List of European Respiratory Journal peer reviewers 2021
The European Respiratory Journal is voluntarily reviewed. We are most grateful for the hard work and dedication of all those who reviewed articles for the ERJ in 2021. (Source: European Respiratory Journal)
Source: European Respiratory Journal - January 27, 2022 Category: Respiratory Medicine Tags: Acknowledgement Source Type: research

The evolution of the European Respiratory Journal: adapting in an era of change
This will be our final new year editorial, as in September we will make way for a new editorial team who can continue the evolution of the European Respiratory Journal. Here, we want to look back on some of the highlights of a remarkable year at the ERJ and pay tribute to the pillars of the journal's success, our editors, reviewers and the editorial staff who have worked so hard throughout our 5-year tenure. (Source: European Respiratory Journal)
Source: European Respiratory Journal - January 27, 2022 Category: Respiratory Medicine Authors: Chalmers, J. D., Kolb, M. Tags: Editorials Source Type: research

Jugular venous ultrasound predicts outcomes in pulmonary hypertension outpatients
Assessment of jugular venous pressure (JVP) is a classic physical examination manoeuvre that serves as an estimate of right atrial pressure (RAP). Although JVP was rated by experts as the most important physical examination finding to monitor response to therapy in pulmonary hypertension (PH) patients [1], it has been understudied in PH. Since RAP is an accurate predictor of outcome in PH [2, 3], determining whether clinically assessed JVP (as a non-invasive surrogate for RAP) also predicts outcomes is an important, unanswered question. Since JVP can be difficult to measure on physical examination due to obesity and challe...
Source: European Respiratory Journal - January 27, 2022 Category: Respiratory Medicine Authors: Lammi, M. R., Samant, S., Tran, H. V., Uddo, R. B., Saketkoo, L. A., Saito, S., Helmcke, F. R., deBoisblanc, B. P. Tags: Original Articles: Research letters Source Type: research

Improving lung transplant outcomes in France: the high emergency lung transplantation programme
With the advancement in diagnostics, therapeutics and dietary programmes, outcomes in cystic fibrosis (CF) have significantly improved for individuals fortunate enough to have access to care [1–4]. However, mortality in advanced CF remains high for those who do not receive lung transplant [5]. Efforts to increase access to lung transplant and/or reduce waitlist times are important. (Source: European Respiratory Journal)
Source: European Respiratory Journal - January 27, 2022 Category: Respiratory Medicine Authors: Bayomy, O. F., Ramos, K. J., Goss, C. H. Tags: Editorials Source Type: research

Surfactant protein C mutations and familial pulmonary fibrosis: stuck in a loop on the scenic route
Alveolar lining fluid requires surfactant to prevent alveolar collapse at end expiration. This activity is generated by interactions of phospholipids with the hydrophobic surfactant proteins SP-B and -C [1]. Mutations in SP-B and -C cause familial pulmonary fibrosis [2, 3]. Whilst loss of surfactant activity is associated with respiratory distress syndromes, this does not seem to be the main driver of disease caused by SP-C mutations [4, 5], indicating there is instead a pathogenic gain-of-function. What is going on, and why should we care? (Source: European Respiratory Journal)
Source: European Respiratory Journal - January 27, 2022 Category: Respiratory Medicine Authors: Gooptu, B. Tags: Editorials Source Type: research

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia: clinical characteristics and progression to carcinoid tumour
Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is considered a preinvasive lesion that may progress to carcinoid tumour [1]. Histologically, it is marked by a proliferation of neuroendocrine cells that is confined to the basement membrane (neuroendocrine cell hyperplasia; NECH), and/or has invaded past the basement membrane (carcinoid tumourlet) [2]. Tumourlets equal to or larger than 5 mm are classified as carcinoid tumours. Per the World Health Organization 2021 criteria, DIPNECH can be pathological (based solely on characteristic histological features) or clinical (diagnosed per characterist...
Source: European Respiratory Journal - January 27, 2022 Category: Respiratory Medicine Authors: Sun, T. Y., Hwang, G., Pancirer, D., Hornbacker, K., Codima, A., Lui, N. S., Raj, R., Kunz, P., Padda, S. K. Tags: Original Articles: Research letters Source Type: research

Novel insights into surfactant protein C trafficking revealed through the study of a pathogenic mutant
Conclusion These data show for the first time that all SFTPC transits the cell surface during normal trafficking, and the I73T mutation accumulates at the cell surface through both retarded trafficking and active recycling. This understanding of normal SFTPC trafficking and how the I73T mutant disturbs it provides novel insight into SFTPC biology in health and disease, and in the contribution of the SFTPC mutant to IPF development. (Source: European Respiratory Journal)
Source: European Respiratory Journal - January 27, 2022 Category: Respiratory Medicine Authors: Dickens, J. A., Rutherford, E. N., Abreu, S., Chambers, J. E., Ellis, M. O., van Schadewijk, A., Hiemstra, P. S., Marciniak, S. J. Tags: Original Articles: Basic science Source Type: research

