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  1. Article ; Online: Seeing the forest for the trees: fractal dimensions measure COPD airway remodeling.

    Dunican, Eleanor M

    The Journal of clinical investigation

    2018  Volume 128, Issue 12, Page(s) 5203–5205

    Abstract: Chronic obstructive pulmonary disease (COPD) is extremely heterogenous in its effects on airway remodeling. Parsing the complex and interrelated morphologic changes and understanding their contribution to disease severity has posed a significant ... ...

    Abstract Chronic obstructive pulmonary disease (COPD) is extremely heterogenous in its effects on airway remodeling. Parsing the complex and interrelated morphologic changes and understanding their contribution to disease severity has posed a significant challenge to the field. In the current issue of the JCI, Bodduluri et al. measured the complex effects of COPD on the airway tree using airway fractal dimension (AFD) on computerized tomography in a large cohort of smokers with and without COPD. They found that lower AFD was independently associated with disease severity and mortality in COPD. This work highlights AFD as a noninvasive approach to analyze complex changes in airway geometry.
    MeSH term(s) Airway Remodeling ; Cohort Studies ; Fractals ; Humans ; Pulmonary Disease, Chronic Obstructive ; Tomography, X-Ray Computed
    Language English
    Publishing date 2018-10-29
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 3067-3
    ISSN 1558-8238 ; 0021-9738
    ISSN (online) 1558-8238
    ISSN 0021-9738
    DOI 10.1172/JCI124776
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Reply to Ikeda and Tomita.

    Tang, Monica / Mauger, David T / Fahy, John V / Dunican, Eleanor M

    American journal of respiratory and critical care medicine

    2022  Volume 206, Issue 10, Page(s) 1299–1300

    Language English
    Publishing date 2022-07-28
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202207-1337LE
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Asthma and corticosteroids: time for a more precise approach to treatment.

    Dunican, Eleanor M / Fahy, John V

    The European respiratory journal

    2017  Volume 49, Issue 6

    MeSH term(s) Administration, Inhalation ; Adrenal Cortex Hormones ; Anti-Asthmatic Agents ; Asthma ; Humans
    Chemical Substances Adrenal Cortex Hormones ; Anti-Asthmatic Agents
    Language English
    Publishing date 2017-06-29
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 639359-7
    ISSN 1399-3003 ; 0903-1936
    ISSN (online) 1399-3003
    ISSN 0903-1936
    DOI 10.1183/13993003.01167-2017
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  4. Article ; Online: Autopsy and Imaging Studies of Mucus in Asthma. Lessons Learned about Disease Mechanisms and the Role of Mucus in Airflow Obstruction.

    Dunican, Eleanor M / Watchorn, David C / Fahy, John V

    Annals of the American Thoracic Society

    2018  Volume 15, Issue Suppl 3, Page(s) S184–S191

    Abstract: Autopsy studies in fatal asthma have clearly documented the central role of airway plugging with pathologic mucus in the pathophysiology of death from asthma, but the role of mucus plugs in chronic severe asthma has been less well understood. Recently, ... ...

    Abstract Autopsy studies in fatal asthma have clearly documented the central role of airway plugging with pathologic mucus in the pathophysiology of death from asthma, but the role of mucus plugs in chronic severe asthma has been less well understood. Recently, multidetector computerized tomography imaging of the lungs has emerged as a valuable method to visualize mucus plugs in asthma. These multidetector computerized tomography data have revealed mucus plugs as a common occurrence in severe forms of asthma. In addition, an image-based mucus plug scoring system shows that mucus plugs are strongly associated with measures of airflow obstruction and with biomarkers of type 2 cytokine and eosinophilic inflammation. These data provide a rationale for treating airflow obstruction in severe asthma with mucolytics, and they also raise the possibility that treatments that target type 2 inflammation may decrease mucus plugs in asthma.
    MeSH term(s) Airway Obstruction/diagnostic imaging ; Airway Obstruction/etiology ; Airway Obstruction/pathology ; Asthma/diagnostic imaging ; Asthma/etiology ; Asthma/pathology ; Autopsy ; Cytokines/physiology ; Eosinophils/physiology ; Humans ; Mucus/physiology ; Multidetector Computed Tomography
    Chemical Substances Cytokines
    Language English
    Publishing date 2018-09-12
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 2717461-X
    ISSN 2325-6621 ; 1943-5665 ; 2325-6621
    ISSN (online) 2325-6621 ; 1943-5665
    ISSN 2325-6621
    DOI 10.1513/AnnalsATS.201807-485AW
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5828: Show issues Location:
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  5. Article ; Online: The Role of Type 2 Inflammation in the Pathogenesis of Asthma Exacerbations.

