European Respiratory Review最新文献

{"title":"\"Sex and gender differences during the lung lifespan: unveiling a pivotal impact\" P. Tondo, C. Meschi, M. Mantero, G. Scioscia, M. Siciliano, M. Bradicich and G.M. Stella, on behalf of the Italian Respiratory Society (SIP/IRS) TF on Gender Medicine. <i>Eur Respir Rev</i> 2025; 34: 240121.","authors":"","doi":"10.1183/16000617.5121-2024","DOIUrl":"10.1183/16000617.5121-2024","url":null,"abstract":"","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771837","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":"Extrapulmonary effects of lung volume reduction in severe emphysema: a systematic review.","authors":"Else A M D Ter Haar, Dirk-Jan Slebos, Jorine E Hartman","doi":"10.1183/16000617.0258-2024","DOIUrl":"10.1183/16000617.0258-2024","url":null,"abstract":"<p><strong>Background: </strong>Lung volume reduction, either surgical or bronchoscopic, is an effective therapeutic strategy that improves pulmonary function, quality of life and exercise capacity in patients with advanced emphysema. The aim of this review was to evaluate the extrapulmonary effects of this treatment.</p><p><strong>Methods: </strong>PubMed, Embase and Web of Science were searched until 19 August 2024. The extrapulmonary effects were classified into nine distinct domains. Studies that reported outcomes related to one of the predefined extrapulmonary domains with a follow-up duration of at least 1 month were eligible for inclusion. A descriptive summary of the effects from all studies was compiled.</p><p><strong>Results: </strong>A total of 85 articles were included. The majority of studies were conducted in patients who underwent lung volume reduction surgery (74%). The greatest improvements were found in respiratory muscle strength, ventilatory drive, diaphragm morphology and body mass index. While the effects were less pronounced, beneficial outcomes were also observed for body composition, inflammation, oxidative stress, anxiety, depression and bone mineral density. The overall treatment effect of lung volume reduction on cardiac function and pulmonary arterial pressure was inconclusive; however, there is no evidence to suggest any significant deterioration. For the extrapulmonary domains of cognition, sleep and peripheral muscle function, evidence is currently insufficient to determine whether lung volume reduction has any impact.</p><p><strong>Conclusion: </strong>Lung volume reduction treatment has multiple beneficial extrapulmonary effects in patients with severe emphysema and lung hyperinflation. These findings support the use of lung volume reduction as a treatment for this patient population.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771908","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":"Pro: Clinical remission in asthma - implications for asthma management.","authors":"Stefania Principe, Nizar N Jarjour","doi":"10.1183/16000617.0181-2024","DOIUrl":"10.1183/16000617.0181-2024","url":null,"abstract":"<p><p>Asthma treatment has seen significant advancements over the recent years. However, despite improvements in disease control, some patients continue to experience persistent symptoms and exacerbations, necessitating a deeper understanding of disease mechanisms and optimisation of treatment strategies. The introduction of biologics has marked a new era in severe asthma management, targeting underlying molecular mechanisms and raising the possibility of achieving asthma remission. Key indicators of remission include high asthma control, absence of exacerbations and stabilised, or normalised, lung function. However, there is currently no common definition for remission, with various studies using different criteria. Real-world studies and <i>post hoc</i> analyses of clinical trials emphasise the potential of biologics in achieving clinical remission in a significant proportion of patients. Here, we provide a comprehensive review of studies in support of incorporating asthma remission as potential goal in asthma management. Despite the lack of a universally accepted definition and large prospective studies focused on remission, we believe that incorporating long-term outcomes and the currently accepted elements of remission in the approach to asthma care will shift the emphasis from reactive symptom control to proactive disease management, ultimately aiming for better asthma outcomes.