Expert review of respiratory medicine最新文献_第5页

The unique metabolic and lipid profiles of patients with severe COVID-19 compared to severe community-acquired pneumonia: a potential prognostic and therapeutic target. 与重症社区获得性肺炎相比，重症 COVID-19 患者具有独特的代谢和血脂特征：潜在的预后和治疗目标。

Expert review of respiratory medicine Pub Date : 2024-10-01 Epub Date: 2024-09-29 DOI: 10.1080/17476348.2024.2409264

Elsa D Ibáñez-Prada, Jose L Guerrero, Ingrid G Bustos, Lizeth León, Yuli V Fuentes, Mary Santamaría-Torres, Juan M Restrepo-Martínez, Cristian C Serrano-Mayorga, Lina Mendez, Salome Gomez-Duque, Carlos A Santacruz, Andrew Conway-Morris, Ignacio Martín-Loeches, Norberto Gonzalez-Juarbe, Mónica P Cala, Luis Felipe Reyes

{"title":"The unique metabolic and lipid profiles of patients with severe COVID-19 compared to severe community-acquired pneumonia: a potential prognostic and therapeutic target.","authors":"Elsa D Ibáñez-Prada, Jose L Guerrero, Ingrid G Bustos, Lizeth León, Yuli V Fuentes, Mary Santamaría-Torres, Juan M Restrepo-Martínez, Cristian C Serrano-Mayorga, Lina Mendez, Salome Gomez-Duque, Carlos A Santacruz, Andrew Conway-Morris, Ignacio Martín-Loeches, Norberto Gonzalez-Juarbe, Mónica P Cala, Luis Felipe Reyes","doi":"10.1080/17476348.2024.2409264","DOIUrl":"10.1080/17476348.2024.2409264","url":null,"abstract":"Background: Compare the changes and differences in metabolome and lipidome profiles among severe COVID-19 and CAP patients with ARF to identify biomarkers that could be used for personalized diagnosis, prognosis, and treatment.Research design and methods: Plasma samples were taken at hospital admission (baseline) and on the 5th day of hospitalization (follow-up) and examined by RP-LC-QTOF-MS and HILIC-LC-QTOF-MS.Results: 127 patients, 17 with CAP and 110 with COVID-19, were included. The analysis revealed 87 altered metabolites, suggesting changes in the metabolism of arachidonic acid, glycerolipids, glycerophospholipids, linoleic acid, pyruvate, glycolysis, among others. Most of these metabolites are involved in inflammatory, hypoxic, and thrombotic processes. At baseline, the greatest differences were found in phosphatidylcholine (PC) 31:4 (p < 0.001), phosphoserine (PS) 34:3 (p < 0.001), and phosphatidylcholine (PC) 36:5 (p < 0.001), all of which were notably decreased in COVID-19 patients. At follow-up, the most dysregulated metabolites were monomethyl-phosphatidylethanolamine (PE-Nme) 40:5 (p < 0.001) and phosphatidylcholine (PC) 38:4 (p < 0.001).Conclusions: Metabolic and lipidic alterations suggest inhibition of innate anti-inflammatory and anti-thrombotic mechanisms in COVID-19 patients, which might lead to increased viral proliferation, uncontrolled inflammation, and thrombi formation. Results provide novel targets for predictive biomarkers against CAP and COVID-19.Trial registration: Not applicable.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"815-829"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335088","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

It is high time to discard a cut-off of 0.70 in the diagnosis of COPD. 在诊断慢性阻塞性肺病时，现在应该摒弃 0.70 的临界值。

Expert review of respiratory medicine Pub Date : 2024-09-01 Epub Date: 2024-08-27 DOI: 10.1080/17476348.2024.2397480

Joon Young Choi, Chin Kook Rhee

引用次数: 0

Apolipoprotein E in patients with undiagnosed pleural effusion: a prospective diagnostic test accuracy study. 未确诊胸腔积液患者体内的载脂蛋白 E：一项前瞻性诊断测试准确性研究。

