Current Opinion in Pulmonary Medicine最新文献_第4页

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

Update in paediatric asthma. 儿科哮喘的最新进展。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-02-20 DOI: 10.1097/MCP.0000000000001160

Andrew Bush

{"title":"Update in paediatric asthma.","authors":"Andrew Bush","doi":"10.1097/MCP.0000000000001160","DOIUrl":"10.1097/MCP.0000000000001160","url":null,"abstract":"Purpose of review: The field of paediatric asthma is rapidly moving, with the advent of new biologicals for severe asthma and increased understanding of preschool wheeze amongst other developments and insights.Recent findings: There is increasing evidence of efficacy in children for biologics directed against Type 2 inflammation (especially mepolizumab and dupilumab) as well encouraging evidence that Tezepelumab may be effective against Type 2 low phenotypes. The importance of airway remodelling and infection in the pathophysiology of preschool wheeze is increasingly appreciated. The treatment of preschool wheeze is moving from symptom-based to biomarker driven therapies. Other important areas are prediction of risk of asthma attacks, the SMART regime, the importance of climate change and reducing greenhouse gas emissions from inhalers while ensuring adequate therapy for young children, the association of early adverse environmental factors including childhood poverty and deprivation and the switch to race-neutral lung function equations.Summary: We are increasingly moving towards personalized medicine and the use of biomarkers to guide treatment of wheeze at all ages, but we need to move from counting cells to determining their functional status. Airway wall structural changes rather than inflammation may drive the progression of preschool wheeze to school age asthma.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"279-286"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457184","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

Parasitic lung diseases. 肺部寄生虫病。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-03-10 DOI: 10.1097/MCP.0000000000001161

Samuel H Allen

引用次数: 0

Impact of occupational exposures in patients with chronic obstructive pulmonary disease: current understanding and knowledge gaps. 职业暴露对慢性阻塞性肺病患者的影响：目前的认识和知识差距。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-11-20 DOI: 10.1097/MCP.0000000000001141

Quinn Bongers, Alejandro P Comellas

{"title":"Impact of occupational exposures in patients with chronic obstructive pulmonary disease: current understanding and knowledge gaps.","authors":"Quinn Bongers, Alejandro P Comellas","doi":"10.1097/MCP.0000000000001141","DOIUrl":"10.1097/MCP.0000000000001141","url":null,"abstract":"Purpose of review: Chronic obstructive pulmonary disease (COPD) is thought of as a disease caused by tobacco exposure, but numerous occupational exposures have been identified as risk factors for development of disease and exacerbations, although these remain underappreciated and underdiagnosed. We highlight evidence of occupational exposures and how they relate to COPD, while also looking at gaps in how the changing workplace might affect the occupational COPD landscape.Recent findings: Historical exposures linked to COPD included inorganic dusts like coal and silica and organic dusts like cotton and wood. Other data associated agricultural exposures, cleaning agents, air pollution, and construction work with COPD. As the workplace has evolved to include more work from home and growing industries like ridesharing and delivery, items like radon and indoor and outdoor air quality must be factored into the equation as occupational exposures with the potential to cause COPD and increase its morbidity. Despite this, causal conclusions with many risk factors are challenging due to the complex interaction between patient susceptibilities and environmental factors, both occupation-related and nonoccupation related.Summary: Additional studies are needed, not only to better evaluate occupational exposures and COPD pathogenesis, but also to look at more solution-oriented areas like precision medicine and interventions targeting a healthier workplace.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"98-105"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675410","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

Initiation of home noninvasive ventilation in hypercapnic chronic obstructive pulmonary disease: when, where, and how? 高碳酸血症慢性阻塞性肺疾病的家庭无创通气：何时、何地、如何开始？

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-11-14 DOI: 10.1097/MCP.0000000000001139

Spyridon Fortis, Kathleen F Sarmiento

{"title":"Initiation of home noninvasive ventilation in hypercapnic chronic obstructive pulmonary disease: when, where, and how?","authors":"Spyridon Fortis, Kathleen F Sarmiento","doi":"10.1097/MCP.0000000000001139","DOIUrl":"10.1097/MCP.0000000000001139","url":null,"abstract":"Purpose of review: This review aims to highlight the importance of timely initiation of home noninvasive ventilation (homeNIV) for patients with chronic hypercapnic respiratory failure (CHRF) due to chronic obstructive pulmonary disease (COPD). As emerging evidence continues to show substantial benefits in reducing mortality and hospitalizations, it's crucial to identify which patients will benefit most and to provide clear guidance on implementing homeNIV effectively.Recent findings: Recent research supports the use of high intensity homeNIV for CHRF secondary to COPD, showing marked reductions in hospitalizations and mortality. However, despite its proven benefits, homeNIV is underutilized, often due to significant barriers related to payor policies and gaps in knowledge by those most likely to be evaluating and managing patients with advanced COPD. The literature also reveals ongoing debate about the optimal timing and setting for starting homeNIV, whether in outpatient clinics or directly after hospital discharge.Summary: The evidence suggests that homeNIV should be more widely used, with a focus on early initiation and careful titration to normalize PaCO 2 over time. By addressing the barriers to its broader use, we can improve outcomes for patients with CHRF due to COPD.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"165-174"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853276","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

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-12-06 DOI: 10.1097/MCP.0000000000001146

