ERJ Open Research最新文献

{"title":"LUCIND: profiling respiratory comorbidity in paediatric neurological diseases.","authors":"Daniel A F Bernard, Luca Salhöfer, Florian Stehling, Cathrin Dahl, Ulrike Schara-Schmidt, Anna Pauly, Margarete Olivier, Matthias Welsner, Eva-Maria Huessler, Irma Kollenda, Bernd Schweiger, Sebastian Zensen, Johannes Haubold, Marcel Opitz","doi":"10.1183/23120541.00081-2026","DOIUrl":"https://doi.org/10.1183/23120541.00081-2026","url":null,"abstract":"<p><strong>Background: </strong>Children and adolescents with neurodisability are at high risk of respiratory comorbidity and secondary pulmonary disease due to impaired airway clearance, thoracic restriction, dysphagia and microbial airway colonisation. Despite the clinical relevance of these complications, systematic imaging data on structural lung changes and their clinical correlates in this population remain scarce.</p><p><strong>Methods: </strong>LUCIND (Lung Comorbidity in Neurological Diseases) is a prospective, cross-sectional imaging study enrolling 150 children and adolescents with neurodisability without primary pulmonary disease. Participants are stratified into three risk-based subgroups (n=50 each): 1) neurodisability with tracheostomy, 2) neurodisability with dysphagia, and 3) neurodisability without dysphagia. The primary objective is to detect chronic structural lung abnormalities such as bronchiectasis, bronchial wall thickening and consolidations using ultralow-dose photon-counting computed tomography. This technique yields robust morphological data at radiation levels approaching those of conventional radiography. Due to ultra-short acquisition times, imaging is performed without sedation, ensuring high patient safety and feasibility in this vulnerable population. Secondary aims include the correlation of radiological findings with clinical features, such as swallowing function, respiratory infection burden, microbial airway colonisation, and therapeutic measures including airway clearance and antibiotic use. Imaging will be complemented by standardised clinical data, logopaedic assessment, and detailed caregiver questionnaires.</p><p><strong>Conclusion: </strong>LUCIND will provide a unique dataset to refine our understanding of chronic lung disease in children with neurodisability. Results may inform future risk stratification, early intervention strategies, and optimised clinical pathways, potentially improving both quality of life and long-term respiratory outcomes.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"12 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13699374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149264572","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":"Cardiovascular outcomes in COPD, obstructive sleep apnoea and the overlap syndrome.","authors":"Amar J Shah, Muhammad Qummer Ul Arfeen, Spiros Denaxas, Natalie Fitzpatrick, Patrick Murphy, John R Hurst, Swapna Mandal","doi":"10.1183/23120541.00419-2026","DOIUrl":"https://doi.org/10.1183/23120541.00419-2026","url":null,"abstract":"<p><strong>Rationale: </strong>COPD and obstructive sleep apnoea (OSA) are both independently associated with an increased risk of cardiovascular disease. It is not clear whether this risk is further increased in COPD-OSA overlap. We aimed to determine whether COPD-OSA overlap has a higher cardiovascular burden compared with COPD or OSA alone.</p><p><strong>Methods: </strong>This was a matched cohort study using electronic health records from the Clinical Practice Research Datalink Aurum database (England). Exposures of interest were a diagnosis of COPD, OSA or both based on validated code lists. Our primary outcome of interest was cardiovascular mortality defined using ICD-10 codes. Our secondary outcomes of interest included: all-cause mortality, incident acute coronary syndrome (ACS), incident stroke and incident heart failure.</p><p><strong>Results: </strong>The initial study cohort consisted of 365 667 people with COPD (mean±sd) age 68±11 years, 59 526 with OSA age 57±11 years and 11 040 with COPD-OSA age 65±10 years. Cardiovascular mortality was significantly higher in patients with COPD-OSA overlap compared with OSA alone (adjusted hazard ratio 1.72 (1.58-1.88); p<0.001) but not compared with COPD alone. People with COPD-OSA overlap had 27% and 58% increased risk of developing ACS compared with COPD and OSA alone respectively, and 69% and 101% increased risk of developing heart failure compared with COPD and OSA respectively.