The prevalence and related factors of fatigue in patients with COPD: a systematic review
Conclusions Fatigue is a prevalent symptom in patients with COPD. Multiple physical and psychological factors seem to be associated with fatigue. Future studies are needed to evaluate these underlying factors in integral analyses in samples of patients with COPD. (Source: European Respiratory Review)
Source: European Respiratory Review - April 13, 2021 Category: Respiratory Medicine Authors: Ebadi, Z., Goërtz, Y. M. J., Van Herck, M., Janssen, D. J. A., Spruit, M. A., Burtin, C., Thong, M. S. Y., Muris, J., Otker, J., Looijmans, M., Vlasblom, C., Bastiaansen, J., Prins, J., Wouters, E. F. M., Vercoulen, J. H., Peters, J. B. Tags: COPD and smoking Reviews Source Type: research

Exercise intolerance in pulmonary arterial hypertension: insight into central and peripheral pathophysiological mechanisms
Exercise intolerance is a cardinal symptom of pulmonary arterial hypertension (PAH) and strongly impacts patients' quality of life (QoL). Although central cardiopulmonary impairments limit peak oxygen consumption (V'O2peak) in patients with PAH, several peripheral abnormalities have been described over the recent decade as key determinants in exercise intolerance, including impaired skeletal muscle (SKM) morphology, convective O2 transport, capillarity and metabolism indicating that peripheral abnormalities play a greater role in limiting exercise capacity than previously thought. More recently, cerebrovascular alterations...
Source: European Respiratory Review - April 13, 2021 Category: Respiratory Medicine Authors: Malenfant, S., Lebret, M., Breton-Gagnon, E., Potus, F., Paulin, R., Bonnet, S., Provencher, S. Tags: Pulmonary vascular disease Reviews Source Type: research

Minute ventilation/carbon dioxide production in patients with dysfunctional breathing
Dysfunctional breathing refers to a multi-dimensional condition that is characterised by pathological changes in an individual's breathing. These changes lead to a feeling of breathlessness and include alterations in the biomechanical, psychological and physiological aspects of breathing. This makes dysfunctional breathing a hard condition to diagnose, given the diversity of aspects that contribute to the feeling of breathlessness. The disorder can debilitate individuals without any health problems, but may also be present in those with underlying cardiopulmonary co-morbidities. The ventilatory equivalent for CO2 (VeqCO2) ...
Source: European Respiratory Review - April 13, 2021 Category: Respiratory Medicine Authors: Watson, M., Ionescu, M. F., Sylvester, K., Fuld, J. Tags: Mechanisms of lung disease Ventilatory efficiency and its clinical prognostic value in cardiorespiratory disorders Source Type: research

Ventilation/carbon dioxide output relationships during exercise in health
"Ventilatory efficiency" is widely used in cardiopulmonary exercise testing to make inferences regarding the normality (or otherwise) of the arterial CO2 tension (PaCO2) and physiological dead-space fraction of the breath (VD/VT) responses to rapid-incremental (or ramp) exercise. It is quantified as: 1) the slope of the linear region of the relationship between ventilation (V'E) and pulmonary CO2 output (V'CO2); and/or 2) the ventilatory equivalent for CO2 at the lactate threshold (V'E/V'CO2 ) or its minimum value (V'E/V'CO2min), which occurs soon after but before respiratory compensation. Although these indice...
Source: European Respiratory Review - April 13, 2021 Category: Respiratory Medicine Authors: Ward, S. A. Tags: Mechanisms of lung disease Ventilatory efficiency and its clinical prognostic value in cardiorespiratory disorders Source Type: research

Natural variability in the disease course of SSc-ILD: implications for treatment
Interstitial lung disease (ILD) affects approximately 50% of patients with systemic sclerosis (SSc) and is the leading cause of death in SSc. Our objective was to gain insight into the progression of SSc-associated ILD (SSc-ILD). Using data from longitudinal clinical trials and observational studies, we assessed definitions and patterns of progression, risk factors for progression, and implications for treatment. SSc-ILD progression was commonly defined as exceeding specific thresholds of lung function worsening and/or increasing radiographic involvement. One definition used in several studies is decline in forced vital c...
Source: European Respiratory Review - March 24, 2021 Category: Respiratory Medicine Authors: Vonk, M. C., Walker, U. A., Volkmann, E. R., Kreuter, M., Johnson, S. R., Allanore, Y. Tags: Pulmonary vascular disease Reviews Source Type: research

