Current Opinion in Pulmonary Medicine最新文献_第2页

Pleural infection: controversies on the therapeutic strategies. 胸膜感染：治疗策略之争。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-02-17 DOI: 10.1097/MCP.0000000000001157

Ken K P Chan, Estee P M Lau, Y C Gary Lee

{"title":"Pleural infection: controversies on the therapeutic strategies.","authors":"Ken K P Chan, Estee P M Lau, Y C Gary Lee","doi":"10.1097/MCP.0000000000001157","DOIUrl":"10.1097/MCP.0000000000001157","url":null,"abstract":"Purpose of review: Management of pleural infection remains heterogeneous worldwide. This review highlights current controversies in therapeutic strategies for pleural infection, focusing particularly on recent studies and their implications.Recent findings: The introduction of intrapleural therapy combining alteplase [a tissue plasminogen activator (tPA)] and deoxyribonuclease (DNase) has revolutionized treatment practices, though the optimal delivery and dosing regimen is an area of active investigation. Variations to simplify administration protocols and/or to lower the required drug doses have been published. Most were exploratory studies, but the variations showed maintained therapeutic efficacy.Whether intrapleural alteplase/DNase or video-assisted thoracoscopic surgery (VATS) is superior is a topic of debate. Retrospective comparative analyses between the two revealed no clear benefits on all-cause mortality from either approach. Pilot randomized trials have been published and further full-scale, head-to-head trials are underway.Summary: Effective management of pleural infection involves adequate pleural drainage and appropriate antibiotic use. This review outlines the current evidence (and its limitations) and highlights knowledge gaps in optimizing the therapeutic strategies.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"218-222"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Novel biomarkers in asthma. 哮喘的新生物标志物。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-02-14 DOI: 10.1097/MCP.0000000000001155

Nikita Agrawal, Monica Kraft

{"title":"Novel biomarkers in asthma.","authors":"Nikita Agrawal, Monica Kraft","doi":"10.1097/MCP.0000000000001155","DOIUrl":"10.1097/MCP.0000000000001155","url":null,"abstract":"Purpose of review: Asthma is a common global respiratory disease characterized by airway inflammation. It is a heterogenous group of disorders with overlapping biological mechanisms. This review will discuss the current state of the use of biomarkers in asthma with an eye to the future. The identification of biomarkers has advanced our understanding of inflammatory pathways in asthma and aided in development of targeted therapies. However, even with similar inflammatory biomarkers, not all patients respond uniformly. Thus, further research into novel biomarkers in asthma is needed.Recent findings: Recent literature highlights several key themes in biomarker research for asthma. Biomarkers can be derived from various sources, including sputum, blood, urine, and exhaled breath. Historically, studies have focused on eosinophilic inflammation, yet total blood eosinophil counts do not capture asthma pathology and treatment responses. Recent investigations explore eosinophil activity as well as eosinophil subpopulations based on surface protein expressions. Mast cell involvement, their mediators, and club cell secretory protein are further being examined across different asthma molecular phenotypes.Summary: The complexity of inflammatory pathways in asthma, influenced by various factors, underscores the inadequacy of relying on a single biomarker at one time point. Continued research is essential to identify appropriate biomarkers.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"243-250"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413527","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

Community acquired pneumonia due to antibiotic resistant- Streptococcus pneumoniae : diagnosis, management and prevention. 耐药肺炎链球菌引起的社区获得性肺炎：诊断、管理和预防。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-02-07 DOI: 10.1097/MCP.0000000000001153