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771168","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":"Neutrophilic inflammation in bronchiectasis.","authors":"James D Chalmers, Mark Metersky, Stefano Aliberti, Lucy Morgan, Sebastian Fucile, Melanie Lauterio, Patrick P McDonald","doi":"10.1183/16000617.0179-2024","DOIUrl":"10.1183/16000617.0179-2024","url":null,"abstract":"<p><p>Noncystic fibrosis bronchiectasis, hereafter referred to as bronchiectasis, is a chronic, progressive lung disease that can affect people of all ages. Patients with clinically significant bronchiectasis have chronic cough and sputum production, as well as recurrent respiratory infections, fatigue and impaired health-related quality of life. The pathophysiology of bronchiectasis has been described as a vicious vortex of chronic inflammation, recurring airway infection, impaired mucociliary clearance and progressive lung damage that promotes the development and progression of the disease. This review describes the pivotal role of neutrophil-driven inflammation in the pathogenesis and progression of bronchiectasis. Delayed neutrophil apoptosis and increased necrosis enhance dysregulated inflammation in bronchiectasis and failure to resolve this contributes to chronic, sustained inflammation. The excessive release of neutrophil serine proteases, such as neutrophil elastase, cathepsin G and proteinase 3, promotes a protease-antiprotease imbalance that correlates with increased inflammation in bronchiectasis and contributes to disease progression. While there are currently no licensed therapies to treat bronchiectasis, this review will explore the evolving evidence for neutrophilic inflammation as a novel treatment target with meaningful clinical benefits.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 176","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771911","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":"Risk factors for drug-resistant pathogens in community-acquired pneumonia: systematic review and meta-analysis.","authors":"Natsuki Nakagawa, Masahiro Katsurada, Yosuke Fukuda, Shingo Noguchi, Nobuyuki Horita, Makoto Miki, Hiroki Tsukada, Kazuyoshi Senda, Yuichiro Shindo, Hiroshi Mukae","doi":"10.1183/16000617.0183-2024","DOIUrl":"10.1183/16000617.0183-2024","url":null,"abstract":"<p><strong>Introduction: </strong>Community-acquired pneumonia (CAP) is a leading cause of death worldwide. Reducing inappropriate and excessive use of extended-spectrum antibiotics is essential for treating CAP effectively. Evaluating the risk of drug-resistant pathogens (DRPs) is crucial for determining initial antibiotic therapy in clinical settings.</p><p><strong>Methods: </strong>This systematic review and meta-analysis assessed the risk factors for DRPs in patients with CAP. CAP-DRPs were defined as pathogens resistant to commonly used antibiotics for CAP, including nonpseudomonal β-lactams such as ceftriaxone or sulbactam-ampicillin, macrolides and respiratory fluoroquinolones. The studies included were divided into two cohorts, namely an all-patient cohort, comprising both culture-positive and culture-negative patients, and a culture-positive pneumonia cohort, comprising patients with identified causative pathogens. The primary objective of this study was to evaluate the risk factors for CAP-DRPs in the all-patient cohort.</p><p><strong>Results: </strong>24 articles were included with 11 categorised into the all-patient cohort. The meta-analysis identified 11 significant risk factors for CAP-DRPs, namely prior DRP infection/colonisation, tracheostomy, severe respiratory failure requiring early induction of mechanical ventilation, prior use of antibiotics, chronic lung disease, COPD, wound care, neurological disorders, prior hospitalisation, nursing home residence and low activities of daily living.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first systematic review focused on CAP-DRP. Unlike previous reviews, the all-patient and culture-positive pneumonia cohorts were analysed separately. Findings from the all-patient cohort are particularly relevant for guiding initial antimicrobial selection in clinical practice. Furthermore, the abovementioned factors should be considered when developing prediction models for CAP-DRPs.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663099","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":"Interplay between respiratory viruses and cilia in the airways.","authors":"Katie Horton, Peter A C Wing, Claire L Jackson, Christopher J McCormick, Mary P Carroll, Jane S Lucas","doi":"10.1183/16000617.0224-2024","DOIUrl":"10.1183/16000617.0224-2024","url":null,"abstract":"<p><p>The airway epithelium is the first point of contact for inhaled pathogens. The role of epithelial cells in clearance, infection and colonisation of bacteria is established. The interactions of respiratory viruses and cilia is less understood, but viruses are known to target ciliated epithelial cells for entry, replication and dissemination. Furthermore, some respiratory viruses impair and/or enhance ciliary activity. This review examines what is known about the interactions between cilia and viral infection and how respiratory viruses effect cilia function with subsequent consequences for human health. We discuss the models which can be used to investigate the relationship between respiratory viruses and the host airway.