Current Opinion in Pulmonary Medicine最新文献_第6页

Rethinking pneumonia in terms of the lung microbiome. 从肺部微生物组的角度重新思考肺炎。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-05-01 Epub Date: 2026-01-29 DOI: 10.1097/MCP.0000000000001247

Nicolas Gordon, Leopoldo N Segal, Benjamin G Wu

{"title":"Rethinking pneumonia in terms of the lung microbiome.","authors":"Nicolas Gordon, Leopoldo N Segal, Benjamin G Wu","doi":"10.1097/MCP.0000000000001247","DOIUrl":"10.1097/MCP.0000000000001247","url":null,"abstract":"Purpose of review: This review aggregates, analyzes, and summarizes the current understanding of the lung microbiome as it relates to pneumonia. We will review the composition and function of a healthy lung microbiome and conceptualize dysbiosis associated with pneumonia. Finally, we discuss how the lung microbiome impacts the diagnosis, prognostication and pathogenesis, and recovery from pneumonia.Recent findings: The most tangible benefit of studying the lung microbiome has been the identification of pathogenic organisms in suspected pneumonia; however, as there is a growing body of evidence that suggest the lung microbiome is critical to pneumonia. Generally, detection of potential pathogens such as Staphylococcus aureus , Pseudomonas aeruginosa , Streptococcus pneumoniae , and Escherichia coli can be found even when sampling the lung microbiome of healthy individuals, yet it is unclear what determines the transition from potential pathogens present as bystanders to pathogens driving the development of pneumonia. Analysis of the lung microbiome suggests that the loss of \"oral commensals\" (bacteria found in the oral microbiome) in the lower airways is associated with the development of pneumonia and may provide diagnostic and prognostic insights.Summary: The lung microbiome is a rich and dynamic ecosystem comprised of numerous bacterial, fungal, and viral taxa that may contribute to pneumonia pathogenesis. There is increasing evidence that the lung microbiome may provide insight into factors that determine the pathogenicity of respiratory microbes and the susceptibility of individuals to those pathogens.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"169-181"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104286","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

Pulmonary fungal infections in the age of biologics and climate change. 生物制剂和气候变化时代的肺部真菌感染。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-05-01 Epub Date: 2026-02-23 DOI: 10.1097/MCP.0000000000001262

Dora Edith Corzo-Leon

{"title":"Pulmonary fungal infections in the age of biologics and climate change.","authors":"Dora Edith Corzo-Leon","doi":"10.1097/MCP.0000000000001262","DOIUrl":"10.1097/MCP.0000000000001262","url":null,"abstract":"Purpose of review: This review examines the evolving epidemiology of invasive fungal infections, with emphasis in pulmonary presentations, in the context of climate change and the expanding immunomodulatory therapy use.Recent findings: Fungal infections represent a growing global health threat, with epidemiological patterns increasingly extending beyond traditional immunocompromised populations. Climate-driven thermal adaptation and geographic range expansion of endemic fungi, particularly Coccidioides and Histoplasma species, are exposing immunologically naive populations to infection. The higher use of new biologic therapies (IFNγ inhibitors, immune checkpoint inhibitors, CAR-T cells) is growing cohorts of patients with selective immunosuppression/immunomodulation who exhibit distinct fungal infection susceptibility patterns compared to traditional immunocompromised populations. Additionally, severe respiratory viral pandemics have demonstrated that acute viral pneumonia - independent of underlying immunosuppression - constitutes a significant risk factor for secondary invasive fungal diseases, as evidenced by IAPA and CAPA outbreaks. These shifts are occurring in parallel to increasing azole resistance and rising Pneumocystis pneumonia incidence in non-HIV populations, collectively challenging surveillance strategies, diagnostic algorithms, and therapeutic approaches.Summary: This review synthesizes current evidence on how climate-mediated geographic expansion, biologic-associated immunosuppression, and virus-associated fungal infections are redefining populations at risk for pulmonary fungal infections.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"147-155"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282721","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

