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Letter from the Editor

Prof. Richard Dekhuijzen, Radboud University Medical Center, Nijmegen, the Netherlands
ATS 2019
Dear Reader,

This year’s International Congress of the American Thoracic Society (ATS) in Dallas, USA, was again the place to be to get the most recent updates in important areas of pulmonary diseases. Several important studies are presented and discussed in detail in this report.

Data from the MUST-ARDS trial were presented. ARDS remains to be a significant clinical condition with severe short-term and long-term consequences. Adult progenitor cell-expanding therapy may improve 28-day mortality, lessened ventilator and ICU burden, and demonstrated overall safety in patients with ARDS.

The effects of nintedanib on lung function decline were investigated in systemic sclerosis-associated ILD. The SENSCIS trial, a randomised control trial studying the efficacy of nintedanib vs placebo on respiratory function among patients with interstitial lung disease mediated by systemic sclerosis (SSc-ILD), found a slower forced vital capacity decline in patients treated with nintedanib.

New post-hoc analyses from the large-scale GRIPHON trial assessing selexipag, an oral selective prostacyclin I2 receptor agonist, in patients with pulmonary arterial hypertension demonstrated that early, aggressive treatment after diagnosis is associated with the greatest benefits, irrespective of background therapy.

Dupilumab, which inhibits both the IL-4 and IL-13 pathways, improves outcomes in patients with severe chronic rhinosinusitis with nasal polyps and comorbid asthma, as shown by a pooled analysis of the SINUS-24 and SINUS-52 trials.

E-cigarette use disrupts normal immune response to viral infections, particularly in women. A
preliminary study explored differences in immune response between non-smokers and people who use cigarettes or e-cigarettes by inoculating 47 participants with live attenuated influenza virus. They found that at baseline, e-cigarette use disrupted normal immune response to viral infections, especially for women and girls.

The short- and long-term data on the effects and safety of biological agents in the treatment of severe asthma are accumulating and may guide to further personalise pharmacological treatment. Modulators of IL-5 and IL-4/IL-13 activity show important effects on exacerbation rates, hospitalisations, and dose of oral corticosteroids. Insights into relevant patient phenotypes are increasing and contribute to personalised treatment in patients with severe asthma.

If you have not been able to experience these aspects of the ATS yourself, this report will outline the most significant advancements discussed at the conference, and practical advices disseminated there. So, we hope that you will enjoy reading this Conference Report!

Kind regards,
Prof. Richard Dekhuijzen

Prof. P.N. Richard Dekhuijzen is Professor of Pulmonology at the Radboud University Medical Center in Nijmegen, the Netherlands. His specific area of clinical and research interest includes asthma, COPD, and inhalation technology. He studied medicine at VU Amsterdam and completed his training in pulmonology at the Onze Lieve Vrouwe Gasthuis in Amsterdam and in the Academic Hospital Nijmegen. In 1989, he finished his PhD thesis on training of the respiratory muscles in COPD, followed by a PhD thesis on steroid induced myopathy of the diaphragm in 1994 at the Catholic University Leuven (Belgium). He is author/co-author of over 330 peer-reviewed papers and many textbook chapters on respiratory medicine. From 2008-2010, he was Head of the Cardiology Department at Radboudumc. Until 2016, he chaired the Department of Pulmonary Diseases, the Heart-Lung Centre Nijmegen, and the Medical Staff at Radboudumc. He is the scientific chair of the Aerosol Drug Management Improvement Team (ADMIT) and chair of the Dutch Inhalation Technology Working Group. Currently, he is chair of the Medical Ethical Committee of the

Conflict of Interest Statement:

In the last 3 years, Richard Dekhuijzen and/or his department received research grants, unrestricted educational grants, and/or fees for lectures and advisory board meetings from AstraZeneca, Boehringer-Ingelheim, Chiesi, GSK, Mundipharma, Novartis, Sandoz, Teva, and Zambon.

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