University Of Medicine And Pharmacy Grtpopa Iasi

Iaşi, Romania

University Of Medicine And Pharmacy Grtpopa Iasi

Iaşi, Romania

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Antoniu S.A.,University Of Medicine And Pharmacy Grtpopa Iasi | Sampablo I.,Anáhuac University of Cancún | Carone M.,Fondazione Salvatore Maugeri
Expert Opinion on Pharmacotherapy | Year: 2011

Existing asthma therapies are not always able to achieve disease control. The addition of tiotropium bromide to inhaled corticosteroids might be effective in improving disease outcome. This paper discusses the results of a study evaluating the effects of tiotropium bromide added to inhaled corticosteroids when compared to other regimens in patients with uncontrolled asthma. The addition of tiotropium to the current inhaled corticosteroid dose is comparable to the addition of salmeterol: both are more effective in achieving disease control versus doubling the inhaled corticosteroid dose. It is well worth investigating the effects of tiotropium in asthma that is not adequately controlled with higher doses of inhaled corticosteroids. © 2011 Informa UK, Ltd.


Antoniu S.A.,University Of Medicine And Pharmacy Grtpopa Iasi | Carone M.,Fondazione Salvatore Maugeri | Sampablo I.,Anáhuac University of Cancún
Expert Opinion on Pharmacotherapy | Year: 2010

Inhaled long-acting bronchodilators (of β2-agonist or muscarinic antagonist type) or corticosteroids are used in stable chronic obstructive pulmonary disease (COPD) treatment in a step-up approach according to disease severity. Consequently, in more severe disease triple therapy with two bronchodilators and an inhaled corticosteroid can often be encountered in clinical practice, but its short-and long-term effects on disease outcomes are not very well known. The results of a study evaluating the short-term effects of budesonide/formoterol (inhaled corticosteroid/inhaled long-acting β2-agonist combination) and tiotropium (inhaled long-acting muscarinic antagonist) against tiotropium alone are analysed and discussed. On a short-term basis, triple therapy improves lung function, health status and disease morbidity irrespective of disease severity. Long-term benefits of triple inhaled therapy including the effects of its precocious use in less severe COPD subjects should be evaluated. © 2010 Informa UK Ltd.


Antoniu S.A.,University Of Medicine And Pharmacy Grtpopa Iasi | Antoniu S.A.,Pulmonary Disease University Hospital
Expert Opinion on Therapeutic Targets | Year: 2011

In allergic airways, as in asthma, inflammation and impaired functioning of toll-like receptor 7 (TLR7) has been found. The augmentation of this receptor with agonist compounds resulted in bronchodilation and a switch of the TH2 inflammatory pattern, specific for allergic conditions, to TH1 inflammation, characterised by an increased production of interferon- γÎ3. This was a preclinical study evaluating the effects of two TLR7 agonists, imiquimod and resiquimod, on the isolated guinea pig trachea. The TLR7-related downstream signalling pathways were also assessed. Both TLR7 agonists were shown to reduce serotonin-induced bronchoconstriction, which is possibly exerted via the p38MAPK and NF-κΰB pathways. Therapeutic targeting of TLR7 with specific agonists might represent a promising immunomodulatory approach in asthma, especially if systemic exposure is minimised with inhaled formulations. © 2011 Informa UK, Ltd.


Antoniu S.A.,University Of Medicine And Pharmacy Grtpopa Iasi | Trofor A.C.,University Of Medicine And Pharmacy Grtpopa Iasi
Expert Opinion on Pharmacotherapy | Year: 2011

Bronchiectasis is a disease state defined by irreducible dilations of the airways. If they occur in diseases other than cystic fibrosis they are termed non-CF bronchiectasis. The common denominator is the increased risk of recurrent infections with bacteria, such as Staphylococcus aureus or Pseudomonas aeruginosa. Such infections are difficult to eradicate with systemic antibiotics because the structural abnormalities in the bronchial wall reduce their bactericidal effect at this level. An alternative to systemic antibiotics might be represented by inhaled formulations, which can be given in much lower doses and can be more effective. Previous studies demonstrated that inhaled gentamicin can reduce bacterial load and local infection in both cystic fibrosis and non-CF bronchiectasis. The study discussed in this paper demonstrates that long-term therapy with inhaled gentamicin can eradicate the infection or reduce the bacterial load, decrease the risk of subsequent infections and improve the quality of life in patients with non-CF bronchiectasis with a minimal risk of side effects. © 2011 Informa UK, Ltd.


Antoniu S.A.,University Of Medicine And Pharmacy Grtpopa Iasi
Expert Opinion on Investigational Drugs | Year: 2011

Introduction: Several types of mutations in the cystic fibrosis transmembrane regulator (CFTR) gene lead to abnormal CFTR protein and alterations of chloride and sodium transmembrane transportation in cystic fibrosis (CF). Some investigational compounds such as VX-770 can improve CFTR protein function. Areas covered: This paper discusses the results of a Phase II study investigating the safety and efficacy of VX-770 in patients with CF. Expert opinion: VX-770 is able to improve chloride and sodium transportation and has a good safety profile. Although such compounds have limited therapeutic targeting potential, preliminary results show great promise in the context of CF therapy. © 2011 Informa UK, Ltd.


