Seminars in Respiratory and Critical Care Medicine

Our medical research library holds 17 studies published in Seminars in Respiratory and Critical Care Medicine (2003–2023). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 16 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it.

About the journal

• Publisher: Thieme Medical Publishers
• Published: 1994 to the present, United States
• Language: English
• ISSN: 1069-3424 (print), 1098-9048 (electronic)
• Continues: Seminars in Respiratory Medicine
• Its record in the NLM Catalog

2020s

• New Markers for Management of Mesothelioma. A. Nash, T. Firth Née Phan, J. Creaney. 2023;44(4):491-501. Review PubMed · Publisher

  Abstract

  In this review, we provide an update on the status of cancer biomarkers for the clinical management of pleural mesothelioma, an aggressive cancer associated with asbestos exposure. Mesothelioma can be difficult to diagnose, and response to treatment is transient, even with recently adopted immune checkpoint inhibitor (ICI) combinations. Identification of mesothelioma-specific biomarkers could facilitate early diagnosis and tailor treatment strategies. Mesothelioma is characterized by frequent loss or alteration of the tumor suppressor genes cyclin-dependent kinase inhibitor 2A (CDKN2A) and BRCA1-associated protein-1 (BAP1). Accumulating data show these genes and/or their related protein products will be valuable tissue-based biomarkers for mesothelioma. Loss of BAP1, CDKN2A, p16, or methylthioadenosine phosphorylase provide pathologists with a reliable means of differentiating between mesothelioma and reactive mesothelial cell proliferations. This can aid diagnosis in difficult cases and is requisite for the identification of the new pathological entity malignant mesothelioma in situ. However, limited progress in identifying clinically useful soluble biomarkers in this cancer type has been made, with mesothelin remaining the benchmark. To date, results from studies to identify predictive biomarkers for ICI response have been disappointing. A recent retrospective study demonstrated BAP1 loss was predictive of improved survival following combination pemetrexed- and platinum-based chemotherapy. Validation of this result could have important clinical implications. Clinical trials aimed at targeting therapy based on biomarker expression are generally in the early phase setting, with overall results being moderate. The identification of biomarkers for mesothelioma remains a key research question due to their potential to improve patient outcomes in this deadly cancer.

  Thieme. All rights reserved.

• Pathology and Mineralogy of the Pneumoconioses. J.T. Hua, C.D. Cool, F.H.Y. Green. 2023;44(3):327-339. Review PubMed · Publisher · Free full text

  Abstract

  Pneumoconioses represent the spectrum of lung diseases caused by inhalation of respirable particulate matter small enough (typically <5-µm diameter) to reach the terminal airways and alveoli. Pneumoconioses primarily occur in occupational settings where workers perform demanding and skilled manual labor including mining, construction, stone fabrication, farming, plumbing, electronics manufacturing, shipyards, and more. Most pneumoconioses develop after decades of exposure, though shorter latencies can occur from more intense particulate matter exposures. In this review, we summarize the industrial exposures, pathologic findings, and mineralogic features of various well-characterized pneumoconioses including silicosis, silicatosis, mixed-dust pneumoconiosis, coal workers' pneumoconiosis, asbestosis, chronic beryllium disease, aluminosis, hard metal pneumoconiosis, and some less severe pneumoconioses. We also review a general framework for the diagnostic work-up of pneumoconioses for pulmonologists including obtaining a detailed occupational and environmental exposure history. Many pneumoconioses are irreversible and develop due to excessive cumulative respirable dust inhalation. Accurate diagnosis permits interventions to minimize ongoing fibrogenic dust exposure. A consistent occupational exposure history coupled with typical chest imaging findings is usually sufficient to make a clinical diagnosis without the need for tissue sampling. Lung biopsy may be required when exposure history, imaging, and testing are inconsistent, there are unusual or new exposures, or there is a need to obtain tissue for another indication such as suspected malignancy. Close collaboration and information-sharing with the pathologist prior to biopsy is of great importance for diagnosis, as many occupational lung diseases are missed due to insufficient communication. The pathologist has a broad range of analytic techniques including bright-field microscopy, polarized light microscopy, and special histologic stains that may confirm the diagnosis. Advanced techniques for particle characterization such as scanning electron microscopy/energy dispersive spectroscopy may be available in some centers.

  Thieme. All rights reserved.

