C-reactive protein point of care testing: the answer to antibiotic prescribing in ambulatory patients with exacerbations of chronic obstructive pulmonary disease?
Authors: Llor C, Miravitlles M PMID: 32476530 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - June 3, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Prevalence, distribution and clinical significance of joints, muscles and bones in sarcoidosis:an18F-FDG-PET/CT study.
CONCLUSION: 18F-FDG-PET/CT revealed JMBs localizations and coexistence with other organ sites supporting the concept that sarcoidosis is a systemic disease. By allowing an integrative interpretation of multi-organ involvement in the context of a pattern highly suggestive of sarcoidosis, it strongly keeps-off the diagnosis of malignancy. PMID: 32460642 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - May 30, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Depression and anxiety in patients with interstitial lung disease.
Authors: Yohannes AM PMID: 32460643 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - May 30, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Efficacy and safety of percutaneous tube drainage in lung abscess: a systematic review and meta-analysis.
Authors: Lin Q, Jin M, Luo Y, Zhou M, Cai C Abstract Objectives: Lung abscess is an infectious lung disease. The main objective of this review was to assess the efficacy and safety of percutaneous tube drainage (PTD) in patients with lung abscess by systematic review and meta-analysis of published data.Methods: We searched all literature published between January 1, 2010, and August 6, 2019, in the PubMed, Cochrane Central Library, EMBASE, Wanfang, Chinese National Knowledge Infrastructure, and Chinese Biomedical Literature databases for relevant reports. The data from these studies were pooled for statistical anal...
Source: Expert Review of Respiratory Medicine - May 20, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Lung involvement associated with anti-NXP2 autoantibodies in inflammatory myopathies: a French monocenter series.
Conclusion: We observed that subclinical lung involvement is not rare in patients with IMM associated with positive anti-NXP2 Ab, with various radiological patterns and a significant lung function defect. Such data deserve to be known by the pulmonologist in order to perform a complete lung screening in all patients with positive anti-NXP2 antibody and to detect earlier a concomitant lung impairment. PMID: 32394768 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - May 14, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The challenge of resuming classes for young students in Wuhan, China.
Authors: Yang R, Gui X, Zhang Y, Xiong Y PMID: 32375523 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - May 8, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Determining emphysema in adult patients with COPD-Bronchiectasis overlap using a novel spirometric parameter: area under the forced expiratory flow-volume loop.
Conclusions: We found that AreaFE% is more suitable for determining the presence of emphysema than conventional spirometric parameters in CBO patients. This novel parameter may be helpful instead of scanning thorax CT to indicate presence of emphysema and manage treatment in the follow-up of CBO patients. We think that this study sheds light on future studies having larger sample to determine different cut-off values for each extent of BE. PMID: 32379507 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - May 8, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Smoking associated interstitial lung disease: update and review.
Authors: Dawod YT, Cook NE, Graham WB, Madhani-Lovely F, Thao C Abstract Introduction: Smoking-associated interstitial lung disease manifests as several heterogeneous disorders involving the airways, pleura, and lung parenchyma with various radiological patterns. The clinical history, radiologic, and pathologic findings are important to distinguish these more uncommon diseases. A multidisciplinary approach is recommended for diagnosis and to manage these conditions appropriately.Areas covered: This review provides an overview of the epidemiology, risk factors, pathogenesis, clinical features, diagnosis, and treatme...
Source: Expert Review of Respiratory Medicine - May 8, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The role of essential organ-based comorbidities in the prognosis of COVID-19 infection patients.
Authors: Yang R, Gui X, Zhang Y, Xiong Y Abstract Objectives: To assess the role of essential organ-based comorbidities in the prognosis of COVID-19 patients.Methods: All consecutive patients diagnosed with COVID-19 admitted to the Zhongnan Hospital of Wuhan University from 11 January to 16 March 2020 were enrolled in this retrospective cohort study.Results: A total of 212 COVID-19 patients were included. COVID-19 patients with heart, liver and kidneycomorbidity, compared to patients without related comorbidities, were more likely to have cardiac injuries [9.1%(3/33) vs 2.2%(4/179), P = 0.043], liver inju...
Source: Expert Review of Respiratory Medicine - May 1, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Prevalence of, and risk factors for underweight or excess weight in patients with chronic obstructive emphysema from a multiethnic region of Xinjiang, China.
