Expert review of respiratory medicine最新文献

Improving access to non-pharmacological treatment for chronic respiratory disease: what? Why? How? 改善慢性呼吸系统疾病非药物治疗的可及性：是什么、为什么、怎么做？

Expert review of respiratory medicine Pub Date : 2025-01-06 DOI: 10.1080/17476348.2024.2444335

Yet H Khor, Narelle S Cox

引用次数: 0

Achieving sustained remission in severe asthma: goals, challenges, issues and opportunities.

Expert review of respiratory medicine Pub Date : 2025-01-05 DOI: 10.1080/17476348.2024.2449080

Alessandro Vatrella, Angelantonio Maglio

引用次数: 0

Interactions between epithelial mesenchymal plasticity, barrier dysfunction and innate immune pathways shape the genesis of allergic airway disease.

Expert review of respiratory medicine Pub Date : 2025-01-02 DOI: 10.1080/17476348.2024.2449079

Allan R Brasier

{"title":"Interactions between epithelial mesenchymal plasticity, barrier dysfunction and innate immune pathways shape the genesis of allergic airway disease.","authors":"Allan R Brasier","doi":"10.1080/17476348.2024.2449079","DOIUrl":"https://doi.org/10.1080/17476348.2024.2449079","url":null,"abstract":"Introduction: In genetically predisposed individuals, exposure to aeroallergens and infections from RNA viruses shape epithelial barrier function, leading to Allergic Asthma (AA). Here, activated pattern recognition receptors (PRRs) in lower airway sentinel cells signal epithelial injury-repair pathways leading to cell-state changes [epithelial mesenchymal plasticity (EMP)], barrier disruption and sensitization.Areas covered: 1. Characteristics of sentinel epithelial cells of the bronchoalveolar junction; 2. The effect of aeroallergens on epithelial PRRs; 3. Role of tight junctions (TJs) in barrier function and how aeroallergens disrupt their function; 4. Induction of mucosal TGF βautocrine loops activating type-2 innate lymphoid cells (ICL2s) leading to Th2 polarization; 5. How respiratory syncytial virus (RSV) directs goblet cell hyperplasia; 6. Coupling of endoplasmic reticulum (ER) stress to metabolic adaptations and effects on basal lamina remodeling.Expert opinion: When aeroallergens or viral infections activate innate immunity in sentinel cells of the bronchoalveolar junction, normal barrier function is disrupted, promoting chronic inflammation and Th2 responses. An improved mechanistic understanding of how activated PRRs induce EMP couples with TJ disruption, metabolic reprogramming and ECM deposition provides new biologically validated targets to restore barrier function, reduce sensitization and remodeling in AA.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unveiling the potential of lung transplantation for situs inversus.

Expert review of respiratory medicine Pub Date : 2024-12-26 DOI: 10.1080/17476348.2024.2447513

Yudai Miyashita, Taisuke Kaiho, Chitaru Kurihara

{"title":"Unveiling the potential of lung transplantation for situs inversus.","authors":"Yudai Miyashita, Taisuke Kaiho, Chitaru Kurihara","doi":"10.1080/17476348.2024.2447513","DOIUrl":"10.1080/17476348.2024.2447513","url":null,"abstract":"Introduction: Situs inversus is a rare congenital condition where the organs in the chest and abdomen are reversed, thus complicating surgeries such as lung transplantation. Kartagener syndrome (KS), associated with situs inversus, includes chronic sinusitis and bronchiectasis, which can progress to end-stage lung disease requiring transplantation. This review discusses the unique surgical considerations, technical challenges, and outcomes of lung transplantation in patients with situs inversus, particularly KS.Areas covered: The review highlights anatomical and physiological challenges in lung transplantation due to reversed organ positioning, requiring customized surgical approaches and intraoperative modifications. Preoperative imaging, anesthesia adjustments, and tailored surgical techniques are crucial for successful transplantation. Postoperative care focuses on managing complications such as primary graft dysfunction, infections, and anastomotic issues. Literature on survival rates, chronic lung allograft dysfunction, and quality of life is analyzed, indicating outcomes comparable to other lung transplant recipients.Expert opinion: Despite significant challenges, lung transplantation in patients with situs inversus and KS is feasible with outcomes similar to traditional cases. Advances in imaging, surgical planning, and minimally invasive techniques offer promise for improved outcomes. Ongoing research, collaboration, and ethical considerations are essential to optimizing care and expand treatment possibilities for this high-risk patient population.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparative effectiveness of olodaterol/tiotropium and vilanterol/umeclidinium among COPD patients: a high-dimensional propensity score matched new user cohort study in a US Medicare population.

