Publications
259 results found
Haworth CS, Banks J, Capstick T, et al., 2017, British Thoracic Society guidelines for the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD), THORAX, Vol: 72, ISSN: 0040-6376
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- Citations: 426
Burgess H, Cowman S, Jones A, et al., 2016, A RETROSPECTIVE STUDY INTO THE CLINICAL RELEVANCE OF ISOLATING NON-TUBERCULOUS MYCOBACTERIA IN PULMONARY SAMPLES, THORAX, Vol: 71, Pages: A25-A25, ISSN: 0040-6376
Goldman N, Loebinger MR, Wilson R, 2016, Long-term antibiotic treatment for non-cystic fibrosis bronchiectasis in adults: evidence, current practice and future use, EXPERT REVIEW OF RESPIRATORY MEDICINE, Vol: 10, Pages: 1259-1268, ISSN: 1747-6348
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- Citations: 6
McDonnell MJ, Aliberti S, Goeminne PC, et al., 2016, Comorbidities and the risk of mortality in patients with bronchiectasis: an international multicentre cohort study, LANCET RESPIRATORY MEDICINE, Vol: 4, Pages: 969-979, ISSN: 2213-2600
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- Citations: 187
Pigott E, Cowman S, Wilson R, et al., 2016, STENOTROPHOMONAS MALTOPHILIA INFECTION IN A BRONCHIECTASIS COHORT, THORAX, Vol: 71, Pages: A234-A235, ISSN: 0040-6376
Faverio P, Stainer A, Bonaiti G, et al., 2016, Characterizing Non-Tuberculous Mycobacteria Infection in Bronchiectasis, INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES, Vol: 17
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- Citations: 56
McDonnell MJ, Aliberti S, Goeminne PC, et al., 2016, Multidimensional Severity Assessment in Bronchiectasis-An Analysis of 7 European Cohorts, IRISH JOURNAL OF MEDICAL SCIENCE, Vol: 185, Pages: S480-S480, ISSN: 0021-1265
Cowman S, Jacob J, Hansell D, et al., 2016, Latent class analysis of CT patterns in pulmonary non-tuberculous mycobacterial infection, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
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- Citations: 1
Fernandes M, Shah A, Brooks S, et al., 2016, Caspofungin pulses for CPA (chronic pulmonary aspergillosis): A retrospective study, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Spinou A, Siegert R, Patel A, et al., 2016, The development and validation of the bronchiectasis health questionnaire (BHQ), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Irving S, Carr S, Hogg C, et al., 2016, Lung clearance index is stable in most primary ciliary dyskinesia (PCD) patients managed in a specialist centre: A pilot study, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Aliberti S, Masefield S, Polverino E, et al., 2016, Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration, EUROPEAN RESPIRATORY JOURNAL, Vol: 48, Pages: 632-647, ISSN: 0903-1936
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- Citations: 149
Woodfield G, Nisbet M, Jacob J, et al., 2016, Bronchiectasis in yellow nail syndrome, Respirology, Vol: 22, Pages: 101-107, ISSN: 1440-1843
BACKGROUND AND OBJECTIVE: Yellow nail syndrome (YNS) is a rare and poorly described disease process. In this case-control study, clinical features and findings on HRCT were compared with idiopathic bronchiectasis (IBx). METHODS: A review of all patients attending an adult bronchiectasis clinic between 2007 and 2013 identified 25 YNS patients. IBx patients were matched in a 2:1 ratio for age, duration of symptoms and gender. RESULTS: Median age of onset was 53 years. There were 12 male and 23 Caucasian YNS patients. Respiratory manifestations included chronic productive cough (100%), chronic rhinosinusitis (88%), pleural effusions (20%) and lymphoedema (12%). Chest symptoms preceded yellow nails in the majority (68%). Abnormal nails persisted at follow-up in 23 of 25 patients but improved in 14. In both disorders, there was symmetrical, predominantly lower lobe bronchiectasis on HRCT. Extent (P = 0.04), severity (P = 0.03) and bronchial wall thickness (P = 0.05) scores were lower in YNS, with less upper and middle lobe disease. Multivariate analysis showed an independent association with increased mucus plugging in YNS. There was a similar prevalence of Pseudomonas aeruginosa infection and mild lung function abnormalities. CONCLUSION: Bronchiectasis in YNS is less severe than IBx but is associated with increased mucus plugging, onset is in middle age and there is no female predominance. Treatment targeted at improved secretion clearance may improve both chest and nail symptoms, with consideration of long-term macrolide antibiotics.
