Presse Medicale最新文献_第2页

Sicca induced by immune checkpoint inhibitors 免疫检查点抑制剂诱导的Sicca。

IF 3.4 3区医学

Presse Medicale Pub Date : 2026-06-01 Epub Date: 2025-11-22 DOI: 10.1016/j.lpm.2025.104331

Rakiba Belkhir , Marjolaine Gosset , Antoine Rousseau , Samuel Bitoun , Thierry Lazure , Xavier Mariette , Gaetane Nocturne

{"title":"Sicca induced by immune checkpoint inhibitors","authors":"Rakiba Belkhir , Marjolaine Gosset , Antoine Rousseau , Samuel Bitoun , Thierry Lazure , Xavier Mariette , Gaetane Nocturne","doi":"10.1016/j.lpm.2025.104331","DOIUrl":"10.1016/j.lpm.2025.104331","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment but are associated with immune-related adverse events (irAEs), including sicca syndrome. This condition, characterized by ocular and oral dryness, is under-recognized yet significantly impacts patients' quality of life.</div></div><div><h3>Objectives</h3><div>This review aims to highlight the prevalence, clinical features, and management strategies for ICI-induced sicca syndrome, emphasizing its distinction from Sjögren disease (SjD) and the importance of early detection and treatment.</div></div><div><h3>Key points</h3><div>Sicca induced by immune checkpoint inhibitors (ICI) is under-estimated but might affect 5 to 24 % of the patients treated by ICI. The pathophysiology of ICI-induced sicca is different from SjD, with infiltration of salivary glands mainly by T lymphocytes. Management of sicca induced by ICI consists of a graded approach, including symptomatic treatment and corticosteroids.</div></div><div><h3>Future directions</h3><div>Future research on ICI-induced sicca syndrome should focus on prospective studies to accurately determine its frequency and validate screening tools for early diagnosis. Assessing the benefits of early immunomodulatory treatments and exploring the long-term outcome of the condition are also essential. Understanding the immunological mechanisms and risk factors will be crucial to improve the management. Collaboration among specialists is mandatory to develop comprehensive management guidelines and improving patient condition.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 2","pages":"Article 104331"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596816","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

Gastrointestinal complications of immune checkpoint Inhibitor therapy 免疫检查点抑制剂治疗的胃肠道并发症。

IF 3.4 3区医学

Presse Medicale Pub Date : 2026-06-01 Epub Date: 2025-11-21 DOI: 10.1016/j.lpm.2025.104326

Franck Carbonnel , Antoine Martin , Lysiane Marthey , Christophe Bellanger , Rita Bou-Farah , Isabelle Boytchev , Raef Abdallah , Aurélien Amiot , Antoine Meyer

引用次数: 0

Immunotherapy and the heart: Understanding the cardiovascular risks of immune checkpoint inhibitors 免疫治疗和心脏：了解免疫检查点抑制剂的心血管风险。

IF 3.4 3区医学

Presse Medicale Pub Date : 2026-06-01 Epub Date: 2025-11-21 DOI: 10.1016/j.lpm.2025.104327

Maria Sol Andres, Maria Clara Llamedo, Sivatharshini Ramalingam, Alexander R. Lyon

