Maria Kallieri

National and Kapodistrian University of Athens

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Andriana Ι. Papaioannou

National and Kapodistrian University of Athens

Stelios Loukides

National and Kapodistrian University of Athens

Effrosyni D. Manali

National and Kapodistrian University of Athens

Spyros A. Papiris

National and Kapodistrian University of Athens

Lykourgos Kolilekas

Sotiria General Hospital

Petros Bakakos

Sotiria General Hospital

Evangelia Fouka

G. Papanikolaou General Hospital

Katerina Dimakou

Sotiria General Hospital

Vasiliki Apollonatou

National and Kapodistrian University of Athens

Sofia Koukidou

Sotiria General Hospital

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National and Kapodistrian University of Athens

201

University General Hospital Attikon

Sotiria General Hospital

Aristotle University of Thessaloniki

Inserm

G. Papanikolaou General Hospital

Observational & Pragmatic Research Institute

Athens State University

Assistance Publique – Hôpitaux de Paris

Université Paris Cité

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Switching from omalizumab to mepolizumab in severe asthmatics: A post hoc analysis of the RELight study

Clinical & Experimental Allergy (2023)

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

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Omalizumab

Post-hoc analysis

Post hoc

10.1111/cea.14436

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Citations (0)

Mycophenolate mofetil as an alternative treatment in sarcoidosis

Pulmonary Pharmacology & Therapeutics (2019)

Spyros Papiris Eleni Stagaki Georgia Papadaki Lykourgos Kolilekas Ioanna Korbila

Prednisolone

Mycophenolate

10.1016/j.pupt.2019.101840

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Citations (16)

Sensitization to Staphylococcus Enterotoxin: Relationship with Aspects of Disease Severity

Journal of Clinical Medicine (2024)

Pinelopi Schoini Vasiliki Apollonatou Maria Kallieri Myrto Blizou Maria Sfika

Background/Objective: Sensitization to specific IgE Staphylococcus aureus enterotoxins (SEs) is associated with an increased risk for severe asthma development. Limited data exist regarding the association of seropositivity for specific IgE SEs and the different aspects of severe asthma. We aimed to determine whether the presence of SEs is associated with asthma-related parameters such as inflammatory cells in the airways, features of airway remodeling, and other variables relating to asthma assessment and severity. Methods: Fifty patients with severe asthma were recruited in the study. Demographics, comorbidities, asthma duration, and asthma medication were recorded by treating physicians. Specific IgE SE measurement, lung function, atopic status, asthma control test (ACT), sputum induction, bronchoscopy with BAL, and indices of airway remodeling were also assessed. Results: Twelve patients were positive to enterotoxin sensitization. Patients seropositive to specific IgE SEs significantly differed in regard to FEV1% pred and FEV1/FVC ratio compared to seronegative ones. Analyzing the inflammatory variables obtained from induced sputum, BAL, and endobronchial biopsies, the only significant difference was that of smooth muscle area (SMA), which was greater in specific IgE SE seropositive patients. The multivariate linear regression analysis showed two significant associations of specific IgE SE seropositivity. We found a negative with FEV1% pred with beta standardized coefficient 95%CI −0.054 (−0.083, −0.031), p < 0.001, and a positive with SMA with beta standardized coefficient 95%CI 0.054 (0.081, 0.037), p < 0.001. Conclusions: Seropositivity to specific IgE SEs in severe asthma is associated with more severe airflow limitation, obstruction, and upregulation in SMA, indicating a possible role in the remodeling process.

10.3390/jcm13195836

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Biologic Utilization Patterns: Data from the International Severe Asthma Registry (ISAR)

Andrew Menzies‐Gow Eileen Wang Mari-Anne Rowlands Marianna Alacqua Mona Al‐Ahmad

10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a7739

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Citations (1)

Prevalence, distribution and clinical significance of joints, muscles and bones in sarcoidosis: an ¹⁸F-FDG-PET/CT study

Expert Review of Respiratory Medicine (2020)

Spyros A. Papiris Effrosyni D. Manali Andriana Ι. Papaioannou Αλέξανδρος Γεωργακόπουλος Lykourgos Kolilekas

