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1

Chung, Kian Fan. "Diagnosis and Management of Severe Asthma." Seminars in Respiratory and Critical Care Medicine 39, no. 01 (2018): 091–99. http://dx.doi.org/10.1055/s-0037-1607391.

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AbstractSevere therapy-resistant asthma has been defined as “asthma which requires treatment with high dose inhaled corticosteroids (ICSs) plus a second controller (and/or systemic corticosteroids) to prevent it from becoming ‘uncontrolled’ or which remains ‘uncontrolled’ despite this therapy”. Patients who usually present with ‘difficult-to-treat asthma’ should first be assessed to determine whether he/she has asthma with the exclusion of other diagnoses and if so, whether the asthma can be classified as severe therapy-resistant. This necessitates an assessment of adherence to medications, co
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Porcaro, Federica, Nicola Ullmann, Annalisa Allegorico, Antonio Di Marco, and Renato Cutrera. "Difficult and Severe Asthma in Children." Children 7, no. 12 (2020): 286. http://dx.doi.org/10.3390/children7120286.

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Asthma is the most frequent chronic inflammatory disease of the lower airways affecting children, and it can still be considered a challenge for pediatricians. Although most asthmatic patients are symptom-free with standard treatments, a small percentage of them suffer from uncontrolled persistent asthma. In these children, a multidisciplinary systematic assessment, including comorbidities, treatment-related issues, environmental exposures, and psychosocial factors is needed. The identification of modifiable factors is important to differentiate children with difficult asthma from those with t
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Mandal, Anirban, and Puneet Kaur Sahi. "Is it Difficult to Treat Asthma in Children?" Journal of Medical Research and Innovation 1, no. 3 (2017): 23–30. http://dx.doi.org/10.15419/jmri.77.

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Asthma, the commonest chronic lung disease in childhood, is managed effectively with inhaled medications in most of the cases. But a subset of pediatric asthma patients continues to experience substantial morbidity even after higher doses of medications; they are referred to as problematic severe asthma. In many such cases, the apparent resistance to therapy is actually due to a number of remediable factors. These cases are called ‘difficult to treat asthma’. The physician dealing with a child with problematic severe asthma needs to follow a systematic step- wise approach to find any possible
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Mandal, A., and PK Shahi. "Is it difficult to treat asthma in children." Journal of Medical Research and Innovation 1, no. 3 (2017): 23–30. https://doi.org/10.5281/zenodo.825267.

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Asthma, the commonest chronic lung disease in childhood, is managed effectively with inhaled medications in most of the cases. But a subset of pediatric asthma patients continues to experience substantial morbidity even after higher doses of medications; they are referred to as problematic severe asthma. In many such cases, the apparent resistance to therapy is actually due to a number of remediable factors. These cases are called ‘difficult to treat asthma’. The physician dealing with a child with problematic severe asthma needs to follow a systematic step- wise approach to find any possible
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Kulikov, Ye S., L. M. Ogorodova, M. B. Freidin, I. V. Saltikova, I. A. Deyev, and P. A. Selivanova. "GENE EXPRESSION DYNAMICS IN PATIENTS WITH SEVERE THERAPY-RESISTANT ASTHMA DURING TREATMENT PERIOD." Bulletin of Siberian Medicine 13, no. 1 (2014): 47–55. http://dx.doi.org/10.20538/1682-0363-2014-1-47-55.

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Introduction: The leading mechanisms and causes of severe therapy resistant asthma are poorly understood. The aim of this study was to define global patterns of gene expression in adults with severe therapy-resistant asthma in dynamic during treatment period.Methods: Performed 24-week prospective interventional study in parallel groups. Severe asthma patients was aposterior divided at therapy sensitive and resistant patients according to ATS criteria. Global transcriptome profile was characterized using the Affymetrix HuGene ST1.0 chip. Cluster analysis was performed.Results and conclusion: Ac
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Bush, Andrew. "Evaluating Severe Therapy-Resistant Asthma in Children: Diagnostic and Therapeutic Strategies." Medicina 60, no. 11 (2024): 1799. http://dx.doi.org/10.3390/medicina60111799.

