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CD206+ macrophages are relevant non-invasive imaging biomarkers and therapeutic targets in experimental lung fibrosis Thorax (IF 9.0) Pub Date : 2024-07-20 Lenny Pommerolle, Guillaume Beltramo, Leo Biziorek, Marin Truchi, Alexandre Magno Maneschy Dias, Lucile Dondaine, Julie Tanguy, Nicolas Pernet, Victor Goncalves, Alexanne Bouchard, Marie Monterrat, Grégoire Savary, Nicolas Pottier, Kjetil Ask, Martin R J Kolb, Bernard Mari, Carmen Garrido, Bertrand Collin, Philippe Bonniaud, Olivier Burgy, Françoise Goirand, Pierre-Simon Bellaye
Background Interstitial lung diseases (ILDs) include a large number of diseases associated with progressive pulmonary fibrosis (PPF), including idiopathic pulmonary fibrosis (IPF). Despite the rarity of each of the fibrotic ILDs individually, they cumulatively affect a considerable number of patients. PPF is characterised by an excessive collagen deposition leading to functional decline. Objectives
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Non-cigarette tobacco products, aryl-hydrocarbon receptor repressor gene methylation and smoking-related health outcomes Thorax (IF 9.0) Pub Date : 2024-07-20 Christina M Eckhardt, Pallavi Balte, Jack E Morris, Surya P Bhatt, David Couper, Jessica Fetterman, Neal Freedman, David R Jacobs, Lifang Hou, Ravi Kalhan, Yongmei Liu, Laura Loehr, Pamela L Lutsey, Joseph E Schwartz, Wendy White, Sachin Yende, Stephanie J London, Tiffany R Sanchez, Elizabeth C Oelsner
Introduction Cigarette smoking leads to altered DNA methylation at the aryl-hydrocarbon receptor repressor (AHRR) gene. However, it remains unknown whether pipe or cigar smoking is associated with AHRR methylation. We evaluated associations of non-cigarette tobacco use with AHRR methylation and determined if AHRR methylation was associated with smoking-related health outcomes. Methods Data were pooled
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Refractory granulomatous Pneumocystis jirovecii pneumonia masquerading as malignancy Thorax (IF 9.0) Pub Date : 2024-07-20 Chi Wan Koo, Ananya Panda, Jennifer Boland Froemming
An elderly female, lifelong non-smoker, with rheumatoid arthritis treated with methotrexate and prednisone for 10 years was referred for evaluation of incidentally detected, randomly distributed pulmonary nodules on a CT performed for pleuritic chest pain and dyspnoea (figure 1A). Subsequent [18F]fluoro-d-glucose (FDG)-positron emission tomography (PET) showed the nodules had increased in size and
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Unusual cause of trepopnea Thorax (IF 9.0) Pub Date : 2024-07-18 Suat Yee Lee, Juo-Hau Su, Chia-Chen Chang, Fatt Yang Chew
A 19-year-old female presented with a 6-month history of progressive shortness of breath. She reported a new onset of palpitations preceding her shortness of breath, which progressed progressively into dull chest pain and trepopnea, and she experienced dyspnoea while lying on her right side. With wheezing and rhinorrhoea, the symptoms became more prominent. She had no previous history of haemoptysis
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Rectal organoid morphometric analysis (ROMA): reoptimising measurements automatically Thorax (IF 9.0) Pub Date : 2024-07-17 Shafagh Waters, Peter G Middleton
Quantification of the physiological changes in people with cystic fibrosis (pwCF) has long been important for clinical diagnosis. Since the original discovery of abnormal sweat electrolytes in pwCF, the standardised pilocarpine iontophoresis sweat test was developed1 to clearly distinguish those with CF. While the sweat chloride test remains an important early step in the diagnostic algorithm, complementary
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Human mesenchymal stromal cells inhibit Mycobacterium avium replication in clinically relevant models of lung infection Thorax (IF 9.0) Pub Date : 2024-08-01 Timothy D Shaw, Anna D Krasnodembskaya, Gunnar N Schroeder, Declan F Doherty, Johnatas Dutra Silva, Shikha M Tandel, Yue Su, David Butler, Rebecca J Ingram, Cecilia M O'Kane
Introduction Novel therapeutic strategies are urgently needed for Mycobacterium avium complex pulmonary disease (MAC-PD). Human mesenchymal stromal cells (MSCs) can directly inhibit MAC growth, but their effect on intracellular bacilli is unknown. We investigated the ability of human MSCs to reduce bacterial replication and inflammation in MAC-infected macrophages and in a murine model of MAC-PD. Methods
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Children’s interstitial lung disease (chILD): less rare than we thought? Thorax (IF 9.0) Pub Date : 2024-07-16 Andrew Bush, Lawrence Nogee
The presentation of childhood interstitial lung disease (chILD) is non-specific,1 and chILD is usually low on the list of diagnoses in children with combinations of respiratory symptoms, feeding difficulties and failure to thrive. However, if a diagnosis is not considered, it will never be made. In this issue of the Journal , Fletcher et al describe nearly 800 French children, suggesting that chILD
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Epigenetic clock as the new hand of time for lung cancer in never smokers Thorax (IF 9.0) Pub Date : 2024-08-01 David C Christiani
