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Kallieri M, Papaioannou AI, Zervas E, Fouka E, Porpodis K, Hadji Mitrova M, Tzortzaki E, Makris M, Ntakoula M, Lyberopoulos P, Dimakou K, Koukidou S, Ampelioti S, Papaporfyriou A, Katsoulis K, Kipourou M, Rovina N, Antoniou K, Vittorakis S, Bakakos P, Steiropoulos P, Markopoulou K, Avarlis P, Papanikolaou ΙC, Markatos M, Gaki E, Samitas K, Glynos K, Papiris SA, Papakosta D, Tzanakis N, Gaga M, Kostikas K, Loukides S. Switching from omalizumab to mepolizumab in severe asthmatics: A post hoc analysis of the RELight study. Clin Exp Allergy 2024; 54:286-290. [PMID: 38084474 DOI: 10.1111/cea.14436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/30/2023] [Accepted: 11/23/2023] [Indexed: 03/12/2024]
Affiliation(s)
- Maria Kallieri
- 2nd Respiratory Department, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Andriana I Papaioannou
- 1st Respiratory Department, Sotiria Chest Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | | | - Evangelia Fouka
- Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Konstantinos Porpodis
- Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Marija Hadji Mitrova
- Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Thessaloniki, Greece
| | | | - Michael Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology, Attikon University General Hospital, Athens, Greece
| | - Maria Ntakoula
- Allergy Unit, 2nd Department of Dermatology and Venereology, Attikon University General Hospital, Athens, Greece
| | - Panagiotis Lyberopoulos
- 2nd Respiratory Department, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Katerina Dimakou
- 5th Respiratory Clinic, "Sotiria" Chest Hospital, Athens, Greece
| | - Sofia Koukidou
- 5th Respiratory Clinic, "Sotiria" Chest Hospital, Athens, Greece
| | | | - Anastasia Papaporfyriou
- Department of Medicine II, Division of Pulmonology, Medical University of Vienna, Vienna, Austria
| | | | - Maria Kipourou
- Pulmonary Department, 424 Army General Hospital, Thessaloniki, Greece
| | - Nikoletta Rovina
- 1st Respiratory Department, Sotiria Chest Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Katerina Antoniou
- Respiratory Medicine School of Medicine, University of Crete, Heraklion, Crete, Greece
| | | | - Petros Bakakos
- 1st Respiratory Department, Sotiria Chest Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, Alexandroupolis, Greece
| | - Katerina Markopoulou
- 1st Pulmonary Department, Papanikolaou General Hospital Thessaloniki, Thessaloniki, Greece
| | | | | | | | | | | | | | - Spyros A Papiris
- 2nd Respiratory Department, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Despoina Papakosta
- Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Nikolaos Tzanakis
- Respiratory Medicine School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Mina Gaga
- 7th Respiratory Clinic, "Sotiria" Chest Hospital, Athens, Greece
| | - Konstantinos Kostikas
- Respiratory Medicine Department, University of Ioannina Medical School, Ioannina, Greece
| | - Stelios Loukides
- 2nd Respiratory Department, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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Panagiotidou E, Βoutou A, Fouka E, Papakosta D, Chatzopoulos E, Sourla E, Markopoulou A, Kioumis I, Stanopoulos I, Pitsiou G. Phenotyping exercise limitation of patients with Interstitial Fibrosing Lung Disease: the importance of exercise hemodynamics. Pulmonology 2024; 30:104-112. [PMID: 35568651 DOI: 10.1016/j.pulmoe.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION AND OBJECTIVE Left-heart dysfunction and pulmonary vasculopathy are increasingly recognized as contributing factors of exercise capacity limitation in interstitial fibrosing lung disease (IFLD). Moreover, the clinical significance of exercise pulmonary hypertension (ePH) in pulmonary and cardiac diseases has been documented, representing a risk factor for decreased exercise capacity and survival, progression to resting pulmonary hypertension (PH) and overall clinical worsening. We conducted a prospective study aiming at: (a) assessing the prevalence of PH and ePH in a cohort of 40 functionally limited patients with IFLD, (b) determining the post-capillary (postC) or pre-capillary (preC) etiology of either PH or ePH in this cohort, and (c) examining the correlations between invasively and non-invasively measured exercise variables among hemodynamic groups. PATIENTS AND METHODS 40 IFLD patients underwent cardiopulmonary evaluation, including: clinical examination, lung function tests, 6-minute walking test, heart ultrasonography, cardiopulmonary exercise test and, finally, right heart catheterization (RHC). Resting hemodynamic evaluation was followed by the exercise protocol proposed by Herve et al, using a bedside cycle ergometer in the supine position. Abnormal elevation of mean pulmonary artery pressure (mPAP) above 30mmHg during exercise, with respect to abnormal elevation of cardiac output (CO) below 10 L/min (mPAP-CO ratio ⩾3 mmHg·min·L-1) was used to define ePH (Herve et al, 2015). Secondary hemodynamic evaluation involved detection of abnormal pulmonary arterial wedge pressure (PAWP) increase at peak exercise in relation to CO. Specifically, ΔPAWP/ΔCO >2 mmHg/L per minute determined an abnormal PAWP elevation (Bentley et al, 2020). RESULTS Among the 40-patient cohort, 25% presented postC PH, 37.5% preC PH, 27.5% ePH, with the remaining 10% recording normal hemodynamics. PAWP evaluation during exercise revealed a postC etiology in 4 out of the 11 patients presenting ePH, and a postC etiology in 6 out of the 15 patients presenting resting preC PH. Mean values of non-invasive variables did not display statistically significant differences among hemodynamic groups, except for: diffusing capacity for carbon monoxide (DLCO), carbon monoxide transfer coefficient (KCO) and the ratio of functional vital capacity to DLCO (FVC%/DLCO%), which were lower in both ePH and PH groups (p < 0.05). Resting values of CO, cardiac index (CI), stroke volume (SV) and pulmonary vascular compliance (PVC) were significantly impaired in ePH, preC-PH and postC-PH groups when compared to the normal group. CONCLUSIONS Both PH and ePH were highly prevalent within the IFLD patient group, suggesting that RHC should be offered more frequently in functionally limited patients. Diffusion capacity markers must thus guide decision making, in parallel to clinical evaluation. ePH was associated to lower resting CO and PVC, in a similar way to resting PH, indicating the relevance of cardiopulmonary function to exercise limitation. Finally, the use of the ΔPAWP/ΔCO>2 criterion further uncovered PH of postcapillary etiology, highlighting the complexity of hemodynamics in IFLD. CLINICALTRIALS gov ID: NCT03706820.
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Affiliation(s)
- E Panagiotidou
- Respiratory Failure Clinic, General Hospital of Thessaloniki "G. Papanikolaou", Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - A Βoutou
- Department of Respiratory Medicine, General Hospital "G. Papanikolaou", Thessaloniki, Greece
| | - E Fouka
- University Department of Respiratory Medicine, General Hospital of Thessaloniki "G. Papanikolaou", Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Papakosta
- University Department of Respiratory Medicine, General Hospital of Thessaloniki "G. Papanikolaou", Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Chatzopoulos
- Respiratory Failure Clinic, General Hospital of Thessaloniki "G. Papanikolaou", Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Sourla
- Respiratory Failure Clinic, General Hospital of Thessaloniki "G. Papanikolaou", Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Markopoulou
- Department of Respiratory Medicine, General Hospital "G. Papanikolaou", Thessaloniki, Greece
| | - I Kioumis
- University Department of Respiratory Medicine, General Hospital of Thessaloniki "G. Papanikolaou", Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - I Stanopoulos
- University Department of Respiratory Medicine, General Hospital of Thessaloniki "G. Papanikolaou", Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Pitsiou
- University Department of Respiratory Medicine, General Hospital of Thessaloniki "G. Papanikolaou", Aristotle University of Thessaloniki, Thessaloniki, Greece
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Papiris SA, Veith M, Papaioannou AI, Apollonatou V, Ferrarotti I, Ottaviani S, Tzouvelekis A, Tzilas V, Rovina N, Stratakos G, Gerogianni I, Daniil Z, Kolilekas L, Dimakou K, Pitsidianakis G, Tzanakis N, Tryfon S, Fragopoulos F, Antonogiannaki EM, Lazaratou A, Fouka E, Papakosta D, Emmanouil P, Anagnostopoulos N, Karampitsakos T, Vlami K, Kallieri M, Lyberopoulos P, Loukides S, Bouros D, Bush A, Balduyck M, Lombard C, Cottin V, Mornex JF, Vogelmeier CF, Greulich T, Manali ED. Alpha1-antitrypsin deficiency in Greece: Focus on rare variants. Pulmonology 2024; 30:43-52. [PMID: 36797151 DOI: 10.1016/j.pulmoe.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 02/16/2023] Open
Abstract
PURPOSE A1Antitrypsin deficiency (AATD) pathogenic mutations are expanding beyond the PI*Z and PI*S to a multitude of rare variants. AIM to investigate genotype and clinical profile of Greeks with AATD. METHODS Symptomatic adult-patients with early-emphysema defined by fixed airway obstruction and computerized-tomography scan and lower than normal serum AAT levels were enrolled from reference centers all over Greece. Samples were analyzed in the AAT Laboratory, University of Marburg-Germany. RESULTS Included are 45 adults, 38 homozygous or compound heterozygous for pathogenic variants and 7 heterozygous. Homozygous were 57.9% male, 65.8% ever-smokers, median (IQR) age 49.0(42.5-58.5) years, AAT-levels 0.20(0.08-0.26) g/L, FEV1(%predicted) 41.5(28.8-64.5). PI*Z, PI*Q0, and rare deficient allele's frequency was 51.3%, 32.9%,15.8%, respectively. PI*ZZ genotype was 36.8%, PI*Q0Q0 21.1%, PI*MdeficientMdeficient 7.9%, PI*ZQ0 18.4%, PI*Q0Mdeficient 5.3% and PI*Zrare-deficient 10.5%. Genotyping by Luminex detected: p.(Pro393Leu) associated with MHeerlen (M1Ala/M1Val); p.(Leu65Pro) with MProcida; p.(Lys241Ter) with Q0Bellingham; p.(Leu377Phefs*24) with Q0Mattawa (M1Val) and Q0Ourem (M3); p.(Phe76del) with MMalton (M2), MPalermo (M1Val), MNichinan (V) and Q0LaPalma (S); p.(Asp280Val) with PLowell (M1Val); PDuarte (M4), YBarcelona (p.Pro39His). Gene-sequencing (46.7%) detected Q0GraniteFalls, Q0Saint-Etienne, Q0Amersfoort(M1Ala), MWürzburg, NHartfordcity and one novel-variant (c.1A>G) named Q0Attikon.Heterozygous included PI*MQ0Amersfoort(M1Ala), PI*MMProcida, PI*Mp.(Asp280Val), PI*MOFeyzin. AAT-levels were significantly different between genotypes (p = 0.002). CONCLUSION Genotyping AATD in Greece, a multiplicity of rare variants and a diversity of rare combinations, including unique ones were observed in two thirds of patients, expanding knowledge regarding European geographical trend in rare variants. Gene sequencing was necessary for genetic diagnosis. In the future the detection of rare genotypes may add to personalize preventive and therapeutic measures.
