European Respiratory Review最新文献

{"title":"Content, uptake and adherence of exercise interventions after an acute exacerbation of COPD: a scoping review.","authors":"Marieke Wuyts, Heleen Demeyer, Thomas Vandendriessche, Yiting Cui, Paulien Mellaerts, Wim Janssens, Thierry Troosters","doi":"10.1183/16000617.0172-2024","DOIUrl":"10.1183/16000617.0172-2024","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary rehabilitation is underutilised in patients after an acute exacerbation of COPD (AECOPD). Retrieving information regarding the setting, training modalities and the uptake and adherence to exercise interventions for these individuals in a vulnerable state could potentially guide future research.</p><p><strong>Aim: </strong>To provide a comprehensive review of the existing literature on the content, uptake and adherence of different exercise interventions for patients after an AECOPD.</p><p><strong>Methods: </strong>Eight different databases were searched for 1) patients experiencing an AECOPD and 2) performing any form of exercise intervention. Information on content, uptake and adherence was collected and the Consensus on Exercise Reporting Template (CERT) checklist was performed for each included record.</p><p><strong>Results: </strong>59 distinct interventions were identified between 1998 and 2023 including a total of 9238 patients. All studies included patients requiring hospitalisation for the AECOPD, four studies additionally included patients not requiring hospitalisation for the AECOPD. Nine different settings were identified, with the majority of studies conducted in an inpatient setting (n=26) and including whole-body and strength exercises. The overall uptake was mentioned in 38 (62%) studies and was 70% with a 13% dropout rate. No paper reported the full CERT checklist. Adherence was defined <i>a priori</i> in 16 (27%) studies, with the most common definition being attendance of >80% of sessions.</p><p><strong>Conclusion: </strong>Studies properly reporting on the uptake and adherence of well-described interventions, including information regarding fidelity, are needed to further investigate suitable programmes for patients experiencing an AECOPD.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying outcome domains to establish a core outcome set for progressive pulmonary fibrosis: a scoping review.","authors":"Anouk Delameillieure, Vivien Somogyi, Silja Schenk, Nur Toreyin, Nikola Stenzel, Liesbet Van Bulck, Sofie Breuls, Michael Kreuter, Wim A Wuyts, Nesrin Mogulkoc, Jeanette Boyd, Steve Jones, Liam Galvin, Fabienne Dobbels","doi":"10.1183/16000617.0133-2024","DOIUrl":"10.1183/16000617.0133-2024","url":null,"abstract":"<p><strong>Introduction: </strong>People with idiopathic pulmonary fibrosis (IPF) and other forms of progressive pulmonary fibrosis (PPF) have a high symptom burden and a poor health-related quality of life (HRQoL). Despite efforts to offer specialised treatment, clinical care for these patients remains suboptimal and several nonmedical needs remain unaddressed. Developing a core outcome set (COS) can help to identify a minimum set of agreed-upon outcomes that should be measured and acted-upon in clinical care.</p><p><strong>Aim: </strong>As a first step towards developing a COS for IPF/PPF, we aimed to identify outcome domains investigated in IPF/PPF research.</p><p><strong>Methods: </strong>Conducted within the COCOS-IPF (Co-designing a Core Outcome Set for and with patients with IPF) project, this scoping review follows Joanna Briggs Institute methodology and PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines to search PubMed, Embase and Web of Science for quantitative, qualitative and mixed-methods papers. We extracted each paper's outcomes verbatim and classified them using the COMET (Core Outcome Measures in Effectiveness Trials) taxonomy. Then, the research team structured outcomes or concepts with similar meanings inductively into outcome domains.</p><p><strong>Results: </strong>We included 428 papers, extracting 1685 outcomes. Most outcomes (n=1340) were identified in quantitative sources, which we could classify in 64 outcome domains, with the main domains being \"all-cause survival\" (n=237), \"lung function\" (n=164) and \"exercise capacity\" (n=99). Qualitative sources identified 51 outcome domains, with the most frequent being \"capability to do activities you enjoy\" (n=31), \"anxiety, worry and fear\" (n=26) and \"dealing with disease progression\" (n=25).</p><p><strong>Conclusions: </strong>The identified outcomes, spanning diverse domains, highlight the complexity of patient experiences and can form the basis to develop a COS for IPF/PPF clinical care, as well as future research.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nitrogen single and multiple breath washout test and lung imaging to detect treatment-related pulmonary toxicity in paediatric cancer patients and survivors: a systematic review.","authors":"Christine Schneider, Christa Koenig, Maša Žarković, Enno Stranzinger, Tania M Rivero, Jochen Rössler, Claudia E Kuehni, Philipp Latzin, Christina Schindera, Jakob Usemann","doi":"10.1183/16000617.0178-2024","DOIUrl":"10.1183/16000617.0178-2024","url":null,"abstract":"<p><strong>Background: </strong>Spirometry-based assessment of pulmonary function has limitations in detecting pulmonary toxicity following cancer treatment with chemotherapy, haematopoietic stem cell transplantation, radiotherapy or thoracic surgery. Nitrogen single and multiple breath washout tests are sensitive in assessing peripheral airway function, and lung imaging detects structural abnormalities, but little is known about their use in paediatric cancer patients and survivors. We aimed to 1) identify studies using nitrogen single or multiple breath washout tests and/or lung imaging to assess pulmonary toxicity in paediatric cancer patients and survivors, and 2) describe reported abnormalities.