Clinical Reviews in Allergy & Immunology最新文献

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Systemic Sclerosis-Specific Antibodies: Novel and Classical Biomarkers. 系统性硬化症特异性抗体:新的和经典的生物标志物。
IF 9.1 2区 医学
Clinical Reviews in Allergy & Immunology Pub Date : 2023-06-01 DOI: 10.1007/s12016-022-08946-w
Ilaria Cavazzana, Tamara Vojinovic, Paolo Airo', Micaela Fredi, Angela Ceribelli, Eleonora Pedretti, Maria Grazia Lazzaroni, Emirena Garrafa, Franco Franceschini
{"title":"Systemic Sclerosis-Specific Antibodies: Novel and Classical Biomarkers.","authors":"Ilaria Cavazzana, Tamara Vojinovic, Paolo Airo', Micaela Fredi, Angela Ceribelli, Eleonora Pedretti, Maria Grazia Lazzaroni, Emirena Garrafa, Franco Franceschini","doi":"10.1007/s12016-022-08946-w","DOIUrl":"https://doi.org/10.1007/s12016-022-08946-w","url":null,"abstract":"<p><p>Disease-specific autoantibodies are considered the most important biomarkers for systemic sclerosis (SSc), due to their ability to stratify patients with different severity and prognosis. Anti-nuclear antibodies (ANA), occurring in subjects with isolated Raynuad's phenomenon, are considered the strongest independent predictors of definite SSc and digital microvascular damage, as observed by nailfold videocapillaroscopy. ANA are present in more than 90% of SSc, but ANA negativity does not exclude SSc diagnosis: a little rate of SSc ANA negative exists and shows a distinct subtype of disease, with less vasculopathy, but more frequent lower gastrointestinal involvement and severe disease course. Anti-centromere, anti-Th/To, and anti-Topoisomerase I antibodies could be considered as classical biomarkers, covering about 60% of SSc and defining patients with well-described cardio-pulmonary complications. In particular, anti-Topoisomerase I represent a risk factor for development of diffuse cutaneous involvement and digital ulcers in the first 3 years of disease, as well as severe interstitial lung disease (ILD). Anti-RNA polymerase III is a biomarker with new clinical implications: very rapid skin thickness progression, gastric antral vascular ectasia, the occurrence of synchronous cancers, and possible association with silicone breast implants rupture. Moreover, novel SSc specific autoantibodies have been globally described in about 10% of \"seronegative\" SSc patients: anti-elF2B, anti-RuvBL1/2 complex, anti-U11/U12 RNP, and anti-BICD2 depict specific SSc subtypes with severe organ complications. Many autoantibodies could be considered markers of overlap syndromes, including SSc. Anti-Ku are found in 2-7% of SSc, strictly defining the PM/SSc overlap. They are associated with synovitis, joint contractures, myositis, and negatively associated with vascular manifestation of disease. Anti-U3RNP are associated with a well-defined clinical phenotype: Afro-Caribbean male patients, younger at diagnosis, and higher risk of pulmonary hypertension and gastrointestinal involvement. Anti-PM/Scl define SSc patients with high frequency of ILD, calcinosis, dermatomyositis skin changes, and severe myositis. The accurate detection of autoantibodies SSc specific and associated with overlap syndromes is crucial for patients' stratification. ANA should be correctly identified using indirect immunofluorescent assay and a standardized way of patterns' interpretation. The gold-standard technique for autoantibodies' identification in SSc is still considered immunoprecipitation, for its high sensitivity and specificity, but other assays have been widely used in routine practice. The identification of SSc autoantibodies with high diagnostic specificity and high predictive value is mandatory for early diagnosis, a specific follow-up and the possible definition of the best therapy for every SSc subsets. In addition, the validation of novel autoantibodies is mandatory in wide","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"64 3","pages":"412-430"},"PeriodicalIF":9.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9444757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 15
Reproductive Issues and Pregnancy Implications in Systemic Sclerosis. 系统性硬化症的生殖问题和妊娠影响。
IF 9.1 2区 医学
Clinical Reviews in Allergy & Immunology Pub Date : 2023-06-01 DOI: 10.1007/s12016-021-08910-0