McDonnell MJ, Aliberti S, Goeminne PC, et al., 2016, Multidimensional severity assessment in bronchiectasis: an analysis of seven European cohorts, Thorax, Vol: 71, Pages: 1110-1118, ISSN: 1468-3296
INTRODUCTION: Bronchiectasis is a multidimensional disease associated with substantial morbidity and mortality. Two disease-specific clinical prediction tools have been developed, the Bronchiectasis Severity Index (BSI) and the FACED score, both of which stratify patients into severity risk categories to predict the probability of mortality. METHODS: We aimed to compare the predictive utility of BSI and FACED in assessing clinically relevant disease outcomes across seven European cohorts independent of their original validation studies. RESULTS: The combined cohorts totalled 1612. Pooled analysis showed that both scores had a good discriminatory predictive value for mortality (pooled area under the curve (AUC) 0.76, 95% CI 0.74 to 0.78 for both scores) with the BSI demonstrating a higher sensitivity (65% vs 28%) but lower specificity (70% vs 93%) compared with the FACED score. Calibration analysis suggested that the BSI performed consistently well across all cohorts, while FACED consistently overestimated mortality in 'severe' patients (pooled OR 0.33 (0.23 to 0.48), p<0.0001). The BSI accurately predicted hospitalisations (pooled AUC 0.82, 95% CI 0.78 to 0.84), exacerbations, quality of life (QoL) and respiratory symptoms across all risk categories. FACED had poor discrimination for hospital admissions (pooled AUC 0.65, 95% CI 0.63 to 0.67) with low sensitivity at 16% and did not consistently predict future risk of exacerbations, QoL or respiratory symptoms. No association was observed with FACED and 6 min walk distance (6MWD) or lung function decline. CONCLUSION: The BSI accurately predicts mortality, hospital admissions, exacerbations, QoL, respiratory symptoms, 6MWD and lung function decline in bronchiectasis, providing a clinically relevant evaluation of disease severity.
Spinou A, Fragkos KC, Lee KK, et al., 2016, The validity of health-related quality of life questionnaires in bronchiectasis: a systematic review and meta-analysis, THORAX, Vol: 71, Pages: 683-694, ISSN: 0040-6376
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- Citations: 41
Shah A, Shoemark A, MacNeill SJ, et al., 2016, A longitudinal study characterising a large adult primary ciliary dyskinesia population, European Respiratory Journal, Vol: 48, Pages: 441-450, ISSN: 1399-3003
Primary ciliary dyskinesia (PCD) in adults has not been well described. In this retrospective observational study we aimed to characterise a large adult population and identify features associated with disease progression.We retrospectively analysed 151 adult patients at a single tertiary centre at baseline and longitudinally for a median of 7 years.We found significant variation in age at diagnosis (median 23.5 years; range <1-72 years). Older age at diagnosis was associated with impaired baseline forced expiratory volume in 1 s (FEV1) (r= -0.30, p=0.01) and increased Pseudomonas aeruginosa colonisation (difference in medians 17 years (95% CI 4.5-20 years); p=0.002). Lung function decline was estimated at FEV1 decline of 0.49% predicted per year. Lung function decline was associated with ciliary ultrastructure, with microtubular defect patients having the greatest decline (p=0.04). High-resolution computed tomography (HRCT) scores of severity of bronchial wall dilatation (p<0.001) and extent of bronchiectasis (p=0.03) additionally showed evidence of modifying FEV1 decline with age.Our study reveals that a large proportion of adult PCD patients are diagnosed late, with impaired FEV1 and increased P. aeruginosa colonisation. Increased disease burden on HRCT and ciliary ultrastructure may predict progressive lung function decline. This study characterises a large adult PCD population, identifies features associated with disease progression and highlights the need for prospective trials to determine whether early diagnosis of high-risk subgroups alongside optimal management can modify disease progression.
Cowman S, Wilson R, Loebinger MR, 2016, Opportunistic mycobacterial diseases, Medicine (United Kingdom), Vol: 44, Pages: 390-392, ISSN: 1357-3039
Non-tuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can cause a variety of infections including pulmonary disease, the prevalence of which is increasing. Although patients with immunodeficiency or chronic lung disease are most often affected, individuals with no apparent underlying predisposition can also develop infection. The most common species causing NTM pulmonary disease in the UK are Mycobacterium avium complex, Mycobacterium abscessus, Mycobacterium kansasii, Mycobacterium xenopi and Mycobacterium malmoense. Their ubiquitous nature makes them frequent contaminants, and the diagnosis of pulmonary disease requires firm evidence of infection with supportive clinical and radiological features. The management of NTM pulmonary disease is challenging as patients can remain stable for prolonged periods and treatment can be poorly tolerated. Treatment varies according to the species but involves prolonged courses of a combination of antibiotics. NTM are often drug resistant, and surgery can be considered in selected cases. Treatment outcomes are inferior to tuberculosis, and cure is sometimes not attainable.
