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  1. AU="Kurukulaaratchy, Ramesh"
  2. AU="Rosengart, AnnaElaine"

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  1. Article ; Online: New Real-World Insights Into Severe Asthma: All About the Eosinophil?

    Kurukulaaratchy, Ramesh J / Mistry, Heena

    Chest

    2021  Volume 160, Issue 3, Page(s) 789–790

    MeSH term(s) Anti-Asthmatic Agents/therapeutic use ; Asthma/drug therapy ; Eosinophils ; Humans ; Leukocyte Count
    Chemical Substances Anti-Asthmatic Agents
    Language English
    Publishing date 2021-09-06
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2021.05.030
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Effects of air purifiers on rhinitis quality of life and perception of sleep quality in people with asthma: Randomised controlled trial.

    Kadalayil, Latha / Lowther, Scott / Fong, Wei Chern Gavin / Nicolas, Frédéric / Potter, Stephen / Larsson, Maria / Kurukulaaratchy, Ramesh / Arshad, Syed Hasan

    Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology

    2024  Volume 54, Issue 5, Page(s) 350–352

    MeSH term(s) Humans ; Quality of Life ; Asthma ; Female ; Male ; Rhinitis ; Sleep Quality ; Adult ; Air Filters ; Middle Aged ; Perception
    Language English
    Publishing date 2024-02-05
    Publishing country England
    Document type Letter ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 645204-8
    ISSN 1365-2222 ; 0954-7894 ; 0960-2178
    ISSN (online) 1365-2222
    ISSN 0954-7894 ; 0960-2178
    DOI 10.1111/cea.14459
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Dual biologic therapy for the treatment of rheumatic diseases and asthma: a case series.

    Malik, Mariam / Jones, Bryony / Williams, Emma / Kurukulaaratchy, Ramesh / Holroyd, Chris / Mason, Alice

    Rheumatology advances in practice

    2023  Volume 7, Issue 1, Page(s) rkad018

    Abstract: Objective: Combination biological therapies are being considered increasingly for patients with multiple co-morbidities requiring biologics. There are limited data available on this approach, and concerns remain about the possible risk of adverse events, ...

    Abstract Objective: Combination biological therapies are being considered increasingly for patients with multiple co-morbidities requiring biologics. There are limited data available on this approach, and concerns remain about the possible risk of adverse events, particularly infection.
    Methods: We present three patients on dual biologics for rheumatic disease and asthma. The biologic combinations used were etanercept and mepolizumab, infliximab and omalizumab, and etanercept and omalizumab. The time on combination biologic therapies ranged from 24 to 36 months. Patients were monitored for any serious adverse events.
    Results: All three patients were able to tolerate combined biologic therapies, with no serious adverse events. All three patients gained improvement in their rheumatic and asthma disease control, with reduction in disease activity scores and reduction in steroid usage.
    Conclusion: The decision to start dual biologic therapy should be considered carefully, on a case-by-case basis. The number of patients who are on combination biological therapy is small, and data are sparse. Real-world data are needed to examine the long-term benefits and risks of different forms of combination biologic therapies.
    Language English
    Publishing date 2023-02-03
    Publishing country England
    Document type Journal Article
    ISSN 2514-1775
    ISSN (online) 2514-1775
    DOI 10.1093/rap/rkad018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Recent Insights into the Management of Inflammation in Asthma.

    Rupani, Hitasha / Fong, Wei Chern Gavin / Kyyaly, Aref / Kurukulaaratchy, Ramesh J

    Journal of inflammation research

    2021  Volume 14, Page(s) 4371–4397

    Abstract: The present prevailing inflammatory paradigm in asthma is of T2-high inflammation orchestrated by key inflammatory cells like Type 2 helper lymphocytes, innate lymphoid cells group 2 and associated cytokines. Eosinophils are key components of this T2 ... ...

