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- Epidemiology and Risk Factors
-
1. The changing prevalence of asthma
- Dr. Deborah Jarvis
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2. Recent advances in asthma genetics
- Prof. Miriam Moffatt
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3. Asthma: an epidemic caused by epigenetics?
- Prof. David Schwartz
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4. Role of the microbiota in asthma
- Prof. B. Brett Finlay
-
5. Diet and asthma
- Prof. Lewis Smith
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6. Obesity and asthma
- Prof. Anne Dixon
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7. Occupational asthma: management beyond the textbooks
- Prof. Paul Cullinan
- Clinical Phenotypes
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8. The origins of asthma
- Prof. Peter Sly
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9. Pre-school wheeze
- Prof. Andrew Bush
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11. Smoking asthmatics
- Prof. Neil Thomson
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12. Aspirin exacerbated respiratory disease
- Prof. Chris Corrigan
- Mechanisms of Asthma
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13. Advances in asthma: airway inflammation
- Prof. William Busse
-
14. The role of mast cells in asthma
- Prof. Peter Bradding
-
15. Dendritic cells in asthma
- Prof. Bart Lambrecht
-
16. The airway smooth muscle in asthma
- Prof. Judith Black
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17. Role of virus infection in asthma 1
- Prof. Sebastian Johnston
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18. Role of virus infection in asthma 2
- Prof. Sebastian Johnston
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19. Severe asthma: characterisation, mechanisms & treatment
- Prof. Fan Chung
-
20. Steroid resistance in asthma: mechanisms and potential therapies
- Prof. Ian Adcock
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21. Macrophage in asthma
- Prof. Douglas Robinson
- Diagnosis of Asthma
-
22. Physiology of asthma and involvement of small airways
- Prof. Charles G. Irvin
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23. Induced sputum in asthma
- Prof. Antonio Spanevello
- Therapy and Management
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25. Pulmonary drug delivery
- Prof. Anthony J. Hickey
-
26. The management of chronic asthma
- Prof. Mark Fitzgerald
-
27. Inhaled corticosteroids and beta2-agonists
- Dr. Omar S. Usmani
-
28. Management of "difficult asthma"
- Prof. Elisabeth Bel
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29. Management of acute exacerbations of asthma
- Dr. Chris Fanta
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30. Non-pharmacological treatments for asthma
- Prof. Neil Thomson
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31. Asthma: beyond the prescription
- Prof. Martyn Partridge
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32. New drugs for asthma
- Prof. Peter Barnes
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33. Anti-IgE therapy for asthma
- Dr. Andrew Menzies-Gow
- Archived Lectures *These may not cover the latest advances in the field
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34. New drugs for asthma
- Prof. Peter Barnes
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35. Asthma phenotypes in children
- Prof. Andrew Bush
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36. Steroid resistance in asthma: mechanisms and potential therapies
- Prof. Ian Adcock
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37. Severe asthma in children
- Prof. Andrew Bush
Printable Handouts
Navigable Slide Index
- Introduction
- Talk outline
- Definition of severe asthma
- GINA 2006: asthma treatment steps (1)
- Evaluation of difficult asthma
- Alternative diagnoses for difficult-to-treat asthma
- Factors contributing to loss of control in asthma
- Asthma co-morbidities
- Definition of refractory asthma
- Severe asthma research program (SARP)
- SARP: demographics and treatments
- SARP: lung function & inflammatory markers
- GINA 2006: asthma treatment steps (2)
- Therapeutic approach: step 4
- Therapeutic approach: step 5
- Omalizumab on exacerbations in severe asthma
- Omalizumab in severe asthma: AQLQ
- Omalizumab for severe persistent allergic asthma
- Oral steroid-sparing agents
- Therapeutic approaches: the next 20 years
- Characteristics of severe asthma: heterogeneity
- Concept of phenotype
- SARP/NIH asthma cohort: cluster analysis (1)
