Steroid-resistant asthma

Varricchi and colleagues (2016) noted that although eosinophils represent approximately 1 % of peripheral blood leukocytes, they have the propensity to leave the blood stream and migrate into inflamed tissues.  Eosinophils and their mediators are critical effectors to asthma and eosinophilic granulomatosis with polyangiitis (EGPA).  Eosinophils are equipped with a large number of cell-surface receptors and produce specific cytokines and chemokines.  Eosinophils are the major source of iIL-5 and highly express the IL-5Rα on their surface.  Clinical trials evaluating monoclonal antibodies (MAbs) to IL-5 (mepolizumab and reslizumab) and its receptor IL-5Rα (benralizumab) have been or are underway in patients with eosinophilic asthma, EGPA and chronic obstructive pulmonary disease (COPD).  Overall, targeting IL-5/IL-5Rα is associated with a marked decrease in blood and sputum eosinophilia, the number of exacerbations and improvement of some clinical parameters in adult patients with severe eosinophilic asthma.  Preliminary findings from pilot studies suggested that mepolizumab might be a glucocorticoid-sparing treatment in patients with EGPA.  A preliminary study found that benralizumab did not reduce the exacerbations and did modify lung function in patients with eosinophilic COPD.  The authors concluded that this review examined recent advances in the biology of eosinophils and how targeting the iIL-5 pathway might offer benefit to some patients with severe asthma, EGPA, and COPD.  They stated that IL-5/IL-5Rα-targeted treatments offer promises to patients with eosinophilic respiratory disorders.  These researchers noted that ongoing studies will provide information whether IL-5/IL-5Rα inhibition is safe and effective in children with eosinophilic asthma and selected patients with EGPA or COPD.

Hello Amy and dJason, I too am in Florida and in the middle of an allergic reaction, but I am confused as I thought it was caused by the Prednisolone, am I now to understand Amy that you are saying the withdrawal causes the rash? Yesterday was my last day of the Prednislone pack, I also did a Prednisone pack before the Hurricane, (went through 36 hours with acute sciatica pain, no power, or ac) at first I thought it was a Heat Rash, was so focused on getting help for my Sciatica pain after the storm that I didn't deal with the rash except to put some aloe on it. The rash spread yesterday to my back and along the band of my underwear with red welts, the pain and itching was so bad we called the dr who recommended Benadryl which thankfully knocked me out! Back up this morning, same thing, itchy and red. So confused now, is it an allergic reaction or withdrawal, not sure how to deal...going to try and see a dermatologist next I guess...

Stephen P Peters, MD, PhD, FACP, FAAAAI, FCCP, FCPP  Thomas H Davis Chair in Pulmonary Medicine, Chief, Section on Pulmonary, Critical Care, Allergy and Immunologic Diseases, Professor of Internal Medicine, Pediatrics, and Translational Science, Associate Director, Center for Genomics and Personalized Medicine Research, Wake Forest University School of Medicine; Executive Director of the Respiratory Service Line, Wake Forest Baptist Medical Center

Stephen P Peters, MD, PhD, FACP, FAAAAI, FCCP, FCPP is a member of the following medical societies: American Academy of Allergy Asthma and Immunology , American Association of Immunologists , American College of Chest Physicians , American College of Physicians , American Federation for Medical Research , American Thoracic Society , Sigma Xi

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Integrity CE, Merck<br/>Received income in an amount equal to or greater than $250 from: – Array Biopharma, AstraZeneca, Aerocrine, Airsonett AB, Boehringer-Ingelheim, Experts in Asthma, Gilead, GlaxoSmithKline, Merck, Novartis, Ono Pharmaceuticals, Pfizer, PPD Development, Quintiles, Sunovion, Saatchi & Saatichi, Targacept, TEVA, Theron.

Steroid-resistant asthma

steroid-resistant asthma

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