Fawaz Alenezi, Anna Costelle, Seth Lee, Bastiaan Driehuys, Sudarshan Rajagopal
{"title":"The emerging role of hyperpolarized <sup>129</sup>Xe MRI in pulmonary hypertension.","authors":"Fawaz Alenezi, Anna Costelle, Seth Lee, Bastiaan Driehuys, Sudarshan Rajagopal","doi":"10.1080/17476348.2025.2529543","DOIUrl":"https://doi.org/10.1080/17476348.2025.2529543","url":null,"abstract":"","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546571","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}
{"title":"Response to letter to the editor: 'roles of vitamins and nutrition in obstructive sleep apnea'.","authors":"Kostas Archontogeorgis, Evangelia Nena, Paschalis Steiropoulos","doi":"10.1080/17476348.2025.2499295","DOIUrl":"10.1080/17476348.2025.2499295","url":null,"abstract":"","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"761"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028172","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}
Arnau Ulsamer, Sergio Bonilla, Xosé Pérez-Fernández, Jordi Rello, Joan Sabater-Riera
{"title":"The pathogenesis of ventilator-associated pneumonia: old and new mechanisms.","authors":"Arnau Ulsamer, Sergio Bonilla, Xosé Pérez-Fernández, Jordi Rello, Joan Sabater-Riera","doi":"10.1080/17476348.2025.2493366","DOIUrl":"10.1080/17476348.2025.2493366","url":null,"abstract":"<p><strong>Introduction: </strong>Ventilator-associated pneumonia (VAP), defined as a lung infection that occurs in patients after 48 hours on mechanical ventilation, is among the most frequently found nosocomial infections in intensive care units around the world and is associated with increased morbidity, mortality, and economic burden.</p><p><strong>Areas covered: </strong>We review the classical mechanisms of VAP development and explore more recent ones, such as dysbiosis, which has changed our view of the pathogenesis of the disease; whereas in the past the lower respiratory tract was classically considered a sterile organ, the use of new diagnostic techniques has shown that the lungs of healthy humans are inhabited by a large, dynamic ecosystem of microorganisms. Dysbiosis is the disruption of this ecosystem and is a key factor in the development of VAP. Recent findings have demonstrated that host immunity is microbiome-regulated and, consequently, is profoundly affected by dysbiosis. In this paper the significance of the microbiome-immunity crosstalk in the pathophysiology of VAP will be discussed.</p><p><strong>Expert opinion: </strong>A deeper understanding of mechanisms of VAP pathogenesis should help to devise new preventive, diagnostic and therapeutic strategies for reducing the incidence of this condition and for improving patient prognosis.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"655-671"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063592","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}
{"title":"Recent discoveries from clinical trials: why opioids should not be used for dyspnea management in COPD.","authors":"Nicholas T Vozoris","doi":"10.1080/17476348.2025.2494643","DOIUrl":"10.1080/17476348.2025.2494643","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic breathlessness among persons with chronic obstructive pulmonary disease (COPD) is a distressing and limiting symptom and a substantial management challenge for healthcare practitioners. Historically, multiple professional respiratory societies have encouraged the prescription of opioid drugs as a therapeutic intervention for chronic breathlessness. However, in 2024, the European Respiratory Society (ERS) published clinical practice guidelines that markedly departed from such traditional recommendations and stated that opioids should not be used for chronic breathlessness.</p><p><strong>Areas covered: </strong>This manuscript will review recently published, well-designed, randomized controlled trials (literature was searched on PubMed from January 2020 to January 2025) that evaluated the efficacy of oral opioids for chronic breathlessness in persons with COPD and which influenced the new position adopted by ERS in 2024.</p><p><strong>Expert opinion: </strong>Recent, well-designed, adequately powered clinical trials consistently demonstrate that oral opioids are not effective at reducing chronic breathlessness (nor at improving overall quality of life, functional status or exercise tolerance) amongst individuals with advanced COPD. Other professional respiratory societies need to consider and potentially embrace the new ERS position on opioids for dyspnea in COPD, so as to guide members away from an unhelpful, and in some cases harmful, management paradigm.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"673-678"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059112","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}
Annemarie Louise Lee, Imogen Nicola Clark, Adam Lewis
{"title":"Harnessing music therapy and music medicine in chronic respiratory disease management.","authors":"Annemarie Louise Lee, Imogen Nicola Clark, Adam Lewis","doi":"10.1080/17476348.2025.2501279","DOIUrl":"10.1080/17476348.2025.2501279","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment options for those living with chronic respiratory disease include non-pharmacological therapies to maximize outcomes. However, some individuals are limited by their symptoms, which inhibit their ability to benefit to an equivalent or expected level. Both music therapy and music medicine are therapeutic approaches which could address these limitations.</p><p><strong>Areas covered: </strong>This perspective reviews the clinical effects of music therapy and music medicine in chronic respiratory diseases. This considers active music therapy methods of re-creating (group singing), improvisation (instrument playing), receptive music listening and music medicine, with a specific focus at rest and during exercise.</p><p><strong>Expert commentary: </strong>The precise role of music therapy or music medicine as an adjunct to exercise testing or structured exercise programs for people with chronic respiratory disease is unclear. Choice of music (for background or individual use for this purpose) requires input from participants and would benefit from music therapists to guide selection. While preliminary findings of group singing and instrument playing highlight some efficacy, their role in comparison to pulmonary rehabilitation requires further clarification. At present, these music therapy and music medicine approaches can be considered as adjunct therapies which may assist in managing symptoms and improving wellbeing alongside existing management strategies.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"639-654"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012091","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}
