Potential Use of GLP-1 and GIP/GLP-1 Receptor Agonists for Respiratory Disorders: Where Are We at?

Chronic respiratory disorders are the third leading cause of mortality globally. Consequently, there is a continuous pursuit of effective therapies beyond those currently available. The therapeutic potential of the glucagon-like peptide-1 (GLP-1) and the glucose-dependent insulinotropic polypeptide/GLP-1 (GIP/GLP-1) receptor agonists extends beyond the regulation of glycemia, including glucometabolic, cardiovascular, and renal effects, rendering them viable candidates, due to their mechanisms of action, for the possible treatment of respiratory disorders.

Obesity and Insulin Resistance in Asthma Pathogenesis and Clinical Outcomes.

Common inflammatory ground links obesity, insulin resistance, and asthma. As recognition of their interplay, one worsening the natural course of the other, is recognised, questions remain about how to adequately address them altogether to improve clinical outcomes. The present manuscript sheds light on the problem, describing possible pathophysiological links, clinical views, and therapeutic challenges, raising questions about what remains to be done, and calling for multidisciplinary treatment of these patients to detect diseases early and adequately address them before they become full-blown and deteriorate their health and quality of life.

Severe and Rare Case of Human Dirofilaria repens Infection with Pleural and Subcutaneous Manifestations, Slovenia.

We report a case of human Dirofilaria repens infection in a woman in Slovenia who had concomitant pleural and subcutaneous manifestations of the infection. This case report illustrates the clinical course of a severe symptomatic parasitic infection that had multisystemic manifestations.

Gamma-glutamyltransferase is a strong predictor of secondary sclerosing cholangitis after lung transplantation for COVID-19 ARDS.

Background: Lung transplantation (LTx) can be considered for selected patients suffering from COVID-19 acute respiratory distress syndrome (ARDS). Secondary sclerosing cholangitis in critically ill (SSC-CIP) patients has been described as a late complication in COVID-19 ARDS survivors, however, rates of SSC-CIP after LTx and factors predicting this detrimental sequela are unknown.

Methods: This retrospective analysis included all LTx performed for post-COVID ARDS at 8 European LTx centers between May 2020 and January 2022.

Case report: Congenital extrahepatic portocaval shunt presenting as pulmonary arterial hypertension in a pregnant patient.

Congenital extrahepatic portocaval shunt (CEPS) is a rare condition in which a rare congenital vascular anomaly of the portal system is present. CEPS may manifest as pulmonary arterial hypertension (PAH). When diagnosed and treated early, PAH can be reversible.

Lung Transplantation for End-Stage Respiratory Failure After Severe COVID-19: A Report of 2 Cases.

We report 2 cases of bilateral lung transplantation for nonresolving coronavirus disease 2019 associated respiratory failure. In the first patient, the severe acute respiratory syndrome coronavirus 2 infection caused acute respiratory distress syndrome requiring prolonged extracorporeal membrane oxygenation support; in the second patient, coronavirus disease 2019 resulted in irreversible pulmonary fibrosis requiring only ventilatory support. The 2 cases represent the 2 ends of the spectrum showing significant differences in preoperative and postoperative courses.

Urgent lung transplantation for thymic neoplasm-associated severe constrictive bronchiolitis with bronchiectasis and radiotherapy-induced organizing pneumonia: A case report.

Here, we present the case of a 28-year-old woman who developed severe and progressive thymoma-associated constrictive bronchiolitis with bronchiectasis, despite undergoing thymectomy. The disease was further complicated by radiation-induced organizing pneumonia (RIOP), which developed after adjuvant radiotherapy (RT) for Masaoka stage II thymoma. The patient was successfully treated with an urgent lung transplantation (LTx) for irreversible respiratory failure.

Clinical and spirometric variables are better predictors of COPD exacerbations than routine blood biomarkers.

Background: Understanding the risk factors for exacerbations of COPD may help provide a more personalised approach to exacerbation prevention.

Method: Observational, prospective, international, multicentre study aimed at identifying risk factors for exacerbations of COPD. Clinical variables, lung function and CAT scores were collected at baseline.

Acute interstitial pneumonia triggered by strenuous exercise.

Acute interstitial pneumonia (AIP) is a rare and severe form of idiopathic interstitial lung disease. Treatment is primarily supportive with supplemental oxygenation and mechanical ventilation. Prognosis is poor, but long-term survival is possible after recovery from AIP.

Association Between Routine Blood Biomarkers and Clinical Phenotypes and Exacerbations in Chronic Obstructive Pulmonary Disease.

Introduction: Chronic obstructive pulmonary disease (COPD) is associated with increased lung and systemic inflammation. We aimed to identify associations between easy-to-obtain blood biomarkers and the frequency and severity of exacerbations.

Methods: Cross-sectional, multicentre study performed in four centres in Spain, Italy, Bulgaria, and Slovenia.

