Mortality in interstitial lung disease: do race and skin colour matter?
In recent years, research surrounding health disparities has begun to focus more on the complex relationship between race, genetics and disease. Race has come to be recognised as an important factor, not only when discussing disparities and determining policy, but also in the diagnosis, approach and response to treatment. (Source: European Respiratory Journal)
Source: European Respiratory Journal - June 14, 2018 Category: Respiratory Medicine Authors: Morisset, J., Mageto, Y., Raghu, G. Tags: Editorials Source Type: research

The ageing brain in sleep apnoea: paradoxical resilience, survival of the fittest, or simply comparing apples and oranges?
The elevated prevalence of obstructive sleep apnoea (OSA) and its association with a long and ever expanding list of end-organ morbidities has prompted substantial interest in identifying mechanistic pathways underlying such deleterious consequences, and their potential reversibility with treatment. Over the last several decades, we have witnessed substantial increases in the granularity of the morbid phenotype of OSA, and such observations have prompted us to rethink some of the stricter early concepts. Among them, rather than viewing OSA as a single disease model that is applicable to all patients, we have formulated the...
Source: European Respiratory Journal - June 14, 2018 Category: Respiratory Medicine Authors: Gozal, D. Tags: Editorials Source Type: research

A multi-organ loss of tissue phenotype in COPD: involvement of the functional muscle-bone unit
In the ECLIPSE (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints) chronic obstructive pulmonary disease (COPD) cohort including 1817 men and women aged 40–75 years with full computed tomography (CT) data, Celli et al. [1] showed that emphysema progression was associated with loss of extrapulmonary tissues such as skeletal muscle and bone. I agree with the authors that identification of the patients they proposed to name a multi-organ loss of tissue (MOLT) COPD phenotype is important because of worse clinical outcomes [1] and would also like to point out that physical activity pla...
Source: European Respiratory Journal - June 14, 2018 Category: Respiratory Medicine Authors: Sugiyama, T. Tags: Original Articles: Correspondence Source Type: research

A harmonised European training syllabus for thoracic surgery: report from the ESTS/ERS task force group
As has been reported for respiratory medicine, a high variance exists among European countries in the content and modes of delivery for specialty training in thoracic surgery. According to a survey by the Union Européenne des Médecins Spécialistes (UEMS; European Union of Medical Specialists) section of thoracic surgery conducted in 2013, disparities begin at the certifying body level: the specialist diploma is delivered by the ministry of health in half of the countries, and by various other authorities in the remaining countries [1]. Additionally, the designation of the specialty differs considerably...
Source: European Respiratory Journal - June 14, 2018 Category: Respiratory Medicine Authors: Massard, G., Tabin, N., Mitchell, S., Batirel, H., Brunelli, A., Elia, S., Frick, A., Huertgen, M., Lerut, A., Molins, L., Papagiannopoulos, K., Subotic, D., van Schil, P., Varela, G., van Raemdonck, D. Tags: Editorials Source Type: research

Survival of patients with schistosomiasis-associated pulmonary arterial hypertension in the modern management era
Pulmonary arterial hypertension (PAH) is a life-threatening disease characterised by an elevated pulmonary vascular resistance in the absence of left ventricular disease, and increasing pulmonary artery pressure, with consequent right ventricular failure and death [1]. Several aetiologies have been associated with PAH, including connective tissue diseases, congenital heart diseases and chronic infections, such as HIV. Due to its high prevalence in developing countries, one of the most relevant forms of PAH worldwide is the one associated to schistosomiasis [2]. (Source: European Respiratory Journal)
Source: European Respiratory Journal - June 14, 2018 Category: Respiratory Medicine Authors: Fernandes, C. J. C., Piloto, B., Castro, M., Gavilanes Oleas, F., Alves, J. L., Lopes Prada, L. F., Jardim, C., Souza, R. Tags: Original Articles: Research letters Source Type: research

African-American race and mortality in interstitial lung disease: a multicentre propensity-matched analysis
We studied whether African-American race is associated with younger age and decreased survival time at diagnosis of interstitial lung disease (ILD). We performed a multicentre, propensity score-matched analysis of patients with an ILD diagnosis followed at five US hospitals between 2006 and 2016. African-Americans were matched with patients of other races based on a time-dependent propensity score calculated from multiple patient, physiological, diagnostic and hospital characteristics. Multivariable logistic regression models were used. All-cause mortality and hospitalisations were compared between race-stratified patient ...
Source: European Respiratory Journal - June 14, 2018 Category: Respiratory Medicine Authors: Adegunsoye, A., Oldham, J. M., Bellam, S. K., Chung, J. H., Chung, P. A., Biblowitz, K. M., Montner, S., Lee, C., Hsu, S., Husain, A. N., Vij, R., Mutlu, G., Noth, I., Churpek, M. M., Strek, M. E. Tags: Interstitial and orphan lung disease Original Articles: Interstitial lung diseases Source Type: research

Early experience with delamanid-containing regimens in the treatment of complicated multidrug-resistant tuberculosis in Hong Kong
Hong Kong is an intermediate tuberculosis (TB) burden region with a disease notification rate of 60.5 per 100 000 population in 2015. With the use of supervised treatment since 1970s and the use of drug susceptibility testing (DST) for guiding use of TB drugs for several decades [1], TB drug resistance rates in Hong Kong have declined and the multidrug-resistant (MDR)-TB rate has been kept at ~1%. Successful control of MDR-TB was partly attributable to judicious use of ofloxacin and later levofloxacin in the 1990s [2, 3], the introduction of linezolid in the 2000s [4] among patients with fluoroquinolone-resistant MDR-TB or...
Source: European Respiratory Journal - June 14, 2018 Category: Respiratory Medicine Authors: Chang, K.-C., Leung, E. C.-C., Law, W.-S., Leung, W.-M., Tai, L.-B., Lee, S.-N., Lam, F.-M., Chau, C.-H., Mok, T. Y.-W., Yew, W.-W., Leung, C.-C. Tags: Original Articles: Research letters Source Type: research

