Therapeutic Advances in Respiratory Disease最新文献

{"title":"Role of alveolar nitric oxide in gastroesophageal reflux-associated cough: prospective observational study.","authors":"Li Zhang, Mengru Zhang, Alimire Aierken, Ran Dong, Qiang Chen, Zhongmin Qiu","doi":"10.1177/17534666241231117","DOIUrl":"10.1177/17534666241231117","url":null,"abstract":"<p><strong>Background: </strong>Fractional exhaled nitric oxide (FeNO) measured at multiple exhalation flow rates can be used as a biomarker to differentiate central and peripheral airway inflammation. However, the role of alveolar nitric oxide (CaNO) indicating peripheral airway inflammation remains unclear in gastroesophageal reflux-associated cough (GERC).</p><p><strong>Objectives: </strong>We aimed to characterize the changes in alveolar nitric oxide (CaNO) and determine its clinical implication in GERC.</p><p><strong>Design: </strong>This is a single-center prospective observational study.</p><p><strong>Methods: </strong>FeNOs at exhalation flow rates of 50 and 200 ml/s were measured in 102 patients with GERC and 134 patients with other causes of chronic cough (non-GERC). CaNO was calculated based on a two-compartment model and the factors associated with CaNO were analyzed. The effect of anti-reflux therapy on CaNO was examined in 26 GERC patients with elevated CaNO.</p><p><strong>Results: </strong>CaNO was significantly elevated in GERC compared with that in non-GERC (4.6 ± 4.4 ppb <i>versus</i> 2.8 ± 2.3 ppb, <i>p</i> < 0.001). GERC patients with high CaNO (>5 ppb) had more proximal reflux events (24 ± 15 <i>versus</i> 9 ± 9 episodes, <i>p</i> = 0.001) and a higher level of pepsin (984.8 ± 492.5 <i>versus</i> 634.5 ± 626.4 pg/ml, <i>p</i> = 0.002) in sputum supernatant than those with normal CaNO. More GERC patients with high CaNO required intensified anti-reflux therapy (χ² = 3.963, <i>p</i> = 0.046), as predicted by a sensitivity of 41.7% and specificity of 83.3%. Cough relief paralleled a significant improvement in CaNO (8.3 ± 3.0 <i>versus</i> 4.8 ± 2.6 ppb, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Peripheral airway inflammation can be assessed by CaNO measurement in GERC. High CaNO indicates potential micro-aspiration and may predict a necessity for intensified anti-reflux therapy.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241231117"},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10898302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973590","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":"The role and mechanism of AMPK in pulmonary hypertension.","authors":"Jing Hou, Yu Nie, Yiqiong Wen, Shu Hua, Yunjiao Hou, Huilin He, Shibo Sun","doi":"10.1177/17534666241271990","DOIUrl":"10.1177/17534666241271990","url":null,"abstract":"<p><p>Pulmonary hypertension (PH) is a chronic progressive disease with high mortality. There has been more and more research focusing on the role of AMPK in PH. AMPK consists of three subunits-α, β, and γ. The crosstalk among these subunits ultimately leads to a delicate balance to affect PH, which results in conflicting conclusions about the role of AMPK in PH. It is still unclear how these subunits interfere with each other and achieve balance to improve or deteriorate PH. Several signaling pathways are related to AMPK in the treatment of PH, including AMPK/eNOS/NO pathway, Nox4/mTORC2/AMPK pathway, AMPK/BMP/Smad pathway, and SIRT3-AMPK pathway. Among these pathways, the role and mechanism of AMPK/eNOS/NO and Nox4/mTORC2/AMPK pathways are clearer than others, while the SIRT3-AMPK pathway remains still unclear in the treatment of PH. There are drugs targeting AMPK to improve PH, such as metformin (MET), MET combination, and rhodiola extract. In addition, several novel factors target AMPK for improving PH, such as ADAMTS8, TUFM, and Salt-inducible kinases. However, more researches are needed to explore the specific AMPK signaling pathways involved in these novel factors in the future. In conclusion, AMPK plays an important role in PH.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241271990"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11322949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971906","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":"Extrafine single inhaler triple therapy effectiveness in COPD patients previously treated with multiple-inhaler triple therapy: the TRIWIN study.","authors":"Paschalis Steiropoulos, Niki Georgatou, George Krommidas, Konstantinos Bartziokas, Aliki Korkontzelou, Panos Katerelos, Petros Efstathopoulos, Dimosthenis Papapetrou, Stavros Theodorakis, Konstantinos Porpodis","doi":"10.1177/17534666241263439","DOIUrl":"10.1177/17534666241263439","url":null,"abstract":"<p><strong>Background: </strong>The extrafine single inhaler triple therapy (efSITT) containing beclomethasone dipropionate/formoterol fumarate/glycopyrronium 87/5/9 μg has proved to be efficacious in patients with chronic obstructive pulmonary disease (COPD) in randomized control trials.