Current Opinion in Pulmonary Medicine最新文献

Echocardiographic evaluation of the pulmonary circulation and right ventricular functional unit during exercise and its clinical value. 运动时肺循环和右心室功能单位的超声心动图评价及其临床价值。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-07-24 DOI: 10.1097/MCP.0000000000001186

Teresa John, Tall Roschinsky, Philipp Douschan

{"title":"Echocardiographic evaluation of the pulmonary circulation and right ventricular functional unit during exercise and its clinical value.","authors":"Teresa John, Tall Roschinsky, Philipp Douschan","doi":"10.1097/MCP.0000000000001186","DOIUrl":"https://doi.org/10.1097/MCP.0000000000001186","url":null,"abstract":"Purpose of review: In this review, we provide an overview of the echocardiographic evaluation of the pulmonary circulation - right ventricular functional unit during exercise and its clinical value.Recent findings: An increased understanding on the physiological response of pulmonary hemodynamics during exercise and evidence of the impact of an abnormal mean pulmonary arterial pressure (mPAP)/cardiac output (CO) slope on survival led to the reintroduction of exercise pulmonary hypertension (EPH), defined as a mPAP/CO slope >3 mmHg/l/min, in the current European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines for pulmonary hypertension. Additionally, noninvasive exercise echocardiography may enable easy and readily available assessment of pulmonary exercise hemodynamics.Summary: Impaired pulmonary exercise hemodynamics are considered early hemodynamic signs of cardiopulmonary disease. In order to diagnose EPH, exercise right heart catheterization (RHC) is needed, which is invasive, highly cost- and staff intensive and reserved to expert centers. Noninvasive surrogates derived from exercise echocardiography might be an appropriate alternative to invasive RHC.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

PROMs in sarcoidosis - what to use for systemic disease and individual organs and why? 结节病中的PROMs -用于全身性疾病和单个器官，为什么？

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-07-16 DOI: 10.1097/MCP.0000000000001203

Claudia Ravaglia

{"title":"PROMs in sarcoidosis - what to use for systemic disease and individual organs and why?","authors":"Claudia Ravaglia","doi":"10.1097/MCP.0000000000001203","DOIUrl":"https://doi.org/10.1097/MCP.0000000000001203","url":null,"abstract":"Purpose of review: This review provides a critical evaluation of patient-reported outcome measures (PROMs) in sarcoidosis, focusing on their use in assessing systemic disease and organ-specific involvement. We aim to summarize current tools, identify evidence gaps, and explore the evolving role of PROMs in both clinical research and practice.Recent findings: generic instruments such as the SF-36, EQ-5D, and PROMIS have been widely applied in sarcoidosis cohorts, yet their lack of disease specificity limits their interpretability and responsiveness. Sarcoidosis-specific tools [including the Sarcoidosis Health Questionnaire (SHQ), the King's Sarcoidosis Questionnaire (KSQ), and the Fatigue Assessment Scale (FAS)] offer greater construct validity and capture symptoms more relevant to patient experience. On the other hand, PROMs for cardiac, neurologic, ocular, and hepatic involvement remain underdeveloped. PROMs are increasingly incorporated into clinical trials but are rarely used in routine care, partly due to challenges in implementation, interpretation, and integration into workflows. Technological innovations such as computer-adaptive testing and ePROMs offer promising solutions.Summary: PROMs are essential for capturing the subjective burden of sarcoidosis, particularly in domains poorly reflected by physiologic measures. Further work is needed to expand validation across phenotypes, develop organ-specific tools, and embed PROMs into clinical decision-making and regulatory frameworks.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Deciphering sarcoidosis immunopathogenesis through systems biology. 通过系统生物学解读结节病的免疫发病机制。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-07-16 DOI: 10.1097/MCP.0000000000001202

