Therapeutic Advances in Respiratory Disease最新文献

{"title":"Video-assisted thoracoscopic surgery for non-cystic fibrosis bronchiectasis in children.","authors":"Fengxia Ding, Zhengxia Pan, Chun Wu, Hongbo Li, Yonggang Li, Yong An, Jiangtao Dai, Gang Wang, Bo Liu","doi":"10.1177/17534666241228159","DOIUrl":"10.1177/17534666241228159","url":null,"abstract":"<p><strong>Background: </strong>Pediatric bronchiectasis is a common respiratory disease in children. The use of video-assisted thoracoscopic surgery (VATS) for its treatment remains controversial.</p><p><strong>Objectives: </strong>The objective of our study was to compare and analyze the clinical efficacy of thoracoscopic surgery and thoracotomy in the treatment of pediatric bronchiectasis and summarize the surgical treatment experience of VATS in children with bronchiectasis.</p><p><strong>Design: </strong>Retrospective single-center cohort study.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 46 pediatric patients who underwent surgery with bronchiectasis at the Children's Hospital of Chongqing Medical University from May 2015 to May 2023. The patients were divided into two groups: the VATS group (25 cases) and the thoracotomy group (21 cases). Comparative analysis was performed on various parameters including basic clinical data, surgical methods, operation time, intraoperative blood loss, transfusion status, postoperative pain, postoperative mechanical ventilation time, chest tube drainage time, length of hospital stay, incidence of complications, and follow-up information.</p><p><strong>Results: </strong>There were no statistically significant differences between the two groups of patients in terms of age, weight, gender, etiology, duration of symptoms, site of onset, and comorbidities (<i>p</i> > 0.05). The operation time in the VATS group was longer than that in the thoracotomy group (<i>p</i> < 0.001). However, the VATS group had better outcomes in terms of intraoperative blood loss, transfusion status, postoperative pain, postoperative mechanical ventilation time, chest tube drainage time, and length of hospital stay (<i>p</i> < 0.05). The incidence of postoperative complications in the VATS group was lower than that in the thoracotomy group, although the difference was not statistically significant (<i>p</i> = 0.152). Follow-up data showed no statistically significant difference in the surgical treatment outcomes between the two groups (<i>p</i> = 0.493).</p><p><strong>Conclusion: </strong>The incidence of complications and mortality in surgical treatment of bronchiectasis is acceptable. Compared with thoracotomy surgery, VATS has advantages such as smaller trauma, less pain, faster recovery, and fewer complications. For suitable pediatric patients with bronchiectasis, VATS is a safe and effective surgical method.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703509","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}

{"title":"Optimal flow of high-flow nasal cannula oxygenation to prevent desaturation during sedation for bronchoscopy: a randomized controlled study.","authors":"Wen Zhang, Xiaohong Yuan, Yajian Shen, Jiangling Wang, Kangjie Xie, Xinzhong Chen","doi":"10.1177/17534666241246637","DOIUrl":"https://doi.org/10.1177/17534666241246637","url":null,"abstract":"<p><strong>Background: </strong>Although high-flow nasal cannula (HFNC) oxygenation is currently recommended to prevent desaturation during sedation for bronchoscopy, there is no consensus on an optimal flow rate.</p><p><strong>Objective: </strong>To determine the optimal oxygen flow rate for HFNC to effectively prevent desaturation during sedation for bronchoscopy.</p><p><strong>Design: </strong>Prospective, randomized, and controlled study.</p><p><strong>Methods: </strong>Patients (<i>n</i> = 240) scheduled for bronchoscopy were randomized to receive HFNC with propofol sedation (fraction of inspired oxygen, 100%) at one of six flow rates of 10, 20, 30, 40, 50, and 60 L/min, designated as groups 1-6, respectively.</p><p><strong>Results: </strong>The incidence of desaturation significantly decreased by increasing the oxygen flow rate (42.5%, 17.5%, 15%, 10%, 2.5%, and 0% for groups 1-6, respectively, <i>p</i> < 0.0001). The optimal oxygen flow rate for HFNC determined by probit regression to effectively prevent desaturation in 95% of patients was 43.20 (95% confidence interval, 36.43-55.96) L/min. The requirement for airway intervention was significantly decreased by increasing the oxygen flow rate.</p><p><strong>Conclusion: </strong>An HFNC flow rate of 50-60 L/min is recommended to prevent desaturation during sedation for bronchoscopy.</p><p><strong>Registration: </strong>NCT05298319 at ClinicalTrials.gov.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11044788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868667","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}