Conclusions: This study highlighted the prevalence of underweight and excess weight in patients among emphysema. Comorbidities were important risk factors of underweight or excess weight among chronic emphysema patients. These findings were important for the prevention and treatment of chronic obstructive emphysema in the future. PMID: 32343156 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - April 30, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

New perspectives on the role of muscarinic antagonists in asthma therapy.
Authors: Matera MG, Belardo C, Rinaldi M, Rinaldi B, Cazzola M Abstract Introduction: Tiotropium is useful in the presence of severe uncontrolled asthma despite the optimization of therapy with inhaled corticosteroids (ICSs) and long-acting β2 agonists (LABAs) as recommended by the current guidelines. However, in recent years there has been some further preclinical and clinical evidence on the pharmacological and therapeutic impact of these agents.Areas covered: We have conducted an extensive search on muscarinic antagonists in asthma therapy throughout several sources and discuss what has emerged in the last ...
Source: Expert Review of Respiratory Medicine - April 24, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

What can be done to impact respiratory inhaler misuse: exploring the problem, reasons, and solutions.
Authors: Volerman A, Carpenter D, Press VG Abstract Introduction: Respiratory inhalers, when used correctly, provide critical treatments for managing pulmonary conditions. However, many patients misuse inhalers, negatively affecting disease control, quality of life, healthcare utilization, and costs. Numerous factors are associated with misuse and are nested within four levels of influence: individual, interpersonal, organizational/institutional, and policy.Areas covered: This review analyzed published literature and identified the most salient factors at each level of this socio-ecological framework. English langu...
Source: Expert Review of Respiratory Medicine - April 21, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Calcilytics: a non-steroidal replacement for inhaled steroid and SABA/LABA therapy of human asthma?
This article elaborates evidence supporting the hypothesis that topically delivered, inhaled antagonists of the calcium-sensing receptor (CaSR) have the potential to meet these requirements, and the practicality of repurposing existing, small molecule CaSR antagonists (calcilytics) for this purpose. PMID: 32306788 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - April 21, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Pulmonary manifestations of gastroesophageal reflux disease.
Authors: Griffiths TL, Nassar M, Soubani AO Abstract Introduction: Gastroesophageal Reflux Disease (GERD) is a wide spread condition with significant impact on quality of life and healthcare resources. In addition to its gastrointestinal problems, GERD is has been linked to a variety of respiratory diseases either as a direct cause, or risk factor to inability to control or worsening of the disease.Areas covered: We performed literature search in PubMed database for articles addressing GERD and pulmonary diseases. This review will discuss several different pulmonary diseases affected by GERD ranging from upper airw...
Source: Expert Review of Respiratory Medicine - April 21, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Advances in the diagnosis of fungal pneumonias.
Authors: Kelly BT, Pennington KM, Limper AH Abstract Introduction: Fungal infections are increasingly encountered in clinical practice due to more favorable environmental conditions and increasing prevalence of immunocompromised individuals. The diagnostic approach for many fungal pathogens continues to evolve. Herein, we outline available diagnostic tests for the most common fungal infections with a focus on recent advances and future directions.Areas covered: We discuss the diagnostic testing methods for angioinvasive molds (Aspergillus spp. and Mucor spp.), invasive yeast (Candida spp. and Cryptococcus sp.), Pne...
Source: Expert Review of Respiratory Medicine - April 17, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Diagnostic management of acute pulmonary embolism in special populations.
Authors: Stals MA, Klok FA, Huisman MV Abstract Introduction: Pulmonary embolism (PE) is a potentially life-threatening disease, making an accurate and prompt diagnosis thus very important. However, the normally used diagnostic algorithms may not be as efficient and safe in special patient populations. The diagnostic management of suspected PE in these patients is particularly challenging.Areas covered: Current diagnostic strategies in patients with malignancy, elderly patients and patients with renal insufficiency are discussed in this review. A special focus is on reviewing the literature supporting the use of ad...
Source: Expert Review of Respiratory Medicine - April 11, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Influences of environmental exposures on individuals living with cystic fibrosis.
Authors: Szczesniak R, Rice JL, Brokamp C, Ryan P, Pestian T, Ni Y, Andrinopoulou ER, Keogh RH, Gecili E, Huang R, Clancy JP, Collaco JM Abstract Introduction: Natural, social, and constructed environments play a critical role in the development and exacerbation of respiratory diseases. However, less is known regarding the influence of these environmental/community risk factors on the health of individuals living with cystic fibrosis (CF), compared to other pulmonary disorders.Areas Covered: Here, we review current knowledge of environmental exposures related to CF, which suggest that environmental/community risk f...
