Angelica TIOTIU - Academia.edu (original) (raw)
Papers by Angelica TIOTIU
05.01 - Airway pharmacology and treatment
Revue des Maladies Respiratoires, 2019
Pour citer cet article : Tiotiu A, et al. Stratégies thérapeutiques dans le cancer bronchique non... more Pour citer cet article : Tiotiu A, et al. Stratégies thérapeutiques dans le cancer bronchique non à petites cellules ALK positif de stade IV. Revue des Maladies Respiratoires (2019),
Revue des Maladies Respiratoires, 2019
Introduction.-Occupational asthma is a disease where the pathophysiological characteristics of as... more Introduction.-Occupational asthma is a disease where the pathophysiological characteristics of asthma are linked to repeated exposure to a sensitizing agent present in the workspace. Assessment of patients with severe asthma to identify and manage comorbidities improves asthma control and is recommended in international guidelines on the management of severe asthma. Case report.-We report the case of a 49-year-old patient, nonsmoker, without atopy, who had severe work-related asthma due to exposure to isocyanates, which was uncontrolled despite the avoidance of the occupational exposure and maximal medical treatment. A systematic assessment for possible comorbidities revealed gastroesophageal reflux and obstructive sleep apnea syndrome. The specific management of these two comorbidities led to an improvement of asthma control with a reduction in the number of exacerbations, a reduced burden of treatment and a resumption of employment. Conclusions.-As with all cases of severe asthma, the assessment of comorbidities must be systematic in the presence of an occupational asthma which persists after the cessation of the occupational exposure. The management of these comorbidities can lead to an improvement in asthma control and severity.
Asthma Research and Practice, 2018
Asthma is a heterogenous disease characterized by multiple phenotypes driven by different mechani... more Asthma is a heterogenous disease characterized by multiple phenotypes driven by different mechanisms. The implementation of precision medicine in the management of asthma requires the identification of phenotypespecific markers measurable in biological fluids. To become useful, these biomarkers need to be quantifiable by reliable systems, reproducible in the clinical setting, easy to obtain and cost-effective. Using biomarkers to predict asthma outcomes and therapeutic response to targeted therapies has a great clinical significance, particularly in severe asthma. In the last years, significant research has been realized in the identification of valid biomarkers for asthma. This review focuses on the existent and emerging biomarkers with clinical higher applicability in the management of asthma.
Asthma is one of the most frequent obstructive airway diseases with a prevalence of 6-12% in the ... more Asthma is one of the most frequent obstructive airway diseases with a prevalence of 6-12% in the adult population across the world. It is a heterogeneous disease characterized by chronic airway inflammation associated with bronchial hyperresponsiveness and symptoms such as wheezing, dyspnoea, cough, and chest tightness. Despite a controller treatment according to the current guidelines (e.g. inhaled/systemic corticosteroids, leukotriene receptor antagonists), 17% of adult asthmatics have difficult-to-treat asthma with a negative impact on their quality of life and high costs for the healthcare system. These patients should be addressed in expert centers in order to optimize their management. However, despite the optimization, 4% of asthmatic patients finally have the diagnosis of severe asthma. Most of the recent research was focused on the identification of different phenotypes of severe asthma and the mechanisms driving the inflammatory reaction for each phenotype in order to find...
Expert Review of Respiratory Medicine
ABSTRACT Introduction: Chronic rhinitis is defined as nasal inflammation with the presence of min... more ABSTRACT Introduction: Chronic rhinitis is defined as nasal inflammation with the presence of minimum two symptoms such as nasal obstruction, rhinorrhea, sneezing and/or itching one hour daily for a minimum of 12 weeks/year. According their etiology, four groups of rhinitis are described: allergic, infectious, non-allergic non-infectious and mixed. Chronic rhinitis is frequently associated with asthma, shares similar mechanisms of the pathogenesis and has a negative impact of its outcomes sustaining the concept of unified airways disease. Areas covered: The present review summarizes the complex relationship between chronic rhinitis and asthma on the basis of recent epidemiological data, clinical characteristics, diagnosis and therapeutic management. All four groups are discussed with the impact of their specific treatment on asthma outcomes. Some medications are common for chronic rhinitis and asthma while others are more specific but able to treat the associated comorbidity. Expert opinion: The systematic assessment of chronic rhinitis in patients with asthma and its specific treatment improves both disease outcomes. Conversely, several therapies of asthma demonstrated beneficial effects on chronic rhinitis. Treating both diseases at the same time by only one medication is an interesting option to explore in the future in order to limit drugs administration, related costs and side effects.