Impact of a high emergency lung transplantation programme for cystic fibrosis in France: insight from a comparison with Canada
The objectives of our study were to compare health outcomes within France as well as between Canada and France before and after the HELT programme in a population with cystic fibrosis (CF). Methods This population-based cohort study utilised data from the French and Canadian CF registries. A cumulative incidence curve assessed time to transplant with death without transplant as competing risks. The Kaplan–Meier method was used to estimate post-transplant survival. Results Between 2002 and 2016, there were 1075 (13.0%) people with CF in France and 555 (10.2%) people with CF in Canada who underwent lung transplantati...
Source: European Respiratory Journal - January 27, 2022 Category: Respiratory Medicine Authors: Coriati, A., Sykes, J., Lemonnier, L., Ma, X., Stanojevic, S., Dehillotte, C., Carlier, N., Stephenson, A. L., Burgel, P.-R. Tags: CF and non-CF bronchiectasis Original Articles: Cystic fibrosis and lung transplant Source Type: research

Diffusing capacity of the lung for carbon monoxide: association with long-term outcomes after lung transplantation in a 20-year longitudinal study
Rationale The diffusing capacity of the lung for carbon monoxide corrected for haemoglobin (DLCOcor) measures gas movement across the alveolar–capillary interface. We hypothesised that DLCOcor is a sensitive measure of injurious allograft processes disrupting this interface. Objectives To determine the prognostic significance of the DLCOcor trajectory on chronic lung allograft dysfunction (CLAD) and survival. Methods A retrospective analysis was conducted of all bilateral lung transplant recipients at a single centre, between January 1998 and January 2018, with one or more DLCOcor measurements. Low baseline DLCOcor...
Source: European Respiratory Journal - January 27, 2022 Category: Respiratory Medicine Authors: Darley, D. R., Ma, J., Huszti, E., Ghany, R., Hutcheon, M., Chow, C.-W., Tikkanen, J., Keshavjee, S., Singer, L. G., Martinu, T. Tags: Interstitial and orphan lung disease Original Articles: Lung transplant Source Type: research

Applications of CRISPR technology to lung cancer research
(Source: European Respiratory Journal)
Source: European Respiratory Journal - January 20, 2022 Category: Respiratory Medicine Authors: Sorolla, A., Parisi, E., Sorolla, M. A., Marques, M., Porcel, J. M. Tags: ERJ Methods Source Type: research

Double-lung transplantation followed by delayed percutaneous repair for atrial septal defect-associated pulmonary arterial hypertension
Pulmonary arterial hypertension (PAH) is a rare but severe complication of unrepaired atrial septal defect (ASD) and appears to be among the strongest predictors of death in adults with Eisenmenger syndrome [1]. For decades, heart–lung transplantation (HLTx) has been considered the best treatment of last resort for patients with ASD-associated PAH and right ventricular failure. Nonetheless, over 25% of patients die within 1 year after the procedure [2]. In addition, severe organ shortages result in long waiting list times, during which the frequency of clinical deterioration or death exceeds 30% [3]. Double-lung...
Source: European Respiratory Journal - January 20, 2022 Category: Respiratory Medicine Authors: Gazengel, P., Hascoët, S., Amsallem, M., Savale, L., Montani, D., Mercier, O., Humbert, M., Fadel, E., Le Pavec, J. Tags: Original Articles: Research letters Source Type: research

The hidden history of hypersensitivity pneumonitis
Hypersensitivity pneumonitis (HP) is a relatively new construct, first reported in the early 20th century, despite major aetiological factors (farming, bird husbandry) having been part of human activities for millennia. Initial confirmed HP reports included exposure to farming and forestry (1932) and bird exposure (1965), much more recently than is often assumed. Later changes in occupational and living practices have led to HP associated with isocyanates, machine coolants, indoor mould, hot tubs and other exposures. Evolution of our pathological understanding of interstitial lung disease in general, wider computed tomogra...
Source: European Respiratory Journal - January 20, 2022 Category: Respiratory Medicine Authors: Barnes, H., Jones, K., Blanc, P. Tags: State of the Art Source Type: research

Glucocorticoid toxicity reduction with mepolizumab using the Glucocorticoid Toxicity Index
Background Reduction in glucocorticoid exposure is the primary benefit of new biologic treatments in severe asthma, but there is currently no evidence that reduction in glucocorticoid exposure corresponds to a proportionate reduction in associated toxicity. Objectives To use the validated Glucocorticoid Toxicity Index (GTI) to assess change in glucocorticoid toxicity after 12 months treatment with mepolizumab, and compare toxicity change to glucocorticoid reduction and change in patient-reported outcome measures (PROMs). Methods A longitudinal, real-world prospective cohort of 101 consecutive patients with severe as...
Source: European Respiratory Journal - January 20, 2022 Category: Respiratory Medicine Authors: McDowell, P. J., Stone, J. H., Zhang, Y., Honeyford, K., Dunn, L., Logan, R. J., McGarvey, L. P. A., Butler, C. A., Heaney, L. G. Tags: Asthma and allergy Original Articles: Asthma Source Type: research

