American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Mar 2018
Features and Outcomes of Methamphetamine Associated Pulmonary Arterial Hypertension.
Although amphetamines are recognized as "likely" agents to cause drug- and toxin-associated pulmonary arterial hypertension (PAH), (meth)amphetamine-associated PAH (Meth-APAH) has not been well described. ⋯ Meth-APAH is a severe and progressive form of PAH with poor outcomes. Future studies should focus on mechanisms of disease and potential therapeutic considerations.
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Am. J. Respir. Crit. Care Med. · Mar 2018
ReviewAcute Eosinophilic Pneumonia. Causes, Diagnosis, and Management.
Acute eosinophilic pneumonia (AEP) is an uncommon acute respiratory illness of varying severity that includes presentation as acute respiratory distress syndrome with fatal outcome. AEP may be idiopathic, but identifiable causes include smoking and other inhalational exposures, medications, and infections. The pathogenesis of AEP is poorly understood but likely varies depending on the underlying cause. ⋯ Optimal management of AEP depends on the recognition and elimination of the underlying cause when identifiable. The cessation of the exposure to the inciting agent (e.g., smoking), and glucocorticoids represent the mainstay of treating AEP of noninfectious origin. If AEP is recognized and treated in a timely manner, the prognosis is generally excellent, with prompt and complete clinical recovery, even in those patients manifesting acute respiratory failure.
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Am. J. Respir. Crit. Care Med. · Mar 2018
Long-Term Coarse Particulate Matter Exposure Is Associated with Asthma among Children in Medicaid.
Short- and long-term fine particulate matter (particulate matter ≤2.5 μm in aerodynamic diameter [PM2.5]) pollution is associated with asthma development and morbidity, but there are few data on the effects of long-term exposure to coarse PM (PM10-2.5) on respiratory health. ⋯ Among children enrolled in Medicaid, exposure to higher average coarse PM levels is associated with increased asthma prevalence and morbidity. These results suggest the need for direct monitoring of coarse PM and reconsideration of limits on long-term average coarse PM pollution levels.
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Am. J. Respir. Crit. Care Med. · Mar 2018
B Cells Producing Type I Interferon Modulate Macrophage Polarization in Tuberculosis.
In addition to their well-known function as antibody-producing cells, B lymphocytes can markedly influence the course of infectious or noninfectious diseases via antibody-independent mechanisms. In tuberculosis (TB), B cells accumulate in lungs, yet their functional contribution to the host response remains poorly understood. ⋯ Type I IFN produced by Mtb-stimulated B cells favors macrophage polarization toward a regulatory/antiinflammatory phenotype during Mtb infection.