Current Opinion in Pulmonary Medicine最新文献_第5页

Analysis of pleural fluid biomarkers for diagnosis of malignant pleural effusion and molecular characterization of lung cancer: a review. 恶性胸腔积液生物标志物诊断及肺癌分子特征分析综述。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-07-01 Epub Date: 2026-03-24 DOI: 10.1097/MCP.0000000000001269

Audra J Schwalk, Muhammad Abu-Rmaileh, Horiana B Grosu

{"title":"Analysis of pleural fluid biomarkers for diagnosis of malignant pleural effusion and molecular characterization of lung cancer: a review.","authors":"Audra J Schwalk, Muhammad Abu-Rmaileh, Horiana B Grosu","doi":"10.1097/MCP.0000000000001269","DOIUrl":"10.1097/MCP.0000000000001269","url":null,"abstract":"Purpose of review: Malignant pleural effusion (MPE) is a common complication of advanced lung cancer and often represents the first sign of malignancy. Conventional diagnostic methods, including cytology and pleural biopsy, have limited sensitivity. This review provides a timely assessment of emerging pleural fluid biomarkers and their utility in differentiating malignant from benign effusions, as well as their role in guiding molecular characterization of lung cancer to improve diagnostic accuracy and therapeutic decision-making.Recent findings: Recent studies highlight the diagnostic and molecular profiling potential of circulating tumor DNA (ctDNA), microRNAs, proteins, and metabolites detectable in pleural fluid. Advances in next-generation sequencing and liquid biopsy technologies have enabled noninvasive detection of actionable mutations (EGFR, ALK, KRAS, PD-L1), enhancing molecular profiling directly from pleural samples. Integration of multiple biomarkers shows promise for improving sensitivity and specificity compared to cytology alone.Summary: Pleural fluid biomarker analysis offers a minimally invasive, clinically relevant approach for diagnosing MPE and identifying molecular targets in lung cancer. Further standardization and validation of testing protocols are needed, but these advances hold potential to refine early diagnosis, guide targeted therapies, and personalize management strategies for patients with lung cancer-related effusions.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"270-277"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503412","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

Precision immunosuppression in adult lung transplantation: are we there yet? 成人肺移植的精确免疫抑制：我们还在那里吗？

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-07-01 Epub Date: 2026-05-15 DOI: 10.1097/MCP.0000000000001281

Peter Jaksch, Alberto Benazzo, Gabriella Murakoezy

{"title":"Precision immunosuppression in adult lung transplantation: are we there yet?","authors":"Peter Jaksch, Alberto Benazzo, Gabriella Murakoezy","doi":"10.1097/MCP.0000000000001281","DOIUrl":"10.1097/MCP.0000000000001281","url":null,"abstract":"Purpose of review: Long-term outcomes after adult lung transplantation remain limited by rejection, infection, and toxicity related to immunosuppressive therapy. Conventional protocol-based immunosuppression fails to account for substantial interindividual variability in immune risk, drug metabolism, and susceptibility to complications. This review is timely as emerging biomarkers and digital tools promise to shift lung transplantation toward individualized immune management.Recent findings: Recent studies highlight the role of Torque Teno virus (TTV) load as a surrogate marker of net immunosuppression, donor-derived cell-free DNA (dd-cfDNA) as a sensitive indicator of graft injury, and tissue-bound donor-specific antibodies as markers of localized alloimmune activity. Pharmacogenomic profiling and immunomodulatory strategies such as extracorporeal photopheresis further enable risk-adapted therapy. Integration of blood and BAL-based biomarkers allows earlier detection of subclinical rejection and infection risk.Summary: Precision immunosuppression in lung transplantation is transitioning from concept to early clinical implementation. Combining clinical risk stratification with immune and graft-injury biomarkers may allow safer immunosuppression minimization and improved long-term outcomes, although prospective validation is still required.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"359-362"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962537","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 on diffuse idiopathic pulmonary neuroendocrine cell hyperplasia. 弥漫性特发性肺神经内分泌细胞增生的最新进展。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-07-01 Epub Date: 2026-03-05 DOI: 10.1097/MCP.0000000000001264

