BreathePub Date : 2025-06-17eCollection Date: 2025-04-01DOI: 10.1183/20734735.0100-2024
Eugene Yuriditsky, Robert S Zhang, Tania Ahuja, Sripal Bangalore, James M Horowitz
{"title":"The latest in the management of pulmonary embolism.","authors":"Eugene Yuriditsky, Robert S Zhang, Tania Ahuja, Sripal Bangalore, James M Horowitz","doi":"10.1183/20734735.0100-2024","DOIUrl":"10.1183/20734735.0100-2024","url":null,"abstract":"<p><p>Therapeutic anticoagulation is the mainstay therapy in acute pulmonary embolism (PE), however, select patients benefit from emergent reperfusion to prevent or rescue acute right ventricular failure and haemodynamic collapse. Compared to other leading causes of cardiovascular mortality such as myocardial infarction and stroke, there is a substantial paucity of literature informing on advanced therapies in PE. Recent years have seen significant evolution in the armamentarium available for PE care with the uptake of several endovascular treatment modalities and increased use of mechanical circulatory support. While several ongoing randomised controlled trials may alter the therapeutic landscape and approach to PE management, at present, we are left with multiple selections with limited guidance. In this review, we discuss the latest therapeutic options available for acute PE and offer an approach to their implementation.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"21 2","pages":"240100"},"PeriodicalIF":2.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315956","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}
BreathePub Date : 2025-06-17eCollection Date: 2025-04-01DOI: 10.1183/20734735.0166-2024
Áine Connerton, Eoghan McCarthy, Laura Durcan
{"title":"Connective tissue disease-associated interstitial lung disease: a rheumatologist's perspective.","authors":"Áine Connerton, Eoghan McCarthy, Laura Durcan","doi":"10.1183/20734735.0166-2024","DOIUrl":"10.1183/20734735.0166-2024","url":null,"abstract":"<p><p>Pulmonary involvement is common in patients with underlying autoimmune and connective tissue diseases (CTDs) and can encompass a broad spectrum of disorders involving the airways, pleura, parenchyma, vascular system, bronchiectasis and nodules with significant overlap in these pathologies. Interstitial lung disease (ILD) is the most common pulmonary manifestation of systemic autoimmune rheumatic diseases and CTDs. Particular diseases, such as systemic sclerosis, rheumatoid arthritis and inflammatory myopathies, frequently associate with ILD and high-risk patients should be screened. Antibody profiling and imaging characteristics should be used to prognosticate where possible, along with regular surveillance to ensure therapies are optimised. Immunosuppressive therapies can be effective for patients with CTD-associated ILD, but difficulties arise in distinguishing between treatment failures and complications of immunosuppression.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"21 2","pages":"240166"},"PeriodicalIF":2.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315952","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}
BreathePub Date : 2025-06-17eCollection Date: 2025-04-01DOI: 10.1183/20734735.0147-2025
Catharina C Moor, Laura Fabbri, Namrata Kewalramani, Karol Bączek, Nazia Chaudhuri, Heleen Demeyer, Michael Kreuter
{"title":"Accelerate your career: the power of the ERS interstitial lung disease mentorship programme.","authors":"Catharina C Moor, Laura Fabbri, Namrata Kewalramani, Karol Bączek, Nazia Chaudhuri, Heleen Demeyer, Michael Kreuter","doi":"10.1183/20734735.0147-2025","DOIUrl":"10.1183/20734735.0147-2025","url":null,"abstract":"<p><p><b>Assembly 12 has developed an online and onsite mentoring programme for early career members. This article discusses the content of the programme, experiences from mentees and mentors and future plans.</b> https://bit.ly/4iGBr6G.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"21 2","pages":"250147"},"PeriodicalIF":2.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315949","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}
BreathePub Date : 2025-06-17eCollection Date: 2025-04-01DOI: 10.1183/20734735.0173-2024
Caroline Motschwiller, David Morales, Roxana Sulica
{"title":"Connective tissue disease-related interstitial lung disease and pulmonary hypertension.","authors":"Caroline Motschwiller, David Morales, Roxana Sulica","doi":"10.1183/20734735.0173-2024","DOIUrl":"10.1183/20734735.0173-2024","url":null,"abstract":"<p><p>Pulmonary hypertension (PH) is an important cause of morbidity and mortality in connective tissue diseases (CTDs) and may develop either in isolation or in combination with interstitial lung disease (ILD). Based on the World Health Organization PH classification into five groups, patients with CTDs typically belong either to group 1 pulmonary arterial hypertension or to group 3 PH due to chronic lung disease and hypoxaemia (PH-ILD). Recent epidemiological studies have delineated the phenotypical complexity of CTD patients who present with both PH and ILD. This review explores the prevalence, diagnosis, pathophysiology, survival and management strategies for CTD-ILD-PH.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"21 2","pages":"240173"},"PeriodicalIF":2.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315953","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}
