Expert review of respiratory medicine最新文献_第9页

Small RNA-based formulations in precision cut lung slices - is there an alternative for in vivo/in vitro studies? 精确切割肺切片中的小rna制剂-体内/体外研究是否有替代方案？

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-05-01 Epub Date: 2025-12-08 DOI: 10.1080/17476348.2025.2600109

Joanna Nowakowska-Lewicka, Aleksandra Szczepankiewicz

{"title":"Small RNA-based formulations in precision cut lung slices - is there an alternative for in vivo/in vitro studies?","authors":"Joanna Nowakowska-Lewicka, Aleksandra Szczepankiewicz","doi":"10.1080/17476348.2025.2600109","DOIUrl":"10.1080/17476348.2025.2600109","url":null,"abstract":"Introduction: Precision cut lung slices (PCLS) are ex vivo models to study lung diseases. They have numerous advantages related to the presence of different cell types and extracellular matrix. They are an excellent platform to study the biological effects of delivering small molecules with therapeutic potential, such as non-coding RNAs. The aim of this review is to summarize the miRNA and siRNA research on the PCLS model to date and consider therapeutic potential of the proposed solutions.Areas covered: The review focuses on the methodological aspects of delivery of RNA-based formulations, such as miRNA and siRNA, in the PCLSs model. It covers the area of RNA/miRNA isolation from PCLSs and methods of delivering miRNA and siRNA to PCLSs. Analysis of the reported solutions indicated the need for standardization, regarding the information on transfection efficacy at the RNA and protein levels is incomplete.Expert opinion: PCLSs are a promising model for studying small RNA-based drug delivery systems. However, existing models require consistent criteria and methods to assess the biological effect. Because of the heterogeneity of PCLS slices within the single studies, future experiments would benefit from including more independent replicates performed using different methods, in order to improve their reproducibility.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"535-541"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679806","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

Adult asthma in Greece: prevalence, comorbidities, and risk factors. 希腊成人哮喘：患病率、合并症和危险因素

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-05-01 Epub Date: 2025-11-29 DOI: 10.1080/17476348.2025.2595726

Ioannis Tomos, Georgia Vourli, Eleni Peppa, Antonia Trichopoulou

{"title":"Adult asthma in Greece: prevalence, comorbidities, and risk factors.","authors":"Ioannis Tomos, Georgia Vourli, Eleni Peppa, Antonia Trichopoulou","doi":"10.1080/17476348.2025.2595726","DOIUrl":"10.1080/17476348.2025.2595726","url":null,"abstract":"Introduction: Asthma still represents a crucial public health challenge with significant health consequences. The study aims to estimate the prevalence of physician-diagnosed self-reported asthma in Greece and to unravel comorbid conditions and risk factors.Research design and methods: The HYDRIA survey was the first national project on the health of the population in Greece. Data regarding demographic, lifestyle characteristics, and medical history were recorded through personal interviews from June 2013 to December 2014. Weighting factors were applied to ensure national representativeness of results.Results: The study includes 4011 men and women. The estimated prevalence of self-reported physician-diagnosed asthma was 8.6% (95% CI: 7.5-9.8%). The most frequent comorbidity was allergic rhinitis, reaching a prevalence of 47.3%. Individuals with asthma reported a significantly higher percentage of perceived restrictions in daily activities (p-value < 0.001). They presented double the risk of having restrictions [2.04 (95% CI: 1.52-2.74); p-value < 0.001]. Age and atopy were significant predictors, however, an interaction indicated that the effect of atopy decreases with age (p for interaction = 0.037).Conclusions: The estimated prevalence of self-reported physician-diagnosed asthma in Greece is 8.6%. Atopy, especially in young age, and age represent risk factors for asthma. Patients with asthma experience double the risk of having restrictions on daily activities compared to individuals without asthma.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"601-608"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598391","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

What constitutes an obstructive ventilatory impairment in a pediatric population? A comparative study of five definitions by scholarly societies. 在儿科人群中，什么构成阻塞性通气障碍？学术团体五种定义的比较研究。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-05-01 Epub Date: 2025-11-28 DOI: 10.1080/17476348.2025.2594207