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Affiliation(s)
- S A Papiris
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece.
| | - M Veith
- Department of Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Research (DZL), UKGM, Marburg, Germany
| | - A I Papaioannou
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - V Apollonatou
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - I Ferrarotti
- Center for Diagnosis of Inherited Alpha1-antitrypsin Deficiency, Department of Internal Medicine and Therapeutics, Pneumonology Unit, Fondazione IRCCS Policlinico San Matteo, Università di Pavia, Pavia, Italy
| | - S Ottaviani
- Center for Diagnosis of Inherited Alpha1-antitrypsin Deficiency, Department of Internal Medicine and Therapeutics, Pneumonology Unit, Fondazione IRCCS Policlinico San Matteo, Università di Pavia, Pavia, Italy
| | - A Tzouvelekis
- Department of Respiratory Medicine, General Hospital of Patras, University of Patras, Greece
| | - V Tzilas
- 5th Pulmonary Department, Athens Chest Hospital "Sotiria", Athens Greece
| | - N Rovina
- 1st Department of Pulmonary Medicine and Intensive Care Unit, Medical School, National and Kapodistrian University of Athens, Athens 115 27, Greece
| | - G Stratakos
- 1st Respiratory Medicine Department of the National, Kapodistrian University of Athens, Athens, Greece
| | - I Gerogianni
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa Greece
| | - Z Daniil
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa Greece
| | - L Kolilekas
- 7thPulmonary Department, Athens Chest Hospital "Sotiria", Athens Greece
| | - K Dimakou
- 5th Pulmonary Department, Athens Chest Hospital "Sotiria", Athens Greece
| | - G Pitsidianakis
- Department of Thoracic Medicine, University Hospital, University of Crete, Heraklion, Crete 71110, Greece
| | - N Tzanakis
- Department of Thoracic Medicine, University Hospital, University of Crete, Heraklion, Crete 71110, Greece
| | - S Tryfon
- General Hospital "G. Papanikolaou", Thessaloniki, Greece
| | - F Fragopoulos
- Pulmonary Department, General Hospital of Nicosia, Cyprus
| | - E M Antonogiannaki
- 4th Pulmonary Department, Athens Chest Hospital "Sotiria", Athens Greece
| | - A Lazaratou
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - E Fouka
- A Department of Pulmonary Medicine, Aristotle University of Thessaloniki, "G. Papanikolaou" Hospital, Exochi, Thessaloniki, Greece
| | - D Papakosta
- A Department of Pulmonary Medicine, Aristotle University of Thessaloniki, "G. Papanikolaou" Hospital, Exochi, Thessaloniki, Greece
| | | | - N Anagnostopoulos
- 1st Respiratory Medicine Department of the National, Kapodistrian University of Athens, Athens, Greece
| | - T Karampitsakos
- Department of Respiratory Medicine, General Hospital of Patras, University of Patras, Greece
| | - K Vlami
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - M Kallieri
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - P Lyberopoulos
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - S Loukides
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
| | - D Bouros
- Iatriko Medical Center, Athens, Greece; School of Medicine, National and Kapodistrian University of Athens, Athens Greece
| | - A Bush
- Paediatrics and Paediatric Respirology, Imperial College, Imperial Centre for Paediatrics and Child Health, Royal Brompton Harefield NHS Foundation Trust, London, United Kingdom
| | - M Balduyck
- laboratoire de Biochimie et Biologie Moléculaire (HMNO), Centre de Biologie Pathologie, Faculté de pharmacie et EA 7364 RADEME, Laboratoire de Biochimie et Biologie Moléculaire, CHU de Lille, Université de Lille, Lille, France
| | - C Lombard
- Laboratoire d'Immunologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon and Université Claude Bernard-Lyon 1, Lyon, France
| | - V Cottin
- Service de pneumologie, Centre National Coordinateur de Référence des Maladies Pulmonaires Rares, Hôpital Louis Pradel, Hospices Civils de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, UMR754 INRA, IVPC, Lyon, France
| | - J F Mornex
- Service de pneumologie, Centre National Coordinateur de Référence des Maladies Pulmonaires Rares, Hôpital Louis Pradel, Hospices Civils de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, UMR754 INRA, IVPC, Lyon, France
| | - C F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Research (DZL), UKGM, Marburg, Germany
| | - T Greulich
- Department of Medicine, Pulmonary and Critical Care Medicine, Member of the German Center for Lung Research (DZL), UKGM, Marburg, Germany
| | - E D Manali
- 2nd Pulmonary Medicine Department, Medical School, General University Hospital "Attikon", National and Kapodistrian University of Athens, Greece 1 Rimini Street, Haidari 12462, Greece
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4
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Karageorgou V, Papaioannou AI, Kallieri M, Blizou M, Lampadakis S, Sfika M, Krouskos A, Papavasileiou V, Strakosha F, Vandorou KT, Siozos P, Moustaka Christodoulou M, Kontonasiou G, Apollonatou V, Antonogiannaki EM, Kyriakopoulos C, Aggelopoulou C, Chronis C, Kostikas K, Koukaki E, Sotiropoulou Z, Athanasopoulou A, Bakakos P, Schoini P, Alevrakis E, Poupos S, Chondrou E, Tsoukalas D, Chronaiou A, Tsoukalas G, Koukidou S, Hillas G, Dimakou K, Roukas K, Nakou I, Chloros D, Fouka E, Papiris SA, Loukides S. Patients Hospitalized for COVID-19 in the Periods of Delta and Omicron Variant Dominance in Greece: Determinants of Severity and Mortality. J Clin Med 2023; 12:5904. [PMID: 37762846 PMCID: PMC10531654 DOI: 10.3390/jcm12185904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/03/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has been a pandemic since 2020, and depending on the SARS-CoV-2 mutation, different pandemic waves have been observed. The aim of this study was to compare the baseline characteristics of patients in two phases of the pandemic and evaluate possible predictors of mortality. METHODS This is a retrospective multicenter observational study that included patients with COVID-19 in 4 different centers in Greece. Patients were divided into two groups depending on the period during which they were infected during the Delta and Omicron variant predominance. RESULTS A total of 979 patients (433 Delta, 546 Omicron) were included in the study (median age 67 years (54, 81); 452 [46.2%] female). Compared to the Omicron period, the patients during the Delta period were younger (median age [IQR] 65 [51, 77] vs. 70 [55, 83] years, p < 0.001) and required a longer duration of hospitalization (8 [6, 13] vs. 7 [5, 12] days, p = 0.001), had higher procalcitonin levels (ng/mL): 0.08 [0.05, 0.17] vs. 0.06 [0.02, 0.16], p = 0.005, ferritin levels (ng/mL): 301 [159, 644] vs. 239 [128, 473], p = 0.002, C- reactive protein levels (mg/L): 40.4 [16.7, 98.5] vs. 31.8 [11.9, 81.7], p = 0.003, and lactate dehydrogenase levels (U/L): 277 [221, 375] vs. 255 [205, 329], p < 0.001. The Charlson Comorbidity Index was lower (3 [0, 5] vs. 4 [1, 6], p < 0.001), and the extent of disease on computed tomography (CT) was greater during the Delta wave (p < 0.001). No evidence of a difference in risk of death or admission to the intensive care unit was found between the two groups. Age, cardiovascular events, acute kidney injury during hospitalization, extent of disease on chest CT, D-dimer, and neutrophil/lymphocyte ratio values were identified as independent predictors of mortality for patients in the Delta period. Cardiovascular events and acute liver injury during hospitalization and the PaO2/FiO2 ratio on admission were identified as independent predictors of mortality for patients in the Omicron period. CONCLUSIONS In the Omicron wave, patients were older with a higher number of comorbidities, but patients with the Delta variant had more severe disease and a longer duration of hospitalization.
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Affiliation(s)
- Vagia Karageorgou
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Andriana I. Papaioannou
- 1st Respiratory Medicine Department, “Sotiria” Chest Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.I.P.); (Z.S.); (P.B.)
| | - Maria Kallieri
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Myrto Blizou
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Stefanos Lampadakis
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Maria Sfika
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Antonios Krouskos
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Vasileios Papavasileiou
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Franceska Strakosha
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Kalliopi Theoni Vandorou
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Pavlos Siozos
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Marina Moustaka Christodoulou
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Georgia Kontonasiou
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Vasiliki Apollonatou
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Elvira Markella Antonogiannaki
- 4th Respiratory Medicine Department, “Sotiria” Chest Hospital, 11527 Athens, Greece; (E.M.A.); (P.S.); (E.A.); (S.P.); (E.C.); (A.C.)
| | - Christos Kyriakopoulos
- Respiratory Medicine Department, University Hospital of Ioannina, 45500 Ioannina, Greece; (C.K.); (C.C.); (K.K.)
| | - Christina Aggelopoulou
- Respiratory Medicine Department, University Hospital of Ioannina, 45500 Ioannina, Greece; (C.K.); (C.C.); (K.K.)
| | - Christos Chronis
- Respiratory Medicine Department, University Hospital of Ioannina, 45500 Ioannina, Greece; (C.K.); (C.C.); (K.K.)
| | - Konstantinos Kostikas
- Respiratory Medicine Department, University Hospital of Ioannina, 45500 Ioannina, Greece; (C.K.); (C.C.); (K.K.)
| | - Evangelia Koukaki
- 1st Respiratory Medicine Department, “Sotiria” Chest Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.I.P.); (Z.S.); (P.B.)
| | - Zoi Sotiropoulou
- 1st Respiratory Medicine Department, “Sotiria” Chest Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.I.P.); (Z.S.); (P.B.)
| | - Athanasia Athanasopoulou
- 1st Respiratory Medicine Department, “Sotiria” Chest Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.I.P.); (Z.S.); (P.B.)
| | - Petros Bakakos
- 1st Respiratory Medicine Department, “Sotiria” Chest Hospital, Athens Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (A.I.P.); (Z.S.); (P.B.)
| | - Pinelopi Schoini
- 4th Respiratory Medicine Department, “Sotiria” Chest Hospital, 11527 Athens, Greece; (E.M.A.); (P.S.); (E.A.); (S.P.); (E.C.); (A.C.)
| | - Emmanouil Alevrakis
- 4th Respiratory Medicine Department, “Sotiria” Chest Hospital, 11527 Athens, Greece; (E.M.A.); (P.S.); (E.A.); (S.P.); (E.C.); (A.C.)
| | - Sotirios Poupos
- 4th Respiratory Medicine Department, “Sotiria” Chest Hospital, 11527 Athens, Greece; (E.M.A.); (P.S.); (E.A.); (S.P.); (E.C.); (A.C.)
| | - Evangelia Chondrou
- 4th Respiratory Medicine Department, “Sotiria” Chest Hospital, 11527 Athens, Greece; (E.M.A.); (P.S.); (E.A.); (S.P.); (E.C.); (A.C.)
| | - Dionisios Tsoukalas
- 4th Respiratory Medicine Department, “Sotiria” Chest Hospital, 11527 Athens, Greece; (E.M.A.); (P.S.); (E.A.); (S.P.); (E.C.); (A.C.)
| | - Alexia Chronaiou
- 4th Respiratory Medicine Department, “Sotiria” Chest Hospital, 11527 Athens, Greece; (E.M.A.); (P.S.); (E.A.); (S.P.); (E.C.); (A.C.)
| | - George Tsoukalas
- 4th Respiratory Medicine Department, “Sotiria” Chest Hospital, 11527 Athens, Greece; (E.M.A.); (P.S.); (E.A.); (S.P.); (E.C.); (A.C.)
| | - Sofia Koukidou
- 5th Respiratory Medicine Department, “Sotiria” Chest Hospital, 11527 Athens, Greece; (S.K.); (G.H.); (K.D.)
| | - Georgios Hillas
- 5th Respiratory Medicine Department, “Sotiria” Chest Hospital, 11527 Athens, Greece; (S.K.); (G.H.); (K.D.)
| | - Katerina Dimakou
- 5th Respiratory Medicine Department, “Sotiria” Chest Hospital, 11527 Athens, Greece; (S.K.); (G.H.); (K.D.)
| | - Konstantinos Roukas
- COVID-19 Clinic, General Hospital G. Papanikolaou, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece (I.N.); (D.C.); (E.F.)
| | - Ifigeneia Nakou
- COVID-19 Clinic, General Hospital G. Papanikolaou, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece (I.N.); (D.C.); (E.F.)
| | - Diamantis Chloros
- COVID-19 Clinic, General Hospital G. Papanikolaou, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece (I.N.); (D.C.); (E.F.)
| | - Evangelia Fouka
- COVID-19 Clinic, General Hospital G. Papanikolaou, Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece (I.N.); (D.C.); (E.F.)
| | - Spyros A. Papiris
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
| | - Stelios Loukides
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, Athens Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece; (V.K.); (M.K.); (M.B.); (S.L.); (M.S.); (F.S.); (V.A.)