Objectives In Sarcoidosis joints-muscles-bones (JMBs) localizations are of the least common. 18F-FDG-PET/CT imaging revolutionized detection of JMBs involvement by adding metabolic activity information and allowing for a comprehensive, whole-body mapping of the disease.Aim and methods This study investigated prevalence, distribution, and clinical significance of JMBs sarcoidosis in 195 consecutive patients that underwent 18F-FDG PET/CT examination.Results Joint and bone involvement were encountered in 15% of patients with a mean of the maximum-standardized-uptake-value (SUVmax) of 6.1. Most common location was the axial skeleton. Hypercalciuria was significantly more frequent in patients with osseous involvement (p = 0.003). Muscle activity (SUVmax = 2.4) was encountered in 20% of the patients, most frequently in treatment-naïve (p = 0.02). The muscles of the lower extremities were affected the most. Muscle and bone localization coexist in 50% of the cases. JMBs disease was almost asymptomatic, not related to chronicity but to pulmonary, nodal, and systemic disease. Long-term follow-up and treatment response of affected patients confirmed sarcoidosis.Conclusion 18F-FDG-PET/CT revealed JMBs localizations and coexistence with other organ sites supporting the concept that sarcoidosis is a systemic disease. By allowing an integrative interpretation of multi-organ involvement in the context of a pattern highly suggestive of sarcoidosis, it strongly keeps-off the diagnosis of malignancy.

Standardized uptake value

Clinical Significance

PET-CT

10.1080/17476348.2020.1775587

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Citations (5)

CSF2RBmutation-related hereditary pulmonary alveolar proteinosis: the “long and winding road” into adulthood

ERJ Open Research (2023)

Spyros A. Papiris Camille Louvrier Aurélie Fabre Loukas Kaklamanis Iraklis Tsangaris

Genetic analysis pre-lung transplantation diagnosed a case of hereditary pulmonary alveolar proteinosis (PAP) complicated by fibrosis in adulthood. The need for genetic testing in GM-CSF autoantibody negative and unclassifiable PAP is highlighted. https://bit.ly/3QcsYwM.

Pulmonary alveolar proteinosis

10.1183/23120541.00703-2023

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Citations (2)

COVID-19: the day after

10.01 - Respiratory infections and bronchiectasis (2021)

Elvira Markela Antonogiannaki Κonstantinos Thomas Dimitra Kavatha Effrosyni D. Manali Dimitrios Konstantonis

Introduction: Patients recovering from pneumonia and ARDS may develop fibrotic changes. Concerning COVID-19, there is evidence that residual persistent ground glass opacities and/or reticular infiltrates could be related with the development of diffuse parenchymal lung disease. Aim: The detection of interstitial lung disease post COVID-19 pneumonia. Methods: Patients were prospectively assessed 3 months after hospital discharge with high resolution computerized tomography of the chest (HRCT), pulmonary lung function tests (PFTs), SpO2, 6minute walk test (6MWT) and Saint George Respiratory Questionnaire (SGRQ). Patients were classified according to acute phase pneumonia extent as: mild (<25% of parenchyma involved), moderate (25-50%) and severe (>50%). Results: 23 patients (6 women, mean age 55 yrs) were included. 2 patients had a history of mechanical ventilation and 3 of pulmonary embolism. Mild (8), moderate (9) and severe (6) disease patients had no significant differences in age, gender and smoking history. Fifteen (65%) had at least one comorbidity including chronic obstructive respiratory disease. At 3 months patients presented mean values (SD) of FEV1%pred of 98,4±20,3, FVC%pred 104,3±18,3, DLCO%pred 89,2±10,3, Sp02 97,7±0,7%, 6MWT 571,4±87m and SGRQ 4,56(0-8,14). Follow-up HRCT was evaluated as normal or near-normal in all with no significant differences among the three severity groups. 20 patients had normal PFTs, 2 an obstructive pattern (underlying lung disease) and 1 a restrictive pattern with normal DLCO. Conclusion: The results of the present study do not support the hypothesis of the development of diffuse parenchymal lung disease after COVID-19 pneumonia in this study group. The study is ongoing.

