PMID- 28096282
OWN - NLM
STAT- MEDLINE
DCOM- 20170606
LR  - 20221116
IS  - 1600-0617 (Electronic)
IS  - 0905-9180 (Print)
IS  - 0905-9180 (Linking)
VI  - 26
IP  - 143
DP  - 2017 Jan
TI  - The effect of mTOR inhibitors on respiratory infections in 
      lymphangioleiomyomatosis.
LID - 10.1183/16000617.0004-2016 [doi]
LID - 160004
AB  - Lymphangioleiomyomatosis (LAM) is a destructive cystic lung disease. Mammalian 
      target of rapamycin (mTOR) inhibitors are the primary treatment for LAM but it is 
      unknown whether these immunosuppressing medications increase the risk for or the 
      severity of respiratory infections in LAM patients.We searched multiple databases 
      for original articles that reported the rate of respiratory infections in LAM 
      patients treated with mTOR inhibitors or placebo. We calculated incidence rates 
      for respiratory infections in these groups and incidence rate ratios for 
      respiratory infections and severe respiratory infections in mTOR inhibitors 
      treated versus placebo treated patients.11 studies were included. There were 294 
      patients in the treatment groups and 93 patients in the placebo groups. Among 
      subjects in placebo arms, the incidence rate of respiratory infections was 58.8 
      per 100 patient-years (95% CI 35.3-82.3 per 100 patient-years). The 
      incidence-rate ratio (IRR) for respiratory infection among treated subjects was 
      0.71 (95% CI 0.50-1.02; p=0.06 compared to placebo subjects). The IRR for severe 
      respiratory infections among treated subjects was 1.56 (95% CI 0.43-8.55; 
      p=0.52).We found that respiratory infections are common in patients with LAM. 
      Importantly, treatment with mTOR inhibitors does not increase the incidence of 
      these infections and may be protective.
CI  - Copyright (c)ERS 2017.
FAU - Courtwright, Andrew M
AU  - Courtwright AM
AD  - Division of Pulmonary and Critical Care Division, Brigham and Women's Hospital, 
      Boston, MA, USA.
FAU - Goldberg, Hilary J
AU  - Goldberg HJ
AD  - Division of Pulmonary and Critical Care Division, Brigham and Women's Hospital, 
      Boston, MA, USA.
FAU - Henske, Elizabeth Petri
AU  - Henske EP
AD  - Division of Pulmonary and Critical Care Division, Brigham and Women's Hospital, 
      Boston, MA, USA.
FAU - El-Chemaly, Souheil
AU  - El-Chemaly S
AD  - Division of Pulmonary and Critical Care Division, Brigham and Women's Hospital, 
      Boston, MA, USA sel-chemaly@partners.org.
LA  - eng
GR  - T32 HL007633/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20170117
PL  - England
TA  - Eur Respir Rev
JT  - European respiratory review : an official journal of the European Respiratory 
      Society
JID - 9111391
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Protein Kinase Inhibitors)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
SB  - IM
MH  - Humans
MH  - Immunocompromised Host
MH  - Immunosuppressive Agents/adverse effects/*therapeutic use
MH  - Incidence
MH  - Lymphangioleiomyomatosis/*drug therapy/enzymology/epidemiology/immunology
MH  - Molecular Targeted Therapy
MH  - Opportunistic Infections/*epidemiology/immunology/prevention & control
MH  - Protective Factors
MH  - Protein Kinase Inhibitors/adverse effects/*therapeutic use
MH  - Respiratory Tract Infections/*epidemiology/immunology/prevention & control
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - TOR Serine-Threonine Kinases/*antagonists & inhibitors/metabolism
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC9484491
COIS- Conflict of interest: Disclosures can be found alongside this article at 
      err.ersjournals.com
EDAT- 2017/01/18 06:00
MHDA- 2017/06/07 06:00
PMCR- 2017/01/18
CRDT- 2017/01/19 06:00
PHST- 2016/01/22 00:00 [received]
PHST- 2016/03/25 00:00 [accepted]
PHST- 2017/01/19 06:00 [entrez]
PHST- 2017/01/18 06:00 [pubmed]
PHST- 2017/06/07 06:00 [medline]
PHST- 2017/01/18 00:00 [pmc-release]
AID - 26/143/160004 [pii]
AID - ERR-0004-2016 [pii]
AID - 10.1183/16000617.0004-2016 [doi]
PST - epublish
SO  - Eur Respir Rev. 2017 Jan 17;26(143):160004. doi: 10.1183/16000617.0004-2016. 
      Print 2017 Jan.