Maria-Grazia Lazzaroni, Francesca Crisafulli, Liala Moschetti, Paolo Semeraro, Ana-Rita Cunha, Agna Neto, Andrea Lojacono, Francesca Ramazzotto, Cristina Zanardini, Sonia Zatti, Paolo Airò, Angela Tincani, Franco Franceschini, Laura Andreoli
{"title":"Reproductive Issues and Pregnancy Implications in Systemic Sclerosis.","authors":"Maria-Grazia Lazzaroni,&nbsp;Francesca Crisafulli,&nbsp;Liala Moschetti,&nbsp;Paolo Semeraro,&nbsp;Ana-Rita Cunha,&nbsp;Agna Neto,&nbsp;Andrea Lojacono,&nbsp;Francesca Ramazzotto,&nbsp;Cristina Zanardini,&nbsp;Sonia Zatti,&nbsp;Paolo Airò,&nbsp;Angela Tincani,&nbsp;Franco Franceschini,&nbsp;Laura Andreoli","doi":"10.1007/s12016-021-08910-0","DOIUrl":"https://doi.org/10.1007/s12016-021-08910-0","url":null,"abstract":"<p><p>Systemic sclerosis (SSc) is a rare systemic autoimmune disease that can influence reproductive health. SSc has a strong female predominance, and the disease onset can occur during fertility age in almost 50% of patients. Preconception counseling, adjustment of treatment, and close surveillance during pregnancy by a multidisciplinary team, are key points to minimize fetal and maternal risks and favor successful pregnancy outcomes. The rates of spontaneous pregnancy losses are comparable to those of the general obstetric population, except for patients with diffuse cutaneous SSc and severe internal organ involvement who may carry a higher risk of abortion. Preterm birth can frequently occur in women with SSc, as it happens in other rheumatic diseases. Overall disease activity generally remains stable during pregnancy, but particular attention should be paid to women with major organ disease, such as renal and cardiopulmonary involvement. Women with such severe involvement should be thoroughly informed about the risks during pregnancy and possibly discouraged from getting pregnant. A high frequency of sexual dysfunction has been described among SSc patients, both in females and in males, and pathogenic mechanisms of SSc may play a fundamental role in determining this impairment. Fertility is overall normal in SSc women, while no studies in the literature have investigated fertility in SSc male patients. Nevertheless, some considerations regarding the impact of some immunosuppressive drugs should be done with male patients, referring to the knowledge gained in other rheumatic diseases.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"64 3","pages":"321-342"},"PeriodicalIF":9.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9435061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Therapeutic Approaches to Systemic Sclerosis: Recent Approvals and Future Candidate Therapies. 系统性硬化症的治疗方法:最近的批准和未来的候选疗法。
IF 8.4 2区 医学
Clinical Reviews in Allergy & Immunology Pub Date : 2023-06-01 Epub Date: 2021-09-01 DOI: 10.1007/s12016-021-08891-0
Alain Lescoat, David Roofeh, Masataka Kuwana, Robert Lafyatis, Yannick Allanore, Dinesh Khanna
{"title":"Therapeutic Approaches to Systemic Sclerosis: Recent Approvals and Future Candidate Therapies.","authors":"Alain Lescoat, David Roofeh, Masataka Kuwana, Robert Lafyatis, Yannick Allanore, Dinesh Khanna","doi":"10.1007/s12016-021-08891-0","DOIUrl":"10.1007/s12016-021-08891-0","url":null,"abstract":"<p><p>Systemic sclerosis is the rheumatic disease with the highest individual mortality. The severity of the disease is determined by the extent of fibrotic changes to cutaneous and internal organ tissues, the most life-threatening visceral manifestations being interstitial lung disease, SSc-associated-pulmonary arterial hypertension and myocardial involvement. The heterogeneity of the disease has initially hindered the design of successful clinical trials, but considerations on classification criteria have improved patient selection in trials, allowing the identification of more homogeneous groups of patients based on progressive visceral manifestations or the extent of skin involvement with a focus of patients with early disease. Two major subsets of systemic sclerosis are classically described: limited cutaneous systemic sclerosis characterized by distal skin fibrosis and the diffuse subset with distal and proximal skin thickening. Beyond this dichotomic subgrouping of systemic sclerosis, new phenotypic considerations based on antibody subtypes have provided a better understanding of the heterogeneity of the disease, anti-Scl70 antibodies