Highlighted Publications Relating to Severe Asthma
Severe Asthma: Current Management, Targeted Therapies and Future Directions - A Roundtable Report
Phenotyping Asthma and COPD
Omalizumab Treatment Response in a Severe Allergic Asthma Population with Overlapping COPD
How To Set Up A Severe Asthma Service
Reduced Antiviral Interferon Production in Poorly Controlled Asthma Is Associated With Neutrophilic Inflammation and High-Dose Inhaled Corticosteroids
Sputum gene expression signature of 6 biomarkers discriminates asthma inflammatory phenotypes
Severe Asthma: Current Management, Targeted Therapies and Future Directions - A Roundtable Report
Vanessa M. McDonald, Steven Maltby, Helen K. Reddel, Greg G. King, Peter A.B. Wark, Lorraine Smith, John W. Upham, Alan L. James, Guy B. Marks & Peter G. Gibson. 2017. Respirology.
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In this article, we report on roundtable discussions held with severe asthma experts from around Australia, and make recommendations about approaches for better patient diagnosis and assessment of severe asthma. We assess current models of care for patient management and discuss how approaches may be optimized to improve patient outcomes. Finally, we propose mechanisms to assess new therapies and how to best integrate these approaches into future treatment.
Phenotyping Asthma and COPD
Peter G. Gibson & Vanessa M. McDonald. 2016. Barcelona Respiratory Network (BRN) Reviews.
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This review provides an approach to the clinical and inflammatory phenotyping of chronic respiratory disease (asthma and COPD). It proposes assessment based on key clinical domain areas; comorbidity, airway and risk factors. Evidence-based therapy can then be directed to each component of airway disease phenotype. Phenotyping disease represents a new and potentially effective approach for the personalised management of airway disease.
Omalizumab Treatment Response in a Severe Allergic Asthma Population with Overlapping COPD
Steven Maltby, Peter G. Gibson, Heather Powell & Vanessa M. McDonald. 2016. CHEST.
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Asthma and COPD are common airways diseases, that often overlap in individual patients. Omalizumab (anti-IgE monoclonal therapy) is effective in a subset of severe asthma patients. However, there are limited data on its efficacy in individuals with overlapping asthma and COPD. Using data from the Australian Xolair Registry (AXR), we demonstrate that omalizumab treatment markedly improves asthma control and quality-of-life in individuals with overlapping COPD. These findings provide real-world efficacy data for this patient population and suggest omalizumab is useful for management of severe asthma with COPD overlap.
How To Set Up A Severe Asthma Service
Vanessa M. McDonald, Anne E. Vertigan & Peter G. Gibson. 2011. Respirology.
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A practical description of the purpose of a severe asthma clinic, the necessary components including staffing and facilities and the processes for trialling additional therapies used in the management of severe asthma. This structure aids in confirming diagnosis, managing comorbid conditions and provides the environment to optimise treatment and asthma self-management skills and education. A severe asthma service is also the ideal environment for trialling add-on therapies and hence can improve patient outcomes and clinical practice.
Reduced Antiviral Interferon Production in Poorly Controlled Asthma Is Associated With Neutrophilic Inflammation and High-Dose Inhaled Corticosteroids
Jodie L. Simpson, Melanie Carroll, Ian A. Yang, Paul N. Reynolds, Sandra Hodge, Alan L. James, Peter G. Gibson & John W. Upham. 2016. Chest Journal.
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This study assessed the immune response to respiratory viruses in individuals with asthma. The objective was to examine the responsiveness of circulating immune cells to rhinovirus in a large cohort of participants with poorly controlled asthma. In those with neutrophilic asthma, rhinovirus-stimulated immune cells produced less IFN-α than cells from participants with eosinophilic or paucigranulocytic asthma. The findings indicate that antiviral type I IFN production is impaired in those with neutrophilic airway inflammation and in those prescribed high doses of inhaled corticosteroids. This study is an important step toward identifying those with poorly controlled asthma who might respond best to inhaled IFN therapy during exacerbations.
Sputum gene expression signature of 6 biomarkers discriminates asthma inflammatory phenotypes
Katherine J. Baines, Jodie L. Simpson, Lisa G. Wood, Rodney J. Scott, Naomi L. Fibbens, Heather Powell, Douglas C. Cowan, D. Robin Taylor, Jan O. Cowan & Peter G Gibson. 2014. The Journal of Allergy and Clinical Immunology.
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This study aimed to identify and validate a sputum gene expression signature to discriminate between asthma inflammatory phenotypes. A signature of 6 genes was identified that separated eosinophilic asthma from other phenotypes of asthma, as well as neutrophilic asthma from those with paucigranulocytic asthma and healthy control subjects. The gene signature also predicted inhaled corticosteroid response. This signature has potential as a diagnostic tool to assist in the clinical diagnosis and management of asthma.