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5
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Domvri K, Organtzis I, Apostolopoulos A, Fouka E, Kontakiotis T, Papakosta D. Prognostic Value of Serum Biomarkers in Patients with Idiopathic Pulmonary Fibrosis in Relation to Disease Progression. J Pers Med 2023; 13:1307. [PMID: 37763075 PMCID: PMC10532947 DOI: 10.3390/jpm13091307] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The aim of this present study was to determine serum biomarker levels and their correlation with respiratory function and the clinical course of patients with idiopathic pulmonary fibrosis (IPF). MATERIALS AND METHODS This study included 72 IPF patients, according to the ATS/ERS criteria, in whom antifibrotic treatment was initiated. Blood samples were taken, and serum biomarkers, such as KL-6, SP-D, CCL18, CXCL13, VEGF-A, IL-8, IGFBP-1, IGFBP-2, IGFBP-7 and ICAM-1 were measured using ELISA methodology. Pulmonary function tests (FVC, TLC, DLCO-% pred) were determined at baseline and after 12 and 24 months and analyzed in correlation with the biomarkers. RESULTS The majority of patients (mean age 72 ± 6 years) were men (83%). The FVC and DLCO values at the 12-month follow-up were found to be statistically decreased in deceased patients (p < 0.05). The SP-D (p < 0.001) and the IGFBP-1 (p = 0.021) levels were found to be increased at the 1-year follow-up in deceased patients, and similarly, the SP-D (p = 0.005) and ICAM-1 (p = 0.043) levels at the 2-year follow-up. A chi-square test revealed that 70% of the category IV GAP index was found with cut-off elevated levels of a biomarker combination (KL-6, SP-D, VEGF-A) from the ROC curve analysis (p < 0.05). CONCLUSION This study provides evidence, for the first time in a Greek population, of the possibility of using a combination of KL-6, SP-D, and VEGF-A serum levels along with the GAP index.
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Affiliation(s)
- Kalliopi Domvri
- Lung Immunology and Bronchoalveolar Lavage Unit, Pulmonary Department, Medical School, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (A.A.); (D.P.)
- Out-Patient Clinic for ILDs, Pulmonary Department, Medical School, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (I.O.); (E.F.); (T.K.)
| | - Ioannis Organtzis
- Out-Patient Clinic for ILDs, Pulmonary Department, Medical School, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (I.O.); (E.F.); (T.K.)
| | - Apostolos Apostolopoulos
- Lung Immunology and Bronchoalveolar Lavage Unit, Pulmonary Department, Medical School, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (A.A.); (D.P.)
| | - Evangelia Fouka
- Out-Patient Clinic for ILDs, Pulmonary Department, Medical School, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (I.O.); (E.F.); (T.K.)
| | - Theodoros Kontakiotis
- Out-Patient Clinic for ILDs, Pulmonary Department, Medical School, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (I.O.); (E.F.); (T.K.)
| | - Despoina Papakosta
- Lung Immunology and Bronchoalveolar Lavage Unit, Pulmonary Department, Medical School, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (A.A.); (D.P.)
- Out-Patient Clinic for ILDs, Pulmonary Department, Medical School, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (I.O.); (E.F.); (T.K.)
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6
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Papaporfyriou A, Bartziokas K, Gompelmann D, Idzko M, Fouka E, Zaneli S, Bakakos P, Loukides S, Papaioannou AI. Cardiovascular Diseases in COPD: From Diagnosis and Prevalence to Therapy. Life (Basel) 2023; 13:1299. [PMID: 37374082 DOI: 10.3390/life13061299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is considered one of the leading causes of mortality. Cardiovascular comorbidities are diagnosed often in COPD patients, not only because of the common risk factors these two diseases share, but also because of the systemic inflammation which characterizes COPD and has deleterious effects in the cardiovascular system. The comorbid cardiovascular diseases in COPD result in several difficulties in the holistic treatment of these patients and affect outcomes such as morbidity and mortality. Several studies have reported that mortality from cardiovascular causes is common among COPD patients, while the risk for acute cardiovascular events increases during COPD exacerbations and remains high for a long time even after recovery. In this review, we focus on the prevalence of cardiovascular comorbidities in COPD patients, presenting the evidence regarding the interaction of the pathophysiological pathways which characterize each disease. Furthermore, we summarize information regarding the effects of cardiovascular treatment on COPD outcomes and vice versa. Finally, we present the current evidence regarding the impact of cardiovascular comorbidities on exacerbations, quality of life and survival of COPD patients.
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Affiliation(s)
- Anastasia Papaporfyriou
- Division of Pulmonology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria
| | | | - Daniela Gompelmann
- Division of Pulmonology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria
| | - Marco Idzko
- Division of Pulmonology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria
| | - Evangelia Fouka
- General Hospital G. Papanikolaou, Pulmonary Department of Aristotle University of Thessaloniki, 57010 Thessaloniki, Greece
| | - Stavrina Zaneli
- 1st University Department of Respiratory Medicine, "Sotiria" Chest Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros Bakakos
- 1st University Department of Respiratory Medicine, "Sotiria" Chest Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Stelios Loukides
- 2nd Respiratory Medicine Department, "Attikon" University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Andriana I Papaioannou
- 1st University Department of Respiratory Medicine, "Sotiria" Chest Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
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7
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Fouka E, Samitas K, Bakakos P. Ten years of the website for patients with asthma (www.myasthma.gr) by the Asthma Working Group of
the Hellenic Thoracic Society. Pneumon 2023. [DOI: 10.18332/pne/157584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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8
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Verykokou G, Apollonatou V, Papaioannou AI, Vogiatzoglou A, Roukas K, Kyriakopoulos C, Chronis C, Aggelopoulou C, Gundogdu D, Schoini P, Chloros D, Kavatha D, Manali ED, Papiris SA, Tsoukalas G, Kostikas K, Fouka E, Boumpas D, Loukides S. Nursing home elderly patients hospitalized for COVID-19: Characteristics and predictors of outcomes. Geriatr Gerontol Int 2023; 23:62-64. [PMID: 36479800 PMCID: PMC9877989 DOI: 10.1111/ggi.14521] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/08/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Galateia Verykokou
- COVID‐19 Unit, GNDA “Agia Varvara” HospitalAthensGreece,2 Respiratory Medicine DepartmentGeneral University Hospital “Attikon”, Medical School, National and Kapodistrian University of AthensAthensGreece
| | - Vasiliki Apollonatou
- COVID‐19 Unit, GNDA “Agia Varvara” HospitalAthensGreece,2 Respiratory Medicine DepartmentGeneral University Hospital “Attikon”, Medical School, National and Kapodistrian University of AthensAthensGreece
| | - Andriana I Papaioannou
- 2 Respiratory Medicine DepartmentGeneral University Hospital “Attikon”, Medical School, National and Kapodistrian University of AthensAthensGreece
| | - Anastasios Vogiatzoglou
- Department of Respiratory Medicine, General Hospital G. PapanikolaouPulmonary Department of Aristotle University of ThessalonikiThessalonikiGreece
| | - Konstantinos Roukas
- Department of Respiratory Medicine, General Hospital G. PapanikolaouPulmonary Department of Aristotle University of ThessalonikiThessalonikiGreece
| | - Christos Kyriakopoulos
- Respiratory Medicine DepartmentUniversity of Ioannina, Faculty of MedicineIoanninaGreece
| | - Christos Chronis
- Respiratory Medicine DepartmentUniversity of Ioannina, Faculty of MedicineIoanninaGreece
| | - Christina Aggelopoulou
- Respiratory Medicine DepartmentUniversity of Ioannina, Faculty of MedicineIoanninaGreece
| | | | | | - Diamantis Chloros
- Department of Respiratory Medicine, General Hospital G. PapanikolaouPulmonary Department of Aristotle University of ThessalonikiThessalonikiGreece
| | - Dimitra Kavatha
- COVID‐19 Unit, GNDA “Agia Varvara” HospitalAthensGreece,4 Internal Medicine DepartmentGeneral University Hospital “Attikon”, Medical School, National and Kapodistrian University of AthensAthensGreece
| | - Effrosyni D Manali
- 2 Respiratory Medicine DepartmentGeneral University Hospital “Attikon”, Medical School, National and Kapodistrian University of AthensAthensGreece
| | - Spyros A Papiris
- 2 Respiratory Medicine DepartmentGeneral University Hospital “Attikon”, Medical School, National and Kapodistrian University of AthensAthensGreece
| | | | - Konstantinos Kostikas
- Respiratory Medicine DepartmentUniversity of Ioannina, Faculty of MedicineIoanninaGreece
| | - Evangelia Fouka
- Department of Respiratory Medicine, General Hospital G. PapanikolaouPulmonary Department of Aristotle University of ThessalonikiThessalonikiGreece
| | - Dimitrios Boumpas
- COVID‐19 Unit, GNDA “Agia Varvara” HospitalAthensGreece,4 Internal Medicine DepartmentGeneral University Hospital “Attikon”, Medical School, National and Kapodistrian University of AthensAthensGreece
| | - Stelios Loukides
- COVID‐19 Unit, GNDA “Agia Varvara” HospitalAthensGreece,2 Respiratory Medicine DepartmentGeneral University Hospital “Attikon”, Medical School, National and Kapodistrian University of AthensAthensGreece
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9
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Papaioannou AI, Fouka E, Bartziokas K, Kallieri M, Vontetsianos A, Porpodis K, Rovina N, Loukides S, Bakakos P. Defining response to therapy with biologics in severe asthma: from global evaluation to super response and remission. Expert Rev Respir Med 2023; 17:481-493. [PMID: 37318035 DOI: 10.1080/17476348.2023.2226392] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/13/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION In recent years, monoclonal antibodies targeting Type-2 inflammatory pathways have been developed for severe asthma treatment. However, even when patients are carefully selected, the response to treatment varies. AREAS COVERED Different studies have evaluated response to therapy with biologics such as exacerbation reduction, symptom improvement, pulmonary function increase, improvement in QoL, or decrease of oral corticosteroids, showing that all patients do not respond to all disease aspects and leading to an extensive debate regarding the definition of response. EXPERT OPINION Assessing response to therapy is of great importance, but since there is no uniform definition of treatment response, the recognition of patients who really benefit from these therapies remains an unmet need. In the same context, identifying non-responding patients in which biologic therapy should be switched or substituted by alternative treatment options is of paramount importance. In this review, we present the road trip of the definition of therapeutic response to biologics in severe asthmatics by presenting the current relevant medical literature. We also present the suggested predictors of response, with an emphasis on the so-called super-responders. Finally, we discuss the recent insights regarding asthma remission as a feasible treatment goal and provide a simple algorithm for the evaluation of response.