Expert review of respiratory medicine Pub Date : 2024-09-01 Epub Date: 2024-08-18 DOI: 10.1080/17476348.2024.2391943

Dan-Ni Yang, Cheng Yan, Li Yan, Yan Niu, Jian-Xun Wen, Ling Hai, Wen-Hui Gao, Ying-Jun Wang, Ya-Fei Wang, Qianghua Zhou, Wen-Qi Zheng, Zhi-De Hu

{"title":"Apolipoprotein E in patients with undiagnosed pleural effusion: a prospective diagnostic test accuracy study.","authors":"Dan-Ni Yang, Cheng Yan, Li Yan, Yan Niu, Jian-Xun Wen, Ling Hai, Wen-Hui Gao, Ying-Jun Wang, Ya-Fei Wang, Qianghua Zhou, Wen-Qi Zheng, Zhi-De Hu","doi":"10.1080/17476348.2024.2391943","DOIUrl":"10.1080/17476348.2024.2391943","url":null,"abstract":"Introduction: Pleural effusion is common in clinical practice, and its differential diagnosis remains challenging for clinicians. This study investigates the diagnostic value of apolipoprotein E (apoE) in patients with undetermined pleural effusion.Methods: This prospective, double-blind study enrolled 152 patients with undiagnosed pleural effusion. Their pleural fluid apoE levels were measured, and a receiver operating characteristics (ROC) curve was used to evaluate the diagnostic accuracy of apoE. Decision curve analysis (DCA) was used to assess apoE's net benefit. Subgroup analyses were performed to investigate the effect of age on the diagnostic accuracy of apoE.Results: Among the included participants, 23 had heart failure (HF). HF patients had the lowest apoE level among pleural effusion patients. The area under the curve (AUC) of apoE for HF was 0.79 (95% CI: 0.69-0.89). At the threshold of 40 mg/L, the sensitivity and specificity of apoE were 0.96 (95% CI: 0.87-1.00) and 0.33 (95% CI: 0.25-0.42), respectively. The decision curve for apoE was above reference lines. The AUC of apoE decreased in older patients.Conclusion: Pleural fluid apoE has moderate diagnostic value for HF and has net benefits in patients with undiagnosed pleural effusion. The diagnostic accuracy of apoE decreases with age.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"735-741"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972479","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

The continuing need for dornase alfa for extracellular airway DNA hydrolysis in the era of CFTR modulators. 在 CFTR 调节剂时代，细胞外气道 DNA 水解仍需 dornase alfa。

Expert review of respiratory medicine Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.1080/17476348.2024.2394694

Erica A Roesch, Abdelkader Rahmaoui, Robert A Lazarus, Michael W Konstan

{"title":"The continuing need for dornase alfa for extracellular airway DNA hydrolysis in the era of CFTR modulators.","authors":"Erica A Roesch, Abdelkader Rahmaoui, Robert A Lazarus, Michael W Konstan","doi":"10.1080/17476348.2024.2394694","DOIUrl":"10.1080/17476348.2024.2394694","url":null,"abstract":"Introduction: The availability of cystic fibrosis transmembrane conductance regulator (CFTR) modulators opens the possibility of discontinuing some chronic pulmonary therapies to decrease cystic fibrosis (CF) treatment burden. However, CFTR modulators may not adequately address neutrophilic inflammation, which contributes to a self-perpetual cycle of viscous CF sputum, airway obstruction, inflammation, and lung function decline.Areas covered: This review discusses the emerging role of neutrophil extracellular traps in CF and its role in CF sputum viscosity, airway obstruction, and inflammation, based on a literature search of PubMed (1990-present). We summarize clinical trials and real-world studies that support the efficacy of dornase alfa (Pulmozyme) in improving lung function and reducing pulmonary exacerbation in people with CF (PwCF), and we discuss the potential role of dornase alfa in reducing airway inflammation. We also examine the findings of short-term trials evaluating the discontinuation of mucoactive therapy in PwCF receiving CFTR modulators.Expert opinion: Long-term studies are needed to assess the impact of discontinuing mucoactive therapy in PwCF who are clinically stable while receiving CFTR modulatory therapy. Treatment decisions should take into account the severity of underlying lung disease. People with advanced CF will likely require ongoing mucoactive therapy.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"677-691"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038028","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

