Impact of latent tuberculosis infection on health and wellbeing: a systematic review and meta-analysis
The impact of latent tuberculosis infection (LTBI) on health and wellbeing is not well understood. This review aims to evaluate the health and wellbeing of individuals with LTBI. A systematic literature search was performed to assess studies reporting patient-reported outcomes in LTBI management including health-related quality of life (HRQoL), health utilities, disease burden and experience of individuals with LTBI. A pooled analysis was performed to estimate the effect of LTBI on HRQoL. A total of 4464 studies were screened, of which 13 eligible articles describing nine unique studies were included for review. The HRQoL...
Source: European Respiratory Review - January 6, 2021 Category: Respiratory Medicine Authors: Wong, Y. J., Noordin, N. M., Keshavjee, S., Lee, S. W. H. Tags: Respiratory infections and tuberculosis Reviews Source Type: research

Chronic lung diseases: prospects for regeneration and repair
COPD and idiopathic pulmonary fibrosis (IPF) together represent a considerable unmet medical need, and advances in their treatment lag well behind those of other chronic conditions. Both diseases involve maladaptive repair mechanisms leading to progressive and irreversible damage. However, our understanding of the complex underlying disease mechanisms is incomplete; with current diagnostic approaches, COPD and IPF are often discovered at an advanced stage and existing definitions of COPD and IPF can be misleading. To halt or reverse disease progression and achieve lung regeneration, there is a need for earlier identificati...
Source: European Respiratory Review - January 6, 2021 Category: Respiratory Medicine Authors: Barnes, P. J., Anderson, G. P., Fageras, M., Belvisi, M. G. Tags: Mechanisms of lung disease Reviews Source Type: research

The clinical value of cardiopulmonary exercise testing in the modern era
This article belongs to the special series on the "Ventilatory efficiency and its clinical prognostic value in cardiorespiratory disorders", addressed to clinicians, physiologists and researchers, and aims at encouraging them to get acquainted with CPET in order to help and orient the clinical decision concerning individual patients. (Source: European Respiratory Review)
Source: European Respiratory Review - January 6, 2021 Category: Respiratory Medicine Authors: Laveneziana, P., Di Paolo, M., Palange, P. Tags: Mechanisms of lung disease Ventilatory efficiency and its clinical prognostic value in cardiorespiratory disorders Source Type: research

Bronchoscopic diagnosis and treatment of endobronchial carcinoid: case report and review of the literature
Carcinoid tumours are rare neuroendocrine neoplasms that mostly occur in younger adults with low tendencies to metastasise. Based on their histological characteristics, they are divided into typical and atypical subtypes. The most common presenting symptoms are due to central airway obstruction. The first step in the diagnostic assessment should be a computed tomography (CT) scan, as it provides information both for local tumour extent and lymph node involvement. Bronchoscopy is the main tool for histological confirmation, evaluation of bronchial wall invasion and removal of endobronchial manifestation with subsequent res...
Source: European Respiratory Review - January 6, 2021 Category: Respiratory Medicine Authors: Papaporfyriou, A., Domayer, J., Meilinger, M., Firlinger, I., Funk, G.-C., Setinek, U., Kostikas, K., Valipour, A. Tags: Lung cancer Reviews Source Type: research

Current developments and future directions in respiratory physiotherapy
Respiratory physiotherapists have a key role within the integrated care continuum of patients with respiratory diseases. The current narrative review highlights the profession's diversity, summarises the current evidence and practice, and addresses future research directions in respiratory physiotherapy. Herein, we describe an overview of the areas that respiratory physiotherapists can act in the integrated care of patients with respiratory diseases based on the Harmonised Education in Respiratory Medicine for European Specialists syllabus. In addition, we highlight areas in which further evidence needs to be gathered to c...
Source: European Respiratory Review - December 15, 2020 Category: Respiratory Medicine Authors: Rodrigues, A., Munoz Castro, G., Jacome, C., Langer, D., Parry, S. M., Burtin, C. Tags: Respiratory clinical practice ERS Early Career Member Committee Review Source Type: research

Prevalence and outcomes of pulmonary hypertension after percutaneous closure of atrial septal defect: a systematic review and meta-analysis
Conclusions Both PH prevalence and mean sPAP decrease after ASD closure. Larger, prospective studies with consistent PH definitions using the recommended measurement modality are warranted. (Source: European Respiratory Review)
Source: European Respiratory Review - December 15, 2020 Category: Respiratory Medicine Authors: Akseer, S., Horlick, E., Vishwanath, V., Hobbes, B., Huszti, E., Mak, S., Lee, D. S., Abrahamyan, L. Tags: Pulmonary vascular disease Reviews Source Type: research