{"title":"Building and validating an artificial intelligence model to identify tracheobronchopathia osteochondroplastica by using bronchoscopic images.","authors":"Chongxiang Chen, Fei Tang, Felix J F Herth, Yingnan Zuo, Jiangtao Ren, Shuaiqi Zhang, Wenhua Jian, Chunli Tang, Shiyue Li","doi":"10.1177/17534666241253694","DOIUrl":"10.1177/17534666241253694","url":null,"abstract":"<p><strong>Background: </strong>Given the rarity of tracheobronchopathia osteochondroplastica (TO), many young doctors in primary hospitals are unable to identify TO based on bronchoscopy findings.</p><p><strong>Objectives: </strong>To build an artificial intelligence (AI) model for differentiating TO from other multinodular airway diseases by using bronchoscopic images.</p><p><strong>Design: </strong>We designed the study by comparing the imaging data of patients undergoing bronchoscopy from January 2010 to October 2022 by using EfficientNet. Bronchoscopic images of 21 patients with TO at Anhui Chest Hospital from October 2019 to October 2022 were collected for external validation.</p><p><strong>Methods: </strong>Bronchoscopic images of patients with multinodular airway lesions (including TO, amyloidosis, tumors, and inflammation) and without airway lesions in the First Affiliated Hospital of Guangzhou Medical University were collected. The images were randomized (4:1) into training and validation groups based on different diseases and utilized for deep learning by convolutional neural networks (CNNs).</p><p><strong>Results: </strong>We enrolled 201 patients with multinodular airway disease (38, 15, 75, and 73 patients with TO, amyloidosis, tumors, and inflammation, respectively) and 213 without any airway lesions. To find multinodular lesion images for deep learning, we utilized 2183 bronchoscopic images of multinodular lesions (including TO, amyloidosis, tumor, and inflammation) and compared them with images without any airway lesions (1733). The accuracy of multinodular lesion identification was 98.9%. Further, the accuracy of TO detection based on the bronchoscopic images of multinodular lesions was 89.2%. Regarding external validation (using images from 21 patients with TO), all patients could be diagnosed with TO; the accuracy was 89.8%.</p><p><strong>Conclusion: </strong>We built an AI model that could differentiate TO from other multinodular airway diseases (mainly amyloidosis, tumors, and inflammation) by using bronchoscopic images. The model could help young physicians identify this rare airway disease.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157249","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}

{"title":"Prescriptions of opioid-containing drugs in patients with chronic cough.","authors":"Michael Weiner, Ziyue Liu, Jonathan Schelfhout, Paul Dexter, Anna R Roberts, Ashley Griffith, Vishal Bali, Jessica Weaver","doi":"10.1177/17534666241259373","DOIUrl":"10.1177/17534666241259373","url":null,"abstract":"<p><strong>Background: </strong>Chronic cough (CC) affects about 10% of adults, but opioid use in CC is not well understood.</p><p><strong>Objectives: </strong>To determine the use of opioid-containing cough suppressant (OCCS) prescriptions in patients with CC using electronic health records.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>Through retrospective analysis of Midwestern U.S. electronic health records, diagnoses, prescriptions, and natural language processing identified CC - at least three medical encounters with cough, with 56-120 days between first and last encounter - and a 'non-chronic cohort'. Student's <i>t</i>-test, Pearson's chi-square, and zero-inflated Poisson models were used.</p><p><strong>Results: </strong>About 20% of 23,210 patients with CC were prescribed OCCS; odds of an OCCS prescription were twice as great in CC. In CC, OCCS drugs were ordered in 38% with Medicaid insurance and 15% with commercial insurance.</p><p><strong>Conclusion: </strong>Findings identify an important role for opioids in CC, and opportunity to learn more about the drugs' effectiveness.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141321696","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}