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Affiliation(s)
- Andriana I Papaioannou
- 1st Respiratory Medicine Department, National and Kapodistrian University of Athens, Medical School, "Sotiria" Chest Hospital, Athens, Greece
| | - Evangelia Fouka
- Medical School, Department of Respiratory Medicine, General Hospital G. Papanikolaou, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Division for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | | | - Maria Kallieri
- Medical School, 2nd Respiratory Medicine Department, General University Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | - Angelos Vontetsianos
- 1 Respiratory Medicine Department, National and Kapodistrian University of Athens, Medical School, "Sotiria" Chest Hospital, Athens, Greece
| | - Konstantinos Porpodis
- Medical School, Department of Respiratory Medicine, General Hospital G. Papanikolaou, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikoletta Rovina
- 1 Respiratory Medicine Department, National and Kapodistrian University of Athens, Medical School, "Sotiria" Chest Hospital, Athens, Greece
| | - Stelios Loukides
- Medical School, 2 Respiratory Medicine Department, General University Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | - Petros Bakakos
- 1 Respiratory Medicine Department, National and Kapodistrian University of Athens, Medical School, "Sotiria" Chest Hospital, Athens, Greece
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Bakakos P, Fouka E, Galanakis P, Katsoulis K, Kostikas K, Loukides S, Mathioudakis N, Porpodis K, Samitas K, Steiropoulos P, Zervas E. Protocol, rationale and design of the PHOLLOW
cross-sectional and retrospective chart review
study to assess the prevalence and characterize the
patient profile, clinical features and disease burden
of type-2 low severe asthma in routine care settings
in Greece. Pneumon 2022. [DOI: 10.18332/pne/157014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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11
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Bartziokas K, Fouka E, Loukides S, Steiropoulos P, Bakakos P, Papaioannou AI. IL-26 in the Lung and Its Role in COPD Inflammation. J Pers Med 2022; 12:jpm12101685. [PMID: 36294822 PMCID: PMC9605572 DOI: 10.3390/jpm12101685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/02/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022] Open
Abstract
IL-26 is a cytokine expressed by infiltrating pro-inflammatory IL-17-producing T cells in the tissues of patients with chronic lung inflammation. IL-26 induces the chemotactic response of human neutrophils to bacteria and other inflammatory stimuli. In recent years, the innovative properties of IL-26 have been described. Studies have shown that, as DNA is released from damaged cells, it binds to IL-26, which plays the role of a carrier molecule for extracellular DNA, further contributing to its binding to the site of inflammation. This mechanism of action indicates that IL-26 may serve both as a driver as well as a stimulus of the inflammatory process, leading to the installation of a noxious amplification loop and, eventually, persistent inflammation. IL-26 also demonstrates direct antimicrobial effects derived from its capability to create pores and disrupt bacterial membranes, as indicated by the presence of membrane blebs on the surface of the bacteria and cytosolic leakage pores in bacterial walls, produced in response to microbial stimuli in human airways by several different immune and structural cells. Surprisingly, while this particular cytokine induces the gathering of neutrophils in areas of infection, it also exhibits inhibitory and pro-inflammatory effects on airway epithelial and immune cells. These remarkable effects underline the necessity of a better understating of its biological behavior and its role in the pathophysiology and disease burden in several smoking-related airway inflammatory disorders, such as Chronic Obstructive Pulmonary Disease (COPD) and chronic bronchitis. In this review, we aim to discuss the current role of IL-26 in the lung, with an emphasis on systemic inflammation in patients suffering from COPD and chronic bronchitis.
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Affiliation(s)
| | - Evangelia Fouka
- Respiratory Medicine Department, George Papanikolaou Hospital, University of Thessaloniki, 57010 Thessaloniki, Greece
| | - Stelios Loukides
- 2nd Respiratory Medicine Department, “Attikon” University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, University General Hospital Dragana, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Petros Bakakos
- 1st University Department of Respiratory Medicine, “Sotiria” Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
| | - Andriana I. Papaioannou
- 1st University Department of Respiratory Medicine, “Sotiria” Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece
- Correspondence: ; Tel.: +30-21-0583-1163; Fax: +30-21-0583-1184
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12
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Fouka E, Domvri K, Gkakou F, Alevizaki M, Steiropoulos P, Papakosta D, Porpodis K. Recent insights in the role of biomarkers in severe asthma management. Front Med (Lausanne) 2022; 9:992565. [PMID: 36226150 PMCID: PMC9548530 DOI: 10.3389/fmed.2022.992565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/09/2022] [Indexed: 11/28/2022] Open
Abstract
Contemporary asthma management requires a proactive and individualized approach, combining precision diagnosis and personalized treatment. The introduction of biologic therapies for severe asthma to everyday clinical practice, increases the need for specific patient selection, prediction of outcomes and monitoring of these costly and long-lasting therapies. Several biomarkers have been used in asthma in disease identification, prediction of asthma severity and prognosis, and response to treatment. Novel advances in the area of personalized medicine regarding disease phenotyping and endotyping, encompass the development and application of reliable biomarkers, accurately quantified using robust and reproducible methods. The availability of powerful omics technologies, together with integrated and network-based genome data analysis, and microbiota changes quantified in serum, body fluids and exhaled air, will lead to a better classification of distinct phenotypes or endotypes. Herein, in this review we discuss on currently used and novel biomarkers for the diagnosis and treatment of asthma.
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Affiliation(s)
- Evangelia Fouka
- G. Papanikolaou General Hospital, Thessaloniki, Greece
- Pulmonary Department of Aristotle University of Thessaloniki, Thessaloniki, Greece
- *Correspondence: Evangelia Fouka
| | - Kalliopi Domvri
- G. Papanikolaou General Hospital, Thessaloniki, Greece
- Pulmonary Department of Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Foteini Gkakou
- G. Papanikolaou General Hospital, Thessaloniki, Greece
- Pulmonary Department of Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Alevizaki
- G. Papanikolaou General Hospital, Thessaloniki, Greece
- Pulmonary Department of Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Despoina Papakosta
- G. Papanikolaou General Hospital, Thessaloniki, Greece
- Pulmonary Department of Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Porpodis
- G. Papanikolaou General Hospital, Thessaloniki, Greece
- Pulmonary Department of Aristotle University of Thessaloniki, Thessaloniki, Greece
- Konstantinos Porpodis
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13
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Kallieri M, Zervas E, Fouka E, Porpodis K, Mitrova MH, Tzortzaki E, Makris M, Ntakoula M, Papaioannou AI, Lyberopoulos P, Dimakou K, Koukidou S, Ampelioti S, Papaporfyriou A, Katsoulis K, Kipourou M, Rovina N, Antoniou K, Vittorakis S, Bakakos P, Steiropoulos P, Markopoulou K, Avarlis P, Papanikolaou ΙC, Markatos M, Gaki E, Samitas K, Glynos K, Papiris SA, Papakosta D, Tzanakis N, Gaga M, Kostikas K, Loukides S. RELIght: A two-year REal-LIfe study of mepolizumab in patients with severe eosinophilic asTHma in Greece: Evaluating the multiple components of response. Allergy 2022; 77:2848-2852. [PMID: 35595723 DOI: 10.1111/all.15382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/03/2022] [Accepted: 05/14/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Maria Kallieri
- 2nd Respiratory Department, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | | | - Evangelia Fouka
- Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Konstantinos Porpodis
- Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Marija Hadji Mitrova
- Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Thessaloniki, Greece
| | | | - Michael Makris
- Allergy Unit, 2nd Department of Dermatology and Venereology, Attikon University General Hospital, Athens, Greece
| | - Maria Ntakoula
- Allergy Unit, 2nd Department of Dermatology and Venereology, Attikon University General Hospital, Athens, Greece
| | - Andriana I Papaioannou
- 2nd Respiratory Department, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Panagiotis Lyberopoulos
- 2nd Respiratory Department, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Katerina Dimakou
- 5th Respiratory Clinic, "Sotiria" Chest Hospital, Athens, Greece
| | - Sofia Koukidou
- 5th Respiratory Clinic, "Sotiria" Chest Hospital, Athens, Greece
| | | | | | | | - Maria Kipourou
- Pulmonary Department, 424 Army General Hospital, Thessaloniki, Greece
| | - Nikoletta Rovina
- 1st Respiratory Department, National and Kapodistrian University of Athens Medical School, "Sotiria" Chest Hospital, Athens, Greece
| | - Katerina Antoniou
- Respiratory Medicine School of Medicine, University of Crete, Heraklion, Greece
| | | | - Petros Bakakos
- 1st Respiratory Department, National and Kapodistrian University of Athens Medical School, "Sotiria" Chest Hospital, Athens, Greece
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, Alexandroupolis, Greece
| | - Katerina Markopoulou
- 1st Pulmonary Department, Papanikolaou General Hospital Thessaloniki, Thessaloniki, Greece
| | | | | | | | | | | | | | - Spyros A Papiris
- 2nd Respiratory Department, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Despoina Papakosta
- Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Thessaloniki, Greece
| | - Nikolaos Tzanakis
- Respiratory Medicine School of Medicine, University of Crete, Heraklion, Greece
| | - Mina Gaga
- 7th Respiratory Clinic, "Sotiria" Chest Hospital, Athens, Greece
| | - Konstantinos Kostikas
- Respiratory Medicine Department, University of Ioannina Medical School, Ioannina, Greece
| | - Stelios Loukides
- 2nd Respiratory Department, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
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14
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Pavlidis P, Schittek GA, Fouka E, Spyridonidis E, Gouveris H. [Functional and morphological disorders of taste and olfaction in COVID-19 patients]. HNO 2022; 70:828-836. [PMID: 36040511 PMCID: PMC9425785 DOI: 10.1007/s00106-022-01218-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2022] [Indexed: 11/29/2022]
Abstract
Ziele Testen der Prävalenz und Entwicklung akuter olfaktorischer und gustatorischer Funktionsstörungen und ihrer morphologischen Korrelate bei COVID-19-Patienten, die aufgrund von COVID-19-bedingten Atemwegserkrankungen einen Krankenhausaufenthalt benötigen. Methoden Eingeschlossen wurden 53 Krankenhauspatienten (23 Männer, 30 Frauen, Alter 42,54 ± 10,95 Jahre) mit RT-PCR-bestätigter COVID-19-Diagnose. Die Patienten wurden zweimal untersucht: direkt nach der Entlassung aus dem Krankenhaus und 4–6 Wochen später. Elektrogustometrische (EGM-)Schwellen im von der Chorda tympani versorgten Zungenbereich, am weichen Gaumen und im Bereich der Papillae vallatae wurden beidseitig erfasst. Der Geruchssinn wurde mit Riechstäbchen untersucht (Sniffin’ Sticks, Burghart GmbH, Wedel, Deutschland). Mittels Kontaktendoskopie wurden die Nasen- und Mundschleimhäute (fungiforme Papillen, fPap) der Patienten untersucht. Die Ergebnisse wurden mit denen von 53 gesunden Personen verglichen (23 Männer, 30 Frauen, Alter 42,90 ± 10,64 Jahre). Ergebnisse Die EGM-Schwellenwerte der Patienten waren in beiden Fällen signifikant höher als die der gesunden Probanden. Die EGM-Schwellenwerte bei der 2. Messung waren signifikant niedriger als bei der 1. Messung. Dementsprechend waren die vom Patienten berichteten gustatorischen Ergebnisse bei der 2. Messung verbessert. Dasselbe Muster wurde bei der Verwendung von Sniffin’ Sticks gefunden. Signifikante Veränderungen in Form und Vaskularisierung von fPap wurden bei Patienten festgestellt, insbesondere beim 1. Mal. Bemerkenswert ist, dass keine signifikanten Unterschiede in der Vaskularisation der Nasenschleimhaut der Patienten beobachtet wurden. Schlussfolgerung COVID-19 beeinträchtigt sowohl die Geschmacks- als auch die Geruchsfunktion. Es beeinflusst auch parallel die Struktur und Vaskularisierung der Mundschleimhaut, wenn auch die Nasenschleimhaut in einem viel geringeren, nicht signifikanten Ausmaß. Unsere Ergebnisse deuten darauf hin, dass COVID-19 eine leichte bis schwere Neuropathie mehrerer Hirnnerven verursachen kann.
