Abstract:
PURPOSE OF REVIEW:Glucocorticosteroids (GCSs) remain the cornerstone of therapy for treating the inflammatory component of asthma. Clinical response to GCS is heterogeneous, varying both within asthma 'endotypes', as well as the same individual. Different factors and micro-environment can alter the canonical GCS-induced signalling pathways leading to reduced efficacy, collectively termed as GCS subsensitivity, which includes the entire spectrum of steroid insensitivity and steroid resistance. RECENT FINDINGS:In the past, steroid subsensitivity has been associated with dysregulated expression of glucocorticoid-receptor isoforms, neutrophilic inflammation and Th17 cytokines, oxidative stress-inducing factors and their downstream effect on histone deacetylase activities and gene expression. The review highlights recent observations, such as GCS-induced dysregulation of key transcription factors involved in host defence, role of airway infections altering expression of critical regulatory elements like the noncoding microRNAs, and the importance of interleukin (IL)-10 in reinstating steroid response in key immune cells. Further, emerging concepts of autoimmunity triggered because of delayed resolution of eosinophilic inflammation (due to GCS subsensitivity) and observed lymphopenia (plausibly a side-effect of continued GCS use) are discussed. SUMMARY:This review bridges concepts that have been known, and those under current investigation, providing both molecular and clinical insights to aid therapeutic strategies for optimal management of asthmatics with varying degree of steroid subsensitivity and disease severity, with particular emphasis on the PI3 kinase pathways.
journal_name
Curr Opin Pulm Medjournal_title
Current opinion in pulmonary medicineauthors
Mukherjee M,Svenningsen S,Nair Pdoi
10.1097/MCP.0000000000000337subject
Has Abstractpub_date
2017-01-01 00:00:00pages
78-88issue
1eissn
1070-5287issn
1531-6971journal_volume
23pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:This review presents recent advances in the study of the depression that is so often co-morbid with chronic obstructive pulmonary disease. The discussion includes prevalence, etiology, impact and management. RECENT FINDINGS:Efforts continue to find a reliable prevalence rate for co-morbid depression ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000208450.50231.c6
更新日期:2006-03-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide an update on the implementation of precision medicine, based on treatable traits and mechanisms, in the daily clinical management of chronic airways diseases. RECENT FINDINGS:Recent insights into the complex and heterogeneous nature of chronic airway diseases including chronic obstructive ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000639
更新日期:2020-01-01 00:00:00
abstract:PURPOSE OF REVIEW:The assessment of pretest probability, allowing the categorization of patients clinically suspected of having pulmonary embolism in low, intermediate, and high clinical probability, is an essential step in contemporary diagnostic strategies because it permits limiting the number of additional diagnost...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000130329.21799.7b
更新日期:2004-09-01 00:00:00
abstract:PURPOSE OF REVIEW:This review highlights recent developments in liver disease associated with cystic fibrosis. RECENT FINDINGS:The broad spectrum of hepatobiliary problems in cystic fibrosis includes specific alterations ascribable to the underlying defect as well as lesions of iatrogenic origin or that reflect the ef...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e3282f10a16
更新日期:2007-11-01 00:00:00
abstract::Thoracic empyema remains a significant medical problem in 1996. Patients in whom empyema develops suffer significant morbidity, frequently require prolonged hospitalizations, and are at an increased risk of death. In this review of parapneumonic effusions and empyema, four topics are discussed: diagnosis of empyema, t...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-07-01 00:00:00
abstract:PURPOSE OF REVIEW:In this review, we describe the 'state-of-the-art' in our knowledge of asthma and what gaps exist, which can be exploited in the future for effective translation of our knowledge from the bench or population studies to diagnosis and therapy. RECENT FINDINGS:The advent of microbiome research has expan...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32834dccc0
更新日期:2012-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Idiopathic pulmonary fibrosis (IPF) is a progressive, invariably fatal condition with a median survival from diagnosis of only 3 years. Despite improvements in disease understanding, challenges remain in establishing a diagnosis and predicting prognosis in individual patients. Furthermore, limited und...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328363f4b7
更新日期:2013-09-01 00:00:00
abstract:PURPOSE OF REVIEW:This article aims to review the most recent proteomic findings in tissue and biological fluids and application of new technologies for the study of interstitial lung diseases. RECENT FINDINGS:New insights into lung cell biology as well as novel pathogenetic pathways of different interstitial lung dis...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32832ea4f2
更新日期:2009-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Adherence to asthma therapies is poor leading to unnecessary morbidity and increased use of emergency and hospital resources. Strategies to improve adherence have not been successful. RECENT FINDINGS:Asthma adherence disease management is a clinical method to improve adherence for asthma patients. Th...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000128
更新日期:2015-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Nowadays tuberculosis is becoming a worldwide problem, and according to the World Health Organization, which declared tuberculosis a global health emergency in 1993, each year 8 million people worldwide develop the active disease and almost 3 million die. RECENT FINDINGS:Due to this problem there is ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000219264.42686.c9
更新日期:2006-05-01 00:00:00
abstract::One aim of caring for adults and children with asthma should be the identification and treatment of the functional impairments that are troublesome to these patients in their daily lives. Studies have shown that correlations between measures of clinical asthma severity and control and health-related quality of life (H...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199903000-00005
更新日期:1999-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Malignant pleural effusion (MPE) is common. However, regardless of the differences between patients, their underlying cancer type, and pleural fluid characteristics, management options are often limited. These have not advanced significantly over the last 80 years since pleurodesis was first described...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e3283615b67
更新日期:2013-07-01 00:00:00
abstract::Many individuals are now surviving their injuries to face the consequences of an activated immunoinflammatory system and the complications of supportive therapy. The pulmonary system bears the force of this insult. An understanding of the epidemiology of acute respiratory failure, as well as a greater knowledge of the...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199705000-00008
