Seminars in respiratory and critical care medicine最新文献_第10页

Epigenetic Mechanisms in Sepsis-Associated Acute Kidney Injury. 败血症相关急性肾损伤的表观遗传机制

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-08-01 Epub Date: 2024-08-29 DOI: 10.1055/s-0044-1789240

Marco Fiorentino, Reginald Philippe, Carmen A Palumbo, Stefania Prenna, Vincenzo Cantaluppi, Silva De Rosa

{"title":"Epigenetic Mechanisms in Sepsis-Associated Acute Kidney Injury.","authors":"Marco Fiorentino, Reginald Philippe, Carmen A Palumbo, Stefania Prenna, Vincenzo Cantaluppi, Silva De Rosa","doi":"10.1055/s-0044-1789240","DOIUrl":"10.1055/s-0044-1789240","url":null,"abstract":"Sepsis, the dysregulated immune response of the host to infections, leads to numerous complications, including multiple organ dysfunction with sepsis-associated acute kidney injury (SA-AKI) being a frequent complication associated with increased risk of mortality and the progression toward chronic kidney disease (CKD). Several mechanisms have been widely investigated in understanding the complex pathophysiology of SA-AKI, including hemodynamic alterations, inflammation, oxidative stress, and direct cellular injury driven by pathogens or cell-derived products (pathogen-associated molecular patterns and damage-associated molecular patterns). Despite advancements in the management of septic patients, the prognosis of SA-AKI patients remains significantly poor and is associated with high in-hospital mortality and adverse long-term outcomes. Therefore, recent research has focused on the early identification of specific SA-AKI endotypes and subphenotypes through epigenetic analysis and the use of potential biomarkers, either alone or in combination with clinical data, to improve prognosis. Epigenetic regulation, such as DNA methylation, histone modifications, and noncoding RNA modulation, is crucial in modulating gene expression in response to stress and renal injury in SA-AKI. At the same time, these modifications are dynamic and reversible processes that can alter gene expression in several pathways implicated in the context of SA-AKI, including inflammation, immune response, and tolerance status. In addition, specific epigenetic modifications may exacerbate renal damage by causing persistent inflammation or cellular metabolic reprogramming, leading to progression toward CKD. This review aims to provide a comprehensive understanding of the epigenetic characteristics that define SA-AKI, also exploring targeted therapies that can improve patient outcomes and limit the chronic progression of this syndrome.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":"45 4","pages":"491-502"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111911","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

Novel Therapeutic Approaches in Connective Tissue Disease-Associated Interstitial Lung Disease. 结缔组织病相关间质性肺病的新型治疗方法

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-06-01 Epub Date: 2024-05-13 DOI: 10.1055/s-0044-1786155

Erica Mulcaire-Jones, Janelle Vu Pugashetti, Justin M Oldham, Dinesh Khanna

引用次数: 0

Pulmonary Hypertension in Connective Tissue Diseases Other than Systemic Sclerosis. 系统性硬化症以外的结缔组织疾病中的肺动脉高压。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-06-01 Epub Date: 2024-03-18 DOI: 10.1055/s-0044-1782217