All-oral longer regimens are effective for the management of multidrug-resistant tuberculosis in high-burden settings
Conclusions Among individuals receiving bedaquiline and/or delamanid as part of a multidrug regimen for drug-resistant tuberculosis, there was no significant difference between those who received an injectable and those who did not regarding culture conversion within 6 months. The potential contribution of injectable agents in the treatment of drug-resistant tuberculosis among those who were HIV positive requires further study. (Source: European Respiratory Journal)
Source: European Respiratory Journal - January 20, 2022 Category: Respiratory Medicine Authors: Khan, P. Y., Franke, M. F., Hewison, C., Seung, K. J., Huerga, H., Atwood, S., Ahmed, S., Khan, M., Sultana, T., Manzur-ul-Alam, M., Vo, L. N. Q., Lecca, L., Yae, K., Kozhabekov, S., Tamirat, M., Gelin, A., Vilbrun, S. C., Kikvidze, M., Faqirzai, J., Kady Tags: Respiratory infections and tuberculosis Original Articles: Tuberculosis Source Type: research

To code or not to code chronic pulmonary aspergillosis associated malnutrition in PMSI database: that is the problem...
We read with interest the letter from S. Jouneau and co-workers titled "To be malnourished or not to be malnourished: that is the question!", referencing our study in which we overviewed the epidemiology and prognostic of chronic pulmonary aspergillosis (CPA) in France [1]. Based on the French nationwide administrative hospital database (PMSI), which is designed to include discharge abstracts for all inpatients admitted to public and private hospitals in France, we reported that malnutrition is one of the most frequent underlying conditions concerning 38 to 44% of CPA patients from 2014 to 2018. Moreover, in CPA ...
Source: European Respiratory Journal - January 13, 2022 Category: Respiratory Medicine Authors: Maitre, T., Cottenet, J., Godet, C., Roussot, A., Abdoul Carime, N., Ok, V., Parrot, A., Bonniaud, P., Quantin, C., Cadranel, J. Tags: Original Articles: Correspondence Source Type: research

A multi-omics approach to delineate sputum microbiome-associated asthma inflammatory phenotypes
Asthma is a heterogeneous disease with multiple clinical presentations (phenotypes) [1]. Neutrophilic asthma is characterised by increased sputum neutrophils and generally has a poor response to corticosteroids and limited other therapeutic options. Neutrophilia originates from different factors, including the defective resolution of inflammation or bacterial infections [2]. An association between airway bacterial imbalance (disturbance) and the neutrophilic phenotype has been reported [3], suggesting that airway microbiota composition is involved in neutrophilic asthma. Rather than being a separate entity [4], neutrophili...
Source: European Respiratory Journal - January 13, 2022 Category: Respiratory Medicine Authors: Abdel-Aziz, M. I., Vijverberg, S. J. H., Neerincx, A. H., Brinkman, P., Wagener, A. H., Riley, J. H., Sousa, A. R., Bates, S., Wagers, S. S., De Meulder, B., Auffray, C., Wheelock, A. M., Bansal, A. T., Caruso, M., Chanez, P., Uddin, M., Corfield, J., Hor Tags: Original Articles: Research letters Source Type: research

To be malnourished or not to be malnourished: that is the question!
In the European Respiratory Journal, Maitre et al. [1] analysed 17 290 cases of chronic pulmonary aspergillosis (CPA) retrieved between 2009 and 2018 in the French nationwide administrative hospital database (PMSI). They demonstrated high rates of mortality, which was almost one third at 1 year. In multivariate analysis, they showed that mortality was increased in patients with malnutrition with the highest hazard ratio: 2.49, 95% confidence interval 2.05–3.04. Malnutrition, present in 33.4% of patients, was extracted from the database using the ICD-10 code. This implies that the malnutrition diagnosis should have be...
Source: European Respiratory Journal - January 13, 2022 Category: Respiratory Medicine Authors: Jouneau, S., Kerjouan, M., Thibault, R. Tags: Original Articles: Correspondence Source Type: research