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Introduction: Worldwide, asthma is the most common non-communicable respiratory disease and causes considerable morbidity and mortality. Most people with asthma can be treated effectively with low-dose medications if these are taken correctly and regularly. Around 10% of people with asthma have an uncontrolled form of the disease or can only achieve control with high-dose medications, incurring disproportionately high health care costs. Areas Covered: PubMed and personal archives were searched for relevant articles on the definition, management and pharmacotherapy of severe asthma. The WHO cla
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Chung, K. F. "Alternative treatments for difficult severe therapy-resistant asthma." Revue Française d'Allergologie et d'Immunologie Clinique 38, no. 9 (1998): 778–80. http://dx.doi.org/10.1016/s0335-7457(98)80192-5.

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Konradsen, J. R., B. Nordlund, C. Pedroletti, B. Dahlen, and G. Hedlin. "Identification Of Children With Severe Therapy Resistant Asthma." Journal of Allergy and Clinical Immunology 125, no. 2 (2010): AB70. http://dx.doi.org/10.1016/j.jaci.2009.12.276.

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CHOUDHURY, RAKIN, HELEN HASHEMI, and MARK MILLARD. "SEVERE ASTHMA CAUSED BY THERAPY-RESISTANT ASTHMATIC GRANULOMATOSIS." Chest 154, no. 4 (2018): 744A. http://dx.doi.org/10.1016/j.chest.2018.08.672.

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Fassakhov, R. S. "Severe eosinophilic asthma: therapeutic potential of Reslizumab." Medical Council, no. 15 (October 12, 2018): 70–75. http://dx.doi.org/10.21518/2079-701x-2018-15-70-75.

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The review discusses the problems associated with the treatment of patients with severe resistant to therapy asthma: prevalence, socio-economic burden, impact on quality of life. The phenotype of bronchial asthma with eosinophilic inflammation, frequency of occurrence, clinical features, and modern approaches to therapy are discussed in detail, including the use of a drug of monoclonal antibodies against interleukin 5-reslizumab.
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Castanhinha, S., A. Gupta, M. Maglione, et al. "S82 Fungal sensitisation in children with severe therapy resistant asthma." Thorax 66, Suppl 4 (2011): A39—A40. http://dx.doi.org/10.1136/thoraxjnl-2011-201054b.82.

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Bush, Andrew. "Severe and Difficult Asthma: Diagnosis and Management—Challenges for a Low-Resource Environment." Indian Journal of Pediatrics 89, no. 2 (2021): 156–62. http://dx.doi.org/10.1007/s12098-021-03952-w.

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AbstractSevere and difficult asthma in a low- and middle-income country (LMIC) can relate to (a) lack of availability of basic medications; (b) potentially reversible factors such as poor adherence or comorbidities such as obesity inhibiting a good response to treatment; and (c) (rarely) true severe, therapy-resistant asthma. However, definitions of severity should encompass not merely doses of prescribed medication, but also underlying risk. The nature of asthmatic airway disease shows geographical variation, and LMIC asthma should not be assumed to be phenotypically the same as that in high
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Wasti, Binaya, Zhifeng Chen, Yi He, Wen Tao Duan, Shao-Kun Liu, and Xu-Dong Xiang. "Role of Sex Hormones at Different Physiobiological Conditions and Therapeutic Potential in MBD2 Mediated Severe Asthma." Oxidative Medicine and Cellular Longevity 2021 (December 14, 2021): 1–16. http://dx.doi.org/10.1155/2021/7097797.

