Steroid-resistant asthma

Viv was diagnosed with Acute Megakaryoblastic Leukemia on Thursday, July 20, 2017. After weeks of fevers, joint pain, and anemia, the doctors at University Hospital's Rainbow Children's diagnosed her with cancer. She spent 5 months in the hospital battling two rounds of chemotherapy, over a month in the Pediatric ICU where she experienced complications from treatment and ultimately required an ostomy procedure. Ultimately, Viv persevered and was able to make it to a bone marrow transplant. Viv went into a state of remission after the second round of chemotherapy. 
 
She’s been home with her sisters since late December and has been thriving and living a (relatively) normal life. She celebrated her 2nd birthday in January and we’re praying each and every day that she remains in remission and we can look forward to a better future with Viv.

Bapineuzumab, a humanized anti-aβ MAB, is directed against the N-terminus of Aβ. Phase II clinical trials of Bapineuzumab in mild to moderate AD patients resulted in reduced Aβ concentration in the brain. However, in patients with increased apolipoprotein (APOE) e4 carriers, Bapineuzumab treatment is also accompanied by vasogenic edema , [30] a cytotoxic condition where the blood brain barrier has been disrupted thereby affecting white matter from excess accumulation of fluid from capillaries in intracellular and extracellular spaces of the brain. [31] In Phase III clinical trials, Bapineuzumab treatment is associated with reduced rate of accumulation of Aβ in the brain in APOE e4 patients, and no significant reduction of Aβ concentration in APOE e4 patients and non-APOE e4 patients. Therefore, Aβ plaque concentration were not reduced, and there is no significant clinical benefits in cognitive functioning. Bapineuzumab was discontinued after failing in Phase III clinical trial. [32]

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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.

Steroid-resistant asthma

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.

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