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Affiliation(s)
- Pavlos Pavlidis
- HNO-Klinik, Universitätsklinikikum, Mainz, Deutschland. .,, Badralexistr. 3, 59132, Veria, Griechenland.
| | | | - Evangelia Fouka
- Klinik für Pulmologie, Aristotle Universität Thessaloniki, Thessaloniki, Griechenland
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15
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Porpodis K, Tsiouprou I, Apostolopoulos A, Ntontsi P, Fouka E, Papakosta D, Vliagoftis H, Domvri K. Eosinophilic Asthma, Phenotypes-Endotypes and Current Biomarkers of Choice. J Pers Med 2022; 12:jpm12071093. [PMID: 35887589 PMCID: PMC9316404 DOI: 10.3390/jpm12071093] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/25/2022] [Accepted: 06/28/2022] [Indexed: 12/16/2022] Open
Abstract
Asthma phenotyping and endotyping are constantly evolving. Currently, several biologic agents have been developed towards a personalized approach to asthma management. This review will focus on different eosinophilic phenotypes and Th2-associated endotypes with eosinophilic inflammation. Additionally, airway remodeling is analyzed as a key feature of asthmatic eosinophilic endotypes. In addition, evidence of biomarkers is examined with a predictive value to identify patients with severe, uncontrolled asthma who may benefit from new treatment options. Finally, there will be a discussion on the results from clinical trials regarding severe eosinophilic asthma and how the inhibition of the eosinophilic pathway by targeted treatments has led to the reduction of recurrent exacerbations.
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Affiliation(s)
- Konstantinos Porpodis
- Pulmonary Department, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (K.P.); (I.T.); (A.A.); (E.F.); (D.P.)
| | - Ioanna Tsiouprou
- Pulmonary Department, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (K.P.); (I.T.); (A.A.); (E.F.); (D.P.)
| | - Apostolos Apostolopoulos
- Pulmonary Department, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (K.P.); (I.T.); (A.A.); (E.F.); (D.P.)
| | - Polyxeni Ntontsi
- 2nd University Department of Respiratory Medicine, Attikon Hospital, 12462 Athens, Greece;
| | - Evangelia Fouka
- Pulmonary Department, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (K.P.); (I.T.); (A.A.); (E.F.); (D.P.)
| | - Despoina Papakosta
- Pulmonary Department, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (K.P.); (I.T.); (A.A.); (E.F.); (D.P.)
| | - Harissios Vliagoftis
- Department of Medicine, University of Alberta, 567 HMRC, Edmonton, AB T6G 2S2, Canada;
| | - Kalliopi Domvri
- Pulmonary Department, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece; (K.P.); (I.T.); (A.A.); (E.F.); (D.P.)
- Laboratory of Histology-Embryology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-2313307258
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16
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Spyropoulos G, Domvri K, Manika K, Fouka E, Kontakiotis T, Papakosta D. Clinical, imaging and functional determinants of sarcoidosis phenotypes in a Greek population. J Thorac Dis 2022; 14:1941-1949. [PMID: 35813723 PMCID: PMC9264090 DOI: 10.21037/jtd-21-1760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/20/2022] [Indexed: 11/23/2022]
Abstract
Background The aim of the present study was the application of the latest phenotype recommendations in Greek patients, in order to identify specific clinical, imaging and spirometric characteristics, at initial diagnosis of sarcoidosis, related to disease phenotypes. Methods Our cohort included 147 patients coming from Northern Greece, recruited from the Outpatient Sarcoidosis Clinic, of Aristotle University of Thessaloniki. The observation period was 5 years. The Scadding staging system and the World Association of Sarcoidosis and other Granulomatous Disorders (WASOG) Clinical Outcome Status instrument were used. Phenotypes were defined by the latest DELPHI consensus recommendations. Results The following clinical phenotypes were identified: asymptomatic 59%, acute 14.3%, chronic 12.9% and advanced 33.3%. The observed phenotypes were not related to Scadding stages. Lung function decline was in line with phenotype severity. The presence of fibrosis to any extent upon diagnosis differed among phenotypes (asymptomatic 13.8%, acute 38.1%, chronic 57.9%, advanced 61.2%, P<0.001) and was common for relapsing patients (P<0.001). In spontaneously remitting patients, fibrosis upon diagnosis was found less often than in non-remitting patients (P<0.001). Renal involvement was more frequently found in the advanced phenotype (P=0.032). Skin involvement was more common for patients with acute onset (P<0.001) and spontaneous remission (P=0.012). Ocular involvement was mainly found in relapsing patients (P<0.001). Conclusions In our cohort, sarcoidosis clinical phenotypes have certain clinical, imaging and functional characteristics, at initial diagnosis of the disease, which could be assessed in everyday practice.
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Affiliation(s)
- Georgios Spyropoulos
- Pulmonary Department, Aristotle University of Thessaloniki, "Georgios Papanikolaou" Hospital, Exohi, Thessaloniki, Greece
| | - Kalliopi Domvri
- Pulmonary Department, Aristotle University of Thessaloniki, "Georgios Papanikolaou" Hospital, Exohi, Thessaloniki, Greece
| | - Katerina Manika
- Pulmonary Department, Aristotle University of Thessaloniki, "Georgios Papanikolaou" Hospital, Exohi, Thessaloniki, Greece
| | - Evangelia Fouka
- Pulmonary Department, Aristotle University of Thessaloniki, "Georgios Papanikolaou" Hospital, Exohi, Thessaloniki, Greece
| | - Theodoros Kontakiotis
- Pulmonary Department, Aristotle University of Thessaloniki, "Georgios Papanikolaou" Hospital, Exohi, Thessaloniki, Greece
| | - Despoina Papakosta
- Pulmonary Department, Aristotle University of Thessaloniki, "Georgios Papanikolaou" Hospital, Exohi, Thessaloniki, Greece
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17
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Papaioannou AI, Fouka E, Tzanakis N, Antoniou K, Samitas K, Zervas E, Kostikas K, Bartziokas K, Porpodis K, Papakosta D, Tzouvelekis A, Gerogianni I, Kotsiou O, Makris M, Rovina N, Vlachou G, Markatos M, Vittorakis S, Katsoulis K, Papanikolaou I, Afthinos A, Katsaounou P, Steiropoulos P, Latsios D, Dimakou K, Koukidou S, Hillas G, Tryfon S, Kallieri M, Georgopoulou A, Avarlis P, Bakakos P, Markopoulou K, Gaki E, Paspala A, Kyriakaki Z, Gourgoulianis KI, Papiris S, Loukides S. SARS-Cov-2 Infection in Severe Asthma Patients Treated With Biologics. The Journal of Allergy and Clinical Immunology: In Practice 2022; 10:2588-2595. [PMID: 35752436 PMCID: PMC9222651 DOI: 10.1016/j.jaip.2022.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 12/15/2022]
Abstract
Background At the beginning of the pandemic, there have been considerable concerns regarding coronavirus disease 2019 (COVID-19) severity and outcomes in patients with severe asthma treated with biologics. Objective To prospectively observe a cohort of severe asthmatics treated with biologics for the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and disease severity during the COVID-19 pandemic. Methods Physicians from centers treating patients with severe asthma all over Greece provided demographic and medical data regarding their patients treated with biologics. Physicians were also asked to follow up patients during the pandemic and to perform a polymerase chain reaction test in case of a suspected SARS-Cov-2 infection. Results Among the 591 severe asthmatics (63.5% female) included in the study, 219 (37.1%) were treated with omalizumab, 358 (60.6%) with mepolizumab, and 14 (2.4%) with benralizumab. In total, 26 patients (4.4%) had a confirmed SARS-CoV-2 infection, 9 (34.6%) of whom were admitted to the hospital because of severe COVID-19, and 1 required mechanical ventilation and died 19 days after admission. Of the 26 infected patients, 5 (19.2%) experienced asthma control deterioration, characterized as exacerbation that required treatment with systemic corticosteroids. The scheduled administration of the biological therapy was performed timely in all patients with the exception of 2, in whom it was postponed for 1 week according to their doctors’ suggestion. Conclusion Our study confirms that despite the initial concerns, SARS-CoV-2 infection is not more common in asthmatics treated with biologics compared with the general population, whereas the use of biologic treatments for severe asthma during the COVID-19 pandemic does not seem to be related to adverse outcomes from severe COVID-19.
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18
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Manali ED, Kannengiesser C, Borie R, Ba I, Bouros D, Markopoulou A, Antoniou K, Kolilekas L, Papaioannou AI, Tzilas V, Tzouvelekis A, Daniil Z, Fouka E, Papakosta D, Xyfteri A, Karakatsani A, Loukides S, Korbila I, Tomos IP, Konstantinidis AK, Gogali A, Steiropoulos P, Papanikolaou IC, Bazaka C, Haritou A, Vassilakopoulos T, Maniati M, Kagouridis K, Markozannes E, Bouros E, Rampiadou C, Kounti G, Trachalaki A, Dimeas I, Karampitsakos T, Lyberopoulos P, Malamadakis N, Spyropoulou S, Revy P, Lainey E, Dieudé P, Rebah K, Ménard C, Oudin C, Masson C, Plessier A, Legendre M, Nathan N, Coulomb-L'Hermine A, Clement A, Amselem S, Boileau C, Crestani B, Papiris S. Genotype-Phenotype Relationships in Inheritable Idiopathic Pulmonary Fibrosis: A Greek National Cohort Study. Respiration 2022; 101:531-543. [PMID: 35078193 DOI: 10.1159/000520657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/27/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Monogenic and polygenic inheritances are evidenced for idiopathic pulmonary fibrosis (IPF). Pathogenic variations in surfactant protein-related genes, telomere-related genes (TRGs), and a single-nucleotide polymorphism in the promoter of MUC5B gene encoding mucin 5B (rs35705950 T risk allele) are reported. This French-Greek collaborative study, Gen-Phen-Re-GreekS in inheritable IPF (iIPF), aimed to investigate genetic components and patients' characteristics in the Greek national IPF cohort with suspected heritability. PATIENTS AND METHODS 150 patients with familial PF, personal-family extrapulmonary disease suggesting short telomere syndrome, and/or young age IPF were analyzed. RESULTS MUC5B rs35705950 T risk allele was detected in 103 patients (90 heterozygous, 13 homozygous, allelic frequency of 39%), monoallelic TRG pathogenic variations in 19 patients (8 TERT, 5 TERC, 2 RTEL1, 2 PARN, 1 NOP10, and 1 NHP2), and biallelic ABCA3 pathogenic variations in 3. Overlapping MUC5B rs35705950 T risk allele and TRG pathogenic variations were shown in 11 patients (5 TERT, 3 TERC, 1 PARN, 1 NOP10, and 1 NHP2), MUC5B rs35705950 T risk allele, and biallelic ABCA3 pathogenic variations in 2. In 38 patients, neither MUC5B rs35705950 T risk allele nor TRG pathogenic variations were detectable. Kaplan-Meier curves showed differences in time-to-death (p = 0.025) where patients with MUC5B rs35705950 T risk allele alone or in combination with TRG pathogenic variations presented better prognosis. CONCLUSION The Gen-Phen-Re-GreekS in iIPF identified multiple and overlapping genetic components including the rarest, underlying disease's genetic "richesse," complexity and heterogeneity. Time-to-death differences may relate to diverse IPF pathogenetic mechanisms implicating "personalized" medical care driven by genotypes in the near future.
