CHEST Guidelines-The-Possible-Link-Between-Poor-Pulmonary-Function-

The-Possible-Link-Between-Poor-Pulmonary-Function-

Pdf Summary

The document discusses various health studies and hypothesis regarding the risks and links between respiratory health, treatments, and neurological conditions. The first part focuses on the increased pneumonia risk associated with the Inhaled Corticosteroid (ICS) component in patients using triple therapy (LAMA-LABA-ICS) for Chronic Obstructive Pulmonary Disease (COPD) compared to dual therapy (LAMA-LABA). The study conducted by Suissa et al., referenced here, examines the effectiveness of triple therapy versus dual therapy in real-world clinical settings and suggests that the additional ICS component may lead to higher pneumonia risks without offering additional benefits over dual therapy for certain patients.<br /><br />The second part of the document revolves around the potential link between poor pulmonary function and dementia. Gallina and colleagues hypothesize that dysfunctions in the glymphatic system (GS), which manages brain waste removal, may connect poor pulmonary function and neurodegenerative diseases like dementia. They suggest that GS malfunctioning could result from cerebrospinal fluid (CSF) circulation issues, which are related to pulmonary hypertension and systemic venous pressure increases. This derangement might contribute to dementia development, warranting further investigation into the hydrodynamic relations between pulmonary insufficiencies and neurodegeneration.<br /><br />The response to Gallina’s correspondence recognizes the interest in the systematic review by Russ et al., which initially found connections between respiratory issues and dementia, highlighting methodological challenges in asserting causal links from observational data. The correspondence urges a need for varied study designs, like using genetic tools as proxies, to provide more robust evidence in this field, moving beyond observational studies.

Keywords

Inhaled Corticosteroid

pneumonia risk

Chronic Obstructive Pulmonary Disease

triple therapy

dual therapy

glymphatic system

pulmonary function

dementia

neurodegenerative diseases

observational studies