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<br /> EUROPEAN MEDICAL JOURNAL<br /> ISSN 2397-6764 Vol 3.4 • December 2018 • europeanmedical-journal.com<br /> Contents<br /> EDITORIAL BOARD 4<br /> 01 FEATURE<br /> The Lancet Asthma Commission: Towards the Abolition of Asthma? 10<br /> Andy Bush, Ian D. Pavord<br /> 02 SYMPOSIUM REVIEWS<br /> Translating Knowledge of IL-23 Targeting into New Solutions for 16<br /> Psoriasis Treatment<br /> Type 2 Inflammation and the Evolving Profile of Uncontrolled 24<br /> Persistent Asthma<br /> Management of Fluctuating Parkinson’s Disease: From Science to 34<br /> Clinical Wisdom<br /> 03 ARTICLES<br /> Editor’s Pick: Newest Approaches in Immuno<a title="EMJ 3.4 2018 page 1" href="http://viewer.zmags.com/publication/647c38a3?page=1"> EUROPEAN MEDICAL JOURNAL ISSN 2397-6764 </a> <a title="EMJ 3.4 2018 page 2" href="http://viewer.zmags.com/publication/647c38a3?page=2"> Contents EDITORIAL BOARD </a> <a title="EMJ 3.4 2018 page 3" href="http://viewer.zmags.com/publication/647c38a3?page=3"> "EMJ closes the year in style with EMJ 3.4; t</a> <a title="EMJ 3.4 2018 page 4" href="http://viewer.zmags.com/publication/647c38a3?page=4"> Editorial Board Editor-in-Chief Prof Markus Peck-</a> <a title="EMJ 3.4 2018 page 5" href="http://viewer.zmags.com/publication/647c38a3?page=5"> Aims and Scope The European Medical Journal (EMJ)</a> <a title="EMJ 3.4 2018 page 6" href="http://viewer.zmags.com/publication/647c38a3?page=6"> EMJ 3.4 Chief Executive Officer Spencer Gore Seni</a> <a title="EMJ 3.4 2018 page 7" href="http://viewer.zmags.com/publication/647c38a3?page=7"> Welcome The end of December draws near and with i</a> <a title="EMJ 3.4 2018 page 8" href="http://viewer.zmags.com/publication/647c38a3?page=8"> Non-melanoma skin cancer (NMSC): Getting to the </a> <a title="EMJ 3.4 2018 page 9" href="http://viewer.zmags.com/publication/647c38a3?page=9"> Foreword Dear colleagues, A warm welcome to this </a> <a title="EMJ 3.4 2018 page 10" href="http://viewer.zmags.com/publication/647c38a3?page=10"> The Lancet Asthma Commission: Towards the Abolit</a> <a title="EMJ 3.4 2018 page 11" href="http://viewer.zmags.com/publication/647c38a3?page=11"> Asthma mortality rate/100,000 4.4 4.0 3.6 3.2 2.</a> <a title="EMJ 3.4 2018 page 12" href="http://viewer.zmags.com/publication/647c38a3?page=12"> usefulness.9 Arthritis and anaemia we</a> <a title="EMJ 3.4 2018 page 13" href="http://viewer.zmags.com/publication/647c38a3?page=13"> Table 1: Components of airway disease that need t</a> <a title="EMJ 3.4 2018 page 14" href="http://viewer.zmags.com/publication/647c38a3?page=14"> or having multiple emergency attendances. The</a> <a title="EMJ 3.4 2018 page 15" href="http://viewer.zmags.com/publication/647c38a3?page=15"> References 1. Warner JO et al. Management of</a> <a title="EMJ 3.4 2018 page 16" href="http://viewer.zmags.com/publication/647c38a3?page=16"> Translating Knowledge of IL-23 Targeting into </a> <a title="EMJ 3.4 2018 page 17" href="http://viewer.zmags.com/publication/647c38a3?page=17"> Prof Lambert reviewed the current clinical paradi</a> <a title="EMJ 3.4 2018 page 18" href="http://viewer.zmags.com/publication/647c38a3?page=18"> deviation Psoriasis Area Severity Index (PASI) of</a> <a title="EMJ 3.4 2018 page 19" href="http://viewer.zmags.com/publication/647c38a3?page=19"> ustekinumab dose at Week 0 and 4. At Week 16, 