scholarly journals Are the Global Initiative for Asthma (GINA) Guidelines Being Correctly Used to Diagnose Severe Asthma in the UAE?

Cureus ◽  
2020 ◽  
Author(s):  
Mohamed Abuzakouk ◽  
Sonya Jacob ◽  
Omar Ghorab
2016 ◽  
Vol 51 (4) ◽  
pp. 277-284
Author(s):  
Łukasz Kraszula ◽  
Makandjou-Ola Eusebio ◽  
Anna Jasińska ◽  
Maciej Kupczyk ◽  
Piotr Kuna ◽  
...  

The aim of this study was evaluation whether there is an association between BMI, leptin and its soluble receptor, the expression of FoxP3 in CD4+ pTreg in women with severe asthma. Materials and methods. The study included thirty women with asthma: 17 patients with severe and 13 with mild-moderate disease. The control group comprised of 25 healthy women. Asthma was diagnosed in accordance with the Global Initiative For Asthma guidelines (GINA 2014). The phenotype of CD4+CD25highCD127lowFoxp3+CD152+ cells was evaluated by multicolor flow cytometry. The concentration of leptin and its soluble receptor were determined using an immunoenzymatic method (ELISA). Results. It has been shown significantly increased leptin concentration in the group of women with severe asthma compared with mild-moderate asthma and control group (p <0.05). The concentration of the leptin receptor significantly increased (p <0.05) in women with severe asthma compared with control group. There were no differences in percentage of CD4+FoxP3+ and CD4+CD25highCD127low- FoxP3+CD152+ subsets after leptin stimulation in all tested groups. Conclusions. Our results don’t confirm the direct effect of leptin on the CD4+ pTreg cells and the expression of FoxP3 in these cells, in tested groups.


2020 ◽  
Vol 6 (4) ◽  
pp. 00566-2020
Author(s):  
Norrice M. Liu ◽  
Karin C.L. Carlsen ◽  
Steve Cunningham ◽  
Grazia Fenu ◽  
Louise J. Fleming ◽  
...  

New biologics are being continually developed for paediatric asthma, but it is unclear whether there are sufficient numbers of children in Europe with severe asthma and poor control to recruit to trials needed for registration. To address these questions, the European Respiratory Society funded the Severe Paediatric Asthma Collaborative in Europe (SPACE), a severe asthma registry. We report the first analysis of the SPACE registry, which includes data from 10 paediatric respiratory centres across Europe.Data from 80 children with a clinical diagnosis of severe asthma who were receiving both high-dose inhaled corticosteroid and long-acting β2-agonist were entered into the registry between January 2019 and January 2020. Suboptimal control was defined by either asthma control test, or Global Initiative for Asthma criteria, or ≥2 severe exacerbations in the previous 12 months, or a combination.Overall, 62 out of 80 (77%) children had suboptimal asthma control, of whom 29 were not prescribed a biologic. However, in 24 there was an option for starting a licensed biologic. 33 children with suboptimal control were prescribed a biologic (omalizumab (n=24), or mepolizumab (n=7), or dupilumab (n=2)), and for 29 there was an option to switch to a different biologic.We conclude that the SPACE registry provides data that will support the planning of studies of asthma biologics. Not all children on biologics achieve good asthma control, and there is need for new trial designs addressing biologic switching.


2014 ◽  
Vol 17 (3) ◽  
pp. A180
Author(s):  
P.W. Sullivan ◽  
J. Campbell ◽  
V.H. Ghushchyan ◽  
G. Globe ◽  
J. Lange ◽  
...  

2021 ◽  
pp. 2102730
Author(s):  
Helen K. Reddel ◽  
Leonard B. Bacharier ◽  
Eric D. Bateman ◽  
Christopher E. Brightling ◽  
Guy G. Brusselle ◽  
...  

The Global Initiative for Asthma (GINA) Strategy Report provides clinicians with an annually updated evidence-based strategy for asthma management and prevention, which can be adapted for local circumstances (e.g., medication availability). This article summarizes key recommendations from GINA 2021, and the evidence underpinning recent changes.GINA recommends that asthma in adults and adolescents should not be treated solely with short-acting beta2-agonist (SABA), because of the risks of SABA-only treatment and SABA overuse, and evidence for benefit of inhaled corticosteroids (ICS). Large trials show that as- needed combination ICS-formoterol reduces severe exacerbations by >60% in mild asthma compared with SABA alone, with similar exacerbation, symptom, lung function and inflammatory outcomes as daily ICS plus as-needed SABA.Key changes in GINA 2021 include division of the treatment figure for adults and adolescents into two tracks. Track 1 (preferred) has low-dose ICS-formoterol as the reliever at all steps: as-needed only in Steps 1-2 (mild asthma), and with daily maintenance ICS-formoterol (maintenance-and-reliever therapy, MART) in Steps 3-5. Track 2 (alternative) has as-needed SABA across all steps, plus regular ICS (Step 2) or ICS-long-acting beta2-agonist (LABA) (Steps 3-5). For adults with moderate-to-severe asthma, GINA makes additional recommendations in Step 5 for add-on long-acting muscarinic antagonists and azithromycin, with add-on biologic therapies for severe asthma. For children 6-11  years, new treatment options are added at Steps 3-4.Across all age-groups and levels of severity, regular personalized assessment, treatment of modifiable risk factors, self-management education, skills training, appropriate medication adjustment and review remain essential to optimize asthma outcomes.


2016 ◽  
Vol 12 (3) ◽  
pp. 160
Author(s):  
Adnan M. H. Hamawandi ◽  
Kosar M Ali ◽  
Ali Z. Naji

Background: Asthma is a common and potentially serious chronic disease that imposes a substantial burden on patients, their families and the community. Objective: Assessment of the level of asthma control and severity in asthmatic children in Sulaimani city according to the global initiative for asthma (GINA) guidelines. Methods: A cross-sectional study of 82 patients who are known cases of asthma, aged 5 – 15 years , from 1st of March 2014 to 1st of August 2014. Results: Out of 82 patients in our study, 20.8%were classified as having intermittent asthma all of them have well controlled asthma, 42.7% of those classified as having mild persistent asthma 65.7% of them have well controlled asthma, 26.8% of those classified as having moderate persistent asthma 54.5% of them have partly controlled asthma, and 9.8%of those classified as having severe persistent asthma the majority of them 87.5% have uncontrolled asthma and none of them reached to the controlled asthma level according to GINA guidelines. Regarding the peak expiratory flow (PFT) we notice that 58.8% of asthmatic children who were classified as having intermittent severity, their PEF measurements ranged between 160- 250 l/min while those with severe persistent asthma 75% of them have readings between 50-150 l/min. Conclusion: Current levels of asthma control in the Sulaimani city fall far short of the goals specified in the GINA guidelines for asthma management. Also there is a strong correlation between PEF measurements and the level of asthma severity,


2019 ◽  
Vol 10 (3) ◽  
pp. 28-32
Author(s):  
Shreyas Ramchandra Burut ◽  
◽  
Ruchi Doongarshi Shah ◽  
Ramchandra B. Burute ◽  
Sunita Jaiprakash Ramanand ◽  
...  

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