Estimates of lung cancer among persons who never smoked are 10%–20% in the USA, translating into 20–40 000 cases annually. Globally, and especially in East Asia, the incidence of lung cancer among non-tobacco users is considerably higher than in the USA, especially in women.1 The causes of lung cancer in lifelong never-smokers are not well understood. Possibilities include exposure to other carcinogens
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MAC attack: MSCs and macrophages join forces against chronic lung infection Thorax (IF 9.0) Pub Date : 2024-08-01 Hazel Dunbar, Ian James Hawthorne, Karen English
Mesenchymal stromal cells (MSCs) possess several characteristics that make them attractive as a potential adjunct therapy for acute and chronic infectious diseases. MSCs are well known for their impressive immunomodulatory,1 2 pro-repair effects1 3 and clinical safety profile,4 5 however, the efficacy of MSCs in controlling bacterial infections, at least directly, remains unclear.6 Mycobacterium avium
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Lifetime lung function trajectories: insights into risk factors, consequences and implications Thorax (IF 9.0) Pub Date : 2024-08-01 Dinh S Bui, Nur S Idrose, Shyamali C Dharmage
Maintaining optimal lung function throughout life is important not only for respiratory health but also for overall health and longevity. With emerging evidence on the clinical significance of lung function at multiple windows throughout life, there has been an increasing number of studies on lung function trajectories1 including by Zhang et al in this issue.2 The term ‘lung function trajectory’ refers
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Lung allocation: a vexed, complex multifaceted challenge Thorax (IF 9.0) Pub Date : 2024-08-01 Andrew Fisher, Jasvir Parmar
We read with interest the paper from Roussel et al .1 In this study, the authors examine the outcomes for lung transplant recipients who were allocated donor organs in two very different healthcare systems. Their findings raise the complex and vexed question of what the fairest system for the allocation donor lungs is, especially for those candidates identified as being at the highest risk of waiting
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Reinforcing the benefits of children’s physical activity on lung health Thorax (IF 9.0) Pub Date : 2024-08-01 Gang Wang, Erik Melén
Lung development starts already in utero whereas lung function development can be conceived to begin shortly after birth, marked by the infant’s first cry. This development progresses through adolescence until reaching its peak during early adulthood (typically between 20 and 25 years of age). However, a notable portion of the general population (4%–12%) experiences suboptimal lung development, failing
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Undertreating cardiovascular disease in people with chronic obstructive pulmonary disease (COPD) Thorax (IF 9.0) Pub Date : 2024-08-01 Andrea S Gershon, Alina Blazer, Dennis Ko
Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death globally following ischaemic heart disease and stroke.1 Cardiovascular disease (CVD) is one of the most common comorbidities experienced by people with COPD and is a leading cause of death. People with COPD account for about 40% of all cardiovascular hospitalisations.2 3 This is believed to be because of the direct effects
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Respiratory rescue is the new frontier Thorax (IF 9.0) Pub Date : 2024-08-01 Sarath Ranganathan
The cost of delivering healthcare is increasing in many countries, while at the same time, populations are ageing and fertility rates falling. These factors are pushing policy-makers to consider alternative strategies for health service delivery. The recent pandemic has confirmed that many of the impacts of acute infectious diseases can be mitigated through vaccination and other forms of prevention
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Integrated disease management: good news but more work to do Thorax (IF 9.0) Pub Date : 2024-08-01 Christine R Jenkins
Despite regularly updated guidelines, new evidence generation and a growing awareness of the prevalence and burden of asthma and chronic obstructive pulmonary disease (COPD) in the community, both diseases place a major strain on healthcare resources, particularly in causing hospital admissions, demands on urgent healthcare resources and at a personal level, significant impact on school and work attendance
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Improvements of the shape and strength of the diaphragm after endoscopic lung volume reduction Thorax (IF 9.0) Pub Date : 2024-08-01 Olivier Taton, Pierre Alain Gevenois, Alain Van Muylem, Benjamin Bondue, Sébastien Van Laethem, Dimitri Leduc
Rationale Endoscopic lung volume reduction improves lung function, quality of life and exercise capacity in severe emphysema patients. However, its effect on the diaphragm function is not well understood. We hypothesised that endoscopic lung volume reduction increases its strength by modifying its shape. Objectives To investigate changes in both diaphragm shape and strength induced by the insertion