Matthew D James, Danilo C Berton, J Alberto Neder

{"title":"Activity-related dyspnea and exercise intolerance in chronic obstructive pulmonary disease: recent insights.","authors":"Matthew D James, Danilo C Berton, J Alberto Neder","doi":"10.1097/MCP.0000000000001146","DOIUrl":"10.1097/MCP.0000000000001146","url":null,"abstract":"Purpose of review: Exertional dyspnea and exercise intolerance remain key patient-related outcomes in chronic obstructive pulmonary disease (COPD). Improvement in treatment strategies is pendant further understand of their underpinnings across the spectrum of disease severity.Recent findings: Emerging literature has been reviewed based on a conceptual framework that relates ventilatory demand to capacity under the modulating influence of sub-cortical and cortical centers (symptom perception and affective interpretation). Evidence supporting these fundamental tenets is critically appraised, focusing on mechanistic and interventional studies that shed novel light on the sources of heightened and/or mechanically constrained ventilation. Mechanistic studies using proxies of the inspiratory neural drive (e.g., diaphragm electromyography) were particularly informative, as well as interventional trials aimed at decreasing afferent stimulation and/or symptom perception via pharmacological (e.g., low-dose opiates in selected patients, high flow oxygen, oral nitrate) and nonpharmacological (e.g., novel exercise training paradigms, inspiratory muscle training, breathing techniques) interventions.Summary: Therapeutic and rehabilitative strategies to lessen dyspnea's devastating impact on quality of life should minimize demand in the setting of reduced capacity and increased sensation awareness in COPD. The most successful attempts so far have amalgamated pharmacological and nonpharmacological approaches tailored to the main underlying mechanisms on an individual basis.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"145-155"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784461","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

Editorial introductions. 编辑介绍。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-01-30 DOI: 10.1097/MCP.0000000000001147

引用次数: 0

Food for thought: optimal diet in patients with asthma and chronic obstructive pulmonary disease. 思考：哮喘和慢性阻塞性肺病患者的最佳饮食。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-11-28 DOI: 10.1097/MCP.0000000000001142

Motahareh Vameghestahbanati, Carolyn J Wang, Don D Sin

{"title":"Food for thought: optimal diet in patients with asthma and chronic obstructive pulmonary disease.","authors":"Motahareh Vameghestahbanati, Carolyn J Wang, Don D Sin","doi":"10.1097/MCP.0000000000001142","DOIUrl":"10.1097/MCP.0000000000001142","url":null,"abstract":"Purpose of review: Nutritional intake plays a major role in the management of lung health. This review provides the latest perspective on how dietary choices can modulate lung function in patients with chronic obstructive pulmonary disease (COPD) and asthma.Recent findings: The pathophysiology of COPD and asthma is driven by oxidative stress and inflammation of the airways, which is exacerbated by modifiable risk factors such as cigarette smoking and diet. Various foods can influence patient symptoms; highly processed foods increase the production of reactive oxygen species that augment airway inflammation, whereas foods rich in antioxidants, fiber and protein combat oxidative stress and muscle wastage. Patients with COPD or asthma are at increased risk of developing metabolic comorbidities, including cachexia and obesity that complicate disease phenotypes, leading to greater symptom severity. While clinical findings suggest a role for antioxidant and macronutrient support of lung function, comprehensive translational and clinical studies are necessary to better understand the mechanisms underlying nutrient interaction and lung structure-function.Summary: Understanding the nutritional requirements that protect lung health and support weight management in COPD and asthma is imperative to providing personalized dietary recommendations and reducing patient morbidity.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"106-116"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738711","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

Goals of chronic obstructive pulmonary disease management: a focused review for clinicians. 慢性阻塞性肺疾病管理的目标：临床医生的重点综述。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-12-02 DOI: 10.1097/MCP.0000000000001144

Sairam Raghavan, Umur Hatipoğlu, Loutfi S Aboussouan

{"title":"Goals of chronic obstructive pulmonary disease management: a focused review for clinicians.","authors":"Sairam Raghavan, Umur Hatipoğlu, Loutfi S Aboussouan","doi":"10.1097/MCP.0000000000001144","DOIUrl":"10.1097/MCP.0000000000001144","url":null,"abstract":"Purpose of review: The diagnosis of chronic obstructive pulmonary disease (COPD) encompasses heterogeneous pathophysiological mechanisms which can shape an individual patient's experience. This paper reviews available therapeutic options for the clinician intending to individualize care toward patient goals.Recent findings: The contemporary targeted interventions for COPD include the novel phosphodiesterase inhibitor ensifentrine, the interleukin-4 receptor (IL4R alpha subunit) antibody dupilumab, augmentation therapy for alpha-1 antitrypsin deficiency. Other interventions promoting physical and mental well being include re-envisioned pulmonary rehabilitation, self-management, targeting of comorbidities such as sarcopenia, and virtual health coaching interventions to expand patient access. Opioids did not relieve dyspnea and did not change total step count.Summary: Advances in precision therapy are complemented by the discovery of novel pathophysiology pathways and behavioral and rehabilitation interventions as a holistic view of COPD management emerges. The management of COPD continues to evolve with new tools including precision medicine and individualized care. Comorbidities remain important determinants of health, yet their prevalence and impact are underestimated.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"156-164"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767430","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