Aiham H Jbeli, Elliott D Crouser, Maneesh Bhargava

{"title":"Deciphering sarcoidosis immunopathogenesis through systems biology.","authors":"Aiham H Jbeli, Elliott D Crouser, Maneesh Bhargava","doi":"10.1097/MCP.0000000000001202","DOIUrl":"https://doi.org/10.1097/MCP.0000000000001202","url":null,"abstract":"Purpose of review: Sarcoidosis is a complex, multisystem disease characterized by granulomatous inflammation and variable clinical outcomes. Its pathogenesis and progression are driven by intricate biological interactions, involving a complex interplay between patient-specific factors such as genetic background, sex, and environmental exposures, as well as epigenetic modifications that regulate gene expression and protein levels. These interconnected layers ultimately drive immune response to yet unidentified trigger(s), culminating in granuloma formation and, in some cases, with an aberrant repair response leading to irreversible organ dysfunction in some cases. In this review, we aim to synthesize recent multiomics research that unravels the underlying biological networks, offering a systems-level understanding of sarcoidosis.Recent findings: Recent studies have identified several potential robust biomarkers, including microRNAs, CD14, LBP, HBEGF, eNAMPT, and ANG-2, while also highlighting the central role of the PI3K/AKT pathway in immune activation. Additionally, new noninvasive methods, such as extracellular vesicle profiling, have emerged as promising alternatives to traditional tissue biopsies.Summary: We highlight recent findings from transcriptomics, epigenomics, and proteomics. These studies illuminate key molecular pathways that may be crucial in sarcoidosis pathogenesis, offering promising opportunities to identify novel therapeutic targets that could transform clinical management and improve patient outcomes.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Small fibre neuropathy and sarcoidosis, target for diagnosis and treatment? 小纤维神经病和结节病，诊断和治疗的目标？

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-07-08 DOI: 10.1097/MCP.0000000000001191

Christopher P Atkins

{"title":"Small fibre neuropathy and sarcoidosis, target for diagnosis and treatment?","authors":"Christopher P Atkins","doi":"10.1097/MCP.0000000000001191","DOIUrl":"https://doi.org/10.1097/MCP.0000000000001191","url":null,"abstract":"Purpose of review: To update the reader on recent evidence relating to symptoms, diagnostic strategies and management options for small-fibre neuropathy (SFN) in sarcoidosis. Learning points from recent studies are presented in the context of previous research forming the basis of our knowledge of SFN in patients with sarcoidosis.Recent findings: Recent studies have shown overlap of SFN and other symptoms beyond pain in patients with sarcoidosis. Where SFN exists, determining the optimal diagnostic modalities is challenging; there have been developments in how forms of temperature threshold testing should be performed, as well as whether this test may miss patchy involvement by SFN in sarcoidosis. To aid identification of SFN in sarcoidosis, questionnaires has been developed specifically looking at sarcoidosis-associated SFN, attempting to capture the patients with patchy or intermittent SFN symptoms. Standard systemic management for sarcoidosis is ineffective for SFN, though infliximab shows promise and is increasingly being utilised as a treatment option.Summary: Few studies have been published in the last two years but there have been developments that have progressed our knowledge. This review collates the latest research alongside prior work, aiming to help summarise diagnosis and management strategies for this problematic manifestation of sarcoidosis.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Important negative trials in pulmonary hypertension. 肺动脉高压的重要阴性试验。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-07-08 DOI: 10.1097/MCP.0000000000001198

Sarah Cullivan, Lucy McCourt, Sean Gaine

引用次数: 0

Precision medicine in pulmonary hypertension: how close are we today? 精准医学治疗肺动脉高压：我们离目标还有多远？

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-07-08 DOI: 10.1097/MCP.0000000000001195