</p><p><strong>Objective: </strong>TRIWIN study evaluated the effectiveness of efSITT delivering beclomethasone dipropionate/formoterol fumarate/glycopyrronium 87/5/9 μg in COPD patients previously treated with multiple-inhaler triple therapy (MITT) in a real-world study in Greece.</p><p><strong>Design: </strong>Prospective, multicenter, observational, non-interventional study was conducted over 24 weeks.</p><p><strong>Methods: </strong>A total of 475 eligible patients had moderate-to-severe COPD, an indication for treatment with efSITT, and were symptomatic despite receiving MITT. COPD Assessment Test (CAT) score, pulmonary function parameters, use of rescue medication, and adherence to inhaler use were recorded at baseline (Visit 1), 3 (Visit 2), and 6 months (Visit 3) after treatment.</p><p><strong>Results: </strong>Mean CAT score decreased from 21.4 points at Visit 1, to 16.6 at Visit 2 and 15.1 at Visit 3 (<i>p</i> < 0.001 for all pair comparisons). At Visit 3, 79.8% of patients reached a CAT improvement exceeding minimal clinically important difference (⩾2), compared to baseline. Mean forced expiratory volume in 1 s (%pred.) increased from 55.4% at Visit 1 to 63.5% at the end of study period (<i>p</i> < 0.001), while mean forced vital capacity (%pred.) increased from 71.1% at Visit 1, to 76.7% at Visit 3 (<i>p</i> < 0.001). The mean Test of Adherence to Inhalers score increased from 42.5 to 45.3 and 46.3 points, for the three visits, respectively (<i>p</i> < 0.001 comparing Visits 1/2 and Visits 1/3; <i>p</i> = 0.006 comparing Visits 2/3). The percentage of patients showing good adherence rose from 33.7% at baseline to 58.3% at Visit 3. The percentage of patients using rescue medication during the last month dropped from 16.2% to 7.4% at the end of study period (<i>p</i> < 0.001). Pulmonary function parameters also improved.</p><p><strong>Conclusion: </strong>The TRIWIN results suggest that extrafine beclomethasone dipropionate/formoterol fumarate/glycopyrronium is effective in improving health status, pulmonary function, and adherence and in reducing rescue medication use in COPD patients previously treated with MITT, in a real-world setting in Greece.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241263439"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11301738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761049","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":"Non-traditional pulmonary function tests in risk stratification of anatomic lung resection: a retrospective review.","authors":"Christopher W Towe, Avanti Badrinathan, Alina Khil, Christine E Alvarado, Vanessa P Ho, Aria Bassiri, Philip A Linden","doi":"10.1177/17534666241305954","DOIUrl":"10.1177/17534666241305954","url":null,"abstract":"<p><strong>Background: </strong>Guidelines advocate pulmonary function testing (PFT) in preoperative evaluation before lung resection. Although forced expiratory volume in 1 s (FEV1) and diffusing capacity of the lungs for carbon monoxide (DLCO) are recommended, they are often poor predictors of complications.</p><p><strong>Objectives: </strong>Determine if PFT testing results other than FEV1 and DLCO are associated with post-operative complications. We hypothesized that other PFT test results may improve the prediction of post-operative complications.</p><p><strong>Design: </strong>Retrospective cohort study of a single institution.</p><p><strong>Methods: </strong>We analyzed patients who underwent anatomic lung resections from 1/2007 to 1/2017. Percent predicted post-operative (ppo) PFT values were calculated for each test result. Outcome of interest was any post-operative complication. Wilcoxon rank-sum and multivariable regression were used to determine the relationship of PFT results to post-operative complications.</p><p><strong>Results: </strong>We analyzed 922 patients who underwent anatomic lung resections. Complications occurred in 240 (26.0%) patients, and mortality occurred in 12 (1.3%) patients. In univariate analysis, predicted and percent predicted post-operative (ppo) forced vital capacity (FVC), FEV1, FEF2575, DLCO, DLCO/VA, and VC values were predictors of post-operative complications. Multivariable logistic regression found no independent relationship of test results to post-operative complications, likely reflecting the collinearity of PFT results.</p><p><strong>Conclusion: </strong>Our findings suggest that non-traditional PFTs, such as FVC, may enhance risk stratification for post-operative complications following anatomic lung resection. Notably, traditional parameters like FEV1 and DLCO were not independently predictive, highlighting the need to reconsider their role in isolation. These findings highlight the need to reconsider how PFT are used in surgical risk stratification given high levels of collinearity.