TB research and innovation in Latin America
The production of tuberculosis (TB) research and innovation in Latin America during the past decade has notably improved. Its role in the acceleration of the decline of the average annual TB incidence rate by 2.5% from 2017 to 2018 is still unclear, but it is looking promising that the region will meet the End TB Strategy targets set for 2030. Well performed and high-quality research and evidence is critical for improving national TB control programme outcomes. In Latin America, this need is most apparent when responding to the multidrug-resistant TB epidemic. There is an urgent need for technological breakthroughs to acc...
Source: European Respiratory Review - March 24, 2021 Category: Respiratory Medicine Authors: Manga, S. Tags: Respiratory infections and tuberculosis Latin America Thoracic Society Series Source Type: research

Current evidence for COVID-19 therapies: a systematic literature review
Effective therapeutic interventions for the treatment and prevention of coronavirus disease 2019 (COVID-19) are urgently needed. A systematic review was conducted to identify clinical trials of pharmacological interventions for COVID-19 published between 1 December 2019 and 14 October 2020. Data regarding efficacy of interventions, in terms of mortality, hospitalisation and need for ventilation, were extracted from identified studies and synthesised qualitatively. In total, 42 clinical trials were included. Interventions assessed included antiviral, mucolytic, antimalarial, anti-inflammatory and immunomodulatory therapies...
Source: European Respiratory Review - March 17, 2021 Category: Respiratory Medicine Authors: Welte, T., Ambrose, L. J., Sibbring, G. C., Sheikh, S., Müllerova, H., Sabir, I. Tags: Respiratory infections and tuberculosis Reviews Source Type: research

Cystic fibrosis-related diabetes and lung disease: an update
The development of cystic fibrosis-related diabetes (CFRD) often leads to poorer outcomes in patients with cystic fibrosis including increases in pulmonary exacerbations, poorer lung function and early mortality. This review highlights the many factors contributing to the clinical decline seen in patients diagnosed with CFRD, highlighting the important role of nutrition, the direct effect of hyperglycaemia on the lungs, the immunomodulatory effects of high glucose levels and the potential role of genetic modifiers in CFRD. (Source: European Respiratory Review)
Source: European Respiratory Review - February 16, 2021 Category: Respiratory Medicine Authors: Prentice, B. J., Jaffe, A., Hameed, S., Verge, C. F., Waters, S., Widger, J. Tags: CF and non-CF bronchiectasis Reviews Source Type: research

Genetic disorders of the surfactant system: focus on adult disease
This article describes the genetic origin of surfactant-related lung disease and presents spectra for gene, age, sex and pulmonary phenotype of adult carriers of germline mutations in surfactant-related genes. (Source: European Respiratory Review)
Source: European Respiratory Review - February 16, 2021 Category: Respiratory Medicine Authors: van Moorsel, C. H. M., van der Vis, J. J., Grutters, J. C. Tags: Genetics Rare genetic interstitial lung diseases Source Type: research

Asthma-COPD overlap: current understanding and the utility of experimental models
Pathological features of both asthma and COPD coexist in some patients and this is termed asthma-COPD overlap (ACO). ACO is heterogeneous and patients exhibit various combinations of asthma and COPD features, making it difficult to characterise the underlying pathogenic mechanisms. There are no controlled studies that define effective therapies for ACO, which arises from the lack of international consensus on the definition and diagnostic criteria for ACO, as well as scant in vitro and in vivo data. There remain unmet needs for experimental models of ACO that accurately recapitulate the hallmark features of ACO in patients...
Source: European Respiratory Review - February 16, 2021 Category: Respiratory Medicine Authors: Tu, X., Donovan, C., Kim, R. Y., Wark, P. A. B., Horvat, J. C., Hansbro, P. M. Tags: COPD and smoking, Asthma and allergy Reviews Source Type: research

"Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis." Ana Machado, Pedro Matos Silva, Vera Afreixo, Catia Caneiras, Chris Burtin and Alda Marques. Eur Respir Rev 2020; 29: 200039.
(Source: European Respiratory Review)
Source: European Respiratory Review - February 9, 2021 Category: Respiratory Medicine Tags: Author correction Source Type: research

The application of barium oesophagography in patients with suspected tracheo-oesophageal fistula: preferred or avoided?
The review article by Kim et al. [1] presents excellent work in the evolving management of tracheo-oesophageal fistula (TOF) in adults. (Source: European Respiratory Review)
Source: European Respiratory Review - February 9, 2021 Category: Respiratory Medicine Authors: Li, Y., Lu, H., Ren, K., Han, X., Ren, J. Tags: Lung structure and function, Pulmonary pharmacology and therapeutics Correspondence Source Type: research