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QRISK3 underestimates the risk of cardiovascular events in patients with COPD Thorax (IF 9.0) Pub Date : 2024-08-01 Joseph Emil Amegadzie, Zhiwei Gao, Jennifer K Quint, Richard Russell, John R Hurst, Tae Yoon Lee, Don D Sin, Wenjia Chen, Mona Bafadhel, Mohsen Sadatsafavi
Background Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease (CVD). The extent to which the excess CVD risk is captured by risk factors in QRISK, a widely used CVD risk scoring tool, is not well studied. Methods We created an incidence cohort of diagnosed COPD patients from the United Kingdom (UK) Clinical Practice Research Datalink GOLD database
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Quantifying sustained health system benefits of primary care-based integrated disease management for COPD: a 6-year interrupted time series study Thorax (IF 9.0) Pub Date : 2024-08-01 Christopher Licskai, Anna Hussey, Véronique Rowley, Madonna Ferrone, Zihang Lu, Kimball Zhang, Emilie Terebessy, Andrew Scarffe, Shannon Sibbald, Cathy Faulds, Tim O'Callahan, Teresa To
Background Severe exacerbation of chronic obstructive pulmonary disease (COPD) is a trajectory-changing life event for patients and a major contributor to health system costs. This study evaluates the real-world impact of a primary care, integrated disease management (IDM) programme on acute health service utilisation (HSU) in the Canadian health system. Methods Interrupted time series analysis using
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Epigenome-wide association study of lung cancer among never smokers in two prospective cohorts in Shanghai, China Thorax (IF 9.0) Pub Date : 2024-08-01 Mohammad L Rahman, Charles E Breeze, Xiao-Ou Shu, Jason Y Y Wong, Batel Blechter, Andres Cardenas, Xuting Wang, Bu-Tian Ji, Wei Hu, Qiuyin Cai, H Dean Hosgood, Gong Yang, Jianxin Shi, Jirong Long, Yu-Tang Gao, Douglas A Bell, Wei Zheng, Nathaniel Rothman, Qing Lan
Background The aetiology of lung cancer among individuals who never smoked remains elusive, despite 15% of lung cancer cases in men and 53% in women worldwide being unrelated to smoking. Epigenetic alterations, particularly DNA methylation (DNAm) changes, have emerged as potential drivers. Yet, few prospective epigenome-wide association studies (EWAS), primarily focusing on peripheral blood DNAm with
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Survival outcomes following urgent lung transplantation in France and the USA Thorax (IF 9.0) Pub Date : 2024-08-01 Arnaud Roussel, Edouard Sage, Pierre-Emmanuel Falcoz, Pascal Alexandre Thomas, Yves Castier, Elie Fadel, Françoise Le Pimpec-Barthes, François Tronc, Jacques Jougon, Philippe Lacoste, Johanna Claustre, Laurent Brouchet, Richard Dorent, Edward Cantu, Michael Harhay, Raphaël Porcher, Pierre Mordant
Introduction Lung graft allocation can be based on a score (Lung Allocation Score) as in the USA or sequential proposals combined with a discrete priority model as in France. We aimed to analyse the impact of allocation policy on the outcome of urgent lung transplantation (LT). Methods US United Network for Organ Sharing (UNOS) and French Cristal databases were retrospectively reviewed to analyse LT
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Distinct trajectories of lung function from childhood to mid-adulthood Thorax (IF 9.0) Pub Date : 2024-08-01 Xian Zhang, Andrew R Gray, Robert J Hancox
Rationale Life course trajectories of lung function development and decline influence the risk for lung disease but are poorly documented. Objective To document lung function trajectories from childhood to mid-adult life. Methods We modelled forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC at ages 9, 11, 13, 15, 18, 21, 26, 32, 38 and 45 years from a population-based
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Physical activity and body mass related to catch-up lung function growth in childhood: a population-based accelerated cohort study Thorax (IF 9.0) Pub Date : 2024-08-01 Sarah Koch, Gabriela Prado Peralta, Anne-Elie Carsin, Alicia Abellan, Celine Roda, Maties Torrent, Carmen Iñiguez, Ferran Ballester, Amparo Ferrero, Carlos Zabaleta, Aitana Lertxundi, Mònica Guxens, Martine Vrijheid, Jordi Sunyer, Maribel Casas, Judith Garcia-Aymerich
Objective The existence of catch-up lung function growth and its predictors is uncertain. We aimed to identify lung function trajectories and their predictors in a population-based birth cohort. Methods We applied group-based trajectory modelling to z-scores of forced expiratory volume in 1 second (zFEV1) and z-scores of forced vital capacity (zFVC) from 1151 children assessed at around 4, 7, 9, 10
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Lung function trajectories from school age to adulthood and their relationship with markers of cardiovascular disease risk Thorax (IF 9.0) Pub Date : 2024-08-01 Raquel Granell, Sadia Haider, Matea Deliu, Anhar Ullah, Osama Mahmoud, Sara Fontanella, Lesley Lowe, Angela Simpson, James William Dodd, Seyed Hasan Arshad, Clare S Murray, Graham Roberts, Alun Hughes, Chloe Park, John W Holloway, Adnan Custovic
Rationale Lung function in early adulthood is associated with subsequent adverse health outcomes. Objectives To ascertain whether stable and reproducible lung function trajectories can be derived in different populations and investigate their association with objective measures of cardiovascular structure and function. Methods Using latent profile modelling, we studied three population-based birth
