Pulmonary Therapy最新文献

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Responsiveness of Inhaled Corticosteroid Treatment in Children with Asthma: The Role of rs242941 Polymorphism of CRHR1 Gene. 哮喘患儿吸入皮质类固醇治疗的反应性:CRHR1基因rs242941多态性的作用
IF 3
Pulmonary Therapy Pub Date : 2023-03-01 DOI: 10.1007/s41030-022-00205-9
Hanh Nguyen-Thi-Bich, Thuy Nguyen-Thi-Dieu, Le Nguyen-Ngoc-Quynh, Huong Le-Thi-Minh, Sy Duong-Quy
{"title":"Responsiveness of Inhaled Corticosteroid Treatment in Children with Asthma: The Role of rs242941 Polymorphism of CRHR1 Gene.","authors":"Hanh Nguyen-Thi-Bich,&nbsp;Thuy Nguyen-Thi-Dieu,&nbsp;Le Nguyen-Ngoc-Quynh,&nbsp;Huong Le-Thi-Minh,&nbsp;Sy Duong-Quy","doi":"10.1007/s41030-022-00205-9","DOIUrl":"https://doi.org/10.1007/s41030-022-00205-9","url":null,"abstract":"<p><strong>Introduction: </strong>Inhaled corticosteroid (ICS) is the most widely used and effective treatment of asthma. However, some patients do not respond to ICS, which might be due to various genetic factors. Hence, understanding the genetic factors involved in the ICS response could help physicians to individualize their treatment decision and action plans for given patients. This study aimed to analyze the characteristics of corticotropin-releasing hormone receptor 1 (CRHR1) genotypes in children with asthma and the correlation between rs242941 polymorphism of CRHR1 gene and ICS responsiveness.</p><p><strong>Methods: </strong>This prospective study included children with uncontrolled asthma, assessing their eosinophil count, IgE concentration, lung function, and fractional concentration of nitric oxide in exhaled breath (FENO) and performing CRHR1 polymorphism sequencing. The level of asthma control was assessed by asthma control test (ACT); the responsiveness of asthma treatment with ICS was evaluated by measuring the change of ACT and forced expiratory volume in 1 s (FEV<sub>1</sub>) after treatment versus at inclusion.</p><p><strong>Results: </strong>In total, 107 patients were analyzed for CRHR1 at rs242941. Among these, 86 (80.3%) had homozygous wild-type GG, 20 (18.7%) had heterozygous GT genotypes, and 1 (1.0%) had a homozygous variant for TT. Children with personal and family history of atopy were more likely to have GT and TT genotypes. The severity of asthma was similar between children with asthma in the three groups of GG, GT, and TT genotypes of CRHR1 at rs242941. FENO level, total IgE concentration, and eosinophilic count in children with asthma were not significantly different between GG and GT genotypes. The patient with a TT homozygous variant genotype had a higher level of FENO. There was no correlation between CRHR1 polymorphism at rs242941 and asthma control evaluated by asthma control test and lung function parameters.</p><p><strong>Conclusion: </strong>TT genotype of rs242941 in the CRHR1 gene is not frequent. Clinical and functional characteristics of children with asthma with rs242941 polymorphism of CRHR1 gene remain homogeneously similar. There is no correlation between rs242941 polymorphism and ACT or FEV<sub>1</sub>.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"9 1","pages":"127-137"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/28/41030_2022_Article_205.PMC9931962.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10730107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Autologous Blood Patch Pleurodesis for Secondary Spontaneous Pneumothorax: A Narrative Review, a Retrospective Case Series and State of Play in the UK. 自体血贴片胸膜切除术治疗继发性自发性气胸:一项叙述性回顾,回顾性病例系列和在英国发挥的状态。
IF 3
Pulmonary Therapy Pub Date : 2023-03-01 DOI: 10.1007/s41030-022-00212-w
Sufyan Shakir, Brian Choo-Kang, Clare Ross, Kevin Conroy, Richard Thorley, Steven Walker, Rahul Bhatnagar, Avinash Aujayeb
{"title":"Autologous Blood Patch Pleurodesis for Secondary Spontaneous Pneumothorax: A Narrative Review, a Retrospective Case Series and State of Play in the UK.","authors":"Sufyan Shakir,&nbsp;Brian Choo-Kang,&nbsp;Clare Ross,&nbsp;Kevin Conroy,&nbsp;Richard Thorley,&nbsp;Steven Walker,&nbsp;Rahul Bhatnagar,&nbsp;Avinash Aujayeb","doi":"10.1007/s41030-022-00212-w","DOIUrl":"https://doi.org/10.1007/s41030-022-00212-w","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment of prolonged air leak due to secondary spontaneous pneumothorax is challenging. Autologous blood patch pleurodesis (ABPP) is a treatment option. Previous evidence is reliant on single-centre series and underpowered trials and is mostly described in air leaks post cardiothoracic intervention. There are no United Kingdom (UK) wide data.