Corticosteroids for CAP, influenza and COVID-19: when, how and benefits or harm?
Conclusions The use of corticosteroids has been considered as a potential alternative co-adjuvant treatment in patients with pneumonia. In patients with COVID-19, the evidence is quite strong and there is a clear benefit of the use of corticosteroids in those patients presenting severe forms of disease. (Source: European Respiratory Review)
Source: European Respiratory Review - February 9, 2021 Category: Respiratory Medicine Authors: Martin-Loeches, I., Torres, A. Tags: Respiratory infections and tuberculosis Reviews Source Type: research

The impact of outdoor air pollution on COVID-19: a review of evidence from in vitro, animal, and human studies
Studies have pointed out that air pollution may be a contributing factor to the coronavirus disease 2019 (COVID-19) pandemic. However, the specific links between air pollution and severe acute respiratory syndrome-coronavirus-2 infection remain unclear. Here we provide evidence from in vitro, animal and human studies from the existing literature. Epidemiological investigations have related various air pollutants to COVID-19 morbidity and mortality at the population level, however, those studies suffer from several limitations. Air pollution may be linked to an increase in COVID-19 severity and lethality through its impact ...
Source: European Respiratory Review - February 9, 2021 Category: Respiratory Medicine Authors: Bourdrel, T., Annesi-Maesano, I., Alahmad, B., Maesano, C. N., Bind, M.-A. Tags: Epidemiology, occupational and environmental lung disease Reviews Source Type: research

Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research
Acute respiratory distress syndrome (ARDS) is a devastating critical illness that can be triggered by a wide range of insults and remains associated with a high mortality of around 40%. The search for targeted treatment for ARDS has been disappointing, possibly due to the enormous heterogeneity within the syndrome. In this perspective from the European Respiratory Society research seminar on "Precision medicine in ARDS", we will summarise the current evidence for heterogeneity, explore the evidence in favour of precision medicine and provide a roadmap for further research in ARDS. There is evident variation in th...
Source: European Respiratory Review - February 2, 2021 Category: Respiratory Medicine Authors: Bos, L. D. J., Artigas, A., Constantin, J.-M., Hagens, L. A., Heijnen, N., Laffey, J. G., Meyer, N., Papazian, L., Pisani, L., Schultz, M. J., Shankar-Hari, M., Smit, M. R., Summers, C., Ware, L. B., Scala, R., Calfee, C. S. Tags: Interstitial and orphan lung disease Reviews Source Type: research

The ventilatory efficiency and its clinical and prognostic value in cardiorespiratory disorders
Resting pulmonary function tests (PFTs) are of great diagnostic, discriminative and evaluative value in patients with suspected or established pulmonary disease [1]. Within PFT measurements, there is no doubt that forced expiratory volume in 1 s, forced vital capacity, diffusing capacity of the lung for carbon monoxide, and total lung capacity have stood the test of time and are widely used in clinical studies to judge the efficacy of pharmacological and non-pharmacological interventions in various chronic respiratory diseases [1, 2]. (Source: European Respiratory Review)
Source: European Respiratory Review - February 2, 2021 Category: Respiratory Medicine Authors: Laveneziana, P., Adir, Y., Palange, P. Tags: Mechanisms of lung disease Editorial Source Type: research

Systematic review and meta-analysis of residential radon and lung cancer in never-smokers
Conclusion This study provided quantified risk estimates for lung cancer from residential radon exposure among both never-smokers and ever-smokers. Among never-smokers in radon-prone areas, men were at higher risk of lung cancer than women. (Source: European Respiratory Review)
Source: European Respiratory Review - February 2, 2021 Category: Respiratory Medicine Authors: Cheng, E. S., Egger, S., Hughes, S., Weber, M., Steinberg, J., Rahman, B., Worth, H., Ruano-Ravina, A., Rawstorne, P., Yu, X. Q. Tags: Lung cancer Reviews Source Type: research