Grace C Y Lui, Christopher K C Lai

{"title":"Community acquired pneumonia due to antibiotic resistant- Streptococcus pneumoniae : diagnosis, management and prevention.","authors":"Grace C Y Lui, Christopher K C Lai","doi":"10.1097/MCP.0000000000001153","DOIUrl":"10.1097/MCP.0000000000001153","url":null,"abstract":"Purpose of review: A resurgence of pneumococcal pneumonia has been observed after a marked reduction in the early COVID-19 pandemic. Penicillin-nonsusceptible Streptococcus pneumoniae is regarded as a WHO priority pathogen.Recent findings: Overall antibiotic resistance rates in S. pneumoniae have increased due to increase in antibiotic consumption and changes in serotype distribution, partly driven by the rollout of pneumococcal vaccination. Isolates from pneumococcal pneumonia have higher resistance rates than those from invasive pneumococcal disease. New antibiotics have been approved for treatment of community-acquired pneumonia, and are active against multidrug-resistant S. pneumoniae . Pneumococcal vaccines in both children and adults are effective in reducing the burden of pneumococcal pneumonia in adults, though some circulating vaccine and nonvaccine serotypes are driving antibiotic resistance.Summary: Continual surveillance of serotype and resistance patterns of S. pneumoniae causing pneumonia in adult populations is important after the introduction of new pneumococcal vaccines. Novel pneumococcal vaccine platforms are needed to overcome the threats of serotype replacement and antibiotic resistance.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"211-217"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364030","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

Comorbidities and multimorbidity in asthma. 哮喘的合并症和多病。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-03-06 DOI: 10.1097/MCP.0000000000001162

Diego J Maselli, Jesse Sherratt, Sandra G Adams

{"title":"Comorbidities and multimorbidity in asthma.","authors":"Diego J Maselli, Jesse Sherratt, Sandra G Adams","doi":"10.1097/MCP.0000000000001162","DOIUrl":"10.1097/MCP.0000000000001162","url":null,"abstract":"Purpose of review: To describe the associations between asthma and relevant comorbidities, and appraise the latest evidence on the management strategies of asthmatics with comorbid conditions.Recent findings: Conditions such as allergic rhinitis, chronic rhinosinusitis with and without nasal polyps, gastroesophageal reflux disease, obesity, chronic obstructive pulmonary disease, bronchiectasis, anxiety and depression have been linked to worse outcomes in asthma. Recognition and treatment of these conditions is important in asthma, particularly in those with uncontrolled or severe asthma. Biologics for asthma have been effective in those with chronic rhinosinusitis with nasal polyps and chronic obstructive pulmonary disease (COPD), with emerging evidence in bronchiectasis. Weight loss programs with diet and exercise improve asthma control. Anxiety and depression are often unrecognized in patients with asthma.Summary: Comorbid conditions have been recognized as important factors in the diagnosis and treatment of asthma, particularly in patients who have severe disease and remain uncontrolled. Comorbidities in asthma are correlated with poor quality of life and asthma control, increased healthcare utilization and their treatment is associated with improved outcomes.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"270-278"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566330","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

Mucosal-associated invariant T-cells in pulmonary pathophysiology. 肺部病理生理学中的粘膜相关不变 T 细胞

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-03-19 DOI: 10.1097/MCP.0000000000001163