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663062","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 role of heat shock protein 90 in idiopathic pulmonary fibrosis: state of the art.","authors":"Giorgio Monteleone, Paolo Cameli, Francesco Bonella","doi":"10.1183/16000617.0147-2024","DOIUrl":"10.1183/16000617.0147-2024","url":null,"abstract":"<p><p>Heat shock protein 90 (HSP 90) and its isoforms are a group of homodimeric proteins that regulate several cellular processes, such as the elimination of misfolded proteins, cell development and post-translational modifications of kinase proteins and receptors. Due to its involvement in extracellular matrix (ECM) remodelling, myofibroblast differentiation and apoptosis, HSP 90 has been investigated as a key player in the pathogenesis of lung fibrosis. Idiopathic pulmonary fibrosis (IPF) is the most common and deadly interstitial lung disease, due to the progressive distortion of lung parenchyma related to the overproduction and deposition of altered ECM, driven by transforming growth factor-β (TGF-β) dependent and independent pathways. The inhibition or induction of HSP 90 is associated with a reduced or increased expression of TGF-β receptors, respectively, suggesting a role for HSP 90 as a biomarker and therapeutic target in IPF. Experimental drugs such as geldanamycin and its derivatives 17-AAG (17-<i>N</i>-allylamino-17-demethoxygeldanamicin) and 17-DMAG (17-dimethylaminoethylamino-17-demethoxigeldanamycin), along with AUY-922, 1G6-D7, AT-13387, TAS-116 and myricetin, have been found to reduce lung fibrosis in both <i>in vivo</i> and <i>in vitro</i> models, supporting the role of this emerging target. This review aims to illustrate the structure and biological function of HSP 90 in the context of IPF pathobiology, as well as perspective application of this molecule as a biomarker and therapeutic target for IPF.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663102","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":"Comorbidities in the idiopathic pulmonary fibrosis and progressive pulmonary fibrosis trial population: a systematic review and meta-analysis.","authors":"Tyson M Walters, Marcus C H Leong, Sydney B Montesi, Christopher J Ryerson, Yet H Khor","doi":"10.1183/16000617.0238-2024","DOIUrl":"10.1183/16000617.0238-2024","url":null,"abstract":"<p><strong>Background: </strong>Comorbidities can affect drug tolerability and health outcomes in patients with fibrotic interstitial lung disease. This systematic review and meta-analysis evaluated the types and prevalence of comorbidities amongst participants in pharmaceutical randomised controlled trials (RCTs) of idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF).</p><p><strong>Methods: </strong>Ovid Medline, Embase and CENTRAL databases were searched to identify phase II and III pharmaceutical RCTs of IPF or PPF. Reporting of comorbidities was evaluated, with meta-analyses being performed for the prevalence of different conditions.</p><p><strong>Results: </strong>34 articles were included, with 23 unique trials for IPF and one for PPF. A mean of 14 (range 1-44) comorbidities per study was reported in the IPF RCTs, with 11 being reported in the PPF RCT. Common comorbidities in the IPF RCT cohorts were systemic hypertension (pooled prevalence 45%, 95% CI 39-50%), hyperlipidaemia (38%, 95% CI 27-49%), gastro-oesophageal reflux disease (45%, 95% CI 36-54%), ischaemic heart disease (18%, 95% CI 13-42%) and diabetes mellitus (16%, 95% CI 13-20%). The PPF trial cohort had similar types and prevalence of comorbidities to those reported in the IPF trial cohorts.</p><p><strong>Conclusions: </strong>Reporting of comorbidities varied across previous IPF RCTs, with limited data available for PPF. Prevalence of comorbidities reported in the IPF and PPF trial cohorts appear to be lower than those reported in prospective patient registries. There is a need for careful consideration of trial eligibility criteria with detailed reporting of comorbidities in future pharmaceutical RCTs to better understand the applicability of trial findings to real-world patients.