Lung involvement in monogenic interferonopathies
Monogenic type I interferonopathies are inherited heterogeneous disorders characterised by early onset of systemic and organ specific inflammation, associated with constitutive activation of type I interferons (IFNs). In the last few years, several clinical reports identified the lung as one of the key target organs of IFN-mediated inflammation. The major pulmonary patterns described comprise children's interstitial lung diseases (including diffuse alveolar haemorrhages) and pulmonary arterial hypertension but diagnosis may be challenging. Respiratory symptoms may be either mild or absent at disease onset and variably asso...
Source: European Respiratory Review - December 15, 2020 Category: Respiratory Medicine Authors: Cazzato, S., Omenetti, A., Ravaglia, C., Poletti, V. Tags: Acute lung injury and critical care Rare genetic interstitial lung diseases Source Type: research

Current developments and future directions in COPD
The European Respiratory Society journals publish respiratory research and policy documents of the highest quality, offering a platform for the exchange and promotion of scientific knowledge. In this article, focusing on COPD, the third leading cause of death globally, we summarise novel research highlights focusing on the disease's underlying mechanisms, epidemiology and management, with the aim to inform and inspire respiratory clinicians and researchers. (Source: European Respiratory Review)
Source: European Respiratory Review - December 2, 2020 Category: Respiratory Medicine Authors: Mathioudakis, A. G., Vanfleteren, L. E. G. W., Lahousse, L., Higham, A., Allinson, J. P., Gotera, C., Visca, D., Singh, D., Spanevello, A. Tags: COPD and smoking ERS Early Career Member Committee Review Source Type: research

2-year survival among elderly hospitalised for acute respiratory infection versus hip fracture: a useful comparison to raise awareness
We read with great interest the article by Cillóniz et al. [1]. The authors nicely reported and discussed recent literature showing that pneumonia is a common lung infection that can be life-threatening, with particular concern for the elderly. Indeed, the annual incidences of hospitalisation for respiratory infections increase with age from 0.2% (for patients aged
Source: European Respiratory Review - December 2, 2020 Category: Respiratory Medicine Authors: Guillon, A., Mizgerd, J. P., Grammatico-Guillon, L. Tags: Correspondence Source Type: research

Early diagnosis of COPD: myth or a true perspective
The early stages of COPD have recently become a hot topic as many new risk factors have been proposed, but substantial knowledge gaps remain in explaining the natural history of the disease. If we are to modify the outcomes of COPD, early detection needs to play a critical role. However, we need to sort out the barriers to early detection and have a better understanding of the definition of COPD and its diagnosis and therapeutic strategies to identify and treat patients with COPD before structural changes progress. In this review, we aim to clarify the differences between early COPD, mild COPD and early detection of COPD, ...
Source: European Respiratory Review - December 2, 2020 Category: Respiratory Medicine Authors: Laucho-Contreras, M. E., Cohen-Todd, M. Tags: COPD and smoking Latin America Thoracic Society Series Source Type: research

Pulmonary alveolar microlithiasis
(PAM) is a fascinating rare lung disease that is associated with the accumulation of hydroxyapatite microliths within the lumen of the alveolar spaces. In most patients, PAM is discovered incidentally on radiographs performed for other purposes, and the typical disease course is characterised by slowly progressive respiratory insufficiency over decades. Recent genetic analyses that have revealed that the deficiency of the sodium-phosphate cotransporter NPT2B is the cause of PAM have enabled the development of powerful animal models that inform our approach to disease management and treatment. Here we review the epidemiolo...
Source: European Respiratory Review - November 27, 2020 Category: Respiratory Medicine Authors: Kosciuk, P., Meyer, C., Wikenheiser-Brokamp, K. A., McCormack, F. X. Tags: Interstitial and orphan lung disease Ultra-rare lung disease Source Type: research

Bacterial lysate therapy for the prevention of wheezing episodes and asthma exacerbations: a systematic review and meta-analysis
Wheezing and asthma are a growing cause of morbidity in children and adults. Treatment is aimed at prevention of disease exacerbations and preservation of lung function. Respiratory viruses are involved in ~40–60% of exacerbations. Bacterial lysates prevent recurrent respiratory tract infections and might reduce exacerbations. Moreover, immunomodulatory effects have been observed in human and animal studies. Here we aimed to assess the effects of bacterial lysate therapy on preschool wheezing episodes and asthma exacerbation frequency. We performed a systematic literature review based on the Preferred Reporting Item...
Source: European Respiratory Review - November 27, 2020 Category: Respiratory Medicine Authors: de Boer, G. M., Zołkiewicz, J., Strzelec, K. P., Ruszczynski, M., Hendriks, R. W., Braunstahl, G.-J., Feleszko, W., Tramper-Stranders, G. A. Tags: Asthma and allergy Reviews Source Type: research

Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis
This systematic review aimed to systematise the different designs used to deliver pulmonary rehabilitation during acute exacerbations of COPD (AECOPD) and explore which ones are the most effective. PubMed, Scopus, Web of Science, EBSCO and Cochrane were searched. Randomised controlled trials comparing pulmonary rehabilitation or at least one of its components with usual care or comparing different components of pulmonary rehabilitation were included. Network meta-analysis was conducted in MetaXL 5.3 using a generalised pairwise modelling framework. Pooled effects compared each treatment to usual care. 42 studies were incl...
Source: European Respiratory Review - November 18, 2020 Category: Respiratory Medicine Authors: Machado, A., Matos Silva, P., Afreixo, V., Caneiras, C., Burtin, C., Marques, A. Tags: COPD and smoking Reviews Source Type: research