</p><p><strong>Method: </strong>We systematically searched MEDLINE, Embase and the Cochrane Library for studies published in 1995‒2023. Eligible studies included paediatric cancer patients and survivors under 22 years of age receiving haematopoietic stem cell transplantation, chemotherapy, radiotherapy and/or thoracic surgery who underwent nitrogen single or multiple breath washout tests or lung imaging for detecting pulmonary toxicity. Two independent reviewers identified the studies, performed data extraction and assessed risk of bias.</p><p><strong>Results: </strong>We included 12 of 6544 publications. Three studies used nitrogen single or multiple breath washout tests, seven conducted lung imaging using computed tomography and two used both nitrogen single or multiple breath washout tests and lung imaging. Abnormal test results for nitrogen single and multiple breath washout tests and lung imaging were mainly reported following haematopoietic stem cell transplantation (67%). All studies performing lung imaging reported structural abnormalities. Study results were heterogeneous due to varying patient and methodological characteristics.</p><p><strong>Conclusion: </strong>We identified a limited number of studies, mainly after haematopoietic stem cell transplantation, reporting functional and structural lung abnormalities in paediatric cancer patients and survivors. Longitudinal studies with standardised assessments using nitrogen single or multiple breath washout tests and lung imaging are needed to improve our understanding of treatment-related pulmonary toxicity.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway clearance techniques for people with acute exacerbation of COPD: a scoping review.","authors":"William Poncin, Christine Schrøder, Ana Oliveira, Beatriz Herrero-Cortina, Pierre Cnockaert, Lucile Gely, Christian Osadnik, Gregory Reychler, Inger Mechlenburg, Arietta Spinou","doi":"10.1183/16000617.0191-2024","DOIUrl":"10.1183/16000617.0191-2024","url":null,"abstract":"<p><strong>Introduction: </strong>Acute exacerbations of COPD (AECOPD) often involve mucus hypersecretion. Thus, management of sputum retention is critical. However, the use of airway clearance techniques (ACTs) in people with AECOPD across different healthcare settings and factors influencing their selection remain unclear.</p><p><strong>Objective: </strong>To identify and map ACTs used for AECOPD in different healthcare settings and the factors influencing clinical decision-making worldwide.</p><p><strong>Methods: </strong>Four electronic databases and grey literature were searched from 1995 to December 2023, with hand-searching of eligible records. The Joanna Briggs Institute methodology for scoping reviews was followed.</p><p><strong>Results: </strong>25 articles were included: 14 clinical studies, five guidelines/statements and six surveys/audits. Clinical studies reported the use of a wide range of single or combined ACTs, with no clear pattern in using particular ACTs in different parts of the world. Recent guidelines advise using ACTs for certain patients with AECOPD, particularly those with hypersecretion, with most guidelines recommending positive expiratory pressure (PEP) therapy. According to surveys, the most used ACTs in Australia and Europe are active cycle of breathing techniques, PEP or forced expiratory technique, while vibrations are most frequently used in Canada. Factors influencing the selection of specific ACTs include the presence of contraindications, level of dyspnoea, access to resources/equipment and ease of learning/performing the technique. All information was derived from hospital settings.</p><p><strong>Conclusions: </strong>This scoping review identified and mapped ACTs used for people with AECOPD worldwide and their decision-making factors. Future work should focus on community settings.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-derived asthma and allergy trajectories in children: a systematic review and meta-analysis.","authors":"Daniil Lisik, Saliha Selin Özuygur Ermis, Gregorio Paolo Milani, Giulia Carla Immacolata Spolidoro, Selin Ercan, Michael Salisu, Faozyat Odetola, Daniele Giovanni Ghiglioni, Danylo Pylov, Emma Goksör, Rani Basna, Göran Wennergren, Hannu Kankaanranta, Bright I Nwaru","doi":"10.1183/16000617.0160-2024","DOIUrl":"10.1183/16000617.0160-2024","url":null,"abstract":"<p><strong>Introduction: </strong>Numerous studies have characterised trajectories of asthma and allergy in children using machine learning, but with different techniques and mixed findings. The present work aimed to summarise the evidence and critically appraise the methodology.</p><p><strong>Methods: </strong>10 databases were searched. Screening, data extraction and quality assessment were performed in pairs. Trajectory characteristics were tabulated and visualised. Associated risk factor and outcome estimates were pooled using a random-effects meta-analysis.