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Sex hormone has become a “hot topic” to evaluate the hormonal therapeutic potential in severe asthma. Th17 cell is one of the main influencing factors involved in the pathogenesis of severe asthma, hence also called as kernel of severe asthma, and Th17 subtype of non-T2 asthma is less responsive (resistance) to inhaled corticosteroid (ICS), so severe in nature. Methyl-CpG binding domain protein 2 (MBD2) is overexpressed and regulates the Th17 differentiation, showing the possibility of therapeutic target in treating Th17 mediated severe asthma. Sex hormone fluctuates at the different physiobio
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14

Waheed, Zeeshan, Muhammad Irfan, Mohammad Salih, and Ali Bin Sarwar Zubairi. "Differentiating Asthma from its mimics." Chest Disease Reports 1, no. 1 (2011): e17. http://dx.doi.org/10.4081/cdr.1.191.

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All that wheezes is not asthma this adage accredited to Chevalier Jackson emphasizes the importance of differentiating asthma from its mimics, particularly if the patient is not responding to usual therapy. The above statement also warrants further diagnostic evaluation and management of non-asthma conditions that mimic asthma. We present here a case of a middle aged female who presented with severe bronchospasm, initially labeled as asthma but was resistant to usual anti-asthma therapy. After further workup she was eventually diagnosed to have esophageal achalasia.
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15

Yilmaz, Insu. "Confusing Terminology: Difficult Asthma, Difficult-to-Treat Asthma, Difficult-to-Control Asthma, Therapy-Resistant Asthma, Severe Asthma, and Refractory Asthma. Which One is Truly Severe Asthma?" Turkish Thoracic Journal 19, no. 4 (2018): 235–36. http://dx.doi.org/10.5152/turkthoracj.2018.18026.

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Waheed, Zeeshan, Muhammad Irfan, Mohammad Salih, and Ali Bin Sarwar Zubairi. "Differentiating Asthma from its mimics." Chest Disease Reports 1, no. 1 (2011): 17. http://dx.doi.org/10.4081/cdr.2011.e17.

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<em>All that wheezes is not asthma</em> this adage accredited to Chevalier Jackson emphasizes the importance of differentiating asthma from its mimics, particularly if the patient is not responding to usual therapy. The above statement also warrants further diagnostic evaluation and management of non-asthma conditions that mimic asthma. We present here a case of a middle aged female who presented with severe bronchospasm, initially labeled as asthma but was resistant to usual anti-asthma therapy. After further workup she was eventually diagnosed to have esophageal achalasia.
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Namakanova, Olga A., Ekaterina A. Gorshkova, Ruslan V. Zvartsev, Sergei A. Nedospasov, Marina S. Drutskaya, and Ekaterina O. Gubernatorova. "Therapeutic Potential of Combining IL-6 and TNF Blockade in a Mouse Model of Allergic Asthma." International Journal of Molecular Sciences 23, no. 7 (2022): 3521. http://dx.doi.org/10.3390/ijms23073521.

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Combined anti-cytokine therapy is a promising therapeutic approach for uncontrolled steroid-resistant asthma. In this regard, simultaneous blockade of IL-4 and IL-13 signaling by Dupilumab (anti-IL-4Ra monoclonal antibody) was recently approved for severe eosinophilic asthma. However, no therapeutic options for neutrophilic asthma are currently available. Recent advances in our understanding of asthma pathogenesis suggest that both IL-6 and TNF may represent potential targets for treatment of severe neutrophilic asthma. Nevertheless, the efficacy of simultaneous pharmacological inhibition of T
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18

Antunes, L., A. P. Duarte de Souza, P. D. de Araújo, et al. "iNKT cells are increased in children with severe therapy-resistant asthma." Allergologia et Immunopathologia 46, no. 2 (2018): 175–80. http://dx.doi.org/10.1016/j.aller.2017.05.009.

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Gupta, A., A. Bush, D. Richards, C. Hawrylowicz, and S. Saglani. "Serum vitamin D levels and severe therapy resistant asthma in children." Paediatric Respiratory Reviews 12 (June 2011): S71. http://dx.doi.org/10.1016/s1526-0542(11)70073-2.