更新日期:1997-05-01 00:00:00
abstract::Pulmonary function changes in interstitial lung disease are characterized by loss of lung volume, increase in ratio of forced expiratory volume in 1 second to forced vital capacity, and decrease in carbon monoxide diffusion capacity. Recent developments in the assessment of respiratory mechanics in infiltrative lung d...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199609000-00005
更新日期:1996-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Cancer patients with venous thromboembolism (VTE) are at increased risk of mortality. Estimating the risks for specific causes of death may help to weigh the risks and benefits of different therapeutic strategies in an individual patient. RECENT FINDINGS:In the Registro Informatizado de la Enfermedad...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32835463a4
更新日期:2012-09-01 00:00:00
abstract:PURPOSE OF REVIEW:To examine the recent advancements of the epidemiology, pathophysiology, clinical characteristics, radiographic studies, diagnostic modalities, treatment, and prognosis of pulmonary hypertension in sarcoidosis. RECENT FINDINGS:A large retrospective study found 73.8% of patients with sarcoidosis liste...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328273bc5c
更新日期:2007-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Global climate change and population explosion leading to changes in natural ecosystem and travel across the continents have resulted in an increase in the transmission of parasites to human beings. This review focuses on recent advancements in parasitic lung infections. RECENT FINDINGS:Invasive para...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328326f3f8
更新日期:2009-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Ever since sarcoidosis was first described, its relationship with tuberculosis has been debated. Whereas some consider sarcoidosis and tuberculosis as two extremes of the same disease process, other researchers have negated the role of mycobacteria in causation of sarcoidosis. Whether or not linked ca...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e3283560809
更新日期:2012-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Accurate diagnosis of interstitial lung diseases (ILDs) can be challenging, and a substantial percentage of ILD patients remain unclassifiable even after thorough assessment by an experienced multidisciplinary team. In this review, we summarize the recent literature on the definition, prevalence, diag...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000509
更新日期:2018-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Pleural effusions are frequent in the context of acute idiopathic pericarditis and following pericardiotomy, but they have seldom been characterized. This review summarizes their most relevant clinical features. RECENT FINDINGS:In acute idiopathic pericarditis, pleural effusions tend to be left-sided...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000383
更新日期:2017-07-01 00:00:00
abstract:PURPOSE OF REVIEW:This article reviews current data on pathophysiologic mechanisms by which sleep-disordered breathing during pregnancy may cause harm, and explores biological pathways for associated adverse maternal and fetal outcomes, especially pregnancy-induced hypertension and gestational diabetes. RECENT FINDING...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32833f0d55
更新日期:2010-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Heparin-induced thrombocytopenia is a severe side effect of treatment with unfractionated heparin. The relation of low-molecular-weight heparin to heparin-induced thrombocytopenia is less well understood. This review will summarize what is known about the similarities and differences between thrombocy...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/01.mcp.0000174232.78219.03
更新日期:2005-09-01 00:00:00
abstract::The pleural space in healthy humans was thought to contain a few milliliters of fluid, based on extrapolation from animal studies. However, because of the obvious technical difficulties in atraumatically retrieving such a small volume of fluid, the exact volume and cellular content of human pleural fluid has not been ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-200107000-00002
更新日期:2001-07-01 00:00:00
abstract::Parapneumonic effusions are frequent complications of bacterial pneumonia. Depending on the severity of the underlying pneumonia, the promptness of antibiotic therapy, and the virulence of the infecting organism, 5% to 50% of patients will require pleural fluid drainage to prevent progression to an empyema. The decisi...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/00063198-199605000-00007
更新日期:1996-05-01 00:00:00
abstract:PURPOSE OF REVIEW:This article explains the high comorbidity of craniofacial pain (chronic face pain, temporomandibular disorders, and primary headaches) with obstructive sleep breathing disorders and obstructive sleep apnea (OSA). It is recommended that physicians treating OSA should be aware of the concurrent chronic...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0000000000000325
更新日期:2016-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review is to provide an update on the diagnosis and classification of interstitial lung disease (ILD), with a specific focus on newly described ILD subtypes and phenotypes. In addition, the strengths and limitations of the current approach to ILD diagnosis and management are discus...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328363f48d
更新日期:2013-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Malignant central airway obstruction heavily impacts patients' quality of life and its management continues to be a challenge. The current article will review the use of airway stents in this population. RECENT FINDINGS:Airway stenting is highly effective in palliating symptoms of airway obstruction....
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32833a260
更新日期:2010-07-01 00:00:00
abstract:PURPOSE OF REVIEW:This review highlights recent data detailing the prevalence and characteristics of pleural effusions occurring in patients with superior vena cava syndrome. RECENT FINDINGS:Numerous case reports have described pleural effusions in conjunction with the superior vena cava syndrome. Recent data suggest ...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e32812144aa
更新日期:2007-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Recent work demonstrates that patients with refractory asthma are likely to be sensitized to environmental fungi and that specific antifungal treatments may be of benefit to this group. RECENT FINDINGS:The relationships among fungal sensitization, exposure and asthma severity are imperfectly understo...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章,评审
doi:10.1097/MCP.0b013e328333900a
更新日期:2010-01-01 00:00:00
abstract:PURPOSE OF REVIEW:To review and compare the constellations of causes and consequences of the two current pandemics, Covid-19 and climate change. RECENT FINDINGS:There has been a transient counterbalancing, in which the response to Covid-19 has briefly mitigated pollution and greenhouse gasses. This divergence belies m...
journal_title:Current opinion in pulmonary medicine
pub_type: 杂志文章
doi:10.1097/MCP.0000000000000756
更新日期:2021-03-01 00:00:00