Green inhalers: reducing the carbon footprint of asthma care. 绿色吸入器：减少哮喘护理的碳足迹。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-05-01 Epub Date: 2026-02-11 DOI: 10.1097/MCP.0000000000001252

Alexander J K Wilkinson, Laura-Jane E Smith, Ashley Woodcock

{"title":"Green inhalers: reducing the carbon footprint of asthma care.","authors":"Alexander J K Wilkinson, Laura-Jane E Smith, Ashley Woodcock","doi":"10.1097/MCP.0000000000001252","DOIUrl":"10.1097/MCP.0000000000001252","url":null,"abstract":"Purpose of review: The respiratory community faces an urgent need to reduce the environmental impact of care as the wider climate crisis threatens to worsen airways disease worldwide. Inhalers contribute a disproportionate share of healthcare emissions because of the hydrofluorocarbon (HFC) propellants in pressurized metered-dose inhalers (pMDIs). We already have effective, low-carbon, per- and polyfluoroalkyl substances (non-PFAS) options; particularly dry-powder inhalers (DPIs). This review summarizes recent developments in propellant technology and evidence on optimizing asthma care to improve outcomes while lowering emissions.Recent findings: Life-cycle studies confirm that pMDI emissions are dominated by propellant released during use, whereas DPIs have far lower footprints. New global warming potential (low-GWP) propellants are in advanced development, and the first inhaler using HFO-1234ze(E) has recently been licensed in the UK. Emerging clinical and prescribing data show that optimized therapy, particularly strategies that incorporate low-carbon inhalers, can reduce short-acting beta-agonist (SABA) over-reliance, exacerbations, and per-patient emissions. Guideline-driven, health-system approaches using prescribing data and formulary design can accelerate sustainable, evidence-based inhaler use.Summary: The most immediate path to reducing inhaler-related emissions is to optimize asthma care while prioritizing low-carbon devices where appropriate. As low-GWP pMDIs enter the market, careful planning will be needed to ensure reliable, affordable access to pMDIs is maintained or improved globally, particularly in low- and middle-income countries.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"239-244"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156525","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

From guidelines to algorithms: the future of AI-augmented asthma care. 从指南到算法：人工智能增强哮喘护理的未来。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-05-01 Epub Date: 2026-02-23 DOI: 10.1097/MCP.0000000000001255

Rachel Culver, Anissa Johnson, Laren Tan

{"title":"From guidelines to algorithms: the future of AI-augmented asthma care.","authors":"Rachel Culver, Anissa Johnson, Laren Tan","doi":"10.1097/MCP.0000000000001255","DOIUrl":"10.1097/MCP.0000000000001255","url":null,"abstract":"Purpose of review: Artificial intelligence (AI) has emerged as an increasingly accessible and influential resource within both public and clinical domains. The role of AI in asthma care is expanding; therefore, it must be discussed in the context of evolving management strategies for both clinician and patient.Recent findings: Recent literature demonstrates that AI can integrate evidence-based guidelines with large-scale clinical data to support diagnostic interpretation and therapeutic decision-making in asthma care. Studies have shown that AI platforms can accurately assess asthma symptoms, monitor disease progression, and generate recommendations aimed at reducing exacerbations across diverse clinical scenarios. AI has also demonstrated utility in patient education and self-management support, with variable performance depending on the complexity of clinical inputs and the level of personalization required.Summary: The integration of AI into asthma care offers meaningful opportunities to enhance patient engagement, improve consistency in guideline-based management, and facilitate timely escalation of therapy. For clinicians, AI may serve as a supportive decision-making tool, while for patients, it may provide guidance when healthcare access is limited. Although further validation and oversight are necessary, the increasing use of AI in asthma management has the potential to enhance overall disease control and clinical outcomes.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"232-238"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282713","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 allergen immunotherapy for asthma. 过敏原免疫治疗哮喘的最新进展。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-05-01 Epub Date: 2026-02-25 DOI: 10.1097/MCP.0000000000001259