Clinical Reviews in Allergy & Immunology
Biological therapies are available for the treatment of the severe allergic asthma (SAA) with blo... more Biological therapies are available for the treatment of the severe allergic asthma (SAA) with blood eosinophil count ≥ 0.3 × 109/L. Several of them also showed benefits on nasal polyps (NP), one of the most frequent comorbidities of the severe asthma, but comparative studies on their effectiveness in the association SAA-NP are currently lacking. The aim of this study is to compare the effectiveness of benralizumab, mepolizumab and omalizumab in patients with SAA-NP in real-life settings. A retrospective, observational, multicenter real-life study was realized including patients with SAA-NP treated by benralizumab, mepolizumab or omalizumab for 6 months. We analysed the nasal and respiratory symptoms, the number of asthma attacks and salbutamol use/week, acute sinusitis and severe exacerbation rates, the asthma control score, the lung function parameters, the NP endoscopic score, the sinus imaging and the blood eosinophil count 6 months before and after treatment. Seventy-two patients with SAA-NP were included: 16 treated by benralizumab, 21 by mepolizumab and 35 by omalizumab. After 6 months of treatment, almost all studied parameters were improved (except sinus imaging) with a greater effect of omalizumab on the nasal pruritus (p = 0.001) and more benefits of benralizumab on exacerbations rate, asthma attacks per week and lung function (all p < 0.05). Benralizumab and mepolizumab were more effective to improve the NP endoscopic score and the blood eosinophil count (both p < 0.001). All three biological therapies showed effectiveness by improving asthma and nasal outcomes in patients with SAA-NP. Several differences have been found that should be confirmed by larger comparative studies.
Bulletin Du Cancer, Apr 27, 2018
Journal of Asthma, 2022
The optimal use of drug combinations for the management of asthma is providing significant result... more The optimal use of drug combinations for the management of asthma is providing significant results. This has prompted INTERASMA (Global Asthma Association) to take a position on inhaled triple therapy in asthma. Starting from an extensive literature review, Interasma executive committee discussed and approved this Manifesto, developed by Interasma scientific network (INES) members. The manifesto describes the evidence gathered to date and states, advocates, and proposes issues on Inhaled corticosteroid (ICS) plus Long-acting beta 2 agonist (LABA) and long-acting muscarinic antagonists (LAMA) with the aim of challenging assumptions, fostering commitment, and bringing about change.
International Journal of Environmental Research and Public Health, 2021
Background: Tobacco smoking is associated with more severe asthma symptoms, an accelerated declin... more Background: Tobacco smoking is associated with more severe asthma symptoms, an accelerated decline in lung function, and reduced responses to corticosteroids. Our objective was to compare asthma outcomes in terms of disease control, exacerbation rates, and lung function in a population of asthmatic patients according to their smoking status. Methods: We compared patients’ demographics, disease characteristics, and lung-function parameters in current-smokers (CS, n = 48), former-smokers (FS, n = 38), and never-smokers (NS, n = 90), and identified predictive factors for asthma control. Results: CS had a higher prevalence of family asthma/atopy, a lower rate of controlled asthma, impaired perception of dyspnea, an increased number of exacerbations, and poorer lung function compared to NS. The mean asthma control questionnaire’s (ACQ) score was higher in CS vs. NS and FS (1.9 vs. 1.2, p = 0.02). Compared to CS, FS had a lower rate of exacerbations, a better ACQ score (similar to NS), a ...