</p><p><strong>Methods: </strong>Members of the UK Pleural Society were surveyed for their practice and for patients who underwent blood patch. There were 16 respondents from 333 members. Twelve had performed the procedure, and six had kept records and could submit data. Basic demographics, intervention and clinical details of patients were then collected. The study was sponsored by the Audit Department of Northumbria Healthcare NHS Foundation Trust (reference 8124), and Caldicott Clearance for data sharing was provided by the Trust's Information Goverance Board (reference C4221). There was no requirement for informed consent.</p><p><strong>Results: </strong>Data for 12 patients that received ABPP between 2014 and 2022 in six respiratory centres were assessed. The aetiology of the secondary pneumothoraces was mostly due to chronic obstructive pulmonary disease and end-stage interstitial lung disease. The patients had a median age of 75 years. The median air leak time before ABPP was 17 days. A total of 50-100 ml of blood was used for ABPP. Five patients had two attempts at ABPP. Air leak resolved in six patients (50%). Four patients had pleural apposition prior to ABPP. Four patients were diagnosed with hospital-acquired pneumonia following ABPP.</p><p><strong>Conclusion: </strong>This is the only UK-wide retrospective case series of ABPP of 'medical' patients with secondary pneumothorax. There is widespread variation in care. No formal conclusions can be drawn, and much larger robust datasets are required. An application has been made to the European Respiratory Society to incorporate ABPP within the International Collaborative Effusion database.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"9 1","pages":"165-172"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/74/41030_2022_Article_212.PMC9931973.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10747424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Single-Dose Pharmacokinetics and Metabolism of the Oral Decongestant Phenylephrine HCl in Children and Adolescents. 儿童和青少年口服减充血剂盐酸苯肾上腺素的单剂量药代动力学和代谢。
IF 3
Pulmonary Therapy Pub Date : 2023-03-01 DOI: 10.1007/s41030-022-00206-8
Cathy K Gelotte, Dolly A Parasrampuria, Brenda A Zimmerman
{"title":"Single-Dose Pharmacokinetics and Metabolism of the Oral Decongestant Phenylephrine HCl in Children and Adolescents.","authors":"Cathy K Gelotte,&nbsp;Dolly A Parasrampuria,&nbsp;Brenda A Zimmerman","doi":"10.1007/s41030-022-00206-8","DOIUrl":"https://doi.org/10.1007/s41030-022-00206-8","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric data for phenylephrine, a decongestant used in cold medicines, are limited. This study characterized the pharmacokinetics and metabolism of phenylephrine HCl in children aged 2-17 years.</p><p><strong>Methods: </strong>Forty-one children experiencing nasal congestion were dosed orally with phenylephrine HCl from 2.5 to 10 mg using a modified weight-age schedule. Plasma from blood samples collected up to 4.5 h after dosing was analyzed for phenylephrine. Urine collected over 24 h was analyzed for phenylephrine and metabolites. Blood pressure and pulse were measured after each blood sampling, and electrocardiograms were recorded before and after dosing. Pharmacokinetic parameters were estimated using noncompartmental methods.</p><p><strong>Results: </strong>Mean phenylephrine total exposure (AUC<sub>∞</sub>) for children aged 2-5, 6-11, and 12-17 years was 672, 830, and 1020 pg∙h/mL, and mean maximum concentration (C<sub>max</sub>) was 477, 589, and 673 pg/mL, respectively. Times to peak concentration (T<sub>max</sub>) ranged from 0.17 to 1.5 h, and elimination half-life (t<sub>½,β</sub>) was short from 1.2 to 1.6 h. Oral clearance (CL/F) increased with age, but with allometric scaling for body size, this trend reversed as scaled clearance (CL/F,<sub>scaled</sub>) was modestly higher in youngest children. No clinically relevant changes in vital signs or electrocardiograms were observed.</p><p><strong>Conclusion: </strong>A dosing schedule with additional weight-age increments would provide more consistent systemic concentrations as children age and receive the next higher dose. No developmental delays in clearance mechanisms were apparent when oral clearance was scaled for body size. Phenylephrine pharmacokinetics and metabolism were consistent with adult data, although AUC∞ for the youngest group and C<sub>max</sub> for all pediatric groups were lower. Single doses of phenylephrine HCl were well tolerated. TRIAL REGISTRATION: Clintrials.gov NCT00762567, registered 30 September 2008.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"9 1","pages":"139-150"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/1d/41030_2022_Article_206.PMC9931972.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9290393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Why Living with Pulmonary Arterial Hypertension Requires a Holistic Approach: A Patient and Clinician Perspective. 为什么生活肺动脉高压需要一个整体的方法:一个病人和临床医生的观点。