• The Global Burden of Pleural Diseases. E. Vakil, N. Taghizadeh, A. Tremblay. 2023;44(4):417-425. PubMed · Publisher

  Abstract

  Pleural diseases include a spectrum of disorders broadly categorized into pneumothorax and pleural effusion. They often cause pain, breathlessness, cough, and reduced quality of life. The global burden of diseases reflects regional differences in conditions and exposures associated with pleural disease, such as smoking, pneumonia, tuberculosis, asbestos, cancer, and organ failure. Disease burden in high-income countries is overrepresented given the availability of data and disease burden in lower-income countries is likely underestimated. In the United States, in 2016, there were 42,215 treat-and-discharge visits to the emergency room for pleural diseases and an additional 361,270 hospitalizations, resulting in a national cost of $10.1 billion.

  Thieme. All rights reserved.

• Familial Interstitial Lung Disease. J.A. Kropski. 2020;41(2):229-237. Review PubMed · Publisher · Free full text

  Abstract

  The interstitial lung diseases (ILDs) are a group of progressive disorders characterized by chronic inflammation and/or fibrosis in the lung. While some ILDs can be linked to specific environmental causes (i.e., asbestosis, silicosis), in many individuals, no culprit exposure can be identified; these patients are deemed to have "idiopathic interstitial pneumonia" (IIP). Family history is now recognized as the strongest risk factor for IIP, and IIP cases that run in families comprise a syndrome termed "familial interstitial pneumonia" (FIP). Mutations in more than 10 different genes have been implicated as responsible for disease in FIP families. Diverse ILD clinical phenotypes can be seen within a family, and available evidence suggests underlying genetic risk is the primary determinant of disease outcomes. Together, these FIP studies have provided unique insights into the pathobiology of ILDs, and brought focus on the unique issues that arise in the care of patients with FIP.

  Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

2010s

• Malignant Mesothelioma: Has Anything Changed?. R.Y. Kim, D.H. Sterman, A.R. Haas. 2019;40(3):347-360. Review PubMed · Publisher

  Abstract

  Malignant pleural mesothelioma is a rare cancer associated with asbestos exposure and portends a dismal prognosis. Its worldwide incidence has been increasing, and treatment options are currently suboptimal and noncurative. However, since the turn of the century, several encouraging steps have been made toward improving outcomes for mesothelioma patients. An increased understanding of disease pathophysiology has led to more accurate diagnosis and staging, and the establishment of the standard of care first-line pemetrexed/platin doublet chemotherapy regimen in 2003 initially revolutionized treatment. While significant debate remains regarding the preferred approach to surgical and radiation therapy in the context of multimodal therapy, recent breakthroughs in immunotherapy offer hope for another paradigm shift in the near future. This review will summarize the current clinical approach to diagnosis, staging, and treatment of malignant pleural mesothelioma.

  Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

• Erratum to: Asbestos-Related Lung Cancer and Malignant Mesothelioma of the Pleura: Selected Current Issues (Semin Respir Crit Care Med 2015;36(3):334-346). S. Markowitz. 2016;37(1):143-4. PubMed · Publisher

• Asbestos-related lung cancer and malignant mesothelioma of the pleura: selected current issues. S. Markowitz. 2015;36(3):334-46. Review PubMed · Publisher

  Abstract

  Asbestos-related diseases persist, because millions of workers have had prior exposure and many industrializing countries continue to use asbestos. Globally, an estimated 107,000 people die annually from lung cancer, malignant mesothelioma, and asbestosis due to occupational asbestos exposure. Malignant mesothelioma and lung cancer are caused by all major types of asbestos. Asbestos causes more lung cancer deaths than malignant mesothelioma of the pleura; most cases of the latter are due to asbestos exposure. The cancer risk increases with cumulative asbestos exposure, with increased risk even at low levels of exposure to asbestos. Based on empirical studies, an estimated cumulative occupational exposure to asbestos of 1 fiber/mL-year substantially raises malignant mesothelioma risk. No safe threshold for asbestos exposure has been established for lung cancer and mesothelioma. The validity of fiber-type risk assessments depends critically on the quality of exposure assessments, which vary considerably, leading to a high degree of uncertainty. Asbestos exposure without asbestosis and smoking increases the risk of lung cancer. The joint effect of asbestos and smoking is supra-additive, which may depend in part on the presence of asbestosis. Asbestos workers who cease smoking experience a dramatic drop in lung cancer risk, which approaches that of nonsmokers after 30 years. Studies to date show that longer, thinner fibers have a stronger association with lung cancer than shorter, less thin fibers, but the latter nonetheless also show an association with lung cancer and mesothelioma. Low-dose chest computed tomographic scanning offers an unprecedented opportunity to detect early-stage lung cancers in asbestos-exposed workers.

  Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

• Gene-environment interaction from international cohorts: impact on development and evolution of occupational and environmental lung and airway disease. A. Gaffney, D.C. Christiani. 2015;36(3):347-57. Review PubMed · Publisher · Free full text

  Abstract

  Environmental and occupational pulmonary diseases impose a substantial burden of morbidity and mortality on the global population. However, it has been long observed that only some of those who are exposed to pulmonary toxicants go on to develop disease; increasingly, it is being recognized that genetic differences may underlie some of this person-to-person variability. Studies performed throughout the globe are demonstrating important gene-environment interactions for diseases as diverse as chronic beryllium disease, coal workers' pneumoconiosis, silicosis, asbestosis, byssinosis, occupational asthma, and pollution-associated asthma. These findings have, in many instances, elucidated the pathogenesis of these highly complex diseases. At the same time, however, translation of this research into clinical practice has, for good reasons, proceeded slowly. No genetic test has yet emerged with sufficiently robust operating characteristics to be clearly useful or practicable in an occupational or environmental setting. In addition, occupational genetic testing raises serious ethical and policy concerns. Therefore, the primary objective must remain ensuring that the workplace and the environment are safe for all.

  Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

• Role of chest computed tomography in prevention of occupational respiratory disease: review of recent literature. D.N. Weissman. 2015;36(3):433-48. Review PubMed · Publisher · Free full text

  Abstract

  This review provides an update on literature published over the past 5 years that is relevant to using chest computed tomography (CT) as a tool for preventing occupational respiratory disease. An important area of investigation has been in the use of low-dose CT (LDCT) to screen asbestos-exposed populations for lung cancer. Two recent systematic reviews have reached conclusions in support of screening. Based on the limited evidence that is currently available, the Finnish Institute of Occupational Health has recommended LDCT screening in asbestos-exposed individuals if their personal combination of risk factors yields a risk for lung cancer equal to that needed for entry into the National Lung Screening Trial. It has also recommended further research, such as to document the optimal frequency of screening and the effectiveness of screening. Recent literature continues to support high-resolution CT (HRCT) as being more sensitive than chest radiography in detecting pneumoconiosis. However, there are insufficient data to determine the effectiveness of HRCT screening in improving individual outcomes if used in screening for pneumoconiosis and its routine use for this purpose cannot be recommended. However, if HRCT is used to evaluate populations, recent literature shows that the International Classification of HRCT for Occupational and Environmental Respiratory Diseases provides an important tool for reproducible evaluation and recording of findings. HRCT is an important tool for individual patient management and recent literature has documented that chest HRCT findings are significantly associated with outcomes such as pulmonary function and mortality.

  Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

• Current controversies in the management of malignant pleural effusions. M. Azzopardi, J.M. Porcel, C.F. Koegelenberg, et al. 2014;35(6):723-31. Review PubMed · Publisher

  Abstract

  Malignant pleural effusion (MPE) can complicate most malignancies and is a common clinical problem presenting to respiratory and cancer care physicians. Despite its frequent occurrence, current knowledge of MPE remains limited and controversy surrounds almost every aspect in its diagnosis and management. A lack of robust data has led to significant practice variations worldwide, inefficiencies in healthcare provision, and threats to patient safety. Recent studies have highlighted evolving concepts in MPE care that challenge traditional beliefs. Advancing laboratory techniques have improved the diagnostic yield from pleural fluid cytology, minimizing the need for invasive tissue biopsies, even in many cases of mesothelioma. Imaging-guided biopsy is comparable to thoracoscopy in suitable patients, if cytological examination was noncontributory. Cumulating evidence for the benefits of indwelling pleural catheters (IPCs) has led some centers to adopt this approach as first-line definitive management for MPE over conventional talc pleurodesis. The optimal technique of talc pleurodesis is still debated despite its use for many decades. Strategies combining pleurodesis and IPC are being studied. MPE consists of a heterogenous group of diseases and careful phenotyping of malignant effusion patients can provide important clinical information that will advance the field and allow better stratification of patients and planning of therapy accordingly. This review addresses the controversies in MPE diagnosis and management and exposes the deficits in knowledge of MPE that should be the focus of future research.

  Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

• New applications of magnetic resonance imaging for thoracic oncology. Y. Ohno. 2014;35(1):27-40. Review PubMed · Publisher

  Abstract

  Since the clinical introduction of magnetic resonance imaging (MRI), the chest has been one of its most challenging applications, and since the 1980s many physicists and radiologists have been trying to evaluate images for various lung diseases as well as mediastinal and pleural diseases. However, thoracic MRI could not yield image quality sufficient for a convincing diagnosis within an acceptable examination time, so MRI did not find acceptance as a substitute for computed tomography (CT) and other modalities. Until the 2000, thoracic MRI was generally used only for select, minor clinical indications. Within the past decade, however, technical advances in sequencing, scanners and coils, adaptation of parallel imaging techniques, utilization of contrast media, and development of postprocessing tools have been developed. In addition, pulmonary functional MRI has been extensively researched, and MR is being assessed as a new research and diagnostic tool for pulmonary diseases. State-of-the art thoracic MRI now has the potential as a substitute for traditional imaging techniques and/or to play a complimentary role in patient management. In this review, we focus on these advances in MRI for thoracic oncologic imaging, especially for pulmonary nodule assessment, lung cancer staging, mediastinal tumor diagnosis and malignant mesothelioma evaluation, prediction of postoperative lung function, and prediction or evaluation of therapeutic effectiveness. We also discuss the potential and limitations of these advances for routine clinical practice in comparison with other modalities such as CT, positron emission tomography (PET), PET/CT, or nuclear medicine studies.

  Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

• Surgical pathology of lung cancer. M.K. Rezaei, N.J. Nolan, A.M. Schwartz. 2013;34(6):770-86. Review PubMed · Publisher

  Abstract

  The diagnosis, treatment, and management of lung tumors represent a complex set of decision algorithms and require the cooperation and interaction of a team of experts and support systems. The surgical pathologist, an early, important member of the diagnostic team, uses clinical and radiological evidence to differentiate benign from malignant tumors and renders a unique diagnosis that provides both prognostic and treatment information. Using routine histopathologic criteria, histochemical and immunohistochemical stains, and molecular and genetic testing, surgical pathologists and cytopathologists may distinguish between small cell and other bronchogenic carcinomas, separate adenocarcinomas from squamous cell carcinomas, differentiate between pleural carcinomas and diffuse malignant mesotheliomas, and discriminate among the varieties of neuroendocrine carcinomas. Among adenocarcinomas, the pathological examination stratifies those tumors with absent or minimal central invasive cores that have an excellent prognosis from the more common adenocarcinomas with larger invasive components. These distinctions are necessary based on differences in tumor biology, response to therapy, and prognosis for these different histological types. Histopathologic analysis should attempt to provide a precise diagnosis and limit the usage of the term non-small cell carcinoma. The team approach also enables the optimal use of tumor tissue for diagnostic purposes as well as molecular genetic testing and the discovery of targetable sites for therapeutic management. Though low-stage tumors tend to be initially treated with surgical resection, more advanced stages will be approached with limited tissue acquisition, necessitating a strategy for best practices of scarce tissue resources. The awareness of diagnostic modalities and tissue handling by all members of the team ensures the best patient-centered care.

  Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

• Update on malignant pleural mesothelioma. N.P. Campbell, H.L. Kindler. 2011;32(1):102-10. Review PubMed · Publisher

  Abstract

  Malignant pleural mesothelioma is an aggressive cancer principally attributable to asbestos. Although the incidence is now declining in the United States, it will continue to increase worldwide until all nations institute regulations limiting asbestos use and exposure. This is a heterogeneous disease, with three pathological subtypes that yield very different outcomes. Stage is less important than histology in determining prognosis. The biomarkers serum mesothelin-related peptide and osteopontin are being evaluated for screening asbestos-exposed individuals and monitoring disease response. The optimal surgical procedure remains controversial because extrapleural pneumonectomy and pleurectomy/decortication can achieve similar results. The reference chemotherapy regimen, pemetrexed-cisplatin, improves survival and quality of life. Key questions about maintenance therapy and the optimal regimens for elderly and frail patients remain to be answered. Although few other cytotoxic drugs have activity, a surprising number of novel agents are being investigated.

  © Thieme Medical Publishers.