Chitotriosidase Activity in Plasma and COPD Exacerbations.

Introduction: This study aimed to determine the association between plasma chitotriosidase activity and the clinical characteristics and exacerbation rate of COPD patients.

Methods: The study comprised 97 patients with COPD. Their clinical characteristics and a history of exacerbations in the last 12 months were noted.

Should Patients Switched from D to B in the GOLD 2017 Classification be Discontinued from Inhaled Corticosteroids?

Inhaled corticosteroids (ICSs) are the cornerstone of the treatment of asthma, but their role in COPD is limited. Several guidelines recommend their use in patients with severe airflow limitation, frequent exacerbations and asthma-COPD overlap (ACO), while the previous GOLD document recommended ICS for patients with high risk of exacerbations and a high level of symptoms (group D). Following the changes in the GOLD document 2017 update, in which impaired lung function is no longer considered as a determinant of exacerbation risk, a high number of COPD patients can now be labeled as group B (low risk of exacerbations and high level of symptoms) instead of D, and hence, no longer fulfill the indication for ICS.

Bronchoalveolar lavage chitotriosidase activity as a biomarker of sarcoidosis.

Background: Chitotriosidase (CTO) was shown to be a good biomarker of sarcoidosis. Increased levels in bronchoalveolar lavage fluid (BALF) were reported and associated with more severe forms of the disease.

Objectives: The aim of the study was to evaluate the value of CTO in BALF as a routine biomarker of sarcoidosis.

Common chitotriosidase duplication gene polymorphism and clinical outcome status in sarcoidosis.

Background: Chitotriosidase has been found to be useful as a sarcoidosis biomarker. In patients with better outcome lower values were observed. Some subjects have 24-base pair duplication in the chitotriosidase gene (CHIT1) that results in the production of inactive enzyme.

Serial chitotriosidase measurements in sarcoidosis--two to five year follow-up study.

Introduction: Chitotriosidase (CTO) is a human chitinolytic enzyme secreted by activated macrophages and polymorphonuclear neutrophils. Albeit not specific for sarcoidosis, it is increased in over 90% of patients with active disease. The aims of this study were to correlate CTO measurements with clinical assessment of sarcoidosis and to test CTO as a marker of sarcoidosis relapse.

Phrenic nerve conduction studies in patients with chronic obstructive pulmonary disease.

Introduction: The most common etiology of hypercapnic respiratory failure is chronic obstructive pulmonary disease (COPD). However, the differential diagnosis also includes neuromuscular disorders. We studied the specificity of reduced amplitude phrenic nerve compound motor action potential (CMAP) to diagnose neuromuscular disorders.

Fungal exposure in homes of patients with sarcoidosis - an environmental exposure study.

Background: There is increasing evidence that exposure to moulds (fungi) may influence the development of sarcoidosis. To assess the influence of the environmental exposure, a study was undertaken to determine the exposure to fungi in homes of subjects with sarcoidosis.

Methods: Subjects were patients with clinically established sarcoidosis recruited during the period September 2007 till June 2010.

Ex vivo study of altered mitral apparatus geometry in functional mitral regurgitation.

Background: Functional mitral regurgitation (FMR) in patients with ischemic or nonischemic cardiomyopathy has been related to several overlapping factors. In vivo, these factors are very difficult to study independently of dynamic processes, such as ventricular wall motion or annular contraction. We developed an ex vivo left ventricular model that allows independent variations of annular size, papillary muscle (PM) position, and transvalvular pressure.

Regurgitant flow in ischemic and dilative mitral regurgitation.

Background And Aim Of The Study: It is well established that there are geometric differences between ischemic and dilative mitral regurgitation (MR), yet data on the hemodynamic consequences of these differences are scarce. The study aim was to determine whether mitral regurgitant flows in ischemic MR differ from those in dilative MR.

Methods: A left heart simulator was developed to evaluate possible differences in regurgitant flows between two pathological mitral valve configurations, ischemic and dilative.

Fire-eater's lung complicated by an infectious abscess requiring surgical treatment.

We describe a case of fire-eater's pneumonia that was complicated by an infectious lung abscess with substantial haemoptysis. Conservative treatment was inadequate. Surgical resection was necessary and proved to be successful.

Monoparesis due to spinal cord infarction associated with thoracoabdominal aneurysm.

We describe a case of acute monoparesis of a lower limb due to asymmetric spinal cord infarction in a patient with previously unrecognized thoracoabdominal aneurysm. The clinical course suggested that the likely reason for the spinal cord infarction was thromboembolism originating from the aneurysm's mural thrombi. This rare entity should be considered when managing patients with acute mono- or paraparesis who have a thoracoabdominal aneurysm with mural thrombi because interventions aimed at preventing further embolisms could be beneficial in these patients.