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Gupta, A., A. Bush, D. Richards, C. Hawrylowicz, and S. Saglani. "Serum vitamin D levels and severe therapy resistant asthma in children." Archives of Disease in Childhood 96, Supplement 1 (2011): A13. http://dx.doi.org/10.1136/adc.2011.212563.24.

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Bush, Andrew. "This Child’s Asthma Appears to Be Severe: But Where Actually Is the Severe Problem?" Acta Medica Academica 49, no. 2 (2020): 103. http://dx.doi.org/10.5644/ama2006-124.290.

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<p>The aim of this manuscript is to outline an approach to severe asthma, which is among the most challenging problems faced by paediatric pulmonologists. A logical, protocolised approach is essential. The first step is to rule out alternative diagnoses. The next step is a multidisciplinary assessment. Severe, therapy resistant asthma (STRA) is rare, and most of those referred will improve if basic management is corrected, especially adherence to treatment. However some are unable or unwilling to make necessary changes (refractory asthma plus or refractory difficult asthma). Some, especi
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BUSH, Andrew. "Problematic, severe asthma in children: a new concept and how to manage it." Acta medica Lituanica 17, no. 1-2 (2010): 51–64. http://dx.doi.org/10.15388/amed.2010.21692.

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Most children with asthma respond to low doses of inhaled corticosteroids, but a few remain symptomatic despite being prescribed the routine usual asthma medications. The first steps are to ensure that the diagnosis is correct and that the inhaled medications are being given regularly with an appropriately used device. If the children continue to be symptomatic, with any or all of chronic symptoms, acute exacerbations, the need for regular oral corticosteroids, or persistent airflow limitation, then they are considered to have problematic, severe asthma. The next step is to perform a detailed
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Scotney, Elizabeth, and Sejal Saglani. "Diagnosis and Management of Problematic Severe Asthma." Acta Medica Academica 49, no. 2 (2020): 117. http://dx.doi.org/10.5644/ama2006-124.291.

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<p>This review will outline an evidence-based approach for diagnosing and managing children with problematic severe asthma (PSA). Children with PSA have uncontrolled asthma symptoms, despite maximal prescribed asthma treatment. These children have high morbidity and mortality and should be referred for specialist respiratory assessment and management. The first step in the assessment of a child with PSA is confirming the diagnosis of asthma using objective evidence. Following this, an assess- ment of inhaled corticosteroid adherence and a multi-disciplinary team approach is essential for
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Zaytseva, Svetlana V., Anna U. Tomilova, Olga V. Zaytseva, et al. "Genetically Engineered Biologic Drugs in Management of Children with Bronchial Asthma." Pediatric pharmacology 18, no. 6 (2021): 460–68. http://dx.doi.org/10.15690/pf.v18i6.2325.

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Current article represents the modern clinical guidelines on management of severe bronchial asthma (BA) in children and practical use of genetically engineered biologic drugs. Clinical efficacy and safety of omalizumab has its special role. Efficacy analysis was carried out in real-life' clinical setting (considering high economical expenses of biological treatment) to estimate effective response predictors and principles of patients selection for such therapy. Two years of anti-IgE treatment experience in inpatient pediatric department settings demonstrates that omalizumab inclusion to treatm
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Ali, SH, P. Nagakumar, P. Kenia, and S. Rao. "G525(P) Wet cough in children with Severe Therapy Resistant Asthma (STRA)." Archives of Disease in Childhood 101, Suppl 1 (2016): A310—A311. http://dx.doi.org/10.1136/archdischild-2016-310863.512.

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Martin Alonso, Aldara, Valentina Fainardi, and Sejal Saglani. "Severe therapy resistant asthma in children: translational approaches to uncover sub-phenotypes." Expert Review of Respiratory Medicine 11, no. 11 (2017): 867–74. http://dx.doi.org/10.1080/17476348.2017.1368391.

