ERJ Open Research最新文献

{"title":"Validation of artificial intelligence spirometry diagnostic support software in primary care: a blinded diagnostic accuracy study.","authors":"Anthony Sunjaya, George D Edwards, Jennifer Harvey, Karl Sylvester, Joanna Purvis, Matthew Rutter, Joanna Shakespeare, Vicky Moore, Ethaar El-Emir, Gillian Doe, Karolien Van Orshoven, Suhani Patel, Maarten de Vos, Ahmed Elmahy, Benoit Cuyvers, Paul Desbordes, Satesh Sehdev, Rachael A Evans, Michael D Morgan, Richard Russell, Ian Jarrold, Nannette Spain, Stephanie Taylor, David A Scott, A Toby Prevost, Nicholas S Hopkinson, Samantha Kon, Marko Topalovic, William D-C Man","doi":"10.1183/23120541.00116-2025","DOIUrl":"10.1183/23120541.00116-2025","url":null,"abstract":"<p><strong>Objective and design: </strong>The objective of the present study was to assess the discriminative accuracy of artificial intelligence (AI) software to identify COPD and other chronic respiratory diseases from primary care spirometry. This was a diagnostic study with blinded analysis.</p><p><strong>Methods: </strong>Retrospective hand-held spirometry data from consecutive patients attending primary care clinics in Hillingdon (London, UK) between September 2015 and March 2019 were used. The index diagnosis was the \"preferred\" diagnosis determined by AI software (highest probability) using supervised random-forest machine learning to interpret raw spirometry data and basic demographics. The reference diagnosis was based on the consensus of expert pulmonologists with access to primary and secondary care medical notes and results of relevant investigations. Cross-tabulation of the index test results by the results of the reference standard for COPD and other respiratory disease categories provided the main outcome measures.</p><p><strong>Results: </strong>In this primary care spirometry dataset from 1113 patients, 543 (48.8%) had a reference diagnosis of COPD. AI preferred diagnosis detected 456, achieving a sensitivity of 84.0% (95% CI 80.6-87.0%), specificity of 86.8% (83.8-89.5%), accuracy of 85.4% (83.2-87.5%) with area under curve (AUC) of 0.914 (0.896-0.930). AI preferred diagnosis identified 187 out of 249 patients with reference diagnosis of interstitial lung disease and 59 out of 107 patients with asthma, with AUCs of 0.900 (0.880-0.916) and 0.814 (0.790-0.836), respectively.</p><p><strong>Conclusion: </strong>AI software achieved high sensitivity and specificity in identifying COPD using spirometry and basic demographic data and may support accurate diagnosis of COPD in primary care. AI software performed less well for other chronic respiratory disease categories.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Aspergillus fumigatus</i> is influenced by mucus accumulation, airway inflammation and cystic fibrosis transmembrane conductance regulator function.","authors":"T Spencer Poore, Anh Nguyen, Levi Schaefers, Anna Solomonik, Ashleigh Rieglers, Sixto M Leal, Steven M Rowe, Susan Birket","doi":"10.1183/23120541.01035-2024","DOIUrl":"10.1183/23120541.01035-2024","url":null,"abstract":"<p><strong>Background: </strong><i>Aspergillus fumigatus</i> (Af) is an inhaled mould found in people with cystic fibrosis (CF) that results in significant airway inflammation. Studies have shown allergic (Th2) inflammatory responses to Af, little change in allergic bronchopulmonary aspergillosis despite CF transmembrane conductance regulator (CFTR) modulation and associations with <i>Pseudomonas aeruginosa</i> (PsA) infections. We hypothesised that CF mucus inherently promotes Af growth in a concentration-dependent fashion that is exacerbated by Th2 inflammation and preceding PsA infection.</p><p><strong>Methods: </strong>We collected mucus from primary non-CF and CF human bronchial epithelial cells stimulated with interleukin (IL)-4, IL-1β, pyocyanin (PYO) or co-infected with PsA. Paired sputum samples from people with CF before and after elexacaftor/tezacaftor/ivacaftor (ETI) treatment were also utilised. Af infection was then performed directly on each mucus sample and imaged with microscopy. Images were analysed by ImageJ particle tracking.</p><p><strong>Results: </strong>Higher concentrations of CF and non-CF mucus promoted more Af growth. Af germinated more in IL-4-stimulated CF mucus than CF mucus alone as well as IL-4-stimulated non-CF mucus, even when controlling for per cent solid content. PYO exposure showed increased Af growth in CF and non-CF mucus, while co-infection of CF mucus with PsA and tobramycin treatment restored Af growth in both conditions. Paired sputum samples from people with CF showed more Af growth pre-ETI than post-ETI even when controlling for per cent solid content.