</p><p><strong>Results: </strong>89 studies were included. Early-onset (infancy) persistent, mid-onset (∼2-5 years) persistent, early-onset early-resolving (within ∼2 years) and early-onset mid-resolving (by ∼3-6 years) wheezing and eczema, respectively, were the most commonly identified disease trajectories. Intermediate/transient trajectories were rare. Male sex was associated with a higher risk of most wheezing trajectories and possibly with early-resolving eczema, while being slightly protective against mid-onset persistent eczema. Parental disease/genetic markers were associated with persistent trajectories of wheezing and eczema, respectively. Prenatal (and less so postnatal) tobacco smoke exposure was associated with most wheezing trajectories, as were lower respiratory tract infections in infancy (particularly with the early-onset resolving patterns). Most studies (69%) were of low methodological quality (particularly in modelling approaches and reporting). Few studies investigated allergic multimorbidity, allergic rhinitis and food allergy.</p><p><strong>Conclusions: </strong>Childhood asthma/wheezing and eczema can be characterised by a few relatively consistent trajectories, with some actionable risk factors such as pre-/postnatal smoke exposure. Improved computational methodology is warranted to better assess generalisability and elucidate the validity of intermediate/transient trajectories. Likewise, allergic multimorbidity and trajectories of allergic rhinitis and food allergy need to be further elucidated.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influenza vaccine outcomes: a meta-analysis revealing morbidity benefits amid low infection prevention.","authors":"Jesus Presa, Javier Arranz-Herrero, Laura Alvarez-Losa, Sergio Rius-Rocabert, Maria Jose Pozuelo, Antonio Lalueza, Jordi Ochando, Jose María Eiros, Ivan Sanz-Muñoz, Estanislao Nistal-Villan","doi":"10.1183/16000617.0144-2024","DOIUrl":"10.1183/16000617.0144-2024","url":null,"abstract":"<p><strong>Background: </strong>The morbidity and mortality associated with influenza viruses are a significant public health challenge. Annual vaccination against circulating influenza strains reduces hospitalisations and increases survival rates but requires a yearly redesign of vaccines against prevalent subtypes. The complex genetics of influenza viruses with high antigenic drift create an ongoing challenge in vaccine development to address dynamic influenza epidemiology. Understanding the evolution of influenza viruses and the vaccine's effectiveness against different types and subtypes is pivotal to designing public health measures against influenza.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of 192 705 patients, collecting information on the incidence and severity of the disease. The results of this meta-analysis were further validated using data from 6 594 765 patients from TriNetX. We analysed the prevalence of the most common influenza A virus (IAV) subtypes (H1N1 and H3N2) and influenza B virus (IBV), as well as vaccination effectiveness against them in three age groups, given that age is associated with influenza disease severity.</p><p><strong>Results: </strong>Our analysis reflects that overall vaccination against H1N1 IAV and IBV is effective in reducing infection and influenza-related complications in children aged <5 years old, individuals between 5 and 65 years old and older adults aged >65 years old. By contrast, while vaccination against H3N2 IAV is effective in protecting against infection in infants <5 years old, it provides reduced protection against infection in older individuals.</p><p><strong>Conclusions: </strong>Despite higher infection rates, vaccination against H3N2 remains as highly effective as vaccination against H1N1 and IBV in reducing influenza-related morbidity and mortality in all age groups. Detailing vaccine effectiveness in terms of infection protection and disease burden across different age groups is necessary for understanding vaccine impacts in terms of other outcomes, <i>e.g.</i> hospitalisations, mortality and disease severity; for improving vaccine formulations and public awareness; and for enhancing vaccination campaigns to improve coverage and public acceptance.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologics in severe asthma: a state-of-the-art review.","authors":"Bishal Gyawali, Steve N Georas, Sandhya Khurana","doi":"10.1183/16000617.0088-2024","DOIUrl":"10.1183/16000617.0088-2024","url":null,"abstract":"<p><p>Asthma is considered severe if it remains uncontrolled despite optimal conventional therapy, characterised by poor symptom control, frequent exacerbations and increased exposure to systemic corticosteroids. This has a significant impact on morbidity, mortality and healthcare resource utilisation. Recent advances in the understanding of asthma heterogeneity and immunopathogenesis have helped delineate precise disease pathways. The discovery of these pivotal pathways has led to the development of highly effective biologic therapies. Currently available asthma biologics target immunoglobulin E, interleukin (IL)-5/IL-5Rα, IL-4Rα and thymic stromal lymphopoietin. Identification of specific asthma phenotypes, utilising easily measurable biomarkers, has paved the way towards personalised and precision asthma management. Biologic therapies play a significant role in reducing exacerbations, hospitalisations and the need for maintenance systemic steroids, while also improving the quality of life in patients with severe asthma. The evidence for their clinical efficacy comes from randomised controlled trials (RCTs), extension studies, metanalyses and real-world data. This review synthesises findings from early, pivotal RCTs and subsequent studies following the approval of biologics for severe asthma. The safety and efficacy data from these studies, completed in a variety of settings, provide practical perspectives on their application and enhance their generalisability.