Hermansky-Pudlak syndrome pulmonary fibrosis: a rare inherited interstitial lung disease
Pulmonary fibrosis is a progressive interstitial lung disease of unknown aetiology with a poor prognosis. Studying genetic diseases associated with pulmonary fibrosis provides insights into the pathogenesis of the disease. Hermansky–Pudlak syndrome (HPS), a rare autosomal recessive disorder characterised by abnormal biogenesis of lysosome-related organelles, manifests with oculocutaneous albinism and excessive bleeding of variable severity. Pulmonary fibrosis is highly prevalent in three out of 10 genetic types of HPS (HPS-1, HPS-2 and HPS-4). Thus, genotyping of individuals with HPS is clinically relevant. HPS-1 ten...
Source: European Respiratory Review - February 2, 2021 Category: Respiratory Medicine Authors: Yokoyama, T., Gochuico, B. R. Tags: Genetics Rare genetic interstitial lung diseases Source Type: research

The role of mucin 1 in respiratory diseases
Recent evidence has demonstrated that mucin 1 (MUC1) is involved in many pathological processes that occur in the lung. MUC1 is a transmembrane protein mainly expressed by epithelial and hematopoietic cells. It has a receptor-like structure, which can sense the external environment and activate intracellular signal transduction pathways through its cytoplasmic domain. The extracellular domain of MUC1 can be released to the external environment, thus acting as a decoy barrier to mucosal pathogens, as well as serving as a serum biomarker for the diagnosis and prognosis of several respiratory diseases such as lung cancer and ...
Source: European Respiratory Review - February 2, 2021 Category: Respiratory Medicine Authors: Ballester, B., Milara, J., Cortijo, J. Tags: Mechanisms of lung disease Reviews Source Type: research

Minute ventilation/carbon dioxide production in chronic heart failure
In chronic heart failure, minute ventilation (V'E) for a given carbon dioxide production (V'CO2) might be abnormally high during exercise due to increased dead space ventilation, lung stiffness, chemo- and metaboreflex sensitivity, early metabolic acidosis and abnormal pulmonary haemodynamics. The V'E versus V'CO2 relationship, analysed either as ratio or as slope, enables us to evaluate the causes and entity of the V'E/perfusion mismatch. Moreover, the V'E axis intercept, i.e. when V'CO2 is extrapolated to 0, embeds information on exercise-induced dead space changes, while the analysis of end-tidal and arterial CO2 pressu...
Source: European Respiratory Review - February 2, 2021 Category: Respiratory Medicine Authors: Agostoni, P., Sciomer, S., Palermo, P., Contini, M., Pezzuto, B., Farina, S., Magini, A., De Martino, F., Magri, D., Paolillo, S., Cattadori, G., Vignati, C., Mapelli, M., Apostolo, A., Salvioni, E. Tags: Mechanisms of lung disease Ventilatory efficiency and its clinical prognostic value in cardiorespiratory disorders Source Type: research

New bronchoscopic treatment modalities for patients with chronic bronchitis
Chronic bronchitis is a chronic, progressive disease that is difficult to treat. Despite much effort, patients remain highly symptomatic. Currently, a number of innovative bronchoscopic treatments for this disease are under investigation. Liquid nitrogen metered cryospray, bronchial rheoplasty and balloon desobstruction all aim to destroy the hyperplastic goblet cells and excess submucous glands using different strategies. These therapies are in an early phase of clinical research and larger randomised controlled trials are needed to confirm the pilot data available and to evaluate the treatment durability. The fourth tech...
Source: European Respiratory Review - January 19, 2021 Category: Respiratory Medicine Authors: Hartman, J. E., Garner, J. L., Shah, P. L., Slebos, D.-J. Tags: Pulmonary pharmacology and therapeutics Reviews Source Type: research

Update on biology and management of mesothelioma
Malignant pleural mesothelioma is an aggressive, incurable cancer that is usually caused by asbestos exposure several decades before symptoms arise. Despite widespread prohibition of asbestos production and supply, its incidence continues to increase. It is heterogeneous in its presentation and behaviour, and diagnosis can be notoriously difficult. Identification of actionable gene mutations has proven challenging and current treatment options are largely ineffective, with a median survival of 10–12 months. However, the past few years have witnessed major advances in our understanding of the biology and pathogen...
Source: European Respiratory Review - January 19, 2021 Category: Respiratory Medicine Authors: Asciak, R., George, V., Rahman, N. M. Tags: Lung cancer Thoracic oncology Source Type: research

Post-intubation subglottic stenosis: aetiology at the cellular and molecular level
Subglottic stenosis (SGS) is a narrowing of the airway just below the vocal cords. This narrowing typically consists of fibrotic scar tissue, which may be due to a variety of diseases. This review focuses on post-intubation (PI) SGS. SGS can result in partial or complete narrowing of the airway. This narrowing is caused by fibrosis and can cause serious breathing difficulties. It can occur in both adults and children. The pathogenesis of post-intubation SGS is not well understood; however, it is considered to be the product of an abnormal healing process. This review discusses how intubation can change the local micro-envi...
Source: European Respiratory Review - January 19, 2021 Category: Respiratory Medicine Authors: Dorris, E. R., Russell, J., Murphy, M. Tags: Lung structure and function Reviews Source Type: research