IF 3
Pulmonary Therapy Pub Date : 2023-03-01 DOI: 10.1007/s41030-022-00213-9
Haley Lynn, Melisa Wilson
{"title":"Why Living with Pulmonary Arterial Hypertension Requires a Holistic Approach: A Patient and Clinician Perspective.","authors":"Haley Lynn,&nbsp;Melisa Wilson","doi":"10.1007/s41030-022-00213-9","DOIUrl":"https://doi.org/10.1007/s41030-022-00213-9","url":null,"abstract":"<p><p>Pulmonary arterial hypertension (PAH) is a rare disease caused by high pressure in the blood vessels leading from the heart to the lung. PAH affects many parts of a patient's life, which means that patients should be managed by a clinical team of different specialists, including doctors, advance practice providers, nurses, social workers, and therapists. This article is co-authored by a patient living with PAH and an acute care nurse practitioner specializing in the management of patients with pulmonary hypertension. In the first section of this commentary, the patient describes her experience of living with PAH. The specialist nurse practitioner then discusses the management of PAH, to provide a clinician perspective in the context of the patient's experiences.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"9 1","pages":"1-13"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/54/41030_2022_Article_213.PMC9931975.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10740986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Extracorporeal Membrane Oxygenation in Acute Respiratory Failure. 急性呼吸衰竭的体外膜氧合。
IF 3
Pulmonary Therapy Pub Date : 2023-03-01 DOI: 10.1007/s41030-023-00214-2
Patrick M Wieruszewski, Jamel P Ortoleva, Daniel S Cormican, Troy G Seelhammer
{"title":"Extracorporeal Membrane Oxygenation in Acute Respiratory Failure.","authors":"Patrick M Wieruszewski,&nbsp;Jamel P Ortoleva,&nbsp;Daniel S Cormican,&nbsp;Troy G Seelhammer","doi":"10.1007/s41030-023-00214-2","DOIUrl":"https://doi.org/10.1007/s41030-023-00214-2","url":null,"abstract":"<p><p>Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is a form of mechanical life support that provides full respiratory bypass in patients with severe respiratory failure as a bridge to recovery or lung transplantation. The use of ECMO for respiratory failure and capable centers offering ECMO has expanded over the years, increasing its availability. As VV-ECMO provides an artificial mechanism for oxygenation and decarboxylation of native blood, it allows for an environment in which safer mechanical ventilatory care may be provided, allowing for treatment and resolution of underlying respiratory pathologies. Landmark clinical trials have provided a framework for better understanding patient selection criteria, resource utilization, and outcomes associated with ECMO when applied in settings of refractory respiratory failure. Maintaining close vigilance and management of complications during ECMO as well as identifying strategies post-ECMO (e.g., recovery, transplantation, etc.), are critical to successful ECMO support. In this review, we examine considerations for candidate selection for VV-ECMO, review the evidence of utilizing VV-ECMO in respiratory failure, and provide practical considerations for managing respiratory ECMO patients, including complication identification and management, as well as assessing for the ability to separate from ECMO support and the procedures for decannulation.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"9 1","pages":"109-126"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9a/e7/41030_2023_Article_214.PMC9859746.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9296723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Tests and Indices Predicting Extubation Failure in Children: A Systematic Review and Meta-analysis. 预测儿童拔管失败的测试和指标:系统回顾与元分析》。
IF 2.3
Pulmonary Therapy Pub Date : 2023-03-01 Epub Date: 2022-12-02 DOI: 10.1007/s41030-022-00204-w
Priscilla Ng, Herng Lee Tan, Yi-Jyun Ma, Rehena Sultana, Victoria Long, Judith J-M Wong, Jan Hau Lee