    Abstract The present prevailing inflammatory paradigm in asthma is of T2-high inflammation orchestrated by key inflammatory cells like Type 2 helper lymphocytes, innate lymphoid cells group 2 and associated cytokines. Eosinophils are key components of this T2 inflammatory pathway and have become key therapeutic targets. Real-world evidence on the predominant T2-high nature of severe asthma is emerging. Various inflammatory biomarkers have been adopted in clinical practice to aid asthma characterization including airway measures such as bronchoscopic biopsy and lavage, induced sputum analysis, and fractional exhaled nitric oxide. Blood measures like eosinophil counts have also gained widespread usage and multicomponent algorithms combining different parameters are now appearing. There is also growing interest in potential future biomarkers including exhaled volatile organic compounds, micro RNAs and urinary biomarkers. Additionally, there is a growing realisation that asthma is a heterogeneous state with numerous phenotypes and associated treatable traits. These may show particular inflammatory patterns and merit-specific management approaches that could improve asthma patient outcomes. Inhaled corticosteroids (ICS) remain the mainstay of asthma management but their use earlier in the course of disease is being advocated. Recent evidence suggests potential roles for ICS in combination with long-acting beta-agonists (LABA) for as needed use in mild asthma whilst maintenance and reliever therapy regimes have gained widespread acceptance. Other anti-inflammatory strategies including ultra-fine particle ICS, leukotriene receptor antagonists and macrolide antibiotics may show efficacy in particular phenotypes too. Monoclonal antibody biologic therapies have recently entered clinical practice with significant impacts on asthma outcomes. Understanding of the efficacy and use of those agents is becoming clearer with a growing body of real-world evidence as is their potential applicability to other treatable comorbid traits. In conclusion, the evolving understanding of T2 driven inflammation alongside a treatable traits disease model is enhancing therapeutic approaches to address inflammation in asthma.
    Language English
    Publishing date 2021-09-02
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2494878-0
    ISSN 1178-7031
    ISSN 1178-7031
    DOI 10.2147/JIR.S295038
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: A Role for Mucolytics and Expectorants in Aiding Inhaled Therapies in Asthma? [Response To Letter].

    Kurukulaaratchy, Ramesh J / Rupani, Hitasha / Fong, Wei Chern Gavin / Kyyaly, Aref

    Journal of inflammation research

    2021  Volume 14, Page(s) 5183–5185

    Language English
    Publishing date 2021-10-08
    Publishing country New Zealand
    Document type Journal Article ; Comment
    ZDB-ID 2494878-0
    ISSN 1178-7031
    ISSN 1178-7031
    DOI 10.2147/JIR.S341547
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Clinical features and later prognosis of replicable early-life wheeze clusters from two birth cohorts 12 years apart.

    Ngo, Suzanne Y / Venter, Carina / Anderson, William C / Picket, Kaci / Zhang, Hongmei / Arshad, S Hasan / Kurukulaaratchy, Ramesh J

    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

    2023  Volume 34, Issue 7, Page(s) e13999

    Abstract: Background: Clustering techniques can define the heterogeneity of asthma and wheezing. Defining early-life wheezing clusters and associated asthma risk could potentially inform patient management strategies. Clustering models that yield replicable ... ...

