CHEST Guidelines-Response

Response_chest (24)

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The document includes two main correspondences published in the CHEST journal concerning lung diseases, specifically microRNAs (miRNAs) and their role in diseases like sarcoidosis, and a study on the effectiveness of Xpert-Ultra testing for diagnosing pleural tuberculosis (TB).<br /><br />The first correspondence addresses a review by Hoefel et al., which focused on miRNAs in various lung diseases but omitted sarcoidosis. The authors Bijay Pattnaik and colleagues from the All India Institute of Medical Sciences emphasize the role of specific miRNAs in sarcoidosis, a chronic lung disease characterized by inflammation and granuloma formation. They highlight miRNAs like let-7, miR-34/SIRT1, miR-146a, and others as significant in regulating immune responses in sarcoidosis. The authors also suggest exploring exhaled breath condensate (EBC) as a noninvasive tool for miRNA testing. Hoefel and colleagues respond by acknowledging the limited studies on miRNA in sarcoidosis and the potential of using miRNAs as biomarkers. They mention the limitations and controversies in using EBC as a diagnostic technique.<br /><br />The second correspondence discusses advancements in the diagnosis of pleural TB using Xpert-Ultra testing. The study, referred to by unnamed authors, found that Xpert-Ultra has a higher detection yield in pleural fluid compared to traditional culture methods. The letter further suggests that thoracoscopic biopsy samples tested with Xpert-Ultra may provide even higher diagnostic yields than pleural fluid samples. Despite thoracoscopy being invasive, it allows precise sampling of infected areas, leading to possibly better diagnostic outcomes.<br /><br />Both letters imply the necessity for further research to confirm these preliminary findings and explore new diagnostic methodologies in lung diseases.

Keywords

microRNAs

sarcoidosis

lung diseases

Xpert-Ultra

pleural tuberculosis

diagnostic techniques

exhaled breath condensate

thoracoscopic biopsy

immune response

biomarkers