Smouldering fire or conflagration? An illustrated update on the concept of inflammation in pulmonary arterial hypertension
Pulmonary arterial hypertension (PAH) is a rare condition that is characterised by a progressive increase of pulmonary vascular resistances that leads to right ventricular failure and death, if untreated. The underlying narrowing of the pulmonary vasculature relies on several independent and interdependent biological pathways, such as genetic predisposition and epigenetic changes, imbalance of vasodilating and vasoconstrictive mediators, as well as dysimmunity and inflammation that will trigger endothelial dysfunction, smooth muscle cell proliferation, fibroblast activation and collagen deposition. Progressive constriction...
Source: European Respiratory Review - December 22, 2021 Category: Respiratory Medicine Authors: Perros, F., Humbert, M., Dorfmüller, P. Tags: Pulmonary vascular disease Reviews Source Type: research
Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection
Acute manifestations of SARS-CoV-2 infection continue to impact the lives of many across the world. Post-acute sequelae of coronavirus disease 2019 (COVID-19) may affect 10–30% of survivors of COVID-19, and post-acute sequelae of COVID-19 (PASC)-pulmonary fibrosis is a long-term outcome associated with major morbidity. Data from prior coronavirus outbreaks (severe acute respiratory syndrome and Middle East respiratory syndrome) suggest that pulmonary fibrosis will contribute to long-term respiratory morbidity, suggesting that PASC-pulmonary fibrosis should be thoroughly screened for through pulmonary function testing...
Source: European Respiratory Review - December 15, 2021 Category: Respiratory Medicine Authors: Mylvaganam, R. J., Bailey, J. I., Sznajder, J. I., Sala, M. A., on behalf of the Northwestern Comprehensive COVID Center Consortium Tags: Interstitial and orphan lung disease, Respiratory infections and tuberculosis COVID-19 Reviews Source Type: research
The impact of therapeutics on mortality in hospitalised patients with COVID-19: systematic review and meta-analyses informing the European Respiratory Society living guideline
Hospitalised patients with coronavirus disease 2019 (COVID-19) have a high mortality rate. There are an increasing number of published randomised controlled trials for anti-inflammatory, anti-viral and other treatments. The European Respiratory Society Living Guidelines for the Management of Hospitalised Adults with COVID-19 were published recently, providing recommendations on appropriate pharmacotherapy.
Patient, Intervention, Comparator and Outcomes questions for key interventions were identified by an international panel and systematic reviews were conducted to identify randomised controlled trials meeting the inclusio...
Source: European Respiratory Review - December 15, 2021 Category: Respiratory Medicine Authors: Crichton, M. L., Goeminne, P. C., Tuand, K., Vandendriessche, T., Tonia, T., Roche, N., Chalmers, J. D., on behalf of the European Respiratory Society COVID-19 Task Force Tags: Respiratory infections and tuberculosis COVID-19 Reviews Source Type: research
Asthma and COVID-19: an update
As the world faces the coronavirus disease 2019 (COVID-19) pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, concerns have been raised that asthma patients could be at increased risk of SARS-CoV-2 infection and disease severity. However, it appears that asthma is not an independent risk factor for both. Furthermore, asthma is not over-represented in hospitalised patients with severe pneumonia due to SARS-CoV-2 infection and there was no increased risk of asthma exacerbations triggered by SARS-CoV-2. There is accumulating evidence that asthma phenotypes and comorbidities are important f...
Source: European Respiratory Review - December 15, 2021 Category: Respiratory Medicine Authors: Adir, Y., Saliba, W., Beurnier, A., Humbert, M. Tags: Respiratory clinical practice, Asthma and allergy COVID-19 Reviews Source Type: research
Revisiting the role of pulmonary surfactant in chronic inflammatory lung diseases and environmental exposure
Pulmonary surfactant is a crucial and dynamic lung structure whose primary functions are to reduce alveolar surface tension and facilitate breathing. Though disruptions in surfactant homeostasis are typically thought of in the context of respiratory distress and premature infants, many lung diseases have been noted to have significant surfactant abnormalities. Nevertheless, preclinical and clinical studies of pulmonary disease too often overlook the potential contribution of surfactant alterations – whether in quantity, quality or composition – to disease pathogenesis and symptoms. In inflammatory lung diseases...