Impact of a rare respiratory diseases reference centre set-up on primary ciliary dyskinesia care pathway
Rare diseases have such a low prevalence that special organisation of the patient care pathway is required to address them. In France, the implementation of specific cystic fibrosis (CF) centres [1] has improved the care pathway of CF patients. Indeed, early diagnosis and progress in usual routine treatment might have contributed to improving the prognosis of CF [2]. In the light of this success, rare respiratory diseases reference centres (CRMR: "centre de Références des Maladies Respiratoires Rares") were created from 2007 under the framework of the national plan for rare diseases. The ear, nose a...
Source: European Respiratory Journal - January 13, 2022 Category: Respiratory Medicine Authors: Epaud, S., Epaud, R., Salaün-Penquer, N., Belozertseva, E., Remus, N., Douvry, B., Bequignon, E., Coste, A., Pruliere-Escabasse, V., Schlemmer, F., Jung, C., Ortala, M., Maitre, B., Delestrain, C. Tags: Original Articles: Research letters Source Type: research

PROMising developments in IPF patient-reported outcome measures
Idiopathic pulmonary fibrosis (IPF) is characterised by increasing severity of symptoms, including dyspnoea, cough and fatigue, functional decline and poor prognosis with a median untreated survival of 3 years from diagnosis [1]. Traditionally, IPF research and clinical management have involved objective assessments including pulmonary function tests, high-resolution computed tomography scans as well as morbidity (e.g. exacerbations, hospitalisation) and mortality endpoints. However, these measures may not capture aspects of the disease important to people living with IPF, such as symptoms and quality of life, which can be...
Source: European Respiratory Journal - January 13, 2022 Category: Respiratory Medicine Authors: Nolan, C. M., Birring, S. S. Tags: Editorials Source Type: research

Interpreting blood eosinophil counts in health and obstructive lung disease
Asthma and COPD are prevalent chronic diseases characterised by presence of respiratory symptoms and airflow limitation caused by ongoing inflammatory process in the airways [1, 2]. While the clinical features are reversible or variable over time in asthma [1], they are more persistent and usually progressive over time in COPD [2]. The connection between these two common disorders has been debated thoroughly for many decades with proponents for both "splitting" or "lumping" them into either two distinct or one common entity [3–6]. The clinical heterogeneity of both conditions has also been recogni...
Source: European Respiratory Journal - January 13, 2022 Category: Respiratory Medicine Authors: Colak, Y., Lange, P. Tags: Editorials Source Type: research

The use of online visual analogue scales in idiopathic pulmonary fibrosis
Idiopathic pulmonary fibrosis (IPF) is a progressive, deadly disease with a major impact on the lives of patients [1]. Symptom burden and quality of life (QoL) can be assessed with patient-reported outcome measures (PROMs). In the past decade, PROM use was increasingly advocated to capture the impact of treatments and interventions on patients’ symptoms and wellbeing [2]. PROMs are often lengthy, on paper, and with difficult scoring systems, hampering direct use in clinical practice [2]. Thus, there is a need for easy-to-use PROMs in IPF and other interstitial lung diseases (ILDs), both for clinical trials and daily ...
Source: European Respiratory Journal - January 13, 2022 Category: Respiratory Medicine Authors: Moor, C. C., Mostard, R. L. M., Grutters, J. C., Bresser, P., Wijsenbeek, M. S. Tags: Original Articles: Research letters Source Type: research

R-scale for pulmonary fibrosis: a simple, visual tool for the assessment of health-related quality of life
Conclusions The R-Scale-PF correlates well with the K-BILD and EQ-5D-5L. It is hoped that this novel simple numerical rating scale tool, subject to validation in patients from other centres, will provide an opportunity to objectively measure HRQoL in routine clinical practice for patients with IPF. (Source: European Respiratory Journal)
Source: European Respiratory Journal - January 13, 2022 Category: Respiratory Medicine Authors: Scallan, C., Strand, L., Hayes, J., Kadura, S., Collins, B., Ho, L., Spada, C., Canestaro, W., Kolb, M., Raghu, G. Tags: Original Articles: Interstitial lung disease Source Type: research

Accelerated decline in lung function in adults with a history of remitted childhood asthma
Conclusions A history of clinically remitted childhood asthma is an independent risk factor for accelerated decline in lung function in adults. Remitted childhood asthma and smoking may additively accelerate the development of obstructive lung disease. (Source: European Respiratory Journal)
Source: European Respiratory Journal - January 13, 2022 Category: Respiratory Medicine Authors: Miura, S., Iwamoto, H., Omori, K., Yamaguchi, K., Sakamoto, S., Horimasu, Y., Masuda, T., Miyamoto, S., Nakashima, T., Fujitaka, K., Hamada, H., Yokoyama, A., Hattori, N. Tags: Original Articles: Asthma and lung function Source Type: research

Rapid, simplified whole blood-based multiparameter assay to quantify and phenotype SARS-CoV-2-specific T-cells
Conclusions This proof-of-concept study presents a scalable alternative to peripheral blood mononuclear cell-based assays to enumerate and phenotype SARS-CoV-2-responding T-cells, thus representing a practical tool to monitor adaptive immunity due to natural infection or vaccine trials. (Source: European Respiratory Journal)
Source: European Respiratory Journal - January 13, 2022 Category: Respiratory Medicine Authors: Riou, C., Schäfer, G., du Bruyn, E., Goliath, R. T., Stek, C., Mou, H., Hung, D., Wilkinson, K. A., Wilkinson, R. J. Tags: Lung biology and experimental studies, Respiratory infections and tuberculosis Original Articles: Infection and basic science Source Type: research