    Abstract Background: Clustering techniques can define the heterogeneity of asthma and wheezing. Defining early-life wheezing clusters and associated asthma risk could potentially inform patient management strategies. Clustering models that yield replicable cluster groups will have greater validity and clinical utility. This study sought to identify early-life wheezing clusters that are translatable into clinical practice and assess their stability over time in two whole-population birth cohorts established a decade apart from the same geographical location.
    Methods: Nonparametric K-means cluster analysis was performed separately on two birth cohorts from the Isle of Wight, UK; the Isle of Wight Birth Cohort (IOWBC) and Food Allergy and Intolerance Research Cohort (FAIR), using clinically defining variables in wheezing subjects in the first 3-4 years. Associations of resulting clusters with potential early-life risk factors and 10-year asthma outcomes were further assessed.
    Results: Five clusters were identified in both cohorts: (1) infantile-onset-transient-non-atopic-wheeze, (2) infantile-onset-persistent-non-atopic-wheeze, (3) infantile-onset-atopic-wheeze, (4) early-childhood-onset-non-atopic-wheeze, and (5) early-childhood-onset-atopic-wheeze. Two atopic wheezing clusters (3 and 5) were associated with greatest early-life wheeze frequency, highest wheeze persistence, and asthma prevalence at 10 years. Cluster 1 was commonest but had lowest early-life wheeze frequency and asthma prevalence at 10 years. Cluster 2, characterized by limited atopy but recurrent infantile respiratory infections and ongoing early-life wheezing, had high 10-year asthma prevalence only in IOWBC.
    Conclusions: Early-life wheeze comprises several disease clusters (two more severe and three mild-moderate) with differing relationships to later childhood asthma, which can be replicated over time supporting their potential validity and clinical utility.
    MeSH term(s) Humans ; Infant ; Child ; Birth Cohort ; Respiratory Sounds/etiology ; Hypersensitivity, Immediate/epidemiology ; Asthma/diagnosis ; Asthma/epidemiology ; Asthma/complications ; Risk Factors ; Prognosis ; Phenotype
    Language English
    Publishing date 2023-07-26
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 1057059-7
    ISSN 1399-3038 ; 0905-6157 ; 0906-5784
    ISSN (online) 1399-3038
    ISSN 0905-6157 ; 0906-5784
    DOI 10.1111/pai.13999
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Prediction of adult asthma risk in early childhood using novel adult asthma predictive risk scores

    Farhan, Abdal J. / Kothalawala, Dilini M. / Kurukulaaratchy, Ramesh J. / Granell, Raquel / Simpson, Angela / Murray, Clare / Custovic, Adnan / Roberts, Graham / Zhang, Hongmei / Arshad, S. Hasan

    Allergy. 2023 Nov., v. 78, no. 11, p. 2969-2979

    2023  , Page(s) 2969–2979

    Abstract: BACKGROUND: Numerous risk scores have been developed to predict childhood asthma. However, they may not predict asthma beyond childhood. We aim to create childhood risk scores that predict development and persistence of asthma up to young adult life. ... ...

    Abstract BACKGROUND: Numerous risk scores have been developed to predict childhood asthma. However, they may not predict asthma beyond childhood. We aim to create childhood risk scores that predict development and persistence of asthma up to young adult life. METHODS: The Isle of Wight Birth Cohort (n = 1456) was prospectively assessed up to 26 years of age. Asthma predictive scores were developed based on factors during the first 4 years, using logistic regression and tested for sensitivity, specificity and area under the curve (AUC) for prediction of asthma at (i) 18 and (ii) 26 years, and persistent asthma (PA) (iii) at 10 and 18 years, and (iv) at 10, 18 and 26 years. Models were internally and externally validated. RESULTS: Four models were generated for prediction of each asthma outcome. ASthma PredIctive Risk scorE (ASPIRE)‐1: a 2‐factor model (recurrent wheeze [RW] and positive skin prick test [+SPT] at 4 years) for asthma at 18 years (sensitivity: 0.49, specificity: 0.80, AUC: 0.65). ASPIRE‐2: a 3‐factor model (RW, +SPT and maternal rhinitis) for asthma at 26 years (sensitivity: 0.60, specificity: 0.79, AUC: 0.73). ASPIRE‐3: a 3‐factor model (RW, +SPT and eczema at 4 years) for PA‐18 (sensitivity: 0.63, specificity: 0.87, AUC: 0.77). ASPIRE‐4: a 3‐factor model (RW, +SPT at 4 years and recurrent chest infection at 2 years) for PA‐26 (sensitivity: 0.68, specificity: 0.87, AUC: 0.80). ASPIRE‐1 and ASPIRE‐3 scores were replicated externally. Further assessments indicated that ASPIRE‐1 can be used in place of ASPIRE‐2‐4 with same predictive accuracy. CONCLUSION: ASPIRE predicts persistent asthma up to young adult life.
    Keywords asthma ; chest ; childhood ; eczema ; models ; prediction ; regression analysis ; rhinitis ; risk ; skin prick tests ; young adults
    Language English
    Dates of publication 2023-11
    Size p. 2969-2979
    Publishing place John Wiley & Sons, Ltd
    Document type Article ; Online
    Note JOURNAL ARTICLE
    ZDB-ID 391933-x
    ISSN 1398-9995 ; 0105-4538
    ISSN (online) 1398-9995
    ISSN 0105-4538
    DOI 10.1111/all.15876
    Database NAL-Catalogue (AGRICOLA)

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  8. Article ; Online: Response to correspondence: Prediction of adult asthma risk in early childhood using novel adult asthma predictive risk scores.