BreathePub Date : 2025-06-17eCollection Date: 2025-04-01DOI: 10.1183/20734735.0097-2024
Brídóg Nic Aodha Bhuí, Eoin Fahy
{"title":"Assessment of breathlessness: a cardiologist's perspective.","authors":"Brídóg Nic Aodha Bhuí, Eoin Fahy","doi":"10.1183/20734735.0097-2024","DOIUrl":"10.1183/20734735.0097-2024","url":null,"abstract":"<p><p>\"Breathlessness\" or dyspnoea is a common, subjective symptom that can be multifactorial. It is a frequent complaint encountered by cardiologists, both in the outpatient and inpatient clinical setting. It requires a comprehensive clinical evaluation including accurate history taking and pursuing appropriate clinical investigations. It is imperative to distinguish cardiac causes of dyspnoea from other causes, including pulmonary, neurological and other systemic conditions. In this review we attempt to summarise the approach to the evaluation of dyspnoea.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"21 2","pages":"240097"},"PeriodicalIF":2.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315951","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}
BreathePub Date : 2025-06-17eCollection Date: 2025-04-01DOI: 10.1183/20734735.0230-2024
Diana Marangu-Boore, Jane S Lucas, Nicole Beydon
{"title":"Nasal nitric oxide measurement for the diagnosis of primary ciliary dyskinesia: summary of the European Respiratory Society technical standard.","authors":"Diana Marangu-Boore, Jane S Lucas, Nicole Beydon","doi":"10.1183/20734735.0230-2024","DOIUrl":"10.1183/20734735.0230-2024","url":null,"abstract":"<p><p>Nasal nitric oxide (nNO) measurement is important in the primary ciliary dyskinesia (PCD) diagnostic pathway because levels are consistently very low in most patients. Machine type, environmental factors, respiratory manoeuvres and report interpretation are fundamental considerations when performing nNO testing. A European Respiratory Society Task Force recently published standards for testing which we summarise and discuss in this article. There are two main types of nNO machines: chemiluminescence and electrochemical analysers. Chemiluminescence analysers are highly accurate, reliable, real-time and have been validated in multicentre studies but are less portable and more expensive to purchase and maintain in comparison to electrochemical devices. Several factors may influence nNO levels and need to be addressed during patient preparation for testing. Factors including acute viral infections and nose bleeds may contribute to falsely low nNO levels, whereas high ambient NO levels may falsely increase nNO. Tidal breathing, breath-hold and exhalation against resistance are the three main respiratory manoeuvres used in nNO sampling and require a minimal, modest and high level of patient cooperation respectively. Finally, standardised reporting of nNO testing and the correct interpretation helps clinicians to formulate an appropriate clinical plan towards an accurate PCD diagnosis.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"21 2","pages":"240230"},"PeriodicalIF":2.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315954","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}
BreathePub Date : 2025-06-17eCollection Date: 2025-04-01DOI: 10.1183/20734735.0259-2024
Anna Denis, Panagiota Tsiri, Julien Guiot, Argyris Tzouvelekis
{"title":"A new era in the treatment of progressive fibrosing interstitial lung diseases.","authors":"Anna Denis, Panagiota Tsiri, Julien Guiot, Argyris Tzouvelekis","doi":"10.1183/20734735.0259-2024","DOIUrl":"10.1183/20734735.0259-2024","url":null,"abstract":"<p><p>Idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) are characterised by an irreversible progression of pulmonary fibrosis and functional lung decline. Current antifibrotic therapies (nintedanib and pirfenidone for IPF and nintedanib for PPF) can reduce disease progression but not halt or reverse it. PPF and IPF share common pathophysiological pathways that need to be further elucidated for the development of novel therapeutic strategies. The educational aim of this review is to explain the pathogenic pathways that have led to the discovery of new therapeutic agents and their favourable implementation in phase 2 and 3 studies. This includes phosphodiesterase 4 inhibitors, αvβ6 and αvβ1 integrin inhibitors, lymphosphatidic acid antagonists, inhaled treprostinil, hedgehog inhibitors, tyrosine kinase inhibitors and angiotensin type 2 receptor agonists. The aim is also to better understand current therapeutic challenges and future perspectives, including cellular therapies, exosomes and their cargoes, as well as the integration of transcriptomics and proteomics, plus gene therapy.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"21 2","pages":"240259"},"PeriodicalIF":2.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315948","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}
