Severe asthma is thought to be a heterogeneous disease with different phenotypes predicated primarily on the nature of the inflammatory cell infiltrate and response to corticosteroid therapy. This group of patients often has refractory disease with an associated increase in morbidity and mortality, and there remains a need for better therapies for severe asthmatics. Inflammatory changes in asthma are driven by immune mechanisms, within which interleukins play an integral role. Interleukins are cell-signaling cytokines that are produced by a variety of cells, predominantly T cells. Knowledge about their actions has improved the understanding of the pathogenesis of asthma and provided potential targets for novel therapies.
To date, this has not translated into clinical use. However, there are ongoing clinical trials that use monoclonal antibodies for various interleukins, some of which have shown to be promising in Phase II studies.
The health status of patients with chronic obstructive pulmonary disease (COPD) is currently being assessed using several different questionnaires. One of them is the COPD Assessment Test (CAT), which is a quick and easy test for patients to complete and provides a score that indicates the impact of the disease on their health status. There is increasing evidence that the CAT is a promising tool to quantify COPD exacerbations. Accordingly, the CAT score can be a useful marker in clinical trials that evaluate the effectiveness of treatments in prevention or management of COPD exacerbations, or that investigate the disease progression over time. In the future, the CAT score could also be used as an outcome measure in clinical practice to track changes in patients’ overall health status and to improve communication between patients and healthcare professionals.
Exercise-induced bronchoconstriction (EIB) describes the transient narrowing of the airways that follows vigorous exercise. It occurs most commonly in people with currently active asthma but has also been identified in school children, elite athletes and defence force recruits with no clinical diagnosis of asthma. EIB is identified by measuring a 10% fall in the forced expiratory volume in 1 s (FEV1) from the pre-exercise value within 30 min after exercise.
The maximum % fall in FEV1 is used to express the severity of EIB, with the area above the % fall in FEV1 time curve providing an index of severity over time. ....