European Respiratory Review最新文献

{"title":"Breathing new life into the study of COPD with genes identified from genome-wide association studies","authors":"Rhiannon B. Werder, Xiaobo Zhou, Michael H. Cho, Andrew A. Wilson","doi":"10.1183/16000617.0019-2024","DOIUrl":"https://doi.org/10.1183/16000617.0019-2024","url":null,"abstract":"<p>COPD is a major cause of morbidity and mortality globally. While the significance of environmental exposures in disease pathogenesis is well established, the functional contribution of genetic factors has only in recent years drawn attention. Notably, many genes associated with COPD risk are also linked with lung function. Because reduced lung function precedes COPD onset, this association is consistent with the possibility that derangements leading to COPD could arise during lung development. In this review, we summarise the role of leading genes (<I>HHIP</I>, <I>FAM13A</I>, <I>DSP</I>, <I>AGER</I> and <I>TGFB2</I>) identified by genome-wide association studies in lung development and COPD. Because many COPD genome-wide association study genes are enriched in lung epithelial cells, we focus on the role of these genes in the lung epithelium in development, homeostasis and injury.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"97 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141170868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between alcohol consumption and pulmonary function: a scoping review","authors":"Line Bjerrehave Nielsen, Maria Oxbøl Johansen, Signe Juul Riddersholm, Ulla Møller Weinreich","doi":"10.1183/16000617.0233-2023","DOIUrl":"https://doi.org/10.1183/16000617.0233-2023","url":null,"abstract":"<sec><st>Introduction:</st>\u0000<p>The health effects of alcohol are well established but the influence on pulmonary function remains debated. Studies indicate that small amounts of alcohol are beneficial and heavy consumption is harmful, suggesting a U-shaped association. Our objective is to determine whether there is an association between alcohol intake and changes in pulmonary function parameters, exploring the potential protective effect of moderate alcohol consumption and the harm caused by heavy drinking.</p>\u0000</sec>\u0000<sec><st>Methods:</st>\u0000<p>A comprehensive search from PubMed, Embase, Cochrane and CINAHL was carried out, and studies were evaluated using the JBI methodological framework for scoping reviews. Two independent reviewers conducted parallel screening and data extraction. A data extraction form was utilised to organise key themes, with qualitative analysis and visual representation of the results.</p>\u0000</sec>\u0000<sec><st>Results:</st>\u0000<p>Among 4427 screened abstracts, 179 underwent full-text review, resulting in 30 eligible studies. Of these, 10 showed a negative effect, nine reported no impact, nine exhibited a positive effect and two indicated a nonlinear U-shaped association between alcohol consumption and pulmonary function parameters.</p>\u0000</sec>\u0000<sec><st>Conclusion:</st>\u0000<p>While the U-shaped curve hypothesis remains unconfirmed by the current literature, there are notable associations. Heavy alcohol consumption appears to negatively affect pulmonary function, while low to moderate intake shows a positive influence in included studies. However, the diversity in study quality, the nonstandardised alcohol intake quantification and the confounding role of smoking challenge definitive conclusions. The need for consistent, long-term international studies is evident to further explore this relationship while addressing the complex interplay between alcohol and smoking.</p>\u0000</sec>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"730 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140884216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subclinical tuberculosis: a meta-analysis of prevalence and scoping review of definitions, prevalence and clinical characteristics","authors":"Alvin Kuo Jing Teo, Emily Lai-Ho MacLean, Greg J. Fox","doi":"10.1183/16000617.0208-2023","DOIUrl":"https://doi.org/10.1183/16000617.0208-2023","url":null,"abstract":"<sec><st>Background:</st>\u0000<p>This scoping review aimed to characterise definitions used to describe subclinical tuberculosis (TB), estimate the prevalence in different populations and describe the clinical characteristics and treatment outcomes in the scientific literature.</p>\u0000</sec>\u0000<sec><st>Methods:</st>\u0000<p>A systematic literature search was conducted using PubMed. We included studies published in English between January 1990 and August 2022 that defined \"subclinical\" or \"asymptomatic\" pulmonary TB disease, regardless of age, HIV status and comorbidities. We estimated the weighted pooled proportions of subclinical TB using a random-effects model by World Health Organization reported TB incidence, populations and settings. We also pooled the proportion of subclinical TB according to definitions described in published prevalence surveys.