BreathePub Date : 2025-06-17eCollection Date: 2025-04-01DOI: 10.1183/20734735.0040-2025
Ali Al-Mukhaizeem, Katherine O'Reilly, Paul Reddy, Sean Gaine, Brian McCullagh, Sarah Cullivan
{"title":"An unprecedented pathology in a 20-year-old with progressive dyspnoea and parenchymal infiltrates.","authors":"Ali Al-Mukhaizeem, Katherine O'Reilly, Paul Reddy, Sean Gaine, Brian McCullagh, Sarah Cullivan","doi":"10.1183/20734735.0040-2025","DOIUrl":"10.1183/20734735.0040-2025","url":null,"abstract":"<p><p><b>Sarcoidosis-associated pulmonary hypertension can manifest with a broad range of phenotypes. There may be a role for genetic testing in specific cases of severe disease when the relevance of comorbid sarcoidosis is unclear.</b> https://bit.ly/42kscnz.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"21 2","pages":"250040"},"PeriodicalIF":2.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315950","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}
BreathePub Date : 2025-06-17eCollection Date: 2025-04-01DOI: 10.1183/20734735.0171-2024
Niamh Boyle, Jonathan Miller, Sean Quinn, Jess Maguire, Aurelie Fabre, Kathleen Morrisroe, David J Murphy, Cormac McCarthy
{"title":"Systemic autoimmune rheumatic diseases-associated interstitial lung disease: a pulmonologist's perspective.","authors":"Niamh Boyle, Jonathan Miller, Sean Quinn, Jess Maguire, Aurelie Fabre, Kathleen Morrisroe, David J Murphy, Cormac McCarthy","doi":"10.1183/20734735.0171-2024","DOIUrl":"10.1183/20734735.0171-2024","url":null,"abstract":"<p><p>Connective tissue disease (CTD)-associated interstitial lung disease (ILD) is a complex condition arising in various autoimmune disorders, such as systemic sclerosis, Sjögren disease, systemic lupus erythematosus and idiopathic inflammatory myopathies. The broader term of systemic autoimmune rheumatic diseases (SARDs) and SARD-ILD are increasingly adopted in various guidelines to allow inclusion of other rheumatic diseases such as rheumatoid arthritis. SARD-ILD significantly impacts morbidity and mortality, with disease manifestations ranging from mild to severe and life-threatening. Epidemiological data show varying ILD prevalence rates amongst SARDs, with fibrosis being a key pathological component secondary to immune-mediated inflammation and tissue remodelling. SARD-ILD presents diverse histological patterns, primarily nonspecific interstitial pneumonia and usual interstitial pneumonia, each informing prognosis and guiding therapeutic strategies. Diagnosis relies on a comprehensive evaluation of clinical, serological, radiological and histological data, involving a multidisciplinary team. Immunosuppressive therapy is the cornerstone of treatment, with concurrent use of anti-fibrotic agents in specific progressive cases. Disease management is stratified by severity, with distinct guidelines for stable, progressive and rapidly progressive ILD. The prognosis varies across SARD-ILD types, influenced by specific markers, imaging features, and response to therapy. In severe cases, lung transplantation may be considered. Early recognition remains critical in optimising outcomes for SARD-ILD patients.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"21 2","pages":"240171"},"PeriodicalIF":2.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315955","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}
BreathePub Date : 2025-05-13eCollection Date: 2025-04-01DOI: 10.1183/20734735.0224-2024
Tiago Alfaro, Cormac McCarthy, Francesco Bonella, Elisabeth Bendstrup, Marissa O'Callaghan
{"title":"Summary for clinicians: ERS guidelines on pulmonary alveolar proteinosis.","authors":"Tiago Alfaro, Cormac McCarthy, Francesco Bonella, Elisabeth Bendstrup, Marissa O'Callaghan","doi":"10.1183/20734735.0224-2024","DOIUrl":"10.1183/20734735.0224-2024","url":null,"abstract":"<p><p>Pulmonary alveolar proteinosis (PAP) is a rare lung disease caused by accumulation of surfactant in the alveoli, leading to debilitating respiratory symptoms and impaired gas exchange. The recent European Respiratory Society guidelines provide evidence-based recommendations for its diagnosis and management. Autoimmune PAP (aPAP) is the most common form, driven by granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies. Recommended diagnostic tools include bronchoalveolar lavage and quantitative GM-CSF antibody testing. Whole lung lavage and inhaled GM-CSF are first-line treatments for symptomatic or progressive aPAP. Rituximab, plasmapheresis, and lung transplantation are options for refractory disease. Referral to expert centres is advised for diagnostic and therapeutic guidance. This case-based summary for clinicians highlights the best clinical approach to patients with suspicion or confirmation of PAP.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"21 2","pages":"240224"},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970529","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}