Source: European Respiratory Review - December 15, 2021 Category: Respiratory Medicine Authors: Milad, N., Morissette, M. C. Tags: Epidemiology, occupational and environmental lung disease Reviews Source Type: research
European Respiratory Society guideline on non-CPAP therapies for obstructive sleep apnoea
Treatment of obstructive sleep apnoea (OSA) in adults is evolving, as new therapies have been explored and introduced in clinical practice, while other approaches have been refined or reconsidered. In this European Respiratory Society (ERS) guideline on non-continuous positive airway pressure (CPAP) therapies for OSA, we present recommendations determined by a systematic review of the literature. It is an update of the 2011 ERS statement on non-CPAP therapies, advanced into a clinical guideline. A multidisciplinary group of experts, including pulmonary, surgical, dentistry and ear–nose–throat specialists, metho...
Source: European Respiratory Review - November 30, 2021 Category: Respiratory Medicine Authors: Randerath, W., Verbraecken, J., de Raaff, C. A. L., Hedner, J., Herkenrath, S., Hohenhorst, W., Jakob, T., Marrone, O., Marklund, M., McNicholas, W. T., Morgan, R. L., Pepin, J.-L., Schiza, S., Skoetz, N., Smyth, D., Steier, J., Tonia, T., Trzepizur, W., Tags: Sleep medicine ERS Guidelines Source Type: research
Crosslink bio-adhesives for bronchoscopic lung volume reduction: current status and future direction
In conclusion, we describe the key biological (therapeutic benefit and biocompatibility) and biomechanical (degradability, adhesive strength, stiffness, viscoelasticity, tunability and self-healing capacity) characteristics that are essential for an ideal lung bio-adhesive material with the potential to overcome the concerns related to current adhesives. (Source: European Respiratory Review)
Source: European Respiratory Review - November 30, 2021 Category: Respiratory Medicine Authors: Joglekar, M. M., Slebos, D.-J., Leijten, J., Burgess, J. K., Pouwels, S. D. Tags: Respiratory clinical practice Reviews Source Type: research
Chronic cough: new insights and future prospects
Chronic cough is defined in adults as a cough that lasts for ≥8 weeks. When it proves intractable to standard-of-care treatment, it can be referred to as refractory chronic cough (RCC). Chronic cough is now understood to be a condition of neural dysregulation. Chronic cough and RCC result in a serious, often unrecognized, disease burden, which forms the focus of the current review.
The estimated global prevalence of chronic cough is 2–18%. Patients with chronic cough and RCC report many physical and psychological effects, which impair their quality of life. Chronic cough also has a significant economic burden...
Source: European Respiratory Review - November 30, 2021 Category: Respiratory Medicine Authors: Morice, A., Dicpinigaitis, P., McGarvey, L., Birring, S. S. Tags: Respiratory clinical practice Reviews Source Type: research
Ventilatory efficiency and its clinical and prognostic value in adults with cystic fibrosis
Cystic fibrosis, due to the absence or abnormal function of the cystic fibrosis transmembrane conductance regulator, is the most common life-limiting autosomal recessive genetic disorder among the Caucasian population. The lungs are particularly affected due to thick and tenacious mucus causing parenchymal anomalies ranging from bronchiectasis, progressive airflow limitation, respiratory infections, lung destruction and ultimately respiratory failure. Despite the remarkable advances in treatment that have greatly improved survival, most patients experience progressive exercise curtailment, with the consequence that a growi...
Source: European Respiratory Review - November 30, 2021 Category: Respiratory Medicine Authors: Laveneziana, P., Palange, P. Tags: CF and non-CF bronchiectasis Ventilatory efficiency and its clinical prognostic value in cardiorespiratory disorders Source Type: research
Cardiopulmonary exercise testing in interstitial lung diseases and the value of ventilatory efficiency
Interstitial lung diseases (ILDs) are diverse parenchymal pulmonary disorders, primarily characterised by alveolar and interstitial inflammation and/or fibrosis, and sharing pathophysiological similarities. Thus, patients generally harbour common respiratory symptoms, lung function abnormalities and modified exercise adaptation. The most usual and disabling complaint is exertional dyspnoea, frequently responsible for premature exercise interruption. Cardiopulmonary exercise testing (CPET) is increasingly used for the clinical assessment of patients with ILD. This is because exercise performance or dyspnoea on exertion cann...
