1.International Severe Asthma Registry (ISAR): 2017–2024 Status and Progress Update
Désirée LARENAS-LINNEMANN ; Chin Kook RHEE ; Alan ALTRAJA ; John BUSBY ; Trung N. TRAN ; Eileen WANG ; Todor A. POPOV ; Patrick D. MITCHELL ; Paul E. PFEFFER ; Roy Alton PLEASANTS ; Rohit KATIAL ; Mariko Siyue KOH ; Arnaud BOURDIN ; Florence SCHLEICH ; Jorge MÁSPERO ; Mark HEW ; Matthew J. PETERS ; David J. JACKSON ; George C. CHRISTOFF ; Luis PEREZ-DE-LLANO ; Ivan CHERREZ- OJEDA ; João A. FONSECA ; Richard W. COSTELLO ; Carlos A. TORRES-DUQUE ; Piotr KUNA ; Andrew N. MENZIES-GOW ; Neda STJEPANOVIC ; Peter G. GIBSON ; Paulo Márcio PITREZ ; Celine BERGERON ; Celeste M. PORSBJERG ; Camille TAILLÉ ; Christian TAUBE ; Nikolaos G. PAPADOPOULOS ; Andriana I. PAPAIOANNOU ; Sundeep SALVI ; Giorgio Walter CANONICA ; Enrico HEFFLER ; Takashi IWANAGA ; Mona S. AL-AHMAD ; Sverre LEHMANN ; Riyad AL-LEHEBI ; Borja G. COSIO ; Diahn-Warng PERNG ; Bassam MAHBOUB ; Liam G. HEANEY ; Pujan H. PATEL ; Njira LUGOGO ; Michael E. WECHSLER ; Lakmini BULATHSINHALA ; Victoria CARTER ; Kirsty FLETTON ; David L. NEIL ; Ghislaine SCELO ; David B. PRICE
Tuberculosis and Respiratory Diseases 2025;88(2):193-215
The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.
2.International Severe Asthma Registry (ISAR): 2017–2024 Status and Progress Update
Désirée LARENAS-LINNEMANN ; Chin Kook RHEE ; Alan ALTRAJA ; John BUSBY ; Trung N. TRAN ; Eileen WANG ; Todor A. POPOV ; Patrick D. MITCHELL ; Paul E. PFEFFER ; Roy Alton PLEASANTS ; Rohit KATIAL ; Mariko Siyue KOH ; Arnaud BOURDIN ; Florence SCHLEICH ; Jorge MÁSPERO ; Mark HEW ; Matthew J. PETERS ; David J. JACKSON ; George C. CHRISTOFF ; Luis PEREZ-DE-LLANO ; Ivan CHERREZ- OJEDA ; João A. FONSECA ; Richard W. COSTELLO ; Carlos A. TORRES-DUQUE ; Piotr KUNA ; Andrew N. MENZIES-GOW ; Neda STJEPANOVIC ; Peter G. GIBSON ; Paulo Márcio PITREZ ; Celine BERGERON ; Celeste M. PORSBJERG ; Camille TAILLÉ ; Christian TAUBE ; Nikolaos G. PAPADOPOULOS ; Andriana I. PAPAIOANNOU ; Sundeep SALVI ; Giorgio Walter CANONICA ; Enrico HEFFLER ; Takashi IWANAGA ; Mona S. AL-AHMAD ; Sverre LEHMANN ; Riyad AL-LEHEBI ; Borja G. COSIO ; Diahn-Warng PERNG ; Bassam MAHBOUB ; Liam G. HEANEY ; Pujan H. PATEL ; Njira LUGOGO ; Michael E. WECHSLER ; Lakmini BULATHSINHALA ; Victoria CARTER ; Kirsty FLETTON ; David L. NEIL ; Ghislaine SCELO ; David B. PRICE
Tuberculosis and Respiratory Diseases 2025;88(2):193-215
The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.