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241305954"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829945","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":"Clinical implications of six-minute walk test in patients with idiopathic pulmonary fibrosis: a retrospective cohort study.","authors":"Min Jee Kim, Steven D Nathan, Hyeon Hwa Kim, Ho Cheol Kim","doi":"10.1177/17534666241275329","DOIUrl":"10.1177/17534666241275329","url":null,"abstract":"<p><strong>Background: </strong>A six-minute walk test (6MWT) is a reproducible, easily performed test, and is widely used to determine functional exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). However, there is currently a paucity of data on the clinical significance of baseline and serial 6-minute walk tests in patients with IPF, especially in Asian patients.</p><p><strong>Objectives: </strong>We aimed to investigate the clinical significance of serial 6MWT in patients with IPF, especially in Asian patients.</p><p><strong>Design: </strong>This is a single-center retrospective cohort study.</p><p><strong>Methods: </strong>Clinical data of patients diagnosed with IPF at a tertiary center in Korea were retrospectively analyzed. IPF diagnosis was defined according to the clinical guidelines of the American Thoracic Society (ATS)/European Respiratory Society (ERS)/Japanese Respiratory Society/Latin American Thoracic Association.</p><p><strong>Results: </strong>There were 216 patients diagnosed with IPF from December 2012 to January 2022, of whom 198 had a baseline of 6MWT data. The mean age of the cohort was 66.9 ± 8.6, and 89% were male. The non-survivors showed significantly lower six-minute walk distance (6MWD), minimum saturation of peripheral oxygen (SpO₂) during 6MWT, forced vital capacity, and diffusing capacity of the lung for carbon monoxide than survivors at baseline. A multivariate Cox analysis demonstrated that lower minimum SpO₂ was independently associated with increased mortality rates (Hazard ratio (HR): 1.081, 95% confidence interval (CI): 1.024-1.142, <i>p</i> = 0.005). Higher mortality rates were also associated with echocardiographic-determined pulmonary hypertension (HR: 2.466, 95% CI: 1.149-5.296, <i>p</i> = 0.021) at diagnosis. Among 144 patients with 6MWT results at 12 months, patients with a decline of 50 m or more in the 6MWD showed poorer overall survival than others (median survival: 45.0 months vs 58.0 months, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Baseline lower minimum SpO₂ during 6MWT was an independent prognostic factor in patients with IPF, and a decline in 6MWD in serial follow-up was also associated with a poorer prognosis. These findings suggest that both baseline 6MWT and follow-up data are important in the prognostication of patients with IPF.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241275329"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037060","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":"A review of the therapeutic potential of the cysteinyl leukotriene antagonist Montelukast in the treatment of bronchiolitis obliterans syndrome following lung and hematopoietic-stem cell transplantation and its possible mechanisms.","authors":"Nastaran Kordjazy, Shahideh Amini","doi":"10.1177/17534666241232284","DOIUrl":"10.1177/17534666241232284","url":null,"abstract":"<p><p>Lung and hematopoietic stem cell transplantation are therapeutic modalities in chronic pulmonary and hematological diseases, respectively. One of the complications in these patients is the development of bronchiolitis obliterans syndrome (BOS). The efficacy and safety of available treatment strategies in BOS remain a challenge. A few mechanisms have been recognized for BOS in lung transplant and graft-<i>versus</i>-host disease (GVHD) patients involving the TH-1 and TH-2 cells, NF-kappa B, TGF-b, several cytokines and chemokines, and cysteinyl leukotrienes (CysLT). Montelukast is a highly selective CysLT receptor antagonist that has been demonstrated to exert anti-inflammatory and anti-fibrotic effects in abundant experiments. One area of interest for the use of montelukast is lung transplants or GVHD-associated BOS. Herein, we briefly review data regarding the mechanisms involved in BOS development and montelukast administration as a treatment modality for BOS, and finally, the possible relationship between CysLTs antagonism and BOS improvement will be discussed.