Anastasia Papaporfyriou

Medical University of Vienna

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

Stelios Loukides

National and Kapodistrian University of Athens

Petros Bakakos

Sotiria General Hospital

ΚΚ

Κonstantinos Κostikas

University of Ioannina

AΙ

Andriana Ι. Papaioannou

National and Kapodistrian University of Athens

Georgios Hillas

Chest Diseases Hospital

ΝK

Νikolaos Koulouris

Sotiria General Hospital

Spyros Papiris

University General Hospital Attikon

Georgios Papatheodorou

University of Ioannina

Maria Kallieri

National and Kapodistrian University of Athens

Spyridon Papiris

National and Kapodistrian University of Athens

Cooperative Institutions

National and Kapodistrian University of Athens

118

Sotiria General Hospital

University General Hospital Attikon

General University Hospital of Patras

Athens State University

Evangelismos Hospital

Chest Diseases Hospital

Aristotle University of Thessaloniki

G. Papanikolaou General Hospital

University of Patras

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Blood eosinophils in COPD: friend or foe?

Expert Review of Respiratory Medicine (2021)

Anastasia Papaporfyriou Petros Bakakos Georgios Hillas Andriana Ι. Papaioannou Stelios Loukides

The pathogenesis of chronic obstructive pulmonary disease (COPD) is highly complex and the underlying cellular and molecular mechanisms remain poorly understood.COPD has been traditionally associated with neutrophilic inflammation of the bronchi, but in the last decade, studies have demonstrated that eosinophils may also migrate into the lower airways of patients with COPD and their increased numbers can be noticed during exacerbations as well as stable disease. In this review, we present clinical characteristics of eosinophilic COPD, as well as the role of eosinophils as a biomarker-guided therapy in COPD. A systematic research using the database of Pubmed up to February 2021 was performed. The terms we searched were eosinophilic inflammation, COPD, COPD phenotypes, COPD exacerbations, corticosteroids in COPD, and monoclonal antibodies in COPD.Blood eosinophil levels show strong potential as a prognostic and theragnostic biomarker in the clinical management of COPD being at the moment the most reliable biomarker. The lack of a certain cutoff value of blood eosinophils as guidance for treatment with ICS and biologic therapies and the uncertainty regarding the stability of eosinophilia and eosinophilic phenotype through the course of COPD remain as unmet dilemmas and problems.

10.1080/17476348.2021.2011219

Cite

Citations (5)

Cryobiopsy under simultaneous confocal laser endomicroscopy guidance for peripheral pulmonary lesions

Daniela Gompelmann Anastasia Papaporfyriou Christina Bal Christopher Milacek Marco Idzko

Endomicroscopy

10.1183/13993003.congress-2024.oa2800

Cite

Citations (0)

Pulmonary alveolar proteinosis: time to shift?

Expert Review of Respiratory Medicine (2015)

Spyros A. Papiris Panagiotis Tsirigotis Likurgos Kolilekas Georgia Papadaki Andriana Ι. Papaioannou

Pulmonary alveolar proteinosis (PAP) is categorized into hereditary, secondary and autoimmune PAP (aPAP) types. The common pathogenesis is the ability of the alveolar macrophages to catabolize phagocytized surfactant is affected. Hereditary PAP is caused by mutations involving the GM-CSF signaling, particularly in genes for the GM-CSF receptor and sometimes by GATA2 mutations. Secondary PAP occurs in hematologic malignancies, other hematologic disorders, miscellaneous malignancies, fume and dust inhalation, drugs, autoimmune disorders and immunodeficiencies. aPAP is related to the production of GM-CSF autoantibodies. PAP is characterized morphologically by the inappropriate and progressive 'occupation' of the alveolar spaces by an excessive amount of unprocessed surfactant, limiting gas exchange and gradually exhausting the respiratory reserve. Myeloid cells' immunity deteriorates, increasing the risk of infections. Treatment of PAP is based on its etiology. In aPAP, recent therapeutic advances might shift the treatment option from the whole lung lavage procedure under general anesthesia to the inhalation of GM-CSF 'as needed'.

Pulmonary alveolar proteinosis

Pathogenesis

Etiology

Hypersensitivity pneumonitis

10.1586/17476348.2015.1035259

Cite

Citations (26)

Late onset asthma: A distinct phenotype

05.02 - Monitoring airway disease (2018)

Anastasia Papaporfyriou Georgios Hillas Andriana Papaioannou Κonstantinos Κostikas Elissavet Konstantelou

