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Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5)(Clin Transl Allergy (2016) 6 (29) DOI: 10.1186/s13601-016-0116-9)
No full text[This corrects the article DOI: 10.1186/s13601-016-0116-9.]
Asthma
No full textAsthma is a chronic inflammatory disease ofthe airways, characterised clinically byrecurrent respiratory symptoms: dyspnoea,wheezing, chest tightness and/or cough,almost always associated with reversibleairflow limitation.The diagnosis of asthma is based on clinicalhistory and lung function tests, particularlypeak expiratory flow (PEF) and spirometry,with assessment of variable and/or reversibleairflow limitation. Allergy tests are alsousually performed during the first assessmentof a patient with suspected asthma to identifypossible triggers of asthma and to guide theiravoidance
Symptomatic elderly patients. The urgent need for comprehensive assessment and management
No full textNot availabl
Phosphodiesterase-4 Inhibitor Therapy for Lung Diseases
No full textPhosphodiesterases (PDEs) are a superfamily of enzymes that catalyze the breakdown of cAMP and/or cyclic guanosine monophosphate (GMP) to their inactive form. PDE4 is the main selective cAMP-metabolizing enzyme in inflammatory and immune cells. Because PDE4 is highly expressed in leukocytes and other inflammatory cells involved in the pathogenesis of inflammatory lung diseases, such as asthma and chronic obstructive pulmonary disease (COPD), inhibition of PDE4 has been predicted to have an antiinflammatory effect and thus therapeutic efficacy. The limited and inconsistent efficacy and side effects of the early compounds made their further development less desirable in asthma, given the excellent efficacy/tolerability ratio of inhaled steroids. The lack of effective antiinflammatory drug treatment for COPD has thus shifted the interest in development toward COPD. Roflumilast, the only PDE4 inhibitor that has reached the market because of the good efficacy/tolerability ratio, is recommended for patients with COPD with severe airflow limitation, symptoms of chronic bronchitis, and a history of exacerbations, whose disease is not adequately controlled by long-acting bronchodilators. Albeit safe, it maintains significant side effects (diarrhea, nausea, weight loss) that make it intolerable in some patients. Future developments of PDE4 inhibitors include extended indications of roflumilast (1) in patients with COPD, and(2) in other respiratory (e. g., asthma) and nonrespiratory chronic inflammatory/metabolic conditions (e. g., diabetes), as well as (3) the development of new molecules with PDE4 inhibitory properties with an improved efficacy/tolerability profile
COPD and the Solar System:Introducing the Chronic Obstructive Pulmonary Disease Comorbidome
No full textChronic obstructive pulmonary disease (COPD) is increasingly recognized as the pulmonary component of a more complex syndrome characterized by structural abnormalities of the airways (bronchiolitis) and lung (emphysema), and also by concomitant disorders (comorbidities) such as cardiovascular disease, metabolic syndrome, osteoporosis, depression, cancer, and inflammatory bowel disease. These comorbidities influence not only the severity of the symptoms and the quality of life of individual patients, but also the risk of hospitalization and eventually death. In turn, COPD is a frequent and important comorbidity of these same chronic conditions (e.g., ischemic heart disease, chronic heart failure, arrhythmia, osteoporosis, and metabolic syndrome). Indeed, only a minority of patients with COPD die of respiratory failure; most die of other conditions, particularly cardiovascular disease, pneumonia, thromboembolism, and cancer (mainly lung cancer
Roflumilast:un nuovo farmaco per il trattamento della BPCO
No full textLa broncopneumopatia cronica ostruttiva (BPCO) è una malattia respiratoria cronica il cui principale fattore di rischio è il fumo di sigaretta. La patologia è caratterizzata da una progressiva limitazione del flusso aereo non completamente reversibile, da sintomi respiratori quali tosse e dispnea e da frequenti riacutizzazioni cliniche che possono richiedere il ricovero ospedaliero con ulteriore compromissione dello stato di salute, declino della funzionalità respiratoria e aumento del tasso di mortalità. I farmaci attualmente disponibili per il trattamento della BPCO sono i broncodilatatori inalatori a breve (SABA) e a lunga durata d’azione (LABA). Nei pazienti con BPCO grave e molto grave e con frequenti riacutizzazioni i LABA sono somministrati in associazione con gli steroidi inalatori. L’infiammazione cronica dei polmoni gioca un ruolo cruciale nella patogenesi della BPCO. Gli inibitori della fosfodiesterasi 4 (PDE4) sono una nuova classe di farmaci ad azione antinfiammatoria che sono stati sviluppati per controllare l’infiammazione cronica correlata alla BPCO.Gli inibitori della fosfodiesterasi 4 hanno mostrato una buona efficacia e tollerabilità in studi preclinici e clinici condotti nei pazienti con BPC
le infezioni come comorbidità della BPCO
No full textLe infezioni sia acute che croniche si manifestano con maggiore frequenza nei pazienti affetti con BPCO rispetto alla popolazione generale. In questo articolo vengono revisionati i meccanismi patogenetici, i quadri clinici e le strategia teraputich
La NIV nel paziente con insufficienza respiratoria cronica, la gestione domiciliare - Competenza specialistica nelle patologie pneumologiche pure
No full textQuesto capitolo ha lo scopo di revisionare la letteratura in merito ai meccanismi dell’insufficienza respiratoria cronica e gli effetti fisiologici e l’efficacia della ventilazione meccanica non invasiva nei pazienti affetti da BPCO in fase di stabilità clinica, cercando di dare indicazioni sulla selezione dei pazienti che potrebbero maggiormente beneficiare di questo trattamento
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