    Farhan, Abdal J / Kothalawala, Dilini M / Kurukulaaratchy, Ramesh J / Granell, Raquel / Simpson, Angela / Murray, Clare / Custovic, Adnan / Roberts, Graham / Zhang, Hongmei / Arshad, S Hasan

    Allergy

    2024  

    Language English
    Publishing date 2024-02-13
    Publishing country Denmark
    Document type Letter
    ZDB-ID 391933-x
    ISSN 1398-9995 ; 0105-4538
    ISSN (online) 1398-9995
    ISSN 0105-4538
    DOI 10.1111/all.16059
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Blood cytokine profiles - Potential biomarkers for asthma persistence into adulthood?

    Fong, Wei Chern Gavin / Kadalayil, Latha / Lau, Laurie / Kurukulaaratchy, Ramesh J / Arshad, Syed Hasan

    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

    2021  Volume 33, Issue 1, Page(s) e13673

    MeSH term(s) Adult ; Asthma/diagnosis ; Biomarkers ; Cytokines ; Humans ; Hypersensitivity
    Chemical Substances Biomarkers ; Cytokines
    Language English
    Publishing date 2021-10-11
    Publishing country England
    Document type Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1057059-7
    ISSN 1399-3038 ; 0905-6157 ; 0906-5784
    ISSN (online) 1399-3038
    ISSN 0905-6157 ; 0906-5784
    DOI 10.1111/pai.13673
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Multimorbidity in Difficult Asthma: The Need for Personalised and Non-Pharmacological Approaches to Address a Difficult Breathing Syndrome.

    Varkonyi-Sepp, Judit / Freeman, Anna / Ainsworth, Ben / Kadalayil, Latha Perunthadambil / Haitchi, Hans Michael / Kurukulaaratchy, Ramesh J

    Journal of personalized medicine

    2022  Volume 12, Issue 9

    Abstract: Three to ten percent of people living with asthma have difficult-to-treat asthma that remains poorly controlled despite maximum levels of guideline-based pharmacotherapy. This may result from a combination of multiple adverse health issues including ... ...

    Abstract Three to ten percent of people living with asthma have difficult-to-treat asthma that remains poorly controlled despite maximum levels of guideline-based pharmacotherapy. This may result from a combination of multiple adverse health issues including aggravating comorbidities, inadequate treatment, suboptimal inhaler technique and/or poor adherence that may individually or collectively contribute to poor asthma control. Many of these are potentially "treatable traits" that can be pulmonary, extrapulmonary, behavioural or environmental factors. Whilst evidence-based guidelines lead clinicians in pharmacological treatment of pulmonary and many extrapulmonary traits, multiple comorbidities increase the burden of polypharmacy for the patient with asthma. Many of the treatable traits can be addressed with non-pharmacological approaches. In the current healthcare model, these are delivered by separate and often disjointed specialist services. This leaves the patients feeling lost in a fragmented healthcare system where clinical outcomes remain suboptimal even with the best current practice applied in each discipline. Our review aims to address this challenge calling for a paradigm change to conceptualise difficult-to-treat asthma as a multimorbid condition of a "Difficult Breathing Syndrome" that consequently needs a holistic personalised care attitude by combining pharmacotherapy with the non-pharmacological approaches. Therefore, we propose a roadmap for an evidence-based multi-disciplinary stepped care model to deliver this.
    Language English
    Publishing date 2022-08-31
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662248-8
    ISSN 2075-4426
    ISSN 2075-4426
    DOI 10.3390/jpm12091435
    Database MEDical Literature Analysis and Retrieval System OnLINE

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