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Adaptive multi-interventional trial platform to improve patient care for fibrotic interstitial lung diseases Thorax (IF 9.0) Pub Date : 2024-08-01 Leticia Kawano-Dourado, Tejaswini Kulkarni, Christopher J Ryerson, Pilar Rivera-Ortega, Bruno Guedes Baldi, Nazia Chaudhuri, Manuela Funke-Chambour, Anna-Maria Hoffmann-Vold, Kerri A Johannson, Yet Hong Khor, Sydney B Montesi, Lucilla Piccari, Helmut Prosch, María Molina-Molina, Jacobo Sellares Torres, Iazsmin Bauer-Ventura, Sujeet Rajan, Joseph Jacob, Duncan Richards, Lisa G Spencer, Barbara Wendelberger
Background Fibrotic interstitial lung diseases (fILDs) are a heterogeneous group of lung diseases associated with significant morbidity and mortality. Despite a large increase in the number of clinical trials in the last 10 years, current regulatory-approved management approaches are limited to two therapies that prevent the progression of fibrosis. The drug development pipeline is long and there is
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Bilateral mediastinal cysts with müllerian differentiation Thorax (IF 9.0) Pub Date : 2024-08-01 Nuria Domedel Puig, Marta Cufí Quintana, Vanessa Escobedo Rodriguez, Manuela Iglesias Sentís, Miguel Gallego
A chest X-ray was ordered in a 40-year-old woman due to an acute cough, showing an enlarged mediastinal silhouette (figure 1A). A physical examination showed a body mass index of 26 kg/m2. She reported prior use of hormonal contraception. CT scanning led to the detection of two posterior mediastinal, paravertebral and cystic images (figure 1B): a right, 28-mm-wide cyst at T5–T6 and a left, 24-mm-wide
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Journal club Thorax (IF 9.0) Pub Date : 2024-08-01 Zin Nge Nge Sein
Treatment recommendations for primary spontaneous pneumothorax (PSP) have changed significantly in recent years. The latest guideline by the British Thoracic Society (BTS) has shifted towards ambulatory and conservative management, following the publication of two robust randomised controlled trials (RCTs). Keijzers and colleagues have published a further post-hoc analysis from one of these RCTs, demonstrating
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IgG and plasma viscosity as markers of disease activity in primary Sjogren’s syndrome-related lymphocytic interstitial pneumonia Thorax (IF 9.0) Pub Date : 2024-07-15 Sughra Alawi, Giles Dixon, Nidhi Bhatt, Huzaifa I Adamali, Harsha Gunawardena
A 33-year-old woman presented with an 8-month history of dry cough and progressive dyspnoea. Two months later, she developed dry eyes and mouth, petechial rash over both feet, left jaw pain and weight loss. She had no significant medical, medication, smoking or occupational history. Her father had Raynaud’s disease and paternal uncle had systemic lupus erythematosus. Her physical examination revealed
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Nasal epithelial gene expression identifies relevant asthma endotypes in the ATLANTIS study Thorax (IF 9.0) Pub Date : 2024-07-15 Tatiana Karp, Alen Faiz, Jos van Nijnatten, Huib A M Kerstjens, Ilse Boudewijn, Monica Kraft, Judith M Vonk, Martijn C Nawijn, Irene H Heijink, Bianca Beghé, Klaus F Rabe, Alberto Papi, Chris Brightling, Dave Singh, Thys van der Molen, Salman Siddiqui, Stephanie Christenson, Victor Guryev, Maarten van den Berge
Introduction Asthma is an inflammatory airways disease encompassing multiple phenotypes and endotypes. Several studies suggested gene expression in nasal epithelium to serve as a proxy for bronchial epithelium, being a non-invasive approach to investigate lung diseases. We hypothesised that molecular differences in upper airway epithelium reflect asthma-associated differences in the lower airways and
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Rectal organoid morphology analysis (ROMA) as a novel physiological assay for diagnostic classification in cystic fibrosis Thorax (IF 9.0) Pub Date : 2024-07-14 Senne Cuyx, Anabela Santo Ramalho, Steffen Fieuws, Nikky Corthout, Marijke Proesmans, Mieke Boon, Kaline Arnauts, Marianne S Carlon, Sebastian Munck, Lieven Dupont, Kris De Boeck, François Vermeulen
Background Diagnosing cystic fibrosis (CF) is not always straightforward, in particular when sweat chloride concentration (SCC) is intermediate and <2 CF-causing CFTR variants are identified. The physiological CFTR assays proposed in the guidelines, nasal potential difference and intestinal current measurement, are not readily available nor feasible at all ages. Rectal organoid morphology analysis
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TB PCR in BAL and EBUS-TBNA samples for the diagnosis of pulmonary and mediastinal lymph node TB: retrospective TRiBE study Thorax (IF 9.0) Pub Date : 2024-07-08 Mirae Park, Kartik Kumar, Meg Coleman, Laura Martin, Georgina Russell, Pauline Scheelbeek, Ajit Lalvani, Giovanni Satta, Onn Min Kon
