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Advances in Asthma: 2nd Edition
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Advances in Asthma: 2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pulmonology".

Deadline for manuscript submissions: 1 July 2025 | Viewed by 2804

Special Issue Editors

Dr. Gianenrico Senna

E-Mail Website
Guest Editor
Department of Internal Medicine, University of Verona, 37100 Verona, Italy
Interests: allergic rhinitis; asthma; antihistamines; nasal steroids; complementary medicine; anaphylaxis
Special Issues, Collections and Topics in MDPI journals
Dr. Marco Caminati

E-Mail Website
Guest Editor
Asthma Center and Allergy Unit, Center for Hypereosinophilic Dysimmune Conditions, University of Verona, Verona University Hospital, 37126 Verona, Italy
Interests: allergy and clinical immunology; severe asthma; immunoterapy; biologic drugs; hyperesoinophilic dysimmune conditions
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is the 2nd edition of "Advances in Asthma" (https://www.mdpi.com/journal/jcm/special_issues/Frontiers_Asthma).

Bronchial asthma is an intriguing topic. The definition of several different endotypes/phenotypes has led to a more personalized approach, mainly based on different types of biologic inflammation. The development of many biologics has improved the treatment of severe asthma, leading to a significant reduction of exacerbated cases and the use of oral steroids. However, we need to identify more specific biomarkers and carefully clinically evaluate each case. Moreover, despite the availability of very effective drugs for any level of severity, the lack of asthma control is still a major problem in the management of the disease. The support of digital medicine, as well as easier treatments, would improve adherence to the treatment. In summary, the management of asthma is still a “work in progress”, despite significant progress that has been made in its pharmacological treatment.

Dr. Gianenrico Senna
Dr. Marco Caminati
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bronchial asthma
  • biologic inflammation
  • asthma
  • management

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Published Papers (2 papers)