</p><p><strong>Conclusions: </strong>We have demonstrated that people with COPD-OSA overlap have a significantly higher cardiovascular burden compared with COPD or OSA alone with real-world implications. Earlier and targeted treatment with cardiovascular optimisation can potentially reduce downstream sequelae.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"12 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13699401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149264545","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":"Development and external validation of a risk prediction tool for recurrent wheeze attacks in preschool children in England.","authors":"Jonathan Broomfield, Erol A Gaillard, Jennifer K Quint, Hilary Pinnock, Clare L Gillies, Mohammad A Al Sallakh, Gwyneth A Davies, David K H Lo","doi":"10.1183/23120541.00337-2026","DOIUrl":"10.1183/23120541.00337-2026","url":null,"abstract":"<p><strong>Introduction: </strong>Almost half of all children experience wheeze before their sixth birthday, with a subset experiencing recurrent attacks that increase healthcare burden. Early identification of children at high risk could enable timely interventions, but diagnostic tools are limited. The aim of the present study was to develop and validate a prognostic model predicting the risk of recurrent wheeze attacks (primary outcome) and hospitalisations (secondary outcome) within 12 months of an initial preschool acute wheeze presentation.</p><p><strong>Methods: </strong>We developed a multivariable logistic regression model using primary care data from 42 820 children in England aged up to 5 years with acute wheeze episodes recorded in the Clinical Practice Research Datalink. Predictors included demographics, clinical history and treatment patterns. The model was validated internally <i>via</i> bootstrapping and externally using the Secure Anonymised Information Linkage Databank in Wales (9703 children). Model performance was assessed using calibration and discrimination metrics.</p><p><strong>Results: </strong>In the CPRD development cohort, 39.6% experienced a subsequent wheeze attack and 17.4% were hospitalised. Key predictors were the healthcare setting of initial acute wheeze, prior wheeze history and reliever prescriptions; inhaled corticosteroid prescriptions reduced risk. The model demonstrated excellent calibration across internal bootstrap validation and two external validation cohorts (calibration slope=1.00, 0.94 and 0.86, respectively, calibration-in-the-large=0.00, 0.035 and -0.143) and moderate discrimination (C-statistic=0.634, 0.625 and 0.638 for wheeze).</p><p><strong>Conclusions: </strong>Using routinely collected data, the prognostic model shows strong calibration and moderate discrimination for predicting recurrent wheeze in preschool children. Implementation as a web tool could support early risk stratification and guide preventative management.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"12 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223526","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":"Nonadherence to inhaled corticosteroids is associated with negative mepolizumab response.","authors":"Mohammed Ghazi Almutairi, John Marriott, Zahraa Jalal, Louise Wood, Samantha Caddick, Babita Rajkumari, Susan Renwick, Siobhan Wilkinson, Caroline Gallagher, Hollie Morgan, Adel H Mansur","doi":"10.1183/23120541.00135-2026","DOIUrl":"10.1183/23120541.00135-2026","url":null,"abstract":"<p><strong>Background: </strong>Nonadherence to inhaled corticosteroids (ICS) in severe asthma is associated with poor control and may impair response to biologics. The primary objective of the present study was to evaluate ICS nonadherence influence on mepolizumab treatment response in adults with severe eosinophilic asthma.</p><p><strong>Methods: </strong>In this retrospective cohort study, we compared ICS nonadherence rates in mepolizumab responders and nonresponders. Adherence was determined using a prescription possession ratio (PPR) of ≥75% to indicate adherence. Mepolizumab response was assessed using the positive response criteria of a ≥50% reduction in exacerbations and/or in the maintenance oral corticosteroid dose. Predictors of adherence and mepolizumab response were explored using standard statistics.