Introduction The role of Xpert Ultra in bronchoalveolar lavage (BAL) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) samples for pulmonary and mediastinal lymph node tuberculosis (TB) remains unclear. Methods This was a retrospective observational service evaluation at a tertiary TB centre in a low-incidence setting. The diagnostic indices of Xpert Ultra, smear and
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Angiosarcoma of the pulmonary artery as an unexpected evolution of an apparent pulmonary thromboembolism Thorax (IF 9.0) Pub Date : 2024-07-08 Angela Bronte, Sofia González-Ibán, Elia Lecumberri de Fuentes, Héctor Lajusticia
A 70-year-old woman, non-smoker, with previous SARS-CoV-2 infection 6 months ago and 1-month history of cough and expectoration, presented with acute left pleuritic pain and progressive dyspnoea. She was referred to the emergency department, where a chest X-ray showed a left pleural effusion. To exclude a pulmonary embolism (PE), a CT pulmonary angiogram (CTPA) was performed. It demonstrated a filling
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Xpert Ultra for diagnosing tuberculosis at bronchoscopy: thoughts on practical applications Thorax (IF 9.0) Pub Date : 2024-07-08 Graham Bothamley
Tests based on polymerase chain reactions are increasingly important in the microbiological diagnosis of tuberculosis (TB). Park et al1 have extended the use of Xpert Ultra to include material obtained at bronchoscopy, and particularly its use for samples obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). In addition, immediate cytology with rapid onsite evaluation
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Multiple intrathoracic extramedullary haematopoiesis as visualised on medical thoracoscopy Thorax (IF 9.0) Pub Date : 2024-07-05 Jiun Hang Lee, Larry Ellee Nyanti, Nai-Chien Huan, Hema Yamini Ramarmuty, Kunji Kannan Sivaraman Kannan
A 38-year-old man with underlying transfusion-dependent beta-thalassemia and a history of splenectomy in August 2023 presented in December of the same year, complaining of one month of dyspnoea and orthopnoea. The chest radiograph revealed bilateral pleural effusion, with a left-sided predominance. Diagnostic and therapeutic thoracentesis demonstrated straw-coloured serous pleural fluid (pf) with an
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Epidemiology of childhood interstitial lung disease in France: the RespiRare cohort Thorax (IF 9.0) Pub Date : 2024-07-04 Camille Fletcher, Alice Hadchouel, Caroline Thumerelle, Julie Mazenq, Manon Fleury, Harriet Corvol, Nouha Jedidi, Myriam Benhamida, Katia Bessaci, Tiphaine Bilhouee, Raphael Borie, Jacques Brouard, Aurélie Cantais, Annick Clement, Laurianne Coutier, Camille Cisterne, Pierrick Cros, Marie-Laure Dalphin, Christophe Delacourt, Eric Deneuville, Jean-Christophe Dubus, Carole Egron, Ralph Epaud, Michael
Introduction Interstitial lung disease in children (chILD) are rare and mostly severe lung diseases. Very few epidemiological data are available in limited series of patients. The aim of this study was to assess the prevalence and incidence of chILD in France. Methods We performed within the RespiRare network a multicentre retrospective observational study in patients with chILD from 2000 to 2022 and
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Environmental exposures associated with early childhood recurrent wheezing in the mother and child in the environment birth cohort: a time-to-event study Thorax (IF 9.0) Pub Date : 2024-07-04 Kareshma Asharam, Aweke A Abebaw Mitku, Lisa Ramsay, Prakash Mohan Jeena, Rajen N Naidoo
Background Antenatal factors and environmental exposures contribute to recurrent wheezing in early childhood. Aim To identify antenatal and environmental factors associated with recurrent wheezing in children from birth to 48 months in the mother and child in the environment cohort, using time-to-event analysis. Method Maternal interviews were administered during pregnancy and postnatally and children
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Antibiotic pharmacokinetics in infected pleural effusions Thorax (IF 9.0) Pub Date : 2024-07-04 David T Arnold, Liam Read, Oliver Waddington, Fergus W Hamilton, Sonia Patole, Jessica Hughes, Alice Milne, Alan Noel, Mark Bayliss, Nicholas A Maskell, Alasdair MacGowan
Pleural infection is usually treated with empirical broad-spectrum antibiotics, but limited data exist on their penetrance into the infected pleural space. We performed a pharmacokinetic study analysing the concentration of five intravenous antibiotics across 146 separate time points in 35 patients (amoxicillin, metronidazole, piperacillin-tazobactam, clindamycin and cotrimoxazole). All antibiotics
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When is an AVM not an AVM? Thorax (IF 9.0) Pub Date : 2024-07-02 Alice Parry, Amir Awwad, Geoffrey Lie, Matt Matson, William Martin Ricketts
Pulmonary arteriovenous malformations (pAVMs) are abnormal connections between branches of the pulmonary artery and vein resulting in right-to-left shunting of blood. They are the most common pulmonary vascular malformations, with an estimated incidence of 1 in 2600, and typically congenital.1 There is a 30% lifetime risk of shunt related complications, such as stroke or cerebral abscess, secondary
