@article{GredicKarnatiRuppertetal.2023,
  author    = {Gredic, Marija and Karnati, Srikanth and Ruppert, Clemens and Guenther, Andreas and Avdeev, Sergey N. and Kosanovic, Djuro},
  title     = {Combined pulmonary fibrosis and emphysema: when Scylla and Charybdis ally},
  series = {Cells},
  volume    = {12},
  journal   = {Cells},
  number    = {9},
  issn      = {2073-4409},
  doi       = {10.3390/cells12091278},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-313571},
  year      = {2023},
  abstract  = {Combined pulmonary fibrosis and emphysema (CPFE) is a recently recognized syndrome that, as its name indicates, involves the existence of both interstitial lung fibrosis and emphysema in one individual, and is often accompanied by pulmonary hypertension. This debilitating, progressive condition is most often encountered in males with an extensive smoking history, and is presented by dyspnea, preserved lung volumes, and contrastingly impaired gas exchange capacity. The diagnosis of the disease is based on computed tomography imaging, demonstrating the coexistence of emphysema and interstitial fibrosis in the lungs, which might be of various types and extents, in different areas of the lung and several relative positions to each other. CPFE bears high mortality and to date, specific and efficient treatment options do not exist. In this review, we will summarize current knowledge about the clinical attributes and manifestations of CPFE. Moreover, we will focus on pathophysiological and pathohistological lung phenomena and suspected etiological factors of this disease. Finally, since there is a paucity of preclinical research performed for this particular lung pathology, we will review existing animal studies and provide suggestions for the development of additional in vivo models of CPFE syndrome.},
  language  = {en}
}
@article{KarnatiSeimetzKleefeldtetal.2021,
  author    = {Karnati, Srikanth and Seimetz, Michael and Kleefeldt, Florian and Sonawane, Avinash and Madhusudhan, Thati and Bachhuka, Akash and Kosanovic, Djuro and Weissmann, Norbert and Kr{\"u}ger, Karsten and Erg{\"u}n, S{\"u}leyman},
  title     = {Chronic Obstructive Pulmonary Disease and the Cardiovascular System: Vascular Repair and Regeneration as a Therapeutic Target},
  series = {Frontiers in Cardiovascular Medicine},
  volume    = {8},
  journal   = {Frontiers in Cardiovascular Medicine},
  issn      = {2297-055X},
  doi       = {10.3389/fcvm.2021.649512},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235631},
  year      = {2021},
  abstract  = {Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide and encompasses chronic bronchitis and emphysema. It has been shown that vascular wall remodeling and pulmonary hypertension (PH) can occur not only in patients with COPD but also in smokers with normal lung function, suggesting a causal role for vascular alterations in the development of emphysema. Mechanistically, abnormalities in the vasculature, such as inflammation, endothelial dysfunction, imbalances in cellular apoptosis/proliferation, and increased oxidative/nitrosative stress promote development of PH, cor pulmonale, and most probably pulmonary emphysema. Hypoxemia in the pulmonary chamber modulates the activation of key transcription factors and signaling cascades, which propagates inflammation and infiltration of neutrophils, resulting in vascular remodeling. Endothelial progenitor cells have angiogenesis capabilities, resulting in transdifferentiation of the smooth muscle cells via aberrant activation of several cytokines, growth factors, and chemokines. The vascular endothelium influences the balance between vaso-constriction and -dilation in the heart. Targeting key players affecting the vasculature might help in the development of new treatment strategies for both PH and COPD. The present review aims to summarize current knowledge about vascular alterations and production of reactive oxygen species in COPD. The present review emphasizes on the importance of the vasculature for the usually parenchyma-focused view of the pathobiology of COPD.},
  language  = {en}
}
@article{JobstWielpuetzTriphanetal.2015,
  author    = {Jobst, Bertram J. and Wielp{\"u}tz, Mark O. and Triphan, Simon M.F. and Anjorin, Angela and Ley-Zaporozhan, Julia and Kauczor, Hans-Ulrich and Biederer, J{\"u}rgen and Ley, Sebastian and Sedlaczek, Oliver},
  title     = {Morpho-Functional 1H-MRI of the Lung in COPD: Short-Term Test-Retest Reliability},
  series = {PLOS ONE},
  volume    = {10},
  journal   = {PLOS ONE},
  number    = {9},
  doi       = {10.1371/journal.pone.0137282},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-151365},
  pages     = {e0137282},
  year      = {2015},
  abstract  = {Purpose Non-invasive end-points for interventional trials and tailored treatment regimes in chronic obstructive pulmonary disease (COPD) for monitoring regionally different manifestations of lung disease instead of global assessment of lung function with spirometry would be valuable. Proton nuclear magnetic resonance imaging (1H-MRI) allows for a radiation-free assessment of regional structure and function. The aim of this study was to evaluate the short-term reproducibility of a comprehensive morpho-functional lungMRI protocol in COPD. Materials and Methods 20 prospectively enrolled COPD patients (GOLD I-IV) underwent 1H-MRI of the lung at 1.5T on two consecutive days, including sequences for morphology, 4D contrast-enhanced perfusion, and respiratory mechanics. Image quality and COPD-related morphological and functional changes were evaluated in consensus by three chest radiologists using a dedicated MRI-based visual scoring system. Test-retest reliability was calculated per each individual lung lobe for the extent of large airway (bronchiectasis, wall thickening, mucus plugging) and small airway abnormalities (tree in bud, peripheral bronchiectasis, mucus plugging), consolidations, nodules, parenchymal defects and perfusion defects. The presence of tracheal narrowing, dystelectasis, pleural effusion, pulmonary trunk ectasia, right ventricular enlargement and, finally, motion patterns of diaphragma and chest wall were addressed. Results Median global scores [10(Q1:8.00; Q3:16.00) vs. 11(Q1:6.00; Q3:15.00)] as well as category subscores were similar between both timepoints, and kappa statistics indicated "almost perfect" global agreement (\(\kappa\)= 0.86, 95\%CI = 0.81-0.91). Most subscores showed at least "substantial" agreement of MRI1 and MRI2 (\(\kappa\)= 0.64-1.00), whereas the agreement for the diagnosis of dystelectasis/effusion (\(\kappa\)= 0.42, 95\%CI = 0.00-0.93) was "moderate" and of tracheal abnormalities (\(\kappa\)= 0.21, 95\%CI = 0.00-0.75) "fair". Most MRI acquisitions showed at least diagnostic quality at MRI1 (276 of 278) and MRI2 (259 of 264). Conclusion Morpho-functional 1H-MRI can be obtained with reproducible image quality and high short-term test-retest reliability for COPD-related morphological and functional changes of the lung. This underlines its potential value for the monitoring of regional lung characteristics in COPD trials.},
  language  = {en}
}