Source: Expert Review of Respiratory Medicine - April 10, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Value of serum soluble Interleukin-2 Receptor as a diagnostic and predictive biomarker in sarcoidosis.
Conclusion: High levels of sIL-2R are suggestive of sarcoidosis, although a broad overlap exists in sIL-2R levels across sarcoidosis, cHP and IPF. High levels of sIL-2R might serve as a prognostic biomarker for chronicity. PMID: 32248706 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - April 8, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The association of patient-reported symptoms and clinical and lung function parameters in patients with chronic obstructive pulmonary disease in stable phase.
We described the correlation between clinical and functional respiratory parameters in one-year follow-up observational study during stable phase COPD and regular inhalation therapy.Methods: In 237 patients, the impact of respiratory symptoms was evaluated using the modified Medical Research Council (mMRC) dyspnea scale, the COPD assessment test (CAT), and a self-assessment of patient's perceived COPD severity (Mapel scale) at baseline (T0) and after one year (T1).Results: Mean CAT and mMRC scores at T0 were 10.55 and 1.2, respectively. The majority of patients pointed out mild symptoms (values between 1 and 2 at Mapel sca...
Source: Expert Review of Respiratory Medicine - April 8, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

An overview of the available treatments for chronic cavitary pulmonary aspergillosis.
Authors: Sehgal IS, Dhooria S, Muthu V, Prasad KT, Agarwal R Abstract Introduction: Chronic pulmonary aspergillosis (CPA) is a chronic infection of the lung parenchyma caused by Aspergillus fumigatus complicating structural lung diseases. Of the different types of CPA, chronic cavitary pulmonary aspergillosis (CCPA) is the most common form. Untreated, most patients with CCPA will progress to chronic fibrosing pulmonary aspergillosis. The mainstay of treatment of CCPA is oral triazoles. However, many gaps exist in clinical decision-making about the agent of choice, the duration, and the assessment of treatment respo...
Source: Expert Review of Respiratory Medicine - April 8, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The role of the paediatrician in caring for children with tracheobronchomalacia.
This article focuses on the role of the paediatrician in recognising the condition, the investigative process, and the medical management based on the clinical severity. The principle of management should be holistic, tackling the medical issues of TBM and associated comorbidities, as providing support to families.Expert opinion: There remains a need to devise objective and reproducible bronchoscopic and radiological definitions of severity of TBM. Further studies looking at long-term outcomes of medical therapies used in TBM are required. PMID: 32249702 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - April 8, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Immunoactive preparations and regulatory responses in the respiratory tract: potential for clinical application in chronic inflammatory airway diseases.
Authors: Feleszko W, Rossi GA, Krenke R, Canonica GW, van Gerven L, Kalyuzhin O Abstract Introduction: The prevalence of chronic inflammatory airway diseases is rising. Their treatment with corticosteroids increases infection risk, while overuse of antimicrobial agents may increase morbidity and antimicrobial resistance. Non-specific immunomodulatory compounds alter immune responses to both infectious and atopic challenges. These compounds may offer an alternative approach for symptom reduction and prophylaxis against both infections and exacerbations in chronic inflammatory airway disease.Areas covered: We assesse...
Source: Expert Review of Respiratory Medicine - April 8, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Clinical recommendations for cardiopulmonary exercise testing in children with respiratory diseases.
Authors: Takken T, Sonbahar Ulu H, Hulzebos EH Abstract Introduction: Cardiopulmonary exercise testing (CPET) quantitates and qualitates the integrated physiological response of a person to incremental exercise and provides additional information compared to static lung function tests alone.Areas covered: This review covers rationale for the use of CPET parameters beyond the usual parameters like peak oxygen uptake and peak minute ventilation in children with respiratory disease.Expert opinion: CPET provides a wealth of data from rest, submaximal and maximal exercise and data during recovery from exercise. In this ...
Source: Expert Review of Respiratory Medicine - April 8, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Validation of the Persian Work Productivity and Activity Impairment questionnaire in asthmatic patients.