Kalber TL, Ordidge KL, Southern P, et al., 2016, Hyperthermia treatment of tumors by mesenchymal stem cell-delivered superparamagnetic iron oxide nanoparticles., International Journal of Nanomedicine, Vol: 2016, Pages: 1973-1983, ISSN: 1178-2013
Magnetic hyperthermia - a potential cancer treatment in which superparamagnetic iron oxide nanoparticles (SPIONs) are made to resonantly respond to an alternating magnetic field (AMF) and thereby produce heat - is of significant current interest. We have previously shown that mesenchymal stem cells (MSCs) can be labeled with SPIONs with no effect on cell proliferation or survival and that within an hour of systemic administration, they migrate to and integrate into tumors in vivo. Here, we report on some longer term (up to 3 weeks) post-integration characteristics of magnetically labeled human MSCs in an immunocompromized mouse model. We initially assessed how the size and coating of SPIONs dictated the loading capacity and cellular heating of MSCs. Ferucarbotran(®) was the best of those tested, having the best like-for-like heating capability and being the only one to retain that capability after cell internalization. A mouse model was created by subcutaneous flank injection of a combination of 0.5 million Ferucarbotran-loaded MSCs and 1.0 million OVCAR-3 ovarian tumor cells. After 2 weeks, the tumors reached ~100 µL in volume and then entered a rapid growth phase over the third week to reach ~300 µL. In the control mice that received no AMF treatment, magnetic resonance imaging (MRI) data showed that the labeled MSCs were both incorporated into and retained within the tumors over the entire 3-week period. In the AMF-treated mice, heat increases of ~4°C were observed during the first application, after which MRI indicated a loss of negative contrast, suggesting that the MSCs had died and been cleared from the tumor. This post-AMF removal of cells was confirmed by histological examination and also by a reduced level of subsequent magnetic heating effect. Despite this evidence for an AMF-elicited response in the SPION-loaded MSCs, and in contrast to previous reports on tumor remission in immunocompetent mouse models, in this case, no significant d
Cowman S, Burns K, Benson S, et al., 2016, The antimicrobial susceptibility of non-tuberculous mycobacteria, JOURNAL OF INFECTION, Vol: 72, Pages: 324-331, ISSN: 0163-4453
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- Citations: 94
Ellis HC, Cowman S, Fernandes M, et al., 2016, Predicting mortality in bronchiectasis using bronchiectasis severity index and FACED scores: a 19-year cohort study, EUROPEAN RESPIRATORY JOURNAL, Vol: 47, Pages: 482-489, ISSN: 0903-1936
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- Citations: 50
Chalmers JD, Aliberti S, Polverino E, et al., 2016, The EMBARC European Bronchiectasis Registry: protocol for an international observational study, ERJ Open Research, Vol: 2, ISSN: 2312-0541
Bronchiectasis is one of the most neglected diseases in respiratory medicine. There are no approved therapies and few large-scale, representative epidemiological studies. The EMBARC (European Multicentre Bronchiectasis Audit and Research Collaboration) registry is a prospective, pan-European observational study of patients with bronchiectasis. The inclusion criterion is a primary clinical diagnosis of bronchiectasis consisting of: 1) a clinical history consistent with bronchiectasis; and 2) computed tomography demonstrating bronchiectasis. Core exclusion criteria are: 1) bronchiectasis due to known cystic fibrosis; 2) age <18 years; and 3) patients who are unable or unwilling to provide informed consent. The study aims to enrol 1000 patients by April 2016 across at least 20 European countries, and 10 000 patients by March 2020. Patients will undergo a comprehensive baseline assessment and will be followed up annually for up to 5 years with the goal of providing high-quality longitudinal data on outcomes, treatment patterns and quality of life. Data from the registry will be available in the form of annual reports. and will be disseminated in conference presentations and peer-reviewed publications. The European Bronchiectasis Registry aims to make a major contribution to understanding the natural history of the disease, as well as guiding evidence-based decision making and facilitating large randomised controlled trials.