European Journal of Dermatology, 2019
Regarding the latter, long-lasting evaporation may lead to chronic ACD with features of AD-like d... more Regarding the latter, long-lasting evaporation may lead to chronic ACD with features of AD-like dermatosis [5]. In this respect, the patient retrospectively reported that she renovated her apartment almost every spring by painting different rooms herself. She also noted an improvement in the symptoms, with disappearance of facial, and especially nasal, eczema when she was away from home on holiday. The positive reaction to octylisothiazolinone probably represents cross-reactivity to MIT [6]. In conclusion, ACD due to MIT should be considered when managing patients with generalized, severe or atypical eczema.
Archivos de Bronconeumología, 2021
European Respiratory Journal, 2020
Background: Although recognized for its role in allergic reactions, mast cell (MC) involvement in... more Background: Although recognized for its role in allergic reactions, mast cell (MC) involvement in severe asthma (SA) pathogenesis remains ill-defined. Objective: To investigate the role of MCs in SA compared to healthy volunteers (HV) using sputum transcriptomic data from the U-BIOPRED adult cohort. Methods: We analysed transcriptomic data from 61 non-smoking SA patients (SAns), 23 SA patients who were current or ex-smokers (SAsm), 20 subjects with mild-moderate asthma (MMA) and 16 HV. Ten MC transcriptomic signatures that define their response to exogenous stimuli (IgE, IL-33, LPS and IFNγ) were used. We calculated enrichment scores (ESs) across severity and transcriptome-associated clusters (TACs) using gene set variation analysis (GSVA). Results: Despite no increase in sputum mast cell numbers, most MC signatures were significantly enriched in SA vs MMA and HV, using gene signatures derived from mast cells exposed to IgE, IL-33, LPS or IFNg (all adjusted p Conclusions: MCs are hi...
Archivos de Bronconeumología, 2021
Expert Review of Respiratory Medicine, 2021
ABSTRACT Introduction: The COVID-19 pandemic has challenged health care across the world, not jus... more ABSTRACT Introduction: The COVID-19 pandemic has challenged health care across the world, not just by the severity of the disease and the high mortality rate but also by the consequences on the management of the patients with chronic diseases. Areas covered: This review summarizes the most up-to-date published data regarding the impact of COVID-19 on the management and outcomes of patients with chronic noninfectious respiratory illnesses including obstructive sleep apnea, asthma, chronic obstructive pulmonary disease, bronchiectasis, interstitial and pulmonary vascular diseases, and lung cancer. Expert opinion: Most of chronic respiratory diseases (except asthma and cystic fibrosis) are associated with more severe COVID-19 and poor outcomes but the mechanisms involved are not yet identified. The therapeutic management of the patients with chronic respiratory diseases and COVID-19 is similar to the other patients but the post-recovery course could be worse in this population and followed by the development of pulmonary fibrosis, bronchiectasis, and pulmonary hypertension. The pandemic highly impacted our usual medical activities by limiting the access to several diagnosis procedures, the necessity to develop new methods for the monitoring of the disease and adapt the therapeutic strategies. The long-term consequences of all these changes are still unknown.
European Respiratory Journal, 2021
IntroductionAsthma is a heterogeneous disease with poorly defined phenotypes. Patients with sever... more IntroductionAsthma is a heterogeneous disease with poorly defined phenotypes. Patients with severe asthma often receive multiple treatments including oral corticosteroids (OCS). Treatment may modify the observed metabotype, rendering it challenging to investigate underlying disease mechanisms. Here, we aimed to identify dysregulated metabolic processes in relation to asthma severity and medication.MethodsBaseline urine was collected prospectively from healthy participants (n=100), patients with mild-to-moderate asthma (n=87) and patients with severe asthma (n=418) in the cross-sectional U-BIOPRED cohort; 12–18-month longitudinal samples were collected from patients with severe asthma (n=305). Metabolomics data were acquired using high-resolution mass spectrometry and analysed using univariate and multivariate methods.ResultsA total of 90 metabolites were identified, with 40 significantly altered (p<0.05, false discovery rate <0.05) in severe asthma and 23 by OCS use. Multivari...