Coinfection with Pseudomonas aeruginosa and Aspergillus fumigatus in cystic fibrosis
Conclusion A complex bi-directional relationship exists between P. aeruginosa and A. fumigatus, exhibiting both mutually antagonistic and cooperative facets. Cross-sectional data indicate a worsened disease state in coinfected patients; however, robust longitudinal studies are required to derive causality and to determine whether interspecies interaction contributes to disease progression. (Source: European Respiratory Review)
Source: European Respiratory Review - November 18, 2020 Category: Respiratory Medicine Authors: Keown, K., Reid, A., Moore, J. E., Taggart, C. C., Downey, D. G. Tags: CF and non-CF bronchiectasis Reviews Source Type: research

Therapeutic bronchoscopy for central airway diseases
Over the past century rigid bronchoscopy has been established as the main therapeutic means for central airway diseases of both benign and malignant aetiology. Its use requires general anaesthesia and mechanical ventilation usually in the form of manual or high-frequency jet ventilation. Techniques applied to regain patency of the central airways include mechanical debulking, thermal ablation (laser, electrocautery and argon plasma coagulation) and cryo-surgery. Each of these techniques have their advantages and limitations and best results can be attained by combining different modalities according to the type, location a...
Source: European Respiratory Review - November 18, 2020 Category: Respiratory Medicine Authors: Rosell, A., Stratakos, G. Tags: Respiratory clinical practice Interventional pulmonology Source Type: research

Chaotic activation of developmental signalling pathways drives idiopathic pulmonary fibrosis
Idiopathic pulmonary fibrosis (IPF) is characterised by an important remodelling of lung parenchyma. Current evidence indicates that the disease is triggered by alveolar epithelium activation following chronic lung injury, resulting in alveolar epithelial type 2 cell hyperplasia and bronchiolisation of alveoli. Signals are then delivered to fibroblasts that undergo differentiation into myofibroblasts. These changes in lung architecture require the activation of developmental pathways that are important regulators of cell transformation, growth and migration. Among others, aberrant expression of profibrotic Wnt-β-caten...
Source: European Respiratory Review - November 18, 2020 Category: Respiratory Medicine Authors: Froidure, A., Marchal-Duval, E., Homps-Legrand, M., Ghanem, M., Justet, A., Crestani, B., Mailleux, A. Tags: Pulmonary vascular disease Reviews Source Type: research

Extracellular matrix remodelling in COPD
The extracellular matrix (ECM) of the lung plays several important roles in lung function, as it offers a low resistant pathway that allows the exchange of gases, provides compressive strength and elasticity that supports the fragile alveolar–capillary intersection, controls the binding of cells with growth factors and cell surface receptors and acts as a buffer against retention of water. COPD is a chronic inflammatory respiratory condition, characterised by various conditions that result in progressive airflow limitation. At any stage in the course of the disease, acute exacerbations of COPD may occur and lead to a...
Source: European Respiratory Review - November 18, 2020 Category: Respiratory Medicine Authors: Karakioulaki, M., Papakonstantinou, E., Stolz, D. Tags: COPD and smoking Reviews Source Type: research

COVID-19 and COPD: a narrative review of the basic science and clinical outcomes
The 2019 coronavirus disease (COVID-19) pandemic is caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Clinical outcomes, including mortality, are worse in males, older individuals and patients with comorbidities. COPD patients are included in shielding strategies due to their susceptibility to virus-induced exacerbations, compromised pulmonary function and high prevalence of associated comorbidities. Using evidence from basic science and cohort studies, this review addresses key questions concerning COVID-19 and COPD. First, are there mechanisms by which COPD patients are more susceptible to SARS-CoV-...
Source: European Respiratory Review - November 5, 2020 Category: Respiratory Medicine Authors: Higham, A., Mathioudakis, A., Vestbo, J., Singh, D. Tags: COPD and smoking, Respiratory infections and tuberculosis Reviews Source Type: research

Health-related quality of life of patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis
This study also demonstrated that a diverse number of instruments are used to evaluate HRQoL. In view of this diversity, a standardised approach to measurement of HRQoL for IPF is important to ensure that comparisons made are reliable. (Source: European Respiratory Review)
Source: European Respiratory Review - November 5, 2020 Category: Respiratory Medicine Authors: Cox, I. A., Borchers Arriagada, N., de Graaff, B., Corte, T. J., Glaspole, I., Lartey, S., Walters, E. H., Palmer, A. J. Tags: Pulmonary vascular disease Reviews Source Type: research