{"title":"Real-world therapeutic performance of pirfenidone for connective tissue disease-associated interstitial lung diseases.","authors":"Xueting Yuan, Chen Yu, Shengyun Liu, Qiang Shu, Xinwang Duan, Lin Tang, Liying Peng, Shuang Zhou, Chanyuan Wu, Jiuliang Zhao, Dong Xu, Lan Song, Hui Huang, Mengtao Li, Yanhong Wang, Qian Wang, Xiaofeng Zeng","doi":"10.1177/17534666241292507","DOIUrl":"https://doi.org/10.1177/17534666241292507","url":null,"abstract":"<p><strong>Background: </strong>Pirfenidone (PFD) is commonly applied for antifibrotic treatment in patients with idiopathic pulmonary fibrosis but has rarely been studied in cases with connective tissue disease-associated interstitial lung diseases (CTD-ILDs).</p><p><strong>Objectives: </strong>We aimed to examine the efficacy of PFD in patients with CTD-ILD based on real-world data.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Methods: </strong>This study assessed the clinical features of CTD-ILD patients with or without a 6-month PFD treatment. A linear mixed effects model was employed to evaluate the effectiveness of PFD in alleviating lung function changes. Differences in response to PFD were analyzed based on CTD subtype, imaging classification, and pattern of pulmonary function at baseline.</p><p><strong>Results: </strong>A total of 289 patients with CTD-ILD were included, with 155 (53.6%) receiving PFD treatment and the remaining constituting the control group. Patients with the usual interstitial pneumonia (UIP) pattern were more likely to receive PFD treatment, and a relatively lower proportion of cases in the PFD group received immunosuppressive therapies compared to the control group (<i>p</i> < 0.05). At the 6-month follow-up, patients in the PFD group demonstrated a more significant improvement in forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLCO) (ΔFVC%: 2.9% vs 0.45%, <i>p</i> = 0.009; ΔDLCO%: 1.9% vs -1.1%, <i>p</i> = 0.004). In the linear mixed model analysis, there was a statistically significant group-time interaction between FVC% and DLCO% changes over time (FVC%: β = 4.52, <i>p</i> < 0.001; DLCO%: β = 4.13, <i>p</i> = 0.003). Furthermore, subgroup analysis indicated that pirfenidone may have superior therapeutic effects in patients with systemic sclerosis (SSc)-associated ILD, non-UIP pattern, and restrictive pattern of lung function at baseline.</p><p><strong>Conclusion: </strong>This study provided real-world data demonstrating the effectiveness of PFD in terms of lung function improvement in patients with CTD-ILD.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605139","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}

{"title":"A real-world study of quality of life following treatment with xylometazoline hydrochloride in individuals with common cold.","authors":"Martina Hagen, Kim Clark, Pranab Kalita, Gessica Serra, Edwin Sanchez, Gabor Varbiro, Mathieu M Albasser","doi":"10.1177/17534666241228927","DOIUrl":"10.1177/17534666241228927","url":null,"abstract":"<p><strong>Background: </strong>The common cold is a frequent, acute, and mild upper respiratory human disease. Nasal congestion has been considered the most bothersome symptom in the common cold, impacting quality of life (QoL). Topical decongestants containing steroids benefit QoL in allergic rhinitis, but no published research has assessed the impact of topical decongestants on QoL in the common cold.</p><p><strong>Objective: </strong>To evaluate the effects of xylometazoline hydrochloride 0.1% (Otrivin, GSK Consumer Healthcare SARL, Switzerland) for up to 7 days on QoL in participants with nasal congestion associated with the common cold.</p><p><strong>Design: </strong>This was a decentralized, longitudinal, open-label study.</p><p><strong>Methods: </strong>The study enrolled 136 participants (⩾18 years) with early symptoms of the common cold, of which 102 were included in the modified intention-to-treat (mITT) population. Within 24 h of study product receipt, participants confirmed a 'plugged nose' and ⩾1 other common cold symptom. Primary endpoints were Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21) total score, total and individual symptom scores, and total QoL score. Secondary endpoints were additional QoL scores. Exploratory and <i>post hoc</i> analyses included median days to resolution for each QoL factor and analyses of five QoL categories.</p><p><strong>Results: </strong>Consistent improvements in symptoms and QoL were seen in the mITT population. From day 1, improvements were seen in the 'plugged nose' symptom (<i>p</i> = 0.0023), WURSS-21 total QoL score, and all individual QoL scores (<i>p</i> < 0.0001 for all). After the last dose needed, significant improvements were seen in sleep quality (73%), vitality (76%), physical activity (71%), social activity (80%), and sensation (81%). No serious or unexpected adverse events were reported.</p><p><strong>Conclusion: </strong>This study is the first to demonstrate in a real-life setting that treating nasal congestion in adults with xylometazoline hydrochloride 0.1% during the common cold positively impacts QoL factors relevant to daily living [Otrivin: Quality of Life (QoL) Impact in a Real-World Setting; https://clinicaltrials.gov/study/NCT05556148].</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10878222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900479","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}