Uddalak Majumdar, Peter J Mazzone

{"title":"Update on diffuse idiopathic pulmonary neuroendocrine cell hyperplasia.","authors":"Uddalak Majumdar, Peter J Mazzone","doi":"10.1097/MCP.0000000000001264","DOIUrl":"10.1097/MCP.0000000000001264","url":null,"abstract":"Purpose of review: Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a disorder characterized by neuroendocrine cell hyperplasia, tumorlets and tumors, manifesting as lung nodules, chronic cough, and airflow obstruction. Often misdiagnosed as asthma, DIPNECH lies at the cross-section of oncology, obstructive airway disease and interstitial lung disease. With the increasing use of CT scans leading to higher rates of lung nodule detection, it is important for clinicians to be familiar with DIPNECH.Recent findings: The evidence base in DIPNECH is sparse and limited to retrospective case series. In the last 5 years, clinical experiences in large academic centers have been published describing variability in clinical presentation and pulmonary function, use of DOTATATE scans, efficacy of somatostatin analogs, and principles of surveillance imaging.Summary: More awareness of DIPNECH is needed among pulmonary clinicians. Apart from the usual presentation of cough with lung nodules and spirometric obstruction in women, patients also present with dyspnea and/or restrictive patterns on PFTs. Variability in diagnosis and management is widespread. Multidisciplinary assessment is helpful in guiding management. Multicenter and multispecialty collaboration is needed to establish best practices and improve clinical management.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"283-292"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354219","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

The changing face of lung transplant candidates. 肺移植候选者的变化。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-07-01 Epub Date: 2026-05-15 DOI: 10.1097/MCP.0000000000001273

Frank R Leuzzi, Emily S Clausen, Daniel F Dilling

{"title":"The changing face of lung transplant candidates.","authors":"Frank R Leuzzi, Emily S Clausen, Daniel F Dilling","doi":"10.1097/MCP.0000000000001273","DOIUrl":"10.1097/MCP.0000000000001273","url":null,"abstract":"Purpose of review: Lung transplant remains the ultimate life-saving therapy for people with progressive end-stage lung disease. It is important to highlight the evolution of the field in the United States, as its development has had varying impacts on the different lung transplant candidate groups. This review seeks to synthesize current evidence on the evolution of transplantation across various patient groups, reflecting advances in medical therapies, the implementation of the new composite allocation score (CAS) and trends in lung transplant candidate groups over the years.Recent findings: The proportion of waitlisted candidate with chronic obstructive pulmonary disease (COPD, group A) and cystic fibrosis (group C) has declined, reflecting the impact of novel therapeutics and advanced procedural interventions. In contrast, restrictive lung disease patients (group D) now account for most lung transplant recipients, which is likely reflective of our increased use of extracorporeal membrane oxygen (ECMO) for bridging and transplant centers expanded eligibility. Pulmonary hypertension patients (group B) continue to face high waitlist mortality despite the change to the new allocation scoring system.Summary: Advancements in medical therapies and the new composite allocation scoring system has altered both the timing and outcomes for various transplant candidate groups. It is important that we continue to study these findings to optimize patient outcomes and organ allocation.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"335-340"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962471","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

Strategies to address donor organ shortages in lung transplantation. 解决肺移植供体器官短缺的策略。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-07-01 Epub Date: 2026-04-30 DOI: 10.1097/MCP.0000000000001276