{"title":"Immunotherapy and the heart: Understanding the cardiovascular risks of immune checkpoint inhibitors","authors":"Maria Sol Andres, Maria Clara Llamedo, Sivatharshini Ramalingam, Alexander R. Lyon","doi":"10.1016/j.lpm.2025.104327","DOIUrl":"10.1016/j.lpm.2025.104327","url":null,"abstract":"<div><div>The advent of immune checkpoint inhibitors (ICIs) has revolutionized cancer therapy, offering improved survival outcomes in various malignancies. However, their use is associated with immune-related adverse events (irAEs), including severe cardiovascular complications. Initially considered a rare and highly fatal condition, ICI-related myocarditis was first recognized in 2016, when Johnson et al. reported an incidence of 0.09 % with 50 % mortality among patients treated with ICIs. Over time, growing awareness, early detection, and advancements in treatment have led to a significant reduction in mortality, with recent studies reporting rates as low as 7 % and lower. Importantly, it is now recognized that myocarditis is not the only cardiovascular adverse event (CVAE) related to ICIs. The spectrum of CVAEs has expanded to include conditions such as pericarditis, non-inflammatory left ventricular dysfunction, acute coronary syndrome, and arrhythmias, among others. This review aims to provide an overview of the current understanding of ICI-mediated cardiovascular adverse effects, highlighting diagnostic challenges, therapeutic strategies, and future directions for research.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 2","pages":"Article 104327"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588293","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 the pathogenetic hallmarks of chronic obstructive pulmonary disease 慢性阻塞性肺疾病发病特点的最新进展。

IF 3.4 3区医学

Presse Medicale Pub Date : 2026-03-01 Epub Date: 2025-10-30 DOI: 10.1016/j.lpm.2025.104315

Ken R. Bracke , Guy G. Brusselle

引用次数: 0

Pre-COPD: Impact on prevention, detection, and treatment copd前期：对预防、检测和治疗的影响。

IF 3.4 3区医学

Presse Medicale Pub Date : 2026-03-01 Epub Date: 2025-11-09 DOI: 10.1016/j.lpm.2025.104316

Christopher B. Bosma, Wassim W. Labaki, MeiLan K. Han

{"title":"Pre-COPD: Impact on prevention, detection, and treatment","authors":"Christopher B. Bosma, Wassim W. Labaki, MeiLan K. Han","doi":"10.1016/j.lpm.2025.104316","DOIUrl":"10.1016/j.lpm.2025.104316","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>The ability to identify individuals at risk for progression to chronic obstructive pulmonary disease (COPD) remains challenging. The concept of pre-COPD has been proposed as a framework to identify patients without current airflow obstruction at greatest risk for progression to COPD using a constellation of symptoms, physiologic changes, and structural changes on chest imaging. While multiple biomarkers are linked to the subsequent development of COPD in at-risk individuals, no single biomarker has emerged as the best predictor. The goal of this review is to define the concept of pre-COPD, summarize known biomarkers associated with later development of COPD, and address the impact of pre-COPD on patient care.</div></div><div><h3>Methods</h3><div>Narrative Review</div></div><div><h3>Conclusion</h3><div>The concept of pre-COPD can help meet current gaps in screening and care for patients at risk of progression to COPD. A framework definition of pre-COPD allows for identification of individuals at risk for progression to COPD and indicates increased morbidity and mortality. While the ideal biomarker for pre-COPD has not been identified, multimodal risk prediction scores and practical clinical definitions are emerging for use in clinical practice. Additional research is needed to better understand optimal clinical screening and management of patients with pre-COPD.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 1","pages":"Article 104316"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496460","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

Integrated care in COPD 慢性阻塞性肺病的综合护理。

IF 3.4 3区医学

Presse Medicale Pub Date : 2026-03-01 Epub Date: 2025-10-30 DOI: 10.1016/j.lpm.2025.104320

Jean Bourbeau , Claudia LeBlanc

引用次数: 0

COPD exacerbations: Major events in the course of the disease COPD加重：病程中的主要事件。

IF 3.4 3区医学

Presse Medicale Pub Date : 2026-03-01 Epub Date: 2025-10-30 DOI: 10.1016/j.lpm.2025.104317

Sachin Ananth, Jadwiga A. Wedzicha

引用次数: 0

Pharmacological management of COPD 慢性阻塞性肺病的药理管理。

IF 3.4 3区医学

Presse Medicale Pub Date : 2026-03-01 Epub Date: 2025-10-30 DOI: 10.1016/j.lpm.2025.104319