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Affiliation(s)
- Effrosyni D Manali
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Caroline Kannengiesser
- Département de Génétique, APHP Hôpital Bichat, Paris, France.,Université de Paris, Paris, France.,INSERM UMR 1152, Université de Paris, Paris, France
| | - Raphael Borie
- INSERM UMR 1152, Université de Paris, Paris, France.,APHP, Service de Pneumologie A, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
| | - Ibrahima Ba
- Département de Génétique, APHP Hôpital Bichat, Paris, France.,Université de Paris, Paris, France.,INSERM UMR 1152, Université de Paris, Paris, France
| | - Demosthenes Bouros
- First Academic Department of Pneumonology, Hospital for Diseases of the Chest "Sotiria," Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Iatriko Medical Center, Athens, Greece
| | | | - Katerina Antoniou
- Laboratory of Molecular & Cellular Pneumonology, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | | | - Andriana I Papaioannou
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasileios Tzilas
- First Academic Department of Pneumonology, Hospital for Diseases of the Chest "Sotiria," Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Iatriko Medical Center, Athens, Greece
| | - Argyrios Tzouvelekis
- Department of Respiratory Medicine, General Hospital of Patras, University of Patras, Patras, Greece
| | - Zoe Daniil
- Department of Respiratory Medicine, Medical School, University of Thessaly, Larissa, Greece
| | - Evangelia Fouka
- A Department of Pulmonary Medicine, Aristotle University of Thessaloniki, "G. Papanikolaou" Hospital, Thessaloniki, Greece
| | - Despoina Papakosta
- A Department of Pulmonary Medicine, Aristotle University of Thessaloniki, "G. Papanikolaou" Hospital, Thessaloniki, Greece
| | | | - Anna Karakatsani
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stylianos Loukides
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Korbila
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis P Tomos
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Athina Gogali
- Department of Pneumonology, Medical School, University of Ioannina, Ioannina, Greece
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, University General Hospital Alexandroupolis, Medical School, Democritus University of Thrace, Thrace, Greece
| | | | | | | | - Theodoros Vassilakopoulos
- 3rd Department of Critical Care Medicine, Evgenideio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Maniati
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Kagouridis
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Markozannes
- First Academic Department of Pneumonology, Hospital for Diseases of the Chest "Sotiria," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Bouros
- First Academic Department of Pneumonology, Hospital for Diseases of the Chest "Sotiria," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Rampiadou
- Pulmonary Department, "G Papanikolaou" General Hospital, Thessaloniki, Greece
| | - Georgia Kounti
- Pulmonary Department, "G Papanikolaou" General Hospital, Thessaloniki, Greece
| | - Athina Trachalaki
- Laboratory of Molecular & Cellular Pneumonology, Department of Respiratory Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Ilias Dimeas
- Department of Respiratory Medicine, Medical School, University of Thessaly, Larissa, Greece
| | - Theodoros Karampitsakos
- Department of Respiratory Medicine, General Hospital of Patras, University of Patras, Patras, Greece
| | - Panagiotis Lyberopoulos
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Malamadakis
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Patrick Revy
- Laboratory of Genome Dynamics in the Immune System, Imagine Institute, INSERM UMR 1163, Labellisé Ligue Contre Le Cancer, Université de Paris, Paris, France
| | - Elodie Lainey
- Service d'Hématologie Biologique, Hôpital Robert Debré, APHP, UMRS 1131, Institut Universitaire d'Hématologie, Paris, France
| | - Philippe Dieudé
- Department of Rheumatology, Hôpital Bichat-Claude Bernard, APHP, INSERM U1152, Université de Paris, Paris, France
| | - Khedidja Rebah
- Département de Génétique, APHP Hôpital Bichat, Paris, France.,Université de Paris, Paris, France
| | - Christelle Ménard
- Département de Génétique, APHP Hôpital Bichat, Paris, France.,Université de Paris, Paris, France
| | - Claire Oudin
- Département de Génétique, APHP Hôpital Bichat, Paris, France.,Université de Paris, Paris, France
| | - Cécile Masson
- Imagine Institute, Bioinformatics Platform, INSERM UMR 1163, Université de Paris, Paris, France
| | | | - Marie Legendre
- Sorbonne Université, INSERM UMR S933 Maladies Génétiques d'Expression Pédiatrique, and Assistance Publique Hôpitaux de Paris, U.F. de Génétique Moléculaire, Hôpital Armand Trousseau, Paris, France
| | - Nadia Nathan
- Sorbonne Université, INSERM UMR S933, France, Assistance Publique Hôpitaux de Paris, Service de Pneumologie Pédiatrique, Hôpital Armand Trousseau, Centre National de Référence des Maladies Respiratoires Rares RespiRare, Paris, France
| | - Aurore Coulomb-L'Hermine
- Service d'Anatomie et de Cytologie Pathologiques, Sorbonne Université, Hôpital d'Enfants Armand Trousseau, Paris, France
| | - Annick Clement
- Sorbonne Université, INSERM UMR S933, France, Assistance Publique Hôpitaux de Paris, Service de Pneumologie Pédiatrique, Hôpital Armand Trousseau, Centre National de Référence des Maladies Respiratoires Rares RespiRare, Paris, France
| | - Serge Amselem
- Sorbonne Université, INSERM UMR S933 Maladies Génétiques d'Expression Pédiatrique, and Assistance Publique Hôpitaux de Paris, U.F. de Génétique Moléculaire, Hôpital Armand Trousseau, Paris, France
| | - Catherine Boileau
- Département de Génétique, APHP Hôpital Bichat, Paris, France.,Université de Paris, Paris, France
| | - Bruno Crestani
- INSERM UMR 1152, Université de Paris, Paris, France.,APHP, Service de Pneumologie A, Centre de Référence des Maladies Pulmonaires Rares, FHU APOLLO, Hôpital Bichat, Paris, France
| | - Spyros Papiris
- 2nd Pulmonary Medicine Department, General University Hospital "Attikon," Medical School, National and Kapodistrian University of Athens, Athens, Greece
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19
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Fouka E, Kalomenidis I, Gianniou N, Gida S, Steiropoulos P. COVID-19 Advanced Care. J Pers Med 2021; 11:1082. [PMID: 34834434 PMCID: PMC8621119 DOI: 10.3390/jpm11111082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/10/2021] [Accepted: 10/22/2021] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, related to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a worldwide sudden and substantial burden in public health due to an enormous increase in hospitalizations for pneumonia with the multiorgan disease. Treatment for individuals with COVID-19 includes best practices for supportive management of acute hypoxic respiratory failure. Emerging data indicate that dexamethasone therapy reduces 28-day mortality in patients requiring supplemental oxygen compared with usual care, and ongoing trials are testing the efficacy of antiviral therapies, immune modulators and anticoagulants in the prevention of disease progression and complications, while monoclonal antibodies and hyperimmune globulin may provide additional preventive strategies. Consensus suggestions can standardize care, thereby improving outcomes and facilitating future research. This review discusses current evidence regarding the pharmacotherapy of COVID-19.
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Affiliation(s)
- Evangelia Fouka
- Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, 57010 Thessaloniki, Greece
| | - Ioannis Kalomenidis
- 1st Department of Critical Care and Pulmonary Medicine, Evaggelismos Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece; (I.K.); (N.G.)
| | - Niki Gianniou
- 1st Department of Critical Care and Pulmonary Medicine, Evaggelismos Hospital, National and Kapodistrian University of Athens, 10679 Athens, Greece; (I.K.); (N.G.)
| | - Sofia Gida
- Intensive Care Unit, General Hospital of Trikala, 42100 Trikala, Greece;
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, 67100 Alexandroupolis, Greece;
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20
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Pavlidis P, Fouka E, Katsilis G, Gouveris H, Papakosta D. Morphological changes in nasal mucosa in patients with sarcoidosis. Clin Otolaryngol 2021; 47:212-217. [PMID: 34555266 DOI: 10.1111/coa.13865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 08/11/2021] [Accepted: 09/05/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Evangelia Fouka
- Pulmonary Department of Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Despoina Papakosta
- Pulmonary Department of Aristotle University of Thessaloniki, Thessaloniki, Greece
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21
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Papaioannou AI, Mplizou M, Porpodis K, Fouka E, Zervas E, Samitas K, Markatos M, Bakakos P, Papiris S, Gaga M, Papakosta D, Loukides S. Long-term efficacy and safety of omalizumab in patients with allergic asthma: A real-life study. Allergy Asthma Proc 2021; 42:235-242. [PMID: 33980337 DOI: 10.2500/aap.2021.42.210014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: The efficacy and safety of omalizumab in patients with severe allergic asthma have been established in both randomized controlled trials and real-life studies. Objective: To evaluate the sustained effectiveness and safety of long-term treatment with omalizumab in a real-world setting. Methods: In this retrospective study, we included patients treated with omalizumab for at least 8 years in four asthma clinics in Greece. Pulmonary function, asthma control, oral corticosteroids (OCS) dose, and exacerbations were recorded before treatment, 6 months later, and annually thereafter. Adverse events were also recorded. Results: Forty-five patients (66.7% women), mean ± standard deviation (SD) age 55.3 ± 12.2 years, were included. The duration of treatment with omalizumab was 10.6 ± 1.2 years. The annual exacerbation rate decreased from 4.1 before omalizumab initiation to 1.1 after 1 year of treatment and remained low up to the 8th year of treatment (p < 0.001). From the 19 patients who were receiving OCS at baseline, 21.1% patients discontinued after 6 months, 47.4% were still on OCS after 4 years of therapy, and 31.6% were on OCS after 8 years. With regard to the OCS dose, 36.8% of the patients reduced the dose ≥ 50% after 6 months and 68.4% achieved 50% reduction after 2 years. The mean daily OCS dose before omalizumab initiation was 7.8 mg of prednisolone or the equivalent, reduced to 4.7 mg/day after 6 months, which reached 1.6 mg/day after 8 years (p < 0.001). Treatment with omalizumab resulted in significant improvements of asthma control and lung function. No severe adverse events were reported. Conclusion: In this real-life study, omalizumab resulted in significant and sustained improvements in asthma exacerbations, asthma control, and lung function, and had a steroid sparing effect and a good safety profile.
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Affiliation(s)
- Andriana I. Papaioannou
- From the 2nd Respiratory Medicine Department, National and Kapodistrian University of Athens, 2nd Respiratory Medicine Department, “Attikon” University Hospital, Chaidari, Athens, Greece
| | - Myrto Mplizou
- From the 2nd Respiratory Medicine Department, National and Kapodistrian University of Athens, 2nd Respiratory Medicine Department, “Attikon” University Hospital, Chaidari, Athens, Greece
| | - Konstantinos Porpodis
- Prof, Respiratory Medicine Department, Aristotle University of Thessaloniki, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Evangelia Fouka
- Prof, Respiratory Medicine Department, Aristotle University of Thessaloniki, G Papanikolaou Hospital, Thessaloniki, Greece
| | | | | | | | - Petros Bakakos
- National and Kapodistrian University of Athens National and Kapodistrian University of Athens, 1st Respiratory Medicine Department, “Sotiria” Hospital, Athens, Greece
| | - Spyridon Papiris
- From the 2nd Respiratory Medicine Department, National and Kapodistrian University of Athens, 2nd Respiratory Medicine Department, “Attikon” University Hospital, Chaidari, Athens, Greece
| | - Mina Gaga
- 7th Respiratory Medicine Department, Sotiria Hospital, Athens. Greece
| | - Despoina Papakosta
- Prof, Respiratory Medicine Department, Aristotle University of Thessaloniki, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Stelios Loukides
- From the 2nd Respiratory Medicine Department, National and Kapodistrian University of Athens, 2nd Respiratory Medicine Department, “Attikon” University Hospital, Chaidari, Athens, Greece
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Papaioannou AI, Bartziokas K, Hillas G, Fouka E, Dimakou K, Kallieri M, Tsikrika S, Papadaki G, Papathanasiou E, Papaporfyriou A, Apollonatou V, Verykokou G, Mplizou M, Papakosta D, Manali ED, Papiris S, Loukides S. Device use errors among patients with asthma and COPD and the role of training: a real-life study. Postgrad Med 2021; 133:524-529. [PMID: 33689545 DOI: 10.1080/00325481.2021.1902188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background and objectives: Administration of inhaled medication for asthma and COPD is often difficult and incorrect device use is associated with unfavorable outcomes. We aimed to evaluate device use errors in asthma and COPD patients and to associate incorrect use with the patient's characteristics and medical history.Methods: Demographics and medical history were recorded. The use of each prescribed device was evaluated according to predefined steps.Results: 607 patients (49.9% male, median age (IQR) 63 (51, 70) years performed 663 demonstrations (56 patients were using 2 different types of devices). 51.4% were treated for asthma and 48.6% for COPD. 79.6% of demonstrations were performed using DPIs. Errors were documented on 41.2% of demonstrations and were associated with the type of device, p < 0.001. Elderly patients were less frequently using their devices correctly compared to younger patients, 50.8% vs 62.2%, respectively, p = 0.007. Correct demonstrations were more among asthmatics compared to COPD patients 63.1% vs 54.5%, p = 0.024. Incorrect use was associated with more acute exacerbations in the preceding year [median(IQR), 1(0, 2) vs 1(0, 1)], for incorrect and correct use, respectively, p < 0.001. Upon demonstration, 15.5% of patients have never been trained (i.e., undergone actual demonstrations and observation while using their device) by anyone. Errors occurred more frequently among patients who reported not to be trained compared to those who were trained, 67.0% vs 14.6%, respectively, p < 0.001. The commonest error was associated with the inspiration maneuver and accounted for the 48.3% of errors in the DPIs and 53.0% of errors in the MDIs.Conclusion: Device use errors are common and associated with unfavorable outcomes. Trained patients were more likely to use the device correctly.
