Flic Gabbay

Bio: Flic Gabbay is an academic researcher. The author has contributed to research in topics: Medicine & Menopause. The author has an hindex of 1, co-authored 1 publications receiving 185 citations.

The effect of inhaled IFN-β on worsening of asthma symptoms caused by viral infections. A randomized trial.

Abstract: Rationale: Ex vivo, bronchial epithelial cells from people with asthma are more susceptible to rhinovirus infection caused by deficient induction of the antiviral protein, IFN-β. Exogenous IFN-β restores antiviral activity. Objectives: To compare the efficacy and safety of inhaled IFN-β with placebo administered to people with asthma after onset of cold symptoms to prevent or attenuate asthma symptoms caused by respiratory viruses. Methods: A total of 147 people with asthma on inhaled corticosteroids (British Thoracic Society Steps 2–5), with a history of virus-associated exacerbations, were randomized to 14-day treatment with inhaled IFN-β (n = 72) or placebo (n = 75) within 24 hours of developing cold symptoms and were assessed clinically, with relevant samples collected to assess virus infection and antiviral responses. Measurements and Main Results: A total of 91% of randomized patients developed a defined cold. In this modified intention-to-treat population, asthma symptoms did not get clinically significantly worse (mean change in six-item Asthma Control Questionnaire <0.5) and IFN-β treatment had no significant effect on this primary endpoint, although it enhanced morning peak expiratory flow recovery (P = 0.033), reduced the need for additional treatment, and boosted innate immunity as assessed by blood and sputum biomarkers. In an exploratory analysis of the subset of more difficult-to-treat, Step 4-5 people with asthma (n = 27 IFN-β; n = 31 placebo), Asthma Control Questionnaire-6 increased significantly on placebo; this was prevented by IFN-β (P = 0.004). Conclusions: Although the trial did not meet its primary endpoint, it suggests that inhaled IFN-β is a potential treatment for virus-induced deteriorations of asthma in difficult-to-treat people with asthma and supports the need for further, adequately powered, trials in this population. Clinical trial registered with www.clinicaltrials.gov (NCT 01126177).

Menopause practice standards

Abstract: Produced by: British Menopause Society (BMS) Royal College of Obstetricians and Gynaecologists (RCOG) Society for Endocrinology (SfE) Faculty of Sexual and Reproductive Health (FSRH) Faculty of Pharmaceutical Medicine (FPM) Royal Pharmaceutical Society (RPS) TheseMenopause Practice Standards were produced by the British Menopause Society (BMS), Royal College of Obstetricians and Gynaecologists (RCOG), Society for Endocrinology (SfE), Faculty of Sexual and Reproductive Health (FSRH), Faculty of Pharmaceutical Medicine (FPM) and the Royal Pharmaceutical Society (RPS). The aim of the standards is to provide evidence-based recommendations and guidance on best menopause practice to support healthcare practitioners delivering menopause care in line with current national and international guidelines and recommendations.

Menopause Practice Standards.

Abstract: Menopause Practice Standards This article is protected by copyright. All rights reserved.

Richard Bax

Abstract: As grandson of Sir Albert Cook, the founder of the Mengo Hospital Kampala, Uganda, Richard Bax had a rich family heritage of innovation in healthcare and infectious disease. He qualified from the Royal Free in 1970, where his mother had trained as a physician. After specialising as a GP, he was inspired by the opportunity for therapeutic development offered by emerging pharmaceutical companies and joined Glaxo in the mid-1970s. He maintained his membership of the Royal College of GPs throughout his career, doing locums alongside pharmaceutical medicine. With the British Association of Antimicrobial Chemotherapy (BSAC), Richard was one of the first to warn (in The BMJ) of the potential for antimicrobial resistance (AMR) from the increase in antibiotic usage by GPs in the 80s

The immunology of asthma

Abstract: Asthma is a common disease that affects 300 million people worldwide. Given the large number of eosinophils in the airways of people with mild asthma, and verified by data from murine models, asthma was long considered the hallmark T helper type 2 (T(H)2) disease of the airways. It is now known that some asthmatic inflammation is neutrophilic, controlled by the T(H)17 subset of helper T cells, and that some eosinophilic inflammation is controlled by type 2 innate lymphoid cells (ILC2 cells) acting together with basophils. Here we discuss results from in-depth molecular studies of mouse models in light of the results from the first clinical trials targeting key cytokines in humans and describe the extraordinary heterogeneity of asthma.

Mepolizumab for Severe Eosinophilic Asthma (DREAM): A Multicentre, Double-Blind, Placebo-Controlled Trial

Abstract: ID Pavord, S Korn, P Howarth. Lancet. 2012;380(9842):651–659 To elucidate the efficacy, safety, and patient characteristics of responsiveness to mepolizumab (a humanized monoclonal antibody against interleukin 5). Previous small, proof-of-concept studies in subjects with severe, eosinophilic asthma revealed that mepolizumab decreased exacerbation rates. From 81 multinational centers, 621 pa-tients were enrolled. Major inclusion criteria included: age 12 to 74 years, asthma diagnosis with objective measures, ≥2 asthma exacerbations requiring oral corticosteroids in the last year, refractory asthma as defined by the American …

Role of viral infections in the development and exacerbation of asthma in children

Abstract: Viral infections are closely linked to wheezing illnesses in children of all ages. Respiratory syncytial virus (RSV) is the main causative agent of bronchiolitis, whereas rhinovirus (RV) is most commonly detected in wheezing children thereafter. Severe respiratory illness induced by either of these viruses is associated with subsequent development of asthma, and the risk is greatest for young children who wheeze with RV infections. Whether viral illnesses actually cause asthma is the subject of intense debate. RSV-induced wheezing illnesses during infancy influence respiratory health for years. There is definitive evidence that RSV-induced bronchiolitis can damage the airways to promote airway obstruction and recurrent wheezing. RV likely causes less structural damage and yet is a significant contributor to wheezing illnesses in young children and in the context of asthma. For both viruses, interactions between viral virulence factors, personal risk factors (eg, genetics), and environmental exposures (eg, airway microbiome) promote more severe wheezing illnesses and the risk for progression to asthma. In addition, allergy and asthma are major risk factors for more frequent and severe RV-related illnesses. Treatments that inhibit inflammation have efficacy for RV-induced wheezing, whereas the anti-RSV mAb palivizumab decreases the risk of severe RSV-induced illness and subsequent recurrent wheeze. Developing a greater understanding of personal and environmental factors that promote more severe viral illnesses might lead to new strategies for the prevention of viral wheezing illnesses and perhaps reduce the subsequent risk for asthma.