268</a> <a title="EMJ 3.4 2018 page 20" href="http://viewer.zmags.com/publication/647c38a3?page=20"> on data from 22 treatment arms across 13 r</a> <a title="EMJ 3.4 2018 page 21" href="http://viewer.zmags.com/publication/647c38a3?page=21"> > Members of the audience highlighted the need </a> <a title="EMJ 3.4 2018 page 22" href="http://viewer.zmags.com/publication/647c38a3?page=22"> focus – The primary role of IL-23 in psoriasis an</a> <a title="EMJ 3.4 2018 page 23" href="http://viewer.zmags.com/publication/647c38a3?page=23"> Xarelto®. Tailored Protection for Your Cardio-Vas</a> <a title="EMJ 3.4 2018 page 24" href="http://viewer.zmags.com/publication/647c38a3?page=24"> Type 2 Inflammation and the Evolving Profile of </a> <a title="EMJ 3.4 2018 page 25" href="http://viewer.zmags.com/publication/647c38a3?page=25"> Prof Diamant highlighted the scale and seve</a> <a title="EMJ 3.4 2018 page 26" href="http://viewer.zmags.com/publication/647c38a3?page=26"> comorbidities, and chronic environmental</a> <a title="EMJ 3.4 2018 page 27" href="http://viewer.zmags.com/publication/647c38a3?page=27"> In 2016, asthma was prevalent among </a> <a title="EMJ 3.4 2018 page 28" href="http://viewer.zmags.com/publication/647c38a3?page=28"> similar to that previously observed in mice was p</a> <a title="EMJ 3.4 2018 page 29" href="http://viewer.zmags.com/publication/647c38a3?page=29"> IgE-switched IgE plasma cell IgE </a> <a title="EMJ 3.4 2018 page 30" href="http://viewer.zmags.com/publication/647c38a3?page=30"> Prof Dahlén said the work was at an early stage, </a> <a title="EMJ 3.4 2018 page 31" href="http://viewer.zmags.com/publication/647c38a3?page=31"> 17% said they used it only 25% of the time. On th</a> <a title="EMJ 3.4 2018 page 32" href="http://viewer.zmags.com/publication/647c38a3?page=32"> have atypical features of Type 2 asthma. </a> <a title="EMJ 3.4 2018 page 33" href="http://viewer.zmags.com/publication/647c38a3?page=33"> 38. Peters MC et al. Measures of gene </a> <a title="EMJ 3.4 2018 page 34" href="http://viewer.zmags.com/publication/647c38a3?page=34"> Management of Fluctuating Parkinson’s Disease: </a> <a title="EMJ 3.4 2018 page 35" href="http://viewer.zmags.com/publication/647c38a3?page=35"> 2016 as an adjunct to levodopa for PD patients ex</a> <a title="EMJ 3.4 2018 page 36" href="http://viewer.zmags.com/publication/647c38a3?page=36"> symptoms, such as pain, anxiety, fatigue, mood ch</a> <a title="EMJ 3.4 2018 page 37" href="http://viewer.zmags.com/publication/647c38a3?page=37"> Managing Motor Fluctuations: A Case-Based Pers</a> <a title="EMJ 3.4 2018 page 38" href="http://viewer.zmags.com/publication/647c38a3?page=38"> Overall, the majority of patients repor</a> <a title="EMJ 3.4 2018 page 39" href="http://viewer.zmags.com/publication/647c38a3?page=39"> References 1. Poewe W et al. Parkinson disea</a> <a title="EMJ 3.4 2018 page 40" href="http://viewer.zmags.com/publication/647c38a3?page=40"> Newest Approaches in Immunotherapy for No</a> <a title="EMJ 3.4 2018 page 41" href="http://viewer.zmags.com/publication/647c38a3?page=41"> INTRODUCTION While the long-term overall </a> <a title="EMJ 3.4 2018 page 42" href="http://viewer.zmags.com/publication/647c38a3?page=42"> overexpression of PDL1 on >90% of </a> <a title="EMJ 3.4 2018 page 43" href="http://viewer.zmags.com/publication/647c38a3?page=43"> The Phase I trial of nivolumab in s</a> <a title="EMJ 