Bacterial burden in the lower airways predicts disease progression in idiopathic pulmonary fibrosis and is independent of radiological disease extent

Increasing bacterial burden in the lower airways of patients with idiopathic pulmonary fibrosis confers an increased risk of disease progression and mortality. However, it remains unclear whether this increased bacterial burden directly influences progression of fibrosis or simply reflects the magnitude of the underlying disease extent or severity. We prospectively recruited 193 patients who underwent bronchoscopy and received a multidisciplinary diagnosis of idiopathic pulmonary fibrosis. Quantification of the total bacterial burden in bronchoalveolar lavage fluid was performed by 16S rRNA gene qPCR. Imaging was independently evaluated by two readers assigning quantitative scores for extent, severity and topography of radiographic changes and relationship of these features with bacterial burden was assessed. Increased bacterial burden significantly associated with disease progression (HR 2.1; 95% CI 1.287–3.474; p=0.0028). Multivariate stepwise regression demonstrated no relationship between bacterial burden and radiological features or extent of disease. When specifically considering patients with definite or probable usual interstitial pneumonia there was no difference in bacterial burden between these two groups. Despite a postulated association between pleuroparenchymal fibroelastosis and clinical infection, there was no relationship between either the presence or extent of pleuroparenchymal fibroelastosis and bacterial burden. We demonstrate that bacterial burden ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interstitial and orphan lung disease Original Articles: Interstitial lung disease Source Type: research

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Conclusion Most of LC-ILD were elderly patients with multiple comorbidities and decreased p ulmonary function, leading to significantly increased surgical risk. The ILD should be fully evaluated and controlled before surgery, intraoperative trauma should be minimized, and special attention should be paid to pulmonary complications and AE-ILD after surgery. Postoperative AE-ILD has a poor p rognosis and glucocorticoids may be effective. Early diagnosis and treatment is the key to treatment of AE-ILD. DOI: 10.3779/j.issn.1009-3419.2020.104.19
Source: Chinese Journal of Lung Cancer - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: GLILD is the major cause of lung disease in CVID. Computed tomography is useful for diagnosis but not necessary in follow-up, in which functional tests should have better correlation with clinical evolution, reducing radiation exposure. Biopsy should be indicated when the clinical diagnosis is unclear. Treatment should be considered whenever there is clear evidence of disease progression. PMID: 32446785 [PubMed - as supplied by publisher]
Source: Allergologia et Immunopathologia - Category: Allergy & Immunology Authors: Tags: Allergol Immunopathol (Madr) Source Type: research
Authors: Dawod YT, Cook NE, Graham WB, Madhani-Lovely F, Thao C Abstract Introduction: Smoking-associated interstitial lung disease manifests as several heterogeneous disorders involving the airways, pleura, and lung parenchyma with various radiological patterns. The clinical history, radiologic, and pathologic findings are important to distinguish these more uncommon diseases. A multidisciplinary approach is recommended for diagnosis and to manage these conditions appropriately.Areas covered: This review provides an overview of the epidemiology, risk factors, pathogenesis, clinical features, diagnosis, and treatme...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research
A 49 ‐year‐old man presented to our outpatient clinic complaining of nonproductive cough and exertional dyspnea for two months. He had been diagnosed with large B cell non‐Hodgkin's lymphoma seven months previously, and the tumor had almost disappeared after four cycles of rituximab‐contain ing chemotherapy. He then developed a severe dry cough, progressive dyspnea and hypoxia two weeks after the fifth cycle. Bilateral diffuse ground‐glass opacities were visible on chest X‐ray. Although the patient's symptoms were ameliorated temporarily after two weeks of methylprednisolone a...
Source: Thoracic Cancer - Category: Cancer & Oncology Authors: Tags: CASE REPORT Source Type: research
ConclusionsThis study demonstrated that patients who developed GGO exhibited worse outcomes among non ‐small‐cell lung cancer patients receiving anti‐PD‐1 therapies.
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Abstract Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic progressive fibrosing interstitial lung disease with a poor prognosis. High-resolution computed tomography (HRCT) plays an important role in the work-up of patients with suspected IPF. In HRCT IPF is characterized by the pattern of usual interstitial pneumonia (UIP). For a long time only supportive or immunosuppressive treatment was possible. The approval of antifibrotic agents in 2012 marked a turning point and triggered further clinical and scientific interest. Based on the recently gained knowledge the revised version of the in...
Source: Der Radiologe - Category: Radiology Authors: Tags: Radiologe Source Type: research
Abstract PURPOSE: Drug induced interstitial lung disease (DILD) is a rare, but potentially fatal toxicity. Clinical and radiological features of DILD in the early experimental setting are poorly described. EXPERIMENTAL DESIGN: 2499 consecutive advanced cancer patients on phase I clinical trials were included. DILD was identified by a dedicated radiologist and investigators, categorized per internationally recognized radiological patterns and graded per CTCAE and the Royal Marsden Hospital DILD score. Clinical and radiological features of DILD were analysed. RESULTS: 60 patients overall (2.4%) developed D...
Source: Clinical Cancer Research - Category: Cancer & Oncology Authors: Tags: Clin Cancer Res Source Type: research
Authors: Cameli P, Bergantini L, D'alessandro M, Vietri L, Cameli M, Sestini P, Bargagli E Abstract BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is the most common among idiopathic interstitial pneumonia. Life expectancy is estimated around 3-5 years at diagnosis. No reliable prognostic biomarker has been approved for routinary clinical practice of IPF. The aim of this study is to investigate the potential prognostic value of serum CD59 in a cohort of IPF patients. METHODS: 57 patients (45 males, 66.1 ± 10 years old) were recruited in Siena Regional Referral Centre for Interstitial Lung Disease and un...
Source: Panminerva Medica - Category: General Medicine Tags: Panminerva Med Source Type: research
We report the case of a woman initially treated for drug-induced acute interstitial lung disease revealing chronic interstitial pneumonia with autoimmune features. The disease evolved in three stages with the occurrence of a rapidly progressive diffuse skin sclerosis with anti-ARNPol3 antibodies in the context of ovarian cancer remission. PMID: 32284205 [PubMed - as supplied by publisher]
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Tags: Rev Mal Respir Source Type: research
In conclusion, IIP patients with a probable UIP pattern on initial chest CT had a better prognosis and longer time to first AE than those with a UIP pattern. However, when baseline data and longitudinal behaviour provided a final diagnosis of IPF, CT pattern was not associated with these outcomes. This suggests diagnostic heterogeneity among patients with a probable UIP pattern.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interstitial and orphan lung disease Original Articles: Interstitial lung disease Source Type: research
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