Expert Review of Respiratory Medicine

Optimizing protective ventilation in adults with acute brain injury--challenging misconceptions and prioritizing neuromonitoring
Goossen RL, Schultz MJ, van Meenen DMP, Horn J, Rocco PR and Robba C
Long COVID: a consequence of chronic post-infectious inflammation!
Blondeau JM
Long COVID defines persistence of symptoms in patients that recovered from acute COVID-19 infections. This manuscript is a brief update on current thinking on long COVID and potential causes and consequences.
Pulmonary tuberculosis in non-HIV adults: an evergreen old-fashioned disease in high-income countries. A narrative review
Guerrieri M, Bargagli E, Cassai L, Gangi S, Genovese M, Viani M and Melani AS
Tuberculosis (TB), an infective air-borne disease with worldwide non-homogeneous distribution, remains a top cause of morbidity and mortality. TB control is linked to early diagnosis and proper treatment of contagious TB cases and infected subjects at high risk of developing TB.
Bronchomotor tone imbalance evokes airway hyperresponsiveness
Jude JA and Panettieri RA
Obstructive airway diseases asthma and COPD represent a significant healthcare burden. Airway hyperresponsiveness (AHR), a salient feature of these two diseases, remains the main therapeutic target. Airway smooth muscle (ASM) cell is pivotal for bronchomotor tone and development of AHR in airway diseases. The contractile and relaxation processes in ASM cells maintain a homeostatic bronchomotor tone. It is critical to understand the molecular mechanisms that disrupt the homeostasis to identify novel therapeutic strategies for AHR.
Effects of cystic fibrosis transmembrane conductance regulator potentiators on clinical outcomes of chronic obstructive pulmonary disease: a systematic review and meta-analysis
Yan X, Deqing Q, Yu F, Wang T, Xu D, Wen F and Chen J
Excessive mucus secretion is pivotal in chronic obstructive pulmonary disease (COPD) pathophysiology, particularly in chronic bronchitis phenotypes. Cystic fibrosis transmembrane conductance regulator (CFTR) has been implicated in COPD-related hypersecretion with acquired dysfunction, and emerged as a therapeutic target. However, the clinical efficacy of CFTR-potentiators in COPD remains controversial.
Compatibility of the global lung function 2012 spirometry reference values in children, adolescents and young adults: a systematic review
Weber Santos B, Scalco JC, Parazzi PLF and Schivinski CIS
The Global Lung Function Initiative (GLI 2012) has published multiethnic spirometry reference values. To identify studies that evaluated the compatibility (applicability, validity, representativeness, agreement and/or adequacy) of the reference equations proposed by the GLI 2012 for spirometry tests in different populations.
Advancements and challenges in the management of pneumonia in elderly patients with COPD
Ocrospoma S, Anzueto A and Restrepo MI
Chronic Obstructive Pulmonary Disease (COPD) significantly predisposes the elderly to pneumonia, presenting a complex interplay of pulmonary dysfunction and infection risk.
Recent advances in the use of liquid biopsy for the diagnosis and treatment of lung cancer
Gristina V, Russo G, Bazan Russo TD, Busuito G, Iannì G, Pisapia P, Scimone C, Palumbo L, Incorvaia L, Badalamenti G, Galvano A, Bazan V, Russo A, Troncone G, Malapelle U and Pepe F
In the era of precision medicine, liquid biopsy rapidly emerges as an integrative diagnostic tool to successfully stratify solid tumor patients in accordance with molecular fingerprinting. As the matter of fact, a plethora of analytes may be isolated from liquid biosources supporting the potential application of liquid biopsy in several clinical scenarios. Despite this promising role, liquid biopsy is drastically affected by low abundance of analytes in biological matrix requiring highly sensitive technologies, trained personnel, and optimized diagnostic procedures to successfully administrate this revolutionary diagnostic tool in clinical practice.
Some challenges in implementing updated European respiratory society (ERS)/American thoracic society (ATS)-2022 interpretive strategies for routine pulmonary function tests
Abdesslem M, Barkous B and Ben Saad H
What is new in synthetic lung surfactant protein technology?
Walther FJ, Zasadzinski JA and Waring AJ
Is the nicotine metabolite ratio a useful tool to improve the effectiveness, safety, and adherence to quitting smoking? Systematic review of the literature and meta-analysis
de Granda-Orive JI, Alonso-Arroyo A, López-Padilla D, Aleixandre-Benavent R, Solano-Reina S, Riesco-Miranda JA, Rábade-Castedo C, Jiménez-Gómez M, Revuelta-Salgado F and Jiménez-Ruiz CA
We have carried out a systematic review of the literature (SRL) and a meta-analysis (MA) to answer: 1. Validity of the nicotine metabolite ratio (NMR) in improving the effectiveness of pharmacological treatments (PT) for smoking cessation (SC). 2. Validity of the NMR to improve the safety of the use of these PT? and 3. Validity of NMR in improving adherence to these PT?