3.4 2018 page 44" href="http://viewer.zmags.com/publication/647c38a3?page=44"> RECEPTOR T CELLS CHIMERIC ANTIGEN In the last fe</a> <a title="EMJ 3.4 2018 page 45" href="http://viewer.zmags.com/publication/647c38a3?page=45"> (doxorubicin, etoposide, cyclophosphamide w</a> <a title="EMJ 3.4 2018 page 46" href="http://viewer.zmags.com/publication/647c38a3?page=46"> Table 2: Chimeric antigen receptor T cells enceph</a> <a title="EMJ 3.4 2018 page 47" href="http://viewer.zmags.com/publication/647c38a3?page=47"> References 1. Crump M et al. Outcomes in </a> <a title="EMJ 3.4 2018 page 48" href="http://viewer.zmags.com/publication/647c38a3?page=48"> Chemotherapy-refractory diffuse large B-cell lymp</a> <a title="EMJ 3.4 2018 page 49" href="http://viewer.zmags.com/publication/647c38a3?page=49"> Coming soon. </a> <a title="EMJ 3.4 2018 page 50" href="http://viewer.zmags.com/publication/647c38a3?page=50"> iBiopsy® for Precision Medicine Authors: </a> <a title="EMJ 3.4 2018 page 51" href="http://viewer.zmags.com/publication/647c38a3?page=51"> training. To date, early efforts are limited and </a> <a title="EMJ 3.4 2018 page 52" href="http://viewer.zmags.com/publication/647c38a3?page=52"> detection of abnormalities in medical images. Whi</a> <a title="EMJ 3.4 2018 page 53" href="http://viewer.zmags.com/publication/647c38a3?page=53"> Rather than striving for simplification, the goal </a> <a title="EMJ 3.4 2018 page 54" href="http://viewer.zmags.com/publication/647c38a3?page=54"> counterparts. Most of them fall in the category o</a> <a title="EMJ 3.4 2018 page 55" href="http://viewer.zmags.com/publication/647c38a3?page=55"> approach, building models of integrated genetic, </a> <a title="EMJ 3.4 2018 page 56" href="http://viewer.zmags.com/publication/647c38a3?page=56"> COMBINING IMAGING PHENOMICS AND ARTIFICIAL INTELL</a> <a title="EMJ 3.4 2018 page 57" href="http://viewer.zmags.com/publication/647c38a3?page=57"> is not limited to the handling and processing of </a> <a title="EMJ 3.4 2018 page 58" href="http://viewer.zmags.com/publication/647c38a3?page=58"> Phenotype I</a> <a title="EMJ 3.4 2018 page 59" href="http://viewer.zmags.com/publication/647c38a3?page=59"> A unique strength of the iBiopsy platform i</a> <a title="EMJ 3.4 2018 page 60" href="http://viewer.zmags.com/publication/647c38a3?page=60"> CONCLUSION Several challenges still need to be ad</a> <a title="EMJ 3.4 2018 page 61" href="http://viewer.zmags.com/publication/647c38a3?page=61"> 33. Schlegl T et al. Unsupervised anomaly </a> <a title="EMJ 3.4 2018 page 62" href="http://viewer.zmags.com/publication/647c38a3?page=62"> Liposomal-Glutathione as a Potential Therapeutic </a> <a title="EMJ 3.4 2018 page 63" href="http://viewer.zmags.com/publication/647c38a3?page=63"> INTRODUCTION Since the discovery of HIV in 1981, </a> <a title="EMJ 3.4 2018 page 64" href="http://viewer.zmags.com/publication/647c38a3?page=64"> HIV virus HIV virus gp41 gp120 CD4+ CXCR4</a> <a title="EMJ 3.4 2018 page 65" href="http://viewer.zmags.com/publication/647c38a3?page=65"> pathogens and tissue repair;15 however, when</a> <a title="EMJ 3.4 2018 page 66" href="http://viewer.zmags.com/publication/647c38a3?page=66"> Reduced </a> <a title="EMJ 3.4 2018 page 67" href="http://viewer.zmags.com/publication/647c38a3?page=67"> together to combat intracellular M. tuberculosis </a> <a title="EMJ 3.4 2018 page 68" href="http://viewer.zmags.com/publication/647c38a3?page=68"> SUMMARY AND FUTURE DIRECTIONS Compromised CD4+</a> <a title="EMJ 3.4 2018 page 69" href="http://viewer.zmags.com/publication/647c38a3?page=69"> Cytokine Mediat Res. 2010;2(1):137-47. 