Severe asthma is a form of asthma that responds poorly to currently available medication, and its patients represent those with greatest unmet needs. In the last 10 years, substantial progress has been made in terms of understanding some of the mechanisms that drive severe asthma; there have also been concomitant advances in the recognition of specific molecular phenotypes. This ERS Monograph covers all aspects of severe asthma – epidemiology, diagnosis, mechanisms, treatment and management – but has a particular focus on recent understanding of mechanistic heterogeneity based on an analytic approach using various ‘omics platforms applied to clinically well-defined asthma cohorts. How these advances have led to improved management targets is also emphasised. This book brings together the clinical and scientific expertise of those from around the world who are collaborating to solve the problem of severe asthma.

Respiratory diseases affect a large proportion of the population and can cause complications when associated with pregnancy. Pregnancy induces profound anatomical and functional physiological changes in the mother, and subjects the mother to pregnancy-specific respiratory conditions. Reviewing respiratory conditions both specific and non-specific to pregnancy, the book also addresses related issues such as smoking and mechanical ventilation. Basic concepts for the obstetrician are covered, including patient history, physiology and initial examinations. Topics such as physiological changes during pregnancy and placental gas exchange are discussed for the non-obstetrician. Guidance is practical, covering antenatal and post-partum care, as well as management in the delivery suite. An essential guide to respiratory diseases in pregnancy, this book is indispensable to both obstetricians and non-obstetric physicians managing pregnant patients.

This book focuses on the fundamentals of the use of biologics in asthma, describing the rationale, principles, mechanisms of action, and indications. It offers an excellent balance between basic science and the analysis of clinical trials, updating readers with new developments that are changing the global scenario for targeted biological anti-asthma therapies, especially with regard to more severe disease. A range of therapies are considered, from the humanized monoclonal anti-IgE antibody omalizumab, widely approved as add-on treatment for inadequately controlled disease, through to emerging biologics for which evidence supportive of efficacy is accumulating, including anti-IL-5, anti-IL-4, and anti-IL-13 therapies. One aspect to emerge is the variability in individual response, which suggests a need for characterization of different asthma subtypes to permit the effective implementation of phenotype-targeted treatments. This book will be of interest for pulmonologists, clinical immunologists, and physicians seeking sound information on these therapies, but also for scientists and pharmacologists wishing to enhance their knowledge of the therapeutic implications of the cellular and molecular mechanisms that underlie severe, uncontrolled asthma.

This book provides readers with a comprehensive review of severe asthma in children and adolescents, covering epidemiology, genetics, risk factors, co-morbidities, clinical presentation, diagnosis and treatment. Written by leaders in the field, chapter discussions draw on the mechanisms driving the disease, genetics, multidisciplinary approaches, immunomodulators, and other important aspects in the management of the disease. Severe Asthma in Children and Adolescents: Mechanisms and Management is designed to be a practical guide, opening with an introduction on the epidemiology of severe childhood asthma, as well as a discussion of special considerations of the disease unique to the preschool-aged patient. The distinctions between the diagnosis and management of asthma in young children of various ages, and specific approaches for the adolescent with severe asthma, including the transition into adult care are then addressed. Finally, the book closes with a discussion on the current state and future avenues for severe asthma research. Severe Asthma in Children and Adolescents is an indispensable reference for the healthcare professional, for basic and translational researchers, as well as for students, residents and fellows.

This massive reference thoroughly analyzes the mechanisms implicated in the pathophysiology of asthma, such as T helper lymphocyte subsets, and the consequences of various extrinsic and intrinsic factors, and IgE receptor expression-reviewing current concepts in immunotherapeutic approaches for the treatment of this and other allergic diseases. Investigates the only category of treatment showing the potential to affect the natural course of allergic diseases and prevent the onset of asthma. Written by more than 80 internationally renowned pulmonary experts, allergic disease specialists, and basic researchers, Immunotherapy in Asthma discusses the efficacy of new medications examines the role of metachromatic cells, lymphocytes, macrophages, and other cell types present in bronchial biopsies presents basic topics such as the functional and phenotypic properties of Th1 and Th2 cells and their role in allergic disease and the regulation of IgE-mediated inflammatory responses addresses the deleterious effects of smoking and passive exposure to cigarette smoke in children and adults assesses differences and similarities between intrinsic and antigen-induced asthma describes the effects of immunogenic peptides on the cytokine production profile of allergen-specific CD4+ T cells explains the different clinical aspects of allergic responses, such as bronchial hyperreactivity and eosinophilic inflammation of the airways reviews the genetic basis of allergy, as well as risk factors for asthma explores oral, sublingual, local nasal, and local bronchial routes for noninjective immunotherapies evaluates various agents with modulatory effects on normal and pathogenic immune responses focuses on strategies for the prevention of childhood asthma and more! Containing over 3000 references, drawings, and tables, Immunotherapy in Asthma is an indispensable resource for pulmonologists, immunologists, allergists, and medical school students in these disciplines.