Expert review of respiratory medicine Pub Date : 2024-12-24 DOI: 10.1080/17476348.2024.2446598

Chintal H Shah, Robert M Reed, Linda Simoni-Wastila, Eberechukwu Onukwugha, Mathangi Gopalakrishnan, Zafar Zafari

{"title":"Comparative effectiveness of olodaterol/tiotropium and vilanterol/umeclidinium among COPD patients: a high-dimensional propensity score matched new user cohort study in a US Medicare population.","authors":"Chintal H Shah, Robert M Reed, Linda Simoni-Wastila, Eberechukwu Onukwugha, Mathangi Gopalakrishnan, Zafar Zafari","doi":"10.1080/17476348.2024.2446598","DOIUrl":"https://doi.org/10.1080/17476348.2024.2446598","url":null,"abstract":"Background: Two long-acting muscarinic antagonist inhaler fixed dose combinations (olodaterol/tiotropium (OLO/TIO) and vilanterol/umeclidinium (VI/UMEC)) have once-a-day dosing for managing chronic obstructive pulmonary disease (COPD). This study aimed to compare clinical effectiveness of these inhalers in terms of ability to prevent severe COPD exacerbations in a United States Medicare population.Research design and methods: Using nationally representative Medicare data (2013-2019), we employed a new user, active comparator design among beneficiaries aged 65 years and older with COPD. The outcome of interest was time to first occurrence of a severe COPD exacerbation. To ensure comparability between the groups, we performed 1:3 (VI/UMEC:OLO/TIO) nearest neighbor matching based on their high-dimensional propensity scores.Results: The study included 2,263 OLO/TIO new initiators matched to 6,789 VI/UMEC new initiators. The incidence rate of the first severe COPD exacerbation was 40.8 per 100 person-years among new initiators (39.9 per 100 person-years for OLO/TIO, 41.1 per 100 person-years for VI/UMEC). The adjusted hazard ratio of the time to first COPD exacerbation was 0.948 (95% Confidence interval: 0.813-1.105) for individuals initiating OLO/TIO versus VI/UMEC.Conclusion: We did not find a statistically significant difference between the OLO/TIO and VI/UMEC new users in terms of time to first severe exacerbation among Medicare COPD patients aged 65 or older.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Polypharmacy in older patients with asthma: hidden risks and opportunities for improvement.

Expert review of respiratory medicine Pub Date : 2024-12-23 DOI: 10.1080/17476348.2024.2444331

Alessandra Tomasello, Alida Benfante, Alessia Lisotta, Dario Macaluso, Sengottuwell Viswanathan, Katherine N Cahill, Nicola Scichilone

{"title":"Polypharmacy in older patients with asthma: hidden risks and opportunities for improvement.","authors":"Alessandra Tomasello, Alida Benfante, Alessia Lisotta, Dario Macaluso, Sengottuwell Viswanathan, Katherine N Cahill, Nicola Scichilone","doi":"10.1080/17476348.2024.2444331","DOIUrl":"10.1080/17476348.2024.2444331","url":null,"abstract":"Introduction: Polypharmacy can be considered the norm in elderly patients, because older individuals experience an increasing number of concomitant respiratory and non-respiratory diseases other than asthma, carrying the risk of drug-to-drug-interactions and drug-to-comorbidities interactions. In this context, asthma in older adults, conventionally aging >65 years of age, cannot be adequately managed without considering their individual characteristics, as these challenge the traditional therapeutic algorithms/management strategies commonly applied to younger populations.Areas covered: The current article aims at addressing pitfalls and advantages of current pharmacological strategies in older individuals with asthma. Comorbidities become more common with increasing age and are also more frequent in adults with asthma than in those without it. Multiple medications are often needed to control asthma symptoms and prevent asthma exacerbations, and older patients with asthma may also take multiple medications for common comorbidities and complex health conditions, such as chronic cardiometabolic diseases. Polypharmacy is an emerging concern in the elderly population.Expert opinion: A patient-centered approach is crucial and polypharmacy in asthma requires careful management. A multidisciplinary approach will allow for a more holistic care and will ensure that all aspects of a patient's health are considered, optimizing medication management.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Radon exposure as an occupational risk factor for lung cancer in conventional workplaces. An overview. 氡暴露作为传统工作场所肺癌的职业风险因素。概述。

Expert review of respiratory medicine Pub Date : 2024-12-22 DOI: 10.1080/17476348.2024.2444363