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Association between socioeconomic deprivation, ethnicity and health outcomes in preschool children with recurrent wheeze in England: a retrospective cohort study Thorax (IF 9.0) Pub Date : 2024-07-02 David Lo, Claire Lawson, Clare Gillies, Sharmin Shabnam, Erol A Gaillard, Hilary Pinnock, Jennifer K Quint
Background Preschool-aged children have among the highest burden of acute wheeze. We investigated differences in healthcare use, treatment and outcomes for recurrent wheeze/asthma in preschoolers from different ethno-socioeconomic backgrounds. Methods Retrospective cohort study using data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics in England. We reported number
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Unveiling the occupational hazards: exploring the association between organic dust exposure and hypersensitivity pneumonitis and other interstitial lung diseases Thorax (IF 9.0) Pub Date : 2024-06-29 Sheikh M Alif, Geza Benke
Organic dusts are mixtures of particles originating from plants, animals and often endotoxins from gram-negative bacteria. Several occupations, including farming (where exposures can occur during grain, animal handling and feeding), woodworking (where exposures can occur from wood dust) and textile work (during cotton processing), are the primary sources of occupational exposure to organic dust.1 2
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Long-term impact of ivacaftor on mortality rate and health outcomes in people with cystic fibrosis Thorax (IF 9.0) Pub Date : 2024-06-27 Christian A Merlo, Teja Thorat, Maral DerSarkissian, Lisa J McGarry, Catherine Nguyen, Yuqian M Gu, Joe Healy, Jaime L Rubin, M Alan Brookhart
Background Ivacaftor (IVA) has been shown to improve lung function and other clinical outcomes in people with cystic fibrosis (CF). A decade of real-world IVA availability has enabled the examination of long-term outcomes with this treatment. This retrospective, longitudinal cohort study investigated the impact of IVA on mortality rate and health outcomes among people with CF in the US. Methods Data
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Sleep-disordered breathing in children and adults with intellectual disability: mind the gap! Thorax (IF 9.0) Pub Date : 2024-06-27 Renata L Riha, Ankur Singh, Elizabeth A Hill, Hazel Evans, David O'Regan
Background In adults and children with intellectual disability (ID), sleep -disordered breathing (SDB) is thought to be common. However, large epidemiological studies are lacking, and there are few studies on optimal methods of investigation and even fewer randomised, controlled intervention trials of treatment. Method Peer-reviewed publications from various databases were examined in line with search
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Cause or consequence in idiopathic pulmonary fibrosis: using genetic data to back the right horse Thorax (IF 9.0) Pub Date : 2024-06-26 Louise V Wain
The task is clear: we need better treatments for pulmonary fibrosis (PF). The two antifibrotic therapies licensed for idiopathic pulmonary fibrosis (IPF) have shown efficacy in other forms of PF but do not meet the needs of people living with PF; drugs that can halt or even reverse progression and, importantly, improve quality of life. Although a number of new potential therapies are now reaching late-stage
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A structural and metabolic framework for classifying pre-clinical tuberculosis infection phenotypes using 18F-FDG PET-CT: a prospective cohort analysis following M. tuberculosis exposure Thorax (IF 9.0) Pub Date : 2024-06-24 Jee Whang Kim, Sonam Vadera, Meedya Sharifpour, Amrita Bajaj, Anver Kamil, Pranabashis Haldar
Tuberculosis (TB) control efforts are limited by ineffective characterisation of tuberculosis infection (TBI) —a heterogeneous spectrum of pre-clinical infection states, invisible to tools of routine clinical screening, that are associated with variable risk of progression to TB disease. In this prospective study, we use positron emission tomography-CT (PET-CT) as a high-resolution imaging modality
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Pulmonary sarcoidosis: differences in lung function change over time Thorax (IF 9.0) Pub Date : 2024-06-21 Michelle Sharp, Kevin J Psoter, Ali M Mustafa, Edward S Chen, Nancy W Lin, Stephen C Mathai, Nisha A Gilotra, Michelle N Eakin, Robert A Wise, David R Moller, Meredith C McCormack
Introduction Given the heterogeneity of sarcoidosis, predicting disease course of patients remains a challenge. Our aim was to determine whether the 3-year change in pulmonary function differed between pulmonary function phenotypes and whether there were differential longitudinal changes by race and sex. Methods We identified individuals seen between 2005 and 2015 with a confirmed diagnosis of sarcoidosis
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Early menopause and hormone therapy as determinants for lung health outcomes: a secondary analysis using the PLCO trial Thorax (IF 9.0) Pub Date : 2024-06-13 Xiaochun Gai, Yue Feng, Tessa M Flores, Huining Kang, Hui Yu, Kimberly K Leslie, Yiliang Zhu, Jennifer A Doherty, Yan Guo, Steven A Belinsky, Linda S Cook, Shuguang Leng