Jéssica Kamiki, Carolina M Gorgulho, Joana R Lérias, Markus J Maeurer

{"title":"Mucosal-associated invariant T-cells in pulmonary pathophysiology.","authors":"Jéssica Kamiki, Carolina M Gorgulho, Joana R Lérias, Markus J Maeurer","doi":"10.1097/MCP.0000000000001163","DOIUrl":"10.1097/MCP.0000000000001163","url":null,"abstract":"Purpose of review: Mucosal-associated invariant T-cells (MAIT) have been associated with lung cancer and pulmonary infections. The treatment of patients with cancer or infections includes host-directed therapies (HDTs). MAIT play a role in shaping the 'milieu interne' in cancer and infections and this review addresses the biology of MAIT in pulmonary pathophysiology.Recent findings: MAIT represent an attractive target for therapy in pulmonary malignancies and infections. T-cells are often difficult to exploit therapeutically due to the diversity of both T-cell receptor (TCR) repertoire and its ligandome. MAIT-cells are restricted by the major histocompatibility complex class I-related gene protein (MR1) that presents nondefined tumor-associated targets, bacterial products, vitamin and drug derivates. Due to their plasticity in gene expression, MAIT are able to conversely switch from IFN-γ to IL-17 production. Both cytokines play a key role in protective immune responses in infections and malignancies. MAIT-derived production of interleukin (IL)-17/TGF-β shapes the tumor micro-environment (TME), including tissue re-modelling leading to pulmonary fibrosis and recruitment of neutrophils. MAIT contribute to the gut-lung axis associated with clinical improved responses of patients with cancer to checkpoint inhibition therapy. MAIT are at the crossroad of HDTs targeting malignant and infected cells. Clinical presentations of overt inflammation, protective immune responses and tissue re-modeling are reviewed along the balance between Th1, Th2, Th9, and Th17 responses associated with immune-suppression or protective immune responses in infections.Summary: MAIT shape the TME in pulmonary malignancies and infections. Drugs targeting the TME and HDTs affect MAIT that can be explored to achieve improved clinical results while curbing overt tissue-damaging immune responses.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"202-210"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Respiratory syncytial virus pulmonary infections in adults - disease burden and prevention. 成人呼吸道合胞病毒肺部感染——疾病负担和预防。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2024-12-23 DOI: 10.1097/MCP.0000000000001151

Grant W Waterer, Mark Metersky

引用次数: 0

An updated review of pulmonary radiological features of acute and chronic COVID-19. 急性和慢性肺部COVID-19肺部影像学特征的最新综述

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-02-04 DOI: 10.1097/MCP.0000000000001152

Raya Tcheroyan, Peter Makhoul, Scott Simpson

{"title":"An updated review of pulmonary radiological features of acute and chronic COVID-19.","authors":"Raya Tcheroyan, Peter Makhoul, Scott Simpson","doi":"10.1097/MCP.0000000000001152","DOIUrl":"10.1097/MCP.0000000000001152","url":null,"abstract":"Purpose of review: Significant progress has been made in our understanding of the acute and chronic clinical and radiological manifestations of coronavirus-19 (COVID-19). This article provides an updated review on pulmonary COVID-19, while highlighting the key imaging features that can identify and distinguish acute COVID-19 pneumonia and its chronic sequelae from other diseases.Recent findings: Acute COVID-19 pneumonia typically presents with manifestations of organizing pneumonia on computed tomography (CT). In cases of severe disease, patients clinically progress to acute respiratory distress syndrome, which manifests as diffuse alveolar damage on CT. The most common chronic imaging finding is ground-glass opacities, which commonly resolves, as well as subpleural bands and reticulation. Pulmonary fibrosis is an overall rare complication of COVID-19, with characteristic features, including architectural distortion, and traction bronchiectasis.Summary: Chest CT can be a helpful adjunct tool in both diagnosing and managing acute COVID-19 pneumonia and its chronic sequelae. It can identify high-risk cases and guide decision-making, particularly in cases of severe or complicated disease. Follow-up imaging can detect persistent lung abnormalities associated with long COVID and guide appropriate management.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"183-195"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122389","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

Recent evidence for stepping down severe asthma therapies. 减少严重哮喘治疗的最新证据。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-02-28 DOI: 10.1097/MCP.0000000000001156

Eric Merrell, Sandhya Khurana

{"title":"Recent evidence for stepping down severe asthma therapies.","authors":"Eric Merrell, Sandhya Khurana","doi":"10.1097/MCP.0000000000001156","DOIUrl":"10.1097/MCP.0000000000001156","url":null,"abstract":"Purpose of review: Biologics have proven safe and effective for severe asthma. Their introduction has offered hope for patients and prescribers with a growing list of novel medications and indications. While 'step-up' indications for biologic initiation are well described in guidelines, 'step-down' strategy remains poorly understood and thus guidance is limited. In this opinion article we aim to focus on recent practice changing evidence for stepping-down severe asthma management, tools for the assessment of biologic efficacy, propose a framework for the step-down of biologic and nonbiologic therapies and suggest topics of interest for future research.Recent findings: Clinical tools have been developed to aid in assessing biologic response. Some patients experience marked improvement and may enter a period of clinical remission or even complete remission. Following positive response, add-on therapy may safely be approached for taper or withdrawal.Summary: There is limited consensus but growing evidence for stepping-down therapies in patients who achieve clinical response and/or remission after biologic initiation. Further structured guidance would benefit clinicians who face clinical uncertainty when deciding to step-down therapy in patients with well controlled asthma.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"294-301"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522924","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