Source: European Respiratory Review - November 30, 2021 Category: Respiratory Medicine Authors: Gille, T., Laveneziana, P. Tags: Interstitial and orphan lung disease, Pulmonary pharmacology and therapeutics Ventilatory efficiency and its clinical prognostic value in cardiorespiratory disorders Source Type: research
Discordant diagnostic criteria for pneumonia in COPD trials: a review
Inhaled corticosteroids (ICS) have a class effect of increasing pneumonia risk in patients with COPD. However, pneumonia incidence varies widely across clinical trials of ICS use in COPD. This review clarifies methodological differences in defining and recording pneumonia events in these trials and discusses factors that could contribute to the varying pneumonia incidence. Literature searches and screening yielded 40 relevant references for inclusion. Methods used to capture pneumonia events in these studies included investigator-reported pneumonia adverse events, standardised list of signs or symptoms, radiographic confir...
Source: European Respiratory Review - November 17, 2021 Category: Respiratory Medicine Authors: Wise, R. A., Bafadhel, M., Crim, C., Criner, G. J., Day, N. C., Halpin, D. M. G., Han, M. K., Lange, P., Lipson, D. A., Martinez, F. J., Maselli, D. J., Midwinter, D., Singh, D., Zysman, M., Dransfield, M. T., Russell, R. E. K. Tags: COPD and smoking Reviews Source Type: research
Sex and gender in interstitial lung diseases
Sex and gender differences influence key domains of research, lung health, healthcare access and healthcare delivery. In interstitial lung diseases (ILDs), mouse models of pulmonary fibrosis are clearly influenced by sex hormones. Additionally, short telomeres, a biomarker of telomere regulation gene mutations, are impacted by sex, while heritability unexplained by genetic variation may be attributable to gendered environmental factors that drive epigenetic control. Diseases like idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, occupational ILDs, connective tissue-associated ILDs and lymphangioleiomyomatosis ha...
Source: European Respiratory Review - November 17, 2021 Category: Respiratory Medicine Authors: Kawano-Dourado, L., Glassberg, M. K., Assayag, D., Borie, R., Johannson, K. A. Tags: Interstitial and orphan lung disease Sex and gender in lung disease Source Type: research
Aspergillus-related lung disease in people with cystic fibrosis: can imaging help us to diagnose disease?
In people with cystic fibrosis (PwCF), viscous sputum and dysfunction of the mucociliary escalator leads to early and chronic infections. The prevalence of Aspergillus fumigatus in sputum is high in PwCF and the contribution of A. fumigatus to the progression of structural lung disease has been reported. However, overall, relatively little is known about the contribution of A. fumigatus to CF lung disease. More knowledge is needed to aid clinical decisions on whether to start antifungal treatment. In this review, we give an overview of A. fumigatus colonisation and infection in PwCF and the different types of pulmonary dis...
Source: European Respiratory Review - November 17, 2021 Category: Respiratory Medicine Authors: Lv, Q., Elders, B. B. L. J., Warris, A., Caudri, D., Ciet, P., Tiddens, H. A. W. M. Tags: CF and non-CF bronchiectasis Reviews Source Type: research
Sex and gender in asthma
Asthma is a heterogenous disease, and its prevalence and severity are different in males versus females through various ages. As children, boys have an increased prevalence of asthma. As adults, women have an increased prevalence and severity of asthma. Sex hormones, genetic and epigenetic variations, social and environmental factors, and responses to asthma therapeutics are important factors in the sex differences observed in asthma incidence, prevalence and severity. For women, fluctuations in sex hormone levels during puberty, the menstrual cycle and pregnancy are associated with asthma pathogenesis. Further, sex differ...
Source: European Respiratory Review - November 17, 2021 Category: Respiratory Medicine Authors: Chowdhury, N. U., Guntur, V. P., Newcomb, D. C., Wechsler, M. E. Tags: Asthma and allergy Sex and gender in lung disease Source Type: research
Clinical utility of diagnostic biomarkers in malignant pleural mesothelioma: a systematic review and meta-analysis
Malignant pleural mesothelioma (MPM) is characterised by late-stage diagnosis and poor prognosis. Currently, no screening tool is advocated and diagnosis is based on invasive techniques, which are not well tolerated. Non-invasive diagnostic biomarkers have shown potential and could have a huge clinical benefit. However, despite extensive research, there is no consensus yet on their clinical use, with many articles reporting contradicting results, limiting their clinical implementation. The aim of this systematic review is therefore to explore the different semi- and non-invasive diagnostic markers in several human matrices...
Source: European Respiratory Review - November 17, 2021 Category: Respiratory Medicine Authors: Schillebeeckx, E., van Meerbeeck, J. P., Lamote, K. Tags: Lung biology and experimental studies Reviews Source Type: research
