المؤلفون: Tillie-Leblond, I.¹, Montani, D.², Crestani, B.³, de Blic, J.⁴, Humbert, M.², Tunon-de-Lara, M.⁵, Magnan, A.⁶, Roche, N.⁷, Ostinelli, J.⁸, Chanez, P.⁹

المصدر: Allergy. Mar2009, Vol. 64 Issue 3, p354-367. 14p. 2 Charts, 3 Graphs.

مصطلحات موضوعية: *INFLAMMATION, *ASTHMA, *RESPIRATORY allergy, *OBSTRUCTIVE lung diseases, *EOSINOPHIL disorders

مستخلص: Asthma symptoms are the main reason for healthcare utilization and are a fundamental parameter for the evaluation of asthma control. Currently, asthma is defined as a chronic inflammatory disease. A French expert group studied the association between inflammation and asthma symptoms by carrying out a critical review of the international literature. Uncontrolled asthmatics have an increased number of polynuclear eosinophils in the induced sputum and an increased production of exhaled NO. Control by anti-inflammatory treatment is accompanied by a reduction in bronchial eosinophilia and exhaled NO. Asthma symptoms are the result of complex mechanisms and many factors modify their perception. Experimental data suggest that there is a relationship between the perception of symptoms and eosinophilic inflammation and that inhaled corticoid therapy improves this perception. Although they are still not applicable in routine practice, follow-up strategies based on the evaluation of inflammation are thought to be more effective in reducing exacerbations than those usually recommended based on symptoms and sequential analysis of respiratory function. Inhaled corticosteroid therapy is the reference disease-modifying therapy for persistent asthma. Recent studies demonstrated that adjustment of anti-inflammatory treatment based on symptoms is an effective strategy to prevent exacerbations and reduce the total number of doses of inhaled corticosteroids. [ABSTRACT FROM AUTHOR]

المؤلفون: Dusser, D.¹, Montani, D.¹, Chanez, P.², de Blic, J.³, Delacourt, C.⁴, Deschildre, A.⁵, Devillier, P.⁶, Didier, A.⁷, Leroyer, C.⁸, Marguet, C.⁹, Martinat, Y.¹⁰, Piquet, J.¹¹, Raherison, C.¹², Serrier, P.¹³, Tillie-Leblond, I.¹⁴, Tonnel, A.-B.¹⁴, Lara, M. T. de¹⁵, Humbert, M.¹⁶

المصدر: Allergy. Jun2007, Vol. 62 Issue 6, p591-604. 14p. 7 Charts.

مصطلحات موضوعية: *BRONCHIAL diseases, *ASTHMA treatment, *CORTICOSTERONE, *ADRENOCORTICAL hormones, *EPIDEMIOLOGY, *ASTHMATICS, *THERAPEUTICS

مستخلص: This review is the synthesis of a working group on mild asthma. Mild asthma includes intermittent and persistent mild asthma according to the Global Initiative for Asthma (GINA) classification, and affects between 50% and 75% of asthmatic patients. Mild asthma is more frequent, more symptomatic, and less well controlled in children than in adults. Cohort studies from childhood to adulthood show that asthma severity usually remains stable over time. Nevertheless, mild asthma can lead to severe exacerbations, with a frequency ranging from 0.12 to 0.77 per patient-year. Severe exacerbations in mild asthma represent 30–40% of asthma exacerbations requiring emergency consultation. In mild asthma, inflammation and structural remodelling are constant, of varying intensity, but nonspecific. Therapy with inhaled corticosteroids (ICS) decreases bronchial inflammation, but has only a slight effect on structural remodelling, and, when stopped, inflammation immediately recurs. Permanent low-dose ICS therapy is the reference treatment for persistent mild asthma. Effectiveness is to be reassessed at 3 months, and if it is insufficient the patient is no longer considered mildly asthmatic, and treatment has to be stepped up. As mild asthma is the most frequent form of the disease, diagnosis and management require physicians’ particular attention. [ABSTRACT FROM AUTHOR]