{"title":"Tests and Indices Predicting Extubation Failure in Children: A Systematic Review and Meta-analysis.","authors":"Priscilla Ng, Herng Lee Tan, Yi-Jyun Ma, Rehena Sultana, Victoria Long, Judith J-M Wong, Jan Hau Lee","doi":"10.1007/s41030-022-00204-w","DOIUrl":"10.1007/s41030-022-00204-w","url":null,"abstract":"<p><strong>Introduction: </strong>There is lack of consensus on what constitutes best practice when assessing extubation readiness in children. This systematic review aims to synthesize data from existing literature on pre-extubation assessments and evaluate their diagnostic accuracies in predicting extubation failure (EF) in children.</p><p><strong>Methods: </strong>A systematic search in PubMed, EMBASE, Web of Science, CINAHL, and Cochrane was performed from inception of each database to 15 July 2021. Randomized controlled trials or observational studies that studied the association between pre-extubation assessments and extubation outcome in the pediatric intensive care unit population were included. Meta-analysis was performed for studies that report diagnostic tests results of a combination of parameters.</p><p><strong>Results: </strong>In total, 41 of 11,663 publications screened were included (total patients, n = 8111). Definition of EF across studies was heterogeneous. Fifty-five unique pre-extubation assessments were identified. Parameters most studied were: respiratory rate (RR) (13/41, n = 1945), partial pressure of arterial carbon dioxide (10/41, n = 1379), tidal volume (13/41, n = 1945), rapid shallow breathing index (RBSI) (9/41, n = 1400), and spontaneous breathing trials (SBT) (13/41, n = 5652). Meta-analysis shows that RSBI, compliance rate oxygenation pressure (CROP) index, and SBT had sensitivities ranging from 0.14 to 0.57. CROP index had the highest sensitivity [0.57, 95% confidence interval (CI) 0.4-0.73] and area under curve (AUC, 0.98). SBT had the highest specificity (0.93, 95% CI 0.92-0.94).</p><p><strong>Conclusions: </strong>Pre-extubation assessments studied thus far remain poor predictors of EF. CROP index, having the highest AUC, should be further explored as a predictor of EF. Standardizing the EF definition will allow better comparison of pre-extubation assessments.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"9 1","pages":"25-47"},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/e3/41030_2022_Article_204.PMC9931987.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9534070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Which Endoscopic Procedure to Use and in What Patient? Valves, Coils, Foam, and Heat in COPD and Asthma. 使用哪种内窥镜手术,对什么患者?慢性阻塞性肺病和哮喘中的阀门,线圈,泡沫和热量。
IF 3
Pulmonary Therapy Pub Date : 2023-03-01 DOI: 10.1007/s41030-022-00208-6
Andrew Li, Pyng Lee
{"title":"Which Endoscopic Procedure to Use and in What Patient? Valves, Coils, Foam, and Heat in COPD and Asthma.","authors":"Andrew Li,&nbsp;Pyng Lee","doi":"10.1007/s41030-022-00208-6","DOIUrl":"https://doi.org/10.1007/s41030-022-00208-6","url":null,"abstract":"<p><p>Despite the latest developments in therapeutic agents targeting airway endotypes, a significant proportion of patients with asthma and chronic obstructive pulmonary disease (COPD) remain symptomatic. Endoscopic therapies have a complementary role in the management of these airway diseases. The sustained efficacy of bronchial thermoplasty (BT) among patients with asthma over 10 years has been encouraging, as it has been shown to improve symptom control and reduce hospital admissions and exacerbations. Studies suggest that BT helps ameliorate airway inflammation and reduce airway smooth muscle thickness. While studies suggest that it is as effective as biologic agents, its role in the management of severe asthma has yet to be clearly defined and GINA 2022 still suggests limiting its use to patients with characteristics of the various populations studied. Conversely, bronchoscopic lung volume reduction has shown promise among patients with advanced COPD. Rigorous patient selection is important. Patients with minimal collateral ventilation (CV) and higher heterogeneity index have shown to benefit the most from endobronchial valve (EBV) therapy. For those with ongoing CV, endobronchial coils would be more appropriate. Both therapeutic modalities have demonstrated improved quality of life, effort tolerance, and lung function indices among appropriately selected patients. The emerging evidence suggests that endoscopic procedures among airway disease still have a substantial role to play despite the development of new therapeutic options.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"9 1","pages":"49-69"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/54/41030_2022_Article_208.PMC9931990.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10737618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Applying Lessons from the COVID-19 Pandemic to Improve Pediatric Asthma Care. 应用COVID-19大流行的经验教训改善儿童哮喘护理。
