Diagnosis, course and management of hypersensitivity pneumonitis
Hypersensitivity pneumonitis (HP) is a complex and heterogeneous interstitial lung disease (ILD) that occurs when susceptible individuals develop an exaggerated immune response to an inhaled antigen. In this review, we discuss the latest guidelines for the diagnostic evaluation of patients with suspected HP, the importance of identifying patients with fibrotic and progressive disease, and the evidence supporting the drugs commonly used in the treatment of HP. Differential diagnosis of HP can be challenging and requires a thorough exposure history, multidisciplinary discussion of clinical and radiologic data, and, in some c...
Source: European Respiratory Review - February 9, 2022 Category: Respiratory Medicine Authors: Hamblin, M., Prosch, H., Vasakova, M. Tags: Interstitial and orphan lung disease Reviews Source Type: research
WASOG statement on the diagnosis and management of sarcoidosis-associated pulmonary hypertension
Sarcoidosis-associated pulmonary hypertension (SAPH) is an important complication of advanced sarcoidosis. Over the past few years, there have been several studies dealing with screening, diagnosis and treatment of SAPH. This includes the results of two large SAPH-specific registries. A task force was established by the World Association of Sarcoidosis and Other Granulomatous disease (WASOG) to summarise the current level of knowledge in the area and provide guidance for the management of patients. A group of sarcoidosis and pulmonary hypertension experts participated in this task force. The committee developed a consensus...
Source: European Respiratory Review - February 9, 2022 Category: Respiratory Medicine Authors: Savale, L., Huitema, M., Shlobin, O., Kouranos, V., Nathan, S. D., Nunes, H., Gupta, R., Grutters, J. C., Culver, D. A., Post, M. C., Ouellette, D., Lower, E. E., Al-Hakim, T., Wells, A. U., Humbert, M., Baughman, R. P. Tags: Interstitial and orphan lung disease, Pulmonary vascular disease Reviews Source Type: research
European Respiratory Review, list of peer reviewers 2021
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 2021. (Source: European Respiratory Review)
Source: European Respiratory Review - January 25, 2022 Category: Respiratory Medicine Tags: Acknowledgement Source Type: research
Current unmet needs and potential solutions to uncontrolled asthma
Despite the availability of effective inhaled therapies, many patients with asthma have poor asthma control. Uncontrolled asthma presents a significant burden on the patient and society, and, for many, remains largely preventable. There are numerous reasons why a patient may remain uncontrolled despite access to therapies, including incorrect inhaler technique, poor adherence to treatment, oversight of triggers and suboptimal medical care. Shared decision-making, good patient–clinician communication, supported self-management, multidisciplinary patient education, new technology and risk stratification may all provide...
Source: European Respiratory Review - January 25, 2022 Category: Respiratory Medicine Authors: Busse, W. W., Kraft, M. Tags: Asthma and allergy Reviews Source Type: research
Eosinophils and eosinophilic immune dysfunction in health and disease
The functions ascribed to eosinophils have classically been limited to host defence against certain parasitic infections and potentially deleterious effects in the setting of specific diseases that are associated with elevated eosinophil counts in blood and/or tissue. The ability to induce eosinophil depletion either experimentally in animal models or through targeted therapies in humans has extended our understanding of the roles played by eosinophils in health and homeostasis as well as in disease pathogenesis. When associated with human disease aetiology, the eosinophil takes on a pathogenic rather than a protective rol...
Source: European Respiratory Review - January 25, 2022 Category: Respiratory Medicine Authors: Jackson, D. J., Akuthota, P., Roufosse, F. Tags: Lung biology and experimental studies, Mechanisms of lung disease Reviews Source Type: research
Multidisciplinary management of tracheobronchial injury
Tracheobronchial injury is a heterogeneous entity comprising multiple rare and potentially life-threatening scenarios. We performed a systematic literature review focusing on post-intubation tracheal injuries (PiTIs) and post-traumatic tracheobronchial injuries (PTTBIs).