Management of tracheo-oesophageal fistula in adults
Tracheo-oesophageal fistula (TOF) is a pathological connection between the trachea and the oesophagus that is associated with various underlying conditions including malignancies, infections, inhalation injuries and traumatic damage. As the condition spans multiple organ systems with varying aetiologies and acuities, TOF poses unique diagnostic and management challenges to pulmonologists, gastroenterologists and thoracic surgeons alike. Although stents have been a cornerstone in the management of TOF, there exists a large gap in our understanding of their efficacy and precise methodology, making stenting procedure both art...
Source: European Respiratory Review - November 5, 2020 Category: Respiratory Medicine Authors: Kim, H. S., Khemasuwan, D., Diaz-Mendoza, J., Mehta, A. C. Tags: Lung structure and function, Pulmonary pharmacology and therapeutics Reviews Source Type: research

Bronchoscopic treatment of inoperable nonsmall cell lung cancer
Patients with unresectable lung cancer range from those with early-stage or pre-invasive disease with comorbidities that preclude surgery to those with advanced stage disease in whom surgery is contraindicated. In such cases, a multidisciplinary approach to treatment is warranted, and may involve medical specialties including medical oncology, radiation oncology and interventional pulmonology. In this article we review bronchoscopic approaches to surgically unresectable lung cancer, including photodynamic therapy, brachytherapy, endoscopic ablation techniques and airway stenting. Current and past literature is reviewed to ...
Source: European Respiratory Review - November 5, 2020 Category: Respiratory Medicine Authors: Kniese, C. M., Musani, A. I. Tags: Lung cancer Interventional pulmonology Source Type: research

Meta-analysis on short-term exposure to ambient ultrafine particles and respiratory morbidity
Aim There is growing interest in the health effects following exposure to ambient particles with a diameter
Source: European Respiratory Review - October 28, 2020 Category: Respiratory Medicine Authors: Samoli, E., Rodopoulou, S., Schneider, A., Morawska, L., Stafoggia, M., Renzi, M., Breitner, S., Lanki, T., Pickford, R., Schikowski, T., Enembe, O., Zhang, S., Zhao, Q., Peters, A. Tags: Epidemiology, occupational and environmental lung disease Reviews Source Type: research

Exercise training for lung transplant candidates and recipients: a systematic review
Exercise intolerance and impaired quality of life (QoL) are characteristic of lung transplant candidates and recipients. This review investigated the effects of exercise training on exercise capacity, QoL and clinical outcomes in pre- and post-operative lung transplant patients. A systematic literature search of PubMed, Nursing and Allied Health, Cochrane (CENTRAL), Scopus and CINAHL databases was conducted from inception until February, 2020. The inclusion criteria were assessment of the impact of exercise training before or after lung transplantation on exercise capacity, QoL or clinical outcomes. 21 studies met the incl...
Source: European Respiratory Review - October 28, 2020 Category: Respiratory Medicine Authors: Hume, E., Ward, L., Wilkinson, M., Manifield, J., Clark, S., Vogiatzis, I. Tags: Respiratory clinical practice Reviews Source Type: research

Alveolar proteinosis of genetic origins
Pulmonary alveolar proteinosis (PAP) is a rare form of chronic interstitial lung disease, characterised by the intra-alveolar accumulation of lipoproteinaceous material. Numerous conditions can lead to its development. Whereas the autoimmune type is the main cause in adults, genetic defects account for a large part of cases in infants and children. Even if associated extra-respiratory signs may guide the clinician during diagnostic work-up, next-generation sequencing panels represent an efficient diagnostic tool. Exome sequencing also allowed the discovery of new variants and genes involved in PAP. The aim of this article ...
Source: European Respiratory Review - October 28, 2020 Category: Respiratory Medicine Authors: Hadchouel, A., Drummond, D., Abou Taam, R., Lebourgeois, M., Delacourt, C., de Blic, J. Tags: Interstitial and orphan lung disease Rare genetic interstitial lung diseases Source Type: research

The effects of lung volume reduction treatment on diffusing capacity and gas exchange
Lung volume reduction (LVR) treatment in patients with severe emphysema has been shown to have a positive effect on hyperinflation, expiratory flow, exercise capacity and quality of life. However, the effects on diffusing capacity of the lungs and gas exchange are less clear. In this review, the possible mechanisms by which LVR treatment can affect diffusing capacity of the lung for carbon monoxide (DLCO) and arterial gas parameters are discussed, the use of DLCO in LVR treatment is evaluated and other diagnostic techniques reflecting diffusing capacity and regional ventilation (V')/perfusion (Q') mismatch are considered....
Source: European Respiratory Review - October 28, 2020 Category: Respiratory Medicine Authors: van Dijk, M., Klooster, K., Ten Hacken, N. H. T., Sciurba, F., Kerstjens, H. A. M., Slebos, D.-J. Tags: Lung structure and function Reviews Source Type: research