{"title":"Albuterol-budesonide fixed-dose combination rescue inhaler for asthma: a plain language summary of the MANDALA study.","authors":"Alberto Papi, Bradley E Chipps, Richard Beasley, Reynold A Panettieri, Elliot Israel, Mark Cooper, Lynn Dunsire, Allison Jeynes-Ellis, Robert Rees, Frank C Albers, Christy Cappelletti","doi":"10.1177/17534666241232264","DOIUrl":"10.1177/17534666241232264","url":null,"abstract":"<p><p><b>What is this summary about?</b>This summary describes the results of a clinical study called MANDALA that was published in the <i>New England Journal of Medicine</i> in 2022. In the MANDALA study, researchers looked at a new asthma rescue inhaler that contains both <b>albuterol</b> and <b>budesonide</b> in a single inhaler (known as <b>albuterol-budesonide</b>, AIRSUPRA™). This summary describes the results for people aged 18 yearsand older who took part in the study.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865865","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}

{"title":"Impact of lumacaftor/ivacaftor on the bacterial and fungal respiratory pathogens in cystic fibrosis: a prospective multicenter cohort study in Sweden.","authors":"Mahasin Al Shakirchi, Kimmo Sorjonen, Lena Hjelte, Lena Klingspor, Peter Bergman, Petrea Ericson, Marcus Svedberg, Ulrika Lindberg, Christine Hansen, Isabelle de Monestrol","doi":"10.1177/17534666241254090","DOIUrl":"10.1177/17534666241254090","url":null,"abstract":"<p><strong>Background: </strong>A significant decline in pulmonary exacerbation rates has been reported in CF patients homozygous for F508del treated with lumacaftor/ivacaftor. However, it is still unclear whether this reduction reflects a diminished microbiological burden.</p><p><strong>Objectives: </strong>The aim of this study was to determine the impact of lumacaftor/ivacaftor on the bacterial and fungal burden.</p><p><strong>Design: </strong>The study is a prospective multicenter cohort study including 132 CF patients homozygous for F508del treated with lumacaftor/ivacaftor.</p><p><strong>Methods: </strong>Clinical parameters as well as bacterial and fungal outcomes 1 year after initiation of lumacaftor/ivacaftor were compared to data from 2 years prior to initiation of the treatment. Changes in the slope of the outcomes before and after the onset of treatment were assessed.</p><p><strong>Results: </strong>Lung function measured as ppFEV1 (<i>p</i> < 0.001), body mass index (BMI) in adults (<i>p</i> < 0.001), and BMI <i>z</i>-score in children (<i>p</i> = 0.007) were improved after initiation of lumacaftor/ivacaftor. In addition, the slope of the prevalence of <i>Streptococcus pneumoniae</i> (<i>p</i> = 0.007) and <i>Stenotrophomonas maltophilia</i> (<i>p</i> < 0.001) shifted from positive to negative, that is, became less prevalent, 1 year after treatment, while the slope for <i>Candida albicans</i> (<i>p</i> = 0.009), <i>Penicillium</i> spp (<i>p</i> = 0.026), and <i>Scedosporium apiospermum</i> (<i>p</i> < 0.001) shifted from negative to positive.</p><p><strong>Conclusion: </strong>The current study showed a significant improvement in clinical parameters and a reduction of some of CF respiratory microorganisms 1 year after starting with lumacaftor/ivacaftor. However, no significant changes were observed for <i>Pseudomonas aeruginosa, Staphylococcus aureus</i>, or <i>Aspergillus fumigatus</i>, key pathogens in the CF context.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11119492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082476","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}