Rationale Early natural menopause (early-M; <45 years of age) increases the risk of lung morbidities and mortalities in smokers. However, it is largely unknown whether early-M due to surgery demonstrates similar effects and whether menopausal hormone therapy (MHT) is protective against lung diseases. Objectives To assess the associations of early-M and MHT with lung morbidities and mortalities using
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Genetic-informed proteome-wide scan reveals potential causal plasma proteins for idiopathic pulmonary fibrosis Thorax (IF 9.0) Pub Date : 2024-06-13 Jiahao Zhu, Houpu Liu, Rui Gao, Ruicheng Gong, Jing Wang, Dan Zhou, Min Yu, Yingjun Li
Idiopathic pulmonary fibrosis (IPF) is a lethal lung disease for which there are no reliable biomarkers or disease-modifying drugs. Here, we integrated human genomics and proteomics to investigate the causal associations between 2769 plasma proteins and IPF. Our Mendelian randomisation analysis identified nine proteins associated with IPF, of which three (FUT3, ADAM15 and USP28) were colocalised. ADAM15
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To progress or not to progress: new insights into the evolution of pleuropulmonary blastomas come from studying lung cysts in adolescents and adults with DICER1-related tumour predisposition Thorax (IF 9.0) Pub Date : 2024-07-01 Eric Santoni-Rugiu
Almost all cases of pleuropulmonary blastoma (PPB), the most common lung malignancy in childhood, are related to biallelic pathogenic variants in DICER1, a gene encoding an RNase III involved in the biogenesis of micro-RNAs, organogenesis and tumor suppression.1 2 Over 70% of patients with PPB are affected by the pleiotropic DICER1 -related tumour susceptibility syndrome caused by heterozygous germline
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Strengthening the evidence base to support stronger regulation of social media based advertising of e-cigarette products to youth Thorax (IF 9.0) Pub Date : 2024-07-01 Kim L Lavoie
Despite the early promise of e-cigarettes as a potential smoking cessation tool, the actual uptake of these products has been the source of much controversy. There have been growing concerns about the exponential rise in the use of e-cigarettes and vaping products among youth and adolescents, with the proportion of those aged 11–15, 16–17 and 18 years in Great Britain using e-cigarettes more than doubling
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New path for understanding mucociliary clearance Thorax (IF 9.0) Pub Date : 2024-07-01 Timothy E Corcoran
The mucociliary clearance (MC) system is a vital host defence in the lungs and upper airways. Airway mucus traps inhaled bacteria, viruses, fungi and toxins. Underneath the mucus, airway cilia beat synchronously within a thin, watery periciliary liquid layer, propelling the overlying mucus layer towards the mouth. MC is dependent on ciliary structure and function and the composition and hydration of
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Heteroresistance in tuberculosis: are we missing drug-resistant bacteria hiding in plain sight? Thorax (IF 9.0) Pub Date : 2024-07-01 Mirae Park, Giovanni Satta, Pranabashis Haldar
Tuberculosis (TB) caused by Mycobacterium tuberculosis (MTB) remains the dominant cause of death from a bacterial infectious disease.1 Sustained global efforts to meet the ambitious elimination targets of WHO’s END-TB strategy have had a limited impact so far. This reflects the complex and multifaceted challenge posed, with multidrug resistant (MDR)-TB representing a significant and growing problem
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Toxic metals and lung health: silent poisons? Thorax (IF 9.0) Pub Date : 2024-07-01 Seif O Shaheen
Lady Astor: ‘Sir, if you were my husband , I would put arsenic in your tea!’ Churchill: ‘If I were your husband , I would drink it!’ This apocryphal joke is a reminder that arsenic is a potentially fatal poison. The phrase ‘mad as a hatter’ stems from the historical use of mercury by hatmakers, which could have neurotoxic consequences. Ironically, both these metals were also used therapeutically in
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Epidemiology of idiopathic pulmonary fibrosis: opportunities and hurdles for population-level studies of rare disease Thorax (IF 9.0) Pub Date : 2024-07-01 Daniel-Costin Marinescu, Alyson W Wong
Idiopathic pulmonary fibrosis (IPF) is a rare condition for which reliable disease trends over time can be difficult to obtain. Understanding the epidemiology of IPF is crucial given its impact on quality of life and productivity of affected individuals and their families,1 as well as substantial costs to the healthcare system.2 The occurrence of IPF over time has likely changed with growing awareness
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Ablation for lung cancer: hot or cold intervention Thorax (IF 9.0) Pub Date : 2024-07-01 Pallav L Shah
Over the past two decades, there has been a notable shift in the natural history and epidemiology of lung cancer. Previously there was a greater preponderance of central lung tumours with a squamous cell pathology, over time there appears to be a shift towards more peripheral lung tumours which more commonly have an adenocarcinoma cell type. The rate of squamous cell lung cancer in men in 2000 was