The promise of mTOR as a therapeutic target pathway in idiopathic pulmonary fibrosis
Idiopathic pulmonary fibrosis (IPF) is characterised by the progressive deposition of excessive extracellular matrix proteins within the lung parenchyma and represents the most rapidly progressive and fatal of all fibrotic conditions. Current anti-fibrotic drugs approved for the treatment of IPF fail to halt disease progression and have significant side-effect profiles. Therefore, there remains a pressing need to develop novel therapeutic strategies for IPF. Mammalian target of rapamycin (mTOR) forms the catalytic subunit of two complexes, mTORC1 and mTORC2. mTORC1 acts as critical cellular sensor which integrates intracel...
Source: European Respiratory Review - October 15, 2020 Category: Respiratory Medicine Authors: Plate, M., Guillotin, D., Chambers, R. C. Tags: Pulmonary vascular disease Mini review Source Type: research

The fog, the attractive and the addictive: pulmonary effects of vaping with a focus on the contribution of each major vaping liquid constituent
Vaping has become increasingly popular over the past decade. This pragmatic review presents the published biological effects of electronic cigarette vapour inhalation with a focus on the pulmonary effects. Special attention has been devoted to providing the documented effects specific to each major ingredient, namely propylene glycol/glycerol, nicotine and flavouring agents. For each ingredient, findings are divided according to the methodology used, being in vitro studies, animal studies and clinical studies. Finally, we provide thoughts and insights on the current state of understanding of the pulmonary effects of vaping...
Source: European Respiratory Review - October 15, 2020 Category: Respiratory Medicine Authors: Lechasseur, A., Morissette, M. C. Tags: COPD and smoking Assembly 3 reviews Source Type: research

Lung regeneration: implications of the diseased niche and ageing
Most chronic and acute lung diseases have no cure, leaving lung transplantation as the only option. Recent work has improved our understanding of the endogenous regenerative capacity of the lung and has helped identification of different progenitor cell populations, as well as exploration into inducing endogenous regeneration through pharmaceutical or biological therapies. Additionally, alternative approaches that aim at replacing lung progenitor cells and their progeny through cell therapy, or whole lung tissue through bioengineering approaches, have gained increasing attention. Although impressive progress has been made,...
Source: European Respiratory Review - October 15, 2020 Category: Respiratory Medicine Authors: Melo-Narvaez, M. C., Stegmayr, J., Wagner, D. E., Lehmann, M. Tags: Mechanisms of lung disease Assembly 3 reviews Source Type: research

Mitochondrial dysfunction in lung ageing and disease
Mitochondrial biology has seen a surge in popularity in the past 5 years, with the emergence of numerous new avenues of exciting mitochondria-related research including immunometabolism, mitochondrial transplantation and mitochondria-microbe biology. Since the early 1960s mitochondrial dysfunction has been observed in cells of the lung in individuals and in experimental models of chronic and acute respiratory diseases. However, it is only in the past decade with the emergence of more sophisticated tools and methodologies that we are beginning to understand how this enigmatic organelle regulates cellular homeostasis an...
Source: European Respiratory Review - October 15, 2020 Category: Respiratory Medicine Authors: Cloonan, S. M., Kim, K., Esteves, P., Trian, T., Barnes, P. J. Tags: Lung structure and function Lung Science Conference Source Type: research

Guidance production before evidence generation for critical issues: the example of COVID-19
The coronavirus disease 2019 (COVID-19) pandemic has inflicted a considerable pressure on populations, healthcare systems and community organisations worldwide, due to the fast spread of the disease and its huge global burden of morbidity and mortality, healthcare resource consumption, and societal and economic implications [1]. (Source: European Respiratory Review)
Source: European Respiratory Review - October 4, 2020 Category: Respiratory Medicine Authors: Roche, N., Tonia, T., Bush, A., Brightling, C., Kolb, M., Dinh-Xuan, A. T., Humbert, M., Simonds, A., Adir, Y. Tags: Respiratory infections and tuberculosis Editorial Source Type: research

Updated guidance on the management of COVID-19: from an American Thoracic Society/European Respiratory Society coordinated International Task Force (29 July 2020)
Conclusions The Task Force addressed questions related to pharmacotherapy in patients with COVID-19 and the post-hospital care of survivors, yielding several consensus suggestions. Management options for which there is insufficient agreement to formulate a suggestion represent research priorities. (Source: European Respiratory Review)
Source: European Respiratory Review - October 4, 2020 Category: Respiratory Medicine Authors: Bai, C., Chotirmall, S. H., Rello, J., Alba, G. A., Ginns, L. C., Krishnan, J. A., Rogers, R., Bendstrup, E., Burgel, P.-R., Chalmers, J. D., Chua, A., Crothers, K. A., Duggal, A., Kim, Y. W., Laffey, J. G., Luna, C. M., Niederman, M. S., Raghu, G., Ramir Tags: Respiratory infections and tuberculosis Reviews Source Type: research

Targeting coagulation activation in severe COVID-19 pneumonia: lessons from bacterial pneumonia and sepsis
Novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has rapidly spread throughout the world, resulting in a pandemic with high mortality. There are no effective treatments for the management of severe COVID-19 and current therapeutic trials are focused on antiviral therapy and attenuation of hyper-inflammation with anti-cytokine therapy. Severe COVID-19 pneumonia shares some pathological similarities with severe bacterial pneumonia and sepsis. In particular, it disrupts the haemostatic balance, which results in a procoagulant state locally in the lungs and syst...
Source: European Respiratory Review - September 30, 2020 Category: Respiratory Medicine Authors: Jose, R. J., Williams, A., Manuel, A., Brown, J. S., Chambers, R. C. Tags: Respiratory infections and tuberculosis Reviews Source Type: research