Brandon Budhram, Jason Weatherald, Marc Humbert

{"title":"Pulmonary Hypertension in Connective Tissue Diseases Other than Systemic Sclerosis.","authors":"Brandon Budhram, Jason Weatherald, Marc Humbert","doi":"10.1055/s-0044-1782217","DOIUrl":"10.1055/s-0044-1782217","url":null,"abstract":"Pulmonary hypertension (PH) is a known complication of certain connective tissue diseases (CTDs), with systemic sclerosis (SSc) being the most common in the Western world. However, PH in association with non-SSc CTD such as systemic lupus erythematous, mixed connective tissue disease, and primary Sjögren's syndrome constitutes a distinct subset of patients with inherently different epidemiologic profiles, pathophysiologic mechanisms, clinical features, therapeutic options, and prognostic implications. The purpose of this review is to inform a practical approach for clinicians evaluating patients with non-SSc CTD-associated PH.The development of PH in these patients involves a complex interplay between genetic factors, immune-mediated mechanisms, and endothelial cell dysfunction. Furthermore, the broad spectrum of CTD manifestations can contribute to the development of PH through various pathophysiologic mechanisms, including intrinsic pulmonary arteriolar vasculopathy (pulmonary arterial hypertension, Group 1 PH), left-heart disease (Group 2), chronic lung disease (Group 3), chronic pulmonary artery obstruction (Group 4), and unclear and/or multifactorial mechanisms (Group 5). The importance of diagnosing PH early in symptomatic patients with non-SSc CTD is highlighted, with a review of the relevant biomarkers, imaging, and diagnostic procedures required to establish a diagnosis.Therapeutic strategies for non-SSc PH associated with CTD are explored with an in-depth review of the medical, interventional, and surgical options available to these patients, emphasizing the CTD-specific considerations that guide treatment and aid in prognosis. By identifying gaps in the current literature, we offer insights into future research priorities that may prove valuable for patients with PH associated with non-SSc CTD.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"419-434"},"PeriodicalIF":3.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140158951","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

Approach to Pulmonary Nodules in Connective Tissue Disease. 结缔组织病肺部结节的治疗方法。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-06-01 Epub Date: 2024-03-28 DOI: 10.1055/s-0044-1782656

Brian Gaffney, David J Murphy

引用次数: 0

Review of Pulmonary Manifestations in Antisynthetase Syndrome. 抗合成代谢酶综合征肺部表现回顾。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-06-01 Epub Date: 2024-05-06 DOI: 10.1055/s-0044-1785536

Mohammad I Ghanbar, Sonye K Danoff

{"title":"Review of Pulmonary Manifestations in Antisynthetase Syndrome.","authors":"Mohammad I Ghanbar, Sonye K Danoff","doi":"10.1055/s-0044-1785536","DOIUrl":"10.1055/s-0044-1785536","url":null,"abstract":"Antisynthetase syndrome (ASyS) is now a widely recognized entity within the spectrum of idiopathic inflammatory myopathies. Initially described in patients with a triad of myositis, arthritis, and interstitial lung disease (ILD), its presentation can be diverse. Additional common symptoms experienced by patients with ASyS include Raynaud's phenomenon, mechanic's hand, and fever. Although there is a significant overlap with polymyositis and dermatomyositis, the key distinction lies in the presence of antisynthetase antibodies (ASAs). Up to 10 ASAs have been identified to correlate with a presentation of ASyS, each having manifestations that may slightly differ from others. Despite the proposal of three classification criteria to aid diagnosis, the heterogeneous nature of patient presentations poses challenges. ILD confers a significant burden in patients with ASyS, sometimes manifesting in isolation. Notably, ILD is also often the initial presentation of ASyS, requiring pulmonologists to remain vigilant for an accurate diagnosis. This article will comprehensively review the various aspects of ASyS, including disease presentation, diagnosis, management, and clinical course, with a primary focus on its pulmonary manifestations.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"365-385"},"PeriodicalIF":3.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866265","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

Overview of Rheumatoid Arthritis-Associated Interstitial Lung Disease and Its Treatment. 类风湿性关节炎相关间质性肺病及其治疗概述。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-06-01 Epub Date: 2024-03-14 DOI: 10.1055/s-0044-1782218