Delamanid for rifampicin-resistant tuberculosis: a retrospective study from South Africa
We report 12-month interim outcomes, sputum culture conversion (SCC) by months 2 and 6, serious adverse events (SAEs) and QT intervals corrected using the Frederica formula (QTcF). Overall, 103 patients were initiated on Dlm; 79 (77%) were HIV positive. The main indication for Dlm was intolerance to second-line anti-tuberculosis (TB) drugs (n=58, 56%). There were 12 months of follow-up for 46 patients; 28 (61%) had a favourable outcome (cure, treatment completion or culture negativity). Positive cultures were found for 57 patients at Dlm initiation; 16 out of 31 (52%) had SCC within 2 months and 25 out of 31...
Source: European Respiratory Journal - June 14, 2018 Category: Respiratory Medicine Authors: Mohr, E., Hughes, J., Reuter, A., Trivino Duran, L., Ferlazzo, G., Daniels, J., De Azevedo, V., Kock, Y., Steele, S. J., Shroufi, A., Ade, S., Alikhanova, N., Benedetti, G., Edwards, J., Cox, H., Furin, J., Isaakidis, P. Tags: Respiratory infections and tuberculosis Original Articles: Tuberculosis Source Type: research

Sleep apnoea in the asymptomatic elderly: a real issue for the brain?
The link between sleep apnoea and brain structure is unclear; although dysfunction of the hippocampus, middle temporal gyrus and brainstem/cerebellum have been observed previously. However, this link has been little explored in elderly subjects. The aim of this study was to explore the link between sleep apnoea and the brain in an elderly population. 226 asymptomatic elderly subjects (age mean±sd 75.3±0.9 years, range 72.3–77.8 years) from the PROOF (Evaluation of Ageing, Autonomic Nervous System Activity and Cardiovascular Events) cohort study were explored using linear voxel-based or cortical thi...
Source: European Respiratory Journal - June 14, 2018 Category: Respiratory Medicine Authors: Celle, S., Boutet, C., Annweiler, C., Barthelemy, J.-C., Roche, F. Tags: Sleep medicine Original Articles: Sleep Source Type: research

"Number needed to treat: enigmatic results for exacerbations in COPD." Samy Suissa. Eur Respir J 2015; 45: 875-878.
(Source: European Respiratory Journal)
Source: European Respiratory Journal - June 14, 2018 Category: Respiratory Medicine Tags: Author Correction Source Type: research

Is low level of vitamin D a marker of poor health, or a cause?
Vitamin D has long been recognised for its role in maintaining good skeletal health in both adults and children, including the rapid bone mineral accrual in infants, and prevention of rickets in children and osteomalacia in adults [1, 2]. Studies suggest that vitamin D, an essential hormone ingested from the diet (food and supplements) or synthesised in the skin when exposed to UV-B radiation, regulates calcium, phosphorous and bone metabolism, promotes skeletal muscle strength, inhibits cell proliferation, promotes cell differentiation, reduces inflammation, modulates the renin-angiotensin system, and influences glucose m...
Source: European Respiratory Journal - June 7, 2018 Category: Respiratory Medicine Authors: Kurmi, O. P. Tags: Editorial Source Type: research

Dysregulation of the "inflammatory reflex" with abnormal neurohumoral activation may contribute to proinflammatory activity driving the progression of COPD
We would like to thank S. Andreas for his interest in our study [1] and for the interesting comments. We agree with the insightful reasoning that subtle neurohormonal activation may be one of the explanations underlying the longitudinal association between subtle signs of cardiovascular autonomic dysfunction and higher risk of chronic obstructive pulmonary disease (COPD). In parallel to the findings in heart failure [2] and COPD [3], manifest clinical entities of cardiovascular autonomic dysfunction, such as orthostatic hypotension [4, 5] and postural orthostatic tachycardia syndrome [6], are all associated with clear...
Source: European Respiratory Journal - June 7, 2018 Category: Respiratory Medicine Authors: Ricci, F., Wollmer, P., Engström, G., Fedorowski, A., Hamrefors, V. Tags: Original Articles: Correspondence Source Type: research

The association of cardiovascular autonomic dysfunction and the prediction of COPD can be explained by neurohumoral activation
I read with great interest the recent work by Ricci et al. [1] published in the European Respiratory Journal. This insightful population-based study followed a very large cohort without baseline airflow obstruction for 32 years. Interestingly, baseline orthostatic blood pressure decrease, as well as increased resting heart rate, was associated with reduced lung function during follow-up. The authors consequently suggested that subtle signs of cardiovascular autonomic dysfunction may precede the development of chronic obstructive pulmonary disease (COPD). (Source: European Respiratory Journal)
Source: European Respiratory Journal - June 7, 2018 Category: Respiratory Medicine Authors: Andreas, S. Tags: Original Articles: Correspondence Source Type: research

