Biologics in severe asthma: the role of real-world evidence from registries
Asthma is one of the most common noncommunicable diseases; in the majority of patients it is well controlled with inhaled bronchodilators and inhaled corticosteroids, but the management of severe asthma has been a significant challenge historically. The introduction of novel biologic drugs in the past few decades has revolutionised the field, presenting physicians with a variety of biologic drugs with different mechanisms for the treatment of severe asthma.
It is of crucial importance to evaluate the effectiveness of these drugs by following their "real-life" effectiveness rather than relying solely on their efficacy, esta...
Source: European Respiratory Review - June 7, 2022 Category: Respiratory Medicine Authors: Paoletti, G., Pepys, J., Casini, M., Di Bona, D., Heffler, E., Goh, C. Y. Y., Price, D. B., Canonica, G. W. Tags: Reviews Source Type: research
No smoke without fire: the impact of cigarette smoking on the immune control of tuberculosis
Cigarette smoke (CS) exposure is a key risk factor for both active and latent tuberculosis (TB). It is associated with delayed diagnosis, more severe disease progression, unfavourable treatment outcomes and relapse after treatment. Critically, CS exposure is common in heavily populated areas with a high burden of TB, such as China, India and the Russian Federation. It is therefore prudent to evaluate interventions for TB while taking into account the immunological impacts of CS exposure. This review is a mechanistic examination of how CS exposure impairs innate barrier defences, as well as alveolar macrophage, neutrophil, ...
Source: European Respiratory Review - June 7, 2022 Category: Respiratory Medicine Authors: Quan, D. H., Kwong, A. J., Hansbro, P. M., Britton, W. J. Tags: Reviews Source Type: research
"Incidental discovery of interstitial lung disease: diagnostic approach, surveillance and perspectives". Sara Tomassetti, Venerino Poletti, Claudia Ravaglia, Nicola Sverzellati, Sara Piciucchi, Diletta Cozzi, Valentina Luzzi, Camilla Comin and Athol U. Wells. Eur Respir Rev 2022; 31: 210206.
(Source: European Respiratory Review)
Source: European Respiratory Review - May 25, 2022 Category: Respiratory Medicine Tags: Erratum Source Type: research
Assessing adherence to inhaled therapies in asthma and the emergence of electronic monitoring devices
Infrequent use of inhaled corticosteroids (ICS) and/or over-reliance of short-acting β-agonists (SABA) are recognised as key contributors to increased morbidity and mortality in asthma. The most frequent measures of ICS adherence and SABA use rely on patient-reported questionnaires or prescription refill records, neither of which are considered sufficiently reliable. Technological advancements in the development of electronic monitoring of inhaler devices allow for monitoring of use, as well as recording of and feedback on inhaler technique for some devices. Most electronic monitoring devices (EMDs) are paired with a ...
Source: European Respiratory Review - May 25, 2022 Category: Respiratory Medicine Authors: Dhruve, H., Jackson, D. J. Tags: Pulmonary pharmacology and therapeutics, Asthma and allergy Mini-reviews Source Type: research
Antibiotic resistance in chronic respiratory diseases: from susceptibility testing to the resistome
The development of resistome analysis, i.e. the comprehensive analysis of antibiotic-resistance genes (ARGs), is enabling a better understanding of the mechanisms of antibiotic-resistance emergence. The respiratory microbiome is a dynamic and interactive network of bacteria, with a set of ARGs that could influence the response to antibiotics. Viruses such as bacteriophages, potential carriers of ARGs, may also form part of this respiratory resistome. Chronic respiratory diseases (CRDs) such as cystic fibrosis, severe asthma, chronic obstructive pulmonary disease and bronchiectasis, managed with long-term antibiotic therapi...