Early origins of lung disease: towards an interdisciplinary approach
The prenatal and perinatal environments can have profound effects on the development of chronic inflammatory diseases. However, mechanistic insight into how the early-life microenvironment can impact upon development of the lung and immune system and consequent initiation and progression of respiratory diseases is still emerging. Recent studies investigating the developmental origins of lung diseases have started to delineate the effects of early-life changes in the lung, environmental exposures and immune maturation on the development of childhood and adult lung diseases. While the influencing factors have been described ...
Source: European Respiratory Review - September 30, 2020 Category: Respiratory Medicine Authors: Ubags, N. D. J., Alejandre Alcazar, M. A., Kallapur, S. G., Knapp, S., Lanone, S., Lloyd, C. M., Morty, R. E., Pattaroni, C., Reynaert, N. L., Rottier, R. J., Smits, H. H., de Steenhuijsen Piters, W. A. A., Strickland, D. H., Collins, J. J. P. Tags: Mechanisms of lung disease Assembly 3 review Source Type: research

The integrated stress response in pulmonary disease
The respiratory tract and its resident immune cells face daily exposure to stress, both from without and from within. Inhaled pathogens, including severe acute respiratory syndrome coronavirus 2, and toxins from pollution trigger a cellular defence system that reduces protein synthesis to minimise viral replication or the accumulation of misfolded proteins. Simultaneously, a gene expression programme enhances antioxidant and protein folding machineries in the lung. Four kinases (PERK, PKR, GCN2 and HRI) sense a diverse range of stresses to trigger this "integrated stress response". Here we review recent advances ...
Source: European Respiratory Review - September 30, 2020 Category: Respiratory Medicine Authors: Emanuelli, G., Nassehzadeh-Tabriz, N., Morrell, N. W., Marciniak, S. J. Tags: Pulmonary vascular disease Assembly 3 review Source Type: research

Artificial intelligence in pulmonary medicine: computer vision, predictive model and COVID-19
Artificial intelligence (AI) is transforming healthcare delivery. The digital revolution in medicine and healthcare information is prompting a staggering growth of data intertwined with elements from many digital sources such as genomics, medical imaging and electronic health records. Such massive growth has sparked the development of an increasing number of AI-based applications that can be deployed in clinical practice. Pulmonary specialists who are familiar with the principles of AI and its applications will be empowered and prepared to seize future practice and research opportunities. The goal of this review is to prov...
Source: European Respiratory Review - September 30, 2020 Category: Respiratory Medicine Authors: Khemasuwan, D., Sorensen, J. S., Colt, H. G. Tags: Lung biology and experimental studies, Respiratory infections and tuberculosis Reviews Source Type: research

Metabolism in tumour-associated macrophages: a quid pro quo with the tumour microenvironment
Lung cancer is the leading cause of death from cancer worldwide. Recent studies demonstrated that the tumour microenvironment (TME) is pivotal for tumour progression, providing multiple targeting opportunities for therapeutic strategies. As one of the most abundant stromal cell types in the TME, tumour-associated macrophages (TAMs) exhibit high plasticity. Malignant cells alter their metabolic profiles to adapt to the limited availability of oxygen and nutrients in the TME, resulting in functional alteration of TAMs. The metabolic features of TAMs are strongly associated with their functional plasticity, which further impa...
Source: European Respiratory Review - September 30, 2020 Category: Respiratory Medicine Authors: Zheng, X., Mansouri, S., Krager, A., Grimminger, F., Seeger, W., Pullamsetti, S. S., Wheelock, C. E., Savai, R. Tags: Mechanisms of lung disease Lung Science Conference Source Type: research

Respiratory muscle senescence in ageing and chronic lung diseases
Ageing is a progressive condition that usually leads to the loss of physiological properties. This process is also present in respiratory muscles, which are affected by both senescent changes occurring in the whole organism and those that are more specific for muscles. The mechanisms of the latter changes include oxidative stress, decrease in neurotrophic factors and DNA abnormalities. Ageing normally coexists with comorbidities, including respiratory diseases, which further deteriorate the structure and function of respiratory muscles. In this context, changes intrinsic to ageing become enhanced by more specific factors s...
Source: European Respiratory Review - September 16, 2020 Category: Respiratory Medicine Authors: Gea, J., Ausin, P., Martinez-Llorens, J. M., Barreiro, E. Tags: Lung structure and function Lung Science Conference Source Type: research