{"title":"Combined medical-interventional approaches for the management of complex fungal balls: a case series as a viable alternative in non-surgical patients.","authors":"Elaine Dumoulin, Christina S Thornton, John H MacGregor, Alain Tremblay, Chrystal Chan, Paul R MacEachern, Margaret M Kelly, Ranjani Somayaji, Michael D Parkins, Christopher H Mody","doi":"10.1177/17534666241255203","DOIUrl":"10.1177/17534666241255203","url":null,"abstract":"<p><p>Intracavitary pulmonary aspergilloma is a persistent and life-threatening infection that carries a mortality rate of up to 15%. It occurs when Aspergillus species gain entry to an existing lung cavity. In the absence of definitive treatment, patients may succumb to severe complications such as massive hemoptysis, cachexia, or secondary infections. Aspergillomas often show limited response to antifungal medications, mainly due to insufficient drug concentrations within the cavities. Surgery is frequently the preferred treatment option, but it poses significant risks, and many individuals are ineligible due to underlying health issues. We present the most extensive non-surgical fungal ball cohort to date, managed using an innovative multimodal strategy that combines antifungal therapy before and after bronchoscopic debulking. This was a cross-sectional observational study. For those who cannot undergo surgery, our medical center has pioneered a multimodal approach to aspergilloma resection. This approach combines bronchoscopic endoscopy with antifungal therapy and has been applied successfully to more than 18 patients that are presented in this series. The median age of the cohort was 58 years (range: 32-73), with an equal sex distribution. The mean percent predicted FEV₁ was 65.3%. The mean follow-up duration was 3.6 years (range: 0.5-10 years). The cohort receiving antifungals systematically prior to debridement showed a reduction of the pre-existing cavity (40.38 mm <i>versus</i> 34.02 mm, <i>p</i> = 0.021). Across the 18 patients during the follow-up period, 94% remained recurrence-free (defined by symptoms and radiology). Our study fills a critical knowledge gap regarding the significance of initiating antifungal treatment before bronchoscopic debulking and presents a viable approach in these cases for which there is a current unmet therapeutic need.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11119499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087788","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}

{"title":"Diagnostic value of serum vascular endothelial growth factor-D in Korean patients with lymphangioleiomyomatosis.","authors":"Hee-Young Yoon, Su-Jin Moon, Song Yee Kim, Jong Sun Park, Sun Mi Choi, Hyung Koo Kang, Jin Woo Song","doi":"10.1177/17534666241272928","DOIUrl":"10.1177/17534666241272928","url":null,"abstract":"<p><strong>Background: </strong>Lymphangioleiomyomatosis (LAM) is a rare multisystemic disorder characterized by the proliferation of abnormal smooth muscle-like cells. Although serum vascular endothelial growth factor-D (VEGF-D) is currently used as a diagnostic biomarker for LAM, its diagnostic value in Korean patients is unclear.</p><p><strong>Objectives: </strong>To evaluate the diagnostic value of serum VEGF-D for LAM in Korean patients.</p><p><strong>Design: </strong>A multicenter prospective cohort study.</p><p><strong>Methods: </strong>Serum samples were prospectively collected from five medical institutions, from patients with LAM (<i>n</i> = 40) and controls (<i>n</i> = 24; healthy participants = 3, other cystic lung diseases = 13, idiopathic pulmonary fibrosis = 4, idiopathic nonspecific interstitial pneumonia = 4). Serum VEGF-D levels were measured using the enzyme-linked immunosorbent assay, and the diagnostic value was evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>The mean age of patients with LAM was 44.5 years, and all were female (controls: 47.8 years; female: 70.8%, <i>p</i> < 0.001). The serum VEGF-D levels were significantly higher in patients with LAM than those in the control group (median: 708.9 pg/mL vs 325.3 pg/mL, <i>p</i> < 0.001). In the ROC curve analysis, serum VEGF-D levels showed good predicting performance for LAM diagnosis (area under the curve = 0.918) with an optimal cut-off value of 432.7 pg/mL (sensitivity = 85.0%, specificity = 87.5%). When 800 pg/mL was used as the cut-off value, the specificity of serum VEGF-D for LAM diagnosis increased to 100.0%.</p><p><strong>Conclusion: </strong>Our results suggest that serum VEGF-D may be a useful biomarker for diagnosing LAM in Korean patients, similar to previous reports.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989000","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}