R John Looney

{"title":"Update on allergen immunotherapy for asthma.","authors":"R John Looney","doi":"10.1097/MCP.0000000000001259","DOIUrl":"10.1097/MCP.0000000000001259","url":null,"abstract":"Purpose of review: The usefulness of allergen-specific immunotherapy for asthma is controversial. Publications from 2024 and 2025 on allergen immunotherapy for asthma will be reviewed.Recent findings: A trial of house dust mite for asthma was strikingly positive for a subset of patients with variant alleles in chromosome 17q12-21. A trail of cockroach immunotherapy for asthma was negative based on nasal challenge. However, there were promising effects on T cells. New allergen-specific vaccines using allergoids and adjuvants are being developed in Europe and look promising for reducing the number of injections and improving safety. Small clinical trials have shown that trained immunity vaccines containing bacterial lysates can reduce wheezing in young children and animal models suggest these vaccines can affect allergen sensitization and asthma. Recent reviews of multiple clinical trials have shown allergen-specific immunotherapy can reduce symptoms and medications in asthmatic individuals but not objective measures of lung fucntion. Recent reviews of combining biologics with allergen-immunotherapy suggest improved safety.Summary: Allergen-specific immunotherapy remains an important treatment for allergic rhinitis and conjunctivitis and can be used safely in patients with mild or moderate well controlled asthma. Several new approaches look promising but need a lot more work.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"226-231"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282808","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

As-needed inhaled corticosteroids in asthma: from evidence to implementation. 按需吸入皮质类固醇治疗哮喘：从证据到实施。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-05-01 Epub Date: 2026-02-23 DOI: 10.1097/MCP.0000000000001260

Eric Merrell, Sandhya Khurana

{"title":"As-needed inhaled corticosteroids in asthma: from evidence to implementation.","authors":"Eric Merrell, Sandhya Khurana","doi":"10.1097/MCP.0000000000001260","DOIUrl":"10.1097/MCP.0000000000001260","url":null,"abstract":"Purpose of review: This review aims to clarify the role of as-needed ICS through the severity spectrum of adult asthma and explores the challenges associated with implementation. This review is timely following the recent US Food and Drug Administration (FDA) approval of an ICS/SABA combination inhaler.Recent findings: In 2019, the Global Initiative for Asthma (GINA) recommended against the use of short-acting beta agonist (SABA) monotherapy and officially endorsed the use of as-needed inhaled corticosteroid with a fast-acting bronchodilator [anti-inflammatory reliever (AIR)] as the preferred strategy across all treatment steps. In 2020, the US NHLBI asthma guidelines recommended ICS+SABA at step 2, and ICS/formoterol to be used as maintenance and reliever therapy (MART) at treatment steps 3 and 4. Despite these strong recommendations, uptake of this strategy in the United States has been slow. Barriers to MART implementation are explained, and implementation strategies are reviewed.Summary: Transition to a single ICS/formoterol inhaler as MART from traditional multiinhaler regimens offers the opportunity for multidomain benefits. The role of novel ICS/SABA combination inhalers remains to be determined across the continuum of asthma.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"245-252"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282723","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

Immunocompromised host pneumonia: a shifting landscape of risk. 免疫功能低下的宿主肺炎：不断变化的风险格局

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-05-01 Epub Date: 2026-03-05 DOI: 10.1097/MCP.0000000000001261

Alejandra García-Martínez, Laila Woc-Colburn

引用次数: 0

The landscape of aerosol transmission after COVID-19. COVID-19后气溶胶传播格局。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-05-01 Epub Date: 2026-02-23 DOI: 10.1097/MCP.0000000000001263

