Data from The Asthma Report - Curated by EPG Health - Last updated 31 October 2018

Our team of reporters in Paris surveyed the landscape of posters to bring you our exclusive highlights. Harvey et al reported on psychological comorbidity in severe and difficult asthma. 42.7% of patients had a psychological diagnosis, predominantly combined anxiety/depression, highlighting the need for psychological support in severe asthma care.

Chrystyn et al presented an electronic module attached to a Spiromax inhaler which recorded time of inhaler use, duration of inhalation, peak inspiration flow and time to peak flow. This could be connected to a mobile device by Bluetooth, and data confirmed accurate measurements of inspiration variables. This device could prove highly beneficial in assessment and correction of adherence in patients with asthma.

Zamarrón presented findings from the Respiratory Diseases Department, La Paz University Hospital, Madrid, Spain looking at 161 patients with severe asthma in whom sinus and chest CTs were performed. Over two thirds of patients had mucosal thickening in the sinuses, while high prevalence of bronchiectasis was noted (39%), particularly in older patients with more severe lung function deficits.

Davies et al from Univeristy of Southampton reported on a mouse model of IL-13 overexpression demonstrating both T2 and non-T2 inflammatory responses. Administration of defame that’s one resulted in amelioration of some classic T2 markers, but T17 markers remained high indicating a mechanism of action for anti IL-4R therapy in non-T2 asthma.

il13 overexpression demonstrating both T2 and non T2 inflammatory responses

 

Data was presented by Regeneron showing that IL-4R therapy in mice with humanised IL-4/ra blocked B cell activation, immunoglobulin class switching and T cell activation. This resulted in blockage of eosinophils recruitment and preservation of lung function in house dust mite models, further elucidating the mechanism of this novel therapy.

IL4R therapy in mice with humanised IL4/ra blocked B cell activation, immunoglobulin class switching and T cell activation

 

More mouse model data from Brazil showed a partial protective effect from angiotensin-1-7 in Ovalbumin induced models of asthma. Both inflammatory and structural effects were ameliorated, suggesting a promising potential future therapy.

partial protective effect from angiotensin-1-7 in Ovalbumin induced models of asthma

 

In a timely fashion given the recent NICE (UK) appraisal of Bronchial Thermoplasty (BT), Goorsenberg et al showed a case series of 14 patients undergoing BT who experienced a 58% reduction in airway smooth muscle mass, but increased mast cell density following the procedures. Symptom scores were not shown, so the impact of this is hard to assess.

While apparently rather underpowered, Sposato et al showed data from Italy confirming that blood and sputum eosinophilia and elevated FeNO predict increased exacerbation frequency in severe asthma. Sputum eosinophilia over 50% resulted in an OR of 20.7 for 3+ exacerbations per year, although the n for this group is presumably small!

Finally UBIOPRED report on serum perisostin, biopsy periostin and POSTN expression showing a tight correlation between tissue and genes, a weaker link between serum and genes and no significant correlation between serum and tissue, highlighting some of the limitations of this biomarker.

Read all the ERS 2018 Highlights

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