Lung cancer screening in advanced chronic obstructive pulmonary disease: helpful or harmful?
Commonly in medicine we encounter situations where a potential intervention may not be in the patient’s best interests due to the balance of benefits and harms. In screening, there is the additional goal of the intervention being beneficial to the screened population as a whole.1 With the recent endorsement from the UK National Screening Committee for lung cancer screening (LCS) with low-dose CT (LDCT) in the UK,2 and with LCS efforts stepping up worldwide, it is imperative we understand how best to offer screening to the ‘correct’ individuals. The benefits of LCS have been well demonstrated in the litera...
Source: Thorax - June 15, 2023 Category: Respiratory Medicine Authors: Ruparel, M. Tags: Thorax Editorial Source Type: research
Respiratory effects of air pollution: time to stop this deadly trajectory
The Global Burden of Disease Study has estimated that over 500 million subjects, around 7% of the global population, are affected by chronic respiratory diseases, with substantial individual and societal costs concerning morbidity, disability and mortality.1 Identifying and mitigating potentially modifiable risk factors are crucial in preventing the associated public health burden. Extensive literature has provided compelling evidence that air pollution, especially fine particulate matter (PM)2.5 (diameter <2.5 µm), is a leading risk factor for the incidence and mortality of acute and chronic respiratory diseases,...
Source: Thorax - June 15, 2023 Category: Respiratory Medicine Authors: De Matteis, S. Tags: Thorax Editorial Source Type: research
Journal club
The rise of the novel antihyperglycaemic agents: are patients with chronic obstructive pulmonary disease the next to benefit? The role of novel antihyperglycaemic drugs in cardiology and diabetes is well recognised, and laboratory studies have suggested possible mechanisms by which these drugs could reduce chronic obstructive pulmonary disease (COPD) exacerbations in patients with type 2 diabetes mellitus. A population-based cohort study by Pradhan et al (BMJ 2022;379:e071380) used primary care and hospital databases to compare 3 novel antihyperglycaemic drugs (glucagon-like peptide 1 (GLP-1) receptor agonists, n=1252; dip...
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Burney, R. Tags: Thorax Journal club Source Type: research
Invasive pulmonary infection caused by Trichoderma longibrachiatum
A 38-year-old woman presented with a 1-month history of progressive cough and phlegm. She was an office worker. She denied the presence of comorbidities including diabetes, renal disease, malignancy and acquired immune deficiency syndrome. She underwent chest CT scan (figure 1A) 2 weeks before admission, having been taking moxifloxacin treatment for 12 days without improvement in symptoms. A repeat CT scan at admission showed significant progression of the lung lesions compared with previous imaging (figure 1B). Sputum culture was negative. Laboratory investigations revealed NK cells, CD4+, CD8+ lymphocytes and the CD4+/CD...
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Wang, S., Tu, J. Tags: Images in Thorax, Thorax Source Type: research
Tracheal stenosis after endobronchial ultrasound-guided transbronchial needle aspiration
A 78-year-old man was referred to our hospital to study a pulmonary nodule in the left lower lobe, suspicious for malignancy. An endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was carried out for the study, during the procedure samples were taken from lymph node stations 4R (lower paratracheal right), 7 (subcarinal) and 11 L (interlobar left) using a 22-gauge needle. The histological results ruled out lymph node involvement. There were no immediate complications, however, the patient developed a dry cough 72 hours after the procedure. After assessment by the multidisciplinary lung tumour commi...
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Grau, A., Lozano, C., Gallego, M. Tags: Images in Thorax, Thorax Source Type: research
Mesenchymal stromal cells-derived extracellular vesicles reprogramme macrophages in ARDS models through the miR-181a-5p-PTEN-pSTAT5-SOCS1 axis
Conclusion
miR-181a-PTEN-pSTAT5-SOCS1 axis is a novel pathway responsible for immunomodulatory effect of MSC EVs in ARDS. (Source: Thorax)
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Su, Y., Silva, J. D., Doherty, D., Simpson, D. A., Weiss, D. J., Rolandsson-Enes, S., McAuley, D. F., O'Kane, C. M., Brazil, D. P., Krasnodembskaya, A. D. Tags: Open access, Thorax Critical care Source Type: research
C reactive protein utilisation, a biomarker for early COVID-19 treatment, improves lenzilumab efficacy: results from the randomised phase 3 'LIVE-AIR trial
Conclusion
Hospitalised hypoxemic patients with COVID-19 with baseline CRP <150 mg/L derived the greatest clinical benefit from treatment with lenzilumab.
Trial registration number
NCT04351152; ClinicalTrials.gov (Source: Thorax)
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Temesgen, Z., Kelley, C. F., Cerasoli, F., Kilcoyne, A., Chappell, D., Durrant, C., Ahmed, O., Chappell, G., Catterson, V., Polk, C., Badley, A., Marconi, V. C., LIVE-AIR Study Group, Lewis, Sher, Bowdish, Wald-Dickler, Biswas, Lam, Vo, Poblete, Lee, Hutc Tags: Open access, Thorax, COVID-19 Respiratory infection Source Type: research
COPD in Africa: risk factors, hospitalisation, readmission and associated outcomes--a systematic review and meta-analysis
Conclusion
This study not only highlights specific risk factors for COPD risk in Africa but also demonstrates the paucity and absence of research in several countries in a continent with substantial COPD-related mortality. Our findings contribute towards the development of evidence-based clinical guidelines for COPD in Africa.