Blood eosinophil counts in the general population and airways disease: a comprehensive review and meta-analysis
We describe EOS distributions and ranges published in asthma, COPD, control (non-asthma/COPD) and general populations. Methods We conducted a comprehensive literature review and meta-analysis of observational studies (January 2008 to November 2018) that included EOS counts in asthma, severe asthma, COPD, control and general populations. Excluded studies had total sample sizes
Source: European Respiratory Journal - January 13, 2022 Category: Respiratory Medicine Authors: Benson, V. S., Hartl, S., Barnes, N., Galwey, N., Van Dyke, M. K., Kwon, N. Tags: Review Source Type: research

Lessons learnt from hydroxychloroquine/azithromycin in treatment of COVID-19
Coronavirus disease 2019 (COVID-19) is still exerting a great influence on global health and economy. The initial fight against COVID-19 relied mainly on non-pharmacological measures, including social distancing, facial masks, active screening and isolation, etc. In terms of pharmacological interventions, huge progress has been made in the development of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), although the appearance of several mutant variants has raised concerns for lasting immunity. The repurposing of established drugs has been another strategy to search for weapons in treatment or ...
Source: European Respiratory Journal - January 6, 2022 Category: Respiratory Medicine Authors: Xu, J., Cao, B. Tags: Editorials Source Type: research

Azithromycin and hydroxychloroquine in hospitalised patients with confirmed COVID-19: a randomised double-blinded placebo-controlled trial
Conclusions The combination of azithromycin and hydroxychloroquine did not improve survival or length of hospitalisation in patients with COVID-19. (Source: European Respiratory Journal)
Source: European Respiratory Journal - January 6, 2022 Category: Respiratory Medicine Authors: Sivapalan, P., Ulrik, C. S., Lapperre, T. S., Bojesen, R. D., Eklöf, J., Browatzki, A., Wilcke, J. T., Gottlieb, V., Hakansson, K. E. J., Tidemandsen, C., Tupper, O., Meteran, H., Bergsoe, C., Brondum, E., Bodtger, U., Bech Rasmussen, D., Graff Je Tags: Respiratory infections and tuberculosis Original Articles: Infection Source Type: research

Stopping versus continuing long-term mepolizumab treatment in severe eosinophilic asthma (COMET study)
Background The long-term efficacy and safety of mepolizumab for treatment of severe eosinophilic asthma are well established. Here, we examine the clinical impact of stopping mepolizumab after long-term use. Methods COMET (NCT02555371) was a randomised, double-blind, placebo-controlled, parallel-group, multicentre study. Patients who had completed COLUMBA (NCT01691859) or COSMEX (NCT02135692) and received continuous mepolizumab treatment for ≥3 years were randomised 1:1 to stop (switch to placebo) or continue subcutaneous mepolizumab 100 mg every 4 weeks for 52 weeks. Primary end-point: time to firs...
Source: European Respiratory Journal - January 6, 2022 Category: Respiratory Medicine Authors: Moore, W. C., Kornmann, O., Humbert, M., Poirier, C., Bel, E. H., Kaneko, N., Smith, S. G., Martin, N., Gilson, M. J., Price, R. G., Bradford, E. S., Liu, M. C. Tags: Asthma and allergy Original Articles: Asthma Source Type: research

Host lipidome and tuberculosis treatment failure
Conclusions We identified lipids, some with known roles in TB pathogenesis, associated with TB treatment failure. In addition, a lipid signature with prognostic accuracy for TB treatment failure was identified. These lipids could be potential targets for risk-stratification, adjunct therapy and treatment monitoring. (Source: European Respiratory Journal)
Source: European Respiratory Journal - January 6, 2022 Category: Respiratory Medicine Authors: Shivakoti, R., Newman, J. W., Hanna, L. E., Queiroz, A. T. L., Borkowski, K., Gupte, A. N., Paradkar, M., Satyamurthi, P., Kulkarni, V., Selva, M., Pradhan, N., Shivakumar, S. V. B. Y., Natarajan, S., Karunaianantham, R., Gupte, N., Thiruvengadam, K., Fie Tags: Respiratory infections and tuberculosis Original Articles: Tuberculosis Source Type: research