Non-T2 asthma. Non-T2哮喘。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-03-27 DOI: 10.1097/MCP.0000000000001154

Emily K Duffus, Fernando Holguin, Deepa Rastogi

{"title":"Non-T2 asthma.","authors":"Emily K Duffus, Fernando Holguin, Deepa Rastogi","doi":"10.1097/MCP.0000000000001154","DOIUrl":"10.1097/MCP.0000000000001154","url":null,"abstract":"Purpose of review: This review provides a comprehensive overview of the non-T asthma phenotypes. Asthma is an umbrella term that defines a complex group of heterogenous airway disorders, which are broadly categorized into predominantly T2 or non-T2 phenotypes depending on the presence and levels of airway and systemic biomarkers associated with a T2 inflammatory response. Individuals with predominant T2 asthma have greater numbers of peripheral blood eosinophils, exhaled nitric oxide and IgE. These patients have more atopy and earlier onset asthma. In contrast, the absence or low levels of these biomarkers define non-T2 asthma. This is a heterogenous group with a later onset of asthma that is also more commonly associated with obesity and with females.Recent findings: This article summarizes new information regarding the plasticity that exists between T2 and non-T2 mechanisms, including their role in exacerbation-prone and nonexacerbating asthma, and many of the risk factors associated with the non-T2 phenotype, such as viral infections, ambient air pollution exposure, smoking, genetic and metabolic factors. It also provides new information on the immunological and metabolic mechanisms associated with non-T2 asthma. We also discuss how to manage this asthma phenotype and how treatment responses differ for these patients.Summary: Non-T2 asthma defines a heterogenous group of asthma phenotypes. However, acknowledging that the absence of T2 biomarkers is influenced by several factors is important and can longitudinally change in relation to exacerbations, particularly in children.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"287-293"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Infection prevention and control of epidemic-prone acute respiratory infections in healthcare setting. 卫生保健机构易流行急性呼吸道感染的感染预防和控制。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-02-27 DOI: 10.1097/MCP.0000000000001158

Alice Simniceanu, Giovanni Satta

{"title":"Infection prevention and control of epidemic-prone acute respiratory infections in healthcare setting.","authors":"Alice Simniceanu, Giovanni Satta","doi":"10.1097/MCP.0000000000001158","DOIUrl":"10.1097/MCP.0000000000001158","url":null,"abstract":"Purpose of review: The recent COVID-19 pandemic sparked discussions and highlighted significant gaps on the most appropriate infection prevention and control (IPC) measures when dealing with acute respiratory infections (ARIs). This narrative review aims to provide an overview of the existing international and national guidelines on the IPC measures to control epidemic and pandemic-prone ARIs in healthcare settings.Recent findings: The WHO has recently produced a report proposing an updated terminology for respiratory pathogens. One of the key outcomes of this consultation was the adoption of the term 'infectious respiratory particles' (IRPs). According to the report, IRPs are defined as infectious particles that can be expired from an infected person through activities like breathing, talking, singing, coughing, sneezing, or even spitting. Most notably, there is no longer the clear and traditional distinction between droplet and aerosol based on the cut-off of particle size, but rather a continuum of particle sizes of IRPs.Summary: Among other recommendations, all international guidelines place emphasis on the use of standard and transmission-based precautions when dealing with respiratory viruses. It is important to assess how the new proposed terminology for respiratory pathogens may affect the current existing IPC measures.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"230-236"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515013","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