Introduction: The age of asthma onset is often implicated in clinical manifestation, diagnosis and management of the disease. Aim: To define demographic, clinical and functional features and inflammatory characteristics in induced sputum in patients with late onset asthma. Methods: 333 asthmatics who are followed up in asthma clinics of two tertiary hospitals were included in the study. All patients underwent detailed assessment of demographic characteristics, evaluation of severity and treatment regimes, pulmonary function tests, skin prick tests, measurement of blood eosinophils and sputum induction for the assessment of sputum inflammatory cells, IL-8 &IL-13 levels in supernatant. Patients with disease onset after the age of 40 were considered as having Late onset asthma. Results: 224 (67.3%) patients were having late onset asthma. Late onset asthmatics were mainly nonsmokers and nonatopic compared to early onset asthmatics (77,1% vs 53,6%, p<0.001) and (55,1% vs 44,7%, p=0.048) respectively. Furthermore, they had lower Forced Vital Capacity (%pred) [90.0 (78.0, 98.0) vs 93.0 (82.0, 105.0), p=0.029], higher Body Mass Index (kg/m²) [27.7 (26.0, 31.7) vs 26.7 (24.3, 29.8), p=0.002], lower levels of sputum eosinophilis (%) [2.0(0.0, 4.0) vs 2.0 (1.0, 7.0), p=0.026] and lower levels of IL-13 in induced sputum (pg/ml) [78.0 (65.0, 104.5) vs 89.0 (67.0, 141.7), p=0.014]. No other significant differences were observed. Conclusion: Patients with late onset asthma seem to have a nonatopic profile with higher BMI and lower T2 related airway inflammation compared to patients with early onset asthma.

10.1183/13993003.congress-2018.pa5029

Cite

Citations (0)

Bronchoscopic diagnosis and treatment of endobronchial carcinoid: case report and review of the literature

European Respiratory Review (2021)

Anastasia Papaporfyriou Julian Domayer Michael Meilinger Irene Firlinger Georg‐Christian Funk

Carcinoid tumours are rare neuroendocrine neoplasms that mostly occur in younger adults with low tendencies to metastasise. Based on their histological characteristics, they are divided into typical and atypical subtypes. The most common presenting symptoms are due to central airway obstruction. The first step in the diagnostic assessment should be a computed tomography (CT) scan, as it provides information both for local tumour extent and lymph node involvement. Bronchoscopy is the main tool for histological confirmation, evaluation of bronchial wall invasion and removal of endobronchial manifestation with subsequent resolution of atelectasis. Endobronchial ultrasound may be necessary to rule out lymph node metastasis. Somatostatin receptor scintigraphy in combination with CT can rule out further metastatic disease.Surgical resection using parenchyma-sparing techniques remains the gold standard for treatment. For selected patients, endobronchial therapy could be an alternative for minimal invasiveness. Long-term follow-up is suggested due to the high likelihood of recurrence.Here, we describe our clinical experience in a 35-year-old male patient who originally presented with haemoptysis and a central polypoid tumour in the left main bronchus revealed by a CT scan. The histological characteristics were indicative of a typical carcinoid. The patient was treated using an endobronchial approach only. No complications and no recurrences have been observed in a follow-up of 2 years.

Atelectasis

Carcinoid tumour

Mediastinal lymph node

10.1183/16000617.0115-2020

Cite

Citations (27)

Activin A and follistatin in patients with asthma. Does severity make the difference?

Respirology (2016)

Anastasia Papaporfyriou Petros Bakakos Κonstantinos Κostikas Georgios Papatheodorou Georgios Hillas

ABSTRACT Background and objective Activin A is a pleiotropic cytokine holding a fundamental role in inflammation and tissue remodelling. Follistatin can modulate the bioactivity of activin. We aimed to measure activin A and follistatin in sputum supernatants and bronchoalveolar lavage ( BAL ) of asthmatic patients and to determine the possible associations with severity as well as with inflammatory and remodelling indices. Methods A total of 58 asthmatic patients (33 with severe refractory asthma ( SRA )) and 10 healthy controls underwent sputum induction for % cells, activin A, follistatin, eosinophilic cationic protein ( ECP ), transforming growth factor beta 1 ( TGF ‐β1), IL ‐13 and IL ‐8 measurements. In 22 asthmatic patients, BAL and bronchial biopsies were also performed for the assessment of the above‐mentioned variables, measurement of remodelling indices and immunostaining for different activin A receptors. Results Sputum activin A (pg/ mL ) was higher in patients with SRA (median (interquartile ranges): 76 (33–185)) compared to mild‐to‐moderate asthma (44 (18–84); P = 0.005), whereas follistatin did not differ between the two groups. BAL activin A (pg/ mL ) was higher in patients with SRA compared to those with mild‐to‐moderate disease. A significant association was observed between activin A and TGF ‐β1, eosinophils in sputum and/or in BAL , while reticular basement membrane ( RBM ) thickness was significantly associated with BAL activin levels only. No difference in immunostaining for activin receptor type IB was observed between patients with SRA and those with mild‐to‐moderate asthma. Conclusion Sputum and BAL levels of activin A are higher in SRA . The association of activin A with TGF ‐β1, eosinophils and RBM thickness may indicate a role of this cytokine in the inflammatory and remodelling process in SRA .