- SARP/NIH asthma cohort: cluster analysis (2)
- Chronic airflow obstruction
- Severe asthma protocol
- Chronic airflow obstruction (1)
- Chronic airflow obstruction (2)
- Air-trapping in severe and non-severe asthma
- Air-trapping in severe asthma: SARP data
- Inflammatory & remodelling response in airways
- Submucosal biopsies in severe asthma
- Inflammatory cells in bronchial biopsies
- Induced sputum cells in severe asthma
- Sputum eosinophilic marker asthma analysis
- Airway wall remodelling in severe asthma
- HRCT and histology of airway
- Corticosteroid insensitivity in severe asthma
- Corticosteroid-dependent asthma
- Corticosteroid responsiveness
- Steroid-suppression of cytokine release
- Heterogeneity of 'causes' of CS insensitivity
- New treatments for severe asthma? (1)
- New treatments for severe asthma? (2)
- Mepolizumab in refractory eosinophilic asthma
- Effect of mepolizumab on exacerbations
- Treatment of severe asthma: summary
Topics Covered
- Definition and characterisation
- From difficult-to-treat asthma to severe asthma
- Phenotypes and characteristics
- Current treatment modalities
- Chronic airflow obstruction
- Corticosteroid insensitivity
- Future treatments: specific targets for specific phenotypes
- Update interview: Biologic antibody therapies for severe asthma
- Update interview: Type 2 high asthma characterised by interleukin 4, 5 and 13
- Update interview: Biomarkers of Type 2 high asthma
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Chung, F. (2022, May 25). Severe asthma: characterisation, mechanisms & treatment [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 21, 2024, from https://doi.org/10.69645/DPXI7897.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Fan Chung has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Update Available
The speaker addresses developments since the publication of the original talk. We recommend listening to the associated update as well as the lecture.
- Full lecture Duration: 50:49 min
- Update Interview Duration: 14:40 min
A selection of talks on Respiratory Diseases
Transcript
Please wait while the transcript is being prepared...
0:00
Hello. I am Professor
Fun Chung from
the National Heart
and Lung Institute
at Imperial College.
I also work as a clinician at
The Royal Brompton
Hospital in London.
One of my major interests
is about severe asthma.
One of the major problems
we have these days with asthma,
is about this group of patients
that we label at severe asthma.
In my talk, I'm
going to talk about
how we characterize these
patients with severe asthma.
I talk a bit about
the mechanisms
underlying this condition
that we call severe asthma.
Of course, end up with some
treatment aspects of this,
what we consider to be quite
difficult to treat the asthma.
0:49
In my talk, I'm going to talk
about the definition
of severe asthma.
The current treatments that
we have for severe asthma.
Then I will move on
to the question of
phenotyping and characterization
of severe asthma.
Then following that,
I will talk about
three important characteristics
of severe asthma.
Namely chronic
airflow obstruction,
chronic inflammation, and
corticosteroid insensitivity.
Then I will end up my talk
by talking about some of
the future approaches
that we have to trying
to get better treatments
for severe asthma.
1:27
I think one of the
first definitions
that came about was in 1999,
when the task force of
the European
Respiratory Society was
set up to look at the question
of definition of this condition.
You will see that these
conditions, severe asthma,
also goes often by
other names like
difficult-to-treat asthma,
or therapy-resistant asthma.
Indeed, those two terms
summarizes the problem
with severe asthma.
That they are
difficult to treat and
some of the treatments
that we have for asthma,
do not work very well for
this special category
of severe asthma.
The definition that came
about in 1999 was that,
severe asthma is a poorly
controlled asthma,
in terms of chronic symptoms,
episodic exacerbations,
persistent and variable
airflow, obstruction,
and a continued requirement for
short acting
Beta2-agonists despite
the use of a maximal dose
of inhaled corticosteroids.
Some of those patients
may require courses or
a regular dose of
oral corticosteroids
to maintain reasonable control.
I think 12 years down the line,
we would probably add
that those patients
would be on a combination
therapy of long acting,
Beta2-agonist and
inhaled corticosteroids,
because in the intervening
period of the last 11 years,
this combination
therapy has become
the mainstay of both
treatment of asthma.