Source: European Respiratory Review - May 25, 2022 Category: Respiratory Medicine Authors: Pailhories, H., Herrmann, J.-L., Velo-Suarez, L., Lamoureux, C., Beauruelle, C., Burgel, P.-R., Hery-Arnaud, G. Tags: Respiratory clinical practice Reviews Source Type: research
Investigation and management of residual sleepiness in CPAP-treated patients with obstructive sleep apnoea: the European view
Excessive daytime sleepiness (EDS) is a major symptom of obstructive sleep apnoea (OSA), defined as the inability to stay awake during the day. Its clinical descriptors remain elusive, and the pathogenesis is complex, with disorders such as insufficient sleep and depression commonly associated. Subjective EDS can be evaluated using the Epworth Sleepiness Scale, in which the patient reports the probability of dozing in certain situations; however, its reliability has been challenged. Objective tests such as the multiple sleep latency test or the maintenance of wakefulness test are not commonly used in patients with OSA, sin...
Source: European Respiratory Review - May 25, 2022 Category: Respiratory Medicine Authors: Craig, S., Pepin, J.-L., Randerath, W., Causse, C., Verbraecken, J., Asin, J., Barbe, F., Bonsignore, M. R. Tags: Sleep medicine Reviews Source Type: research
Toll-like receptor-agonist-based therapies for respiratory viral diseases: thinking outside the cell
Respiratory virus infections initiate in the upper respiratory tract (URT). Innate immunity is critical for initial control of infection at this site, particularly in the absence of mucosal virus-neutralising antibodies. If the innate immune response is inadequate, infection can spread to the lower respiratory tract (LRT) causing community-acquired pneumonia (as exemplified by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/coronavirus disease 2019). Vaccines for respiratory viruses (influenza and SARS-CoV-2) leverage systemic adaptive immunity to protect from severe lung disease. However, the URT remains vuln...
Source: European Respiratory Review - May 4, 2022 Category: Respiratory Medicine Authors: Girkin, J. L. N., Maltby, S., Bartlett, N. W. Tags: Respiratory infections and tuberculosis Reviews Source Type: research
Bidirectional relationships of comorbidity with obstructive sleep apnoea
Obstructive sleep apnoea (OSA) is frequently associated with comorbidities that include metabolic, cardiovascular, renal, pulmonary and neuropsychiatric. There is considerable evidence that OSA is an independent risk factor for many of these comorbidities but, more recently, there is evidence that some of these comorbidities may predispose to the development of OSA. Thus, there is growing evidence of a bidirectional relationship between OSA and comorbidity, especially for heart failure, metabolic syndrome and stroke. Potential mechanisms of bidirectional relationships differ in individual comorbidities with fluid retention...
Source: European Respiratory Review - May 4, 2022 Category: Respiratory Medicine Authors: Gleeson, M., McNicholas, W. T. Tags: Sleep medicine Reviews Source Type: research
The impact of long-acting muscarinic antagonists on mucus hypersecretion and cough in chronic obstructive pulmonary disease: a systematic review
Patients suffering from chronic obstructive pulmonary disease (COPD) clinically manifest airway mucus hypersecretion as sputum expectoration and cough. Evidence accumulated in the past decade has shown that the cholinergic system not only regulates airway smooth muscle contraction but also the activity of inflammatory and airway epithelial cells, including goblet cells, and submucosal gland activity. Long-acting muscarinic antagonists (LAMAs) with the most favourable M3/M2 muscarinic acetylcholine (ACh) receptors residency properties are not only excellent bronchodilators but potentially also mucus-modifying agents, able t...
Source: European Respiratory Review - May 4, 2022 Category: Respiratory Medicine Authors: Calzetta, L., Ritondo, B. L., Zappa, M. C., Manzetti, G. M., Perduno, A., Shute, J., Rogliani, P. Tags: COPD and smoking, Pulmonary pharmacology and therapeutics Reviews Source Type: research
Cardiac consequences of intermittent hypoxia: a matter of dose? A systematic review and meta-analysis in rodents
Conclusion
This meta-analysis demonstrated that severe IH systematically induces cardiac remodelling and contractile dysfunction in rodents, which might trigger or aggravate chronic heart failure. Interestingly, this meta-analysis showed that, depending on stimulus severity, IH exhibits both protective and aggravating effects on infarct size after experimental ischaemia–reperfusion procedures. (Source: European Respiratory Review)
Source: European Respiratory Review - April 13, 2022 Category: Respiratory Medicine Authors: Belaidi, E., Khouri, C., Harki, O., Baillieul, S., Faury, G., Briancon-Marjollet, A., Pepin, J.-L., Arnaud, C. Tags: Lung biology and experimental studies Reviews Source Type: research
COVID-19 and tuberculosis: the double whammy of respiratory pathogens
Prior to coronavirus disease 2019 (COVID-19), tuberculosis (TB) was the worst killer among infectious diseases. The union of these two obnoxious respiratory diseases can be devastating, with severe public health implications. The COVID-19 pandemic has affected all TB-elimination programmes due to the severe burden on healthcare systems and the diversion of funds and attention towards controlling the pandemic. The emerging data show that the COVID-19 pandemic caused a marked decrease in case notifications and bacille Calmette–Guérin immunisations, ultimately promoting disease transmission and increasing the sus...