3.International Severe Asthma Registry (ISAR): 2017–2024 Status and Progress Update
Désirée LARENAS-LINNEMANN ; Chin Kook RHEE ; Alan ALTRAJA ; John BUSBY ; Trung N. TRAN ; Eileen WANG ; Todor A. POPOV ; Patrick D. MITCHELL ; Paul E. PFEFFER ; Roy Alton PLEASANTS ; Rohit KATIAL ; Mariko Siyue KOH ; Arnaud BOURDIN ; Florence SCHLEICH ; Jorge MÁSPERO ; Mark HEW ; Matthew J. PETERS ; David J. JACKSON ; George C. CHRISTOFF ; Luis PEREZ-DE-LLANO ; Ivan CHERREZ- OJEDA ; João A. FONSECA ; Richard W. COSTELLO ; Carlos A. TORRES-DUQUE ; Piotr KUNA ; Andrew N. MENZIES-GOW ; Neda STJEPANOVIC ; Peter G. GIBSON ; Paulo Márcio PITREZ ; Celine BERGERON ; Celeste M. PORSBJERG ; Camille TAILLÉ ; Christian TAUBE ; Nikolaos G. PAPADOPOULOS ; Andriana I. PAPAIOANNOU ; Sundeep SALVI ; Giorgio Walter CANONICA ; Enrico HEFFLER ; Takashi IWANAGA ; Mona S. AL-AHMAD ; Sverre LEHMANN ; Riyad AL-LEHEBI ; Borja G. COSIO ; Diahn-Warng PERNG ; Bassam MAHBOUB ; Liam G. HEANEY ; Pujan H. PATEL ; Njira LUGOGO ; Michael E. WECHSLER ; Lakmini BULATHSINHALA ; Victoria CARTER ; Kirsty FLETTON ; David L. NEIL ; Ghislaine SCELO ; David B. PRICE
Tuberculosis and Respiratory Diseases 2025;88(2):193-215
The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.
4.International Severe Asthma Registry (ISAR): 2017–2024 Status and Progress Update
Désirée LARENAS-LINNEMANN ; Chin Kook RHEE ; Alan ALTRAJA ; John BUSBY ; Trung N. TRAN ; Eileen WANG ; Todor A. POPOV ; Patrick D. MITCHELL ; Paul E. PFEFFER ; Roy Alton PLEASANTS ; Rohit KATIAL ; Mariko Siyue KOH ; Arnaud BOURDIN ; Florence SCHLEICH ; Jorge MÁSPERO ; Mark HEW ; Matthew J. PETERS ; David J. JACKSON ; George C. CHRISTOFF ; Luis PEREZ-DE-LLANO ; Ivan CHERREZ- OJEDA ; João A. FONSECA ; Richard W. COSTELLO ; Carlos A. TORRES-DUQUE ; Piotr KUNA ; Andrew N. MENZIES-GOW ; Neda STJEPANOVIC ; Peter G. GIBSON ; Paulo Márcio PITREZ ; Celine BERGERON ; Celeste M. PORSBJERG ; Camille TAILLÉ ; Christian TAUBE ; Nikolaos G. PAPADOPOULOS ; Andriana I. PAPAIOANNOU ; Sundeep SALVI ; Giorgio Walter CANONICA ; Enrico HEFFLER ; Takashi IWANAGA ; Mona S. AL-AHMAD ; Sverre LEHMANN ; Riyad AL-LEHEBI ; Borja G. COSIO ; Diahn-Warng PERNG ; Bassam MAHBOUB ; Liam G. HEANEY ; Pujan H. PATEL ; Njira LUGOGO ; Michael E. WECHSLER ; Lakmini BULATHSINHALA ; Victoria CARTER ; Kirsty FLETTON ; David L. NEIL ; Ghislaine SCELO ; David B. PRICE
Tuberculosis and Respiratory Diseases 2025;88(2):193-215
The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.