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241232284"},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10953006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176585","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":"Associations of prior pulmonary tuberculosis with the incident COPD: a prospective cohort study.","authors":"Zhilin Zeng, Huilong Chen, Zhonghe Shao, Yunlong Guan, Yuan Zhan, Xi Cao, Si Li, Xingjie Hao","doi":"10.1177/17534666241239455","DOIUrl":"10.1177/17534666241239455","url":null,"abstract":"<p><strong>Background: </strong>Prior pulmonary tuberculosis (PTB) might be associated with the development of chronic obstructive pulmonary disease (COPD). However, the impact of prior PTB on the risk of incident COPD has not been studied in a large prospective cohort study of the European population.</p><p><strong>Objectives: </strong>This study aimed to investigate the association of prior PTB with the risk of COPD.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>A multivariable Cox proportional model was used to estimate the hazard ratio (HR) and 95% confidence interval (95% CI) for the association of prior PTB with COPD. Subgroup analyses were further conducted among individuals stratified by age, sex, body mass index, smoking status, drinking status, physical activity, and polygenic risk score (PRS).</p><p><strong>Results: </strong>The study involved a total of 216,130 participants, with a median follow-up period of 12.6 years and 2788 incident cases of COPD. Individuals with a prior history of PTB at baseline had an 87% higher risk of developing incident COPD compared to those without such history [adjusted hazard ratio (aHR) = 1.87; 95% confidence interval (CI): 1.26-2.77; <i>p</i> = 0.002]. Subgroup analysis revealed that individuals having prior PTB history presented a higher risk of incident COPD among individuals who were aged from 50 to 59 years with aHR of 2.47 (1.02-5.95, <i>p</i> = 0.044), older than 59 years with aHR of 1.81 (1.16-2.81, <i>p</i> = 0.008), male with aHR of 2.37 (1.47-3.83, <i>p</i> < 0.001), obesity with aHR of 3.35 (2.16-5.82, <i>p</i> < 0.001), previous smoking with aHR of 2.27 (1.39-3.72, <i>p</i> < 0.001), current drinking with aHR of 1.98 (1.47-3.83, <i>p</i> < 0.001), low physical activity with aHR of 2.62 (1.30-5.26, <i>p</i> = 0.007), and low PRS with aHR of 3.24 (1.61-6.53, <i>p</i> < 0.001), as well as high PRS with aHR of 2.43 (1.15-5.14, <i>p</i> = 0.019).</p><p><strong>Conclusion: </strong>A history of PTB is an important independent risk factor for COPD. Clinical staff should be aware of this risk factor in patients with prior PTB, particularly in countries or regions with high burdens of PTB.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241239455"},"PeriodicalIF":4.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10966999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289042","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":"A multicenter observational study assessing the safety, feasibility, and complications of Bonastent in central airway obstruction.","authors":"Nagendra Y Madisi, Sana Ali, Daniel Greenberg, Gowthami Kobbari, Muhammad Salick, Anoosh Parimi, Ziad Boujaoude, Wissam Abouzgheib","doi":"10.1177/17534666241260235","DOIUrl":"10.1177/17534666241260235","url":null,"abstract":"<p><strong>Background: </strong>Self-expandable metallic stents (SEMS) are increasingly used in the management of both malignant and nonmalignant airway stenosis. There are multiple stents available in the market; however, the current literature on the efficacy and safety of newly available 3rd generation SEMS (Bonastent) is extremely limited and only has data from single center studies.</p><p><strong>Objectives: </strong>To report the efficacy and early (<7 days) and late (⩾7 days) complications in patients with central airway obstruction (CAO) treated with Bonastent placement at two institutions.</p><p><strong>Design: </strong>We performed a retrospective analysis of data of consecutive patients who underwent therapeutic bronchoscopy and Bonastent placement at two tertiary care university hospitals between January 2019 and November 2023.</p><p><strong>Methods: </strong>Bonastent deployment was performed in the operating room. Stents were deployed using rigid or flexible bronchoscopy under direct visualization with a flexible bronchoscope and in conjunction with fluoroscopic guidance. We then analyzed the effectiveness, short-term, and long-term complications of Bonastent placement.</p><p><strong>Results: </strong>A total of 107 Bonastents® were placed in 96 patients. The most common etiology of CAO was malignancy, 92.7% (<i>n</i> = 89), followed by excessive dynamic airway collapse (EDAC) and post-intubation tracheal stenosis. Seventy-three patients (76%) had improvement in symptoms or imaging within 7 days of stent placement, including successful liberation from mechanical ventilation in a patient with CAO. Early complications occurred in seven patients (two-airway bleeding, two-mucus plugging that improved with airway clearance, two-stent migrations, and one-cough).Late complications occurred in 23 patients (1-stent migration requiring revision bronchoscopy and replacement of airway stent, 11-mucus plugging, 6-granulation tissue, 2-pneumonia, 1-cough, 1-tumor ingrowth/stent fracture, 1-airway emergency due to excessive granulation tissue obstructing the distal end of the stent and had a failed cricothyroidotomy leading to death). Overall, the early complication rate was 7.3% (7/96) and late complication rate was 23.9% (23/96).