being associated with progressive interstitial lung disease regardless of cutaneous involvement. Two targeted therapies, tocilizumab (a monoclonal antibody targeting interleukin-6 receptors (IL-6R)) and nintedanib (a tyrosine kinase inhibitor), have recently been approved by the American Food & Drug Administration to limit the decline of lung function in patients with SSc-associated interstitial lung disease, demonstrating that such better understanding of the disease pathogenesis with the identification of key targets can lead to therapeutic advances in the management of some visceral manifestations of the disease. This review will provide a brief overview of the pathogenesis of SSc and will present a selection of therapies recently approved or evaluated in this context. Therapies evaluated and approved in SSc-ILD will be emphasized and a review of recent phase II trials in diffuse cutaneous systemic sclerosis will be proposed. We will also discuss selected therapeutic pathways currently under investigation in systemic sclerosis that still lack clinical data in this context but that may show promising results in the future based on preclinical data.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"64 3","pages":"239-261"},"PeriodicalIF":8.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9034469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9440492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Narrative Review of Pathogenetic and Histopathologic Aspects, Epidemiology, Classification Systems, and Disease Outcome Measures in Systemic Sclerosis. 系统性硬化症的病原学和组织病理学方面、流行病学、分类系统和疾病结果测量的叙述性综述。
IF 8.4 2区 医学
Clinical Reviews in Allergy & Immunology Pub Date : 2023-06-01 Epub Date: 2022-03-07 DOI: 10.1007/s12016-022-08929-x
Maria-Grazia Lazzaroni, Silvia Piantoni, Fabrizio Angeli, Stefania Bertocchi, Franco Franceschini, Paolo Airò
{"title":"A Narrative Review of Pathogenetic and Histopathologic Aspects, Epidemiology, Classification Systems, and Disease Outcome Measures in Systemic Sclerosis.","authors":"Maria-Grazia Lazzaroni, Silvia Piantoni, Fabrizio Angeli, Stefania Bertocchi, Franco Franceschini, Paolo Airò","doi":"10.1007/s12016-022-08929-x","DOIUrl":"10.1007/s12016-022-08929-x","url":null,"abstract":"<p><p>Systemic sclerosis (SSc) is a rare systemic autoimmune disease, characterized by the presence of three main actors: vasculopathy, immune activation, and fibrosis. This pathologic process is then translated in a clinical picture with great variability among different patients in terms of type of organ involvement, disease severity and prognosis. This heterogeneity is a main feature of SSc, which, in addition to the presence of early phases of the disease characterized by mild symptoms, can explain the high difficulty in establishing classification criteria, and in defining patients' subsets and disease outcomes. The definition of disease outcomes is particularly relevant in the setting of clinical trials, where the aim is to provide reliable endpoints, able to measure the magnitude of the efficacy of a certain drug or intervention. For this reason, in the last years, increasing efforts have been done to design measures of disease activity, damage, severity, and response to treatment, often in the context of composite indexes. When considering disease outcomes, the experience of the patient represents a relevant and complementary aspect. The tools able to capture this experience, the patient-reported outcomes, have been increasingly used in the last years in clinical practice and in clinical trials, both as primary and secondary endpoints. This comprehensive narrative review on SSc will therefore cover pathogenetic and histopathologic aspects, epidemiology, classification systems, and disease outcome measures, in order to focus on issues that are relevant for clinical research and design of clinical trials.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"64 3","pages":"358-377"},"PeriodicalIF":8.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9439376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mesenchymal Stem Cell-Based Therapy as a New Approach for the Treatment of Systemic Sclerosis. 间充质干细胞为基础的治疗系统性硬化症的新途径。
IF 9.1 2区 医学
Clinical Reviews in Allergy & Immunology Pub Date : 2023-06-01 DOI: 10.1007/s12016-021-08892-z