    Dunican, Eleanor M / Fahy, John V

    Annals of the American Thoracic Society

    2015  Volume 12 Suppl 2, Page(s) S144–9

    Abstract: Asthma exacerbations are an important cause of asthma morbidity. Although viral infection of the upper airway is a common cause of asthma exacerbations, the reasons why some patients with asthma are exacerbation prone and others are exacerbation ... ...

    Abstract Asthma exacerbations are an important cause of asthma morbidity. Although viral infection of the upper airway is a common cause of asthma exacerbations, the reasons why some patients with asthma are exacerbation prone and others are exacerbation resistant are not fully understood. In this review, we examine whether Type 2 inflammation modifies airway function to make patients more susceptible to asthma exacerbations. The best data supporting a role for Type 2 inflammation in asthma exacerbations come from clinical trials of inhibitors of Type 2 inflammation in asthma. These trials include studies with omalizumab (an inhibitor of IgE) and others with inhibitors of Type 2 cytokines (IL-4, IL-5, and IL-13). All of these trials consistently show that inhibiting the Type 2 pathway causes a clinically significant reduction in asthma exacerbations. Thus, it is now clear that Type 2 inflammation is an important mechanism of susceptibility to asthma exacerbation.
    MeSH term(s) Anti-Asthmatic Agents/therapeutic use ; Asthma/drug therapy ; Asthma/economics ; Asthma/immunology ; Cytokines/immunology ; Disease Progression ; Humans ; Immunoglobulin E/immunology ; Inflammation/immunology ; Interleukin-13/immunology ; Omalizumab/therapeutic use ; Th2 Cells/immunology
    Chemical Substances Anti-Asthmatic Agents ; Cytokines ; Interleukin-13 ; Omalizumab (2P471X1Z11) ; Immunoglobulin E (37341-29-0)
    Language English
    Publishing date 2015-11-20
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Review
    ZDB-ID 2717461-X
    ISSN 2325-6621 ; 1943-5665 ; 2325-6621
    ISSN (online) 2325-6621 ; 1943-5665
    ISSN 2325-6621
    DOI 10.1513/AnnalsATS.201506-377AW
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  6. Article ; Online: Weight Loss in Individuals with Obesity and Asthma.

    Watchorn, David / Madden, Anne / O'Shea, Donal / Dunican, Eleanor M / Butler, Marcus W

    Annals of the American Thoracic Society

    2019  Volume 16, Issue 7, Page(s) 933–934

    MeSH term(s) Adult ; Asthma ; Child ; Humans ; Obesity ; Randomized Controlled Trials as Topic ; Weight Loss
    Language English
    Publishing date 2019-04-17
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2717461-X
    ISSN 2325-6621 ; 1943-5665 ; 2325-6621
    ISSN (online) 2325-6621 ; 1943-5665
    ISSN 2325-6621
    DOI 10.1513/AnnalsATS.201902-151LE
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  7. Article ; Online: Prevalence of comorbid asthma in COVID-19 patients.