Authors: Seyedrezazadeh E, Ansarin K, Sharifi A, Jafari Rouhi AH, Gilani N, Aftabi Y, Khalili M, Najmi M Abstract Objective: The work productivity and activity impairment (WPAI) questionnaire is a fine linguistic validated tool to measure work productivity and activity impairment. Considering its capability, this study aimed to evaluate the validity of the Persian version of WPAI-AQ in asthmatics.Methods: The standard forward-backward process was used to translate the English version of WPAI-AQ into Persian. The convergent validity and responsiveness were evaluated by analysing the correlations between the Persian ...
Source: Expert Review of Respiratory Medicine - April 4, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Predictors of outcome of pleurodesis in patients with malignant pleural effusion: a systematic review and meta-analysis.
Conclusion: Overall, available results are difficult to interpret due to evidence quality. Prospective studies are needed to further explore these factors.Protocol registration: CRD42018115874 (Prospero database of systematic reviews). PMID: 32213100 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - March 29, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

What is the value of electromagnetic navigation in lung cancer and to what extent does it require improvement?
Authors: Shaller BD, Gildea TR Abstract Introduction: Lung nodules are being identified with increasing frequency. With this growing burden of nodules comes a growing need for diagnostic technologies extending beyond the current reach of conventional bronchoscopy. One such method for diagnosing peripheral lung lesions is electromagnetic navigational bronchoscopy (ENB), which comprises a set of tools designed to aid the bronchoscopist in identifying, accessing, and sampling peripheral lung lesions under virtual guidance.Areas covered: Herein we present an in-depth review of ENB, including commercially-available elec...
Source: Expert Review of Respiratory Medicine - March 29, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Biomarkers and their potential functions in idiopathic pulmonary fibrosis.
Authors: Ni S, Peng H, Song M, Guo W, Guo T, Shen Q Abstract Introduction: Idiopathic pulmonary fibrosis (IPF) is a chronic, devastating, and progressive lung disease which is characterized by fibrosis and respiratory failure. IPF holds high morbidity and poor prognosis and still faces with considerable problems of reliable diagnosis and valid prognosis. A growing body of literatures have reported changes in the level of various biomarkers in IPF patients, which means that they are expected to become a new tool for clinical practice of IPF.Areas covered: We reviewed the recent literature about biomarkers and focus ...
Source: Expert Review of Respiratory Medicine - March 19, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

New options for pneumothorax management.
Authors: Chen KC, Chen PH, Chen JS Abstract Introduction: Pneumothorax is defined as the presence of air in the pleural space. Spontaneous pneumothorax, occurring without antecedent traumatic or iatrogenic cause, is classified as primary or secondary. There are substantial inconsistencies in international guidelines for the treatment of pneumothorax. Moreover, many geographical variations exist in daily clinical practice.Areas covered: In this article, we focus on novel treatment modalities for this significant health problem in young adults.Expert opinion: In part, these discrepancies have been caused by the lack ...
Source: Expert Review of Respiratory Medicine - March 18, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Artificial intelligence and machine learning in respiratory medicine.
Authors: Mekov E, Miravitlles M, Petkov R Abstract Introduction: The application of artificial intelligence (AI) and machine learning (ML) in medicine and in particular in respiratory medicine is an increasingly relevant topic.Areas covered: We aimed to identify and describe the studies published on the use of AI and ML in the field of respiratory diseases. The string "(((pulmonary) OR respiratory)) AND ((artificial intelligence) OR machine learning)" was used in PubMed as a search strategy. The majority of studies identified corresponded to the area of chronic obstructive pulmonary disease (COPD), in par...
Source: Expert Review of Respiratory Medicine - March 15, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The Long-Lasting Effects of the Acute Respiratory Distress Syndrome.
Authors: Mart MF, Ware LB Abstract Introduction: Acute respiratory distress syndrome (ARDS) is a severe form of acute lung injury common in critically ill patients and characterized by significant morbidity and mortality. It frequently manifests long-lasting effects beyond hospitalization, from cognitive impairment to physical weakness.Areas covered: Several complications of ARDS have been identified in patients after hospital discharge. The authors conducted literature searches to identify observational studies, randomized clinical trials, systematic reviews, and guidelines. A summary of is presented here to outli...
Source: Expert Review of Respiratory Medicine - March 15, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Evaluation of fluticasone propionate/salmeterol for the treatment of COPD: a systematic review.