• The pleura in health and disease. R. Murali, K. Park, K.O. Leslie. 2010;31(6):649-73. Review PubMed · Publisher

  Abstract

  A wide variety of local, regional, and systemic diseases may have pleural manifestations. The scope of this pathology encompasses a wide spectrum ranging from minimal inflammatory changes to highly malignant neoplasms. An overview of the normal structure of the pleura is provided, along with the diseases that may be encountered. Pleural specimens from patients with pneumothorax are rarely encountered by pathologists. In contrast, pathologists frequently receive pleural specimens showing evidence of inflammation, repair, or neoplasm. In these circumstances, an awareness of less common (and often clinically highly important) conditions such as epithelioid hemangioendothelioma and primary pleural malignant mesothelioma is essential. Knowledge of the clinical setting (e.g., disease tempo) and radiological picture (e.g., laterality) is often of great value to the pathologist in arriving at a correct diagnosis. Similarly, knowledge of the normal anatomical considerations and familiarity with the expected pleural histopathology for the most clinically relevant pleural diseases are critical assets for pulmonary physicians in providing optimal care for their patients.

  © Thieme Medical Publishers.

2000s

• The burden of exposure-related diffuse lung disease. S.R. Goldyn, R. Condos, W.N. Rom. 2008;29(6):591-602. PubMed · Publisher · Free full text

  Abstract

  Estimating the burden of exposure-related diffuse lung disease in terms of health effects and economic burden remains challenging. Labor statistics are inadequate to define the scope of the problem, and few studies have analyzed the prevalence of exposure-related illnesses and the subsequent health care cost. Well-defined exposures, such as those associated with coal mines, asbestos mines, and stonecutting, have led to more accurate assessment of prevalence and cost. As governmental regulation of workplace exposure has increased, the prevalence of diseases such as silicosis and coal workers' pneumoconiosis has diminished. However, the health and economic effects of diseases with long latency periods, such as asbestosis and mesothelioma, continue to increase in the short term. Newer exposures, such as those related to air pollution, nylon flock, and the World Trade Center collapse, have added to these costs. As a result, estimates of cost for occupational diseases, including respiratory illnesses, exceed $26 billion annually, and the true economic burden is likely much higher.

• Bronchoalveolar lavage in occupational lung diseases. C.R. Cordeiro, J.C. Jones, T. Alfaro, et al. 2007;28(5):504-13. Review PubMed · Publisher

  Abstract

  Occupational lung diseases (OLDs) are related to the exposure and inhalation of organic, inorganic, and synthetic particles, fumes, gases, or infectious agents. From the long list of OLDs this article focuses the discussion on bronchoalveolar lavage (BAL) in parenchymal immunoinflammatory conditions, such as hypersensitivity pneumonitis (HP) and pneumoconiosis. Several antigens may cause HP, including products of plant or animal origin, aerosolized microorganisms, and organic chemicals. BAL is used not only to assess the pathogenesis of these diseases but also to identify the typical pattern of intense lymphocytic alveolitis, usually with a CD4:CD8 ratio below normal and frequently with the presence of mast cells, plasma cells, and foamy macrophages. Pneumoconioses are chronic interstitial lung diseases caused by the inhalation of mineral and metallic inorganic particles/dusts in an occupational setting, showing a decreasing prevalence in recent years. BAL is a useful tool not only to express the complex pathogenic mechanisms of these entities but also in excluding other diagnoses and causes of alveolitis, and to document specific exposures, such as the identification of asbestos bodies (ABs) in asbestosis or the proliferative response of BAL lymphocytes to beryllium in chronic beryllium disease (CBD).

• Bronchiolitis caused by occupational and ambient atmospheric particles. A. Churg, J.L. Wright. 2003;24(5):577-84. PubMed · Publisher

  Abstract

  Occupationally encountered mineral dusts such as asbestos, silica, silicates (talc, mica), and metals can produce a distinctive pattern of fibrosis and distortion of the small airways, particularly the distal membranous bronchioles (MB) and the respiratory bronchioles (RB). Recent reports show that the same types of changes, accompanied by considerable muscle hyperplasia, are found in individuals living in regions with high levels of particulate air pollutants (PM). Models and actual measurements suggest that these changes occur because the small airways are sites of high particle deposition, and inhaled and deposited particulates, including PM, enter the airway walls. Studies from our laboratory using a tracheal explant model have shown that, for many types of particles, entry into the airway wall causes expression of mediators that lead to airway wall fibrosis and airway wall smooth muscle hyperplasia, probably through oxidant mechanisms. These reactions are intrinsic properties of the particles and do not require exogenous inflammatory cells. There is considerable evidence that individuals with occupational exposure to a wide variety of mineral dusts, as well as individuals with chronic exposure to high levels of PM, develop chronic airflow obstruction. The type of small airway remodeling seen in particle-induced bronchiolitis appears to be one cause of chronic airflow obstruction in this setting.

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