</p><p><strong>Conclusion: </strong>Af growth is reduced by mucus dilution, promoted by specific inflammatory cytokines and infection, and is influenced by CFTR function. CF mucus shows pathological differences that promotes Af growth, suggesting an intrinsic defect in this population.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific genetic effects on susceptibility to idiopathic pulmonary fibrosis.","authors":"Olivia C Leavy, Anne F Goemans, Tamara Hernandez-Beeftink, Amy D Stockwell, Richard J Allen, Beatriz Guillen-Guio, Ayodeji Adegunsoye, Helen L Booth, William A Fahy, Tasha E Fingerlin, Harvinder S Virk, Ian P Hall, Simon P Hart, Mike R Hill, Nik Hirani, Naftali Kaminski, Shwu-Fan Ma, Robin J McAnulty, X Rebecca Sheng, Ann B Millar, Maria Molina-Molina, Vidya Navaratnam, Margaret Neighbors, Helen Parfrey, Gauri Saini, Ian Sayers, Mary E Strek, Martin D Tobin, Moira K B Whyte, Yingze Zhang, Toby M Maher, Philip L Molyneaux, Justin M Oldham, Brian L Yaspan, Carlos Flores, Fernando Martinez, Carl J Reynolds, David A Schwartz, Imre Noth, R Gisli Jenkins, Louise V Wain","doi":"10.1183/23120541.00200-2025","DOIUrl":"10.1183/23120541.00200-2025","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a chronic lung condition that is more prevalent in males than females. The reasons for this are not fully understood; differing environmental exposures due to historically sex-biased occupations and diagnostic bias are possible explanations. To date, over 20 independent genetic association signals have been reported for IPF susceptibility, but these have been discovered when combining males and females. The objectives of the present study were to assess whether there is a need to consider sex-specific effects when evaluating genetic risk in clinical prediction models for IPF and to test for sex-specific associations with IPF susceptibility.</p><p><strong>Methods: </strong>We performed a genome-wide single nucleotide polymorphism (SNP)-by-sex interaction study meta-analysis of IPF risk in six independent case-control studies comprising 4561 cases (1280 females, 3281 males) and 22 888 controls (8360 females, 14 528 males) of European genetic ancestry. We used polygenic risk scores (PRSs) comprising common (minor allele frequency >1%) autosomal variants to assess differences in genetic risk prediction between males and females.</p><p><strong>Results: </strong>The predictive accuracy of the PRSs were similar between males and females, regardless of whether using combined or sex-specific association results. Three new independent genetic association signals were identified (p<1×10^-6).</p><p><strong>Conclusions: </strong>The predictive accuracy of common autosomal SNP-based PRSs did not vary significantly between males and females. We prioritised three genetic variants whose effect on IPF risk may be modified by sex. These findings would not account for the differences in prevalence between males and females. Future studies should ensure adequate representation of both sexes.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Aspergillus</i> and <i>Pseudomonas</i> lung infections: that's what friends are spore.","authors":"Dominic Hughes, Freddy Frost","doi":"10.1183/23120541.00421-2025","DOIUrl":"10.1183/23120541.00421-2025","url":null,"abstract":"<p><p><b><i>Aspergillus fumigatus</i> is a significant airway pathogen in chronic suppurative lung diseases. Poore <i>et al</i>. demonstrate the impact of mucus composition, and the importance of competition with <i>Pseudomonas aeruginosa</i> that reduces fungal growth in co-infection</b> https://bit.ly/4mdTvYQ.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spirometry interpretation in primary care: is there a role for artificial intelligence?","authors":"Sherif Gonem","doi":"10.1183/23120541.00353-2025","DOIUrl":"10.1183/23120541.00353-2025","url":null,"abstract":"<p><p><b>Artificial intelligence tools may help with spirometry interpretation and diagnosis of COPD in primary care, but further work is needed to improve calibration to a primary care population and model interpretability</b> https://bit.ly/42mWXIR.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophilic asthma may not be a distinct endotype.","authors":"Anurag Bhalla, Roma Sehmi, Parameswaran Nair, Manali Mukherjee","doi":"10.1183/23120541.00616-2025","DOIUrl":"10.1183/23120541.00616-2025","url":null,"abstract":"<p><p><b>Sputum neutrophilia must take into account total cell counts to differentiate trivial <i>versus</i> intense neutrophilia. Various aberrant cellular mechanisms may increase susceptibility to airway infections, which consequently lead to high neutrophil counts.