Mariem Abdesalem, Ines Ghannouchi, Amine Souissi, Nadia Lazreg, Sonia Rouatbi, Helmi Ben Saad

{"title":"What constitutes an obstructive ventilatory impairment in a pediatric population? A comparative study of five definitions by scholarly societies.","authors":"Mariem Abdesalem, Ines Ghannouchi, Amine Souissi, Nadia Lazreg, Sonia Rouatbi, Helmi Ben Saad","doi":"10.1080/17476348.2025.2594207","DOIUrl":"10.1080/17476348.2025.2594207","url":null,"abstract":"Introduction: To ascertain the frequency of obstructive ventilatory impairment (OVI) among children/adolescents referred for spirometry, using definitions provided by various international respiratory societies.Methods: This cross-sectional, bi-centric study included 602 children/adolescents aged 6 to 18 years. Subjects completed a medical questionnaire, and clinical and anthropometric data were collected. Spirometric measurements were performed using two spirometers. OVI was assessed using five definitions: i) 2023-Global Initiative for Asthma (GINA): FEV1 < 80% and FEV1/FVC ≤ 0.90; ii) Irish College of General Practitioners (ICGP): FEV1/FVC < 0.70; iii) European Respiratory Society and American Thoracic Society (ERS-ATS): FEV1/FVC z-score < -1.645; iv) National Institute for Health and Care Excellence (NICE): FEV1/FVC < 0.70 or FEV1/FVC z-score < -1.645; and v) Canadian Thoracic Society (CTS): FEV1/FVC < 0.80 or a FEV1/FVC z-score < -1.645.Results: The frequency of OVI varied significantly (Chi-square test < 0.001) depending on the definition applied: ICGP (7.6%), ERS-ATS or NICE (19.3%), 2023-GINA (24.9%), and CTS (27.9%). This indicated that the definitions are not equivalent in identifying OVI.Conclusion: The rate of OVI in pediatric populations varies considerably based on the diagnostic criteria used. Clinicians and researchers should therefore interpret prevalence data cautiously and always specify which definition was applied.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"591-600"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598394","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

Harnessing breath biomarkers for pneumonia diagnosis and prognosis. 利用呼吸生物标志物进行肺炎诊断和预后。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-05-01 Epub Date: 2025-11-26 DOI: 10.1080/17476348.2025.2593629

Cosby G Arnold, Mitchell M McCartney, Cristina E Davis, Joseph P Mizgerd, Nicholas J Kenyon

{"title":"Harnessing breath biomarkers for pneumonia diagnosis and prognosis.","authors":"Cosby G Arnold, Mitchell M McCartney, Cristina E Davis, Joseph P Mizgerd, Nicholas J Kenyon","doi":"10.1080/17476348.2025.2593629","DOIUrl":"10.1080/17476348.2025.2593629","url":null,"abstract":"Introduction: Pneumonia is a major cause of death and disability worldwide. A host of pathogens causes pneumonia, and pneumonia presents with a remarkable heterogeneity of clinical symptoms and signs and has varied outcomes. Current approaches to pneumonia diagnosis and risk stratification lack precision such that there is no universally agreed upon biomarker or scoring system. These limitations have prompted calls for novel, noninvasive, and more precise approaches to better diagnosing pneumonia and predicting outcomes.Areas covered: We performed a comprehensive literature search through PubMed to identify studies reporting on breath biomarkers in pneumonia published up to 31 July 2025. This manuscript explores breath-based metabolomics as a novel approach to biomarker development in pneumonia. It describes breath collection methods, including devices available and types of breath samples for analysis. It reviews the potential role of exhaled breath analysis to expedite pneumonia diagnosis, monitor response to therapy, and predict clinical trajectory.Expert opinion: Breath-based metabolomics could improve the recognition and management of pneumonia. It is a noninvasive, potentially continuous method that provides a direct window into the lung for novel insights into the underlying biology of pneumonia.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"491-500"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12688321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590472","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

Indwelling pleural catheters for the treatment of malignant pleural effusions; where are we now? 胸腔留置导尿管治疗恶性胸腔积液我们现在在哪里？

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-10-30 DOI: 10.1080/17476348.2025.2582248