Mesenchymal stromal (stem) cell therapy modulates miR-193b-5p expression to attenuate sepsis-induced acute lung injury
Although mesenchymal stromal (stem) cell (MSC) administration attenuates sepsis-induced lung injury in pre-clinical models, the mechanism(s) of action and host immune system contributions to its therapeutic effects remain elusive. We show that treatment with MSCs decreased expression of host-derived microRNA (miR)-193b-5p and increased expression of its target gene, the tight junctional protein occludin (Ocln), in lungs from septic mice. Mutating the Ocln 3' untranslated region miR-193b-5p binding sequence impaired binding to Ocln mRNA. Inhibition of miR-193b-5p in human primary pulmonary microvascular endothelial cells pr...
Source: European Respiratory Journal - January 6, 2022 Category: Respiratory Medicine Authors: dos Santos, C. C., Amatullah, H., Vaswani, C. M., Maron-Gutierrez, T., Kim, M., Mei, S. H. J., Szaszi, K., Monteiro, A. P. T., Varkouhi, A. K., Herreroz, R., Lorente, J. A., Tsoporis, J. N., Gupta, S., Ektesabi, A., Kavantzas, N., Salpeas, V., Marshall, J Tags: Lung biology and experimental studies, Acute lung injury and critical care Original Articles: Acute lung injury and basic science Source Type: research

Global Initiative for Asthma Strategy 2021: executive summary and rationale for key changes
This article summarizes key recommendations from GINA 2021, and the evidence underpinning recent changes. GINA recommends that asthma in adults and adolescents should not be treated solely with short-acting β2-agonist (SABA), because of the risks of SABA-only treatment and SABA overuse, and evidence for benefit of inhaled corticosteroids (ICS). Large trials show that as-needed combination ICS–formoterol reduces severe exacerbations by ≥60% in mild asthma compared with SABA alone, with similar exacerbation, symptom, lung function, and inflammatory outcomes as daily ICS plus as-needed SABA. Key changes in GINA ...
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Reddel, H. K., Bacharier, L. B., Bateman, E. D., Brightling, C. E., Brusselle, G. G., Buhl, R., Cruz, A. A., Duijts, L., Drazen, J. M., FitzGerald, J. M., Fleming, L. J., Inoue, H., Ko, F. W., Krishnan, J. A., Levy, M. L., Lin, J., Mortimer, K., Pitrez, P Tags: Original Articles: GINA Strategy 2021: Executive Summary Source Type: research

The assessment of pulmonary arterial pressure and its clinical relevance: a 100-year journey from Europe, over the United States to Australia
The elevation of pulmonary arterial pressure is a clinically important, robust, prognostic relevant haemodynamic marker in several diseases and conditions https://bit.ly/3lrN9rF (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Kovacs, G., Maron, B. A. Tags: Editorials Source Type: research

Bronchial thermoplasty: what we know, what we don't know, and what we need to know
Bronchial thermoplasty leads to sustained improvements in airway remodelling and clinical outcomes in severe asthma, but questions remain about how it works, who should be treated, and where it fits in current treatment guidelines https://bit.ly/3xl1qZC (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Russell, R. J., Brightling, C. E. Tags: Editorials Source Type: research

Resilience of the respiratory microbiome in controlled adult RSV challenge study
This study of healthy adults revealed no major changes in the bacterial community of the respiratory tracts following RSV inoculation, suggesting that the adult respiratory microbial community is resilient to viral perturbations https://bit.ly/3AwnMc8 (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Cuthbertson, L., James, P., Habibi, M. S., Thwaites, R. S., Paras, A., Chiu, C., Openshaw, P. J. M., Cookson, W. O. C., Moffatt, M. F. Tags: Original Articles: Research letters Source Type: research

Is tezepelumab more than just an anti-eosinophil drug?
Tezepelumab significantly reduces airway eosinophilia, which is the most likely mechanism by which it reduces the risk of asthma exacerbation in patients with moderate–severe asthma, but has little effect on airway hyperresponsiveness to mannitol https://bit.ly/3xnt5sS (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Adatia, A., Wahab, M., Satia, I. Tags: Editorials Source Type: research

Repeatability of impulse oscillometry in patients with severe asthma
This study reports on medium term repeatability for IOS and proposes values for within subject biological variability in patients with poorly controlled severe asthma. https://bit.ly/3a5o52W (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Chan, R., Misirovs, R., Lipworth, B. Tags: Original Articles: Research letters Source Type: research

Reply to: Digging mediastinal holes with vigour: a word of caution
Transbronchial mediastinal cryobiopsy might be a safe sampling strategy that is associated with improved diagnostic yield and worthy of further investigation https://bit.ly/3gpuVmL (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Zhang, J., Huang, Z.-S., Herth, F. J. F., Fan, Y. Tags: Original Articles: Correspondence Source Type: research

Digging mediastinal holes with vigour: a word of caution
Transbronchial mediastinal cryobiopsy has a superior diagnostic yield versus endobronchial ultrasonography. However, this is exclusively explained for diagnoses other than lung cancer. Uncertainties about safety hinder implementation in routine practice. https://bit.ly/3wo9kkO (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Tournoy, T. K., Tournoy, K. G. Tags: Original Articles: Correspondence Source Type: research