Follistatin

10.1111/resp.12937

Cite

Citations (11)

The clinical experience of patients with severe asthma and previous treatment with omalizumab, choosing mepolizumab in Greece.

05.01 - Airway pharmacology and treatment (2023)

Maria Kallieri Andriana Ι. Papaioannou Εleftherios Ζervas Evangelia Fouka Κonstantinos Porpodis

Introduction: Monoclonal antibodies are the pillar of individualized treatment of severe asthma. However, there is often phenotypic overlap in patients with severe asthma, and these patients may be eligible for more than one of the available therapies and switching between treatments as to achieve the best clinical response. Objective: The clinical benefit of patients with severe asthma who, due to non-response, switched from omalizumab to mepolizumab. Materials-methods: This is the post-hoc analysis of the 2-year prospective, multicenter, non-interventional observational study, RELIght. 2 groups of patients were studied:(A)those who received and (B)those who did not receive omalizumab in the past, before starting treatment with mepolizumab. Results: Of the 169 patients, 60 (35.5%,19 men, median age 59[49.5,67.5]years) had received previous treatment with omalizumab. In Group(A) switching to mepolizumab reduced mean annual exacerbations(CSE) by 67% at the 1st and 69% at 2 years. A corresponding reduction was observed in group(B). Symptom control (ACT,p<0.001) and pulmonary function (FEV1,p<0.001) were also improved clinically significant in both groups at both years of follow-up (Table). Conclusions: The choice of mepolizumab allows patients with severe eosinophilic asthma to achieve clinical improvement regardless of the history of previous treatment with omalizumab.

Omalizumab

Group B

Post-hoc analysis

10.1183/13993003.congress-2023.pa4717

Cite

Citations (0)

Activin -A and follistatin in sputum supernatant and BAL in patients with asthma

Anastasia Papaporfyriou Petros Bakakos Κonstantinos Κostikas Georgios Papatheodorou Georgios Hillas

Introduction: In human asthma, activin A levels are increased and in vitro studies suggest that activin A might be implicated in airway remodeling. Follistatin antagonizes the biological effects of activin-A in several disease models. Objective: We aimed to determine the levels of activin-A and follistatin in sputum supernatants and BAL of patients with asthma and to investigate possible associations with mediators and cells involved in both the inflammatory and the remodeling process. Furthermore, to elucidate whether the underlying asthma severity might influence the observed levels. Methods: Sixty three patients with asthma (33 with Severe Refractory [SRA]) optimally treated and 10 healthy subjects were studied. All subjects underwent lung function tests and sputum induction; 23 patients with asthma underwent bronchoscopy and BAL was performed. In both sputum and BAL activin-A, follistatin, cell counts, IL-8, TGF-β1, ECP and IL-13, were assessed. Results: Activin-A (pg/ml) and follistatin were significantly elevated in patients with asthma compared to healthy subjects As for activin, the above elevated levels were related to the underlying severity [sputum: SRA 76(33-185), mild to moderate 45(18-84), BAL: SRA 193 (87-264), mild to moderate 35(22-93),p<0.001 for both]. Regression analysis in one model showed a significant positive association between activin-A in both sputum and BAL with eosinophils, IL-13 and TGF-β1. Conclusion: Our results indicate that Activin-a is up-regulated in both sputum and BAL of patients with asthma. Its levels are mainly associated with mediators involved in airway remodeling pointing towards a contribution of activin-a in the asthmatic remodeling process.

Follistatin

Cite

Citations (0)

Sputum interleukin‐13 as a biomarker for the evaluation of asthma control

Clinical & Experimental Allergy (2016)

Zoi Tsilogianni Georgios Hillas Petros Bakakos L. Aggelakis Elissavet Konstantellou

10.1111/cea.12825

Cite

Citations (7)

Pharmacological treatment of stable COPD: need for a simplified approach

Postgraduate Medicine (2019)

Georgios Hillas Anastasia Papaporfyriou Katerina Dimakou Andriana Ι. Papaioannou

Chronic obstructive pulmonary disease (COPD) is one of the most common diseases worldwide. Although different guidelines regarding therapeutic algorithms exist, the most widely adopted approach is the one suggested by the Global Initiative in Chronic Obstructive Lung Disease in which patients are stratified according to their dyspnea severity and their exacerbation history during the previous year. This combined assessment of COPD, which takes into consideration all aforementioned characteristics of COPD patients as well as the number of blood eosinophils, results in a proposed therapeutic algorithm which is complex and hard to memorize. This complexity is probable one of the causes that most health care professionals are not adherent to the guidelines when treating COPD patients. Here, we propose a simplified therapeutic algorithm for the treatment of COPD patients taking into consideration the current evidence on the use of bronchodilators and inhaled corticosteroids.

Obstructive lung disease

10.1080/00325481.2019.1706996

Cite

Citations (7)