Dr. Joseph D. Spahn

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  www.kcswcs.org/March_18_22.html - [Cached Version]
  Published on: 3/16/2007    Last Visited: 3/16/2007  

  Preceptor: Joseph Spahn, M.D.
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  Joseph Spahn, M.D., Associate Professor, Pediatrics, University of Colorado Health Sciences Center; Director, Immunopharmacology Lab, Division of Pharmacology, National Jewish Medical Center, Denver, Colorado

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  www.atopicderm.org/news/y2003/asthma-inflammation.aspx - [Cached Version]
  Published on: 7/8/2003    Last Visited: 8/11/2008  

  Using rarely obtained samples of lung tissue, Joseph Spahn, MD, and his colleagues describe six cases of severe childhood asthma that do not fit the generally accepted concept of asthma as a disease driven by long-term inflammation.The findings suggest that scientists need to look beyond inflammation to fully understand and effectively treat severe asthma.
  
  "The concept of asthma as an inflammatory disease has led to very effective treatments for most asthma patients," said Dr. Spahn, a pediatric pharmacologist at National Jewish."But something more is happening in the lungs of children with very severe asthma.
  ...
  Dr. Spahn and his colleagues use results of the bronchoscopies as well as other historical, clinical and pulmonary data to describe six children ages 6 to 17 with severe asthma.Despite aggressive anti-inflammatory treatment with oral corticosteroids, all the patients had uncontrolled asthma.All had been to hospital emergency rooms several times for severe asthma episodes, and four of the six had breathing tubes put down their throats at least once because they had stopped breathing.One patient has died from an asthma exacerbation since being seen at National Jewish.
  
  "These patients have very twitchy, abnormal airways," said Dr. Spahn.
  
  These severely asthmatic patients did not fit the standard inflammation-driven model of asthma.For one, five of the six showed little to no evidence of ongoing inflammation in their lungs.Second, all the patients showed evidence of permanent changes to lung tissue, called remodeling, despite long-term anti-inflammatory therapy.Third, in spite of the apparent remodeling of lung tissue, after treatment at National Jewish, the majority of the patients were able to achieve nearly normal airflow in and out of their lungs.
  
  "These patients clearly do not fit the standard model of asthma," said Dr. Spahn.

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  mastersofpediatrics.com/cme/cme2004/bio_17.asp - [Cached Version]
  Published on: 1/1/2004    Last Visited: 7/28/2008  

  Joseph Spahn, M.D.
  
  Joseph Spahn, M.D.Dr. Spahn is Medical Director of National Jewish Medical and Research Center Department of Pediatrics Childhood Asthma Management Program and is also an Assistant Professor of Pediatrics at the University of Colorado Health Sciences Center.Dr. Spahn received his degree in Medicine at the University of Colorado Health Sciences Center in Denver.He received residency training in pediatrics at the University of California at Davis and fellowship training in allergy and immunology at National Jewish Medical and Research Center in Denver, Colorado.Dr. Spahn is the author of numerous journal articles, scholarly reviews and book chapters.

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  www.atopicderm.org/news/y2003/severe-asthma.aspx - [Cached Version]
  Published on: 10/14/2003    Last Visited: 2/26/2008  

  The research team, led by Joseph Spahn, MD, also found that children with severe asthma had surprisingly good airflow in and out of their lungs, which could lead to misdiagnosis and undertreatment of seriously ill patients.
  
  "Our findings highlight many of the significant differences between severe asthma in children and adults," said Dr. Spahn."We hope they will spur further research that can lead to a better understanding and better treatment of this disease."
  
  People with severe asthma, whose asthma remains uncontrolled in spite of high doses of medication, represent 5 percent to 10 percent of the estimated 20 million asthma patients in the United States.But they are important in terms of suffering, medical costs and difficulty finding effective treatments.Dr. Spahn and his colleagues examined a variety of demographic and biological data for 275 patients with severe asthma who had been referred to National Jewish.
  ...
  "There has been speculation that a woman's hormones or possibly a difference in the size of male and female lungs play a role in this changing pattern of asthma prevalence, but no one really knows for sure why it occurs," said Dr. Spahn."If we could learn why, we might gain valuable insight that could help us better treat all our asthma patients."
  
  Dr. Spahn and his colleagues also found that children with severe asthma have deceptively good lung function.
  ...
  "The good news is that children have significantly less impaired lung function than do adults with asthma," said Dr. Spahn.
  ...
  "Child-onset and adult-onset asthma may be two distinct forms of the disease, one that is slowly progressive over time and another that is associated with significant loss of lung function very shortly after onset," said Dr. Spahn.
  
  Note: This information is provided to you as an educational service of National Jewish.

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  www.hoinews.com/news/news_story.aspx?id=14820 - [Cached Version]
  Published on: 8/16/2006    Last Visited: 3/12/2007  

  Joe Spahn, M.D., Pediatric Allergist with the National Jewish Medical Center, says the theory behind the increasing prevalence of September asthma attacks is that children are exposed to more viral respiratory infections, which can trigger an asthma attack.Not all children with asthma experience an increase in symptoms.Investigation has shown children who are hospitalized are more likely to have stopped taking their inhaled steroid over the summer.
  
  Spahn says during the summer months, children may be exposed to fewer triggers.Since they feel better, they may stop using their inhaler.But inflammation is a chronic condition, even in mild cases of persistent asthma.Thus, the underlying cause of the problem never goes away - even if a child appears to be better or isn't having any symptoms.Thus, when children who stop using their inhaler go back to school and are exposed to respiratory viruses, their bodies aren't prepared to deal with the trigger, leading to severe exacerbations of symptoms.
  