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Affiliation(s)
| | | | - Georgios Hillas
- 5th Respiratory Medicine Department Sotiria Chest Hospital, Athens, Greece
| | - Evangelia Fouka
- Respiratory Medicine Department, Aristotle University of Thessaloniki, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Katerina Dimakou
- 5th Respiratory Medicine Department Sotiria Chest Hospital, Athens, Greece
| | - Maria Kallieri
- 2 Respiratory Medicine Department, "Attikon" University Hospital, Athens, Greece
| | | | - Georgia Papadaki
- 2 Respiratory Medicine Department, "Attikon" University Hospital, Athens, Greece
| | | | | | - Vasiliki Apollonatou
- 2 Respiratory Medicine Department, "Attikon" University Hospital, Athens, Greece
| | - Galateia Verykokou
- 2 Respiratory Medicine Department, "Attikon" University Hospital, Athens, Greece
| | - Myrto Mplizou
- 2 Respiratory Medicine Department, "Attikon" University Hospital, Athens, Greece
| | - Despina Papakosta
- Respiratory Medicine Department, Aristotle University of Thessaloniki, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Effrosyni D Manali
- 2 Respiratory Medicine Department, "Attikon" University Hospital, Athens, Greece
| | - Spyridon Papiris
- 2 Respiratory Medicine Department, "Attikon" University Hospital, Athens, Greece
| | - Stelios Loukides
- 2 Respiratory Medicine Department, "Attikon" University Hospital, Athens, Greece
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Papaioannou AI, Fouka E, Papakosta D, Papiris S, Loukides S. Switching between biologics in severe asthma patients. When the first choice is not proven to be the best. Clin Exp Allergy 2020; 51:221-227. [PMID: 33305478 DOI: 10.1111/cea.13809] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/28/2020] [Accepted: 12/06/2020] [Indexed: 12/14/2022]
Abstract
During the last decades, new treatments targeting disease mechanisms referred as biologics have been introduced in the therapy of asthma and currently, five monoclonal antibodies have been approved. Although these therapeutic agents have been formulated to target specific asthma endotypes, it is often difficult for the treating physician to identify which patient is the best candidate for each one of these specific treatments especially in the clinical scenario of a patient in whom clinical characteristics overlap between different endotypes, allowing the selection of more than one biologic agent. As no head-to-head comparisons between these biologics have been attempted, there is no evidence on the superiority of one biologic agent over the other. Furthermore, a physician's first therapeutic decision, no matter how carefully has been made, may often result in suboptimal clinical response and drug discontinuation, indicating the need for switching to a different biologic. In this short review, we discuss the available evidence regarding the switching between biologics in patients with severe asthma and we propose a simple algorithm on switching possibilities in case that the physicians' initial choice is proven not to be the best.
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Affiliation(s)
- Andriana I Papaioannou
- National and Kapodistrian University of Athens, Medical School, 2nd Respiratory medicine Dept Attikon' University Hospital, Athens, Greece
| | - Evangelia Fouka
- Respiratory Medicine Department, G Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Despina Papakosta
- Respiratory Medicine Department, G Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Spyridon Papiris
- National and Kapodistrian University of Athens, Medical School, 2nd Respiratory medicine Dept Attikon' University Hospital, Athens, Greece
| | - Stelios Loukides
- National and Kapodistrian University of Athens, Medical School, 2nd Respiratory medicine Dept Attikon' University Hospital, Athens, Greece
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24
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Kotoulas SC, Pataka A, Domvri K, Spyratos D, Katsaounou P, Porpodis K, Fouka E, Markopoulou A, Passa-Fekete K, Grigoriou I, Kontakiotis T, Argyropoulou P, Papakosta D. Acute effects of e-cigarette vaping on pulmonary function and airway inflammation in healthy individuals and in patients with asthma. Respirology 2020; 25:1037-1045. [PMID: 32239706 DOI: 10.1111/resp.13806] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/21/2020] [Accepted: 02/27/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND OBJECTIVE The acute effects of e-cigarettes have not been scientifically demonstrated yet. The aim of this study was to assess the acute changes in pulmonary function and airway inflammation in patients with asthma after vaping one e-cigarette. METHODS Twenty-five smokers suffering from stable moderate asthma according to GINA guidelines with no other comorbidities and 25 healthy smokers matched with the baseline characteristics of the asthmatic patients were recruited. PFT, IOS, FeNO and EBC were performed before and after vaping one e-cigarette with nicotine. pH and concentrations of IL-1β, IL-4, IL-5, IL-6, IL-8, IL-10, IL-13, IL-17A, TNF-α, ISO8 and LTB4 were measured in EBC. RESULTS FFEV1/FVC ratio and PEF were reduced in asthmatic patients after e-cigarette. Z5Hz and R5Hz, R10Hz and R20Hz increased in both groups. FeNO and EBC pH increased by 3.60 ppb (P = 0.001) and 0.15 (P = 0.014) in asthmatic patients after e-cigarette, whereas they decreased in control group by 3.28 ppb (P < 0.001) and 0.12 (P = 0.064), respectively. The concentrations of IL-10, TNF-α and ISO8 in EBC increased in asthmatic patients after e-cigarette and the changes in concentrations of IL-1β and IL-4 differed significantly between the two groups. CONCLUSION E-cigarette vaping resulted in acute alteration of both pulmonary function and airway inflammation in stable moderate asthmatic patients.
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Affiliation(s)
- Serafeim-Chrysovalantis Kotoulas
- Clinic of Respiratory Failure, General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasia Pataka
- Clinic of Respiratory Failure, General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kalliopi Domvri
- Department of Pulmonary Medicine, General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dionisios Spyratos
- Department of Pulmonary Medicine, General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paraskevi Katsaounou
- 1st ICU 'Evangelismos Hospital' School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Porpodis
- Department of Pulmonary Medicine, General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelia Fouka
- Department of Pulmonary Medicine, General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini Markopoulou
- Clinic of Pulmonary Medicine of National Healthcare System, General Hospital of Thessaloniki 'Georgios Papanikolaou', Thessaloniki, Greece
| | - Katalin Passa-Fekete
- Clinic of Respiratory Failure, General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioanna Grigoriou
- Clinic of Respiratory Failure, General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros Kontakiotis
- Department of Pulmonary Medicine, General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paraskevi Argyropoulou
- Clinic of Respiratory Failure, General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Despoina Papakosta
- Department of Pulmonary Medicine, General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
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25
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Antoniou K, Markopoulou K, Tzouvelekis A, Trachalaki A, Vasarmidi E, Organtzis J, Tzilas V, Bouros E, Kounti G, Rampiadou C, Kotoulas SC, Bardaka F, Bibaki E, Fouka E, Meletis G, Tryfon S, Daniil Z, Papakosta D, Bouros D. Efficacy and safety of nintedanib in a Greek multicentre idiopathic pulmonary fibrosis registry: a retrospective, observational, cohort study. ERJ Open Res 2020; 6:00172-2019. [PMID: 32010718 PMCID: PMC6983495 DOI: 10.1183/23120541.00172-2019] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/13/2019] [Indexed: 11/09/2022] Open
Abstract
Nintedanib is a tyrosine kinase inhibitor approved for the treatment of idiopathic pulmonary fibrosis (IPF). In a retrospective, real-world study across seven Greek hospitals, we evaluated the effectiveness and safety of nintedanib in routine clinical practice. Patients diagnosed with IPF, as per guideline criteria or multidisciplinary diagnosis, received nintedanib between January 2013 and January 2018. We evaluated 244 patients: mean±sd age 71.8±7.5 years, 79.1% male, 45.1% current smokers and 33.1% ex-smokers at treatment initiation. At baseline, predicted forced vital capacity (FVC) was 73.3±20.7% and predicted diffusing capacity of the lungs for carbon monoxide (DLCO) was 42.6±16.7%. On average, patients spent 23.6±15.0 months on nintedanib. At 3 years, 78 patients had died, equating to a 3-year survival rate of 59.4% (unaffected by treatment discontinuation or dose reduction). FVC% pred and DLCO% pred were largely stable at 3 years, with no significant difference from baseline (FVC 73.3±20.7% pred versus 78±20.1% pred, p=0.074; DLCO 42.6±16.7% pred versus 40.4±18.1% pred, p=0.334). Of the 244 patients, 55.7% reported an adverse event. Gastrointestinal events were the most common (173 (77.2%) out of 224 total events) and 45.0% of patients experienced diarrhoea. Only 32 (13.1%) patients had to permanently discontinue nintedanib due to an adverse event. This real-world study shows a 3-year survival rate of 59.4% and a low discontinuation rate due to adverse events. Our experience is consistent with previous findings in clinical trials of nintedanib in IPF. Findings from the largest registry of Greek patients with IPF receiving nintedanib in routine clinical practice show, over a 3-year period, a low discontinuation rate and efficacy data that support the results of the INPULSIS clinical trialshttp://bit.ly/35a2CS5
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Affiliation(s)
- Katerina Antoniou
- Dept of Thoracic Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.,These authors contributed equally
| | - Katerina Markopoulou
- Respiratory Medicine Dept, George Papanikolaou General Hospital, Thessaloniki, Greece.,These authors contributed equally
| | - Argyrios Tzouvelekis
- First Academic Dept of Pneumonology, Hospital for Diseases of the Chest, "Sotiria", Athens, Greece.,These authors contributed equally
| | - Athina Trachalaki
- Dept of Thoracic Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.,These authors contributed equally
| | - Eirini Vasarmidi
- Dept of Thoracic Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.,These authors contributed equally
| | - Jiannis Organtzis
- Respiratory Medicine Dept, Aristotle University of Thessaloniki, Papanikolaou General Hospital, Thessaloniki, Greece.,These authors contributed equally
| | - Vasilios Tzilas
- First Academic Dept of Pneumonology, Hospital for Diseases of the Chest, "Sotiria", Athens, Greece
| | - Evangelos Bouros
- First Academic Dept of Pneumonology, Hospital for Diseases of the Chest, "Sotiria", Athens, Greece
| | - Georgia Kounti
- Respiratory Medicine Dept, George Papanikolaou General Hospital, Thessaloniki, Greece
| | - Christina Rampiadou
- Respiratory Medicine Dept, George Papanikolaou General Hospital, Thessaloniki, Greece
| | | | - Fotini Bardaka
- Respiratory Medicine Dept, University General Hospital of Larissa, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Eleni Bibaki
- Respiratory Medicine Dept, Venizeleio Pananio General Hospital, Heraklion, Greece
| | - Evangelia Fouka
- Respiratory Medicine Dept, Aristotle University of Thessaloniki, Papanikolaou General Hospital, Thessaloniki, Greece
| | - Georgios Meletis
- Respiratory Medicine Dept, Venizeleio Pananio General Hospital, Heraklion, Greece
| | - Stavros Tryfon
- Respiratory Medicine Dept, George Papanikolaou General Hospital, Thessaloniki, Greece
| | - Zoe Daniil
- Respiratory Medicine Dept, University General Hospital of Larissa, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Despina Papakosta
- Respiratory Medicine Dept, Aristotle University of Thessaloniki, Papanikolaou General Hospital, Thessaloniki, Greece
| | - Demosthenes Bouros
- First Academic Dept of Pneumonology, Hospital for Diseases of the Chest, "Sotiria", Athens, Greece
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Hillas G, Fouka E, Papaioannou AI. Antibodies targeting the interleukin-5 signaling pathway used as add-on therapy for patients with severe eosinophilic asthma: a review of the mechanism of action, efficacy, and safety of the subcutaneously administered agents, mepolizumab and benralizumab. Expert Rev Respir Med 2020; 14:353-365. [PMID: 31958239 DOI: 10.1080/17476348.2020.1718495] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Since the discovery of eosinophils in the sputum of asthmatic patients, several studies have offered evidence on their prominent role in the pathology and severity of asthma. Blood eosinophils, are a useful biomarker for therapy selection in severe asthma patients. IL-5 plays crucial role on maturation, activation, recruitment, and survival of eosinophils and constitutes an important therapeutic target for patients with severe uncontrolled eosinophilic asthma.Areas covered: This review focuses on the similarities and differences on mechanisms of action, efficacy, and safety, of two subcutaneously(SC) administered agents, the anti-interleukin(IL)-5 monoclonal antibody mepolizumab and the IL-5 receptor-α(IL-5Rα)-directed cytolytic monoclonal antibody benralizumab. All information used was collected from PubMed using keywords such as severe asthma, eosinophils, IL-5, airway inflammation, asthma exacerbations, mepolizumab, benralizumab, anti-IL5, and anti-IL5R either as single terms or in several combinations.Expert opinion: Both mepolizumab and benralizumab are promising for the treatment of severe eosinophilic asthma resulting in asthma control improvement and exacerbations reduction and can serve as steroid-sparing agents. However, since no head-to-head comparisons exist, it is unknown whether their different mechanisms of action might be related to different efficacy in specific patients' sub-phenotypes. Long-term clinical observations will provide real-world evidence regarding their lasting effectiveness and safety.