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15 pages, 1663 KiB  
Article
Long-Term Eosinophil Depletion: A Real-World Perspective on the Safety and Durability of Benralizumab Treatment in Severe Eosinophilic Asthma
by Francesco Menzella, Mariarita Marchi, Marco Caminati, Micaela Romagnoli, Claudio Micheletto, Matteo Bonato, Giuseppe Idotta, Manuele Nizzetto, Giuseppina D’Alba, Massimiliano Cavenaghi, Michela Bortoli, Bianca Beghè, Laura Pini, Roberto Benoni, Gianluca Casoni, Rodolfo Muzzolon, Lucio Michieletto, Annamaria Bosi, Andrea Mastrototaro, Adela Diamandi, Mara Nalin and Gianenrico Sennaadd Show full author list remove Hide full author list
J. Clin. Med. 2025, 14(1), 191; https://doi.org/10.3390/jcm14010191 - 31 Dec 2024
Viewed by 633
Abstract
Background/Objectives: Benralizumab is an anti-IL-5 receptor alpha monoclonal antibody that induces the near-complete depletion of eosinophils. This study aimed to evaluate the long-term safety and effectiveness of benralizumab in patients with severe eosinophilic asthma (SEA) over an extended 48-month follow-up period, offering one [...] Read more.
Background/Objectives: Benralizumab is an anti-IL-5 receptor alpha monoclonal antibody that induces the near-complete depletion of eosinophils. This study aimed to evaluate the long-term safety and effectiveness of benralizumab in patients with severe eosinophilic asthma (SEA) over an extended 48-month follow-up period, offering one of the longest real-world perspectives available. Methods: This was a single-arm, retrospective, observational, multicenter study involving 123 SEA patients treated with benralizumab at a dosage of 30 mg every 4 weeks for the first 3 doses and then every 8 weeks. The safety endpoints focused on the frequency and nature of adverse events and the likelihood that they were induced by benralizumab. The efficacy endpoints focused on lung function, asthma exacerbations and control, and oral corticosteroid use. Results: Benralizumab, consistent with its mechanism of action, led to the rapid and nearly complete depletion of eosinophils. In total, 26 adverse events (21.1%) were observed, with 1.6% related to the treatment and 0.8% categorized as serious (vagal hypotension). Bronchitis was the most common unrelated adverse event (15.4%), occurring between months 36 and 38. Importantly, benralizumab effectiveness and safety were maintained consistently across the 48-month duration, resulting in significant improvements in lung function and reductions in oral corticosteroid use and exacerbation frequency. Conclusions: Benralizumab demonstrated a favorable safety profile, comparable to previously published studies, with perdurable effectiveness in controlling SEA and reducing oral corticosteroid use. Finally, this study provides evidence that near-complete eosinophil depletion does not increase long-term safety risks and supports benralizumab as a reliable treatment option for SEA patients. Full article
(This article belongs to the Special Issue Advances in Asthma: 2nd Edition)
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18 pages, 1283 KiB  
Article
Asthma Inflammatory Phenotypes: How Can We Distinguish Them?
by Aleksandra Plavsic, Branka Bonaci Nikolic, Branislava Milenkovic, Rada Miskovic, Natasa Kusic, Milan Dimitrijevic, Snezana Arandjelovic, Katarina Milosevic, Ivana Buha and Vesna Tomic Spiric
J. Clin. Med. 2024, 13(2), 526; https://doi.org/10.3390/jcm13020526 - 17 Jan 2024
Cited by 1 | Viewed by 1704
Abstract
Background and objectives: induced sputum is used to assess different inflammatory phenotypes in asthma, but is not used routinely. We aimed to determine the proportion of inflammatory asthma phenotypes based on induced sputum, to find biomarkers that can discriminate between phenotypes, and to [...] Read more.
Background and objectives: induced sputum is used to assess different inflammatory phenotypes in asthma, but is not used routinely. We aimed to determine the proportion of inflammatory asthma phenotypes based on induced sputum, to find biomarkers that can discriminate between phenotypes, and to evaluate biomarkers in patients with and without biological therapy in different inflammatory asthma phenotypes. Materials and Methods: this cross-sectional study investigated clinical characteristics, asthma control tests, skin prick test, impulse oscillometry (IOS), spirometry, induced sputum, biomarkers (IgE, eosinophils, fractional exhaled nitric oxide (FeNO), serum periostin, IL-5, IL-6, IL-8, IL-17A, IL-33) in 80 asthmatics. A total of 17/80 patients were treated with biologics (10 with omalizumab, 7 with benralizumab). Results: a total of 31% of patients had eosinophilic asthma (EA), 30% had mixed granulocytic asthma (MGA), 24% had paucigranulocytic asthma (PGA), and 15% had neutrophilic asthma (NA). The difference was found in blood eosinophils (p = 0.002), the highest observed in EA. The cut-off ≥ 240/μL eosinophils, with 64% sensitivity and 72.7% specificity, identified EA (AUC = 0.743, p = 0.001). A higher IL-8 level was associated with NA (p = 0.025). In 63 non-biologic asthma group, eosinophils were higher in EA than in NA, MGA, and PGA (p = 0.012, p = 0.028, and p = 0.049, respectively). A higher IL-17A was associated with EA without biologics (p = 0.004). A significantly higher IL-5 was found in EA treated with biologics, in comparison with EA without biologics (p = 0.043). The number of leucocytes and neutrophils was higher in MGA without biologics (p = 0.049, p = 0.019), while IL-5, IL-6, and IL-8 levels were higher in MGA treated with biologics (p = 0.012, p = 0.032, p = 0.038, respectively). Conclusions: EA and MGA were the most prevalent asthma phenotypes. Blood eosinophils can identify EA, both in patients with and without biologics. Apart from the clinical profile, a broad spectrum of biomarkers for assessing inflammatory phenotypes is necessary for an adequate therapy approach to patients with asthma. Full article
(This article belongs to the Special Issue Advances in Asthma: 2nd Edition)
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