{"title":"Unmet needs and future directions of treatment options for chronic cough.","authors":"Mengru Zhang, Alyn Morice","doi":"10.1080/17476348.2025.2499663","DOIUrl":"10.1080/17476348.2025.2499663","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic cough is a persistent condition that significantly affects patients' quality of life and poses diagnostic and therapeutic challenges. Traditional anatomical diagnostic approaches often fail to address the underlying mechanisms, leading to suboptimal treatment outcomes.</p><p><strong>Area covered: </strong>This review aims to summarize the challenges of the management of chronic cough and highlights recent advances of several promising drug candidates in cough trials. PUBMED/CINAHL/Web of Science/Scopus were searched (February 2025).</p><p><strong>Expert opinion: </strong>Over the past 40 years, chronic cough has evolved from a mere symptom to a recognized disease. A key observation is that hypersensitivity of the afferent vagus and its central projections cause the state of cough hypersensitivity leading to the urge to cough being precipitated by otherwise innocuous stimuli. Clinical trial designs have also advanced, incorporating placebo run-in periods to reduce placebo effects and refining patient-reported outcomes to modern standards. Additionally, the realization that the variability in chronic cough, both diurnal and day-to-day, has highlighted the need for continuous cough monitoring, which has only recently been available consequence to the revolution in electronic applications. However, progress is hindered by a widespread lack of awareness among healthcare professionals and patients, underscoring the urgent need for education on this condition.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"709-720"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048637","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}
{"title":"Value-based outcome measures in cough.","authors":"Katherine L Rhatigan, Peter S P Cho","doi":"10.1080/17476348.2025.2498419","DOIUrl":"10.1080/17476348.2025.2498419","url":null,"abstract":"","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"635-637"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038817","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}
Lucypaula Andrade Pinheiro Fernandes, Jose Dirceu Ribeiro
{"title":"Lung ultrasound in children with asthma exacerbations: a systematic review and meta-analysis.","authors":"Lucypaula Andrade Pinheiro Fernandes, Jose Dirceu Ribeiro","doi":"10.1080/17476348.2025.2495166","DOIUrl":"10.1080/17476348.2025.2495166","url":null,"abstract":"<p><strong>Introduction: </strong>Lung ultrasound (LUS) is a noninvasive radiation-free imaging tool used to evaluate respiratory conditions, particularly in children and adolescents with asthma exacerbations. However, its role in diagnosing and managing asthma exacerbations remains unclear. We aimed to demonstrate LUS findings in pediatric asthma exacerbations, focusing on patterns such as B-lines, consolidation, and pleural abnormalities.</p><p><strong>Methods: </strong>A systematic review was conducted following the Preferred reporting items for systematic reviews and meta-analyses guidelines. Databases such as MEDLINE/PubMed and EMBASE were reviewed. The eligibility criterion was observational studies on LUS for pediatric asthma exacerbations. Bias risk was assessed using a validated tool. Data were analyzed both qualitatively and quantitatively, with findings summarized and meta-analysis conducted.</p><p><strong>Results: </strong>Five studies involving 192 participants were included in the analysis. The LUS findings included B-lines, consolidation, and pleural abnormalities. Meta-analysis revealed that 52.0% (95% confidence interval: 23.0-80.3) of the cases demonstrated positive LUS findings.</p><p><strong>Conclusions: </strong>LUS exhibited potential for diagnosing asthma exacerbations, particularly in identifying B-lines, consolidation, and pleural abnormalities. However, variability in detection rates was observed across different studies, which might be due to the differences in study populations and criteria. Despite these limitations, LUS can be a valuable tool for managing asthma exacerbations.</p><p><strong>Protocol registration: </strong>www.crd.york.ac.uk/Prospero identifier CRD42021244729.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"733-740"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035829","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}
{"title":"An update on spinal cord injury and diaphragm neuromotor control.","authors":"Obaid U Khurram, Gary C Sieck","doi":"10.1080/17476348.2025.2495165","DOIUrl":"10.1080/17476348.2025.2495165","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding neuromotor control of the diaphragm muscle (DIAm) is the foundation for developing therapeutic approaches for functional recovery of ventilatory and non-ventilatory behaviors. Although the DIAm is the primary inspiratory pump, it plays a vital role in a wide variety of higher-force behaviors including airway clearance activities. After spinal cord injury (SCI), higher-force behaviors experience the greatest deficits. A classification scheme for SCI that incorporates this information would be clinically valuable.</p><p><strong>Areas covered: </strong>We begin by presenting foundational information about DIAm motor units. In addition, we introduce a classification scheme of SCI based on the impact it has on neural circuitry involved in breathing and other functions of the DIAm. Finally, we consider various promising therapeutic options available to improve DIAm motor function. Relevant literature was identified by searching PubMed and Google Scholar without specific limits on the dates.</p><p><strong>Expert opinion: </strong>Classification of SCI based on its impact on the neural circuitry involved in DIAm motor behaviors is an important part of developing effective therapeutics. An approach that considers the specific type of SCI and leverages a combination of interventions will likely yield the best outcomes for restoring both ventilatory and non-ventilatory functions.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"679-695"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060803","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}
{"title":"Letter to the Editor: 'Roles of vitamins and nutrition in obstructive sleep apnea'.","authors":"Dalmacito A Cordero","doi":"10.1080/17476348.2025.2499145","DOIUrl":"10.1080/17476348.2025.2499145","url":null,"abstract":"","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"759-760"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046197","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}