Occupational and environmental health, 2021
05.01 - Airway pharmacology and treatment
Revue des Maladies Respiratoires, 2019
Pour citer cet article : Tiotiu A, et al. Stratégies thérapeutiques dans le cancer bronchique non... more Pour citer cet article : Tiotiu A, et al. Stratégies thérapeutiques dans le cancer bronchique non à petites cellules ALK positif de stade IV. Revue des Maladies Respiratoires (2019),
Revue des Maladies Respiratoires, 2019
Introduction.-Occupational asthma is a disease where the pathophysiological characteristics of as... more Introduction.-Occupational asthma is a disease where the pathophysiological characteristics of asthma are linked to repeated exposure to a sensitizing agent present in the workspace. Assessment of patients with severe asthma to identify and manage comorbidities improves asthma control and is recommended in international guidelines on the management of severe asthma. Case report.-We report the case of a 49-year-old patient, nonsmoker, without atopy, who had severe work-related asthma due to exposure to isocyanates, which was uncontrolled despite the avoidance of the occupational exposure and maximal medical treatment. A systematic assessment for possible comorbidities revealed gastroesophageal reflux and obstructive sleep apnea syndrome. The specific management of these two comorbidities led to an improvement of asthma control with a reduction in the number of exacerbations, a reduced burden of treatment and a resumption of employment. Conclusions.-As with all cases of severe asthma, the assessment of comorbidities must be systematic in the presence of an occupational asthma which persists after the cessation of the occupational exposure. The management of these comorbidities can lead to an improvement in asthma control and severity.
Asthma Research and Practice, 2018
Asthma is a heterogenous disease characterized by multiple phenotypes driven by different mechani... more Asthma is a heterogenous disease characterized by multiple phenotypes driven by different mechanisms. The implementation of precision medicine in the management of asthma requires the identification of phenotypespecific markers measurable in biological fluids. To become useful, these biomarkers need to be quantifiable by reliable systems, reproducible in the clinical setting, easy to obtain and cost-effective. Using biomarkers to predict asthma outcomes and therapeutic response to targeted therapies has a great clinical significance, particularly in severe asthma. In the last years, significant research has been realized in the identification of valid biomarkers for asthma. This review focuses on the existent and emerging biomarkers with clinical higher applicability in the management of asthma.
Asthma is one of the most frequent obstructive airway diseases with a prevalence of 6-12% in the ... more Asthma is one of the most frequent obstructive airway diseases with a prevalence of 6-12% in the adult population across the world. It is a heterogeneous disease characterized by chronic airway inflammation associated with bronchial hyperresponsiveness and symptoms such as wheezing, dyspnoea, cough, and chest tightness. Despite a controller treatment according to the current guidelines (e.g. inhaled/systemic corticosteroids, leukotriene receptor antagonists), 17% of adult asthmatics have difficult-to-treat asthma with a negative impact on their quality of life and high costs for the healthcare system. These patients should be addressed in expert centers in order to optimize their management. However, despite the optimization, 4% of asthmatic patients finally have the diagnosis of severe asthma. Most of the recent research was focused on the identification of different phenotypes of severe asthma and the mechanisms driving the inflammatory reaction for each phenotype in order to find...
Expert Review of Respiratory Medicine
ABSTRACT Introduction: Chronic rhinitis is defined as nasal inflammation with the presence of min... more ABSTRACT Introduction: Chronic rhinitis is defined as nasal inflammation with the presence of minimum two symptoms such as nasal obstruction, rhinorrhea, sneezing and/or itching one hour daily for a minimum of 12 weeks/year. According their etiology, four groups of rhinitis are described: allergic, infectious, non-allergic non-infectious and mixed. Chronic rhinitis is frequently associated with asthma, shares similar mechanisms of the pathogenesis and has a negative impact of its outcomes sustaining the concept of unified airways disease. Areas covered: The present review summarizes the complex relationship between chronic rhinitis and asthma on the basis of recent epidemiological data, clinical characteristics, diagnosis and therapeutic management. All four groups are discussed with the impact of their specific treatment on asthma outcomes. Some medications are common for chronic rhinitis and asthma while others are more specific but able to treat the associated comorbidity. Expert opinion: The systematic assessment of chronic rhinitis in patients with asthma and its specific treatment improves both disease outcomes. Conversely, several therapies of asthma demonstrated beneficial effects on chronic rhinitis. Treating both diseases at the same time by only one medication is an interesting option to explore in the future in order to limit drugs administration, related costs and side effects.