William E Thinnes, Jennifer D Duke, James Katsis, Samira Shojaee

{"title":"Indwelling pleural catheters for the treatment of malignant pleural effusions; where are we now?","authors":"William E Thinnes, Jennifer D Duke, James Katsis, Samira Shojaee","doi":"10.1080/17476348.2025.2582248","DOIUrl":"10.1080/17476348.2025.2582248","url":null,"abstract":"Introduction: Malignant pleural effusions (MPE) affect many patients with advanced malignant disease and lead to significant symptomatic burden. Management is primarily focused on controlling symptoms. IPCs are considered an alternative treatment strategy to chemical pleurodesis and in randomized clinical trials, are shown to have comparable outcomes with regards to symptom management such as dyspnea score and quality of life, and are associated with shorter length of hospital stay. Additional studies have examined the optimal drainage strategy for IPCs and the combination of IPC and pleurodesis. The most common complication is infection, and management differs based on the specific infection type. For many patients, IPCs are likely a cost-effective option for management of MPE compared to alternative approaches.Areas covered: This review article details the role of the indwelling pleural catheter (IPC) for symptom control, strategies for management, removal, complications, cost-effectiveness, and future directions.Expert opinion: There are various management options for MPE, each with their own advantages and disadvantages. Management should be personalized, with full knowledge of the patient's life expectancy, pleural space physiology, risks and benefits of each approach, and most importantly patient preferences.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"359-367"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380239","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

Managing treatment failure in pleural infection. 胸膜感染治疗失败的处理。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-12-08 DOI: 10.1080/17476348.2025.2600106

Malvika Bhatnagar, Rebecca Burney, Eihab O Bedawi

{"title":"Managing treatment failure in pleural infection.","authors":"Malvika Bhatnagar, Rebecca Burney, Eihab O Bedawi","doi":"10.1080/17476348.2025.2600106","DOIUrl":"10.1080/17476348.2025.2600106","url":null,"abstract":"Introduction: Pleural infection is a common condition associated with significant morbidity, mortality, and prolonged hospital stay. Whilst antibiotics and chest tube drainage comprise initial management, over one-third of patients experience medical treatment failure, necessitating intrapleural enzyme therapy (IET) or surgery. This review examines advances in diagnosis and management of treatment failure in pleural infection.Areas covered: A literature search of PubMed, Embase, and Cochrane Library (January 2005- April 2025) was performed using keywords related to pleural infection, diagnostics, biomarkers, and treatment interventions. Treatment failure emerged as a multifactorial process involving delayed presentation, structural and physiological barriers such as increased pleural fluid viscosity, septation formation, pleural thickening, and biofilm development, alongside host factors and microbiological complexity. We review current strategies including antibiotics, chest tube drainage, IET (tPA + DNase), and surgical options, alongside emerging modalities such as next-generation sequencing, pleural biopsy, medical thoracoscopy, saline irrigation, and indwelling catheters.Expert opinion: Early identification of treatment failure within 48 hours is crucial for guiding escalation. A precision medicine approach integrating microbiological, radiological, and host-response data may redefine standards of care and improve outcomes. Future priorities include early risk stratification, biomarker-guided therapy, microbiome-informed antibiotic strategies, and improving global access to effective treatments.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"425-436"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673198","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

Mesenchymal stromal cell-derived extracellular vesicles as a next-generation therapy for ARDS: mechanisms, advances, and future directions. 间充质间质细胞衍生的细胞外囊泡作为下一代治疗ards的方法：机制、进展和未来方向。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-11-06 DOI: 10.1080/17476348.2025.2583354

Zaquer Suzana Munhoz Costa-Ferro, Kátia Nunes da Silva, Rachel Santana Cunha, Gabriel Berbert de Oliveira, Pedro Augusto Dias Vieira Leite, Erik Aranha Rossi, Bruno Solano de Freitas Souza, Patricia Rieken Macedo Rocco