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Affiliation(s)
- Georgios Hillas
- 5th Pulmonary Department, Sotiria Chest Diseases Hospital, Athens, Greece
| | - Evangelia Fouka
- Pulmonary Department of Aristotele University of Thessaloniki, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Andriana I Papaioannou
- 2nd Respiratory Medicine Department, University of Athens, Attikon Hospital, Athens, Greece
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Kotoulas SC, Fouka E, Kontakiotis T. A case of tracheal diverticulum with an unusual cause. Hippokratia 2017; 21:206. [PMID: 30944516 PMCID: PMC6441344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- S C Kotoulas
- Department of Pulmonary Medicine of General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Fouka
- Department of Pulmonary Medicine of General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - T Kontakiotis
- Department of Pulmonary Medicine of General Hospital of Thessaloniki 'Georgios Papanikolaou', Aristotle University of Thessaloniki, Thessaloniki, Greece
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Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous and complex disease with great morbidity and mortality. Despite the new developments in the managements of COPD, it was recognized that not all patients benefit from the available medications. Therefore, efforts to identify subgroups or phenotypes had been made in order to predict who will respond to a class of drugs for COPD. This review will discuss phenotypes, endotypes, and subgroups such as the frequent exacerbator, the one with systemic inflammation, the fast decliner, ACOS, and the one with co-morbidities and their impact on therapy. It became apparent, that the "inflammatory" phenotypes: frequent exacerbator, chronic bronchitic, and those with a number of co-morbidities need inhaled corticosteroids; in contrast, the emphysematous type with dyspnea and lung hyperinflation, the fast decliner, need dual bronchodilation (deflators). However, larger, well designed studies clustering COPD patients are needed, in order to identify the important subgroups and thus, to lead to personalize management in COPD.
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Affiliation(s)
| | - Alexandru Corlateanu
- b Department of Respiratory Medicine , State University of Medicine and Pharmacy "Nicolae Testemitanu" , Chisinau , Moldova , Republic of Moldova
| | - Evangelia Fouka
- c Pulmonary Department of Aristotle University G. Papanikolaou Hospital , Thessaloniki , Greece
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29
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Natsis K, Grammatikopoulou D, Kokkinos P, Fouka E, Totlis T. Isolated tuberculous arthritis of the ankle: a case report and review of the literature. Hippokratia 2017; 21:97-100. [PMID: 30455563 PMCID: PMC6239087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Isolated ankle joint tuberculous arthritis is extremely rare, comprising an incidence lower than 5 % of skeletal tuberculosis (TB). Description of the case: We present an unusual case of isolated tubercular arthritis of the ankle in a 25-year-old male where the definitive diagnosis was difficult to be reached. The clinical examination revealed slight edema and a slight increase in local skin temperature. Based on magnetic resonance imaging performed, the diagnosis of septic arthritis was made. The arthroscopic appearance of the synovium and polymerase chain reaction analysis (PCR) of the synovial fluid revealed tuberculous arthritis. CONCLUSION TB should be included in the differential diagnosis of inflammatory arthritis in patients with persistent pain and swelling of the ankle. HIPPOKRATIA 2017, 21(2): 97-100.
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Affiliation(s)
- K Natsis
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
- European Interbalkan Medical Center, Thessaloniki, Greece
| | - D Grammatikopoulou
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - P Kokkinos
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - E Fouka
- Pulmonary Department of Aristotle University of Thessaloniki, General Hospital G. Papanikolaou, Thessaloniki, Greece
| | - T Totlis
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
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Organtzis I, Fouka E, Efthymiou C, Mourouzidou V, Spyropoulos G, Kontakiotis T, Papakosta D. AB051. Assessment of pulmonary function kai effect of treatment in patients with idiopathic pulmonary fibrosis (IPF). Ann Transl Med 2016. [DOI: 10.21037/atm.2016.ab051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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31
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Porpodis K, Domvri K, Kontakiotis T, Fouka E, Kontakioti E, Zarogoulidis K, Papakosta D. Comparison of diagnostic validity of mannitol and methacholine challenges and relationship to clinical status and airway inflammation in steroid-naïve asthmatic patients. J Asthma 2016; 54:520-529. [PMID: 27686218 DOI: 10.1080/02770903.2016.1238926] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of this study was to demonstrate and compare the diagnostic validity of two bronchial challenges and to investigate their correlation with patient clinical status, atopy and inflammation markers. METHODS Eighty-eight patients, 47 women and 41 men, mean age 38.56 ± 16.73 years who presented with asthma related symptoms and were not on any anti-asthma medication, were challenged with mannitol and methacholine on separate days. Medical history regarding asthmatic symptoms, physical examination, skin prick tests and FeNO levels were also assessed. The clinical diagnosis of asthma was based on bronchodilator reversibility test. RESULTS Sixty-seven patients were diagnosed with asthma and 21 without asthma. Both methacholine (P < 0.014) and mannitol (P < 0.000) challenges were significant in diagnosing asthma. The positive/negative predictive value was 93.33%/41.86% for methacholine, 97.72%/45.45% for mannitol and 97.05%/45.45%. for both methods assessed together. Worthy of note that 22% of asthmatics had both tests negative. There was a negative correlation between PC20 of methacholine and the FeNO level P < 0.001, and positive with the PD15 of mannitol P < 0.001 and the pre-test FEV1% pred P < 0.005, whereas PD15 of mannitol was negatively correlated with the FeNO level P < 0.001. Furthermore, dyspnea was the only asthmatic symptom associated with FeNO level P < 0.035 and the positivity of mannitol P < 0.014 and methacholine P < 0.04. CONCLUSIONS Both challenge tests were equivalent in diagnosing asthma. Nevertheless, specificity appeared to be slightly higher in mannitol challenge.
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Affiliation(s)
- Konstantinos Porpodis
- a Department of Pulmonary Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Kalliopi Domvri
- a Department of Pulmonary Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Theodoros Kontakiotis
- a Department of Pulmonary Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Evangelia Fouka
- a Department of Pulmonary Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Eirini Kontakioti
- a Department of Pulmonary Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | | | - Despina Papakosta
- a Department of Pulmonary Medicine , Aristotle University of Thessaloniki , Thessaloniki , Greece
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Fouka E, Lamprianidou E, Arvanitidis K, Filidou E, Kolios G, Miltiades P, Paraskakis E, Antoniadis A, Kotsianidis I, Bouros D. Low-Dose Clarithromycin Therapy Modulates Th17 Response In Non-Cystic Fibrosis Bronchiectasis Patients. Lung 2014; 192:849-55. [DOI: 10.1007/s00408-014-9619-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/22/2014] [Indexed: 12/27/2022]
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Abstract
A 48-year-old man was being treated unsuccessfully for miliary tuberculosis for 5 months until he presented with acromioclavicular joint swelling. Imaging of the shoulder revealed destruction of the acromioclavicular joint and the patient was brought to the operating theatre and underwent the excision of the distal end of the clavicle, synovectomy and drainage of the abscess. Surgery was followed by prompt clinical, functional and radiological improvement. Histopathology confirmed the diagnosis of acromioclavicular tuberculosis. Resistance to appropriate antituberculous treatment in patients with miliary tuberculosis can sometimes be a result of undiagnosed extrapulmonary site of infection.
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Affiliation(s)
- Filon Agathangelidis
- First Orthopaedic Department of Aristotle University of Thessaloniki, G Pananikolaou Hospital, Thessaloniki, Greece.
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Zarogoulidis P, Glaros D, Kontakiotis T, Froudarakis M, Kioumis I, Kouroumichakis I, Tsiotsios A, Kallianos A, Steiropoulos P, Porpodis K, Nena E, Papakosta D, Rapti A, Constantinidis TC, Kerenidi T, Panopoulou M, Trakada G, Courcoutsakis N, Fouka E, Zarogoulidis K, Maltezos E. Health costs from hospitalization with H1N1 infection during the 2009-2010 influenza pandemic compared with non-H1N1 respiratory infections. Int J Gen Med 2012; 5:175-82. [PMID: 22419882 PMCID: PMC3302763 DOI: 10.2147/ijgm.s28454] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The first positive patient with influenza A (H1N1) was recorded in March 2009 and the pandemic continued with new outbreaks throughout 2010. This study’s objective was to quantify the total cost of inpatient care and identify factors associated with the increased cost of the 2009–2010 influenza A pandemic in comparison with nonviral respiratory infection. Methods In total, 133 positive and 103 negative H1N1 patients were included from three tertiary care hospitals during the two waves of H1N1 in 2009 and 2010. The health costs for protective equipment and pharmaceuticals and hospitalization (medications, laboratory, and diagnostic tests) were compared between H1N1 positive and negative patients. Results The objective of the study was to quantify the means of daily and total costs of inpatient care. Overall, cost was higher for H1N1 positive (€61,0117.72) than for H1N1-negative patients (€464,923.59). This was mainly due to the protection measures used and the prolonged hospitalization in intensive care units. In H1N1-negative patients, main contributors to cost included additional diagnostic tests due to concern regarding respiratory capacity and laboratory values, as well as additional radiologic and microbial culture tests. The mean duration of hospitalization was 841 days for H1N1 positive and 829 days for negative patients. Conclusion Cost was higher in H1N1 patients, mainly due to the protection measures used and the increased duration of hospitalization in intensive care units. An automated system to monitor patients would be desirable to reduce cost in H1N1 influenza.
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Affiliation(s)
- Paul Zarogoulidis
- Aristotle University of Thessaloniki, Pulmonary Department, "G Papanikolaou" Hospital, Exochi, Thessaloniki
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