</p><p><strong>Conclusion: </strong>Our study is the first multicenter study that found a good safety profile with a low complication rate after tracheobronchial Bonastent placement with improvement in symptoms soon after stent placement.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241260235"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296089","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":"Bronchial thermoplasty for severe asthma: potential mechanisms and response markers.","authors":"Li ChunXiao, Hou Xin, Li Yun, Liu BoWen, Shen KunLu, Lin JiangTao","doi":"10.1177/17534666241266348","DOIUrl":"10.1177/17534666241266348","url":null,"abstract":"<p><p>Severe asthma (SA) poses a significant challenge to management and treatment, leading to a reduced quality of life and a heavy burden on society and healthcare resources. Bronchial thermoplasty (BT) has emerged as a non-pharmacological intervention for SA, demonstrating its efficacy and safety in improving patients' quality of life and reducing exacerbation rates for over a decade. In particular, BT encounters various obstacles in its clinical application. Since asthma is characterized by high heterogeneity, not all patients derive effective outcomes from BT. Furthermore, current knowledge of markers that indicate response to BT remains limited. Recent research has shed light on the intricate mechanism of action of BT, which extends beyond simple smooth muscle ablation. Therefore, to enhance the clinical practice and implementation of BT, this paper aims to elucidate the mechanism of action and identify potential markers associated with BT response.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241266348"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11440556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354341","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":"The efficacy and safety of tofacitinib in anti-melanoma differentiation-associated gene 5 antibody positive dermatomyositis associated interstitial lung disease: a systematic review and meta-analysis.","authors":"Yanhong Wang, Ruyi Zou, Jie Wei, Cheng Tang, Junjie Wang, Minjie Lin","doi":"10.1177/17534666241294000","DOIUrl":"10.1177/17534666241294000","url":null,"abstract":"<p><strong>Background: </strong>The presence of anti-melanoma differentiation-associated gene 5 (MDA5) antibodies in dermatomyositis (DM) is associated with an increased risk of developing rapidly progressive interstitial lung disease (RP-ILD) and a poor prognosis.</p><p><strong>Objectives: </strong>We aimed to explore whether tofacitinib could improve the prognosis of Anti-MDA5 antibody positive DM-interstitial lung disease (ILD).</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources and methods: </strong>Studies were included if they compared mortality rate and infection events in patients with anti-MDA5 antibody positive DM-associated ILD who were treated with or without tofacitinib.</p><p><strong>Results: </strong>The systematic review and meta-analysis included a total of 148 patients from four cohort studies. Fifty-eight patients with anti-MDA5 antibody positive DM-ILD who received combined treatment-containing tofacitinib were enrolled in the experimental group. Additionally, 90 DM-ILD patients who did not receive tofacitinib-based therapy were included in the control group. The pooled risk ratio (RR) for all-cause mortality was 0.61 (95% CI, 0.41-0.91, <i>p</i> = 0.02) with <i>I</i>² = 0 indicating no heterogeneity among the included studies. For virus infection risk, the pooled RR was 1.92 (95% CI, 0.90-4.10, <i>p</i> = 0.09), while bacterial and fungal infection-associated RRs were found to be 1.29 (95% CI, 0.65-2.55, <i>p</i> = 0.47) and 1.15 (95% CI, 0.46-2.89, <i>p</i> = 0.77), respectively. There was no statistically significant difference in infection risk between the two groups, and no heterogeneity was observed.</p><p><strong>Conclusion: </strong>Our findings suggest that tofacitinib may reduce the risk of all-cause mortality in patients with anti-MDA5 antibody-positive DM-ILD without an increased risk of additional infections.</p><p><strong>Trial registration: </strong>PROSPERO: CRD42023445427; https://www.crd.york.ac.uk/prospero/.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"18 ","pages":"17534666241294000"},"PeriodicalIF":3.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558848","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}