    Butler, Marcus W / O'Reilly, Aoife / Dunican, Eleanor M / Mallon, Patrick / Feeney, Eoin R / Keane, Michael P / McCarthy, Cormac

    The Journal of allergy and clinical immunology

    2020  Volume 146, Issue 2, Page(s) 334–335

    MeSH term(s) Adult ; Asthma/epidemiology ; Betacoronavirus ; COVID-19 ; Comorbidity ; Coronavirus Infections ; Humans ; Inpatients ; Pandemics ; Pneumonia, Viral ; Prevalence ; Risk Factors ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-06-10
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 121011-7
    ISSN 1097-6825 ; 1085-8725 ; 0091-6749
    ISSN (online) 1097-6825 ; 1085-8725
    ISSN 0091-6749
    DOI 10.1016/j.jaci.2020.04.061
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  8. Article ; Online: Biomarkers of Airway Type-2 Inflammation and Integrating Complex Phenotypes to Endotypes in Asthma.

    Peters, Michael C / Nguyen, Michelle-Linh T / Dunican, Eleanor M

    Current allergy and asthma reports

    2016  Volume 16, Issue 10, Page(s) 71

    Abstract: Purpose of review: Over the past decade, the most important advance in the field of asthma has been the widespread recognition that asthma is a heterogeneous disease driven by multiple molecular processes.: Recent findings: The most well-established ... ...

    Abstract Purpose of review: Over the past decade, the most important advance in the field of asthma has been the widespread recognition that asthma is a heterogeneous disease driven by multiple molecular processes.
    Recent findings: The most well-established molecular mechanism in asthma is increased airway type-2 inflammation, and consequently, non-invasive biomarkers of increased airway type-2 inflammation, such as blood eosinophil counts or blood periostin levels, have proven important in stratifying asthma patients in clinical trials of type-2 cytokine inhibitors. However, it remains ambiguous how well these non-invasive biomarkers represent airway measures of type-2 inflammation in asthma. As a result, the utility of these biomarkers to assist with asthma management or as research tools to better understand asthma pathogenesis remains unclear. This article reviews primary data assessing biomarkers of airway type-2 inflammation in asthma and describes how the use of biomarkers can advance a precision medicine approach to asthma treatment.
    MeSH term(s) Asthma/drug therapy ; Asthma/genetics ; Biomarkers/metabolism ; Cytokines/metabolism ; Eosinophils/metabolism ; Humans ; Inflammation/metabolism ; Phenotype ; Respiratory System/immunology ; Respiratory System/pathology
    Chemical Substances Biomarkers ; Cytokines
    Language English
    Publishing date 2016-09-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057370-4
    ISSN 1534-6315 ; 1529-7322
    ISSN (online) 1534-6315
    ISSN 1529-7322
    DOI 10.1007/s11882-016-0651-4
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  9. Article ; Online: Utility of eosinophil peroxidase as a biomarker of eosinophilic inflammation in asthma.

    Tang, Monica / Charbit, Annabelle R / Johansson, Mats W / Jarjour, Nizar N / Denlinger, Loren C / Raymond, Wilfred W / Peters, Michael C / Dunican, Eleanor M / Castro, Mario / Sumino, Kaharu / Erzurum, Serpil C / Comhair, Suzy A / Moore, Wendy C / Levy, Bruce D / Israel, Elliot / Phipatanakul, Wanda / Phillips, Brenda R / Mauger, David T / Bleecker, Eugene R /
    Wenzel, Sally E / Fajt, Merritt L / Woodruff, Prescott G / Hastie, Annette T / Fahy, John V

    The Journal of allergy and clinical immunology

    2024  

    Abstract: Background: The relative utility of eosinophil peroxidase (EPX) and blood and sputum eosinophil counts as disease biomarkers in asthma is uncertain.: Objective: To determine the utility of EPX as a biomarker of systemic and airway eosinophilic ... ...