Lucía Martin-Gisbert, Guadalupe García, Ana Teijeiro, Alberto Ruano-Ravina

{"title":"Radon exposure as an occupational risk factor for lung cancer in conventional workplaces. An overview.","authors":"Lucía Martin-Gisbert, Guadalupe García, Ana Teijeiro, Alberto Ruano-Ravina","doi":"10.1080/17476348.2024.2444363","DOIUrl":"10.1080/17476348.2024.2444363","url":null,"abstract":"Introduction: Radon gas has been a declared human carcinogen for more than 30 years and has been causally associated with lung cancer. Studies have shown a linear relationship between residential radon exposure and lung cancer risk.Areas covered: Initially, this risk was subjected to cohorts of underground miners and then in case-control studies in the general population.While the evidence on residential radon exposure and lung cancer risk is extensive, there is little evidence on occupational radon exposure in conventional workplaces. Studies estimating radon-attributed mortality and prevalence also consider only residential radon exposure.Expert opinion: As individuals are also exposed to radon in the workplace, further studies should incorporate an integrated assessment of radon exposure, including both residential and occupational exposure.The European Council Directive established specifications for occupational exposure to radon, indicating the reference level and making it mandatory to measure radon in the workplace. EU countries have adopted national legislation incorporating this framework, some relatively recently. These regulations create an unprecedented situation for previously and currently exposed workers. It is important that the legislation on the determination of radon concentrations in the workplace is rigorously enforced and introduced in countries where this is not yet the case.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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An update on multiple breath washout in children with cystic fibrosis.

Expert review of respiratory medicine Pub Date : 2024-12-22 DOI: 10.1080/17476348.2024.2445683

Natalia S Escobar, Felix Ratjen

{"title":"An update on multiple breath washout in children with cystic fibrosis.","authors":"Natalia S Escobar, Felix Ratjen","doi":"10.1080/17476348.2024.2445683","DOIUrl":"10.1080/17476348.2024.2445683","url":null,"abstract":"Introduction: Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in the CF transmembrane regulator (CFTR) gene, leading to progressive lung disease and systemic complications. Lung disease remains the primary cause of morbidity and mortality, making early detection of lung function decline crucial. The Lung Clearance Index (LCI), derived from the multiple breath washout (MBW) test, has emerged as a sensitive measure for identifying early airway disease.Areas covered: This review examines the technical aspects and clinical relevance of LCI, its advantages over traditional lung function tests, and its application in CF clinical trials. A focused literature review highlights LCI's utility in evaluating treatment efficacy and its potential integration into routine CF care.Expert opinion: LCI is more sensitive than spirometry for detecting early lung function decline and is predominantly used in pediatric settings. Its use is expanding in adult CF populations as advances in treatment allow adults to maintain stable lung function. In clinical trials, LCI is widely recognized as an outcome measure. While implemented into clinical care in many centers in Europe, this is not yet the case in North America. Faster testing protocols and point-of-care interpretation tools will support LCI's integration into routine CF monitoring.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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What's next in digital technology for the management of pediatric asthma? 儿科哮喘管理数字技术的下一步是什么？

Expert review of respiratory medicine Pub Date : 2024-12-17 DOI: 10.1080/17476348.2024.2442663

Giuliana Ferrante

引用次数: 0

Preschool wheeze and asthma endotypes- implications for future therapy.

Expert review of respiratory medicine Pub Date : 2024-12-13 DOI: 10.1080/17476348.2024.2440468

Kushalinii Hillson, Sejal Saglani, Adnan Custovic

{"title":"Preschool wheeze and asthma endotypes- implications for future therapy.","authors":"Kushalinii Hillson, Sejal Saglani, Adnan Custovic","doi":"10.1080/17476348.2024.2440468","DOIUrl":"10.1080/17476348.2024.2440468","url":null,"abstract":"Introduction: Preschool wheeze and school-aged asthma present a large healthcare burden. Both conditions are now recognized to be heterogeneous, with similar symptom presentation but likely different underlying lung pathology.Areas covered: Current treatment options for preschool wheeze are constrained by extrapolations from the management of school-aged children with asthma. While most cases of asthma at school age are caused by classical atopic, eosinophilic, Type-2 driven asthma, only a quarter of preschool children with wheeze fall into this category. Targeting treatment to specific underlying mechanisms resulting in preschool wheeze may alter the progression to school age asthma. Novel biologics have revolutionized the management of severe, treatment-resistant school age asthma, but a limited evidence base limits their use in young children. There are several potential future non-steroid-based treatment options in development, of which bacterial lysates show the most promise.Expert opinion: Effective treatment of preschool wheeze may preserve lung function into later life, which may alter the progression trajectory toward school age asthma. Endotype-driven management will enable more effective treatment of both preschool wheeze and school age asthma.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0