The ongoing Middle East respiratory syndrome coronavirus outbreak in the Republic of Korea is prompting CDC officials to urge physicians to re-educate themselves about the disease and prepare for its potential arrival. (Source: AAFP News)

Summary While the FEV1 had been recognized as an excellent indicator of disability, it is not very sensitive to early and mild disease. In cystic fibrosis (CF) small airway disease is believed to be one of the early hallmarks and indices such as the FEF25–75 and FEF75 have been proposed as sensitive markers of early disease. The site of early disease in asthma is not as well worked out. Recently a study of more than 20,000 spirometries found that neither of these indices added anything to the FEV1/FVC but that study was not disease specific and contained both adults and children and the adults were the most numerous. To see if this would be true in children, 1,175 spirograms from children 6 to 18 years of age with CF or asthma whose FEV1 and FVC were above the lower limit of normal were ...

Abstract Idiopathic pulmonary fibrosis (IPF) is a chronic disorder that results in significant declines in respiratory function and a high mortality rate only a few years after diagnosis. Medical management of IPF has been attempted with various types of medications, such as immunosuppressants, anticoagulants, endothelin receptor antagonists, and anti-inflammatory drugs with less than conclusive results. However, with the approval of nintedanib and pirfenidone following the IMPULSIS-1, IMPULSIS-2, and ASCEND data, there is hope that medical therapy may be able to slow the progression of IPF and decrease the rate of acute exacerbations in this patient population. (Source: Current Emergency and Hospital Medicine Reports)

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Mesenchymal stem cells for therapeutic applications in pulmonary medicine.

Br Med Bull. 2015 Jun 10;

Authors: Stabler CT, Lecht S, Lazarovici P, Lelkes PI

Abstract
INTRODUCTION: Mesenchymal stem cells (MSCs) of different biological sources are in Phase 1 clinical trials and are being considered for Phase 2 therapy of lung disorders, and lung (progenitor) cells derived from pluripotent stem cells (SCs) are under development in preclinical animal models.
SOURCES OF DATA: PubMed.gov and ClinicalTrials.gov.
AREAS OF AGREEMENT: There is consensus about the therapeutic potential of transplanted SCs, mainly MSCs, primarily involves paracrine 'bystander' effects that confer protection of the epithelial and endothelial linings of the lung caused by inflammation and/or fibrosis and lead to increased survival in animal models. Clinical trials of Phase 1 indicate safety and suggest that the efficacy of SC therapy in patients with various lung diseases will require a higher dosage than previously evaluated.
AREAS OF CONTROVERSY: A growing interest in the re-epithelialization and re-endothelialization of damaged lung tissue involves the putative pulmonary differentiation of exogenous MSCs. Currently, it is not clear whether or not the observed regeneration of distal airways/vasculature is derived from lung-resident and/or transplanted SCs.
GROWING POINTS: Important topics under investigation include optimization of the cell source with a decrease in cell population heterogeneity characterized by defined markers, route of delivery for effective treatment, potential dose and therapeutic protocol of SC application, development of quantitative assays and biomarkers of lung disease and repair, and the potential use of tissue engineered lung.
AREAS TIMELY FOR DEVELOPING RESEARCH: Ability of MSCs to differentiate into epithelial cells of the lung, use of autologous induced pluripotent SCs (iPSCs) derived from the patients, complete biochemical characterization of the secretome of SCs used for therapy, and the incorporation of simultaneous and/or subsequent treatment with drugs which also aid in lung repair and regeneration.
CAUTIONARY NOTE: Although safety of MSC-based cell therapy was proved in Phase 1, efficacy, long-term survival and preservation of lung respiratory function need to be further evaluated, cautioning against hastily translating SCs therapy from animal models of lung injury to clinical trials of patients with lung disorders.

PMID: 26063231 [PubMed - as supplied by publisher]