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Sjoukes, A., A. Gupta, T. Oates, A. Bush, and S. Saglani. "S33 Vitamin D and airway remodelling in paediatric severe therapy resistant asthma." Thorax 66, Suppl 4 (2011): A18. http://dx.doi.org/10.1136/thoraxjnl-2011-201054b.33.

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Svetlakov, V. I., A. A. Karabinenko, N. M. Shirokhova, I. I. Ganieva, A. S. Sokolov, and V. M. Pavlov. "Benacort is the first Russian inhaled nebulised steroid." PULMONOLOGIYA, no. 2 (April 28, 2005): 113–16. http://dx.doi.org/10.18093/0869-0189-2005-0-2-113-116.

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The study was designed to investigate efficacy, safety and tolerability of Benacort in patients with moderate to severe acute asthma. The study involved 30 patients (19 females and 11 males, the mean ages, 46.2 ± 18.6 yrs and 54.3 ± 13.6 yrs respectively) with mild, moderate to severe asthma. They were divided into 2 groups: 20 patients with moderate acute asthma who received budesonide 1 000 to 2 000 mcg daily, and 10 patients with severe acute asthma, receiving the drug 2 000 to 4 000 mcg daily. Benacort was given via nebulizer 15 to 20 minutes after an inhaled bronchodilator. We monitores l
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Rodrigues, Andrea Mendonça, Cristian Roncada, Giovana Santos, et al. "Clinical characteristics of children and adolescents with severe therapy-resistant asthma in Brazil." Jornal Brasileiro de Pneumologia 41, no. 4 (2015): 343–50. http://dx.doi.org/10.1590/s1806-37132015000004462.

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AbstractObjective: To describe the clinical characteristics, lung function, radiological findings, and the inflammatory cell profile in induced sputum in children and adolescents with severe therapy-resistant asthma (STRA) treated at a referral center in southern Brazil.Methods: We retrospectively analyzed children and adolescents (3-18 years of age) with uncontrolled STRA treated with high-dose inhaled corticosteroids and long-acting β2 agonists. We prospectively collected data on disease control, lung function, skin test reactivity to allergens, the inflammatory cell profile in induced sputu
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Nagakumar, Prasad, Franz Puttur, Lisa G. Gregory, et al. "Pulmonary type-2 innate lymphoid cells in paediatric severe asthma: phenotype and response to steroids." European Respiratory Journal 54, no. 2 (2019): 1801809. http://dx.doi.org/10.1183/13993003.01809-2018.

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Children with severe therapy-resistant asthma (STRA) have poor control despite maximal treatment, while those with difficult asthma (DA) have poor control from failure to implement basic management, including adherence to therapy. Although recognised as clinically distinct, the airway molecular phenotype, including the role of innate lymphoid cells (ILCs) and their response to steroids in DA and STRA is unknown.Immunophenotyping of sputum and blood ILCs and T-cells from STRA, DA and non-asthmatic controls was undertaken. Leukocytes were analysed longitudinally pre- and post-intramuscular triam
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Wasti, Binaya, Zhifeng Chen, Yu Yuan, et al. "Androgen Plays a Potential Novel Hormonal Therapeutic Role in Th17 Cells Predominant Neutrophilic Severe Asthma by Attenuating BECs Regulated Th17 Cells Differentiation via MBD2 Expression." Oxidative Medicine and Cellular Longevity 2022 (August 25, 2022): 1–22. http://dx.doi.org/10.1155/2022/3096528.