Xiufen Zhuang, Xiao Hu, Shuren Zhang, Xingmin Li, Xiaoying Yuan, Yanhong Wu
{"title":"Mesenchymal Stem Cell-Based Therapy as a New Approach for the Treatment of Systemic Sclerosis.","authors":"Xiufen Zhuang,&nbsp;Xiao Hu,&nbsp;Shuren Zhang,&nbsp;Xingmin Li,&nbsp;Xiaoying Yuan,&nbsp;Yanhong Wu","doi":"10.1007/s12016-021-08892-z","DOIUrl":"https://doi.org/10.1007/s12016-021-08892-z","url":null,"abstract":"<p><p>Systemic sclerosis (SSc) is an intractable autoimmune disease with unmet medical needs. Conventional immunosuppressive therapies have modest efficacy and obvious side effects. Targeted therapies with small molecules and antibodies remain under investigation in small pilot studies. The major breakthrough was the development of autologous haematopoietic stem cell transplantation (AHSCT) to treat refractory SSc with rapidly progressive internal organ involvement. However, AHSCT is contraindicated in patients with advanced visceral involvement. Mesenchymal stem cells (MSCs) which are characterized by immunosuppressive, antifibrotic and proangiogenic capabilities may be a promising alternative option for the treatment of SSc. Multiple preclinical and clinical studies on the use of MSCs to treat SSc are underway. However, there are several unresolved limitations and safety concerns of MSC transplantation, such as immune rejections and risks of tumour formation, respectively. Since the major therapeutic potential of MSCs has been ascribed to their paracrine signalling, the use of MSC-derived extracellular vesicles (EVs)/secretomes/exosomes as a \"cell-free\" therapy might be an alternative option to circumvent the limitations of MSC-based therapies. In the present review, we overview the current knowledge regarding the therapeutic efficacy of MSCs in SSc, focusing on progresses reported in preclinical and clinical studies using MSCs, as well as challenges and future directions of MSC transplantation as a treatment option for patients with SSc.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"64 3","pages":"284-320"},"PeriodicalIF":9.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9435066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
Renal Disease and Systemic Sclerosis: an Update on Scleroderma Renal Crisis. 肾脏疾病和系统性硬化症:硬皮病肾危机的最新进展。
IF 9.1 2区 医学
Clinical Reviews in Allergy & Immunology Pub Date : 2023-06-01 DOI: 10.1007/s12016-022-08945-x
Alice Cole, Voon H Ong, Christopher P Denton
{"title":"Renal Disease and Systemic Sclerosis: an Update on Scleroderma Renal Crisis.","authors":"Alice Cole,&nbsp;Voon H Ong,&nbsp;Christopher P Denton","doi":"10.1007/s12016-022-08945-x","DOIUrl":"https://doi.org/10.1007/s12016-022-08945-x","url":null,"abstract":"<p><p>Scleroderma renal crisis (SRC) is a life-threatening complication of systemic sclerosis (SSc) with a mortality of 20% at 6 months. Once the leading cause of mortality in scleroderma (SSc), it remains a serious complication, often necessitating level three care for patients affected. Whilst renal outcomes have significantly improved following the advent of angiotensin-converting enzyme inhibitor (ACEi) therapy, SRC remains a precarious challenge for clinicians, due to lack of preventative measures and the fact that patients can rapidly decline despite best medical management. Large cohort studies spanning decades have allowed clear identification of phenotypes particularly at risk of developing SRC thus allowing enhanced monitoring and early identification in those individuals. Novel urinary biomarkers for renal disease in SSc may offer a new window for early identification of SRC patients and response to treatment. Multiple studies have demonstrated increased activity of complement pathways in SRC with some anecdotal cases exhibiting serological response to treatment with eculizumab where ACEi and therapeutic plasma exchange (TPE) were not successful. Endothelin-1 blockade, a therapeutic strategy in other SSc vasculopathies, has shown potential as a target but clinical trials are yet to show a clear treatment benefit. Clear guidelines for the management of SRC are in place to standardise care and facilitate early collaboration between rheumatology and renal physicians. Outcomes following renal transplant have improved but the mortality of SRC remains high, indicating the need for continued exploration of the mechanisms precipitating and exacerbating SRC in order to develop novel therapies.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"64 3","pages":"378-391"},"PeriodicalIF":9.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9792531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 15
