4 results on '"Sanjay H. Chotirmall"'
Search Results
2. Sensitization to Aspergillus species is associated with frequent exacerbations in severe asthma
- Author
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Therese Sophie Lapperre, Ken Junyang Goh, Mariko Siyue Koh, Sanjay H. Chotirmall, Fook Tim Chew, Anthony Yii, and Adrian Chan
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0301 basic medicine ,Pulmonary and Respiratory Medicine ,Spirometry ,medicine.diagnostic_test ,business.industry ,Odds ratio ,medicine.disease_cause ,medicine.disease ,respiratory tract diseases ,Atopy ,Allergic sensitization ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Allergen ,medicine.anatomical_structure ,030228 respiratory system ,immune system diseases ,Cohort ,Immunology ,medicine ,Immunology and Allergy ,business ,Sensitization ,Asthma - Abstract
Background Severe asthma is a largely heterogeneous disease with varying phenotypic profiles. The relationship between specific allergen sensitization and asthma severity, particularly in Asia, remains unclear. We aim to study the prevalence of specific allergen sensitization patterns and investigate their association with outcomes in a severe asthma cohort in an Asian setting. Methods We conducted a cross-sectional study of patients receiving step 4 or 5 Global Initiative for Asthma treatment. Univariate and multivariate analyses were performed to assess the association between sensitization to a specific identifiable allergen by skin prick test (SPT) and uncontrolled asthma (defined in our study as the use of ≥2 steroid bursts or hospitalization in the past year, a history of near-fatal asthma or evidence of airflow obstruction on spirometry). Results Two hundred and six severe asthma patients (mean age 45±17 years, 99 [48.1%] male) were evaluated. Of them, 78.2% had a positive SPT to one or more allergens. The most common allergen to which patients were sensitized was house dust mites (Blomia tropicalis, Dermatophagoides pteronyssinus and Dermatophagoides farinae). Also, 11.7% were sensitized to Aspergillus species. On multivariate analysis, Aspergillus sensitization was associated with uncontrolled asthma (odds ratio 6.07, 95% confidence interval 1.80-20.51). In particular, Aspergillus sensitization was independently associated with the use of ≥2 steroid bursts in the past year (odds ratio 3.05, 95% confidence interval 1.04-8.95). No similar associations of uncontrolled asthma with sensitization to any other allergens were found. Conclusion High allergen, specifically Aspergillus sensitization was observed in the Asian population with severe asthma by SPT. Aspergillus sensitization was specifically associated with frequent exacerbations and a greater corticosteroid requirement. An improved understanding of the severe asthma with Aspergillus sensitization phenotype is warranted, which is likely a subgroup of severe asthma with fungal sensitization.
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- 2017
3. Understanding COPD-overlap syndromes
- Author
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Pei Yee Tiew, Mariko Siyue Koh, Anthony Yii, Sanjay H. Chotirmall, Adrian Chan, Valerie Fei Lee Yong, Tuang Yeow Poh, Micheál Mac Aogáin, and Lee Kong Chian School of Medicine (LKCMedicine)
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Pathology ,urologic and male genital diseases ,Overlap syndrome ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Internal medicine ,medicine ,Humans ,Immunology and Allergy ,030212 general & internal medicine ,Respiratory system ,Asthma ,COPD ,Bronchiectasis ,business.industry ,Chronic obstructive pulmonary disease ,fungi ,Public Health, Environmental and Occupational Health ,food and beverages ,Syndrome ,medicine.disease ,Obstructive sleep apnea ,030228 respiratory system ,Lung disease ,business - Abstract
Introduction: Chronic obstructive pulmonary disease accounts for a large burden of lung disease. It can 'overlap' with other respiratory diseases including bronchiectasis, fibrosis and obstructive sleep apnea (OSA). While COPD alone confers morbidity and mortality, common features with contrasting clinical outcomes can occur in COPD 'overlap syndromes'. Areas covered: Given the large degree of heterogeneity in COPD, individual variation to treatment is adopted based on its observed phenotype, which in turn overlaps with features of other respiratory disease states such as asthma. This is coined asthma-COPD overlap syndrome ('ACOS'). Other examples of such overlapping clinical states include bronchiectasis-COPD ('BCOS'), fibrosis-COPD ('FCOS') and OSA-COPD ('OCOS'). The objective of this review is to highlight similarities and differences between the COPD-overlap syndromes in terms of risk factors, pathophysiology, diagnosis and potential treatment differences. Expert commentary: As a consequence of COPD overlap syndromes, a transition from the traditional 'one size fits all' treatment approach is necessary. Greater treatment stratification according to clinical phenotype using a precision medicine approach is now required. In this light, it is important to recognize and differentiate COPD overlap syndromes as distinct disease states compared to individual diseases such as asthma, COPD, fibrosis or bronchiectasis. Accepted version
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- 2017
4. Immune, inflammatory and infectious consequences of estrogen in women with cystic fibrosis
- Author
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Sanjay H. Chotirmall, Noel G. McElvaney, and Catherine M. Greene
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Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Cystic Fibrosis ,medicine.drug_class ,Inflammation ,Respiratory Mucosa ,Disease ,medicine.disease_cause ,Cystic fibrosis ,Contraceptives, Oral, Hormonal ,Immune system ,medicine ,Estrogen Receptor beta ,Humans ,Immunology and Allergy ,Secretory Leukocyte Peptidase Inhibitor ,Interleukin 8 ,Menstrual Cycle ,Estrogen receptor beta ,Estradiol ,Pseudomonas aeruginosa ,business.industry ,Interleukin-8 ,Public Health, Environmental and Occupational Health ,medicine.disease ,Up-Regulation ,Estrogen ,Immunology ,Female ,medicine.symptom ,business - Abstract
Cystic fibrosis (CF), a multisystem genetic disease with predominantly pulmonary manifestations, occurs due to defective chloride secretion at epithelial surfaces. This along with the associated so...
- Published
- 2012
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