An update on endobronchial valve therapy for severe emphysema: real world data and special indications
Sakaguchi T, Hartman JE and Slebos DJ
Bronchoscopic lung volume reduction (BLVR) using one-way endobronchial valves (EBV) is a guideline therapy for patients with severe emphysema without interlobar collateral ventilation, based on solid results from multiple randomized clinical trials (RCTs). However, whether its efficacy and safety in real-world clinical settings are comparable to those observed in RCTs has not been fully investigated. Additionally, recent reports on EBV therapy have focused on specialized populations (e.g. very low FEV, very low D) that were not represented in the RCTs.
Measuring exhaled nitric oxide in COPD: from theoretical consideration to practical views
Högman M, Pham-Ngoc H, Nguyen-Duy B, Ellingsen J, Hua-Huy T, Van Nguyen D and Dinh-Xuan AT
Chronic obstructive pulmonary disease (COPD) is traditionally perceived as Th1-inflammation, but some patients have Th2-inflammation. A high fraction of exhaled nitric oxide (FE) is seen in asthma with Th2-inflammation, justifying FE as a point-of-care biomarker. The use of FE in COPD is much less frequent. We aimed to review the evidence in favor of FE measurement in COPD and discuss its potential usefulness in clinical settings.
Acute respiratory failure in adult patients with acute myeloid leukemia
Chean D, Maillard A, Benattia A, Fodil S and Azoulay E
Patients with acute myeloid leukemia (AML) are at high risk of developing life-threatening complications. It is estimated that a quarter of adult patients diagnosed with AML will require admission to the intensive care unit (ICU) at least once during their disease. Acute respiratory failure (ARF) is the main reason for ICU admission and is associated with high mortality rates, depending on the etiology of ARF.
Inhaled immunosuppressants after lung transplantation -real potential to enhance patient outcomes
Snell GI, Ennis SL and Levvey BJ
Pulmonary rehabilitation guidelines for COPD; where do we go from here?
Vitacca M and Paneroni M
What is the future of inhaled antibiotics for bronchiectasis?
Johnson ED and Chalmers JD
Pulmonary endoscopy - central to an interventional pulmonology program
Griffiths S, Power L and Breen D
Pulmonary endoscopy occupies a central role in Interventional Pulmonology and is frequently the mainstay of diagnosis of respiratory disease, in particular lung malignancy. Older techniques such as rigid bronchoscopy maintain an important role in central airway obstruction. Renewed interest in the peripheral pulmonary nodule is driving major advances in technologies to increase the diagnostic accuracy and advance new potential endoscopic therapeutic options.
Non-invasive respiratory support in elderly hospitalized patients
Coppola S, Radovanovic D, Pozzi T, Danzo F, Rocco C, Lazzaroni G, Santus P and Chiumello D
The proportion of elderly people among hospitalized patients is rapidly growing. Between 7% to 25% of ICU patients are aged 85 and over and noninvasive respiratory support is often offered to avoid the risks of invasive mechanical ventilation or in patients with a 'do-not-intubate' order. However, while noninvasive respiratory support has been extensively studied in the general population, there is limited data available on its efficacy in elderly patients with ARF.
The unique metabolic and lipid profiles of patients with severe COVID-19 compared to severe community-acquired pneumonia: a potential prognostic and therapeutic target
Ibáñez-Prada ED, Guerrero JL, Bustos IG, León L, Fuentes YV, Santamaría-Torres M, Restrepo-Martínez JM, Serrano-Mayorga CC, Mendez L, Gomez-Duque S, Santacruz CA, Conway-Morris A, Martín-Loeches I, Gonzalez-Juarbe N, Cala MP and Reyes LF
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.
Pulmonary rehabilitation and family/friend caregivers: the hidden reciprocal relationship improving outcomes in chronic respiratory diseases
Marques A
The experiences and needs of living with chronic respiratory diseases (CRD) can be overwhelming. Individuals often rely on informal care for daily assistance and having a family/friend caregiver has been associated with better health outcomes. Nevertheless, family/friend caregivers frequently feel alone and unsupported. Pulmonary rehabilitation (PR) leads to multidimensional benefits across CRD and individuals have suggested improvements for PR. Family/friend caregivers highly support PR in practical and psychosocial ways and have identified this intervention as an opportunity to be supported. This reciprocal relationship between PR and the family/friend caregivers has been scarcely explored and its importance for the management of CRD is poorly understood.