ERJ Open Research最新文献

{"title":"Surfactant-derived protein type B: a new biomarker linked to respiratory failure and lung damage in mild to moderate SARS-CoV-2 pneumonia.","authors":"Massimo Mapelli, Elisabetta Salvioni, Irene Mattavelli, Cristina Banfi, Stefania Ghilardi, Arianna Greco, Maria Luisa Biondi, Sara Rovai, Elisabetta Mancini, Sergio Harari, Piergiuseppe Agostoni","doi":"10.1183/23120541.00301-2024","DOIUrl":"10.1183/23120541.00301-2024","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has led to significant concern due to its impact on human health, particularly through pneumonia-induced lung damage. Surfactant proteins A and D (SP-A and SP-D) are implicated in COVID-19 lung damage, but the role of surfactant protein B (SP-B) remains unclear.</p><p><strong>Methods: </strong>We conducted a single-centre, prospective observational study involving 73 hospitalised COVID-19 pneumonia patients. SP-B levels were measured within 48 h of admission, alongside SP-A and SP-D in a subset. Clinical data were collected, and follow-up visits were conducted after 6 months.</p><p><strong>Results: </strong>At hospitalisation, circulating immature SP-B levels measured in 73 patients (median 26.31 arbitrary units (AU) (interquartile range 14.27-41.31)) correlated significantly with lung involvement (r=0.447, p<0.001) and oxygen support requirement (p=0.005). SP-B levels did not predict mechanical ventilation or intensive care unit admission. SP-B decreased significantly (p<0.001) from 25.53 AU (14.36-41.46) at the acute hospitalisation to 12.73 AU (9.12-20.23) at the 6-month follow-up, whereas SP-A and SP-D did not change significantly. Immature SP-B (but not SP-A and SP-D) was confirmed to be significantly associated with the need for oxygen support (n=26, 58%) during the hospitalisation (p<0.05).</p><p><strong>Conclusion: </strong>Immature SP-B emerges as a potential biomarker for COVID-19 pneumonia severity and prognosis. Its dynamic changes suggest utility in monitoring disease progression and long-term outcomes, despite limitations in predicting hard end-points. Larger studies are needed to validate these findings and understand the underlying mechanisms of surfactant protein dysregulation in COVID-19 pathogenesis.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"10 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715817","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":"Efficacy of tezepelumab in patients with severe asthma and persistent airflow obstruction.","authors":"Elliot Israel, Mario Castro, Christopher S Ambrose, Jean-Pierre Llanos, Nestor A Molfino, Nicole L Martin, Sandhia S Ponnarambil, Neil Martin","doi":"10.1183/23120541.00164-2024","DOIUrl":"10.1183/23120541.00164-2024","url":null,"abstract":"<p><strong>Background: </strong>Persistent airflow obstruction (PAO) in patients with asthma can be difficult to treat. Tezepelumab blocks thymic stromal lymphopoietin, an epithelial cytokine implicated in asthma pathogenesis. This analysis evaluated the efficacy of tezepelumab in patients with severe, uncontrolled asthma and PAO.</p><p><strong>Methods: </strong>PATHWAY (phase 2b) and NAVIGATOR (phase 3) were multicentre, randomised, double-blind, placebo-controlled studies. This <i>post hoc</i> analysis included PATHWAY and NAVIGATOR patients who received tezepelumab 210 mg or placebo every 4 weeks for 52 weeks. Change from baseline to week 52 in pre-bronchodilator forced expiratory volume in 1 s (FEV₁) and the annualised asthma exacerbation rate (AAER) over 52 weeks were assessed in patients with and without PAO (post-bronchodilator FEV₁/forced vital capacity ratio <0.7) at baseline.