLOGIA
(2022)
Article
Allergy
Fabiana A. Nunes, Fabio Zanini, Camilla de S. Braga, Andreza L. da Silva, Fatima R. Fernandes, Dirceu Sole, Gustavo F. Wandalsen
Summary: The study assessed the incidence of anaphylaxis in the emergency room of a private pediatric hospital in Sao Paulo, Brazil. The results showed a low incidence rate, with food being the most suspected trigger and most cases presenting with mild symptoms.
WORLD ALLERGY ORGANIZATION JOURNAL
(2022)
Meeting Abstract
Allergy
Juliana Murata, Jessica Drobrzenski, Caroline Ferreira, Nathalia Vital, Renata Dias, Dirceu Sole, Nelson Rosario, Antonio Pastorino, Herberto Chong Neto, Gustavo Wandalsen
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
(2020)
Meeting Abstract
Allergy
Larissa Brandao, Carolina Aranda, Gustavo Wandalsen, Renata Cocco, Dirceu Sole
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
(2020)
Article
Pediatrics
Anna Clara Rabha, Francisco Ivanildo de Oliveira Junior, Thales Araujo de Oliveira, Regina Grigolli Cesar, Giuliana Fongaro, Roberta Ferreira Mariano, Clarice Neves Camargo, Fatima Rodrigues Fernandes, Gustavo Falbo Wandalsen
Summary: Children and adolescents affected by COVID-19 at Sabara Hospital Infantil mostly presented with mild upper airway symptoms, with younger age groups showing more severe symptoms, particularly gastrointestinal and respiratory symptoms.
REVISTA PAULISTA DE PEDIATRIA
(2021)
Meeting Abstract
Allergy
Herberto Chong Neto, Wellington Ferreira, Gustavo Wandalsen, Dirceu Sole, Emanuel Sarinho, Decio Medeiros, Elaine Prestes, Paulo Camargos, Nelson Rosario
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
(2021)