PiTIs are often longitudinal lacerations of the middle third of the membranous trachea. Subcutaneous emphysema of the face and trunk following tracheal intubation should immediately trigger the diagnosis. Diagnosis may be suspected on the chest computed tomography (CT) and should be confirmed by bronchoscopic examination. Conservative management is encoura...
Source: European Respiratory Review - January 25, 2022 Category: Respiratory Medicine Authors: Boutros, J., Marquette, C.-H., Ichai, C., Leroy, S., Benzaquen, J. Tags: Acute lung injury and critical care Reviews Source Type: research
Extracellular vesicle-mediated cellular crosstalk in lung repair, remodelling and regeneration
The unperturbed lung is highly quiescent, with a remarkably low level of cell turnover. However, once damaged, the lung shows an extensive regenerative capacity, with resident progenitor cell populations re-entering the cell cycle and differentiating to promote repair. This quick and dramatic repair response requires interactions among more than 40 different cell lineages in the lung, and defects in any of these processes can lead to various lung pathologies. Understanding the mechanisms of interaction in lung injury, repair and regeneration thus has considerable practical and therapeutic implications. Moreover, therapeuti...
Source: European Respiratory Review - January 25, 2022 Category: Respiratory Medicine Authors: Kadota, T., Fujita, Y., Araya, J., Ochiya, T., Kuwano, K. Tags: Lung biology and experimental studies Reviews Source Type: research
Fiducial markers for stereotactic lung radiation therapy: review of the transthoracic, endovascular and endobronchial approaches
In conclusion, for PPLs, the endobronchial approach provides a low rate of pneumothorax, offers the possibility of concurrent diagnostic sampling for both the PPL and the lymph nodes, and, finally, reduces the intervention time compared to other techniques. In this context, coil-tailed and coil-spring FMs have shown the lowest migration rate with a consequently high tracking rate. (Source: European Respiratory Review)
Source: European Respiratory Review - January 12, 2022 Category: Respiratory Medicine Authors: Casutt, A., Kinj, R., Ozsahin, E.-M., von Garnier, C., Lovis, A. Tags: Lung cancer Reviews Source Type: research
Predicting the pulmonary effects of long-term e-cigarette use: are the clouds clearing?
Commercially available since 2007, e-cigarettes are a popular electronic delivery device of ever-growing complexity. Given their increasing use by ex-smokers, smokers and never-smokers, it is important to evaluate evidence of their potential pulmonary effects and predict effects of long-term use, since there has been insufficient time to study a chronic user cohort. It is crucial to evaluate indicators of harm seen in cigarette use, and those potentially unique to e-cigarette exposure. Evaluation must also account for the vast variation in e-cigarette devices (now including at least five generations of devices) and exposur...
Source: European Respiratory Review - January 12, 2022 Category: Respiratory Medicine Authors: Davis, L. C., Sapey, E., Thickett, D. R., Scott, A. Tags: COPD and smoking Reviews Source Type: research
Just breathe: a review of sex and gender in chronic lung disease
Chronic lung diseases are the third leading cause of death worldwide and are increasing in prevalence over time. Although much of our traditional understanding of health and disease is derived from study of the male of the species – be it animal or human – there is increasing evidence that sex and gender contribute to differences in disease risk, prevalence, presentation, severity, treatment approach, response and outcomes. Chronic obstructive pulmonary disease, asthma and bronchiectasis represent the most prevalent and studied chronic lung diseases and have key sex- and gender-based differences which are criti...
Source: European Respiratory Review - January 12, 2022 Category: Respiratory Medicine Authors: Somayaji, R., Chalmers, J. D. Tags: Respiratory clinical practice Sex and gender in lung disease Source Type: research
The evolving landscape of sex-based differences in lung cancer: a distinct disease in women
In stark contrast to a few decades ago when lung cancer was predominantly a disease of men who smoke, incidence rates of lung cancer in women are now comparable to or higher than those in men and are rising alarmingly in many parts of the world. Women face a unique set of risk factors for lung cancer compared to men. These include exogenous exposures including radon, prior radiation, and fumes from indoor cooking materials such as coal, in addition to endogenous exposures such as oestrogen and distinct genetic polymorphisms. Current screening guidelines only address tobacco use and likely underrepresent lung cancer risk in...