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of steroids in severe community-acquired pneumonia.","authors":"Federica Viola Piedepalumbo, Ana Motos, Francesco Blasi, Antoni Torres","doi":"10.1183/16000617.0131-2024","DOIUrl":"10.1183/16000617.0131-2024","url":null,"abstract":"<p><p>The systemic use of corticosteroids for patients with severe community-acquired pneumonia (sCAP) remains controversial in clinical practice, particularly in terms of the safety profile of these drugs. This narrative review aims to analyse the available literature data concerning the safety of short-term steroid use in the treatment of sCAP, while also highlighting potential future research directions. Several trials and meta-analyses have evaluated corticosteroid therapy as an adjuvant treatment for sCAP, yielding heterogeneous results regarding its efficacy and safety. Despite the wide variability in results, it is generally accepted that steroids are not associated with a significant risk of healthcare-associated infections, gastrointestinal bleeding or acute kidney injury in patients with sCAP in the short term. Nevertheless, such drugs are linked to hyperglycaemia, necessitating regular monitoring and appropriate management. The influence of steroids on long-term outcomes and their potential risks in viral sCAP still needs to be investigated.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142947104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silicotuberculosis: a critical narrative review.","authors":"Rodney Ehrlich, Jill Murray, Qonita Said-Hartley, David Rees","doi":"10.1183/16000617.0168-2024","DOIUrl":"10.1183/16000617.0168-2024","url":null,"abstract":"<p><p>Silicotuberculosis, the combination of silicosis and pulmonary tuberculosis (TB), remains a substantial clinical and public health problem in high TB burden countries with silica-exposed workforces. The objectives of this narrative review are to propose a definition of silicotuberculosis which includes post-tuberculous lung disease, to emphasise the importance of understanding how the two diseases modify each other, and to identify as yet unanswered questions relevant to clinical practice and disease control and mitigation. The unique aetiological relationship between silica exposure and TB is now firmly established, as is the accelerated impairment and mortality imposed by TB on individuals with silicosis. However, the rich clinical, pathology and laboratory literature on combined disease from the pre-TB treatment era appears to have been largely forgotten. The close clinical and pathological appearance of the two diseases continues to pose a challenge to imaging, diagnosis and pathological description, while inconsistent evidence regarding TB treatment and TB preventive treatment prevails. Many other topics raise questions to be answered, <i>inter alia</i>: the range of phenotypes of combined disease; the rates and determinants of disease progression; the role of computed tomography in identifying and characterising combined disease; appropriate screening practice; acceptable policies of management of workers that combine risk reduction with social security; and the workplace respirable silica concentration that protects against the excess TB attributable to inhaled silica.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 174","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The epithelial era of asthma research: knowledge gaps and future direction for patient care.","authors":"Christopher E Brightling, Gianni Marone, Helena Aegerter, Pascal Chanez, Enrico Heffler, Ian D Pavord, Klaus F Rabe, Lena Uller, Del Dorscheid","doi":"10.1183/16000617.0221-2024","DOIUrl":"10.1183/16000617.0221-2024","url":null,"abstract":"<p><p>The Epithelial Science Expert Group convened on 18-19 October 2023, in Naples, Italy, to discuss the current understanding of the fundamental role of the airway epithelium in asthma and other respiratory diseases and to explore the future direction of patient care. This review summarises the key concepts and research questions that were raised. As an introduction to the epithelial era of research, the evolution of asthma management throughout the ages was discussed and the role of the epithelium as an immune-functioning organ was elucidated. The role of the bronchial epithelial cells in lower airway diseases beyond severe asthma was considered, as well as the role of the epithelium in upper airway diseases such as chronic rhinosinusitis. The biology and application of biomarkers in patient care was also discussed. The Epithelial Science Expert Group also explored future research needs by identifying the current knowledge and research gaps in asthma management and ranking them by priority. It was identified that there is a need to define and support early assessment of asthma to characterise patients at high risk of severe asthma. Furthermore, a better understanding of asthma progression is required. The development of new treatments and diagnostic tests as well as the identification of new biomarkers will also be required to address the current unmet needs. Finally, an increased understanding of epithelial dysfunction will determine if we can alter disease progression and achieve clinical remission.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 174","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}