Authors: Calzetta L, Ritondo BL, Matera MG, Cazzola M, Rogliani P Abstract Introduction: Recently, the generic formulation of FP/SAL FDC has been approved in COPD. Although FP/SAL FDC has been the first long acting FDC approved in COPD, no systematic review assessed the effect of this combination for the treatment of COPD by considering specifically Phase IV studies. The aim of this review was to systematically assess the effect of FP/SAL FDC in COPD patients enrolled in Phase IV studies.Areas covered: The question of this systematic review was to examine the evidence regarding the impact of FP/SAL FDC for the trea...
Source: Expert Review of Respiratory Medicine - March 15, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Sex steroid hormones and asthma in women: state-of-the-art and future research perspectives.
Authors: Zhang GQ, Bossios A, Rådinger M, Nwaru BI PMID: 32151191 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - March 12, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Ivacaftor for the treatment of cystic fibrosis in children under six years of age.
Authors: Aoyama BC, Mogayzel PJ Abstract Introduction: Cystic fibrosis (CF) results from aberrant ion transport due to abnormalities or absence of the cystic fibrosis transmembrane conductance regulator (CFTR), a chloride transporter that resides on the apical surface of epithelial cells. A novel class of medications, known as CFTR modulators, specifically target the abnormal protein.Areas covered: Ivacaftor increases the open probability of CFTR located on the cell surface, leading to enhanced chloride transport, and has been shown to improve lung function, weight, and quality of life. We reviewed the sentinel stu...
Source: Expert Review of Respiratory Medicine - March 12, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Impact of long-term exposure wildfire smog on respiratory health outcomes.
Conclusion: Wildfire smog could be induced respiratory pathway inflammation and easily collapsible respiratory airways. PMID: 32156169 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - March 12, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Allergen immunotherapy: what is the added value of real-world evidence from retrospective claims database studies?
Authors: Devillier P, Demoly P, Molimard M Abstract Introduction: Randomized controlled trials (RCTs) show that allergen immunotherapy (AIT) has proven long-term efficacy in patients with allergic rhinitis (AR). However, RCTs have limited generalizability and there is growing recognition that real-world evidence (RWE) is necessary to provide complementary data to those of RCTs, and corroborate their findings. Until recently, data from the real-world setting investigating the benefits of AIT for the treatment of patients with grass and birch pollen-associated AR were sparse, but new retrospective claims database stu...
Source: Expert Review of Respiratory Medicine - March 6, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Benralizumab: an updated treatment of eosinophilic asthma.
Authors: Cushen B, Menzies-Gow A Abstract Introduction: An estimated 5-10% of people with asthma have disease which remains uncontrolled despite maximal treatment with inhaled corticosteroids and long acting beta agonists. Benralizumab is currently licensed for use in patients with severe asthma who have an eosinophilic phenotype. Benralizumab depletes eosinophils by binding to the anti-IL5 receptor on the surface of eosinophils, mitigating the effect of IL-5 on eosinophil proliferation and survival, and induces natural killer cell-mediated eosinophil apoptosis.Areas covered: The authors review the mechanism of act...
Source: Expert Review of Respiratory Medicine - March 6, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Role of the mucins in pathogenesis of COPD: implications for therapy.
Authors: Lo Bello F, Ieni A, Hansbro PM, Ruggeri P, Di Stefano A, Nucera F, Coppolino I, Monaco F, Tuccari G, Adcock IM, Caramori G Abstract Introduction: Evidence accumulated in the last decade has started to reveal the enormous complexity in the expression, interactions and functions of the large number of different mucins present in the different compartments of the human lower airways. This occurs both in normal subjects and in COPD patients in different clinical phases and stages of severity.Areas covered: We review the known physiological mechanisms that regulate mucin production in human lower airways of nor...
Source: Expert Review of Respiratory Medicine - March 6, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Clinical relevance of understanding mitogen-activated protein kinases involved in asthma.
Authors: Pelaia C, Vatrella A, Crimi C, Gallelli L, Terracciano R, Pelaia G Abstract Introduction: Mitogen-activated protein kinases (MAPKs) are a large family of evolutionary conserved intracellular enzymes that play a pivotal role in signalling pathways mediating the biologic actions of a wide array of extracellular stimuli.Areas covered: MAPKs are implicated in most pathogenic events involved in asthma, including both inflammatory and structural changes occurring in the airways. Indeed, MAPKs are located at level of crucial convergence points within the signal transduction networks activated by many cytokines, c...