Serum 25-hydroxyvitamin D levels and risk of lung cancer and histologic types: a Mendelian randomisation analysis of the HUNT study
We aimed to investigate potential causal associations between serum 25-hydroxyvitamin D (25(OH)D) levels and incidence of lung cancer overall and histologic types. We performed a Mendelian randomisation analysis using a prospective cohort study in Norway, including 54 580 individuals and 676 incident lung cancer cases. A 25(OH)D allele score was generated based on the vitamin D-increasing alleles rs2282679, rs12785878 and rs10741657. Hazard ratios with 95% confidence intervals for incidence of lung cancer and histologic types were estimated in relation to the allele score. The inverse-variance weighted method using summari...
Source: European Respiratory Journal - June 7, 2018 Category: Respiratory Medicine Authors: Sun, Y.-Q., Brumpton, B. M., Bonilla, C., Lewis, S. J., Burgess, S., Skorpen, F., Chen, Y., Nilsen, T. I. L., Romundstad, P. R., Mai, X.-M. Tags: Lung cancer Original Articles: Cancer Source Type: research

Risk factors for lung disease progression in children with cystic fibrosis
To identify potential risk factors for lung disease progression in children with cystic fibrosis (CF), we studied the longitudinal data of all children with CF (aged ≥5 years) registered in the Dutch CF Registry (2009–2014). Lung disease progression was expressed as a decline in lung function (forced expiratory volume in 1 s (FEV1) % pred) and pulmonary exacerbation rate. Potential risk factors at baseline included sex, age, best FEV1 % pred, best forced vital capacity % pred, genotype, body mass index z-score, pancreatic insufficiency, medication use (proton pump inhibitors (PPIs), prophylactic antibiot...
Source: European Respiratory Journal - June 7, 2018 Category: Respiratory Medicine Authors: van Horck, M., van de Kant, K., Winkens, B., Wesseling, G., Gulmans, V., Hendriks, H., van der Grinten, C., Jöbsis, Q., Dompeling, E. Tags: CF and non-CF bronchiectasis Original Articles: Paediatrics Source Type: research

Personalised CFTR pharmacotherapeutic response testing and therapy of cystic fibrosis
Cystic fibrosis (CF) is a fatal, multisystem, genetic disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR), a chloride transporter critical to luminal fluid homeostasis at respiratory airway and other ductal epithelial surfaces. Therapeutic options for some CF patients were transformed by the approval of ivacaftor and lumacaftor/ivacaftor, which are indicated, respectively, for patients heterozygous for a subset of rare class III mutations [1] or homozygous for the common class II mutation Phe508del [2]. Notwithstanding, more than 40% of CF patients do not meet the CFTR mutation-sp...
Source: European Respiratory Journal - June 7, 2018 Category: Respiratory Medicine Authors: McCarthy, C., Brewington, J. J., Harkness, B., Clancy, J. P., Trapnell, B. C. Tags: Original Articles: Research letters Source Type: research

Tobacco smoke exposure in early life and adolescence in relation to lung function
Maternal smoking during pregnancy is associated with impaired lung function among young children, but less is known about long-term effects and the impact of adolescents' own smoking. We investigated the influence of maternal smoking during pregnancy, secondhand smoke exposure and adolescent smoking on lung function at age 16 years. The BAMSE (Barn/Child, Allergy, Milieu, Stockholm, Epidemiology) birth cohort collected information on participants' tobacco smoke exposure through repeated questionnaires, and measured saliva cotinine concentrations at age 16 years. Participants performed spirometry and impulse oscillomet...
Source: European Respiratory Journal - June 7, 2018 Category: Respiratory Medicine Authors: Thacher, J. D., Schultz, E. S., Hallberg, J., Hellberg, U., Kull, I., Thunqvist, P., Pershagen, G., Gustafsson, P. M., Melen, E., Bergström, A. Tags: Asthma and allergy, Paediatric pulmonology Original Articles: Paediatrics Source Type: research

Nasopharingeal aspirate value in paediatric chronic lower respiratory tract illness
Respiratory viruses are a common cause of illness in children and are responsible for high morbidity and hospitalisation [1]. The role of infectious agents in chronic/recurrent lower respiratory tract illness (LRTI) is not clearly defined, whereas it is well known in acute forms and in exacerbation of respiratory diseases [2–4]. We have previously demonstrated a high frequency of viruses, particularly human rhinovirus (HRV), in children affected by chronic/recurrent LRTI whose bronchoalveolar lavage (BAL) showed changes in cellularity and inflammatory cytokines [5]. BAL is the gold standard for sensitive detection of...
Source: European Respiratory Journal - June 7, 2018 Category: Respiratory Medicine Authors: Lunardi, F., Vuljan, S. E., Perissinotto, E., Pezzuto, F., Malacrida, S., Bugin, S., Bertozzi, I., Snijders, D., Rizzo, S., Barbato, A., Calabrese, F. Tags: Original Articles: Research letters Source Type: research

Maternal age at delivery, lung function and asthma in offspring: a population-based survey
There is limited information about potential impact of maternal age on the respiratory health of offspring. We investigated the association of maternal age at delivery with adult offspring's lung function, respiratory symptoms and asthma, and potential differences according to offspring sex. 10 692 adults from 13 countries participating in the European Community Respiratory Health Survey (ECRHS) II responded to standardised interviews and provided lung function measurements and serum for IgE measurements at age 25–55 years. In logistic and linear multilevel mixed models we adjusted for participants’ charac...
Source: European Respiratory Journal - June 7, 2018 Category: Respiratory Medicine Authors: Gomez Real, F., Burgess, J. A., Villani, S., Dratva, J., Heinrich, J., Janson, C., Jarvis, D., Koplin, J., Leynaert, B., Lodge, C., Laerum, B. N., Matheson, M. C., Norbäck, D., Omenaas, E. R., Skulstad, S. M., Sunyer, J., Dharmage, S. C., Svanes, Tags: Asthma and allergy, Paediatric pulmonology Original Articles: Asthma Source Type: research

