Publications by authors named "Richeldi Luca"

Patients with pulmonary fibrosis (PF) often experience long waits before getting a correct diagnosis, and this delay in reaching specialized care is associated with increased mortality, regardless of the severity of the disease. Early diagnosis and timely treatment of PF can potentially extend life expectancy and maintain a better quality of life. Crackles present in the recorded lung sounds may be crucial for the early diagnosis of PF.

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Patients with pulmonary fibrosis (PF) often experience long waits before getting a correct diagnosis, and this delay in reaching specialized care is associated with increased mortality, regardless of the severity of the disease. Early diagnosis and timely treatment of PF can potentially extend life expectancy and maintain a better quality of life. Crackles present in the recorded lung sounds may be crucial for the early diagnosis of PF.

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Comprehensive care integrates individual patient needs and is highly valued for patients with pulmonary fibrosis (PF). The importance of a patient-centered care approach is rooted in the unpredictable progressiveness of the disease course in PF. The respiratory impairment associated with PF has a major impact on the quality of life for both patients and their caregivers.

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Background: Although crackles on chest auscultation represent a fundamental component of the diagnostic suspect for fibrotic interstitial lung disease (ILD), their reliability has not been properly studied. We assessed the agreement among respiratory physicians on the presence and changes over time of audible crackles collected in a prospective longitudinal cohort of patients with fibrotic ILD.

Methods: Lung sounds were digitally recorded at baseline and after 12 months at eight anatomical sites.

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Article Synopsis
  • Familial Pulmonary Fibrosis (FPF) is a lung disease caused by genetic mutations, and managing it is still a challenge as of 2023.
  • A survey conducted in Italy found that more FPF patients are seen at hospitals that treat many interstitial lung disease (ILD) patients each year.
  • There were differences in genetic testing services between hospitals, but no major differences in patient care or treatments were found in various medical settings.
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Matrix stiffening by lysyl oxidase-like 2 (LOXL2)-mediated collagen cross-linking is proposed as a core feedforward mechanism that promotes fibrogenesis. Failure in clinical trials of simtuzumab (the humanized version of AB0023, a monoclonal antibody against human LOXL2) suggested that targeting LOXL2 may not have disease relevance; however, target engagement was not directly evaluated. We compare the spatial transcriptome of active human lung fibrogenesis sites with different human cell culture models to identify a disease-relevant model.

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Interstitial lung disease (ILD) in systemic sclerosis (SSc) is a common complication that has a varied progression rate and prognosis. Different progression definitions are available, including minimal clinically important worsening of FVC, EUSTAR (European Scleroderma Trials and Research Group) progression, OMERACT (Outcome Measures in Rheumatology Clinical Trials) progression, and Erice ILD working group progression. Pulmonary function and symptom changes may act as specific confounding factors when applying these definitions in SSc.

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Article Synopsis
  • * An adult woman with ongoing respiratory issues underwent extensive genetic testing, leading to the identification of the novel haplotype F508del/E583G, with bioinformatics analyses suggesting that the E583G variant may be harmful.
  • * The research highlights the importance of updated CFTR-RD guidelines, emphasizing the need for thorough evaluations when discovering new variants to provide better diagnostic and treatment options.
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Introduction: Following the INPULSIS and ASCEND studies, leading to the first two approved antifibrotic therapies for patients with IPF, ongoing investigations are firmly exploring novel agents for a targeted effective and better tolerated therapy able to improve the natural history of the disease.

Areas Covered: This review aims to analyze recent advances in pharmacological research of IPF, discussing the currently available treatments and the novel drugs under investigation in phase 3 trials, with particular emphasis on BI 1015550 and inhaled treprostinil. The literature search utilized Medline and Clinicaltrials.

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Importance: Current treatments for idiopathic pulmonary fibrosis slow the rate of lung function decline, but may be associated with adverse events that affect medication adherence. In phase 2 trials, pamrevlumab (a fully human monoclonal antibody that binds to and inhibits connective tissue growth factor activity) attenuated the progression of idiopathic pulmonary fibrosis without substantial adverse events.

Objective: To assess the efficacy and safety of pamrevlumab for patients with idiopathic pulmonary fibrosis.