</p><p><strong>Results: </strong>A total of 190 participants were included in the analysis (enrolment mean±sd age 52±13 years, 59 (31%) males). There were 153 (80%) responders to mepolizumab who displayed lower median exacerbations than the nonresponders (1 (interquartile range (IQR) 0, 2) <i>versus</i> 4 (IQR 2, 7); p=0.002). ICS nonadherence was detected in 30% and 26% of participants prior to and during mepolizumab treatment respectively. ICS nonadherence was more common in nonresponders 12/23 (52%) than in mepolizumab responders 29/130 (22%), p=0.002. Nonadherent patients had higher exhaled nitric oxide fraction (<i>F</i> _ENO) (ppb) than the adherent patients (median 57 (IQR 35, 81) <i>versus</i> 34 (IQR 21, 61); p=0.009). Pre-mepolizumab nonadherence correlated significantly with on-treatment nonadherence (r=0.75, 95% CI 0.67-0.81; p<0.0001).</p><p><strong>Conclusions: </strong>ICS nonadherence was associated with negative response to mepolizumab treatment and raised <i>F</i> _ENO levels compared to the adherent group. Our findings support the notion for the need for optimisation of ICS adherence during mepolizumab therapy.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"12 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223511","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":"Inhaled corticosteroid adherence in the era of biologics for severe asthma.","authors":"Santi Nolasco, Claudia Crimi","doi":"10.1183/23120541.01219-2026","DOIUrl":"10.1183/23120541.01219-2026","url":null,"abstract":"<p><p><b>Even in the biologic era, optimising ICS adherence remains essential to improve clinical outcomes in severe asthma.</b> https://bit.ly/4wc2uNL.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"12 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227665","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":"Can explainable artificial intelligence classify asthma and COPD from xenon-129 ventilation magnetic resonance imaging?","authors":"Eveline Durom, Mark Wielpütz","doi":"10.1183/23120541.01026-2026","DOIUrl":"10.1183/23120541.01026-2026","url":null,"abstract":"<p><p><b>Explainability-derived imaging biomarkers offer a path to uncovering functional patterns linked to structural changes, advancing ¹²⁹Xe-MRI toward clinical, biomarker-driven phenotyping in asthma and COPD</b> https://bit.ly/4fRksAa.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"12 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227641","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":"Effect of l-menthol on breathlessness and exercise endurance in COPD: a randomised crossover trial.","authors":"Jacob Sandberg, Henrik Mosen, Magnus Ekström, Sara Jesperson, Zainab Ahmadi","doi":"10.1183/23120541.00495-2026","DOIUrl":"10.1183/23120541.00495-2026","url":null,"abstract":"<p><strong>Background and objective: </strong>Breathlessness is a leading cause of disability and reduced quality of life in COPD. Inhaled l-menthol may reduce breathlessness but data on its effect on exertional breathlessness is limited. We aimed to evaluate the effect of inhaled l-menthol on exertional breathlessness and exercise capacity in patients with COPD.</p><p><strong>Methods: </strong>This was a double-blinded, randomised (ratio 1:1), crossover trial (RCT) of l-menthol inhalation <i>versus</i> placebo. 20 participants with COPD performed two constant-load cycle cardiopulmonary exercise tests (CPET) to exhaustion, with either l-menthol or placebo (strawberry) scented patch in the mask in randomised order. The primary outcome was the difference in breathlessness intensity (Borg 0-10 scale) at isotime. Secondary outcomes were change in breathlessness unpleasantness and leg fatigue at isotime, exercise endurance time (EET), exertional physiological responses and multidimensional breathlessness (MDP).</p><p><strong>Results: </strong>Compared with placebo, inhaled l-menthol reduced breathlessness intensity at isotime (mean difference -0.8, 95% CI -1.6-0.0; p=0.042), corresponding to a moderate effect size (Cohen's d= -0.49). Isotime breathlessness unpleasantness (-0.7, -1.7-0.3) and emotional response score was lower with L-menthol (-2.2, -4.4-0.0). Leg discomfort (-0.5, -1.3-0.2) was numerically lower, EET was longer (0.9 min, -0.7-2.5) and physiological responses were unchanged.