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Mucus clears from the trachea in a helix: a new twist to understanding airway diseases Thorax (IF 9.0) Pub Date : 2024-07-01 David Abelson, James Di Michiel, Clayton Frater, Mark Pearson, Robert Russo, Martin Wechselberger, Alice Cottee, Lucy Morgan
Background Mucociliary clearance (MCC) is critical to lung health and is impaired in many diseases. The path of MCC may have an important impact on clearance but has never been rigorously studied. The objective of this study is to assess the three-dimensional path of human tracheal MCC in disease and health. Methods Tracheal MCC was imaged in 12 ex-smokers, 3 non-smokers (1 opportunistically imaged
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Comprehensive analysis of environmental exposure to hazardous trace elements and lung function: a national cross-sectional study Thorax (IF 9.0) Pub Date : 2024-07-01 Yun-Jiang Yu, Tong Zheng, Jennifer L Perret, Yajing Han, Hongyan Li, Wenjie Meng, Dinh Bui, Qi-Zhen Wu, Chenyin Dong, Qiu-Ling Fang, Zhenchi Li, Hongxuan Kuang, Xiaowen Chen, Mingdeng Xiang, Xiaodi Qin, Shyamali C Dharmage, Guang-Hui Dong, Yang Zhou
Background There is growing interest in the joint effects of hazardous trace elements (HTEs) on lung function deficits, but the data are limited. This is a critical research gap given increased global industrialisation. Methods A national cross-sectional study including spirometry was performed among 2112 adults across 11 provinces in China between 2020 and 2021. A total of 27 HTEs were quantified
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Incidence, prevalence and mortality of idiopathic pulmonary fibrosis in England from 2008 to 2018: a cohort study Thorax (IF 9.0) Pub Date : 2024-07-01 Rikisha Gupta, Ann Dorothy Morgan, Peter M George, Jennifer K Quint
Background Owing to discrepancies in methodologies and how idiopathic pulmonary fibrosis (IPF) is diagnosed it is challenging to establish a consistent understanding of the disease burden In the UK, over 10 years ago, the incidence and prevalence of IPF were reported as 2.8–8.7 per 100 000 person-years (from 2000 to 2012) and 39 per 100 000 persons (in 2012), respectively. Here, we estimated the incidence
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Transbronchial cryoablation in peripheral lung parenchyma with a novel thin cryoprobe and initial clinical testing Thorax (IF 9.0) Pub Date : 2024-07-01 Chuanjia Gu, Haibin Yuan, Chi Yang, Fangfang Xie, Junxiang Chen, Lei Zhu, Yifeng Jiang, Jiayuan Sun
Background Transbronchial cryoablation shows potential as a local therapy for inoperable peripheral lung cancer. However, its clinical application for peripheral pulmonary lesions has not been reported yet. Methods An improved cryoprobe with an 8-mm-long, 1.9-mm-wide cryotip was used. Initially, the safety and effectiveness of this cryoprobe were assessed in an in vivo porcine model. Transbronchial
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Prevalence of lung cysts in adolescents and adults with a germline DICER1 pathogenic/likely pathogenic variant: a report from the National Institutes of Health and International Pleuropulmonary Blastoma/DICER1 Registry Thorax (IF 9.0) Pub Date : 2024-07-01 Alexander T Nelson, Lauren M Vasta, Dave Watson, Jung Kim, Anne K Harris, Ana F Best, Laura A Harney, Ann G Carr, Nicole Frederickson, Louis P Dehner, Christian P Kratz, Kelly N Hagedorn, William A Mize, Alexander Ling, Yoav H Messinger, D Ashley Hill, Kris Ann P Schultz, Douglas R Stewart
Background Pleuropulmonary blastoma (PPB), the hallmark tumour associated with DICER1 -related tumour predisposition, is characterised by an age-related progression from a cystic lesion (type I) to a high-grade sarcoma with mixed cystic and solid features (type II) or purely solid lesion (type III). Not all cystic PPBs progress; type Ir (regressed), hypothesised to represent regressed or non-progressed
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Definition of diaphragmatic sleep disordered breathing and clinical meaning in Duchenne muscular dystrophy Thorax (IF 9.0) Pub Date : 2024-07-01 Federica Trucco, Matthew Davies, Alberto Andrea Zambon, Deborah Ridout, Francois Abel, Francesco Muntoni
Background Diaphragmatic sleep disordered breathing (dSDB) has been recently identified as sleep dysfunction secondary to diaphragmatic weakness in Duchenne muscular dystrophy (DMD). However, scoring criteria for the identification of dSDB are missing. This study aimed to define and validate dSDB scoring criteria and to evaluate whether dSDB severity correlates with respiratory progression in DMD.
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Association of time spent on social media with youth cigarette smoking and e-cigarette use in the UK: a national longitudinal study Thorax (IF 9.0) Pub Date : 2024-07-01 Nicholas S Hopkinson, Charlotte Vrinten, Jennie C Parnham, Márta K Radó, Filippos Filippidis, Eszter P Vamos, Anthony A Laverty
Background Social media may influence children and young people’s health behaviour, including cigarette and e-cigarette use. Methods We analysed data from participants aged 10–25 years in the UK Household Longitudinal Study 2015–2021. The amount of social media use reported on a normal weekday was related to current cigarette smoking and e-cigarette use. Generalised estimating equation (GEE) logistic