The past few years have seen significant changes in attitude in many countries towards the care of people with chronic obstructive pulmonary disease (COPD). These changes have been driven by a greater understanding of the disease and the nature of its impact. Although there have been no new therapies that can modify the course of airway obstruction, there have been considerable advances in the way that we can lessen the impact of the disease on both the patient and the health community. There has clearly been a desire to improve the lives of individual people with COPD, but the major catalyst for change has probably been the desire of commissioners to reduce the cost of unnecessary hospital admissions resulting from exacerbation. To this end, the development of admission avoidance schemes ...

We read with interest the recent article ‘Genome-wide association studies in lung disease’ by Artigas et al.1 While we agree that a greater understanding of the biological pathways underlying disease development and progression (susceptibility) will be a major outcome from these genetic epidemiological studies, we suggest other benefits may also stem from this research. The genetics of chronic obstructive pulmonary disease (COPD) and lung cancer represent unique models for the genetics of lung disease because they result in the main from a ‘single’ measurable and preventable environmental exposure (cigarette smoking). That we can stratify for smoking exposure in these genetic association studies is critical to disease gene discovery and study design, as many of the ...

This new guideline covers the rapidly advancing field of interventional bronchoscopy using flexible bronchoscopy. It includes the use of more complex diagnostic procedures such as endobronchial ultrasound, interventions for the relief of central airway obstruction due to malignancy and the recent development of endobronchial therapies for chronic obstructive pulmonary disease and asthma. The guideline aims to help all those who undertake flexible bronchoscopy to understand more about this important area. It also aims to inform respiratory physicians and other specialists dealing with lung cancer of the procedures possible in the management and palliation of central airway obstruction. The guideline covers transbronchial needle aspiration and endobronchial ultrasound-guided transbronchial n...

In this study researchers developed a new multistage tuberculosis vaccine (H56) which can be used before and after exposure, and tested it in a mouse model. To construct the H56 vaccine, the authors purified the recombinant fusion protein (Ag85B-ESAT6-Rv2660c) from Escherichia coli. They hypothesised that it is possible to selectively target Mycobacterium tuberculosis (Mtb) in the persistent stage of infection by combining early protective antigens such as Ag85B and ESAT-6 (the H1 vaccine) with the latency protein Rv2660c which is involved in stress responses and characterises long-term Mtb adaptation in the immune host. The authors assessed the effectiveness of H56, H1 and BCG vaccines administrated in mice 6 weeks before Mtb exposure. They demonstrated a statistically significant re...