Augusta Beech , Dave Singh

{"title":"Pharmacological management of COPD","authors":"Augusta Beech , Dave Singh","doi":"10.1016/j.lpm.2025.104319","DOIUrl":"10.1016/j.lpm.2025.104319","url":null,"abstract":"<div><div>The pharmacological management of chronic obstructive pulmonary disease (COPD) focuses on the alleviation of symptoms coupled with exacerbation prevention. Inhaled treatments are the mainstay of management, ensuring adequate lung delivery while minimising the potential for adverse systemic effects. Combination inhalers with long acting bronchodilators, with and without inhaled corticosteroids (ICS), are in widespread use to treat COPD on the basis of clinical trial evidence alongside the practical advantages associated with using a single inhaler in the real life world. There is also a personalised approach to ICS use, as blood eosinophil counts can help identify individuals with a greater probability of responding to treatment. Biological treatments have demonstrated positive results in COPD clinical trials, and will also be used in a precision approach in future.</div><div>The positive clinical trial results for dupilumab (a monoclonal antibody directed against the shared IL-4 and IL-13 receptor) and ensifentrine (an inhibitor of phosphodiesterase 3 and 4) represent significant advances in the pharmacological management of COPD. This review describes the recent progress in COPD pharmacology, covering novel molecules, new evidence and changes in clinical practice.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 1","pages":"Article 104319"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The evolving epidemiology, disease trajectories and etiotypes of COPD 慢性阻塞性肺病的流行病学演变、疾病轨迹和病因型。

IF 3.4 3区医学

Presse Medicale Pub Date : 2026-03-01 Epub Date: 2025-10-30 DOI: 10.1016/j.lpm.2025.104314

Dagmar Düsterhöft, Jaime Alvarado, Daiana Stolz

引用次数: 0

Difficult-to-treat COPD: from concept to practice 难治性慢性阻塞性肺病：从概念到实践。

IF 3.4 3区医学

Presse Medicale Pub Date : 2026-03-01 Epub Date: 2025-11-09 DOI: 10.1016/j.lpm.2025.104321

Lucile Regard , Nicolas Roche

{"title":"Difficult-to-treat COPD: from concept to practice","authors":"Lucile Regard , Nicolas Roche","doi":"10.1016/j.lpm.2025.104321","DOIUrl":"10.1016/j.lpm.2025.104321","url":null,"abstract":"<div><div>Most patients with Chronic Obstructive Pulmonary Disease (COPD) can be managed effectively through standard therapeutic strategies. However, a significant proportion remains symptomatic, experiences recurrent exacerbations, or shows accelerated lung function decline despite apparently appropriate care. These patients often fall into what could be referred to as “difficult-to-treat COPD”, a term still lacking formal definition. Drawing parallels with asthma, this article proposes to consider the concept of disease control in COPD as a key driver of COPD management, not representing a fixed target but a dynamic construct reflecting daily impact and long-term stability.</div><div>We provide a structured framework for reassessing diagnosis accuracy, evaluating treatment adequacy, and identifying unresolved pathophysiological drivers in patients who remain uncontrolled. Core domains include persistent dyspnea, chronic bronchitis, frequent or severe exacerbations, and rapid lung function decline. Each is explored with a focus on clinical reasoning, diagnostic tools, and phenotype- or endotype-based treatable trait-specific strategies. Importantly, the article argues that in patients remaining uncontrolled despite guideline-concordant care, the clinical response paradigm should shift from escalation to recharacterization. Practical pathways beyond standard care such as biologic therapy, lung volume reduction and transplantation, access to research protocols, and early integration of palliative care are reviewed. In the conclusion, we advocate for broader implementation of multidisciplinary case discussions and for using loss of disease control as a clinical trigger to prompt timely reassessment. Rather than defining a new phenotype, the aim is to promote a dynamic, precision-based approach to COPD management that aligns therapeutic strategies with evolving disease trajectories.</div></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"55 1","pages":"Article 104321"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496356","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