Making sense of telemedicine in the management of COPD
Exacerbations of chronic obstructive pulmonary disease (COPD) are important events with negative impact on health status, hospitalisations and readmissions, and disease progression [1]. Treatments aim at reducing the risk of exacerbations and complications such as hospital admissions. Although treatment strategies to prevent COPD exacerbations and their subsequent hospital admissions are still largely based on pharmacological therapies, the Global Initiative for Chronic Obstructive Lung Disease 2017 also recommended non-pharmacological treatment, such as self-management interventions with communication with a healthcare pr...
Source: European Respiratory Journal - May 30, 2018 Category: Respiratory Medicine Authors: Bourbeau, J., Farias, R. Tags: Editorials Source Type: research

Breathlessness measurement should be standardised for the level of exertion
We would like to thank M. Ekström and colleagues for their correspondence with comments on our article entitled "Effects of inspiratory muscle training on dyspnoea in severe COPD patients during pulmonary rehabilitation: a controlled randomised trial" [1]. We agree with most of the points underlined by M. Ekström and colleagues. (Source: European Respiratory Journal)
Source: European Respiratory Journal - May 30, 2018 Category: Respiratory Medicine Authors: Beaumont, M., Mialon, P., Couturaud, F. Tags: Original Articles: Correspondence Source Type: research

Long-term bedaquiline-related treatment outcomes in patients with extensively drug-resistant tuberculosis from South Africa
Optimal treatment regimens for patients with extensively drug-resistant tuberculosis (XDR-TB) remain unclear. Long-term prospective outcome data comparing XDR-TB regimens with and without bedaquiline from an endemic setting are lacking. We prospectively followed-up 272 South African patients (49.3% HIV-infected; median CD4 count 169 cells·µL–1) with newly diagnosed XDR-TB between 2008 and 2017. Outcomes were compared between those who had not received bedaquiline (pre-2013; n=204) and those who had (post-2013; n=68; 80.9% received linezolid in addition). The 24-month favourable outcome rate was subs...
Source: European Respiratory Journal - May 30, 2018 Category: Respiratory Medicine Authors: Olayanju, O., Limberis, J., Esmail, A., Oelofse, S., Gina, P., Pietersen, E., Fadul, M., Warren, R., Dheda, K. Tags: Respiratory infections and tuberculosis Original Articles: Tuberculosis Source Type: research

Breathlessness measurement should be standardised for the level of exertion
Beaumont et al. [1] and Schultz et al. [2] should be commended for evaluating the impact of inspiratory muscle training on clinically relevant outcomes in patients with chronic obstructive pulmonary disease (COPD). Chronic breathlessness [3] is a cardinal symptom in people with cardiopulmonary disease and an essential end-point for trials and clinical care. As discussed in one of the papers [1], there were limitations in that breathlessness was not measured at a standardised level of exertion. This limitation is commonly encountered in clinical trials and warrants wider attention. (Source: European Respiratory Journal)
Source: European Respiratory Journal - May 30, 2018 Category: Respiratory Medicine Authors: Ekström, M., Elmberg, V., Lindow, T., Wollmer, P. Tags: Original Articles: Correspondence Source Type: research

Efficacy and costs of telehealth for the management of COPD: the PROMETE II trial
Chronic obstructive pulmonary disease (COPD) is a significant and largely underdiagnosed cause of morbidity and mortality worldwide [1]. More long-term survivors with advanced disease have led to an ageing COPD population profile with an increased level of acute exacerbations, hospitalisations and polymorbidity [2]. (Source: European Respiratory Journal)
Source: European Respiratory Journal - May 30, 2018 Category: Respiratory Medicine Authors: Ancochea, J., Garcia-Rio, F., Vazquez-Espinosa, E., Hernando-Sanz, A., Lopez-Yepes, L., Galera-Martinez, R., Peces-Barba, G., Perez-Warnisher, M. T., Segrelles-Calvo, G., Zamarro, C., Gonzalez-Ponce, P., Ramos, M. I., Conforto, J. I., Jafri, S., Soriano, Tags: Original Articles: Research letters Source Type: research

Electronic cigarette use in youths: a position statement of the Forum of International Respiratory Societies
Children and adolescents are highly susceptible to nicotine addiction, which affects their brain development, even in those who smoke infrequently. Young people who become addicted to nicotine are at greater risk of becoming lifelong tobacco consumers. The use of nicotine-delivering electronic cigarettes has risen dramatically among youths worldwide. In addition to physical dependence, adolescents are susceptible to social and environmental influences to use electronic cigarettes. The product design, flavours, marketing, and perception of safety and acceptability have increased the appeal of electronic cigarettes to young ...
Source: European Respiratory Journal - May 30, 2018 Category: Respiratory Medicine Authors: Ferkol, T. W., Farber, H. J., La Grutta, S., Leone, F. T., Marshall, H. M., Neptune, E., Pisinger, C., Vanker, A., Wisotzky, M., Zabert, G. E., Schraufnagel, D. E., on behalf of the Forum of International Respiratory Societies Tags: Perspective Source Type: research

Nocturnal cerebral hypoxia in obstructive sleep apnoea: a randomised controlled trial
Cerebral hypoxia may promote cerebral damage in patients with obstructive sleep apnoea (OSA). We investigated whether OSA patients experience nocturnal cerebral hypoxia that is prevented by continuous positive airway pressure (CPAP). OSA patients using CPAP underwent sleep studies including pulse oximetry (arterial oxygen saturation (SpO2)) and near-infrared spectroscopy to monitor cerebral tissue oxygenation (CTO) at baseline and after 2 weeks on either subtherapeutic or therapeutic CPAP according to randomised allocation. Changes in oxygenation at end of the 2-week intervention were compared between groups. Among 21...
Source: European Respiratory Journal - May 30, 2018 Category: Respiratory Medicine Authors: Schwarz, E. I., Furian, M., Schlatzer, C., Stradling, J. R., Kohler, M., Bloch, K. E. Tags: Sleep medicine Original Articles: Sleep medicine Source Type: research