Janelle Vu Pugashetti, Joyce S Lee

{"title":"Overview of Rheumatoid Arthritis-Associated Interstitial Lung Disease and Its Treatment.","authors":"Janelle Vu Pugashetti, Joyce S Lee","doi":"10.1055/s-0044-1782218","DOIUrl":"10.1055/s-0044-1782218","url":null,"abstract":"Interstitial lung disease (ILD) is a common pulmonary complication of rheumatoid arthritis (RA), causing significant morbidity and mortality. Optimal treatment for RA-ILD is not yet well defined. Reliable prognostic indicators are largely byproducts of prior ILD progression, including low or decreasing forced vital capacity and extensive or worsening fibrosis on imaging. In the absence of validated tools to predict treatment response, decisions about whether to initiate or augment treatment are instead based on clinical judgment. In general, treatment should be initiated in patients who are symptomatic, progressing, or at high risk of poor outcomes. Retrospective data suggest that mycophenolate mofetil, azathioprine, and rituximab are likely effective therapies for RA-ILD. Abatacept is also emerging as a potential first-line treatment option for patients with RA-ILD. Further, recent data demonstrate that immunosuppression may be beneficial even in patients with a usual interstitial pneumonia (UIP) pattern on imaging, suggesting that immunosuppression should be considered irrespective of imaging pattern. Recent randomized controlled trials have shown that antifibrotic medications, such as nintedanib and likely pirfenidone, slow forced vital capacity decline in RA-ILD. Consideration can be given to antifibrotic initiation in patients progressing despite immunosuppression, particularly in patients with a UIP pattern. Future research directions include developing tools to predict which patients will remain stable from patients who will progress, discriminating patients who will respond to treatment from nonresponders, and developing algorithms for starting immunosuppression, antifibrotics, or both as first-line therapies.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"329-341"},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pleural Diseases in Connective Tissue Diseases. 结缔组织疾病中的胸膜疾病。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-06-01 Epub Date: 2024-03-28 DOI: 10.1055/s-0044-1782612

Hui Guo, Beenish Iqbal, Najib M Rahman

引用次数: 0

Interstitial Lung Disease Associated with Systemic Sclerosis. 与系统性硬化症有关的间质性肺病

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-06-01 Epub Date: 2024-05-07 DOI: 10.1055/s-0044-1786698

Valentine Mismetti, Salim Si-Mohamed, Vincent Cottin

引用次数: 0

Systemic Lupus Erythematosus-related Lung Disease. 系统性红斑狼疮相关肺病

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-06-01 Epub Date: 2024-03-28 DOI: 10.1055/s-0044-1782653

Elisabeth Bendstrup, Evelyn Lynn, Anne Troldborg

引用次数: 0

Pulmonary Hypertension in Systemic Sclerosis. 结缔组织病的肺部表现。

IF 3.2 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-06-01 Epub Date: 2024-03-26 DOI: 10.1055/s-0044-1782607

Sarah Cullivan, Eleanor Cronin, Sean Gaine

{"title":"Pulmonary Hypertension in Systemic Sclerosis.","authors":"Sarah Cullivan, Eleanor Cronin, Sean Gaine","doi":"10.1055/s-0044-1782607","DOIUrl":"10.1055/s-0044-1782607","url":null,"abstract":"Systemic sclerosis is a multisystem connective tissue disease that is associated with substantial morbidity and mortality. Visceral organ involvement is common in patients with systemic sclerosis and occurs independently of skin manifestations. Pulmonary hypertension (PH) is an important and prevalent complication of systemic sclerosis. The clinical classification of PH cohorts conditions with similar pathophysiological mechanisms into one of five groups. While patients with systemic sclerosis can manifest with a spectrum of pulmonary vascular disease, notable clinical groups include group 1 pulmonary arterial hypertension (PAH) associated with connective tissues disease, PAH with features of capillary/venous involvement, group 2 PH associated with left heart disease, and group 3 PH associated with interstitial lung disease. Considerable efforts have been made to advance screening methods for PH in systemic sclerosis including the DETECT and ASIG (Australian Scleroderma Interest Group) composite algorithms. Current guidelines recommend annual assessment of the risk of PAH as early recognition may result in attenuated hemodynamic impairment and improved survival. The treatment of PAH associated with systemic sclerosis requires a multidisciplinary team including a PH specialist and a rheumatologist to optimize immunomodulatory and PAH-specific therapies. Several potential biomarkers have been identified and there are several promising PAH therapies on the horizon such as the novel fusion protein sotatercept. This chapter provides an overview of PH in systemic sclerosis, with a specific focus on group 1 PAH.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"411-418"},"PeriodicalIF":3.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294466","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