  Spahn recommends all children with persistent asthma continue inhaled steroid therapy year-round.If a child stops taking the medication when school ends, the therapy should be restarted in August to give the airways time to build protection from viral triggers at the start of the school year.Spahn says the treatment won't stop a child from getting sick.

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  www.juicerx.com/asthma.inhalers.change.html - [Cached Version]
  Published on: 10/11/2008    Last Visited: 7/11/2008  

  That's what confuses people," says Dr. Joe Spahn, a pediatric allergist and immunologist at National Jewish Medical and Research Center in Denver."If it's not done correctly, it's like you're not taking it at all."Those asthmatics at greatest risk from the transition to new inhalers are the very old and the very young.Children age 4 or younger "don't have the coordination or the developmental skill" to inhale powerfully and get the full dose of steroid powder, he said.Those children, as well as senior citizens who sometimes can't coordinate their breathing, would do better if they use the inhalers powered by the alternative propellants, along with holding chambers, or nebulizers machines that allow them to breathe medicated air or mist for several minutes.With only the steroid inhalers available in the dry powder devices, "the real big problem with this whole thing is that people are going to have to know both techniques," Spahn said, because even bronchodilators with environmentally friendly propellants still rely upon the old breathing technique.By Jane E. AllenLos Angeles Times - 12/30/2003Topic: Air Pollution

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  www.mdnetguide.com/specialty_editions/africanamer/listi - [Cached Version]
  Published on: 12/18/2003    Last Visited: 7/13/2004  

  "Advair is a highly effective treatment for asthma, and it is great news that it is now available for children as young as four," said Joseph Spahn, MD, Associate Professor of Pediatrics, National Jewish Medical Center and University of Colorado Health Sciences Center.

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  www.inlandempirefamily.com/t-FamilyNews_0804.aspx - [Cached Version]
  Published on: 8/1/2004    Last Visited: 2/17/2008  

  "Advair is a highly effective treatment for asthma, and it is great news that it is now available for children as young as 4," says Dr. Joseph Spahn of the National Jewish Medical Center and University of Colorado Health Sciences Center.

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  www.atopicderm.org/news/y2003/severe-asthma.aspx - [Cached Version]
  Published on: 10/14/2003    Last Visited: 11/12/2007  

  The research team, led by Joseph Spahn, M.D., also found that children with severe asthma had surprisingly good airflow in and out of their lungs, which could lead to misdiagnosis and undertreatment of seriously ill patients.
  
  "Our findings highlight many of the significant differences between severe asthma in children and adults," said Dr. Spahn."We hope they will spur further research that can lead to a better understanding and better treatment of this disease."
  
  People with severe asthma, whose asthma remains uncontrolled in spite of high doses of medication, represent 5 percent to 10 percent of the estimated 20 million asthma patients in the United States.But they are important in terms of suffering, medical costs and difficulty finding effective treatments.Dr. Spahn and his colleagues examined a variety of demographic and biological data for 275 patients with severe asthma who had been referred to National Jewish.
  ...
  "There has been speculation that a woman's hormones or possibly a difference in the size of male and female lungs play a role in this changing pattern of asthma prevalence, but no one really knows for sure why it occurs," said Dr. Spahn."If we could learn why, we might gain valuable insight that could help us better treat all our asthma patients."
  
  Dr. Spahn and his colleagues also found that children with severe asthma have deceptively good lung function.
  ...
  "The good news is that children have significantly less impaired lung function than do adults with asthma," said Dr. Spahn.
  ...
  "Child-onset and adult-onset asthma may be two distinct forms of the disease, one that is slowly progressive over time and another that is associated with significant loss of lung function very shortly after onset," said Dr. Spahn.
  
  Note: This information is provided to you as an educational service of National Jewish.

• 
  www.atopicderm.org/news/y2003/asthma-inflammation.aspx - [Cached Version]
  Published on: 7/8/2003    Last Visited: 2/26/2008  

  Using rarely obtained samples of lung tissue, Joseph Spahn, MD, and his colleagues describe six cases of severe childhood asthma that do not fit the generally accepted concept of asthma as a disease driven by long-term inflammation.The findings suggest that scientists need to look beyond inflammation to fully understand and effectively treat severe asthma.
  
  "The concept of asthma as an inflammatory disease has led to very effective treatments for most asthma patients," said Dr. Spahn, a pediatric pharmacologist at National Jewish."But something more is happening in the lungs of children with very severe asthma.
  ...
  Dr. Spahn and his colleagues use results of the bronchoscopies as well as other historical, clinical and pulmonary data to describe six children ages 6 to 17 with severe asthma.Despite aggressive anti-inflammatory treatment with oral corticosteroids, all the patients had uncontrolled asthma.All had been to hospital emergency rooms several times for severe asthma episodes, and four of the six had breathing tubes put down their throats at least once because they had stopped breathing.One patient has died from an asthma exacerbation since being seen at National Jewish.
  
  "These patients have very twitchy, abnormal airways," said Dr. Spahn.
  
  These severely asthmatic patients did not fit the standard inflammation-driven model of asthma.For one, five of the six showed little to no evidence of ongoing inflammation in their lungs.Second, all the patients showed evidence of permanent changes to lung tissue, called remodeling, despite long-term anti-inflammatory therapy.Third, in spite of the apparent remodeling of lung tissue, after treatment at National Jewish, the majority of the patients were able to achieve nearly normal airflow in and out of their lungs.
  
  "These patients clearly do not fit the standard model of asthma," said Dr. Spahn.

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