"Low prevalence of fluoroquinolone resistance among patients with tuberculosis in the Philippines: results of a national survey." Dodge R. Lim, Anna S. Dean, Mary Rosary Taguinod-Santiago, Angeli Borbe-Reyes, Andrea Maurizio Cabibbe, Matteo Zignol, Ramon P. Basilio, Anna Marie Celina Garfin and Maria Cecilia G. Ama. Eur Respir J 2018; 51: 1702571.
(Source: European Respiratory Journal)
Source: European Respiratory Journal - May 30, 2018 Category: Respiratory Medicine Tags: Author Correction Source Type: research

Low-dose computed tomography for the diagnosis of pneumonia in elderly patients: a prospective, interventional cohort study
The diagnosis of pneumonia is challenging. Our objective was to assess whether low-dose computed tomography (LDCT) modified the probability of diagnosing pneumonia in elderly patients. We prospectively included patients aged over 65 years with a suspicion of pneumonia treated with antimicrobial therapy (AT). All patients had a chest radiograph and LDCT within 72 h of inclusion. The treating clinician assessed the probability of pneumonia before and after the LDCT scan using a Likert scale. An adjudication committee retrospectively rated the probability of pneumonia and was considered as the reference for diagnosi...
Source: European Respiratory Journal - May 30, 2018 Category: Respiratory Medicine Authors: Prendki, V., Scheffler, M., Huttner, B., Garin, N., Herrmann, F., Janssens, J.-P., Marti, C., Carballo, S., Roux, X., Serratrice, C., Serratrice, J., Agoritsas, T., Becker, C. D., Kaiser, L., Rosset-Zufferey, S., Soulier, V., Perrier, A., Reny, J.-L., Mon Tags: Lung imaging Original Articles: Imaging Source Type: research

Reductions in dead space ventilation with nasal high flow depend on physiological dead space volume: metabolic hood measurements during sleep in patients with COPD and controls
Nasal high flow (NHF) reduces minute ventilation and ventilatory loads during sleep but the mechanisms are not clear. We hypothesised NHF reduces ventilation in proportion to physiological but not anatomical dead space. 11 subjects (five controls and six chronic obstructive pulmonary disease (COPD) patients) underwent polysomnography with transcutaneous carbon dioxide (CO2) monitoring under a metabolic hood. During stable non-rapid eye movement stage 2 sleep, subjects received NHF (20 L·min–1) intermittently for periods of 5–10 min. We measured CO2 production and calculated dead space ventilati...
Source: European Respiratory Journal - May 30, 2018 Category: Respiratory Medicine Authors: Biselli, P., Fricke, K., Grote, L., Braun, A. T., Kirkness, J., Smith, P., Schwartz, A., Schneider, H. Tags: COPD and smoking Original Articles: COPD Source Type: research

Pulmonary alveolar proteinosis and Mycobacterium abscessus lung infection related to ruxolitinib after allogeneic stem cell transplantation
Non-infectious pulmonary complications are frequent after allogeneic haematopoietic stem cell transplantation (HSCT). They mainly comprise bronchiolitis obliterans and interstitial pneumonia in the setting of chronic graft-versus-host disease (cGVHD) [1]. (Source: European Respiratory Journal)
Source: European Respiratory Journal - May 30, 2018 Category: Respiratory Medicine Authors: Salvator, H., Berti, E., Catherinot, E., Rivaud, E., Chabrol, A., Nguyen, S., Zemoura, L., Cardot, E., Tcherakian, C., Couderc, L.-J., on behalf of The Foch Hospital Lung Immune Deficiencies Study Group Tags: Original Articles: Research letters Source Type: research

Aminopeptidase antibodies in mesothelioma: new wine deserves new sacks
In this issue of the European Respiratory Journal, Otsuki et al. [1] postulate that antibody targeting of aminopeptidase N (APN)/CD13 by MT95-4 might be a potential therapeutic approach for malignant pleural mesothelioma (MPM). Aminopeptidases have several functions, but their main role is breakdown of small peptides [2]. However, aminopeptidases may also play a role in angiogenesis. Angiogenesis signalling is an important hallmark of solid cancer pathophysiology in general and MPM in particular [3]. Several mechanisms are involved in this process; one of the most important factors is the shedding by the tumour of the liga...
Source: European Respiratory Journal - May 24, 2018 Category: Respiratory Medicine Authors: van Meerbeeck, J. P., Jansen, G., Giovannetti, E., Peters, G. J. Tags: Lung cancer Editorials Source Type: research

Partitioning of pulmonary vascular resistances in group 2 pulmonary hypertension: insightful suggestions for bridging haemodynamics to underlying mechanisms
Haemodynamic profiling of group 2 pulmonary hypertension (PH) is constantly evolving, and poses a number of challenges in terms of diagnosis and staging [1]. Given that the haemodynamic signature of left-sided PH is the increased pulmonary arterial wedge pressure (PAWP) at rest (>15 mmHg) with a mean pulmonary arterial pressure (mPAP) ≥25 mmHg, some diagnostic uncertainty may occur when mPAP is elevated in the presence of a non-dilated left ventricular (LV) chamber with preserved LV ejection fraction and a PAWP at rest within the upper normal limit (range 12–15 mmHg) [2]. Mounting evidence sugges...
Source: European Respiratory Journal - May 24, 2018 Category: Respiratory Medicine Authors: Guazzi, M. Tags: Editorials Source Type: research