Clinical Reviews in Allergy & Immunology
Biological therapies are available for the treatment of the severe allergic asthma (SAA) with blo... more Biological therapies are available for the treatment of the severe allergic asthma (SAA) with blood eosinophil count ≥ 0.3 × 109/L. Several of them also showed benefits on nasal polyps (NP), one of the most frequent comorbidities of the severe asthma, but comparative studies on their effectiveness in the association SAA-NP are currently lacking. The aim of this study is to compare the effectiveness of benralizumab, mepolizumab and omalizumab in patients with SAA-NP in real-life settings. A retrospective, observational, multicenter real-life study was realized including patients with SAA-NP treated by benralizumab, mepolizumab or omalizumab for 6 months. We analysed the nasal and respiratory symptoms, the number of asthma attacks and salbutamol use/week, acute sinusitis and severe exacerbation rates, the asthma control score, the lung function parameters, the NP endoscopic score, the sinus imaging and the blood eosinophil count 6 months before and after treatment. Seventy-two patients with SAA-NP were included: 16 treated by benralizumab, 21 by mepolizumab and 35 by omalizumab. After 6 months of treatment, almost all studied parameters were improved (except sinus imaging) with a greater effect of omalizumab on the nasal pruritus (p = 0.001) and more benefits of benralizumab on exacerbations rate, asthma attacks per week and lung function (all p < 0.05). Benralizumab and mepolizumab were more effective to improve the NP endoscopic score and the blood eosinophil count (both p < 0.001). All three biological therapies showed effectiveness by improving asthma and nasal outcomes in patients with SAA-NP. Several differences have been found that should be confirmed by larger comparative studies.
Bulletin Du Cancer, Apr 27, 2018
Journal of Asthma, 2022
The optimal use of drug combinations for the management of asthma is providing significant result... more The optimal use of drug combinations for the management of asthma is providing significant results. This has prompted INTERASMA (Global Asthma Association) to take a position on inhaled triple therapy in asthma. Starting from an extensive literature review, Interasma executive committee discussed and approved this Manifesto, developed by Interasma scientific network (INES) members. The manifesto describes the evidence gathered to date and states, advocates, and proposes issues on Inhaled corticosteroid (ICS) plus Long-acting beta 2 agonist (LABA) and long-acting muscarinic antagonists (LAMA) with the aim of challenging assumptions, fostering commitment, and bringing about change.
International Journal of Environmental Research and Public Health, 2021
Background: Tobacco smoking is associated with more severe asthma symptoms, an accelerated declin... more Background: Tobacco smoking is associated with more severe asthma symptoms, an accelerated decline in lung function, and reduced responses to corticosteroids. Our objective was to compare asthma outcomes in terms of disease control, exacerbation rates, and lung function in a population of asthmatic patients according to their smoking status. Methods: We compared patients’ demographics, disease characteristics, and lung-function parameters in current-smokers (CS, n = 48), former-smokers (FS, n = 38), and never-smokers (NS, n = 90), and identified predictive factors for asthma control. Results: CS had a higher prevalence of family asthma/atopy, a lower rate of controlled asthma, impaired perception of dyspnea, an increased number of exacerbations, and poorer lung function compared to NS. The mean asthma control questionnaire’s (ACQ) score was higher in CS vs. NS and FS (1.9 vs. 1.2, p = 0.02). Compared to CS, FS had a lower rate of exacerbations, a better ACQ score (similar to NS), a ...