Awareness of COPD in low-and middle-income countries and implications for treatment. 中低收入国家对慢性阻塞性肺病的认识及其对治疗的影响。

Expert review of respiratory medicine Pub Date : 2024-09-01 Epub Date: 2024-09-09 DOI: 10.1080/17476348.2024.2400983

Deesha Ghorpade, Sundeep Salvi

{"title":"Awareness of COPD in low-and middle-income countries and implications for treatment.","authors":"Deesha Ghorpade, Sundeep Salvi","doi":"10.1080/17476348.2024.2400983","DOIUrl":"10.1080/17476348.2024.2400983","url":null,"abstract":"Introduction: COPD is the 3rd leading cause of death worldwide, affecting an estimated 212.3 million people. More than 80% of this burden occurs in low- and middle-income countries. One of the major reasons for this growing burden, is the lack of awareness of COPD among all levels.Areas covered: In this review article, we studied the level of awareness of COPD among lay people, health care providers and policy makers in the LMICs. Search engines including Google Scholar, PubMed, and Scopus were used for relevant articles. Articles spanning from 1990 to March 2024 were screened on COPD awareness in LMICs and its treatment implications using a combination of key words.Expert opinion: We report that the overall awareness of COPD is low at all levels. There are several reasons such as poverty, illiteracy, societal beliefs, cultural beliefs, and misconceptions. This is associated with increase in suffering, deaths, and economic loss, due to poor adaption correct prescription and compliance to treatment. And very little is being done to improve the current status. COPD needs to be highlighted in the national programs in LMICs.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"721-733"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157047","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

Correction. 更正。

Expert review of respiratory medicine Pub Date : 2024-09-01 Epub Date: 2024-07-30 DOI: 10.1080/17476348.2024.2385771

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Advances in lung cancer surgery: the role of segmentectomy in early-stage management. 肺癌手术的进展：分段切除术在早期治疗中的作用。

Expert review of respiratory medicine Pub Date : 2024-09-01 Epub Date: 2024-03-08 DOI: 10.1080/17476348.2024.2324083

Luca Bertolaccini, Monica Casiraghi, Clarissa Uslenghi, Cristina Diotti, Antonio Mazzella, Giovanni Caffarena, Lorenzo Spaggiari

引用次数: 0

New methods to detect bacterial or viral infections in patients with chronic obstructive pulmonary disease. 检测慢性阻塞性肺病患者细菌或病毒感染的新方法。

Expert review of respiratory medicine Pub Date : 2024-09-01 Epub Date: 2024-08-29 DOI: 10.1080/17476348.2024.2396413

John C Hu, Sanjay Sethi

{"title":"New methods to detect bacterial or viral infections in patients with chronic obstructive pulmonary disease.","authors":"John C Hu, Sanjay Sethi","doi":"10.1080/17476348.2024.2396413","DOIUrl":"10.1080/17476348.2024.2396413","url":null,"abstract":"Introduction: Patients with chronic obstructive pulmonary disease (COPD) are frequently colonized and infected by respiratory pathogens. Identifying these infectious etiologies is critical for understanding the microbial dynamics of COPD and for the appropriate use of antimicrobials during exacerbations.Areas covered: Traditional methods, such as bacterial and viral cultures, have been standard in diagnosing respiratory infections. However, these methods have significant limitations, including lack of sensitivity and prolonged turnaround time. Modern molecular approaches offer rapid, sensitive, and specific detection, though they also come with their own challenges. This review explores and evaluates the clinical utility of the latest advancements in detecting bacterial and viral respiratory infections in COPD, encompassing molecular techniques, biomarkers, and emerging technologies.Expert opinion: In the evolving landscape of COPD management, integrating molecular diagnostics and emerging technologies holds great promise. The enhanced sensitivity of molecular techniques has significantly advanced our understanding of the role of microbes in COPD. However, many of these technologies have primarily been developed for pneumonia diagnosis or research applications, and their clinical utility in managing COPD requires further evaluation.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"693-707"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038027","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}