20. 6.</a> <a title="EMJ 3.4 2018 page 70" href="http://viewer.zmags.com/publication/647c38a3?page=70"> From Renal Biomarkers to Therapeutic Targets: </a> <a title="EMJ 3.4 2018 page 71" href="http://viewer.zmags.com/publication/647c38a3?page=71"> condition to be applied more generally. In additi</a> <a title="EMJ 3.4 2018 page 72" href="http://viewer.zmags.com/publication/647c38a3?page=72"> Table 2: Sensitivity and specificity of biomarkers</a> <a title="EMJ 3.4 2018 page 73" href="http://viewer.zmags.com/publication/647c38a3?page=73"> found that TGF-β1 levels were significantly i</a> <a title="EMJ 3.4 2018 page 74" href="http://viewer.zmags.com/publication/647c38a3?page=74"> et al.41 used samples from 380 patients enrolled </a> <a title="EMJ 3.4 2018 page 75" href="http://viewer.zmags.com/publication/647c38a3?page=75"> Table 3: Comparison of the use of key biomarkers </a> <a title="EMJ 3.4 2018 page 76" href="http://viewer.zmags.com/publication/647c38a3?page=76"> individual condition. Therefore, can it be inferr</a> <a title="EMJ 3.4 2018 page 77" href="http://viewer.zmags.com/publication/647c38a3?page=77"> anti-glomerular-basement-membrane 20. antibod</a> <a title="EMJ 3.4 2018 page 78" href="http://viewer.zmags.com/publication/647c38a3?page=78"> associated vasculitis--A meta- 51.</a> <a title="EMJ 3.4 2018 page 79" href="http://viewer.zmags.com/publication/647c38a3?page=79"> Central Processes Underlying Fibromyalgia Autho</a> <a title="EMJ 3.4 2018 page 80" href="http://viewer.zmags.com/publication/647c38a3?page=80"> For study purposes, the 1990 American College of </a> <a title="EMJ 3.4 2018 page 81" href="http://viewer.zmags.com/publication/647c38a3?page=81"> pain symptoms or the onset of widespread pa</a> <a title="EMJ 3.4 2018 page 82" href="http://viewer.zmags.com/publication/647c38a3?page=82"> of a range of psychological factors that influence</a> <a title="EMJ 3.4 2018 page 83" href="http://viewer.zmags.com/publication/647c38a3?page=83"> symptomatic muscle or joints in patients with fibr</a> <a title="EMJ 3.4 2018 page 84" href="http://viewer.zmags.com/publication/647c38a3?page=84"> Much attention has been given to psychological st</a> <a title="EMJ 3.4 2018 page 85" href="http://viewer.zmags.com/publication/647c38a3?page=85"> these are links between thoughts, emotional </a> <a title="EMJ 3.4 2018 page 86" href="http://viewer.zmags.com/publication/647c38a3?page=86"> 1997;59(6):572-7. 39. Alexander RW et al. Sexual</a> <a title="EMJ 3.4 2018 page 87" href="http://viewer.zmags.com/publication/647c38a3?page=87"> Customised Oocyte Donation Enhancement and N</a> <a title="EMJ 3.4 2018 page 88" href="http://viewer.zmags.com/publication/647c38a3?page=88"> discussed. A strategy of customised oocyte d</a> <a title="EMJ 3.4 2018 page 89" href="http://viewer.zmags.com/publication/647c38a3?page=89"> repeated failures of assisted reproduction with d</a> <a title="EMJ 3.4 2018 page 90" href="http://viewer.zmags.com/publication/647c38a3?page=90"> Abnormal Metabolism of Exogenous Steroid Hormones</a> <a title="EMJ 3.4 2018 page 91" href="http://viewer.zmags.com/publication/647c38a3?page=91"> Between the Start of Endometrial Growth Stimulati</a> <a title="EMJ 3.4 2018 page 92" href="http://viewer.zmags.com/publication/647c38a3?page=92"> if diagnosis is not possible at the current stage</a> <a title="EMJ 3.4 2018 page 93" href="http://viewer.zmags.com/publication/647c38a3?page=93"> increased risk of RIF or early embryo wastage, or</a> <a title="EMJ 3.4 2018 page 94" href="http://viewer.zmags.com/publication/647c38a3?page=94"> 873-84. 