A Summary on the Genetics of Systemic Lupus Erythematosus, Rheumatoid Arthritis, Systemic Sclerosis, and Sjögren's Syndrome. 系统性红斑狼疮、类风湿性关节炎、系统性硬化症和Sjögren综合征的遗传学综述。
IF 9.1 2区 医学
Clinical Reviews in Allergy & Immunology Pub Date : 2023-06-01 DOI: 10.1007/s12016-022-08951-z
Lourdes Ortíz-Fernández, Javier Martín, Marta E Alarcón-Riquelme
{"title":"A Summary on the Genetics of Systemic Lupus Erythematosus, Rheumatoid Arthritis, Systemic Sclerosis, and Sjögren's Syndrome.","authors":"Lourdes Ortíz-Fernández,&nbsp;Javier Martín,&nbsp;Marta E Alarcón-Riquelme","doi":"10.1007/s12016-022-08951-z","DOIUrl":"https://doi.org/10.1007/s12016-022-08951-z","url":null,"abstract":"<p><p>Systemic lupus erythematosus, systemic sclerosis, rheumatoid arthritis, and Sjögren's syndrome are four major autoimmune rheumatic diseases characterized by the presence of autoantibodies, caused by a dysregulation of the immune system that leads to a wide variety of clinical manifestations. These conditions present complex etiologies strongly influenced by multiple environmental and genetic factors. The human leukocyte antigen (HLA) region was the first locus identified to be associated and still represents the strongest susceptibility factor for each of these conditions, particularly the HLA class II genes, including DQA1, DQB1, and DRB1, but class I genes have also been associated. Over the last two decades, the genetic component of these disorders has been extensively investigated and hundreds of non-HLA risk genetic variants have been uncovered. Furthermore, it is widely accepted that autoimmune rheumatic diseases share molecular disease pathways, such as the interferon (IFN) type I pathways, which are reflected in a common genetic background. Some examples of well-known pleiotropic loci for autoimmune rheumatic diseases are the HLA region, DNASEL13, TNIP1, and IRF5, among others. The identification of the causal molecular mechanisms behind the genetic associations is still a challenge. However, recent advances have been achieved through mouse models and functional studies of the loci. Here, we provide an updated overview of the genetic architecture underlying these four autoimmune rheumatic diseases, with a special focus on the HLA region.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"64 3","pages":"392-411"},"PeriodicalIF":9.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9435558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 10
Real-Life Effectiveness of Benralizumab, Mepolizumab and Omalizumab in Severe Allergic Asthma Associated with Nasal Polyps. Benralizumab, Mepolizumab和Omalizumab在鼻息肉相关的严重过敏性哮喘中的实际有效性
IF 9.1 2区 医学
Clinical Reviews in Allergy & Immunology Pub Date : 2023-04-01 DOI: 10.1007/s12016-022-08938-w
Angelica Tiotiu, Paula Mendez-Brea, Iulia Ioan, Rodrigo Romero-Fernandez, Jean Philippe Oster, Thi-Cam-Tu Hoang, Pauline Roux, Diana Carolina Ochoa-Gutierrez, Philippe Bonniaud, Frederic de Blay, Francisco-Javier Gonzalez-Barcala
{"title":"Real-Life Effectiveness of Benralizumab, Mepolizumab and Omalizumab in Severe Allergic Asthma Associated with Nasal Polyps.","authors":"Angelica Tiotiu,&nbsp;Paula Mendez-Brea,&nbsp;Iulia Ioan,&nbsp;Rodrigo Romero-Fernandez,&nbsp;Jean Philippe Oster,&nbsp;Thi-Cam-Tu Hoang,&nbsp;Pauline Roux,&nbsp;Diana Carolina Ochoa-Gutierrez,&nbsp;Philippe Bonniaud,&nbsp;Frederic de Blay,&nbsp;Francisco-Javier Gonzalez-Barcala","doi":"10.1007/s12016-022-08938-w","DOIUrl":"https://doi.org/10.1007/s12016-022-08938-w","url":null,"abstract":"<p><p>Biological therapies are available for the treatment of the severe allergic asthma (SAA) with blood eosinophil count ≥ 0.3 × 10<sup>9</sup>/L. Several of them also showed benefits on nasal polyps (NP), one of the most frequent comorbidities of the severe asthma, but comparative studies on their effectiveness in the association SAA-NP are currently lacking. The aim of this study is to compare the effectiveness of benralizumab, mepolizumab and omalizumab in