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663060","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":"Remote monitoring in asthma: a systematic review.","authors":"Giselle Mosnaim, Michelle Carrasquel, Tatum Ewing, Alba Berty, Madeline Snedden","doi":"10.1183/16000617.0143-2024","DOIUrl":"10.1183/16000617.0143-2024","url":null,"abstract":"<p><strong>Background: </strong>Poor adherence to maintenance inhalers and incorrect maintenance and reliever inhaler technique are associated with poor asthma outcomes. Remote therapeutic monitoring and remote patient monitoring support asthma guideline recommendations to regularly review adherence and inhaler technique, with the ultimate goal to improve asthma outcomes.</p><p><strong>Objective: </strong>This work systematically reviewed all clinical trials testing remote monitoring interventions on asthma outcomes.</p><p><strong>Methods: </strong>A systematic search of PubMed, SCOPUS, Ovid, CINAHL and reference review databases was conducted from 1 January 2000 to 30 April 2024. Articles were included if the title or abstract included MeSH terms of \"nebulizers and vaporizers\" in combination with \"digital\", \"remote\", \"electronic\" or \"smart inhaler\" to identify interventional studies testing remote monitoring for asthma. We characterised populations, interventions, control groups, outcomes, timeframe and setting across studies.</p><p><strong>Results: </strong>Of 2043 articles reviewed, 19 articles met the inclusion criteria (n=14 remote therapeutic monitoring; n=5 remote patient monitoring). While a wide range of outcomes were measured across studies, overall, the studies (n=19) that met the inclusion criteria demonstrated a slower decline in maintenance inhaler adherence (n=13), decreased reliever use (n=6) and improvements in asthma control (n=3). They did not demonstrate positive outcomes on asthma exacerbations and healthcare utilisation, but this may be due to study sample sizes, eligibility criteria and duration.</p><p><strong>Conclusion: </strong>Remote monitoring demonstrates improvements in important intermediary asthma outcomes. Future studies with larger sample sizes, duration and requiring greater disease severity as eligibility criteria are warranted to evaluate their efficacy at decreasing asthma-related oral steroid use, emergency department visits, hospitalisations and costs.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663063","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":"Patient-centred outcomes in severe asthma: fatigue, sleep, physical activity and work.","authors":"Lianne Ten Have, Fleur L Meulmeester, Kim de Jong, Anneke Ten Brinke","doi":"10.1183/16000617.0122-2024","DOIUrl":"10.1183/16000617.0122-2024","url":null,"abstract":"<p><p>Severe asthma places a significant burden on patients, with recent research revealing overlooked patient needs extending beyond physical symptoms. To optimise the patient-centred approach to managing severe asthma, it is crucial to deepen our understanding of these needs. This review examines the prevalence and impact of four prioritised patient needs in severe asthma, namely fatigue, sleep disturbances, physical inactivity and reduced presence and productivity at work. It explores how these factors relate to classic asthma outcomes and quality of life, and the potential impact of interventions. Fatigue affects up to 90% of patients, while sleep difficulties impact 70-75% of severe cases, contributing to impaired daily function and quality of life. Although both are linked to asthma control, the cause-and-effect relationship remains unclear, making it clinically intriguing to investigate whether interventions targeting fatigue or sleep problems affect asthma control. In asthma patients, physical inactivity occurs both as consequence and contributing factor to uncontrolled disease. Interventions promoting physical activity improve asthma control and quality of life, suggesting a potential role in severe asthma management. Finally, work productivity loss, notably present in severe asthma cases, strongly correlates with asthma control and exacerbations. While biologic therapies show potential to reverse this loss, their effects on physical activity, fatigue and sleep disturbances warrant further investigation. Nonpharmacological interventions targeting these needs, such as pulmonary rehabilitation and behavioural therapies, may provide opportunities to enhance patients' well-being. Overall, this review highlights significant gaps in understanding patient-centred aspects of severe asthma, urging for research on comprehensive interventions to improve patients' lives.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"34 175","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566398","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}