Blood eosinophil count and risk of pneumonia hospitalisations in individuals with COPD
Blood eosinophil count in chronic obstructive pulmonary disease (COPD) is associated with higher exacerbation rate and favourable response to corticosteroids; however, frequent exacerbations and use of inhaled corticosteroids could elevate pneumonia risk. We tested the hypothesis that high blood eosinophil counts are associated with high risk of pneumonia in individuals with severe COPD from the general population. We included 7180 individuals with COPD from the Copenhagen General Population Study, including 643 with forced expiratory volume in 1 s (FEV1)
Source: European Respiratory Journal - May 24, 2018 Category: Respiratory Medicine Authors: Vedel-Krogh, S., Nordestgaard, B. G., Lange, P., Vestbo, J., Nielsen, S. F. Tags: COPD and smoking Original Articles: COPD Source Type: research

Pharmacokinetics of tuberculosis drugs in HIV-infected patients from Irkutsk, Russian Federation: redefining drug activity
The Russian Federation has the third highest burden of multidrug-resistant (MDR) tuberculosis (TB) in the world, accounting for 10.5% of cases worldwide [1]. Management of the drug-resistant TB epidemic in the Siberian province of Irkutsk is further complicated by high rates of HIV co-infection [2], which leads to early mortality and risk for acquired Mycobacterium tuberculosis drug resistance [3]. Such poor treatment outcomes may be in part a consequence of pharmacokinetic variability rendering subtherapeutic drug concentrations [4–6]. Serum area under the concentration curve (AUC) is the pharmacokinetic parameter c...
Source: European Respiratory Journal - May 24, 2018 Category: Respiratory Medicine Authors: Lyles, G., Ogarkov, O., Zhdanova, S., Peloquin, C. A., Ebers, A., Pfaeffle, H., Al-Shaer, M. H., Moiseeva, E., Zorkaltseva, E., Koscheev, M., Houpt, E. R., Heysell, S. K. Tags: Original Articles: Research letters Source Type: research

In-depth haemodynamic phenotyping of pulmonary hypertension due to left heart disease
The commonest cause of pulmonary hypertension (PH) is left heart disease (LHD). The current classification system for definitions of PH-LHD is under review. We therefore performed prospective in-depth invasive haemodynamic phenotyping in order to assess the site of increased pulmonary vascular resistance (PVR) in PH-LHD subsets. Based on pulmonary artery occlusion waveforms yielding an estimate of the effective capillary pressure, we partitioned PVR in larger arterial (Rup, upstream resistance) and small arterial plus venous components (Rds, downstream resistance). In the case of small vessel disease, Rup decreases and Rds...
Source: European Respiratory Journal - May 24, 2018 Category: Respiratory Medicine Authors: Gerges, C., Gerges, M., Fesler, P., Pistritto, A. M., Konowitz, N. P., Jakowitsch, J., Celermajer, D. S., Lang, I. M. Tags: Pulmonary vascular disease Original Articles: Pulmonary vascular diseases Source Type: research

Comparing the use and timing of palliative care services in COPD and lung cancer: a population-based survey
Palliative care is a proven approach to enhance quality of life and care both for people with severe chronic obstructive pulmonary disease (COPD) [1] and those with lung cancer [2], and it is encouraged to start palliative care early in the disease trajectory [3, 4]. Similar symptoms occur in both diseases, such as pain, insomnia, fatigue, low mood and dyspnoea [5], with a study reporting even worse physical and emotional functioning for COPD than for lung cancer [6]. These symptoms signal palliative care needs [6], and require treatment focused on symptom management and psychosocial support for more than just the terminal...
Source: European Respiratory Journal - May 24, 2018 Category: Respiratory Medicine Authors: Scheerens, C., Beernaert, K., Pype, P., Cohen, J., Deliens, L., Chambaere, K. Tags: Original Articles: Research letters Source Type: research

In vitro, in silico and in vivo study challenges the impact of bronchial thermoplasty on acute airway smooth muscle mass loss
Bronchial thermoplasty is a treatment for asthma. It is currently unclear whether its histopathological impact is sufficiently explained by the proportion of airway wall that is exposed to temperatures necessary to affect cell survival. Airway smooth muscle and bronchial epithelial cells were exposed to media (37–70°C) for 10 s to mimic thermoplasty. In silico we developed a mathematical model of airway heat distribution post-thermoplasty. In vivo we determined airway smooth muscle mass and epithelial integrity pre- and post-thermoplasty in 14 patients with severe asthma. In vitro airway smooth muscle and ep...
Source: European Respiratory Journal - May 24, 2018 Category: Respiratory Medicine Authors: Chernyavsky, I. L., Russell, R. J., Saunders, R. M., Morris, G. E., Berair, R., Singapuri, A., Chachi, L., Mansur, A. H., Howarth, P. H., Dennison, P., Chaudhuri, R., Bicknell, S., Rose, F. R. A. J., Siddiqui, S., Brook, B. S., Brightling, C. E. Tags: Mechanisms of lung disease, Asthma and allergy Original Articles: Asthma Source Type: research