Source: European Respiratory Review - January 12, 2022 Category: Respiratory Medicine Authors: Ragavan, M., Patel, M. I. Tags: Respiratory clinical practice, Lung cancer Sex and gender in lung disease Source Type: research
Sex, gender and the pulmonary physiology of exercise
In this review, we detail how the pulmonary system's response to exercise is impacted by both sex and gender in healthy humans across the lifespan. First, the rationale for why sex and gender differences should be considered is explored, and then anatomical differences are highlighted, namely that females typically have smaller lungs and airways than males. Thereafter, we describe how these anatomical differences can impact functional aspects such as respiratory muscle energetics and activation, mechanical ventilatory constraints, diaphragm fatigue, and pulmonary gas exchange in healthy adults and children. Finally, we det...
Source: European Respiratory Review - January 12, 2022 Category: Respiratory Medicine Authors: Dominelli, P. B., Molgat-Seon, Y. Tags: Respiratory clinical practice Sex and gender in lung disease Source Type: research
Some take-home messages from the 9th International Meeting on Pulmonary Rare Diseases and Orphan Drugs
Dissemination of updated knowledge on rare and ultra-rare respiratory diseases has always been a priority of the European Respiratory Review (ERR) [1, 2]. In this issue, we publish the first of a collection of four articles that discuss hot topics with direct practical clinical consequences. First, Mackintosh et al. [3] review the challenges and controversies (which are not few!) in "interstitial pneumonia with autoimmune features" (IPAF). Following the publication, in 2015, of the classification of IPAF proposed by the European Respiratory Society (ERS) and the American Thoracic Society (ATS) [4], a number of articles hav...
Source: European Respiratory Review - December 22, 2021 Category: Respiratory Medicine Authors: Harari, S., Adir, Y., Humbert, M. Tags: Interstitial and orphan lung disease Editorials Source Type: research
Interstitial pneumonia with autoimmune features: challenges and controversies
The presence of clinical, serological and/or radiological features suggestive, but not confirmatory, of a defined connective tissue disease in patients with interstitial lung disease is a relatively frequent occurrence. In 2015, the European Respiratory Society and the American Thoracic Society proposed classification criteria for the interstitial pneumonia with autoimmune features (IPAF) research entity to capture such patients in a standardised manner, with the intention of nurturing clinical research. This initiative resulted in the publication of several series of IPAF patients, with significant variation between cohor...
Source: European Respiratory Review - December 22, 2021 Category: Respiratory Medicine Authors: Mackintosh, J. A., Wells, A. U., Cottin, V., Nicholson, A. G., Renzoni, E. A. Tags: Interstitial and orphan lung disease Reviews Source Type: research
Perioperative approach to precapillary pulmonary hypertension in non-cardiac non-obstetric surgery
Pulmonary hypertension (PH) confers a significant challenge in perioperative care. It is associated with substantial morbidity and mortality. A considerable amount of information about management of patients with PH has emerged over the past decade. However, there is still a paucity of information to guide perioperative evaluation and management of these patients. Yet, a satisfactory outcome is feasible by focusing on elaborate disease-adapted anaesthetic management of this complex disease with a multidisciplinary approach. The cornerstone of the peri-anaesthetic management of patients with PH is preservation of right vent...
Source: European Respiratory Review - December 22, 2021 Category: Respiratory Medicine Authors: Bandyopadhyay, D., Lai, C., Pulido, J. N., Restrepo-Jaramillo, R., Tonelli, A. R., Humbert, M. Tags: Pulmonary vascular disease Reviews Source Type: research