PROSPERO registration number
CRD42020210581. (Source: Thorax)
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Njoku, C. M., Hurst, J. R., Kinsman, L., Balogun, S., Obamiro, K. Tags: Thorax Respiratory epidemiology Source Type: research
ABCA3-related interstitial lung disease beyond infancy
Conclusion
The natural history of ABCA3-related interstitial lung disease progresses during childhood and adolescence. Disease-modifying treatments are desirable to delay such disease course. (Source: Thorax)
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Li, Y., Seidl, E., Knoflach, K., Gothe, F., Forstner, M. E., Michel, K., Pawlita, I., Gesenhues, F., Sattler, F., Yang, X., Kroener, C., Reu-Hofer, S., Ley-Zaporozhan, J., Kammer, B., Krüger-Stollfuss, I., Dinkel, J., Carlens, J., Wetzke, M., More Tags: Open access, Thorax Orphan lung disease Source Type: research
Effects of enhanced recovery after surgery plus pulmonary rehabilitation on complications after video-assisted lung cancer surgery: a multicentre randomised controlled trial
Conclusions
Adding pulmonary rehabilitation to enhanced recovery after surgery appears to be effective in reducing the incidence of PPCs, but not LOS. Standard integration of pulmonary rehabilitation into thoracic enhanced recovery after surgery is a promising approach to PPC prophylaxis.
Trial registration number
ChiCTR1900024646. (Source: Thorax)
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Zheng, Y., Mao, M., Li, F., Wang, L., Zhang, X., Zhang, X., Wang, H., Zhou, H., Ji, M., Wang, Y., Liu, L., Zhu, Q., Reinhardt, J. D., Lu, X. Tags: Thorax Lung cancer Source Type: research
MUC5B, telomere length and longitudinal quantitative interstitial lung changes: the MESA Lung Study
Conclusions
Longitudinal increases in HAAs were associated with the MUC5B risk allele and a higher risk of death and ILD. (Source: Thorax)
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Kim, J. S., Manichaikul, A. W., Hoffman, E. A., Balte, P., Anderson, M. R., Bernstein, E. J., Madahar, P., Oelsner, E. C., Kawut, S. M., Wysoczanski, A., Laine, A. F., Adegunsoye, A., Ma, J. Z., Taub, M. A., Mathias, R. A., Rich, S. S., Rotter, J. I., Not Tags: Editor's choice, Thorax Interstitial lung disease Source Type: research
The relationship between interstitial lung abnormalities, mortality, and multimorbidity: a cohort study
Conclusions
ILAs were associated with mortality adjusted for multimorbidity and were similarly associated with increased mortality compared with several common chronic diseases. ILAs were not consistently associated with the prevalence of these diseases themselves. (Source: Thorax)
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Sanders, J. L., Axelsson, G., Putman, R., Menon, A., Dupuis, J., Xu, H., Wang, S., Murabito, J., Vasan, R., Araki, T., Nishino, M., Washko, G. R., Hatabu, H., O'Connor, G., Gudmundsson, G., Gudnason, V., Hunninghake, G. M. Tags: Thorax Interstitial lung disease Source Type: research
Cluster analysis of transcriptomic datasets to identify endotypes of idiopathic pulmonary fibrosis
Background
Considerable clinical heterogeneity in idiopathic pulmonary fibrosis (IPF) suggests the existence of multiple disease endotypes. Identifying these endotypes would improve our understanding of the pathogenesis of IPF and could allow for a biomarker-driven personalised medicine approach. We aimed to identify clinically distinct groups of patients with IPF that could represent distinct disease endotypes.
Methods
We co-normalised, pooled and clustered three publicly available blood transcriptomic datasets (total 220 IPF cases). We compared clinical traits across clusters and used gene enrichment analysis to identif...
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Kraven, L. M., Taylor, A. R., Molyneaux, P. L., Maher, T. M., McDonough, J. E., Mura, M., Yang, I. V., Schwartz, D. A., Huang, Y., Noth, I., Ma, S. F., Yeo, A. J., Fahy, W. A., Jenkins, R. G., Wain, L. V. Tags: Open access, Thorax Interstitial lung disease Source Type: research
Diagnosis and treatment outcomes from prebronchodilator spirometry performed alongside lung cancer screening in a Lung Health Check programme
Conclusions
Delivering spirometry alongside lung cancer screening may facilitate earlier diagnosis of COPD. However, this study highlights the importance of confirming AO by postbronchodilator spirometry prior to diagnosing and treating patients with COPD and illustrates some downstream challenges in acting on spirometry collected during an LHC. (Source: Thorax)
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Bradley, C., Boland, A., Clarke, L., Dallinson, N., Eckert, C., Ellames, D., Finn, J., Gabe, R., Hancock, N., Kennedy, M. P., Lindop, J., Mohamed, A., Mullen, G., Murray, R. L., Rogerson, S., Shinkins, B., Simmonds, I., Upperton, S., Wilkinson, A., Crosbi Tags: Open access, Thorax Chronic obstructive pulmonary disease Source Type: research
Faster lung function decline in people living with HIV despite adequate treatment: a longitudinal matched cohort study
Conclusion
Well-treated PLWH have faster lung function decline than controls and smoking seems to modify this association, suggesting that smoking may lead to more rapid lung function decline in PLWH than in controls. (Source: Thorax)
Source: Thorax - May 16, 2023 Category: Respiratory Medicine Authors: Thudium, R. F., Ronit, A., Afzal, S., Colak, Y., Forman, J. L., Mendo, F., Chen, F., Estrada, V., Kumarasamy, N., Nordestgaard, B. G., Lundgren, J., Vestbo, J., Kunisaki, K. M., Nielsen, S. D., for the COCOMO, INSIGHT START Pulmonary Substudy and CGPS Stu Tags: Thorax Chronic obstructive pulmonary disease Source Type: research