The effect of tezepelumab on airway hyperresponsiveness to mannitol in asthma (UPSTREAM)
Conclusions Inhibiting TSLP signalling with tezepelumab reduced the proportion of patients with AHR and decreased eosinophilic inflammation in BAL and airway tissue. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Sverrild, A., Hansen, S., Hvidtfeldt, M., Clausson, C.-M., Cozzolino, O., Cerps, S., Uller, L., Backer, V., Erjefält, J., Porsbjerg, C. Tags: Asthma and allergy Original Articles: Asthma Source Type: research

Exercise capacity impairment after COVID-19 pneumonia is mainly caused by deconditioning
Not pulmonary factors, but physical deconditioning is the main limiting factor of exercise capacity in patients after severe COVID-19 pneumonitis. This underscores the importance of an early rehabilitative intervention in these patients. https://bit.ly/2XVvr6C (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Jahn, K., Sava, M., Sommer, G., Schumann, D. M., Bassetti, S., Siegemund, M., Battegay, M., Stolz, D., Tamm, M., Khanna, N., Hostettler, K. E. Tags: Original Articles: Research letters Source Type: research

Tuberculosis diagnostic accuracy of stool Xpert MTB/RIF and urine AlereLAM in vulnerable children
Background Non-sputum-based diagnostic approaches are crucial in children at high risk of disseminated tuberculosis (TB) who cannot expectorate sputum. We evaluated the diagnostic accuracy of stool Xpert MTB/RIF and urine AlereLAM tests in this group of children. Methods Hospitalised children with presumptive TB and either age
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Orikiriza, P., Smith, J., Ssekyanzi, B., Nyehangane, D., Mugisha Taremwa, I., Turyashemererwa, E., Byamukama, O., Tusabe, T., Ardizzoni, E., Marais, B. J., Wobudeya, E., Kemigisha, E., Mwanga-Amumpaire, J., Nampijja, D., Bonnet, M. Tags: Respiratory infections and tuberculosis Original Articles: Tuberculosis Source Type: research

Mild pulmonary hypertension and premature mortality among 154 956 men and women undergoing routine echocardiography
Background Although mild pulmonary hypertension is known to be associated with increased mortality, its impact on premature mortality is largely unknown. Methods We studied the distribution of estimated right ventricular systolic pressure (eRVSP) among a total of 154 956 adults with no evidence of left heart disease investigated with echocardiography. We then examined individually linked mortality, premature mortality and associated life-years lost (LYL) according to eRVSP levels. Results The cohort comprised 70 826 men and 84 130 women (aged 61.3±17.7 and 61.4±18.4 years, respectively). Overall, ...
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Stewart, S., Chan, Y.-K., Playford, D., Strange, G. A., on behalf of the NEDA investigators Tags: Pulmonary vascular disease Original Articles: Pulmonary hypertension Source Type: research

Long-term modulation of airway remodelling in severe asthma following bronchial thermoplasty
Conclusions Bronchial thermoplasty primarily affects airway smooth muscle and nerves with the effects still present at 12 months post-treatment. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Jendzjowsky, N., Laing, A., Malig, M., Matyas, J., de Heuvel, E., Dumonceaux, C., Dumoulin, E., Tremblay, A., Leigh, R., Chee, A., Kelly, M. M. Tags: Asthma and allergy Original Articles: Asthma Source Type: research

Evaluation of bronchial wall thickness in asthma using magnetic resonance imaging
Conclusions We have demonstrated that MRI-UTE is an accurate and reliable radiation-free method to assess bronchial wall dimensions in asthma, with enough spatial resolution to differentiate severe from non-severe asthma. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Benlala, I., Dournes, G., Girodet, P.-O., Benkert, T., Laurent, F., Berger, P. Tags: Lung imaging, Asthma and allergy Original Articles: Asthma and imaging Source Type: research

Characterisation of paediatric pulmonary hypertensive vascular disease from the PPHNet Registry
Background There are limited data about the range of diseases, natural history, age-appropriate end-points and optimal care for children with pulmonary hypertension (PH), including the need for developing high-quality patient registries of children with diverse forms of PH to enhance care and research. Our objective was to characterise the distribution and clinical features of diseases associated with paediatric PH, including natural history, evaluation, therapeutic interventions and outcomes, as defined by the World Symposium on Pulmonary Hypertension (WSPH) classification. Methods 1475 patients were enrolled into a mult...
Source: European Respiratory Journal - December 31, 2021 Category: Respiratory Medicine Authors: Abman, S. H., Mullen, M. P., Sleeper, L. A., Austin, E. D., Rosenzweig, E. B., Kinsella, J. P., Ivy, D., Hopper, R. K., Raj, J. U., Fineman, J., Keller, R. L., Bates, A., Krishnan, U. S., Avitabile, C. M., Davidson, A., Natter, M. D., Mandl, K. D., for th Tags: Pulmonary vascular disease, Paediatric pulmonology Original Articles: Pulmonary hypertension and paediatrics Source Type: research

