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Current and future developments in the pharmacology of asthma and COPD: ERS seminar, Naples 2022.
Stolz, D, Matera, MG, Rogliani, P, van den Berge, M, Papakonstantinou, E, Gosens, R, Singh, D, Hanania, N, Cazzola, M, Maitland-van der Zee, AH, et al
Breathe (Sheffield, England). 2023;(2):220267
Abstract
Pharmacological management of airway obstructive diseases is a fast-evolving field. Several advances in unravelling disease mechanisms as well as intracellular and molecular pathways of drug action have been accomplished. While the clinical translation and implementation of in vitro results to the bedside remains challenging, advances in comprehending the mechanisms of respiratory medication are expected to assist clinicians and scientists in identifying meaningful read-outs and designing clinical studies. This European Respiratory Society Research Seminar, held in Naples, Italy, 5-6 May 2022, focused on current and future developments of the drugs used to treat asthma and COPD; on mechanisms of drug action, steroid resistance, comorbidities and drug interactions; on prognostic and therapeutic biomarkers; on developing novel drug targets based on tissue remodelling and regeneration; and on pharmacogenomics and emerging biosimilars. Related European Medicines Agency regulations are also discussed, as well as the seminar's position on the above aspects.
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Physical exercise, immune response, and susceptibility to infections-current knowledge and growing research areas.
Kurowski, M, Seys, S, Bonini, M, Del Giacco, S, Delgado, L, Diamant, Z, Kowalski, ML, Moreira, A, Rukhadze, M, Couto, M
Allergy. 2022;(9):2653-2664
Abstract
This review presents state-of-the-art knowledge and identifies knowledge gaps for future research in the area of exercise-associated modifications of infection susceptibility. Regular moderate-intensity exercise is believed to have beneficial effects on immune health through lowering inflammation intensity and reducing susceptibility to respiratory infections. However, strenuous exercise, as performed by professional athletes, may promote infection: in about half of athletes presenting respiratory symptoms, no causative pathogen can be identified. Acute bouts of exercise enhance the release of pro-inflammatory mediators, which may induce infection-like respiratory symptoms. Relatively few studies have assessed the influence of regularly repeated exercise on the immune response and systemic inflammation compared to the effects of acute exercise. Additionally, ambient and environmental conditions may modify the systemic inflammatory response and infection susceptibility, particularly in outdoor athletes. Both acute and chronic regular exercise influence humoral and cellular immune response mechanisms, resulting in decreased specific and non-specific response in competitive athletes. The most promising areas of further research in exercise immunology include detailed immunological characterization of infection-prone and infection-resistant athletes, examining the efficacy of nutritional and pharmaceutical interventions as countermeasures to infection symptoms, and determining the influence of various exercise loads on susceptibility to infections with respiratory viruses, including SARS-CoV-2. By establishing a uniform definition of an "elite athlete," it will be possible to make a comparable and straightforward interpretation of data from different studies and settings.
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3.
Health effects of exposure to chlorination by-products in swimming pools.
Couto, M, Bernard, A, Delgado, L, Drobnic, F, Kurowski, M, Moreira, A, Rodrigues-Alves, R, Rukhadze, M, Seys, S, Wiszniewska, M, et al
Allergy. 2021;(11):3257-3275
Abstract
Concerns have been raised regarding the potential negative effects on human health of water disinfectants used in swimming pools. Among the disinfection options, the approaches using chlorine-based products have been typically preferred. Chlorine readily reacts with natural organic matter that are introduced in the water mainly through the bathers, leading to the formation of potentially harmful chlorination by-products (CBPs). The formation of CBPs is of particular concern since some have been epidemiologically associated with the development of various clinical manifestations. The higher the concentration of volatile CBPs in the water, the higher their concentration in the air above the pool, and different routes of exposure to chemicals in swimming pools (water ingestion, skin absorption, and inhalation) contribute to the individual exposome. Some CBPs may affect the respiratory and skin health of those who stay indoor for long periods, such as swimming instructors, pool staff, and competitive swimmers. Whether those who use chlorinated pools as customers, particularly children, may also be affected has been a matter of debate. In this article, we discuss the current evidence regarding the health effects of both acute and chronic exposures in different populations (work-related exposures, intensive sports, and recreational attendance) and identify the main recommendations and unmet needs for research in this area.
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4.
ASSOCIATION BETWEEN URTICARIA AND INFECTIONS (REVIEW).
Gotua, M, Kulumbegov, B, Chanturidze, N, Devidze, M, Lomidze, N, Rukhadze, M
Georgian medical news. 2019;(288):97-101
Abstract
Urticaria is a common disease with 20% of prevalence and marked effects on quality of life. The burden of chronic urticaria for patients, their family and friends, the healthcare system and society is substantial. Triggering of urticaria by infections has been discussed for many years but the exact role and pathogenesis of mast cell activation by infectious processes is unclear. The remission of annoying spontaneous chronic urticaria has been reported after successful treatment of persistent infections. Chronic viral infections including hepatitis B and C have been reported to be associated with CSU. More research is needed to make definitive recommendations regarding the role of infections and their management in case of urticaria and urticarial vasculitis. The routine screening of parasitic, bacterial or viral infections in CU is not recommended, however, testing a patient with urticaria for certain infections is a physician's choice based on the specific characteristics of the patient, such are clinical symptoms and laboratory results, dietary and cultural habits, country of origin and residency, traveling history.