    Abstract Background: The relative utility of eosinophil peroxidase (EPX) and blood and sputum eosinophil counts as disease biomarkers in asthma is uncertain.
    Objective: To determine the utility of EPX as a biomarker of systemic and airway eosinophilic inflammation in asthma.
    Methods: EPX protein was measured by immunoassay in serum and sputum in 110 healthy controls to establish a normal reference range and in repeated samples of serum and sputum collected during three years of observation in 480 participants in the Severe Asthma Research Program (SARP)-3.
    Results: Over three years, EPX levels in asthma patients were higher than normal in 27-31% of serum samples and 36-53% of sputum samples. Eosinophils and EPX correlated better in blood than in sputum (r
    Conclusion: Serum EPX is a valid protein biomarker of systemic eosinophilic inflammation in asthma, and sputum EPX levels are a more sensitive biomarker of airway eosinophilic inflammation than sputum eosinophil counts. Eosinophil measures in blood frequently miss airway eosinophilic inflammation, and mepolizumab frequently fails to normalize airway eosinophilic inflammation even though it invariably normalizes systemic eosinophilic inflammation.
    Language English
    Publishing date 2024-04-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 121011-7
    ISSN 1097-6825 ; 1085-8725 ; 0091-6749
    ISSN (online) 1097-6825 ; 1085-8725
    ISSN 0091-6749
    DOI 10.1016/j.jaci.2024.03.023
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  10. Article ; Online: A Novel Air Trapping Segment Score Identifies Opposing Effects of Obesity and Eosinophilia on Air Trapping in Asthma.

    Leung, Clarus / Tang, Monica / Huang, Brendan K / Fain, Sean B / Hoffman, Eric A / Choi, Jiwoong / Dunican, Eleanor M / Mauger, David T / Denlinger, Loren C / Jarjour, Nizar N / Israel, Elliot / Levy, Bruce D / Wenzel, Sally E / Sumino, Kaharu / Hastie, Annette T / Schirm, Joshua / McCulloch, Charles E / Peters, Michael C / Woodruff, Prescott G /
    Sorkness, Ronald L / Castro, Mario / Fahy, John V

    American journal of respiratory and critical care medicine

    2023  

    Abstract: Background: Density thresholds in computed tomography (CT) lung scans quantify air trapping (AT) at the whole lung level but are not informative for AT in specific bronchopulmonary segments.: Objectives: To apply a segment-based measure of AT in ... ...

    Abstract Background: Density thresholds in computed tomography (CT) lung scans quantify air trapping (AT) at the whole lung level but are not informative for AT in specific bronchopulmonary segments.
    Objectives: To apply a segment-based measure of AT in asthma to investigate the clinical determinants of AT in asthma.
    Methods: In each of 19 bronchopulmonary segments in CT lung scans from 199 asthma patients, AT was categorized as present if lung attenuation was < -856 Hounsfield units at expiration in ≥ 15% of lung area. The resulting AT segment score (0-19) was related to patient outcomes.
    Results: AT varied at the lung segment level and tended to persist at the patient and lung segment level over 3 years. Patients with widespread AT (>10 segments) had more severe asthma (p<0.05). The mean (± SD) AT segment score in patients with a BMI > 30 was lower than in patients with a BMI < 30 (3.5 ± 4.6 vs. 5.5 ± 6.3, p=0.008), and the frequency of AT in lower lobe segments in obese patients was less than in upper and middle lobe segments (35 vs. 46%, p=0.001). The AT segment score in patients with sputum eosinophil % > 2 was higher than in patients without sputum eosinophilia (7.0 ± 6.1 vs. 3.3 ± 4.9, p<0.0001). Lung segments with AT more frequently had airway mucus plugging than lung segments without AT (48 vs. 18%, p≤0.0001).
    Conclusions: In patients with asthma, air trapping is more severe in those with airway eosinophilia and mucus plugging whereas those who are obese have less severe trapping because their lower lobe segments are spared.
    Language English
    Publishing date 2023-12-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202305-0802OC
    Database MEDical Literature Analysis and Retrieval System OnLINE

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