IF 3
Pulmonary Therapy Pub Date : 2023-03-01 DOI: 10.1007/s41030-022-00207-7
Stephanie Lovinsky-Desir, Anna Volerman
{"title":"Applying Lessons from the COVID-19 Pandemic to Improve Pediatric Asthma Care.","authors":"Stephanie Lovinsky-Desir,&nbsp;Anna Volerman","doi":"10.1007/s41030-022-00207-7","DOIUrl":"https://doi.org/10.1007/s41030-022-00207-7","url":null,"abstract":"<p><p>Asthma is the most common chronic childhood condition and is a risk factor for severe respiratory viral infections. Thus, early during the coronavirus disease 2019 (COVID-19) pandemic there was concern that children with asthma would be at risk for severe COVID-19 illness and that asthma control could worsen as a result of the pandemic. This article seeks to summarize what was learned in the early stages of the pandemic about the impact of COVID-19 on children with asthma. We review evidence from several studies that demonstrated a significant decline in asthma morbidity in the first year of the pandemic. Additionally, we describe several potential mechanisms that may explain the reduced frequency in childhood asthma exacerbations as well as review lessons learned for future management of childhood asthma. While the COVID-19 pandemic initially brought uncertainty, it soon became clear that the pandemic had several positive effects for children with asthma. Now we can apply the lessons that were learned during the pandemic to re-examine asthma care practices as well as advocate for best approaches for asthma management.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"9 1","pages":"15-24"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/3f/41030_2022_Article_207.PMC9707220.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9462220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Phage Therapy for Nontuberculous Mycobacteria: Challenges and Opportunities. 非结核分枝杆菌的噬菌体治疗:挑战与机遇。
IF 3
Pulmonary Therapy Pub Date : 2023-03-01 DOI: 10.1007/s41030-022-00210-y
Graham F Hatfull
{"title":"Phage Therapy for Nontuberculous Mycobacteria: Challenges and Opportunities.","authors":"Graham F Hatfull","doi":"10.1007/s41030-022-00210-y","DOIUrl":"https://doi.org/10.1007/s41030-022-00210-y","url":null,"abstract":"<p><p>Non-tuberculous mycobacterium (NTM) infections are often clinically challenging, with lengthy antibiotic regimens that fail to resolve the infections with few good outcomes remaining. Mycobacteriophages-viruses that infect Mycobacterium hosts-show promise as therapeutic agents for NTM infections and have been used in 20 compassionate use cases. Favorable outcomes were observed in many but not all cases, although the phages show exceptional safety profiles and no evidence of phage resistance was observed, even when only a single phage was administered. Phage-specific antibodies are commonly present following intravenous administration and are often neutralizing for the phage in vitro. However, phage neutralization does not consistently correlate with poor treatment outcomes and may not be a therapeutic limitation in all patients, even when immunocompetent. Currently, the therapeutic potential of phages is substantially limited by the great variation in phage susceptibility and a relatively small repertoire of therapeutically useful phages. As many as 45% of clinical isolates can have a smooth colony morphotype, and phages that both efficiently infect and kill these strains have yet to be described. In contrast, ~ 75% of rough strains are susceptible to and killed by one or more phages and therapeutic options can be considered on a compassionate use basis. Although therapies must currently be personalized, elucidating the determinants of phage host specificity, expanding the useful phage repertoire, and identifying the key determinants of clinical outcomes will reveal their full therapeutic potential.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"9 1","pages":"91-107"},"PeriodicalIF":3.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/16/a4/41030_2022_Article_210.PMC9931961.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10740985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Effectiveness and Treatment Compliance of Salmeterol-Fluticasone Easyhaler® Among Patients with Asthma, COPD, or Asthma-COPD Overlap Syndrome: Real-World Study Findings. 哮喘、慢性阻塞性肺病或哮喘-慢性阻塞性肺病重叠综合征患者使用沙美特罗-氟替卡松缓释剂®的疗效和治疗依从性:真实世界的研究结果。
IF 2.3
Pulmonary Therapy Pub Date : 2022-12-01 Epub Date: 2022-11-01 DOI: 10.1007/s41030-022-00201-z
Lilla Tamási, Anna Bartha, Aranka Ferencz, Mihály Tímár, Mikko Vahteristo, Aino Takala, Veronika Müller
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