Bradley A Maron

{"title":"Precision medicine in pulmonary hypertension: how close are we today?","authors":"Bradley A Maron","doi":"10.1097/MCP.0000000000001195","DOIUrl":"https://doi.org/10.1097/MCP.0000000000001195","url":null,"abstract":"Purpose of review: Pulmonary hypertension (PH) is a specific but heterogeneous disease defined foremost by elevated pulmonary artery pressure, typically occurring due to pulmonary vascular fibroproliferative, plexigenic, or thrombotic remodelling. The heterogenous clinical and pathobiological basis of PH poses challenges and opportunities for optimizing treatment alignment to individual patients.Recent findings: Advancing precision medicine through personalized treatment pathways in PH is particularly timely owing to persistent morbidity and shortened lifespan reported for patients despite an expanding armamentarium of pharmacotherapeutics, particularly for pulmonary arterial hypertension. Accomplishing this goal successfully has benefited from efforts that optimize clinical phenotyping, establishing reticulotypes that represent the phenotypic consequences of functionally essential pathogenic molecular events, and build greater insight on treatment response variability observed in randomized clinical trials.Summary: Although as a scientific field PH remains early in the precision medicine journey, wider availability and lower cost of high throughput -omics platforms, and increasingly sophisticated analytical methodologies introduces optimism that clinically actionable strategies that improve patient-treatment alignment can be realized in the near-term.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unraveling mechanistic insights through interstitial lung disease multiomics. 通过间质性肺病多组学揭示机制见解。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-07-08 DOI: 10.1097/MCP.0000000000001192

Aravind A Menon, Auyon J Ghosh

{"title":"Unraveling mechanistic insights through interstitial lung disease multiomics.","authors":"Aravind A Menon, Auyon J Ghosh","doi":"10.1097/MCP.0000000000001192","DOIUrl":"https://doi.org/10.1097/MCP.0000000000001192","url":null,"abstract":"Purpose of review: Interstitial lung disease (ILD) and consequent pulmonary fibrosis are associated with significant morbidity and mortality with limited treatment options. There are more than 200 different etiologies that can lead to ILD. As a result, diagnostic accuracy and delay, prognostication, and treatment responses are still rife with challenges. The integration of bioinformatics with clinical practice is gaining momentum, evolving from a research tool to a practical resource with potential applications at the bedside. Work in this field has opened avenues into the pursuit of precision medicine in ILD.Recent findings: Across various 'omics-based technologies, numerous studies highlight the potential of using molecular data to disentangle the complex processes that lead to pulmonary fibrosis. Recent studies point toward integrating signals across domains to filter out noise and identify true signals. However, there is still a need for functional work to connect the high-dimensional signals to the biology underlying pulmonary fibrosis.Summary: Pursuing a multiomic approach across multiple domains in ILD holds promise for better biomarkers, clinical trial enrichment, and developing a deeper understanding of disease pathology.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New therapeutic options in sarcoidosis. 结节病的新治疗选择。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-07-08 DOI: 10.1097/MCP.0000000000001196

Hilario Nunes, Raphael Hindré, Florence Jeny

{"title":"New therapeutic options in sarcoidosis.","authors":"Hilario Nunes, Raphael Hindré, Florence Jeny","doi":"10.1097/MCP.0000000000001196","DOIUrl":"https://doi.org/10.1097/MCP.0000000000001196","url":null,"abstract":"Purpose of review: Corticosteroids remain the cornerstone of sarcoidosis treatment but are associated with significant toxicities and impaired quality of life. Second-line and third-line treatments include hydroxychloroquine or immunosuppressants (methotrexate, azathioprine, leflunomide and mycophenolate mofetil), and anti-TNF-α agents (infliximab and adalimumab), respectively. The latest identification of significant key cellular pathways in sarcoidosis pathogenesis has led to the development of new therapeutic strategies described in this review.Recent findings: JAK inhibitors, mainly tofacitinib, exhibited encouraging results in case reports, small retrospective series, and two prospective open-label trials for skin and pulmonary sarcoidosis. mTOR inhibitors demonstrated efficacity in one cross-over study on skin involvement. Promising findings were obtained with efzofitimod, an inhibitor of neuropilin-2 receptor, in a pilot study on pulmonary sarcoidosis, which needs to be confirmed. Other drugs with potentially relevant mechanisms of action have been used in case reports or small series or are under investigation: CTLA-4 inhibitors, IL-6 inhibitors, NLRP3 inflammasome inhibitors, GM-CSF inhibitors, PDE-4 inhibitors, and statins. There is very little data available on antifibrotic agents for fibrotic pulmonary sarcoidosis.Summary: Despite many challenges, well designed studies are warranted to investigate new therapeutic options in sarcoidosis, particularly in patients with refractory forms or unacceptable side-effects with third-line treatment.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial intelligence in cardiac sarcoidosis: ECG, Echo, CPET and MRI. 人工智能在心脏结节病中的应用：心电图、超声、CPET和MRI。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-07-08 DOI: 10.1097/MCP.0000000000001193