Source: Expert Review of Respiratory Medicine - February 28, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The Glascow Prognostic Score can be a predictor of mortality in acute exacerbation of chronic obstructive pulmonary disease.
Authors: Kuluöztürk M, Deveci F Abstract Aim: To determine of the prognostic value of Glasgow Prognostic Score (GPS) in acute exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) requiring hospitalization.Methods: Hospital electronic database of 129 patients with AECOPD was retrospectively searched and CRP levels, complete blood count, arterial blood gas (ABG) values and pulmonary function test (PFT) parameters of patients were recorded. Hospital mortality and need for ICU transfer were determined as adverse outcomes from files of cases.Results: 106 of 129 patients were male (82.2%) and rest of ...
Source: Expert Review of Respiratory Medicine - February 27, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Extracorporeal membrane oxygenation support in adult patients with acute respiratory distress syndrome.
Authors: Na SJ, Jeon K Abstract Introduction: The global number of patients receiving extracorporeal membrane oxygenation (ECMO) support has been growing after several studies highlighted the favorable results attained in cases of severe respiratory failure. However, evidence-based guidelines for optimal use of ECMO are lacking.Areas covered: This review covers optimal candidates, timing of initiation, strategies for patient management including mechanical ventilation, and decision-making regarding discontinuation of ECMO based on its potential role in treatment of patients with acute respiratory distress syndrome....
Source: Expert Review of Respiratory Medicine - February 25, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

How may we improve clinical outcomes for patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease? A narrative review about possible therapeutic and preventive strategies.
Authors: Crisafulli E, Manco A, Torres A Abstract Introduction: In a subset of chronic obstructive pulmonary disease (COPD)patients the course of the disease is complicated by a severe acute exacerbations (AECOPD) that may require hospitalization, at which time negative outcomes may occur up to 30 days after discharge. Several predictors of negative outcomes have been documented.Areas covered: We considered five negative outcomes related to patients hospitalized with AECOPD: treatment failure, non-invasive mechanical ventilation (NIMV) failure, prolonged length of hospital stay (LHS), short-term mortality (≤ 90 ...
Source: Expert Review of Respiratory Medicine - February 23, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Role of p38-mitogen-activated protein kinase in COPD: pathobiological implications and therapeutic perspectives.
Authors: Pelaia C, Vatrella A, Sciacqua A, Terracciano R, Pelaia G Abstract Introduction: The p38 serine-threonine kinases are members of the large family of mitogen-activated protein kinases (MAPK). In particular, p38 MAPK subgroup includes four isoforms (α, β, γ, δ), among which p38α and p38β are mainly involved in inflammatory disorders. Indeed, by activating key transcription factors and by inducing the expression of several cytokines and chemokines, p38α plays a central role in the pathobiology of chronic obstructive pulmonary disease (COPD).Areas covered: This concise r...
Source: Expert Review of Respiratory Medicine - February 23, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Spinal cord injury and diaphragm neuromotor control.
Authors: Fogarty MJ, Sieck GC Abstract Introduction: Neuromotor control of diaphragm muscle and the recovery of diaphragm activity following spinal cord injury has been narrowly focused on ventilation. By contrast, the understanding of neuromotor control for non-ventilatory expulsive/straining maneuvers (including coughing, defecation and parturition) is relatively impoverished. This variety of behaviours is achieved via the recruitment of the diverse array of motor units that comprise the diaphragm muscle.Areas covered: The neuromotor control of ventilatory and non-ventilatory behaviors in health and in the contex...
Source: Expert Review of Respiratory Medicine - February 23, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Assessment of efficacy of oseltamivir-azithromycin combination therapy in prevention of influenza-a (H1N1) infection complications and rapidity of symptom relief.
This study aimed to assess the efficacy of Oseltamivir-Azithromycin combination therapy for prevention of Influenza-A(H1)pdm09 infection associated complications and early relief of influenza symptoms.Methods: In a retrospective observational cohort study, Influenza-A(H1)pdm09 infection hospitalized patients were identified and divided into two groups based on the initial therapy. Group-AV patients were initiated on Oseltamivir without any antibiotic in treatment regimen while Group-AV+AZ patients were initiated on Oseltamivir and Azithromycin combination therapy for at least 3-5 days. Patients were evaluated for different...