Birt-Hogg-Dube syndrome
Birt–Hogg–Dubé syndrome (BHD) is a rare inherited autosomal dominant disorder caused by germline mutations in the tumour suppressor gene FLCN, encoding the protein folliculin. Its clinical expression typically includes multiple pulmonary cysts, recurrent spontaneous pneumothoraces, cutaneous fibrofolliculomas and renal tumours of various histological types. BHD has no sex predilection and tends to manifest in the third or fourth decade of life. Multiple bilateral pulmonary cysts are found on chest computed tomography in>80% of patients and more than half experience one or more episodes of pneumothorax...
Source: European Respiratory Review - September 16, 2020 Category: Respiratory Medicine Authors: Daccord, C., Good, J.-M., Morren, M.-A., Bonny, O., Hohl, D., Lazor, R. Tags: Genetics Rare genetic interstitial lung diseases Source Type: research

Recent developments in advanced diagnostic bronchoscopy
The field of bronchoscopy is advancing rapidly. Minimally invasive diagnostic approaches are replacing more aggressive surgical ones for the diagnosis and staging of lung cancer. Evolving diagnostic modalities allow early detection and serve as an adjunct to early treatment, ideally influencing patient outcomes. In this review, we will elaborate on recent bronchoscopic developments as well as some promising investigational tools and approaches in development. We aim to offer a concise overview of the significant advances in the field of advanced bronchoscopy and to put them into clinical context. We will also address poten...
Source: European Respiratory Review - September 1, 2020 Category: Respiratory Medicine Authors: Chandrika, S., Yarmus, L. Tags: Respiratory clinical practice Interventional pulmonology Source Type: research

Ultra-rare cystic disease
This article focuses on lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis and Erdheim–Chester disease, Birt–Hogg–Dubé, follicular bronchiolitis and lymphocytic interstitial pneumonia, light-chain deposition disease and amyloidosis, congenital lung disease associated with aberrant lung development and growth, and cystic lung disease associated with neoplastic lesion. These cystic diseases are epidemiologically considered as ultra-rare conditions as they affect fewer than one individual per 50 000 or fewer than 20 individuals per million. Despite the rarity of this group of disorders,...
Source: European Respiratory Review - September 1, 2020 Category: Respiratory Medicine Authors: Elia, D., Torre, O., Cassandro, R., Caminati, A., Harari, S. Tags: Interstitial and orphan lung disease Ultra-rare lung disease Source Type: research

Primary lung neoplasms presenting as multiple synchronous lung nodules
Multiple synchronous lung nodules are frequently encountered on computed tomography (CT) scanning of the chest and are most commonly either non-neoplastic or metastases from a known primary malignancy. The finding may initiate a search for primary malignancy elsewhere in the body. An exception to this rule, however, is a class of rare primary lung neoplasms that originate from epithelial (pneumocytes and neuroendocrine), mesenchymal (vascular and meningothelial) and lymphoid tissues of the lung. While these rare neoplasms also present as multiple synchronous unilateral or bilateral lung nodules on chest CT, they are often ...
Source: European Respiratory Review - September 1, 2020 Category: Respiratory Medicine Authors: Ghosh, S., Mehta, A. C., Abuquyyas, S., Raju, S., Farver, C. Tags: Lung cancer Reviews Source Type: research

Exhaled air dispersion and use of oronasal masks with continuous positive airway pressure during COVID-19
We applaud Ferioli et al. [1] for their review of practical measures that can be taken to help protect healthcare workers from severe acute respiratory syndrome-coronavirus-2 infection. We urge caution in interpreting data from table 1, which lists maximum air dispersion distance with a variety of oxygen administration and ventilatory support strategies. Reporting that continuous positive airway pressure (CPAP) via oronasal mask at 20 cmH2O has negligible air dispersion is potentially misleading. Much of the data from this table is derived from a series of studies by Hui and co-workers [2–5], in which a human pa...
Source: European Respiratory Review - August 17, 2020 Category: Respiratory Medicine Authors: Sullivan, S. S., Gurubhagavatula, I., for the Public Safety Committee of the American Academy of Sleep Medicine Tags: Respiratory infections and tuberculosis Correspondence Source Type: research

Fibrotic interstitial lung diseases and air pollution: a systematic literature review
Conclusions This systematic review provides supporting evidence linking exposure to air pollution to poor outcomes in patients with IPF and fibrotic ILD. (Source: European Respiratory Review)
Source: European Respiratory Review - August 17, 2020 Category: Respiratory Medicine Authors: Harari, S., Raghu, G., Caminati, A., Cruciani, M., Franchini, M., Mannucci, P. Tags: Epidemiology, occupational and environmental lung disease Reviews Source Type: research

Management of chronic respiratory complications in children and adolescents with sickle cell disease
Sickle cell disease (SCD) is a life-threatening hereditary blood disorder that affects millions of people worldwide, especially in sub-Saharan Africa. This condition has a multi-organ involvement and highly vascularised organs, such as the lungs, are particularly affected. Chronic respiratory complications of SCD involve pulmonary vascular, parenchymal and airways alterations. A progressive decline of lung function often begins in childhood. Asthma, sleep-disordered breathing and chronic hypoxaemia are common and associated with increased morbidity. Pulmonary hypertension is a serious complication, more common in adults th...
Source: European Respiratory Review - August 17, 2020 Category: Respiratory Medicine Authors: Arigliani, M., Gupta, A. Tags: Paediatric pulmonology Reviews Source Type: research