27. Mouhayar Y, Sharara F. Modern </a> <a title="EMJ 3.4 2018 page 95" href="http://viewer.zmags.com/publication/647c38a3?page=95"> Chronic Spontaneous Urticaria in Patients with Co</a> <a title="EMJ 3.4 2018 page 96" href="http://viewer.zmags.com/publication/647c38a3?page=96"> INTRODUCTION Primary immunodeficiencies (PID) are </a> <a title="EMJ 3.4 2018 page 97" href="http://viewer.zmags.com/publication/647c38a3?page=97"> Table 1: Clinical data of Patients 1–3. Patient n</a> <a title="EMJ 3.4 2018 page 98" href="http://viewer.zmags.com/publication/647c38a3?page=98"> A 40 20 β-hexosaminidase release (%) 0 60</a> <a title="EMJ 3.4 2018 page 99" href="http://viewer.zmags.com/publication/647c38a3?page=99"> use of oral corticosteroids, omalizumab was </a> <a title="EMJ 3.4 2018 page 100" href="http://viewer.zmags.com/publication/647c38a3?page=100"> LAD2 cells was analysed; once activated, these ce</a> <a title="EMJ 3.4 2018 page 101" href="http://viewer.zmags.com/publication/647c38a3?page=101"> patients enrolled in this study, urticaria </a> <a title="EMJ 3.4 2018 page 102" href="http://viewer.zmags.com/publication/647c38a3?page=102"> 2016;169(2):130-4. </a> <a title="EMJ 3.4 2018 page 103" href="http://viewer.zmags.com/publication/647c38a3?page=103"> Drilling Down to the Bone: Evaluating Bone Marrow</a> <a title="EMJ 3.4 2018 page 104" href="http://viewer.zmags.com/publication/647c38a3?page=104"> concepts consider OA to be a spectrum of o</a> <a title="EMJ 3.4 2018 page 105" href="http://viewer.zmags.com/publication/647c38a3?page=105"> established that the sum of BML measured vi</a> <a title="EMJ 3.4 2018 page 106" href="http://viewer.zmags.com/publication/647c38a3?page=106"> With regard to histological analyses, studie</a> <a title="EMJ 3.4 2018 page 107" href="http://viewer.zmags.com/publication/647c38a3?page=107"> expression of genes involved in neurogenesis, pai</a> <a title="EMJ 3.4 2018 page 108" href="http://viewer.zmags.com/publication/647c38a3?page=108"> The expression of angiogenic and osteogenic genes</a> <a title="EMJ 3.4 2018 page 109" href="http://viewer.zmags.com/publication/647c38a3?page=109"> BML at different stages of development and </a> <a title="EMJ 3.4 2018 page 110" href="http://viewer.zmags.com/publication/647c38a3?page=110"> 2000;215(3):835-40. 33. Hunter DJ et al. Bone ma</a> <a title="EMJ 3.4 2018 page 111" href="http://viewer.zmags.com/publication/647c38a3?page=111"> Asthma: Diagnosis and Treatment Authors: </a> <a title="EMJ 3.4 2018 page 112" href="http://viewer.zmags.com/publication/647c38a3?page=112"> Clinical Presentation The symptoms of asthma can </a> <a title="EMJ 3.4 2018 page 113" href="http://viewer.zmags.com/publication/647c38a3?page=113"> Patient with dyspnoea suspected of asthma based o</a> <a title="EMJ 3.4 2018 page 114" href="http://viewer.zmags.com/publication/647c38a3?page=114"> useful in the diagnosis of non-eosinophilic </a> <a title="EMJ 3.4 2018 page 