Advances in understanding and managing Scedosporium respiratory infections in patients with cystic fibrosis.

Advances in understanding and managing Scedosporium respiratory infections in patients with cystic fibrosis. Expert Rev Respir Med. 2019 Dec 23;:1-15 Authors: Bouchara JP, Le Govic Y, Kabbara S, Cimon B, Zouhair R, Hamze M, Papon N, Nevez G Abstract Introduction: Considered for a long time to be exclusively responsible for chronic localized infections, fungi of the genus Scedosporium have recently received a renewed interest because of their recognition as common colonizing agents of the respiratory tract of patients with cystic fibrosis, and of the description of severe disseminated infections in patients undergoing lung transplantation. Recently, several studies have been carried out on these opportunistic pathogens, which led to some advances in the understanding of their pathogenic mechanisms and in the biological diagnosis of the airway colonization/respiratory infections caused by these fungi.Areas covered: From a bibliographic search on the Pubmed database, we summarize the current knowledge about the taxonomy of Scedosporium species, the epidemiology of these fungi and their pathogenic mechanisms, and present the improvements in the detection of the airway colonization and diagnosis of Scedosporium respiratory infections, the difficulties in their therapeutic management, and the antifungal drugs in development.Expert opinion: As described in this review, many advances have been made regarding the taxonomy and ecology of Scedosporium species or the...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

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Acute rejection (AR) is common during the first year after lung transplantation (LuTx) and can trigger chronic rejection (CR), the leading cause of late morbidity and mortality of LuTx. Extracorporeal photopheresis (ECP) is a promising treatment for chronic rejection. Few studies focus on ECP as prophylactic therapy of AR and CR. Microvesicles and exosomes (i.e.extracellular vesicles EV) are released into the blood and in bronchoalveolar lavage (BAL) and their role in cell-to-cell communication has been assessed in several studies; EV have been proposed as non-invasive biomarkers to assess lung injury and monitor clinical outcome.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (896) Source Type: research
Pseudomonas aeruginosa (PA) is an established risk factor for chronic lung allograft dysfunction (CLAD) after lung transplantation (LTx). PA eradication in cystic fibrosis patients prevents pulmonary function decline. Therefore, we investigated the effect of PA eradication after LTx on CLAD-free survival, graft survival and pulmonary function.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (746) Source Type: research
The care of the patient with cystic fibrosis (CF) requires a multidisciplinary approach throughout the lifespan by teams specially trained to deal with the complexities of care. Improvements in therapies have resulted in increased life expectancy of those with CF, yet respiratory failure continues to be the leading cause of death. While lung transplant (LTx) can be a viable treatment option, 35% of CF patients who meet criteria are not referred. We sought to understand patient preferences regarding discussions surrounding LTx in anticipation of referral to the LTx center.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (1264) Source Type: research
Lung transplantation (LTX) is an established therapy in selected patients with advanced cystic fibrosis (CF) lung disease. Resumption of employment after LTX is generally supported. In Switzerland, there is no data on long-term LTX employment in patients with CF.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (499) Source Type: research
Clinical outcomes remain extremely poor for children with cystic fibrosis undergoing lung transplantation. Since 1961, the Cystic Fibrosis Foundation has maintained a network of accredited Cystic Fibrosis Care Centers (CFCC) designated to deliver specialized, multidisciplinary care for people with cystic fibrosis (CF). While this integrated clinical approach is thought to be beneficial in patients undergoing transplantation, it remains unknown whether lung transplantation at a CFCC is associated with improved long-term outcomes among children with CF.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (489) Source Type: research
Nontuberculous mycobacteria (NTM) are challenging pathogens in cystic fibrosis (CF). The best approach is unknown, in particular, in patients in need of a lung transplant (LTX).
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (1234) Source Type: research
Patients who undergo repeat lung transplantation (LT) are at high risk for perioperative complications. The complexity of their care requires specialized multidisciplinary collaboration, particularly among people with cystic fibrosis (CF). Since 1961, the Cystic Fibrosis Foundation has established a network of accredited Cystic Fibrosis Care Centers (CFCCs) dedicated to the treatment of people with CF, including LT. We hypothesize that patients undergoing repeat lung transplantation at CFCCs will have improved postoperative outcomes compared to those at non-CFCC centers.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (980) Source Type: research
Since 1961 the Cystic Fibrosis Foundation has designated certain institutions devoted to treating cystic fibrosis (CF) as Cystic Fibrosis Care Centers (CFCC). Little is known about the benefits of undergoing lung transplantation (LT) at a transplant center with an accredited CFCC. The purpose of this study was to evaluate outcomes in people with CF who undergo LT at a transplant center with an accredited CFCC.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (283) Source Type: research
End-stage cystic fibrosis (CF) can be managed by lung transplantation (LT), but chronic allograft dysfunction (CLAD) limits long-term survival. While Pseudomonas aeruginosa airway infection (PsA) is a risk factor for CLAD for most lung allograft recipients, this association does not hold for CF recipients. We hypothesized that differences in host epithelial immune responses and the composition of airway microbial communities could contribute to protection from CLAD in CF recipients with PsA.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (139) Source Type: research
Lung transplantation (LT) is limited by the shortage of suitable donors. To overcome this problem, many programs have begun to use extended criteria donors. However, the use lung donors over 65 years old is rarely reported especially among a population of young cystic fibrosis (CF) recipient.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (945) Source Type: research
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