Gabriel Siebiger, Marcelo Cypel

{"title":"Strategies to address donor organ shortages in lung transplantation.","authors":"Gabriel Siebiger, Marcelo Cypel","doi":"10.1097/MCP.0000000000001276","DOIUrl":"10.1097/MCP.0000000000001276","url":null,"abstract":"Purpose of review: Lung transplantation remains limited by donor organ scarcity. This review summarizes recent strategies with the direct potential to expand lung availability, including 10°C hypothermic preservation, donation after circulatory death (DCD), ex vivo lung perfusion (EVLP), and expanded utilization of elderly donors.Recent findings: Clinical translation of 10°C static preservation has enabled prolonged storage, including preservation for up to 24 h without clear adverse short- or intermediate-term consequences, and the prospect of semi-elective transplantation. Contemporary evidence supports broader use of DCD lungs, particularly controlled DCD, with reassuring long-term outcomes despite small differences in early risk in some cohorts; uncontrolled DCD remains promising in highly organized EVLP-based programs, whereas thoracoabdominal normothermic regional perfusion requires further prospective evaluation. EVLP continues to increase utilization of marginal lungs, and the largest single-center series reported outcomes comparable to conventional transplantation. In parallel, carefully selected septuagenarian and even octo-/nonagenarian donors have demonstrated encouraging short- and long-term clinical outcomes.Summary: Donor shortage in lung transplantation can be mitigated by combining logistics-extending preservation strategies, broader donor pathways, advanced graft assessment, and careful expansion of donor acceptance criteria. Standardized, prospective, multicenter clinical trials are still frequently lacking and represent an area for future improvement.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"316-323"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765304","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 on pleural mesothelioma. 胸膜间皮瘤最新进展。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-07-01 Epub Date: 2026-04-15 DOI: 10.1097/MCP.0000000000001272

Deshawn Chong Xuan Tan, Wee Loong Chin, Yun Chor Gary Lee

{"title":"Update on pleural mesothelioma.","authors":"Deshawn Chong Xuan Tan, Wee Loong Chin, Yun Chor Gary Lee","doi":"10.1097/MCP.0000000000001272","DOIUrl":"10.1097/MCP.0000000000001272","url":null,"abstract":"Purpose of review: Pleural mesothelioma remains a universally lethal cancer with a rising global burden. This underscores the need for pulmonologists to stay abreast of evolving diagnostic and therapeutic strategies.Recent findings: This review highlights paradigm shifts in nomenclature, including recognition of mesothelioma in-situ as a pre-invasive entity made possible by molecular markers defining malignant transformation. High impact randomized clinical trials have provided evidence that radical surgical resection, via extrapleural pneumonectomy or extended pleurectomy/decortication, negatively impacts survival and quality of life. Dual immunotherapy (of nivolumab and ipilimumab) is now incorporated as first-line systemic therapy especially for sarcomatoid-containing mesothelioma. Addition of pembrolizumab to standard pemetrexed and platinum chemotherapy provides modest benefits. Emerging approaches are highlighted and encompass molecularly targeted, metabolic, intrapleural, and artificial intelligence (AI)-based strategies.Summary: These developments underline a move away from aggressive surgical cytoreduction towards more biologically-informed, less invasive management and earlier detection in high-risk cohorts, while embracing biomarker-driven systemic and intrapleural therapies to optimize outcomes. Future research should prioritize mesothelioma-specific trials to define the role and sequencing of perioperative immunotherapy and novel agents. AI tools may assist disease diagnosis, prognostication, and treatment selection.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"293-299"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688767","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

Improving equity of access/transparency in organ allocation. 提高器官分配的公平性和透明度。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-07-01 Epub Date: 2026-02-09 DOI: 10.1097/MCP.0000000000001253

Kateryna Krynychka, Matthew G Hartwig

{"title":"Improving equity of access/transparency in organ allocation.","authors":"Kateryna Krynychka, Matthew G Hartwig","doi":"10.1097/MCP.0000000000001253","DOIUrl":"10.1097/MCP.0000000000001253","url":null,"abstract":"Purpose of review: Persistent inequities in lung transplant access arise from biologic constraints, geographic variation, and system-level practices that are not fully addressed by urgency-based allocation alone. The recent implementation of continuous distribution and the Composite Allocation Score (CAS) represent a major policy shift intended to improve fairness and transparency in lung allocation. This review examines whether early evidence supports these goals and identifies remaining challenges.Recent findings: Early national and multicenter analyses demonstrate increased transplant rates and reduced waitlist mortality under CAS without compromise in short-term posttransplant survival. Continuous geographic scoring and biologic disadvantage adjustments appear to improve access for short-statured candidates, women, and some sensitized patients. However, disparities persist for blood group O recipients, highly sensitized candidates, and patients listed at centers with conservative acceptance practices. Increased travel distance and rising allocation out of sequence (AOOS) highlight emerging transparency and logistical concerns.Summary: Continuous distribution represents a meaningful advance in equity and transparency in lung allocation, but allocation reform alone cannot eliminate disparities arising from biologic limitation, geographic variation, or center-level practices. Ongoing monitoring, policy refinement, and system-wide standardization are essential to ensure equitable and ethical use of donor lungs.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"324-328"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149336","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