</p><p><strong>Conclusion: </strong>Inhalation of l-menthol reduced the intensity and emotional response of exertional breathlessness and increased the EET compared with placebo in patients with COPD. The unchanged physiological responses support a central brain effect and l-menthol might be a promising new treatment.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"12 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227581","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":"Low end-tidal carbon dioxide identifies high-severity pulmonary embolism and shock-level haemodynamics.","authors":"Lee W Greenspon, Patrick Ho, Jason George, Spencer Whealon, Margarita Gianniosis, Betsy Develin, Jonathan Fischer, Stephanie Kjelstrom, Mara Caroline, Eric Gnall","doi":"10.1183/23120541.00062-2026","DOIUrl":"10.1183/23120541.00062-2026","url":null,"abstract":"<p><strong>Background: </strong>End-tidal carbon dioxide tension (<i>P</i> _ETCO₂ ) may be reduced when lung units are ventilated but under-perfused, as occurs in pulmonary embolism (PE). We sought to determine whether early <i>P</i> _ETCO₂ measurement reflects PE severity according to European Society of Cardiology (ESC) risk categories and identifies shock-level haemodynamics among patients undergoing catheter-directed therapy (CDT).</p><p><strong>Methods: </strong>Patients admitted with acute PE confirmed by computed tomography pulmonary angiography were enrolled in this prospective observational study. <i>P</i> _ETCO₂ was measured using nasal capnography within 24 h of presentation or immediately prior to urgent CDT. <i>P</i> _ETCO₂ was compared between lower and higher severity PE groups and between patients referred for CDT or not. In patients undergoing mechanical thrombectomy (CDT) with invasive haemodynamic assessment, pulmonary arterial pressures and cardiac indices were recorded. A subgroup analysis evaluated patients with cardiogenic shock defined as cardiac index ≤1.8 L·min^-1·m^-2.</p><p><strong>Results: </strong>62 patients were analysed. <i>P</i> _ETCO₂ was significantly lower in the combined higher risk group compared to the combined lower risk group (mean 21.7 (95% CI 20.2-23.3) <i>versus</i> 30.2 (95% CI 27.8-32.6) mmHg; p<0.001). <i>P</i> _ETCO₂ was also lower in patients referred for CDT compared to those not referred (mean 20.4 (95% CI 18.7-22.0) <i>versus</i> 28.2 (95% CI 26.2-30.1) mmHg; p<0.001). Among patients who underwent CDT and met haemodynamic criteria for cardiogenic shock (n=16), <i>P</i> _ETCO₂ was the lowest (mean 18.6 (95% CI 16.1-21.1) mmHg).</p><p><strong>Conclusions: </strong><i>P</i> _ETCO₂ can be rapidly obtained early in PE evaluation and reflects ESC-defined severity. A <i>P</i> _ETCO₂ level <20 mmHg was associated with shock-level haemodynamics among normotensive intermediate-high-risk patients undergoing CDT. <i>P</i> _ETCO₂ may serve as a non-invasive marker of physiological severity.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"12 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227603","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":"Erratum: \"Autoimmune pulmonary alveolar proteinosis may not be invariably lifelong: exponential decay of anti-granulocyte-macrophage colony-stimulating factor autoantibodies over more than a decade\" Shinya Ohkouchi, Ryushi Tazawa, Takahiro Tanaka, Nobutaka Kitamura, Haruyuki Ishii and Koh Nakata. <i>ERJ Open Res</i> 2026; 12: 00345-2026.","authors":"","doi":"10.1183/23120541.50345-2026","DOIUrl":"https://doi.org/10.1183/23120541.50345-2026","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1183/23120541.00345-2026.].</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"12 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227650","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":"Assessing response to anti-thymocyte globulin therapy in chronic lung allograft dysfunction.","authors":"Andrea Zajacova, Pedro Argos-Velez, Marta Zapata-Ortega, Lara Verbeylen, Saskia Bos, Bart M Vanaudenaerde, Robin Vos","doi":"10.1183/23120541.00692-2026","DOIUrl":"10.1183/23120541.00692-2026","url":null,"abstract":"<p><p><b>Treatment response to rATLG in chronic lung allograft dysfunction is not uniform but is most evident in patients with rapidly progressive disease, highlighting the importance of trajectory-based patient selection</b> https://bit.ly/4ewNaVq.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"12 5","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227524","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}