Source: Expert Review of Respiratory Medicine - February 15, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The dry powder inhaler features of the Easyhaler that benefit the management of patients.
Authors: Chrystyn H, Lavorini F Abstract Introduction: Inhaled therapies are likely to continue to dominate asthma and chronic obstructive pulmonary disease treatment. Dry powder inhalers (DPIs) have several advantages over pressurized metered-dose inhaler (pMDIs), that are most frequently marketed world-wide, but often difficult to use. This literature search focus on DPI features, with respect to Easyhaler, that may affect their use and patients' clinical benefit.Areas covered: DPIs are breath-actuated, easy to use, convenient to use, and more environmentally friendly. During inhalation, the formulation in a DPI ...
Source: Expert Review of Respiratory Medicine - February 5, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Therapeutic strategies for pulmonary sarcoidosis.
Authors: James WE, Judson MA Abstract Introduction: The treatment of pulmonary sarcoidosis is not standardized. Treatment involves a multi-step decision process beginning with whether treatment is warranted, determining initial therapy, then assessing when therapy requires modifications or can be discontinued.Areas covered: This manuscript will address the following issues concerning the treatment of pulmonary sarcoidosis: Treatment indications, initial anti-granulomatous therapy, therapy for chronic and fibrotic disease, glucocorticoid therapy, alternative therapy to glucocorticoids, non-granulomatous therapies, a...
Source: Expert Review of Respiratory Medicine - February 1, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF): an overview of current and future therapeutic strategies.
Authors: Biondini D, Balestro E, Sverzellati N, Cocconcelli E, Bernardinello N, Ryerson CJ, Spagnolo P Abstract Introduction: Idiopathic pulmonary fibrosis (IPF), the most common of the idiopathic interstitial pneumonias, is a disease with a poor prognosis, and a highly heterogeneous and unpredictable clinical course. While most patients experience a relatively slow clinical, functional and radiological deterioration, a significant minority develops episodes of acute respiratory worsening termed acute exacerbations of IPF (AE-IPF). AE-IPF cannot be predicted or prevented and precede approximately half of IPF-relate...
Source: Expert Review of Respiratory Medicine - January 31, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Respiratory syncytial virus infection: why does disease severity vary among individuals?
This article reviews the available literature on the field of RSV disease severity and discusses important factors associated to susceptibility and different disease outcome.Expert opinion: The severity of RSV-induced illness is a phenomenon that depends on a variety of graded mechanisms of interaction between the host, virus, and environment. This may lead to differences in intensity of immune response in the lung and different courses of the disease. By characterizing, classifying and grading the affecting factors in high-risk patients versus those who do not fall ill by RSV, we may find therapies or point to disease-lim...
Source: Expert Review of Respiratory Medicine - January 31, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Antibodies targeting the interleukin-5 signaling pathway used as add-on therapy for patients with severe eosinophilic asthma: a review of the mechanism of action, efficacy and safety of the subcutaneously administered agents, mepolizumab and benralizumab.
Authors: Hillas G, Fouka E, Papaioannou AI Abstract Introduction: Since the discovery of eosinophils in the sputum of asthmatic patients, several studies have offered evidence on their prominent role in the pathology and severity of asthma. Blood eosinophils, are a useful biomarker for therapy selection in severe asthma patients. IL-5 plays crucial role on maturation, activation, recruitment, and survival of eosinophils and constitutes an important therapeutic target for patients with severe uncontrolled eosinophilic asthma.Areas Covered: This review focuses on the similarities and differences on mechanisms of acti...
Source: Expert Review of Respiratory Medicine - January 22, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

An update on pulmonary rehabilitation techniques for patients with chronic obstructive pulmonary disease.
Authors: Wouters EF, Posthuma R, Koopman M, Liu WY, Sillen MJ, Hajian B, Sastry M, Spruit M, Franssen FM Abstract Introduction: Pulmonary rehabilitation (PR) is one of the core components in the management of patients with chronic obstructive pulmonary disease (COPD). In order to achieve the maximal level of independence, autonomy, and functioning of the patient, targeted therapies and interventions based on the identification of physical, emotional and social traits need to be provided by a dedicated, interdisciplinary PR team.Areas covered: The review discusses cardiopulmonary exercise testing in the selection of...
Source: Expert Review of Respiratory Medicine - January 15, 2020 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research