</p>\u0000</sec>\u0000<sec><st>Results:</st>\u0000<p>We identified 29 prevalence surveys and 71 other studies. Prevalence survey data (2002&ndash;2022) using \"absence of cough of any duration\" criteria reported higher subclinical TB prevalence than those using the stricter \"completely asymptomatic\" threshold. Prevalence estimates overlap in studies using other symptoms and cough duration. Subclinical TB in studies was commonly defined as asymptomatic TB disease. Higher prevalence was reported in high TB burden areas, community settings and immunocompetent populations. People with subclinical TB showed less extensive radiographic abnormalities, higher treatment success rates and lower mortality, although studies were few.</p>\u0000</sec>\u0000<sec><st>Conclusion:</st>\u0000<p>A substantial proportion of TB is subclinical. However, prevalence estimates were highly heterogeneous between settings. Most published studies incompletely characterised the phenotype of people with subclinical TB. Standardised definitions and diagnostic criteria are needed to characterise this phenotype. Further research is required to enhance case finding, screening, diagnostics and treatment options for subclinical TB.</p>\u0000</sec>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"65 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140884215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary meeting review in nonsmall cell lung cancer: a systematic review and meta-analysis","authors":"Rob G. Stirling, Amelia Harrison, Joanna Huang, Vera Lee, John Taverner, Hayley Barnes","doi":"10.1183/16000617.0157-2023","DOIUrl":"https://doi.org/10.1183/16000617.0157-2023","url":null,"abstract":"<sec><st>Background:</st>\u0000<p>Lung cancer diagnosis, staging and treatment may be enhanced by multidisciplinary participation and presentation in multidisciplinary meetings (MDM). We performed a systematic review and meta-analysis to explore literature evidence of clinical impacts of MDM exposure.</p>\u0000</sec>\u0000<sec><st>Methods:</st>\u0000<p>A study protocol was registered (PROSPERO identifier CRD42021258069). Randomised controlled trials and observational cohort studies including adults with nonsmall cell lung cancer and who underwent MDM review, compared to no MDM, were included. MEDLINE, CENTRAL, Embase and ClinicalTrials.gov were searched on 31 May 2021. Studies were screened and extracted by two reviewers. Outcomes included time to diagnosis and treatment, histological confirmation, receipt of treatments, clinical trial participation, survival and quality of life. Risk of bias was assessed using the ROBINS-I (Risk of Bias in Non-randomised Studies &ndash; of Interventions) tool.</p>\u0000</sec>\u0000<sec><st>Results:</st>\u0000<p>2947 citations were identified, and 20 studies were included. MDM presentation significantly increased histological confirmation of diagnosis (OR 3.01, 95% CI 2.30&ndash;3.95; p&lt;0.00001) and availability of clinical staging (OR 2.55, 95% CI 1.43&ndash;4.56; p=0.002). MDM presentation significantly increased likelihood of receipt of surgery (OR 2.01, 95% CI 1.29&ndash;3.12; p=0.002) and reduced the likelihood of receiving no active treatment (OR 0.32, 95% CI 0.21&ndash;0.50; p=0.01). MDM presentation was protective of both 1-year survival (OR 3.23, 95% CI 2.85&ndash;3.68; p&lt;0.00001) and overall survival (hazard ratio 0.63, 95% CI 0.55&ndash;0.72; p&lt;0.00001).</p>\u0000</sec>\u0000<sec><st>Discussion:</st>\u0000<p>MDM presentation was associated with increased likelihood of histological confirmation of diagnosis, documentation of clinical staging and receipt of surgery. Overall and 1-year survival was better in those presented to an MDM, although there was some clinical heterogeneity in participants and interventions delivered. Further research is required to determine the optimal method of MDM presentation, and address barriers to presentation.</p>\u0000</sec>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"28 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140884203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social determinants of respiratory health from birth: still of concern in the 21st century?","authors":"Andrew Bush, Catherine A. Byrnes, Kate C. Chan, Anne B. Chang, Juliana C. Ferreira, Karl A. Holden, Stephanie Lovinsky-Desir, Gregory Redding, Varinder Singh, Ian P. Sinha, Heather J. Zar","doi":"10.1183/16000617.0222-2023","DOIUrl":"https://doi.org/10.1183/16000617.0222-2023","url":null,"abstract":"<p>Respiratory symptoms are ubiquitous in children and, even though they may be the harbinger of poor long-term outcomes, are often trivialised. Adverse exposures pre-conception, antenatally and in early childhood have lifetime impacts on respiratory health. For the most part, lung function tracks from the pre-school years at least into late middle age, and airflow obstruction is associated not merely with poor respiratory outcomes but also early all-cause morbidity and mortality. Much would be preventable if social determinants of adverse outcomes were to be addressed. This review presents the perspectives of paediatricians from many different contexts, both high and low income, including Europe, the Americas, Australasia, India, Africa and China. It should be noted that there are islands of poverty within even the highest income settings and, conversely, opulent areas in even the most deprived countries. The heaviest burden of any adverse effects falls on those of the lowest socioeconomic status. Themes include passive exposure to tobacco smoke and indoor and outdoor pollution, across the entire developmental course, and lack of access even to simple affordable medications, let alone the new biologicals. Commonly, disease outcomes are worse in resource-poor areas. Both within and between countries there are avoidable gross disparities in outcomes. Climate change is also bearing down hardest on the poorest children. This review highlights the need for vigorous advocacy for children to improve lifelong health. It also highlights that there are ongoing culturally sensitive interventions to address social determinants of disease which are already benefiting children.