Antoniu S.A.,University Of Medicine And Pharmacy Grtpopa Iasi
Expert Opinion on Therapeutic Targets | Year: 2011

Introduction: The serotonin pathway was initially identified as a major player in the pathogenesis of a subset of anorexigen-induced pulmonary arterial hypertension (PAH). It has subsequently been shown to be involved in other forms of PAH. Areas covered: In preclinical experiments, terguride (an anatagonist of type 2 serotonin receptors) was found to reduce proliferation of smooth muscle cells and accumulation of collagen, and decrease pulmonary arterial pressure. Expert opinion: Most therapies currently available for PAH primarily tackle vasoconstriction and endothelial dysfunction, whereas vascular remodeling, which is an early pathogenic event in PAH development, is secondary. If terguride demonstrates a prominent antiremodelling effect in PAH, it could be used as a specific therapy for this rare disease. © 2011 Informa UK, Ltd.


Antoniu S.A.,University Of Medicine And Pharmacy Grtpopa Iasi | Trofor A.C.,University Of Medicine And Pharmacy Grtpopa Iasi
Expert Opinion on Pharmacotherapy | Year: 2011

Introduction: In smoking-related chronic obstructive pulmonary disease (COPD), smoking cessation was previously demonstrated to reduce lung function decline and disease morbidity if it resulted in a sustained tobacco abstinence. Varenicline is a newer pharmacologic therapeutic agent able to reduce withdrawal symptoms in smokers, and this makes it particularly valuable in inducing abstinence in patients with significant addiction. Areas covered: This paper discusses the results of a randomized, placebo-controlled study evaluating the effects of a smoking cessation intervention including varenicline in patients with COPD. Expert opinion: Varenicline can be an appropriate aid to maintaining smoking abstinence in patients with COPD and heavier nicotine addiction, and the documentation of the long-term effects of a smoking cessation intervention that includes this pharmacologic therapeutic agent is necessary. © 2011 Informa UK, Ltd.


Antoniu S.A.,University Of Medicine And Pharmacy Grtpopa Iasi
Expert Opinion on Investigational Drugs | Year: 2011

Cystic fibrosis is a rare disease characterized by abnormalities in chloride and sodium transmembrane transportation due to various mutations in the cystic fibrosis transmembrane regulator (CFTR) gene, F508del being the most commonly found. Corrective therapies for this defect are currently under investigation and PDE5 inhibitors such as sildenafil or vardenafil were found to improve CFTR activity in vitro as well as in vivo. This paper evaluates a study investigating the effects of inhaled PDE5 inhibitors in an animal model of F508del cystic fibrosis, demonstrating that in this new formulation, such compounds are also able to improve CFTR function. Such results support the further development of this therapy for a systemic disease such as cystic fibrosis, provided several issues are addressed. © 2011 Informa UK, Ltd.


Antoniu S.A.,University Of Medicine And Pharmacy Grtpopa Iasi
Expert Opinion on Investigational Drugs | Year: 2016

Introduction: In asthma, most commonly, ‘conventional’ anti-inflammatory medications represented by inhaled corticosteroids and leukotriene inhibitors are effective. In some patients however additional inhibition of the airways inflammation is necessary. Such compounds might be molecules inhibiting specifically certain inflammation pathways and lebrikizumab an anti IL-13 molecule might represent a relevant example as a potential asthma therapy. Areas covered: Discussion of the rationale for the use of lebrikizumab in asthma. Analysis of the related preclinical and clinical data on lebrikizumab in asthma. Expert opinion: Lebrikizumab demonstrated efficacy in an asthma subset characterized by high serum periostin levels and by heavy eosinophilic inflammation. Phase III data are necessary in order to better position this therapy in asthma including as a potential personalized approach. © 2016 Informa UK Limited, trading as Taylor & Francis Group.


Antoniu S.A.,University Of Medicine And Pharmacy Grtpopa Iasi
Expert Opinion on Therapeutic Targets | Year: 2011

Introduction: In lung adenocarcinoma, certain mutations such as echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (ALK) are associated with lower sensitivity to chemotherapy, when used conventionally as the first-line therapy in the advanced stage of the disease. Areas covered: This paper discusses the clinical and therapeutic importance of ALK mutations in NSCLC and the early clinical results of a Phase I study assessing crizotinib in patients with ALK mutations. Expert opinion: Abnormal ALK is evolving as an important therapeutic target in patients with more aggressive lung adenocarcinoma. Further clinical studies are needed in order to assess if crizotinib, an ALK inhibitor, is able to increase the efficacy of the conventional chemotherapy in this disease subset. © 2011 Informa UK, Ltd.

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