Advancing lung transplantation: current challenges and future directions. 推进肺移植：当前的挑战和未来的方向。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-07-01 Epub Date: 2026-05-28 DOI: 10.1097/MCP.0000000000001274

Carli J Lehr, Stephen C Juvet

引用次数: 0

Reframing lung transplantation through a sustainability lens. 从可持续发展的角度重新审视肺移植。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-07-01 Epub Date: 2026-03-05 DOI: 10.1097/MCP.0000000000001266

Owais Tisekar, Catherine A Doig, Caroline M Patterson

{"title":"Reframing lung transplantation through a sustainability lens.","authors":"Owais Tisekar, Catherine A Doig, Caroline M Patterson","doi":"10.1097/MCP.0000000000001266","DOIUrl":"10.1097/MCP.0000000000001266","url":null,"abstract":"Purpose of review: Lung transplantation is conspicuously resource intensive, yet the carbon footprint of solid organ transplantation, and lung transplantation in particular, remains relatively unmapped. Moreover, there is growing evidence that climate change adversely affects lung transplant recipients, directly and indirectly. This review explores opportunities to integrate sustainable practices across the lung transplantation pathway, with the dual aims of reducing environmental impact and reducing recipient morbidity and mortality.Recent findings: Published literature outlines mitigation strategies to reduce the drivers of climate change, and adaptation strategies to modify the hazardous effects of the climate crisis on healthcare services. Opportunities to create \"green chains\" of transplant care start with appropriate recipient and donor selection, with both elements optimised to maximise operative success and avoid donor organ discard. The peri-operative phase offers scope for decarbonisation via the reduction of anaesthetic gas emissions, green procurement, and waste reduction. In the post-transplant phase, enhanced recovery after surgery (ERAS) programmes feed into longer term surveillance and care delivery, with increasing opportunities for telemedicine and noninvasive allograft monitoring, to reduce travel-related emissions.Summary: The co-ordinated adoption of low-carbon, sustainable practices within lung transplantation offers a meaningful opportunity to reduce environmental harm, enhance healthcare infrastructure and workforce resilience, and improve patient outcomes in a patient cohort vulnerable to climate change. Lessons can be drawn from the global surgery movement; however, it remains the responsibility of transplant practitioners to foster a culture of environmental advocacy and to implement systematic measurement and targets for climate change and health indicators.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"329-334"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354133","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

Psychosocial challenges with transplantation. 移植带来的社会心理挑战。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-07-01 Epub Date: 2026-02-23 DOI: 10.1097/MCP.0000000000001256

Gabriella Primera, Michaela R Anderson, Brittany Koons

{"title":"Psychosocial challenges with transplantation.","authors":"Gabriella Primera, Michaela R Anderson, Brittany Koons","doi":"10.1097/MCP.0000000000001256","DOIUrl":"10.1097/MCP.0000000000001256","url":null,"abstract":"Purpose of review: Psychosocial factors are associated with pre and posttransplant outcomes, but existing recommendations largely rely on small, single-center lung transplant studies or data extrapolated from other solid organ transplants, highlighting the need for an updated comprehensive review.Recent findings: The 2021 ISHLT consensus statement on lung transplant candidate selection includes psychosocial domains in the evaluation, with few considered absolute contraindications, and instead emphasizes an individualized, holistic approach. Emerging lung-specific evidence supports the continued focus on individual psychosocial risk assessments rather than identification of broad contraindications to transplantation. This is largely due to continued reliance on single-center studies within lung transplantation, use of variable measurement tools for assessing psychosocial domains, and inconsistent associations with outcomes. We identified specific knowledge gaps in need of urgent research, including validation of lung-specific assessment tools, evaluation in larger multicenter and international studies, and development of targeted interventions to address psychosocial domains.Summary: Herein, we review the prior guidelines, synthesize new lung-specific studies, and identify critical knowledge gaps to inform future research directions.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"341-348"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282777","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