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T helper 17 (Th17) cells subtype of non-T2 asthma is less responsive (resistant) to inhaled corticosteroids (ICS), so also called severe asthma. Methyl-CpG-binding domain protein 2 (MBD2) regulates the differentiation of the Th17 cells, showing the possibility of a therapeutic target in severe asthma. Androgen tends to show beneficial therapeutic effects and is a “hot research topic,” but its role in the differentiation and expression of Th17 cells via MBD2 is still unknown. The aim of this study was to evaluate how sex hormone interacts with MBD2 and affects the differentiation and expression
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Trejo Bittar, Humberto E., Daniel Doberer, Mitra Mehrad, et al. "Histologic Findings of Severe/Therapy-Resistant Asthma From Video-assisted Thoracoscopic Surgery Biopsies." American Journal of Surgical Pathology 41, no. 2 (2017): 182–88. http://dx.doi.org/10.1097/pas.0000000000000777.

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Irving, S., A. Bush, C. Bossley, A. Gupta, and S. Saglani. "P77 Lung clearance index (LCI) in children with severe, therapy resistant asthma (STRA)." Thorax 66, Suppl 4 (2011): A99. http://dx.doi.org/10.1136/thoraxjnl-2011-201054c.77.

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Demko, I. V., A. B. Salmina, A. V. Morgun, and N. A. Malinovskaya. "Expression of P-glycoprotein on blood lymphocytes and its role in development of steroid resistance in severe asthma." PULMONOLOGIYA, no. 3 (June 28, 2007): 41–46. http://dx.doi.org/10.18093/0869-0189-2007-0-3-41-46.

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P-glycoprotein (Pgp) is a membrane transporter of hydrophobic molecules providing efflux of xenobiotics from the cytosole outside the cell. In epithelial cells, Pgp is thought to be responsible for resistance to steroids. Severe bronchial asthma (SBA) is a heterogenous disease characterized by resistance to and dependence on steroids. The goal of this study was to assess expression of Pgp on peripheral blood lymphocytes in severe bronchial asthma and to evaluate the role of Pgp in developing the resistance to glucocorticoid therapy (GC). Assessment of Pgp expression revealed difference in resp
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Bush, Andrew. "Which Child with Asthma is a Candidate for Biological Therapies?" Journal of Clinical Medicine 9, no. 4 (2020): 1237. http://dx.doi.org/10.3390/jcm9041237.

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In asthmatic adults, monoclonals directed against Type 2 airway inflammation have led to major improvements in quality of life, reductions in asthma attacks and less need for oral corticosteroids. The paediatric evidence base has lagged behind. All monoclonals currently available for children are anti-eosinophilic, directed against the T helper (TH2) pathway. However, in children and in low and middle income settings, eosinophils may have important beneficial immunological actions. Furthermore, there is evidence that paediatric severe asthma may not be TH2 driven, phenotypes may be less stable
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Cornelius, Victoria, Daphne Babalis, William D. Carroll, et al. "Treating severe paediatric asthma with mepolizumab or omalizumab: a protocol for the TREAT randomised non-inferiority trial." BMJ Open 14, no. 8 (2024): e090749. http://dx.doi.org/10.1136/bmjopen-2024-090749.

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IntroductionA minority of school-aged children with asthma have persistent poor control and experience frequent asthma attacks despite maximal prescribed maintenance therapy. These children have higher morbidity and risk of death. The first add-on biologic therapy, omalizumab, a monoclonal antibody that blocks immunoglobulin (Ig)E, was licensed for children with severe asthma in 2005. While omalizumab is an effective treatment, non-response is common. A second biologic, mepolizumab which blocks interleukin 5 and targets eosinophilic inflammation, was licensed in 2018, but the licence was grant
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Nikitina, L. Yu, F. I. Petrovsky, I. I. Ivanchuk, and A. E. Sazonov. "The peculiarities of eosinophil apoptosis damage in patients with severe therapy-resistant bronchial asthma." Bulletin of Siberian Medicine 4, no. 4 (2005): 64–70. http://dx.doi.org/10.20538/1682-0363-2005-4-64-70.