Lung complications of Sjogren syndrome
Primary Sjogren syndrome (pSS) is a systemic autoimmune disease characterised by lymphocytic infiltration of exocrine glands and by a number of systemic manifestations, including those regarding the lung. Pulmonary involvement in pSS includes interstitial lung disease (ILD) and airway disease, together with lymphoproliferative disorders. Patients with pSS-ILD report impaired health-related quality of life and a higher risk of death, suggesting the importance of early diagnosis and treatment of this type of pulmonary involvement. In contrast, airway disease usually has little effect on respiratory function and is rarely the...
Source: European Respiratory Review - August 17, 2020 Category: Respiratory Medicine Authors: Luppi, F., Sebastiani, M., Sverzellati, N., Cavazza, A., Salvarani, C., Manfredi, A. Tags: Interstitial and orphan lung disease Reviews Source Type: research

Artificial intelligence in thoracic surgery: past, present, perspective and limits
The objective of this article is to review applications of AI related to thoracic surgery and discuss the limits of its application in the European Union. Key aspects of AI will be developed through clinical pathways, beginning with diagnostics for lung cancer, a prognostic-aided programme for decision making, then robotic surgery, and finishing with the limitations of AI, the legal and ethical issues relevant to medicine. It is important for physicians and surgeons to have a basic knowledge of AI to understand how it impacts healthcare, and to consider ways in which they may interact with this technology. Indeed, synergy ...
Source: European Respiratory Review - August 17, 2020 Category: Respiratory Medicine Authors: Etienne, H., Hamdi, S., Le Roux, M., Camuset, J., Khalife-Hocquemiller, T., Giol, M., Debrosse, D., Assouad, J. Tags: Pulmonary pharmacology and therapeutics Reviews Source Type: research

Is ventilated hospital-acquired pneumonia a worse entity than ventilator-associated pneumonia?
Conclusion Nosocomial pneumonia is a multifaced disease with features of pivotal interest in critical care medicine. Due to the worrisome data on mortality of patients with nosocomial pneumonia, further prospective studies focused on this topic are urgently needed. (Source: European Respiratory Review)
Source: European Respiratory Review - August 3, 2020 Category: Respiratory Medicine Authors: Vallecoccia, M. S., Dominedo, C., Cutuli, S. L., Martin-Loeches, I., Torres, A., De Pascale, G. Tags: Respiratory infections and tuberculosis Reviews Source Type: research

"Desquamative interstitial pneumonia: a systematic review of its features and outcomes." Merel E. Hellemons, Catharina C. Moor, Jan von der Thüsen, Mariska Rossius, Arlette Odink, Laila Haugen Thorgersen, Johny Verschakelen, Wim Wuyts, Marlies S. Wijsenbeek and Elisabeth Bendstrup. Eur Respir Rev 2020; 29: 190181.
(Source: European Respiratory Review)
Source: European Respiratory Review - August 3, 2020 Category: Respiratory Medicine Tags: Author correction Source Type: research

Prognosis of idiopathic pulmonary fibrosis without anti-fibrotic therapy: a systematic review
In addition to facilitating healthcare delivery planning, reliable information about prognosis is essential for treatment decisions in patients with idiopathic pulmonary fibrosis (IPF). This review aimed to evaluate the prognosis of patients with IPF without anti-fibrotic therapy. We included all cohort studies and the placebo arms of randomised controlled trials (RCTs) in IPF and follow-up of ≥12 months. Two reviewers independently evaluated studies for inclusion, assessed risk of bias and extracted data. A total of 154 cohort studies and 16 RCTs were included. The pooled proportions of mortality were 0.12 (95% CI...
Source: European Respiratory Review - August 3, 2020 Category: Respiratory Medicine Authors: Khor, Y. H., Ng, Y., Barnes, H., Goh, N. S. L., McDonald, C. F., Holland, A. E. Tags: Pulmonary vascular disease Reviews Source Type: research

Airway mechanical compression: its role in asthma pathogenesis and progression
The lung is a mechanically active organ, but uncontrolled or excessive mechanical forces disrupt normal lung function and can contribute to the development of disease. In asthma, bronchoconstriction leads to airway narrowing and airway wall buckling. A growing body of evidence suggests that pathological mechanical forces induced by airway buckling alone can perpetuate disease processes in asthma. Here, we review the data obtained from a variety of experimental models, including in vitro, ex vivo and in vivo approaches, which have been used to study the impact of mechanical forces in asthma pathogenesis. We review the evide...
Source: European Respiratory Review - August 3, 2020 Category: Respiratory Medicine Authors: Veerati, P. C., Mitchel, J. A., Reid, A. T., Knight, D. A., Bartlett, N. W., Park, J.-A., Grainge, C. L. Tags: Asthma and allergy Reviews Source Type: research