Source: European Respiratory Review - April 13, 2022 Category: Respiratory Medicine Authors: Shariq, M., Sheikh, J. A., Quadir, N., Sharma, N., Hasnain, S. E., Ehtesham, N. Z. Tags: Respiratory infections and tuberculosis Mini-reviews Source Type: research
Incidental discovery of interstitial lung disease: diagnostic approach, surveillance and perspectives
The incidental discovery of pre-clinical interstitial lung disease (ILD) has led to the designation of interstitial lung abnormalities (ILA), a radiological entity defined as the incidental finding of computed tomography (CT) abnormalities affecting more than 5% of any lung zone. Two recent documents have redefined the borders of this entity and made the recommendation to monitor patients with ILA at risk of progression. In this narrative review, we will focus on some of the limits of the current approach, underlying the potential for progression to full-blown ILD of some patients with ILA and the numerous links between su...
Source: European Respiratory Review - April 13, 2022 Category: Respiratory Medicine Authors: Tomassetti, S., Poletti, V., Ravaglia, C., Sverzellati, N., Piciucchi, S., Cozzi, D., Luzzi, V., Comin, C., Wells, A. U. Tags: Interstitial and orphan lung disease Reviews Source Type: research
Correction to subglottic secretion drainage for preventing ventilator-associated pneumonia: an overview of systematic reviews and an updated meta-analysis
The aim of this correspondence is to amend a mistake in our original article [1], and to recalculate our meta-analyses for ventilator-associated pneumonia (VAP) and mortality outcomes. (Source: European Respiratory Review)
Source: European Respiratory Review - March 23, 2022 Category: Respiratory Medicine Authors: Pozuelo-Carrascosa, D. P., Klompas, M., Alvarez-Bueno, C., Anon, J. M., Martinez-Vizcaino, V., Cavero-Redondo, I., Herraiz-Adillo, A. Tags: Correspondence Source Type: research
Disease burden associated with alpha-1 antitrypsin deficiency: systematic and structured literature reviews
Alpha-1 antitrypsin deficiency (AATD) is a rare genetic disorder characterised by reduced levels of circulating alpha-1 antitrypsin and an increased risk of lung and liver disease. Recent reviews of AATD have focused on diagnosis, epidemiology and clinical management; comprehensive reviews examining disease burden are lacking. Therefore, we conducted literature reviews to investigate the AATD disease burden for patients, caregivers and healthcare systems. Embase, PubMed and Cochrane libraries were searched for AATD publications from database inception to June 2021, in accordance with Preferred Reporting Items for Systemati...
Source: European Respiratory Review - March 23, 2022 Category: Respiratory Medicine Authors: Miravitlles, M., Herepath, M., Priyendu, A., Sharma, S., Vilchez, T., Vit, O., Haensel, M., Lepage, V., Gens, H., Greulich, T. Tags: COPD and smoking, Interstitial and orphan lung disease Review Source Type: research
E-cigarettes and nicotine abstinence: a meta-analysis of randomised controlled trials
Conclusions
The use of e-cigarettes as a therapeutic intervention for smoking cessation may lead to permanent nicotine dependence. (Source: European Respiratory Review)
Source: European Respiratory Review - March 23, 2022 Category: Respiratory Medicine Authors: Hanewinkel, R., Niederberger, K., Pedersen, A., Unger, J. B., Galimov, A. Tags: COPD and smoking Review Source Type: research