patients with SAA-NP in real-life settings. A retrospective, observational, multicenter real-life study was realized including patients with SAA-NP treated by benralizumab, mepolizumab or omalizumab for 6 months. We analysed the nasal and respiratory symptoms, the number of asthma attacks and salbutamol use/week, acute sinusitis and severe exacerbation rates, the asthma control score, the lung function parameters, the NP endoscopic score, the sinus imaging and the blood eosinophil count 6 months before and after treatment. Seventy-two patients with SAA-NP were included: 16 treated by benralizumab, 21 by mepolizumab and 35 by omalizumab. After 6 months of treatment, almost all studied parameters were improved (except sinus imaging) with a greater effect of omalizumab on the nasal pruritus (p = 0.001) and more benefits of benralizumab on exacerbations rate, asthma attacks per week and lung function (all p < 0.05). Benralizumab and mepolizumab were more effective to improve the NP endoscopic score and the blood eosinophil count (both p < 0.001). All three biological therapies showed effectiveness by improving asthma and nasal outcomes in patients with SAA-NP. Several differences have been found that should be confirmed by larger comparative studies.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"64 2","pages":"179-192"},"PeriodicalIF":9.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9509379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Inflammaging and Frailty in Immune-Mediated Rheumatic Diseases: How to Address and Score the Issue. 免疫介导的风湿病的炎症和虚弱:如何解决和评分问题。
IF 9.1 2区 医学
Clinical Reviews in Allergy & Immunology Pub Date : 2023-04-01 DOI: 10.1007/s12016-022-08943-z
Fausto Salaffi, Andrea Di Matteo, Sonia Farah, Marco Di Carlo
{"title":"Inflammaging and Frailty in Immune-Mediated Rheumatic Diseases: How to Address and Score the Issue.","authors":"Fausto Salaffi,&nbsp;Andrea Di Matteo,&nbsp;Sonia Farah,&nbsp;Marco Di Carlo","doi":"10.1007/s12016-022-08943-z","DOIUrl":"https://doi.org/10.1007/s12016-022-08943-z","url":null,"abstract":"<p><p>Frailty is a new concept in rheumatology that can help identify people more likely to have less favorable outcomes. Sarcopenia and inflammaging can be regarded as the biological foundations of physical frailty. Frailty is becoming more widely accepted as an indicator of ageing and is linked to an increased risk of negative outcomes such as falls, injuries, and mortality. Frailty identifies a group of older adults that seem poorer and more fragile than their age-matched counterparts, despite sharing similar comorbidities, demography, sex, and age. Several studies suggest that inflammation affects immune-mediated pathways, multimorbidity, and frailty by inhibiting growth factors, increasing catabolism, and by disrupting homeostatic signaling. Frailty is more common in the community-dwelling population as people get older, ranging from 7 to 10% in those over 65 years up to 40% in those who are octogenarians. Different parameters have been validated to identify frailty. These primarily relate to two conceptual models: Fried's physical frailty phenotype and Rockwood's cumulative deficit method. Immune-mediated rheumatic diseases (IMRDs), such as rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus, systemic sclerosis, and vasculitis, are leading causes of frailty in developing countries. The aim of this review was to quantitatively synthesize published literature on the prevalence of frailty in IMRDs and to summarize current evidence on the relevance and applicability of the most widely used frailty screening tools.</p>","PeriodicalId":10423,"journal":{"name":"Clinical Reviews in Allergy & Immunology","volume":"64 2","pages":"206-221"},"PeriodicalIF":9.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10017626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9135033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 13
Immunology of Aging: the Birth of Inflammaging. 衰老免疫学:炎症的诞生。
IF 9.1 2区 医学
Clinical Reviews in Allergy & Immunology Pub Date : 2023-04-01 DOI: 10.1007/s12016-021-08899-6
T Fulop, A Larbi, G Pawelec, A Khalil, A A Cohen, K Hirokawa, J M Witkowski, C Franceschi
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引用次数: 92
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