引用次数: 0

Overcoming resistance in small-cell lung cancer. 克服小细胞肺癌的抗药性。

Expert review of respiratory medicine Pub Date : 2024-08-01 Epub Date: 2024-08-11 DOI: 10.1080/17476348.2024.2388288

Gerhard Hamilton, Maximilian J Hochmair, Sandra Stickler

{"title":"Overcoming resistance in small-cell lung cancer.","authors":"Gerhard Hamilton, Maximilian J Hochmair, Sandra Stickler","doi":"10.1080/17476348.2024.2388288","DOIUrl":"10.1080/17476348.2024.2388288","url":null,"abstract":"Introduction: Small-cell lung cancer (SCLC) accounts for 15% of lung cancers and has a dismal prognosis due to early dissemination and acquired chemoresistance. The initial good response to chemotherapy is followed by refractory relapses within 1-2 years. Mechanisms leading to chemoresistance are not clear and progress is poor.Areas covered: This article reviews the current evidence of the resistance of SCLCs at the cellular level including alteration of key proteins and the possible presence of cancer stem cells (CSCs). Without compelling evidence for cellular mechanisms and clinical failures of novel approaches, the study of SCLC has advanced to the role of 3D tumor cell aggregates in chemoresistance.Expert opinion: The scarcity of viable tumor specimen from relapsed SCLC patients has hampered the investigations of acquired chemoresistance but a panel of nine SCLC circulating tumor cell (CTC) cell lines have revealed characteristics of SCLC in the advanced refractory states. The chemoresistance of relapsed SCLC seems to be linked to the spontaneous formation of large spheroids, termed tumorospheres, which contain resistant quiescent and hypoxic cells shielded by a physical barrier. So far, drugs to tackle large tumor spheroids are in preclinical and early clinical development.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"569-580"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891360","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

Imagining the severe asthma decision trees of the future. 畅想未来的重症哮喘决策树

Expert review of respiratory medicine Pub Date : 2024-08-01 Epub Date: 2024-08-20 DOI: 10.1080/17476348.2024.2390987

Arnaud Bourdin, Phil Bardin, Pascal Chanez

{"title":"Imagining the severe asthma decision trees of the future.","authors":"Arnaud Bourdin, Phil Bardin, Pascal Chanez","doi":"10.1080/17476348.2024.2390987","DOIUrl":"10.1080/17476348.2024.2390987","url":null,"abstract":"Introduction: There are no validated decision-making algorithms concerning severe asthma (SA) management. Future risks are crucial factors and can be derived from SA trajectories.Areas covered: The future severe asthma-decision trees should revisit current knowledge and gaps. A focused literature search has been conducted.Expert opinion: Asthma severity is currently defined a priori, thereby precluding a role for early interventions aiming to prevent outcomes such as exacerbations (systemic corticosteroids exposure) and lung function decline. Asthma 'at-risk' might represent the ultimate paradigm but merits longitudinal studies considering modern interventions. Real exacerbations, severe airway hyperresponsiveness, excessive T2-related biomarkers, noxious environments and patient behaviors, harms of OCS and high-doses inhaled corticosteroids (ICS), and low adherence-to-effectiveness ratios of ICS-containing inhalers are predictors of future risks. New tools such as imaging, genetic, and epigenetic signatures should be used. Logical and numerical artificial intelligence may be used to generate a consistent risk score. A pragmatic definition of response to treatments will allow development of a validated and applicable algorithm. Biologics have the best potential to minimize the risks, but cost remains an issue. We propose a simplified six-step algorithm for decision-making that is ultimately aiming to achieve asthma remission.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"561-567"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908628","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