{"title":"Mesenchymal stromal cell-derived extracellular vesicles as a next-generation therapy for ARDS: mechanisms, advances, and future directions.","authors":"Zaquer Suzana Munhoz Costa-Ferro, Kátia Nunes da Silva, Rachel Santana Cunha, Gabriel Berbert de Oliveira, Pedro Augusto Dias Vieira Leite, Erik Aranha Rossi, Bruno Solano de Freitas Souza, Patricia Rieken Macedo Rocco","doi":"10.1080/17476348.2025.2583354","DOIUrl":"10.1080/17476348.2025.2583354","url":null,"abstract":"Introduction: Acute respiratory distress syndrome (ARDS) is a life-threatening syndrome characterized by diffuse alveolar damage, severe hypoxemia, and dysregulated inflammation. Despite improvements in lung-protective ventilation and supportive care, mortality remains high, highlighting the need for therapies targeting core mechanisms of injury and repair. Mesenchymal stromal cells (MSCs) have demonstrated therapeutic potential largely via paracrine mechanisms, with extracellular vesicles (EVs) emerging as a cell-free alternative that retains key MSC benefits while overcoming limitations related to cell viability, engraftment, and scalability.Areas covered: This review synthesizes current evidence on MSC-derived EVs (MSC-EVs) in ARDS, encompassing mechanisms of action, preclinical efficacy, delivery strategies, and translational challenges. Studies published from 2015 to 2025 were retrieved from PubMed, Web of Science, and ClinicalTrials.gov. Emphasis is placed on immunomodulatory effects, restoration of alveolar - capillary barrier integrity, and transfer of functional proteins, mRNAs, and microRNAs.Expert opinion: MSC-EVs represent a promising, disease-modifying therapy with potential to reduce ventilation duration, extracorporeal support, and overall healthcare burden. Key challenges remain, including standardized manufacturing, validated potency assays, and identification of patient selection biomarkers. Integration of bioengineering innovations, GMP-compliant production pipelines, and stratified clinical trial designs will be critical to accelerate translation and enable definitive evaluation in late-phase studies.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"407-423"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403304","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

Is dual bronchodilation a cost-effective alternative to ICS/LABA in COPD? A Colombian healthcare system evaluation. 对于慢性阻塞性肺病患者，双重支气管扩张是ICS/LABA的一种经济有效的替代方案吗？哥伦比亚医疗保健系统评估。

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-10-30 DOI: 10.1080/17476348.2025.2582249

Jefferson Antonio Buendía, Diana Guerrero Patiño

{"title":"Is dual bronchodilation a cost-effective alternative to ICS/LABA in COPD? A Colombian healthcare system evaluation.","authors":"Jefferson Antonio Buendía, Diana Guerrero Patiño","doi":"10.1080/17476348.2025.2582249","DOIUrl":"10.1080/17476348.2025.2582249","url":null,"abstract":"Background: Chronic obstructive pulmonary disease (COPD) is a major public health challenge in Colombia, particularly among older adults. Although ICS/LABA combinations like fluticasone/salmeterol (FSC) are widely used, dual bronchodilation with umeclidinium/vilanterol (UMEC/VI) may offer clinical and economic advantages.The objective of this paper is to evaluate the long-term cost-effectiveness of UMEC/VI versus FSC in patients with moderate to severe COPD from the perspective of the Colombian healthcare system.Methods: A Markov model with four health states (moderate, severe, very severe COPD, and death) simulated the disease course over a lifetime horizon. Clinical efficacy and utilities were derived from randomized trials and meta-analyses; costs were sourced from national databases. Deterministic and probabilistic sensitivity analyses assessed uncertainty. The economic advantage of UMEC/VI was primarily driven by its ability to reduce moderate and severe exacerbations, which represent nearly 88% of total COPD-related healthcare costs in Colombia.Results: UMEC/VI yielded 8.74 additional QALYs compared to FSC, with an incremental cost of $7,039 USD, resulting in an ICER of $805 per QALY-well below Colombia's WTP threshold of $5,180. Sensitivity analyses confirmed model robustness; UMEC/VI remained cost-effective in 64% of simulations.Conclusion: UMEC/VI is a highly cost-effective alternative to FSC for moderate to severe COPD in Colombia, offering improved clinical outcomes and economic value for resource-constrained health systems.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"447-455"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380349","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 prevalence of and risk factors for bronchiectasis in inflammatory bowel disease: a chest CT-based case-control study. 炎症性肠病中支气管扩张的患病率和危险因素：一项基于胸部ct的病例对照研究

