Lung function improvement
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Lung Function Improvement in Cystic Fibrosis: Triple Modulator Therapy and Broader Trends
Recent studies show that people with cystic fibrosis (CF) have experienced significant improvements in lung function, especially with the introduction of triple modulator therapy (elexacaftor/tezacaftor/ivacaftor). In a nationwide Danish cohort, patients of all ages and disease severities saw a mean improvement in percent predicted forced expiratory volume in 1 second (ppFEV1) of 13.0 points after 12 months of treatment, with the annual rate of lung function decline reversing to a positive trend during therapy. These benefits were consistent across subgroups, regardless of previous modulator use or baseline lung function, marking a new era of consistent lung function improvement for people with CF on this therapy . Similarly, a pan-European analysis found a steady increase in FEV1 % predicted and survival rates over the past decade, particularly in higher and middle-income countries, with notable gains among those carrying the F508del mutation after the introduction of triple modulators .
Surgical and Interventional Approaches: Tracheobronchoplasty and Lung-Reduction Surgery
For patients with moderate to severe airway obstruction, robotic-assisted thoracoscopic tracheobronchoplasty has been shown to significantly improve lung function and quality of life. Forced expiratory volume in 1 second (FEV1) increased notably in patients with moderate and severe preoperative obstruction, and symptom scores improved across all groups . In patients with diffuse emphysema, lung-reduction surgery led to increased elastic recoil, improved FEV1, reduced dyspnea, and better exercise tolerance, demonstrating that surgical interventions can yield meaningful improvements in lung mechanics and patient outcomes .
Asthma and Eosinophilic Asthma: Biologic and Surgical Interventions
In severe refractory eosinophilic asthma, treatment with benralizumab, a monoclonal antibody targeting the IL-5 receptor, resulted in a substantial average increase in FEV1 (21.3% or +680 ml) and improved peak expiratory flow, with the greatest benefits seen in patients with high blood eosinophil counts and chronic rhinosinusitis with nasal polyps . Additionally, a systematic review and meta-analysis found that bariatric surgery in asthmatic patients led to significant improvements in FEV1 and forced vital capacity (FVC), though the FEV1/FVC ratio did not change significantly .
Pediatric and Outreach Care: Equitable Lung Function Gains
Children seen in Indigenous-focused outreach clinics in regional and remote areas of Queensland, Australia, experienced lung function improvements comparable to those treated in tertiary pediatric hospitals. Both groups showed significant gains in FEV1 and FVC, and the proportion of children with above-average lung function increased, indicating that effective care can be delivered in outreach settings .
Environmental Factors: Air Quality and Lung Function
Long-term improvements in air quality, particularly reductions in PM2.5 and PM10, have been associated with significant increases in FVC, FEV1, and forced expiratory flow among young adults. Each 5 μg/m³ decrease in PM2.5 was linked to measurable gains in lung function parameters . Similarly, a rapid reduction in air particle pollution in China was robustly associated with improved peak expiratory flow in adults, supporting the role of environmental policy in promoting respiratory health .
COVID-19 Survivors: Recovery and Long-Term Trends
Among COVID-19 survivors, lung function parameters generally improved from 6 months to 1 year after infection, especially in those who received corticosteroid therapy during hospitalization. However, a decline in lung function was observed from 1 to 2 years post-infection, highlighting the need for ongoing monitoring and intervention in this population .
Conclusion
Across a range of conditions—including cystic fibrosis, asthma, emphysema, and post-COVID-19 recovery—multiple interventions such as advanced drug therapies, surgical procedures, outreach care, and environmental improvements have been shown to significantly improve lung function. These findings underscore the importance of access to effective treatments, equitable healthcare delivery, and public health policies aimed at reducing environmental risk factors to achieve better respiratory outcomes for diverse populations Leo-Hansen2024Inra2022Collaro2020+7 MORE.
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