Personalized medicine is a rapidly emerging area in health care, and asthma management lends itself particularly well to this new development. This practical resource by Dr. Stanley J. Szefler helps you navigate the many asthma medication options available to your patients, as well as providing insights into those which may be introduced within the next several years. - Features a wealth of information on available asthma medications, including new immunomodulators, new responses to treatment, and new treatment strategies at all levels of asthma care. - Prepares you to meet your patients' needs regarding asthma exacerbation prevention and asthma prevention. - Consolidates today's available information and guidance in this timely area into one convenient resource.

Bridging the gap between basic science and clinical research, this comprehensive and fully up-to-date reference presents new directions in asthma care - examining the pathophysiology, epidemiology, immunology, environmental control, and psychosocial impact of severe asthma.

This book provides a practical, stepwise, evidence-based approach to effective management of patients with difficult to treat asthma. The impact of asthma on morbidity and healthcare utilization increases exponentially with severity. Severe refractory asthma accounts for less than 5% of all asthma. Its prevalence, however, is often overestimated as there are several other confounding factors that make asthma ‘difficult to treat’. Many novel (albeit expensive) therapies are now available and providers caring for patients with severe asthma are charged with selecting the best evidence treatment. This calls for complex and nuanced decision-making. Whether people with asthma gain and maintain control over their condition depends not only on the availability of effective drugs, but also multiple patient and healthcare provider behaviors. Therefore, now more than ever, it has become increasingly important to differentiate “difficult” from “severe refractory” asthma to allow identification of patients most likely to benefit from these therapies. This volume delves into the current understanding of mechanisms and increasingly recognized heterogeneity of this complex disease. It discusses a structured approach to identification and optimization of factors contributing to poor asthma control, including nonadherence, comorbidities and occupational/environmental triggers. The book includes ‘state of the art’ reviews on recent advances in traditional and targeted asthma therapies, as well as a glimpse into what the future may hold. Highlights include a comprehensive guide to management of severe asthma in children and pregnancy, as well as practical considerations to management of asthma based on different clinical phenotypes. Each chapter is authored by leading experts in the field who share their own clinical approach. This is an ideal guide for clinical pulmonologists and allergist/immunologists, as well as primary care providers, physician extenders in specialty practice, physicians in pulmonary/allergy training, and even industry partners.

Targeting Chronic Inflammatory Lung Diseases Using Advanced Drug Delivery Systems explores the development of novel therapeutics and diagnostics to improve pulmonary disease management, looking down to the nanoscale level for an efficient system of targeting and managing respiratory disease. The book examines numerous nanoparticle-based drug systems such as nanocrystals, dendrimers, polymeric micelles, protein-based, carbon nanotube, and liposomes that can offer advantages over traditional drug delivery systems. Starting with a brief introduction on different types of nanoparticles in respiratory disease conditions, the book then focuses on current trends in disease pathology that use different in vitro and in vivo models. The comprehensive resource is designed for those new to the field and to specialized scientists and researchers involved in pulmonary research and drug development. - Explores recent perspectives and challenges regarding the management and diagnosis of chronic respiratory diseases - Provides insights into how advanced drug delivery systems can be effectively formulated and delivered for the management of various pulmonary diseases - Includes the most recent information on diagnostic methods and treatment strategies using controlled drug delivery systems (including nanotechnology)

This book provides discussions on bronchial asthma from a clinical perspective, focusing on the recent studies on its pathophysiology, diagnosis and treatment. It also explores the lastest findings regarding the phenotypes and endotypes of asthmatic patients, making it of particular interest to those involved with non-eosinophilic asthma and eosinophilic asthma. Further, it discusses the importance of ILC 2 in eosinophilic asthma, and the accumulated results from the forced oscilliation technique and periostin that are actively practiced in Japan. As some aspects of diagnosis and treatment are different in Western and Asian countries, it is important that the data is disseminated around the globe. The clinical questions addressed by the authors are critical and thought provoking, while the questions raised by the editors are instructive, informative and provide new perspectives on unresolved issues. This book appeals to wide readership from beginning learners to physicians in clinical practice and scholars engaging in basic research.