5.International Severe Asthma Registry (ISAR): 2017–2024 Status and Progress Update
Désirée LARENAS-LINNEMANN ; Chin Kook RHEE ; Alan ALTRAJA ; John BUSBY ; Trung N. TRAN ; Eileen WANG ; Todor A. POPOV ; Patrick D. MITCHELL ; Paul E. PFEFFER ; Roy Alton PLEASANTS ; Rohit KATIAL ; Mariko Siyue KOH ; Arnaud BOURDIN ; Florence SCHLEICH ; Jorge MÁSPERO ; Mark HEW ; Matthew J. PETERS ; David J. JACKSON ; George C. CHRISTOFF ; Luis PEREZ-DE-LLANO ; Ivan CHERREZ- OJEDA ; João A. FONSECA ; Richard W. COSTELLO ; Carlos A. TORRES-DUQUE ; Piotr KUNA ; Andrew N. MENZIES-GOW ; Neda STJEPANOVIC ; Peter G. GIBSON ; Paulo Márcio PITREZ ; Celine BERGERON ; Celeste M. PORSBJERG ; Camille TAILLÉ ; Christian TAUBE ; Nikolaos G. PAPADOPOULOS ; Andriana I. PAPAIOANNOU ; Sundeep SALVI ; Giorgio Walter CANONICA ; Enrico HEFFLER ; Takashi IWANAGA ; Mona S. AL-AHMAD ; Sverre LEHMANN ; Riyad AL-LEHEBI ; Borja G. COSIO ; Diahn-Warng PERNG ; Bassam MAHBOUB ; Liam G. HEANEY ; Pujan H. PATEL ; Njira LUGOGO ; Michael E. WECHSLER ; Lakmini BULATHSINHALA ; Victoria CARTER ; Kirsty FLETTON ; David L. NEIL ; Ghislaine SCELO ; David B. PRICE
Tuberculosis and Respiratory Diseases 2025;88(2):193-215
The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.
7. Research progress on molecular mechanism of traditional chinese medicine active ingredients interfering bone marrow mesenchymal stem cells senescence
Miaoying YU ; Yanhui WANG ; Shi YAN
Chinese Journal of Clinical Pharmacology and Therapeutics 2024;29(1):99-106
The senescence of bone marrow mesenchymal stem cells (BM-MSCs) will induce age-related bone tissue degeneration and chronic inflammation, and reduce its application effect for cell therapy. More and more active ingredients of traditional chinese medicine have been proved to intervene BM - MSCs senescence, playing an important role in bone diseases prevention and treatment, and improving the therapeutic effect of BM-MSCs. In this paper, the latest research progress on the molecular mechanism of traditional chinese medicine active ingredients interfering BM-MSCs senescence was summarized, in order to provide new direction and reference basis for senescence intervention research and clinical application improvement of BM-MSCs.
8.The impact of short-course total neoadjuvant therapy, long-course chemoradiotherapy, and upfront surgery on the technical difficulty of total mesorectal excision: an observational study with an intraoperative perspective
Cheryl Xi-Zi CHONG ; Frederick H. KOH ; Hui-Lin TAN ; Sharmini Su SIVARAJAH ; Jia-Lin NG ; Leonard Ming-Li HO ; Darius Kang-Lie AW ; Wen-Hsin KOO ; Shuting HAN ; Si-Lin KOO ; Connie Siew-Poh YIP ; Fu-Qiang WANG ; Fung-Joon FOO ; Winson Jianhong TAN
Annals of Coloproctology 2024;40(5):451-458
Purpose:
Total neoadjuvant therapy (TNT) is becoming the standard of care for locally advanced rectal cancer. However, surgery is deferred for months after completion, which may lead to fibrosis and increased surgical difficulty. The aim of this study was to assess whether TNT (TNT-RAPIDO) is associated with increased difficulty of total mesorectal excision (TME) compared with long-course chemoradiotherapy (LCRT) and upfront surgery.
Methods:
Twelve laparoscopic videos of low anterior resection with TME for rectal cancer were prospectively collected from January 2020 to October 2021, with 4 videos in each arm. Seven colorectal surgeons assessed the videos independently, graded the difficulty of TME using a visual analog scale and attempted to identify which category the videos belonged to.
Results:
The median age was 67 years, and 10 patients were male. The median interval to surgery from radiotherapy was 13 weeks in the LCRT group and 24 weeks in the TNT-RAPIDO group. There was no significant difference in the visual analog scale for difficulty in TME between the 3 groups (LCRT, 3.2; TNT-RAPIDO, 4.6; upfront, 4.1; P=0.12). A subgroup analysis showed similar difficulty between groups (LCRT 3.2 vs. TNT-RAPIDO 4.6, P=0.05; TNT-RAPIDO 4.6 vs. upfront 4.1, P=0.54). During video assessments, surgeons correctly identified the prior treatment modality in 42% of the cases. TNT-RAPIDO videos had the highest recognition rate (71%), significantly outperforming both LCRT (29%) and upfront surgery (25%, P=0.01).