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-10-21 DOI: 10.1080/17476348.2025.2576337

Jiaqi Ren, Lina Sun, Meijiao Li, Xun Liu, Shigang Ding, Yongchang Sun

{"title":"The prevalence of and risk factors for bronchiectasis in inflammatory bowel disease: a chest CT-based case-control study.","authors":"Jiaqi Ren, Lina Sun, Meijiao Li, Xun Liu, Shigang Ding, Yongchang Sun","doi":"10.1080/17476348.2025.2576337","DOIUrl":"10.1080/17476348.2025.2576337","url":null,"abstract":"Background: To identify the prevalence, clinical and imaging characteristics, and the risk factors for bronchiectasis in IBD.Research design and methods: We retrospectively enrolled IBD patients from 1 January 2020 to 1 July 2022. Chest HRCT was evaluated for the presence and severity of bronchiectasis. The clinical characteristics were compared between the IBD patients with and without bronchiectasis.Results: Among the 429 IBD patients, 34.5% showed bronchiectasis on chest HRCT. Four main imaging characteristics of bronchiectasis showed in IBD patients: multiple lobe involvement: 72.3% (107/148) of the patients had ≥2 lobes involved; Central predominance (>50%) in distribution; Mostly cylindrical bronchiectasis (>90%); Mild severity in most cases with Smith score <4 and Bhalla score of one point. Multi-factor logistic regression analysis showed that age of IBD onset ≥35 years (OR = 2.05, 95%CI 1.26-3.32), history of immunosuppressant therapy (OR = 3.93, 95%CI 2.12-7.27), ESR > 20 mm/h (OR = 2.01, 95%CI 1.21-3.33) and positive ASCA (OR = 1.37, 95% CI 1.06-1.77) were independently associated with the presence of bronchiectasis in IBD.Conclusions: More than 1/3 IBD patients in our cohort presented bronchiectasis on chest HRCT, with almost no respiratory symptoms and the mild degree of bronchiectasis, which is easily overlooked. IBD patients may need routine chest HRCT scanning for bronchiectasis.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"457-465"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294929","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

Treatment options for children with pulmonary arterial hypertension associated with congenital heart disease. 儿童肺动脉高压合并先天性心脏病的治疗方案

IF 2.7

Expert review of respiratory medicine Pub Date : 2026-04-01 Epub Date: 2025-10-30 DOI: 10.1080/17476348.2025.2581340

Julie Wacker, Raphael Joye, Maurice Beghetti

{"title":"Treatment options for children with pulmonary arterial hypertension associated with congenital heart disease.","authors":"Julie Wacker, Raphael Joye, Maurice Beghetti","doi":"10.1080/17476348.2025.2581340","DOIUrl":"10.1080/17476348.2025.2581340","url":null,"abstract":"Introduction: Pulmonary hypertension associated with congenital heart disease (PAH-CHD) represents one of the leading causes of pediatric pulmonary hypertension. Within this entity, patients can be classified into distinct subgroups, each characterized by specific clinical features, pathophysiological mechanisms, and therapeutic approaches.Areas covered: This review provides an update of the current PAH-CHD classification and outlines management strategies in accordance with the most recent international recommendations. Particular attention is given to the ongoing debate regarding operability in patients with open shunts and some degree of increased pulmonary vascular resistance, and key gaps in knowledge are highlighted.Expert opinion: In PAH-CHD, treatment strategies are relatively straightforward in patients with low PVR, where shunt closure is recommended, and in Eisenmenger syndrome, where shunt patency is maintained and pulmonary vasodilators are indicated; however, the management of patients with open shunts and moderately elevated PVR remains highly challenging. Operability in this intermediate group is currently determined by invasive hemodynamic assessment, despite methodological limitations, highlighting the urgent need for reliable noninvasive markers and prospective clinical studies in late-referred patients. Emerging therapies such as sotatercept, along with the development of novel biomarkers to assess pulmonary vascular disease severity may have the potential to redefine operability criteria and expand therapeutic options.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"369-377"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395848","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