European Journal of Dermatology, 2019
Regarding the latter, long-lasting evaporation may lead to chronic ACD with features of AD-like d... more Regarding the latter, long-lasting evaporation may lead to chronic ACD with features of AD-like dermatosis [5]. In this respect, the patient retrospectively reported that she renovated her apartment almost every spring by painting different rooms herself. She also noted an improvement in the symptoms, with disappearance of facial, and especially nasal, eczema when she was away from home on holiday. The positive reaction to octylisothiazolinone probably represents cross-reactivity to MIT [6]. In conclusion, ACD due to MIT should be considered when managing patients with generalized, severe or atypical eczema.
Archivos de Bronconeumología, 2021
European Respiratory Journal, 2020
Background: Although recognized for its role in allergic reactions, mast cell (MC) involvement in... more Background: Although recognized for its role in allergic reactions, mast cell (MC) involvement in severe asthma (SA) pathogenesis remains ill-defined. Objective: To investigate the role of MCs in SA compared to healthy volunteers (HV) using sputum transcriptomic data from the U-BIOPRED adult cohort. Methods: We analysed transcriptomic data from 61 non-smoking SA patients (SAns), 23 SA patients who were current or ex-smokers (SAsm), 20 subjects with mild-moderate asthma (MMA) and 16 HV. Ten MC transcriptomic signatures that define their response to exogenous stimuli (IgE, IL-33, LPS and IFNγ) were used. We calculated enrichment scores (ESs) across severity and transcriptome-associated clusters (TACs) using gene set variation analysis (GSVA). Results: Despite no increase in sputum mast cell numbers, most MC signatures were significantly enriched in SA vs MMA and HV, using gene signatures derived from mast cells exposed to IgE, IL-33, LPS or IFNg (all adjusted p Conclusions: MCs are hi...
Archivos de Bronconeumología, 2021
Expert Review of Respiratory Medicine, 2021
ABSTRACT Introduction: The COVID-19 pandemic has challenged health care across the world, not jus... more ABSTRACT Introduction: The COVID-19 pandemic has challenged health care across the world, not just by the severity of the disease and the high mortality rate but also by the consequences on the management of the patients with chronic diseases. Areas covered: This review summarizes the most up-to-date published data regarding the impact of COVID-19 on the management and outcomes of patients with chronic noninfectious respiratory illnesses including obstructive sleep apnea, asthma, chronic obstructive pulmonary disease, bronchiectasis, interstitial and pulmonary vascular diseases, and lung cancer. Expert opinion: Most of chronic respiratory diseases (except asthma and cystic fibrosis) are associated with more severe COVID-19 and poor outcomes but the mechanisms involved are not yet identified. The therapeutic management of the patients with chronic respiratory diseases and COVID-19 is similar to the other patients but the post-recovery course could be worse in this population and followed by the development of pulmonary fibrosis, bronchiectasis, and pulmonary hypertension. The pandemic highly impacted our usual medical activities by limiting the access to several diagnosis procedures, the necessity to develop new methods for the monitoring of the disease and adapt the therapeutic strategies. The long-term consequences of all these changes are still unknown.
European Respiratory Journal, 2021
IntroductionAsthma is a heterogeneous disease with poorly defined phenotypes. Patients with sever... more IntroductionAsthma is a heterogeneous disease with poorly defined phenotypes. Patients with severe asthma often receive multiple treatments including oral corticosteroids (OCS). Treatment may modify the observed metabotype, rendering it challenging to investigate underlying disease mechanisms. Here, we aimed to identify dysregulated metabolic processes in relation to asthma severity and medication.MethodsBaseline urine was collected prospectively from healthy participants (n=100), patients with mild-to-moderate asthma (n=87) and patients with severe asthma (n=418) in the cross-sectional U-BIOPRED cohort; 12–18-month longitudinal samples were collected from patients with severe asthma (n=305). Metabolomics data were acquired using high-resolution mass spectrometry and analysed using univariate and multivariate methods.ResultsA total of 90 metabolites were identified, with 40 significantly altered (p<0.05, false discovery rate <0.05) in severe asthma and 23 by OCS use. Multivari...
Occupational and environmental health, 2021