Conclusion
TNT does not appear to increase the surgical difficulty of TME.
9.Assessing Neurobehavioral Alterations Among E-waste Recycling Workers in Hong Kong
Gengze LIAO ; Feng WANG ; Shaoyou LU ; Yanny Hoi Kuen YU ; Victoria H. ARRANDALE ; Alan Hoi-shou CHAN ; Lap Ah TSE
Safety and Health at Work 2024;15(1):9-16
Background:
E-waste workers in Hong Kong are handling an unprecedented amount of e-waste, which contains various neurotoxic chemicals. However, no study has been conducted to evaluate the neurological health status of e-waste workers in Hong Kong. This study aimed to evaluate the prevalence of neurobehavioral alterations and to identify the vulnerable groups among Hong Kong e-waste workers.
Methods:
We recruited 109 Hong Kong e-waste workers from June 2021 to September 2022. Participants completed standard questionnaires and wore a GENEActiv accelerometer for seven days. Pittsburgh Sleep Quality Index and Questionnaire 16/18 (Q16/18) were used to assess subjective neurobehavioral alterations. The GENEActiv data generated objective sleep and circadian rhythm variables. Workers were grouped based on job designation and entity type according to the presumed hazardous level. Unconditional logistic regression models measured the associations of occupational characteristics with neurobehavioral alterations after adjusting for confounders.
Results:
While dismantlers/repairers and the workers in entities not funded by the government were more likely to suffer from neurotoxic symptoms in Q18 (adjusted odds ratio: 3.18 [1.18–9.39] and 2.77 [1.10–7.46], respectively), the workers from self-sustained recycling facilities also have poor performances in circadian rhythm. Results also showed that the dismantlers/repairers working in entities not funded by the government had the highest risk of neurotoxic symptoms compared to the lowest-risk group (i.e., workers in government-funded companies with other job designations).
Conclusion
This timely and valuable study emphasizes the importance of improving the working conditions for high-risk e-waste workers, especially the dismantlers or repairers working in facilities not funded by the government.
10.Assessing the Practical Differences in LDL-C Estimates Calculated by Friedewald, Martin/Hopkins, or NIH Equation 2: An Observation CrossSectional Study
Inga WANG ; Mohammad H RAHMAN ; Stephen HOU ; Hui-Wen LIN
Journal of Lipid and Atherosclerosis 2023;12(3):252-266
Objective:
Low-density lipoprotein-cholesterol (LDL-C) remains a clinically important cholesterol target in primary prevention of atherosclerotic cardiovascular disease. The present study aimed to assess the practical differences among three equations utilized for the estimation of LDL-C: the Friedewald, the Martin/Hopkins, and the NIH equation 2.
Methods:
Blood lipid measurements from 4,556 noninstitutionalized participants, aged 12 to 80, were obtained from the 2017-2020 National Health and Nutrition Examination Survey study. We 1) assessed the differences between three calculated LDL-C estimates, 2) examined the correlations between LDL-C estimates using correlation coefficients and regression, and 3) investigated the degree of agreement in classifying individuals into the LDL-C category using weighted Kappa and percentage of agreement.
Results:
The differences in LDL-C estimates between equations varied by sex and triglyceride levels (p<0.001). Overall, the mean of absolute differences between Friedewald and Martin/ Hopkins was 3.17 mg/dL (median=2.0, 95% confidence interval [CI] [3.07–3.27]). The mean of absolute differences between Friedewald and NIH Equation 2 was 2.08 mg/dL (median=2.0, 95% CI [2.03–2.14]). Friedewald correlated highly with Martin/Hopkins (r=0.991, rho=0.989) and NIH Equation 2 (r=0.998, rho=0.997). Cohen’s weighted Kappa=0.92 between Friedewald and Martin/Hopkins, and 0.95 between Friedewald and NIH equation 2. The percentage of agreement in classifying individuals into the same LDL-C category was 93.0% between Friedewald and Martin/Hopkins, and 95.4% between Friedewald and NIH equation 2.
Conclusion
Understanding the practical differences in LDL-C calculations can be helpful in facilitating decision-making during a paradigm shift.

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