Should diffusing capacity quality control be treated like other laboratory devices?
Diffusing capacity of the lung for carbon monoxide (DLCO) is an important pulmonary function test for the diagnosis and management of obstructive, restrictive and pulmonary vascular disease. The 2017 European Respiratory Society (ERS)/American Thoracic Society (ATS) standards for single-breath carbon monoxide uptake in the lungs recommends that a weekly DLCO simulation be performed with a calibrated 3-L syringe [1]. This type of simulation provides quality control values for both DLCO and alveolar volume (VA). After accounting for system dead space, an acceptable simulated VA is defined as 3±0.3 L (gas conditions at...
Source: European Respiratory Journal - December 23, 2021 Category: Respiratory Medicine Authors: Haynes, J. M., Ruppel, G. L., Kaminsky, D. A. Tags: Original Articles: Correspondence Source Type: research

Targeting AMPK and the Nrf2/HO-1 axis: a promising therapeutic strategy in acute lung injury
Acute lung injury (ALI) is defined as pulmonary conditions leading to severe hypoxaemia, with human acute respiratory distress syndrome (ARDS) representing its most severe manifestation [1]. The primary causes of ARDS are trauma, bacterial and viral pneumonia, sepsis and adverse drug reactions [2]. The development of effective therapeutics for ALI/ARDS remains an urgent unmet need [3]. The overall crude incidence of ALI from all sources has been estimated at 76.9 per 100 000 person-years (86.2 after age adjustment) [4]; or ~200 000 cases per year in the USA [1]. ALI is generally associated with endothelial and epithelial c...
Source: European Respiratory Journal - December 23, 2021 Category: Respiratory Medicine Authors: Ryter, S. W. Tags: Editorials Source Type: research

Saliva molecular testing for SARS-CoV-2: simplifying the diagnosis without losing accuracy
The possibility to rely on rapid and accurate diagnostic techniques has proved itself crucial during the past year to contain the spread of SARS-CoV-2 infection [1]. Even if quantitative RT-PCR (RT-qPCR) on nasopharyngeal swab (NPS) is still considered the standard for coronavirus disease 2019 (COVID-19) diagnosis, saliva has been evaluated in several studies as a possible alternative to NPS and is currently extensively utilised in South Korea, Germany and Japan [2, 3]. Nonetheless, the use of saliva is still debated, and a rigorous standardisation of the analysis protocol is greatly needed [4–6]. The application of ...
Source: European Respiratory Journal - December 23, 2021 Category: Respiratory Medicine Authors: Saluzzo, F., Mantegani, P., Poletti de Chaurand, V., Cugnata, F., Rovere-Querini, P., Cilla, M., Erba, P. P., Racca, S., Tresoldi, C., Uberti-Foppa, C., Di Serio, C., Cirillo, D. M. Tags: Original Articles: Research letters Source Type: research

Outcomes over the first two years of treatment with mepolizumab in severe asthma
Mepolizumab was the first anti-interleukin-5 (anti-IL-5) monoclonal antibody licensed for the treatment of severe asthma, recommended as add-on treatment in patients with frequent exacerbations or requiring maintenance oral corticosteroids (OCS) despite optimal inhaled therapy [1, 2]. In clinical trials it reduced exacerbation rates and OCS use, and improved lung function, asthma control and health-related quality of life over the first year of treatment [3–6]. Current guidance states that anti-IL-5 biologics should be continued long term if benefit is demonstrated over the first year, yet little is known about wheth...
Source: European Respiratory Journal - December 23, 2021 Category: Respiratory Medicine Authors: Elsey, L., Pantin, T., Holmes, L.-J., Tavernier, G., Fowler, S. J. Tags: Original Articles: Research letters Source Type: research

Evolution of CT findings after anticoagulant treatment for acute pulmonary embolism in patients with and without an ultimate diagnosis of chronic thromboembolic pulmonary hypertension
Conclusions Webs and tapered pulmonary arteries at the time of PE diagnosis strongly indicate a state of chronic PE and should raise awareness for possible CTEPH, particularly in patients with persistent dyspnoea after anticoagulant treatment for acute PE. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 23, 2021 Category: Respiratory Medicine Authors: Braams, N. J., Boon, G. J. A. M., de Man, F. S., van Es, J., den Exter, P. L., Kroft, L. J. M., Beenen, L. F. M., Huisman, M. V., Nossent, E. J., Boonstra, A., Vonk Noordegraaf, A., Ruigrok, D., Klok, F. A., Bogaard, H. J., Meijboom, L. J. Tags: Pulmonary vascular disease Original Articles: Pulmonary vascular disease Source Type: research