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"2019 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140594541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environment and lung health in a rapidly changing world","authors":"Catherine M. Greene, Renata L. Riha","doi":"10.1183/16000617.0057-2024","DOIUrl":"https://doi.org/10.1183/16000617.0057-2024","url":null,"abstract":"<sec><st>Extract</st>\u0000<p>This issue of the <I>European Respiratory Review</I> features the first articles in a series of reviews entitled \"Environment and lung health in a rapidly changing world\". This series aims to highlight and dissect the complex intersections of environmental factors and their impact on human lung health. Additionally, the series addresses some more specific issues that we continue to face in the 21st century, including health inequity, the increasingly fast-paced integration of artificial intelligence (AI) into every day medical practice and climate change.</p>\u0000</sec>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"17 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140594705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in physical activity, sedentary behaviour and sleep following pulmonary rehabilitation: a systematic review and network meta-analysis","authors":"James Manifield, Yousuf Chaudhry, Sally J. Singh, Thomas J.C. Ward, Maxine E. Whelan, Mark W. Orme","doi":"10.1183/16000617.0225-2023","DOIUrl":"https://doi.org/10.1183/16000617.0225-2023","url":null,"abstract":"<sec><st>Background:</st>\u0000<p>The variety of innovations to traditional centre-based pulmonary rehabilitation (CBPR), including different modes of delivery and adjuncts, are likely to lead to differential responses in physical activity, sedentary behaviour and sleep.</p>\u0000</sec>\u0000<sec><st>Objectives:</st>\u0000<p>To examine the relative effectiveness of different pulmonary rehabilitation-based interventions on physical activity, sedentary behaviour and sleep.</p>\u0000</sec>\u0000<sec><st>Methods:</st>\u0000<p>Randomised trials in chronic respiratory disease involving pulmonary rehabilitation-based interventions were systematically searched for. Network meta-analyses compared interventions for changes in physical activity, sedentary behaviour and sleep in COPD.</p>\u0000</sec>\u0000<sec><st>Results:</st>\u0000<p>46 studies were included, and analyses were performed on most common outcomes: steps per day (k=24), time spent in moderate-to-vigorous physical activity (MVPA; k=12) and sedentary time (k=8). There were insufficient data on sleep outcomes (k=3). CBPR resulted in greater steps per day and MVPA and reduced sedentary time compared to usual care. CBPR+physical activity promotion resulted in greater increases in steps per day compared to both usual care and CBPR, with greater increases in MVPA and reductions in sedentary time compared to usual care, but not CBPR. Home-based pulmonary rehabilitation resulted in greater increases in steps per day and decreases in sedentary time compared to usual care. Compared to usual care, CBPR+physical activity promotion was the only intervention where the lower 95% confidence interval for steps per day surpassed the minimal important difference. No pulmonary rehabilitation-related intervention resulted in greater increases in MVPA or reductions in sedentary time compared to CBPR.</p>\u0000</sec>\u0000<sec><st>Conclusion:</st>\u0000<p>The addition of physical activity promotion to pulmonary rehabilitation improves volume of physical activity, but not intensity, compared to CBPR. High risk of bias and low certainty of evidence suggests that these results should be viewed with caution.</p>\u0000</sec>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"53 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140594539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global respiratory health priorities at the beginning of the 21st century","authors":"Catherine M. Greene, Mohamed Abdulkadir","doi":"10.1183/16000617.0205-2023","DOIUrl":"https://doi.org/10.1183/16000617.0205-2023","url":null,"abstract":"<p>Respiratory health has become a prevailing priority amid the diverse global health challenges that the 21st century brings, due to its substantial impact on individuals and communities on a global scale. Due to rapid advances in medicine, emerging knowledge gaps appear along with new challenges and ethical considerations. While breakthroughs in medical science can bring about encouraging possibilities for better treatments and interventions, they also lead to unanswered questions and areas where further research is warranted. A PubMed search on