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We describe the case of a young 33-year-old woman that was referred to our clinic for evidence of migrant cavitary nodules at CT scan, dyspnea, and blood sputum. Her physical examination showed translucent and thin skin, evident venous vascular pattern, vermilion of the lip thin, micrognathia, thin nose, and occasional Raynaud phenomenon. We prescribed another CT scan that showed multiple pulmonary nodules in both lungs, some of which had evidence of cavitation.

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Article Synopsis
  • The TRITRIAL study evaluated the fixed combination of beclometasone dipropionate/formoterol fumarate/glycopyrronium (BDP/FF/G) in patients with chronic obstructive pulmonary disease (COPD), focusing on patient-reported outcomes over 12 months.
  • In a multicenter, prospective observational study with 655 patients, significant improvements were observed in health status (CAT scores), adherence to medication, quality of life, and sleep quality.
  • The findings suggest that BDP/FF/G not only enhances the management of moderate-severe COPD but also improves overall patient well-being and reduces exacerbation rates.
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Article Synopsis
  • Myocardial injury is common in COVID-19 patients, but the impact of COVID-19 vaccines on this risk is not well understood.
  • A study involving 1019 hospitalized COVID-19 patients found that older age, chronic kidney disease, and hypertension were linked to myocardial injury, while vaccination status did not significantly impact risk.
  • In patients aged 76 and older, vaccines appeared to protect against myocardial injury, but in those aged 60 and younger, vaccination was associated with an increased risk of injury.
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A phase II trial reported clinical benefit over 28 weeks in patients with idiopathic pulmonary fibrosis (IPF) who received zinpentraxin alfa. To investigate the efficacy and safety of zinpentraxin alfa in patients with IPF in a phase III trial. This 52-week phase III, double-blind, placebo-controlled, pivotal trial was conducted at 275 sites in 29 countries.

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Introduction: Idiopathic Pulmonary Fibrosis (IPF) is a progressive, irreversible, and fatal lung disease with unmet medical needs. Autotaxin (ATX) is an extracellular enzyme involved in the generation of lysophosphatidic acid (LPA). Preclinical and clinical data have suggested the ATX-LPAR signaling axis plays an important role in the pathogenesis and the progression of IPF.

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Idiopathic pulmonary fibrosis (IPF) carries significant mortality and unpredictable progression, with limited therapeutic options. Designing trials with patient-meaningful endpoints, enhancing the reliability and interpretability of results, and streamlining the regulatory approval process are of critical importance to advancing clinical care in IPF. A landmark in-person symposium in June 2023 assembled 43 participants from the US and internationally, including patients with IPF, investigators, and regulatory representatives, to discuss the immediate future of IPF clinical trial endpoints.

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Introduction: Currently approved drug treatments for idiopathic pulmonary fibrosis (IPF), pirfenidone and nintedanib, have been shown to slow lung function decline and improve clinical outcomes. Since significant advances in the understanding of pathogenetic mechanisms in IPF, novel potential agents are being tested to identify new targeted and better tolerated therapeutic strategies.

Areas Covered: This review describes the evidence from IPF phase II and III clinical trials that have been completed or are ongoing in recent years.

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Interstitial lung diseases (ILDs) are complex and heterogeneous diseases. The use of traditional diagnostic classification in ILD can lead to suboptimal management, which is worsened by not considering the molecular pathways, biological complexity, and disease phenotypes. The identification of specific "treatable traits" in ILDs, which are clinically relevant and modifiable disease characteristics, may improve patient's outcomes.

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Introduction: The use of pirfenidone and nintedanib in treating Idiopathic Pulmonary Fibrosis (IPF) has shown significant slowing down of the progressive functional decline in these patients. In recent times, antibody-based therapies with precise molecular targets have also been explored as alternative treatments to IPF.

Areas Covered: This review aims to summarize the available updates regarding monoclonal antibodies that have been tested in IPF.

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Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread worldwide since December 2019, causing the COVID-19 pandemic. Several measures have taken place in many countries to avoid further spread of the virus and to manage infected people according to disease severity. Notably, telemedicine (TM) was successfully used to manage less severe patients.

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