Wilfred Ifeanyi Umeojiako, Thomas Lüscher, Rakesh Sharma

{"title":"Artificial intelligence in cardiac sarcoidosis: ECG, Echo, CPET and MRI.","authors":"Wilfred Ifeanyi Umeojiako, Thomas Lüscher, Rakesh Sharma","doi":"10.1097/MCP.0000000000001193","DOIUrl":"https://doi.org/10.1097/MCP.0000000000001193","url":null,"abstract":"Purpose of review: Cardiac sarcoidosis is a form of inflammatory cardiomyopathy that varies in its clinical presentation. It is associated with significant clinical complications such as high-degree atrioventricular block, ventricular tachycardia, heart failure and sudden cardiac death. It is challenging to diagnose clinically, and its increasing detection rate may represent increasing awareness of the disease by clinicians as well as a rising incidence. Prompt diagnosis and risk stratification reduces morbidity and mortality from cardiac sarcoidosis. Noninvasive diagnostic modalities such as ECG, echocardiography, PET/computed tomography (PET/CT) and cardiac MRI (cMRI) are increasingly playing important roles in cardiac sarcoidosis diagnosis. Artificial intelligence driven applications are increasingly being applied to these diagnostic modalities to improve the detection of cardiac sarcoidosis.Recent findings: Review of the recent literature suggests artificial intelligence based algorithms in PET/CT and cMRIs can predict cardiac sarcoidosis as accurately as trained experts, however, there are few published studies on artificial intelligence based algorithms in ECG and echocardiography.Summary: The impressive advances in artificial intelligence have the potential to transform patient screening in cardiac sarcoidosis, aid prompt diagnosis and appropriate risk stratification and change clinical practice.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Immune checkpoint inhibitor-associated pneumonitis: focus on diagnosis and underlying mechanisms. 免疫检查点抑制剂相关性肺炎：关注诊断和潜在机制

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-07-01 Epub Date: 2025-04-23 DOI: 10.1097/MCP.0000000000001175

Mtanis Khoury, Saadia A Faiz, Ajay Sheshadri

{"title":"Immune checkpoint inhibitor-associated pneumonitis: focus on diagnosis and underlying mechanisms.","authors":"Mtanis Khoury, Saadia A Faiz, Ajay Sheshadri","doi":"10.1097/MCP.0000000000001175","DOIUrl":"10.1097/MCP.0000000000001175","url":null,"abstract":"Purpose of review: This review aims to provide an updated overview of the diagnosis, risk factors, and treatment strategies for immune checkpoint inhibitor (ICI) pneumonitis, with a particular emphasis on its underlying pathophysiology.Recent findings: Recent advances, such as single-cell RNA sequencing of bronchoalveolar lavage fluid and the identification of biomarkers, including autoantibodies, are enhancing our understanding of ICI-related pneumonitis. These findings suggest that both cell-mediated and humoral mechanisms contribute to the pathophysiology of the condition.Summary: Pneumonitis can significantly limit the efficacy of life-saving cancer treatments, such as ICIs. Although corticosteroids are the first-line treatment according to guidelines, steroid-refractory pneumonitis remains common and is associated with high mortality. Emerging data is providing a more detailed understanding of the dysregulated immune response responsible for pneumonitis, which may guide the development of targeted therapies and direct future research efforts.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"335-343"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0