the topic \"global respiratory health priorities\" between the years 2000 and 2023 was conducted, which returned 236 articles. Of these, 55 were relevant and selected for inclusion in this article. The selection process took into account literature reviews, opinions from expert groups and careful analysis of existing gaps and challenges within the field; our selection encompasses specific infectious and noninfectious respiratory conditions in both adults and children. The global respiratory health priorities identified were selected on the basis that they have been recognised as critical areas of investigation and potential advancement and they span across clinical, translational, epidemiological and population health domains. Implementing these priorities will require a commitment to fostering collaboration and knowledge-sharing among experts in different fields with the ultimate aim to improve respiratory health outcomes for individuals and communities alike.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"58 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140594684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of flow settings during high-flow nasal cannula oxygen therapy for neonates and young children.","authors":"Jie Li, Ni Deng, Wan Jia Aaron He, Cui Yang, Pan Liu, Fai A Albuainain, Brian J Ring, Andrew G Miller, Alexandre T Rotta, Robert D Guglielmo, Christophe Milési","doi":"10.1183/16000617.0223-2023","DOIUrl":"10.1183/16000617.0223-2023","url":null,"abstract":"<p><strong>Background: </strong>During neonatal and paediatric high-flow nasal cannula therapy, optimising the flow setting is crucial for favourable physiological and clinical outcomes. However, considerable variability exists in clinical practice regarding initial flows and subsequent adjustments for these patients. Our review aimed to summarise the impact of various flows during high-flow nasal cannula treatment in neonates and children.</p><p><strong>Methods: </strong>Two investigators independently searched PubMed, Embase, Web of Science, Scopus and Cochrane for <i>in vitro</i> and <i>in vivo</i> studies published in English before 30 April 2023. Studies enrolling adults (≥18 years) or those using a single flow setting were excluded. Data extraction and risk of bias assessments were performed independently by two investigators. The study protocol was prospectively registered with PROSPERO (CRD42022345419).</p><p><strong>Results: </strong>38 406 studies were identified, with 44 included. <i>In vitro</i> studies explored flow settings' effects on airway pressures, humidity and carbon dioxide clearance; all were flow-dependent. Observational clinical studies consistently reported that higher flows led to increased pharyngeal pressure and potentially increased intrathoracic airway pressure (especially among neonates), improved oxygenation, and reduced respiratory rate and work of breathing up to a certain threshold. Three randomised controlled trials found no significant differences in treatment failure among different flow settings. Flow impacts exhibited significant heterogeneity among different patients.</p><p><strong>Conclusion: </strong>Individualising flow settings in neonates and young children requires consideration of the patient's peak inspiratory flow, respiratory rate, heart rate, tolerance, work of breathing and lung aeration for optimal care.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 171","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10966474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305350","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":"Central sleep apnoea: not just one phenotype.","authors":"Winfried Randerath, Sébastien Baillieul, Renaud Tamisier","doi":"10.1183/16000617.0141-2023","DOIUrl":"10.1183/16000617.0141-2023","url":null,"abstract":"<p><p>Recent scientific findings in the field of sleep disordered breathing have characterised a variety of phenotypes in obstructive sleep apnoea. These findings have prompted investigations aiming to achieve a more precise differentiation and description of the entities of central sleep apnoea (CSA). There is increasing evidence for the heterogeneity of CSA in terms of underlying aetiology, pathophysiological concepts, treatment response and outcome. Assigning patients to these phenotypes allows for the selection of individualised therapies. Major pathophysiological characteristics include loop gain, apnoeic threshold, breathing regulation and neuromuscular mechanics. Chronic heart failure is the most important underlying disease, leading to nonhypercapnic CSA based on increased loop and controller gain. Although many questions remain, this review tries to describe the current knowledge on the pathophysiology of the clinical entities. The description of prognostic aspects may guide treatment indication and the selection of pharmacotherapy and invasive options. In addition, the paper provides an update on the current understanding of adaptive servo-ventilation and its role in the treatment of CSA.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 171","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10966472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305349","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}