Aminopeptidase N/CD13 as a potential therapeutic target in malignant pleural mesothelioma
Angiogenesis is a crucial factor in the progression of malignant pleural mesothelioma (MPM) and antiangiogenic strategies might be effective against MPM. Aminopeptidase N (APN)/CD13 promotes tumour angiogenesis and is associated with poor prognosis; however, its clinical significance in MPM remains unclear. In 37 consecutive patients with surgically resected MPM, we evaluated the association between immunohistochemical APN/CD13 expression in resected tumours and survival. Additionally, the antitumour and antiangiogenic effects of MT95-4, a fully humanised anti-APN/CD13 monoclonal antibody, were evaluated in mice orthotopic...
Source: European Respiratory Journal - May 24, 2018 Category: Respiratory Medicine Authors: Otsuki, T., Nakashima, T., Hamada, H., Takayama, Y., Akita, S., Masuda, T., Horimasu, Y., Miyamoto, S., Iwamoto, H., Fujitaka, K., Miyata, Y., Miyake, M., Kohno, N., Okada, M., Hattori, N. Tags: Lung cancer Original Articles: Lung cancer Source Type: research

Cured bronchi! Extending the use of nebulised hypertonic saline outside of cystic fibrosis?
Plugging of the airways by excessive mucus is an important contributor to morbidity and mortality in chronic airway diseases (e.g. cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), bronchiectasis and primary ciliary dyskinesia (PCD)) [1]. Such findings are the basis for the major interest in drugs that reduce mucus content in airways by targeting mucus production [2] or by increasing clearance of mucus [3]. A single aerosol of hypertonic saline (HS) was shown to enhance clearance of airway secretions in humans>40 years ago [4], and a randomised control trial reported>10 years ago found tha...
Source: European Respiratory Journal - May 17, 2018 Category: Respiratory Medicine Authors: Martin, C., Regard, L., Burgel, P.-R. Tags: Lung biology and experimental studies, CF and non-CF bronchiectasis Editorials Source Type: research

What's in a name? That which we call IPF, by any other name would act the same
Idiopathic pulmonary fibrosis (IPF) remains a truly idiopathic fibrotic disease, with a modest genetic predilection and candidate triggers but no overall explanation for the development of disease in non-familial cases. Agreement on terminology has contributed to major clinical and translational advances since the millennium. It is likely that the entity currently captured by the term "IPF" will be radically reclassified over the next decade, either through "splitting" (into IPF subgroups responding selectively to individual disease-modifying agents) or through "lumping" of IPF with other form...
Source: European Respiratory Journal - May 17, 2018 Category: Respiratory Medicine Authors: Wells, A. U., Brown, K. K., Flaherty, K. R., Kolb, M., Thannickal, V. J., on behalf of the IPF Consensus Working Group Tags: Perspective Source Type: research

Use of Xpert MTB/RIF Ultra assays among paediatric tuberculosis experts in Europe
We read with interest the recent editorial by Cabibbe et al. [1], which highlights the importance of rapid molecular tuberculosis (TB) assays for patient care. (Source: European Respiratory Journal)
Source: European Respiratory Journal - May 17, 2018 Category: Respiratory Medicine Authors: Villanueva, P., Neth, O., Ritz, N., Tebruegge, M., on behalf of the Paediatric Tuberculosis Network European Trials Group Tags: Original Articles: Correspondence Source Type: research

Cough sensitivity to mannitol inhalation challenge identifies subjects with chronic cough
Cough is the most common reason why people seek medical attention [1]. Cough hypersensitivity syndrome (CHS) is a new concept to describe a condition with long-standing hypersensitivity of vagal afferent nerves or an alteration of the central processing of their input regardless of the underlying cause [2]. The current definition of CHS is purely clinical; however, a test capable of demonstrating this hypersensitivity both reliably and feasibly might be used as a diagnostic test for CHS. (Source: European Respiratory Journal)
Source: European Respiratory Journal - May 17, 2018 Category: Respiratory Medicine Authors: Koskela, H. O., Lake, C., Wong, K., Brannan, J. D. Tags: Original Articles: Research letters Source Type: research

The clinical significance of oropharyngeal cultures in young children with cystic fibrosis
In children with cystic fibrosis (CF) the associations between oropharyngeal swabs (OPSs) for detection of Pseudomonas and lung disease have not been evaluated. OPS and bronchoalveolar lavage (BAL) samples were obtained annually in children with CF from 2005 to 2017. OPS test characteristics were calculated using BAL as "gold standard". Results were related to lung inflammation (BAL neutrophil elastase and interleukin-8), structural lung disease (chest computed tomography PRAGMA-CF (Perth–Rotterdam Annotated Grid Morphometric Analysis for CF) scores), respiratory exacerbations and future detection of Pseudo...
Source: European Respiratory Journal - May 17, 2018 Category: Respiratory Medicine Authors: Breuer, O., Caudri, D., Akesson, L., Ranganathan, S., Stick, S. M., Schultz, A., on behalf of AREST CF Tags: CF and non-CF bronchiectasis, Paediatric pulmonology Original Articles: Cystic fibrosis Source Type: research

Lung cancer staging: a concise update
Diagnosis and clinical staging of lung cancer are fundamental to planning therapy. The techniques for clinical staging, i.e. anatomic and metabolic imaging, endoscopies and minimally invasive surgical procedures, should be performed sequentially and with an increasing degree of invasiveness. Intraoperative staging, assessing the magnitude of the primary tumour, the involved structures, and the loco-regional lymphatic spread by means of systematic nodal dissection, is essential in order to achieve a complete resection. In resected tumours, pathological staging, with the systematic study of the resected specimens, is the str...
Source: European Respiratory Journal - May 17, 2018 Category: Respiratory Medicine Authors: Rami-Porta, R., Call, S., Dooms, C., Obiols, C., Sanchez, M., Travis, W. D., Vollmer, I. Tags: Lung cancer Series Source Type: research