</b> https://bit.ly/44ZszWx.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining chronic cough as a disease: why patient registries matter.","authors":"Bohee Lee, Woo-Jung Song","doi":"10.1183/23120541.00608-2025","DOIUrl":"10.1183/23120541.00608-2025","url":null,"abstract":"<p><p><b>Prospective international patient registries help address critical knowledge gaps in chronic cough by providing real-world insights into disease characteristics and supporting evidence for standardised management strategies</b> https://bit.ly/4lE6YrB.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of interstitial lung abnormalities in an adult population: radiological patterns and risk factors.","authors":"Nunzia Cannizzaro, Emanuele Grassedonio, Giada Maria Capizzi, Riccardo Messina, Francesco Battista, Irene Di Leo, Rosangela Di Liberti, Domenico Salvatore Gagliano, Salvatore Battaglia, Nicola Scichilone","doi":"10.1183/23120541.00074-2025","DOIUrl":"10.1183/23120541.00074-2025","url":null,"abstract":"<p><p><b>Considering the prevalence of ILA (3% in the current study) in asymptomatic adults and the association between ILA and lung function decline, early detection of ILAs through routine screenings could facilitate timely intervention and monitoring</b> https://bit.ly/4ijguys.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pushing the limits: does suprahigh-intensity interval training open a new frontier in pulmonary rehabilitation?","authors":"Rainer Gloeckl, Ioannis Vogiatzis","doi":"10.1183/23120541.00452-2025","DOIUrl":"10.1183/23120541.00452-2025","url":null,"abstract":"<p><p><b>Who says COPD rehabilitation must be a slow and gradual process? Suprahigh-intensity training bouts, averaging 200-250 W, are not only feasible but may yield significant physiological benefits in COPD.</b> https://bit.ly/4m2ny5s.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The NEuroCOUGH Chronic Cough Registry: a protocol for a pan-European observational study.","authors":"Peter S P Cho, Surinder S Birring, Clíona McDowell, Tony Brown, James H Hull, Jaclyn A Smith, Laurent Guilleminault, Peter Kardos, Jan W van den Berg, Christian Domingo, Paul Marsden, Marco Idzko, Federico Lavorini, Matthew J Martin, Claire Slinger, Silvia Demoulin-Alexikova, Daiana Stolz, Arent Jan Michels, Madara Tirzite, Brigita Gradauskiene, Joao Carlos Winck, Ossur Ingi Emilsson, Georgios Kaltsakas, Charlotte Hyldgaard, Kian Fan Chung, Eva Millqvist, Ajit Narayanan, Lisa Gossage, Khan Buchwald-Mackintosh, Richard J Siegert, Marianne Schulte, Abitha Nair, Jemma Nelson, Sean M Parker, Marta Dąbrowska, Alyn Morice, Lieven J A Dupont, Lorcan McGarvey","doi":"10.1183/23120541.00289-2025","DOIUrl":"10.1183/23120541.00289-2025","url":null,"abstract":"<p><p>Chronic cough is a common clinical problem which is burdensome for patients and can be difficult to treat. Individual centres of cough expertise have been set up in countries across Europe but to date there has been no means to collate and analyse clinical data from such sites to gain a more comprehensive understanding of cough phenotypes, disease burden and the natural history of this condition. The NEw Understanding in the tReatment Of COUGH (NEuroCOUGH) registry is the first pan-European prospective observational study of adult patients referred for evaluation of chronic cough. Patients (≥18 years old) with a cough lasting more than 8 weeks with no chest radiology findings to explain the cough will be recruited. Key exclusion criteria include current or recent (<12 months) smoking, significant smoking history (≥20 pack-years) and obstructive spirometry (forced expiratory volume in 1 s/forced vital capacity ratio <0.6). The study aims to recruit 2500 patients across 13 European sites by 2026 and participants will be followed up at 12-monthly intervals for 36 months. The registry comprises comprehensive clinical, physiological and biological data on chronic cough, along with data on the impact and longitudinal outcome of chronic cough. The NEuroCOUGH registry has been established at a time of considerable advance in the field of cough. It will serve as a valuable clinical and research resource which will extend our current understanding of this difficult to treat condition. The initiative is also intended to encourage the establishment of new specialist cough clinics, thus creating much needed clinical trial infrastructure throughout Europe to ultimately improve patient care.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 5","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}