DLCO

High-resolution computed tomography

Obstructive lung disease

Restrictive lung disease

10.1183/13993003.congress-2021.pa3478

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The effects of pulmonary rehabilitation in patients with Combined Pulmonary Fibrosis and Emphysema (CPFE)

01.02 - Rehabilitation and chronic care (2018)

Andriana Ι. Papaioannou Effrosyni D. Manali Panagiotis Lyberopoulos Anastasia Papaporfyriou Maria Kallieri

Rationale: CPFE is a disease entity for which clinical management and therapeutic approaches are not clearly defined. Pulmonary rehabilitation (PR) is known to be an effective intervention for COPD patients, however its impact as a therapeutic option for CPFE is still unknown. Methods: We evaluated patients with a CPFE diagnosis based on chest HRCT. All patients underwent pulmonary function tests, cardiopulmonary exercise testing, echocardiography and evaluation of health-related quality of life (HRQoL) measured using the Saint George's Respiratory Questionnaire. Patients participated in a PR program (3 times/week for 3 consecutive months), and all tests were repeated after the end of this program. Results: Seven male patients completed the program (mean age 65.3±5.9years). No difference was observed before and after PR in the level of dyspnea according to the mMRC scale, in echocardiographic measurements or in pulmonary function tests, with the exception of a deterioration in DLCO %pred (median(IQR) [40.0(31.9, 53.7) vs 38.1(25.0, 55.0) p=0.043]. However, patients showed an improvement in HRQoL [31.7(16.9, 47.0) vs 25.5(15.6, 34.5), p=0.043]. Patients showed significant improvements in cardiopulmonary exercise testing parameters, including maximum work(%pred) [46(30, 51) vs 55(36, 73), p=0.018], peakVO2(ml/kg/min) [16.5(13.9, 19.8) vs 19.9(14.6, 25.8), p=0.018], O2 pulse(%pred) [75.0(68.3, 88.8) vs 94.0(80.0, 111.5), p=0.043].and a decrease in end-tidal CO2 [27.3(20.9, 32.5) vs 26.1(19.5, 35.8), p=0.043]. Conclusion: Despite the absence of improvement in lung function and echocardiographic parameters, PR seems to improve HRQoL and exercise capacity in CPFE patients.

Pulmonary emphysema

10.1183/13993003.congress-2018.pa4151

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Citations (1)

Global Access for Biologics in the Treatment of Severe Asthma: A Challenge to Personalized Medicine

Andrew Menzies‐Gow Thai Tran Nooshin Hosseini Nevaashni Eleangovan Mari-Anne Rowlands

Personalized Medicine

10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a5954

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Global Variability in Administrative Approval Prescription Criteria for Biologic Therapy in Severe Asthma

The Journal of Allergy and Clinical Immunology In Practice (2022)

Celeste Porsbjerg Andrew Menzies‐Gow Trung N. Tran Ruth Murray Bindhu Unni

Regulatory bodies have approved five biologics for severe asthma. However, regional differences in accessibility may limit the global potential for personalized medicine.To compare global differences in ease of access to biologics.In April 2021, national prescription criteria for omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab were reviewed by severe asthma experts collaborating in the International Severe Asthma Registry. Outcomes (per country, per biologic) were (1) country-specific prescription criteria and (2) development of the Biologic Accessibility Score (BACS). The BACS composite score incorporates 10 prescription criteria, each with a maximum score of 10 points. Referenced to European Medicines Agency marketing authorization specifications, a higher score reflects easier access.Biologic prescription criteria differed substantially across 28 countries from five continents. Blood eosinophil count thresholds (usually ≥300 cells/μL) and exacerbations were key requirements for anti-IgE/anti-IL-5/5R prescriptions in around 80% of licensed countries. Most countries (40% for dupilumab to 54% for mepolizumab) require two or more moderate or severe exacerbations, whereas numbers ranged from none to four. Moreover, 0% (for reslizumab) to 21% (for omalizumab) of countries required long-term oral corticosteroid use. The BACS highlighted marked between-country differences in ease of access. For omalizumab, mepolizumab, benralizumab, and dupilumab, only two, one, four, and seven countries, respectively, scored equal or higher than the European Medicines Agency reference BACS. For reslizumab, all countries scored lower.Although some differences were expected in country-specific biologic prescription criteria and ease of access, the substantial differences found in the current study present a challenge to implementing precision medicine across the world.

Omalizumab

Dupilumab

Benralizumab

10.1016/j.jaip.2021.12.027

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Citations (38)