Structure and function of small airways in asthma patients revisited
Small airways (
Source: European Respiratory Review - January 19, 2021 Category: Respiratory Medicine Authors: van den Bosch, W. B., James, A. L., Tiddens, H. A. W. M. Tags: Lung structure and function, Asthma and allergy Reviews Source Type: research

Does the use of inhaled corticosteroids in asthma benefit lung function in the long-term? A systematic review and meta-analysis
While asthma is known to be associated with an increased risk of progressive lung function impairments and fixed airflow obstruction, there is ongoing debate on whether inhaled corticosteroids (ICS) modify these long-term risks. Searches were performed of the PubMed, Embase and CENTRAL databases up to 22 July 2019 for studies with follow-up ≥1 year that investigated the effects of maintenance ICS on changes in lung function in asthma. Inclusion criteria were met by 13 randomised controlled trials (RCTs) (n=11 678) and 11 observational studies (n=3720). Median (interquartile range) follow-up was 1.0 (1–4) and...
Source: European Respiratory Review - January 19, 2021 Category: Respiratory Medicine Authors: Tan, D. J., Bui, D. S., Dai, X., Lodge, C. J., Lowe, A. J., Thomas, P. S., Jarvis, D., Abramson, M. J., Walters, E. H., Perret, J. L., Dharmage, S. C. Tags: Asthma and allergy Reviews Source Type: research

European Respiratory Review, list of peer reviewers 2020
The European Respiratory Review is voluntarily reviewed. We are most grateful to the hard work and dedication of those listed below, who reviewed articles for the ERR in 2020. (Source: European Respiratory Review)
Source: European Respiratory Review - January 13, 2021 Category: Respiratory Medicine Tags: Acknowledgement Source Type: research

Influenza vaccination: protecting the most vulnerable
Influenza virus infection causes seasonal epidemics and occasional pandemics, leading to huge morbidity and mortality worldwide. Vaccination against influenza is needed annually as protection from constantly mutating strains is required. Groups at high risk of poor outcomes include the elderly, the very young, pregnant women and those with chronic health conditions. However, vaccine effectiveness in the elderly is generally poor due to immunosenescence and may be altered due to "original antigenic sin". Strategies to overcome these challenges in the elderly include high-dose or adjuvant vaccines. Other options in...
Source: European Respiratory Review - January 13, 2021 Category: Respiratory Medicine Authors: Tanner, A. R., Dorey, R. B., Brendish, N. J., Clark, T. W. Tags: Pulmonary pharmacology and therapeutics Reviews Source Type: research

How to handle oligometastatic disease in nonsmall cell lung cancer
Patients with nonsmall cell lung cancer and limited metastatic disease have been defined as oligometastatic if local ablative therapy of all lesions is amenable. Evidence from different clinical retrospective series suggests that this subgroup harbours better prognosis than other stage IV patients. However, most reports have included patients with inconsistent numbers of metastases in different locations treated by a variety of invasive and noninvasive therapies. As long as further results from randomised clinical trials are awaited, treatment decision follows an interdisciplinary debate in each individual case. Surgery an...
Source: European Respiratory Review - January 13, 2021 Category: Respiratory Medicine Authors: Eichhorn, F., Winter, H. Tags: Lung cancer Thoracic oncology Source Type: research

Bronchoscopic management of asthma, COPD and emphysema
The objectives of this article are to describe the levels of evidence for efficacy and safety, long-term follow-up results beyond 1 year, and current recommendations for clinical practice from international guidelines for each technique. (Source: European Respiratory Review)
Source: European Respiratory Review - January 13, 2021 Category: Respiratory Medicine Authors: Perotin, J. M., Dewolf, M., Launois, C., Dormoy, V., Deslee, G. Tags: COPD and smoking Interventional pulmonology Source Type: research

Advances in pleural infection and malignancy
This article aims to summarise some of the most recent literature informing current practice in these two areas. (Source: European Respiratory Review)
Source: European Respiratory Review - January 13, 2021 Category: Respiratory Medicine Authors: Bedawi, E. O., Guinde, J., Rahman, N. M., Astoul, P. Tags: Lung imaging Interventional pulmonology Source Type: research

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