Ellis HC, Cowman S, Fernandes M, et al., 2015, ASSESSMENT OF BRONCHIECTASIS SCORING SYSTEMS: A LONG TERM COHORT STUDY, Winter Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A178-A179, ISSN: 0040-6376
Shah A, Shoemark A, Macneill SJ, et al., 2015, A LONGITUDINAL STUDY CHARACTERISING A LARGE ADULT PRIMARY CILIARY DYSKINESIA COHORT, Winter Meeting of the British-Thoracic-Society, Publisher: BMJ PUBLISHING GROUP, Pages: A40-A40, ISSN: 0040-6376
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- Citations: 1
Grillo L, Irving S, Hansell DM, et al., 2015, The reproducibility and responsiveness of the lung clearance index in bronchiectasis, European Respiratory Journal, Vol: 46, Pages: 1645-1653, ISSN: 1399-3003
Lung clearance index (LCI) is a potential clinical outcome marker in bronchiectasis. Its responsiveness to therapeutic intervention has not been determined. This study evaluates its responsiveness to a session of physiotherapy and intravenous antibiotic treatment of an exacerbation.32 stable and 32 exacerbating bronchiectasis patients and 26 healthy controls were recruited. Patients had LCI and lung function performed before and after physiotherapy on two separate occasions in the stable patients and at the beginning and end of an intravenous antibiotic course in the exacerbating patients.LCI was reproducible between visits in 25 stable patients, with an intraclass correlation of 0.978 (0.948, 0.991; p<0.001). There was no significant difference in LCI (mean±sd) between stable 11.91±3.39 and exacerbating patients 12.76±3.47, but LCI was significantly higher in both bronchiectasis groups compared with healthy controls (7.36±0.99) (p<0.001). Forced expiratory volume in 1 s improved after physiotherapy, as did alveolar volume after intravenous antibiotics, but LCI did not change significantly.LCI is reproducible in stable bronchiectasis but unlike conventional lung function tests, is unresponsive to two short-term interventions and hence is unlikely to be a useful clinical tool for short-term acute assessment in these patients. Further evaluation is required to establish its role in milder disease and in the evaluation of long-term interventions.
Goeminne P, Bedi P, Kicinski M, et al., 2015, The impact of acute air pollution fluctuations on non-cystic fibrosis bronchiectasis pulmonary exacerbations: A case-crossover analysis, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Aliberti S, Polverino E, De Soyza A, et al., 2015, Research priorities in bronchiectasis: A consensus from the European multicentre bronchiectasis audit and research collaboration (EMBARC) study group, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Loebinger MR, Pozniak A, 2015, Screening for latent tuberculosis before tumour necrosis factor antagonist therapy, EUROPEAN RESPIRATORY JOURNAL, Vol: 45, Pages: 1512-1513, ISSN: 0903-1936
Chalmers JD, Loebinger M, Aliberti S, 2015, Challenges in the development of new therapies for bronchiectasis, EXPERT OPINION ON PHARMACOTHERAPY, Vol: 16, Pages: 833-850, ISSN: 1465-6566
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- Citations: 19
Quigley KJ, Reynolds CJ, Goudet A, et al., 2015, Chronic infection by Mucoid Pseudomonas aeruginosa associated with dysregulation in T cell immunity to OprF., American Journal of Respiratory and Critical Care Medicine, Vol: 191, ISSN: 1073-449X
RATIONALE: Pseudomonas aeruginosa (PA) is an environmental pathogen that commonly infects individuals with cystic fibrosis (CF) and non-CF bronchiectasis, impacting on morbidity and mortality. To understand the pathobiology of interactions between the bacterium and host adaptive immunity and to inform rational vaccine design, it is important to understand the adaptive immune correlates of disease. OBJECTIVES: We characterized T cell immunity to the PA antigen, outer membrane porin F (OprF), analyzing immunodominant epitopes in relation to infection status. METHODS: Non-CF bronchiectasis patients were stratified by frequency of PA isolation. T cell IFNγ immunity to OprF and its immunodominant epitopes was characterized. Patterns of HLA-restriction of immunodominant epitopes were defined using HLA class II transgenic mice. Immunity was characterized with respect to cytokine and chemokine secretion, antibody response and T cell activation transcripts. MEASUREMENTS AND MAIN RESULTS: Patients were stratified according to whether PA was never, sometimes (<50%) or frequently (>or=50%) isolated from sputum. Patients with frequent PA sputum-positive isolates were more likely to be infected by mucoid PA, and showed a narrow T cell epitope response and a relative reduction in Th1 polarizing transcription factors, but enhanced immunity with respect to antibody production, innate cytokines and chemokines. CONCLUSIONS: We have defined the immunodominant, HLA-restricted, T cell epitopes of OprF. Our observation that chronic infection is associated with a response of narrowed specificity, despite strong innate and antibody immunity, may help to explain susceptibility in these individuals and pave the way for better vaccine design to achieve protective immunity.
Hurst JR, Elborn JS, De Soyza A, 2015, COPD-bronchiectasis overlap syndrome, EUROPEAN RESPIRATORY JOURNAL, Vol: 45, Pages: 310-313, ISSN: 0903-1936
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- Citations: 120
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