115" href="http://viewer.zmags.com/publication/647c38a3?page=115"> eosinophilic, neutrophilic, mixed granulocytic</a> <a title="EMJ 3.4 2018 page 116" href="http://viewer.zmags.com/publication/647c38a3?page=116"> Patients with the obesity-related phenotype l</a> <a title="EMJ 3.4 2018 page 117" href="http://viewer.zmags.com/publication/647c38a3?page=117"> Corticosteroids Corticosteroids are integral to t</a> <a title="EMJ 3.4 2018 page 118" href="http://viewer.zmags.com/publication/647c38a3?page=118"> compared to the doubling of ICS or addition of sa</a> <a title="EMJ 3.4 2018 page 119" href="http://viewer.zmags.com/publication/647c38a3?page=119"> Mepolizumab trials have shown a >50% reduction in</a> <a title="EMJ 3.4 2018 page 120" href="http://viewer.zmags.com/publication/647c38a3?page=120"> References 1. World Health Orgnization. Asth</a> <a title="EMJ 3.4 2018 page 121" href="http://viewer.zmags.com/publication/647c38a3?page=121"> 43. U.S. Food and Drug Administration. P</a> <a title="EMJ 3.4 2018 page 122" href="http://viewer.zmags.com/publication/647c38a3?page=122"> Genetic Associations and Environmental Exposures </a> <a title="EMJ 3.4 2018 page 123" href="http://viewer.zmags.com/publication/647c38a3?page=123"> myeloperoxidase (MPO) and proteinase-3 (PR3), cou</a> <a title="EMJ 3.4 2018 page 124" href="http://viewer.zmags.com/publication/647c38a3?page=124"> which encodes alpha-1 antitrypsin, a serine </a> <a title="EMJ 3.4 2018 page 125" href="http://viewer.zmags.com/publication/647c38a3?page=125"> cell surface to be presented to and activated by </a> <a title="EMJ 3.4 2018 page 126" href="http://viewer.zmags.com/publication/647c38a3?page=126"> However, in most cases, the evidence is restricte</a> <a title="EMJ 3.4 2018 page 127" href="http://viewer.zmags.com/publication/647c38a3?page=127"> Box 1: Environmental associations with anti-neutr</a> <a title="EMJ 3.4 2018 page 128" href="http://viewer.zmags.com/publication/647c38a3?page=128"> Kidney Int. 2005;68(5):2225-9. 14. Lyons PA et </a> <a title="EMJ 3.4 2018 page 129" href="http://viewer.zmags.com/publication/647c38a3?page=129"> insights and treatment of ANCA- associated vascul</a> <a title="EMJ 3.4 2018 page 130" href="http://viewer.zmags.com/publication/647c38a3?page=130"> Effect of Mesenchymal Stem Cells in Autoimmune Ar</a> <a title="EMJ 3.4 2018 page 131" href="http://viewer.zmags.com/publication/647c38a3?page=131"> joint conditions, such as osteogenesi</a> <a title="EMJ 3.4 2018 page 132" href="http://viewer.zmags.com/publication/647c38a3?page=132"> MSC could improve native cell viability</a> <a title="EMJ 3.4 2018 page 133" href="http://viewer.zmags.com/publication/647c38a3?page=133"> molecules. Inside EV, there are many kinds of mol</a> <a title="EMJ 3.4 2018 page 134" href="http://viewer.zmags.com/publication/647c38a3?page=134"> thrombospondin-2, insulin growth factor-</a> <a title="EMJ 3.4 2018 page 135" href="http://viewer.zmags.com/publication/647c38a3?page=135"> can reverse the immune regulatory effect of</a> <a title="EMJ 3.4 2018 page 136" href="http://viewer.zmags.com/publication/647c38a3?page=136"> 2012;12(5):574-91. 19. Le Blanc K, Mougiakakos </a> <a title="EMJ 3.4 2018 page 137" href="http://viewer.zmags.com/publication/647c38a3?page=137"> 59. Subesinghe S et al. A systematic rev</a> <a title="EMJ 3.4 2018 page 138" href="http://viewer.zmags.com/publication/647c38a3?page=138"> Never miss an update again. J</a>