Julian W Tang

{"title":"The landscape of aerosol transmission after COVID-19.","authors":"Julian W Tang","doi":"10.1097/MCP.0000000000001263","DOIUrl":"10.1097/MCP.0000000000001263","url":null,"abstract":"Purpose of review: This review describes how the COVID-19 pandemic stimulated a radical shift around the concepts and definitions of aerosol transmission, and how this new understanding led to a rethink around related infection control interventions that were vital to reduce the spread of SARS-CoV-2, and, potentially, other respiratory viruses.Recent findings: A revision of the terminology for aerosol-transmitted pathogens by the WHO, together with its accompanying open access platform (ARIA), to allow users to define their own exposure scenarios and calculate related transmission risks, are just two of many multidisciplinary collaborations that have paved the way for a more effective pandemic response in the future, for aerosol-transmitted, novel pathogens.Summary: A multipronged approach is needed for any next pandemic, including expertise from laboratory microbiologists and virologists, clinical infectious diseases and infection control teams, public health physicians and epidemiologists, aerosol scientists and engineers. We need to develop a rapid evidence pipeline to collate robust scientific data about any new pathogen, how it is transmitted, how it infects and affects humans, and how to control, treat and prevent it. This article briefly outlines how far we have come and proposes some options to better prepare for the next pandemic.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"182-187"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282730","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

Corticosteroid stewardship in asthma: from individual prescribers to system-level change. 哮喘中的皮质类固醇管理：从个体处方到系统水平的变化。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-05-01 Epub Date: 2026-02-10 DOI: 10.1097/MCP.0000000000001254

Vincent Gallub, Linda Rogers, Boram Kim

{"title":"Corticosteroid stewardship in asthma: from individual prescribers to system-level change.","authors":"Vincent Gallub, Linda Rogers, Boram Kim","doi":"10.1097/MCP.0000000000001254","DOIUrl":"10.1097/MCP.0000000000001254","url":null,"abstract":"Purpose of review: In this review, we discuss the under-recognition of harms associated with corticosteroid overuse in asthma and highlight the concept of corticosteroid stewardship as an approach to address these harms.Recent findings: Adverse health effects of chronic systemic steroids to treat asthma are well known in the medical community. There is less familiarity with recent data showing similar harms from repeated short courses of systemic corticosteroids (SCS) to treat asthma flares and long-term use of high dose inhaled corticosteroids (ICS). In this review, we summarize recent advances in our knowledge of adverse effects of corticosteroid overuse in asthma, highlight recent calls for corticosteroids stewardship in asthma care, and describe effective systems-based strategies used to reduce corticosteroid overuse in asthma.Summary: Those involved in primary care, acute care, and specialty care of asthma may use this review for an updated understanding of corticosteroid associated harms, and as a guide to both individual practitioner and health systems-based approaches to corticosteroid stewardship.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"203-209"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149350","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

Breaking barriers in lung research with engineered airway epithelial cell culture models. 利用工程气道上皮细胞培养模型打破肺研究的障碍。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-05-01 Epub Date: 2026-02-23 DOI: 10.1097/MCP.0000000000001257

Mona Sophie Schmitz, Christian Taube, Michaela Schedel

{"title":"Breaking barriers in lung research with engineered airway epithelial cell culture models.","authors":"Mona Sophie Schmitz, Christian Taube, Michaela Schedel","doi":"10.1097/MCP.0000000000001257","DOIUrl":"10.1097/MCP.0000000000001257","url":null,"abstract":"Purpose of review: The airway epithelium is a key regulator of immune responses, tissue repair, and airway remodeling in chronic lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), and idiopathic pulmonary fibrosis (IPF). This review evaluates engineered in vitro airway epithelial models and their value to investigate disease mechanisms, drug responses, and epithelial-mesenchymal transitions (EMT).Recent findings: Recent studies demonstrated that different in vitro models can replicate disease-specific features, including goblet cell metaplasia, epithelial barrier disruption, and EMT, providing mechanistic insight as well as drug screening tools in asthma, COPD, and IPF. Airway epithelial cells (AEC) cultured in air-liquid interface (ALI) allow robust epithelial differentiation to perform functional and barrier integrity studies. Lung organoids provide organ-like structures that capture complex epithelial-mesenchymal crosstalk. Lung-on-chip (LoC) platforms integrate mechanical forces, dynamic airflow, and microfluidics to recapitulate in-vivo microenvironments. Each model presents specific strengths and weaknesses, making careful selection essential.Summary: The strategic selection and integration of engineered airway epithelial models improves mechanistic understanding, supports preclinical drug evaluation, and reduces reliance on animal experiments. These platforms provide physiologically relevant, patient-specific systems for the advancement of translational lung research.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"253-259"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282767","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