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de Araújo, Patrícia Dias, Ana Paula Duarte de Souza, Renato T. Stein, et al. "Distinct patterns of CD4 T-cell phenotypes in children with severe therapy-resistant asthma." Pediatric Allergy and Immunology 30, no. 1 (2018): 130–36. http://dx.doi.org/10.1111/pai.12993.

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Koo, Sergio, Atul Gupta, Valentina Fainardi, et al. "Ethnic Variation in Response to IM Triamcinolone in Children With Severe Therapy-Resistant Asthma." Chest 149, no. 1 (2016): 98–105. http://dx.doi.org/10.1378/chest.14-3241.

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Teague, W. Gerald, Monica G. Lawrence, Debbie-Ann T. Shirley, et al. "Lung Lavage Granulocyte Patterns and Clinical Phenotypes in Children with Severe, Therapy-Resistant Asthma." Journal of Allergy and Clinical Immunology: In Practice 7, no. 6 (2019): 1803–12. http://dx.doi.org/10.1016/j.jaip.2018.12.027.

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Rekalova, O. M. "ASTHMA AS A MASK OF ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS: DIAGNOSIS AND TREATMENT." Ukrainian Pulmonology Journal 29, no. 4 (2021): 57–63. http://dx.doi.org/10.31215/2306-4927-2021-29-4-57-63.

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ASTHMA AS A MASK OF ALLERGIC BRONCHOPULMONARY ASPERGILLOSIS: DIAGNOSIS AND TREATMENT O. M. Rekalova Abstract Asthma is a heterogeneous diseases with multiple phenotypes, 5–10 % of which are associated with severe course of disease, resistant to standard therapy. Allergic bronchopulmonary aspergillosis (ABPA), being a separate disease (ICD-10: B44.9 — aspergillosis unspecified), may mimic asthma. A literature review of major statements regarding ABPA, focusing on definition, pathogenesis, diagnostic criteria, association of different forms of asthma with fungal sensitization and Th2-response, s
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Jochmann, Anja, Luca Artusio, Angela Jamalzadeh, et al. "Electronic monitoring of adherence to inhaled corticosteroids: an essential tool in identifying severe asthma in children." European Respiratory Journal 50, no. 6 (2017): 1700910. http://dx.doi.org/10.1183/13993003.00910-2017.

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International guidelines recommend that severe asthma can only be diagnosed after contributory factors, including adherence, have been addressed. Accurate assessment of adherence is difficult in clinical practice. We hypothesised that electronic monitoring in children would identify nonadherence, thus delineating the small number with true severe asthma.Asthmatic children already prescribed inhaled corticosteroids were prospectively recruited and persistence of adherence assessed using electronic monitoring devices. Spirometry, airway inflammation and asthma control were measured at the start
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Konradsen, Jon R., Björn Nordlund, Marika Lidegran, et al. "Problematic severe asthma: A proposed approach to identifying children who are severely resistant to therapy." Pediatric Allergy and Immunology 22, no. 1-Part-I (2010): 9–18. http://dx.doi.org/10.1111/j.1399-3038.2010.01098.x.

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Bush, A., S. Pedersen, G. Hedlin, et al. "Pharmacological treatment of severe, therapy-resistant asthma in children: what can we learn from where?" European Respiratory Journal 38, no. 4 (2011): 947–58. http://dx.doi.org/10.1183/09031936.00030711.

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Andrea, Rodrigues, Giovana Santos, Rodrigo Souza, et al. "Clinical characteristics, lung function and airway inflammatory patterns of Brazilian children with severe therapy-resistant asthma." Clinical and Translational Allergy 5, Suppl 2 (2015): P5. http://dx.doi.org/10.1186/2045-7022-5-s2-p5.

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Kwak, Dong-Wook, Donghwan Park, and Jae-Hong Kim. "Leukotriene B4 Receptor 2 Mediates the Production of G-CSF That Plays a Critical Role in Steroid-Resistant Neutrophilic Airway Inflammation." Biomedicines 10, no. 11 (2022): 2979. http://dx.doi.org/10.3390/biomedicines10112979.