Gadofosveset-enhanced lung magnetic resonance imaging to detect ongoing vascular leak in pulmonary fibrosis
Vascular leak is a cardinal response to tissue injury [1, 2]. When dysregulated, vascular leak has been shown to contribute to the development of pulmonary fibrosis in the bleomycin mouse model [3]. Specifically targeting vascular endothelial growth factor, initially described as vascular permeability factor [4] and a key mediator regulating capillary permeability, attenuates the development of pulmonary fibrosis in vivo [5]. Gadofosveset (Ablavar; Lantheus Medical Imaging Inc., North Billerica, MA, USA) is a US Food and Drug Administration-approved, gadolinium-based, albumin-binding contrast agent. Gadofosveset has been u...
Source: European Respiratory Journal - May 17, 2018 Category: Respiratory Medicine Authors: Montesi, S. B., Rao, R., Liang, L. L., Goulart, H. E., Sharma, A., Digumarthy, S. R., Shea, B. S., Seethamraju, R. T., Caravan, P., Tager, A. M. Tags: Original Articles: Research letters Source Type: research

ERS/ECDC Statement: European Union standards for tuberculosis care, 2017 update
The International Standards for Tuberculosis Care define the essential level of care for managing patients who have or are presumed to have tuberculosis, or are at increased risk of developing the disease. The resources and capacity in the European Union (EU) and the European Economic Area permit higher standards of care to secure quality and timely TB diagnosis, prevention and treatment. On this basis, the European Union Standards for Tuberculosis Care (ESTC) were published in 2012 as standards specifically tailored to the EU setting. Since the publication of the ESTC, new scientific evidence has become available and, the...
Source: European Respiratory Journal - May 17, 2018 Category: Respiratory Medicine Authors: Migliori, G. B., Sotgiu, G., Rosales-Klintz, S., Centis, R., D'Ambrosio, L., Abubakar, I., Bothamley, G., Caminero, J. A., Cirillo, D. M., Dara, M., de Vries, G., Aliberti, S., Dinh-Xuan, A. T., Duarte, R., Midulla, F., Solovic, I., Subotic, D. R., Amicos Tags: Respiratory infections and tuberculosis Original Articles: ERS/ECDC statement Source Type: research

The in vitro effect of nebulised hypertonic saline on human bronchial epithelium
Inhaled hypertonic saline (HS) is an effective therapy for muco-obstructive lung diseases. However, the mechanism of action and principles pertinent to HS administration remain unclear. An in vitro system aerosolised HS to epithelial cells at rates comparable to in vivo conditions. Airway surface liquid (ASL) volume and cell height responses were measured by confocal microscopy under normal and hyperconcentrated mucus states. Aerosolised HS produced a rapid increase in ASL height and decrease in cell height. Added ASL volume was quickly reabsorbed following termination of nebulisation, although cell height did not recover ...
Source: European Respiratory Journal - May 17, 2018 Category: Respiratory Medicine Authors: Goralski, J. L., Wu, D., Thelin, W. R., Boucher, R. C., Button, B. Tags: Lung biology and experimental studies, CF and non-CF bronchiectasis Original Articles: Basic science Source Type: research

Optimising experimental research in respiratory diseases: an ERS statement
The objective of this task force was to issue a statement with research recommendations about lung disease models by facilitating in-depth discussions between respiratory scientists, and to provide an overview of the literature on the available models. Focus was put on their specific benefits and limitations. This will result in more efficient use of resources and greater reduction in the numbers of animals employed, thereby enhancing the ethical standards and translational capacity of experimental research. The task force statement addresses general issues of experimental research (ethics, species, sex, age, ex vivo and i...
Source: European Respiratory Journal - May 17, 2018 Category: Respiratory Medicine Authors: Bonniaud, P., Fabre, A., Frossard, N., Guignabert, C., Inman, M., Kuebler, W. M., Maes, T., Shi, W., Stampfli, M., Uhlig, S., White, E., Witzenrath, M., Bellaye, P.-S., Crestani, B., Eickelberg, O., Fehrenbach, H., Guenther, A., Jenkins, G., Joos, G., Mag Tags: Original Articles: ERS statement Source Type: research

Meta-analysis of airway epithelium gene expression in asthma
Differential gene expression in the airway epithelium of patients with asthma versus controls has been reported in several studies. However, there is no consensus on which genes are reproducibly affected in asthma. We sought to identify a consensus list of differentially expressed genes (DEGs) using a meta-analysis approach. We identified eight studies with data that met defined inclusion criteria. These studies comprised 355 cases and 193 controls and involved sampling either bronchial or nasal epithelium. We conducted study-level analyses, followed by a meta-analysis. Likewise, we applied a meta-analysis framework to the...
Source: European Respiratory Journal - May 17, 2018 Category: Respiratory Medicine Authors: Tsai, Y.-H., Parker, J. S., Yang, I. V., Kelada, S. N. P. Tags: Original Articles: Asthma Source Type: research

Are peripheral blood eosinophil counts a guideline for omalizumab treatment? STELLAIR says no!
Biologics for the treatment of severe asthma are assuming an ever expanding and important role to gain disease control when current therapeutics are not effective [1, 2]. Although the number of asthma patients with severe disease is relatively small, 10–15%, when compared to the overall prevalence of asthma, the burden of disease in this group is large from many perspectives including compromises to lifestyle, risks for recurrent and severe exacerbations, hospitalisations, unscheduled care needs, potential for adverse effects from medications, and medical costs. Therefore, severe asthma carries a dominant disease bur...
Source: European Respiratory Journal - May 10, 2018 Category: Respiratory Medicine Authors: Busse, W. W. Tags: Editorials Source Type: research