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Topic Review
HRCT of Drug-Induced ILD
Interstitial Lung Diseases (ILDs) represent a heterogeneous group of pathologies, which may be related to different causes. A low percentage of these lung diseases may be secondary to the administration of drugs or substances. Several different high resolution computed tomography (HRCT) patterns related to pulmonary drug toxicity have been reported in literature, and the most frequent ILDs patterns reported include Nonspecific Interstitial Pneumonia (NSIP), Usual Interstitial Pneumonia (UIP), Hypersensitivity Pneumonitis (HP), Organizing Pneumonia (OP), Acute Respiratory Distress Syndrome (ARDS), and Diffuse Alveolar Damage (DAD). 
  • 838
  • 14 Jul 2021
Topic Review
Management of Obstructive Sleep Apnea with Comorbidities
Obstructive sleep apnea (OSA) is a common disease that is often under-diagnosed and under-treated in all ages. Personalized medicine in OSA should focus on the management of patients’ comorbidities. Comorbidities of OSA are more common in adult or elderly patients than children. These include chronic respiratory diseases, cardiovascular diseases, and endocrinological or neurological disorders. The optimal management of OSA, using a personalized approach, should target comorbidities which may improve patient outcomes.
  • 764
  • 21 Dec 2022
Topic Review
COPD T-cells and Comorbidity Biomarkers
In smoking-induced chronic obstructive pulmonary disease (COPD), various comorbidities are linked to systemic inflammation and infection-induced exacerbations. The underlying mechanisms are unclear but might provide therapeutic targets. T-cell activity is central in systemic inflammation and for infection-defense mechanisms and might be influenced by comorbidities. Hypothesis: Circulating biomarkers of comorbidities modulate the activity of T-cells of the T-helper type 1 (Th1) and/or T-cytotoxic type 1 (Tc1). T-cells in peripheral blood mononuclear cells (PBMCs) from non-smokers (NS), current smokers without COPD (S), and COPD subjects (total n = 34) were ex vivo activated towards Th1/Tc1 and were then stimulated with biomarkers for metabolic and/or cardiovascular comorbidities (Brain Natriuretic Peptide, BNP; chemokine (C-C motif) ligand 18, CCL18; C-X3-C motif chemokine ligand 1, CX3CL1; interleukin-18, IL-18) or for asthma- and/or cancer-related comorbidities (CCL22; epidermal growth factor, EGF; IL-17; periostin) each at 10 or 50 ng/mL. The Th1/Tc1 activation markers interferon-γ (IFNγ), tumor necrosis factor-α (TNFα), and granulocyte-macrophage colony-stimulating factor (GM-CSF) were analyzed in culture supernatants by Enzyme-Linked Immunosorbent Assay (ELISA). Ex-vivo activation induced IFNγ and TNFα without differences between the groups but GM-CSF more in S vs. NS. At 10 ng/mL, the different biomarkers increased or reduced the T-cell activation markers without a clear trend for one direction in the different categories of comorbidities or for the different T-cell activation markers. At 50 ng/mL, there was a clear shift towards suppressive effects, particularly for the asthma— and cancer-related biomarkers and in cells of S and COPD. Comorbidities might suppress T-cell immunity in COPD. This could explain the association of comorbidities with frequent exacerbations.
  • 732
  • 14 Jul 2021
Topic Review
Dry Powder Inhaler Products
Dry powder inhalers (DPIs) are drug–device combination products where the complexity of the formulation, its interaction with the device, and input from users play important roles in the drug delivery. As the landscape of DPI products advances with new powder formulations and novel device designs, understanding how these advancements impact performance can aid in developing generics that are therapeutically equivalent to the reference listed drug (RLD) products. 
  • 732
  • 24 Nov 2022
Topic Review
Mycobacterium Tuberculosis Complex
The Mycobacterium tuberculosis complex (MTBC) is a group of bacteria that cause tuberculosis (TB) in diverse hosts, including captive and free-ranging wildlife species. There is significant research interest in developing immunodiagnostic tests for TB that are both rapid and reliable, to underpin disease surveillance and control.
  • 704
  • 04 Aug 2021
Topic Review
Inspiratory Muscle Training in Patients with Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous disease, with pulmonary and extrapulmonary manifestations, which leads to the need to personalize the assessment and treatment of these patients. The latest updates of national and international guidelines for the management of COPD reveal the importance of respiratory rehabilitation (RR) and its role in improving symptoms, quality of life, and psychosocial sphere of patients. Within RR, the inspiratory muscle training (IMT) has received special interest, showing benefits in maximum inspiratory pressure, perception of well-being, and health status in patients with chronic heart disease, respiratory diseases, and dyspnea during exercise. 
  • 701
  • 20 May 2022
Topic Review
Role of Short-Chain Fatty Acids in COPD
Chronic obstructive pulmonary disease (COPD) is a widespread socially significant disease. The development of COPD involves the innate immune system. The regulation of the innate lung immune system is related to the gut microbiota. This connection is due to the production by gut microorganisms of short-chain fatty acids (SCFAs) such as acetate, propionate, and butyrate. Nutritional disturbances and changes in the structure of the intestinal microbiota lead to a decrease in SCFAs production and their effect on pulmonary immunity. The presence of a metabolic and immune axis linking the lungs and gut plays an important role in the pathogenesis of COPD. 
  • 697
  • 27 Jul 2022
Topic Review
Chronic High Fructose Intake in Beverages and SARS-CoV-2
Fructose intake from SSBs increased during the COVID-19 lockdown. Chronic high intake of fructose activates several damage-associated processes of lung injury, including renin-angiotensin system (RAS) activation, uric acid (UA) levels, aldose reductase (AR) activity, and advanced glycation end products (AGEs) production. These molecular mechanisms are involved in lung injury induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. 
  • 686
  • 12 Jan 2023
Topic Review
Management of Obstructive Sleep Apnea in Adults
Obstructive sleep apnea (OSA) is a common disease that is often under-diagnosed and under-treated in all ages. The conventional diagnostic and therapeutic approaches for adults with OSA are usually based on clinical assessments, followed by polysomnography (PSG) or respiratory polygraphy (RPG) in a sleep lab or at home (HSAT: home sleep apnea testing), and treatment decisions. With this approach, it could be unadvisable for physicians to decide the treatment approach for OSA without evaluating AHI.
  • 684
  • 21 Dec 2022
Topic Review
Comorbid Insomnia and Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) and insomnia are the two most common sleep disorders among the general population, and they may often coexist in patients with sleep-disordered breathing (SDB). The higher prevalence of insomnia symptoms in patients with OSA (40–60%) compared to that observed in the general population has thus led researchers to identify a new disorder named comorbid insomnia and OSA (COMISA), whose true burden has been so far largely underestimated. The combined treatment of COMISA patients with positive-airway pressure ventilation (PAP) with cognitive behavioral therapy for insomnia (CBTi) has shown a better patient outcome compared to that obtained with a single treatment. Furthermore, recent evidence has shown that an innovative patient-centered approach taking into consideration patient characteristics, treatment preferences and accessibility to treatment is recommended to optimize clinical management of COMISA patients. However, in this complex mosaic, many other sleep disorders may overlap with COMISA, so there is an urgent need for further research to fully understand the impact of these therapies on outcomes for OSA patients with comorbidity. In light of this need, the major sleep disorders comorbid with OSA and the recent advances in the management of these insomniac patients are discussed. 
  • 674
  • 06 Mar 2023
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