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Granulocyte colony-stimulating factor (G-CSF) has been suggested to be closely associated with neutrophilic asthma pathogenesis. However, little is known about the factors regulating the production of G-CSF in neutrophilic asthma. We previously reported that a leukotriene B4 receptor 2, BLT2, played an important role in neutrophilic airway inflammation. Therefore, in the current study, we investigated whether BLT2 plays a role in the production of G-CSF in lipopolysaccharide/ovalbumin (LPS/OVA)-induced steroid-resistant neutrophilic asthma. The data showed that BLT2 critically mediated G-CSF p
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Gysens, Fien, Pieter Mestdagh, Eric de Bony de Lavergne, and Tania Maes. "Unlocking the secrets of long non-coding RNAs in asthma." Thorax 77, no. 5 (2022): 514–22. http://dx.doi.org/10.1136/thoraxjnl-2021-218359.

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Asthma is a very heterozygous disease, divided in subtypes, such as eosinophilic and neutrophilic asthma. Phenotyping and endotyping of patients, especially patients with severe asthma who are refractory to standard treatment, are crucial in asthma management and are based on a combination of clinical and biological features. Nevertheless, the quest remains to find better biomarkers that distinguish asthma subtypes in a more clear and objective manner and to find new therapeutic targets to treat people with therapy-resistant asthma. In the past, research to identify asthma subtypes mainly focu
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Adcock, IM, and SJ Lane. "Corticosteroid-insensitive asthma: molecular mechanisms." Journal of Endocrinology 178, no. 3 (2003): 347–55. http://dx.doi.org/10.1677/joe.0.1780347.

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Corticosteroids are the most potent anti-inflammatory agents used to treat chronic inflammatory diseases such as bronchial asthma. However, there are a small number (<5%) of asthmatic patients who do not respond well, or at all, to corticosteroid therapy - the corticosteroid-resistant and corticosteroid-dependent patients. Although this phenomenon is relatively uncommon, it poses a difficult therapeutic problem because few alternative therapies are available and these patients account for >50% of the health care costs of asthma. If the mechanisms for corticosteroid insensitivity are unde
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Jaiswal, Anil Kumar, Jyoti Yadav, Sangeet Makhija, et al. "Short palate, lung, and nasal epithelial clone 1 (SPLUNC1) level determines steroid-resistant airway inflammation in aging." American Journal of Physiology-Lung Cellular and Molecular Physiology 322, no. 1 (2022): L102—L115. http://dx.doi.org/10.1152/ajplung.00315.2021.

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Asthma and its heterogeneity change with age. Increased airspace neutrophil numbers contribute to severe steroid-resistant asthma exacerbation in the elderly, which correlates with the changes seen in adults with asthma. However, whether that resembles the same disease mechanism and pathophysiology in aged and adults is poorly understood. Here, we sought to address the underlying molecular mechanism of steroid-resistant airway inflammation development and response to corticosteroid (Dex) therapy in aged mice. To study the changes in inflammatory mechanism, we used a clinically relevant treatme
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Bell, Thomas. "EXTRACORPOREAL LIFE SUPPORT FOR STATUS ASTHMATICUS." Pediatrics 94, no. 2 (1994): 261. http://dx.doi.org/10.1542/peds.94.2.261b.

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Purpose of the Study. This report presents the experience with one case of status asthmaticus who failed to respond to mechanical ventilation and was successfully managed with extracorporeal life support (ECLS) using venovenous bypass. The purpose is to inform the practitioner of an additional therapy, potentially of benefit, in management of asthma complicated by treatment-resistant respiratory failure. Methods. Low volume venovenous bypass with extracorporeal life support resolved severe respiratory failure in a 23-year-old female asthmatic over a 22-hour period after failure of 5 hours of m
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