Medical Grand Rounds: Moving Asthma Treatment into the 21st Century: From Bench to Bedside and Back Again

Drs. Anuradha Ray and Sally Wenzel present on asthma treatment, focusing on immunology and precision medicine.

Educational objectives:

Upon completion of this activity, participants should be able to:

• Explain the development of the concept of a Type-2 asthma phenotype (from bench to bedside)
• Review the data on development and use  of Type-2 targeted therapies for asthma
• Address the underlying pathobiology and potential treatment pathways in very severe, corticosteroid dependent asthma, beyond Type-2 approaches 

Reading Resources:

1. Gauthier M, Ray A, Wenzel SE. Evolving Concepts of Asthma. Am J Respir Crit Care Med. 2015 192:660-8. doi: 10.1164/rccm.201504-0763PP. PubMed PMID: 26161792.
2. Wenzel SE. Asthma phenotypes: the evolution from clinical to molecular approaches. Nat Med. 2012, 18:716-25. doi: 10.1038/nm.2678. Review. PubMed PMID: 22561835.
3. Raundhal M, Morse C, Khare A, Oriss TB, Milosevic J, Trudeau J, Huff R, Pilewski J, Holguin F, Kolls J, Wenzel S, Ray P, Ray A. High IFN-γ and low SLPI mark severe asthma in mice and humans. J Clin Invest. 2015, 125:3037-50. doi: 10.1172/JCI80911. PubMed PMID: 26121748
4. Wenzel S, Ford L, Pearlman D, Spector S, Sher L, Skobieranda F, Wang L, Kirkesseli S, Rocklin R, Bock B, Hamilton J, Ming JE, Radin A, Stahl N, Yancopoulos GD, Graham N, Pirozzi G. Dupilumab in persistent asthma with elevated eosinophil levels. N Engl J Med. 2013, 368:2455-66. doi: 10.1056/NEJMoa1304048. PubMed PMID: 23688323.
5. Ortega HG, Liu MC, Pavord ID, Brusselle GG, FitzGerald JM, Chetta A, Humbert M, Katz LE, Keene ON, Yancey SW, Chanez P; MENSA Investigators. Mepolizumab treatment in patients with severe eosinophilic asthma. N Engl J Med. 2014, 371:1198-207. doi: 10.1056/NEJMoa1403290. Erratum in: N Engl J Med. 2015, 372:1777. PubMed PMID: 25199059.
6. Krug N, Hohlfeld JM, Kirsten AM, Kornmann O, Beeh KM, Kappeler D, Korn S, Ignatenko S, Timmer W, Rogon C, Zeitvogel J, Zhang N, Bille J, Homburg U, Turowska A, Bachert C, Werfel T, Buhl R, Renz J, Garn H, Renz H. Allergen-induced asthmatic responses modified by a GATA3-specific DNAzyme. N Engl J Med. 2015, 372:1987-95. doi: 10.1056/NEJMoa1411776.PubMed PMID: 25981191.
7. Zhang, D. -H., Cohn, L., Ray, P., Bottomly, K., Ray, A.  Transcription factor GATA-3 is differentially expressed in Th1 and Th2 cells and controls Th2-specific expression of the interleukin-5 gene J. Biol. Chem. 1997, 272: 21597-603.

Disclosures:

Dr. Ray has reported no relevant relationships with any entities producing health care goods or services

Dr. Wenzel has financial interests with the following any entity or entities producing health care goods or services as indicated below:

• Grant/Research Support: AstraZeneca, GSK, Sanofi, Genentech, Boehringer-lngelheim
• Consultant: AstraZeneca, GSK, Boehringer-lngelheim, Sanofi(unpaid)

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.1) continuing education units (CEU) which are equivalent to 1 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at http://ccehs.upmc.edu and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 1/4/16 | Last Modified On: 1/4/16 | Expires: 1/4/17