</p><p><strong>Results: </strong>Of the 1334 included patients, 782 (58.6%) had PAO at baseline. At week 52, greater improvements in pre-bronchodilator FEV₁ from baseline were observed in tezepelumab <i>versus</i> placebo recipients with PAO (least-squares (LS) mean 0.24 <i>versus</i> 0.07 L; difference 0.17 L, 95% confidence interval (CI): 0.11-0.23) and without PAO (LS mean 0.20 <i>versus</i> 0.12 L; difference 0.08 L, 95% CI: 0.01-0.15). Tezepelumab reduced the AAER <i>versus</i> placebo by 61% (95% CI: 51-69) and 56% (95% CI: 42-67) in patients with and without PAO, respectively. For patients with PAO at baseline, the proportion without PAO at week 52 was higher with tezepelumab (12.1%) than placebo (6.6%) (odds ratio 1.96, 95% CI: 1.30-2.94).</p><p><strong>Conclusion: </strong>Tezepelumab improved lung function and reduced exacerbations <i>versus</i> placebo in patients with severe, uncontrolled asthma with and without PAO.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"10 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715798","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: \"Global mortality and readmission rates following COPD exacerbation-related hospitalisation: a meta-analysis of 65 945 individual patients\". Kiki Waeijen-Smit, Mieke Crutsen, Spencer Keene, Marc Miravitlles, Ernesto Crisafulli, Antoni Torres, Christian Mueller, Philipp Schuetz, Thomas J. Ringbæk, Fabio Fabbian, Evgeni Mekov, Timothy H. Harries, Chung-tat Lun, Begum Ergan, Cristóbal Esteban, Jose M. Quintana Lopez, José Luis López-Campos, Catherina L. Chang, Robert J. Hancox, Eskandarain Shafuddin, Hollie Ellis, Christer Janson, Charlotte Suppli Ulrik, Gunnar Gudmundsson, Danny Epstein, José Dominguez, Alicia Lacoma, Christian Osadnik, Inmaculada Alia, Francesco Spannella, Zuhal Karakurt, Hossein Mehravaran, Cecile Utens, Martijn D. de Kruif, Fanny Wai San Ko, Samuel P. Trethewey, Alice M. Turner, Dragos Bumbacea, Patrick B. Murphy, Kristina Vermeersch, Shani Zilberman-Itskovich, John Steer, Carlos Echevarria, Stephen C. Bourke, Nicholas Lane, Jordi de Batlle, Roy T.M. Sprooten, Richard Russell, Paola Faverio, Jane L. Cross, Hendrik J. Prins, Martijn A. Spruit, Sami O. Simons, Sarah Houben-Wilke and Frits M.E. Franssen. <i>ERJ Open Res</i> 2024; 10: 00838-2023.","authors":"","doi":"10.1183/23120541.50838-2023","DOIUrl":"10.1183/23120541.50838-2023","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1183/23120541.00838-2023.].</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"10 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715810","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":"Still no room to breathe: insights on supine lung mechanics from oscillometry in COPD.","authors":"David A Kaminsky, Peter M A Calverley","doi":"10.1183/23120541.00620-2024","DOIUrl":"10.1183/23120541.00620-2024","url":null,"abstract":"<p><p><b>A study in <i>ERJ Open Research</i> documents the effects of supine posture on lung mechanics in patients with COPD. Specifically, it finds that hyperinflation is related to expiratory flow limitation and increased dynamic elastance.</b> https://bit.ly/4eQG7G7.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"10 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715816","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":"Vascular involvement in idiopathic pulmonary fibrosis.","authors":"Michele Mondoni, Rocco Rinaldo, Christopher J Ryerson, Cristina Albrici, Andrea Baccelli, Claudio Tirelli, Francesca Marchetti, Jacopo Cefalo, Giulia Nalesso, Giulia Ferranti, Fausta Alfano, Giovanni Sotgiu, Marco Guazzi, Stefano Centanni","doi":"10.1183/23120541.00550-2024","DOIUrl":"10.1183/23120541.00550-2024","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a chronic, fibrosing and progressive interstitial lung disease of unknown aetiology with a pathogenesis still partly unknown. Several microvascular and macrovascular abnormalities have been demonstrated in the pathogenesis of IPF and related pulmonary hypertension (PH), a complication of the disease.</p><p><strong>Methods: </strong>We carried out a non-systematic, narrative literature review aimed at describing the role of the vasculature in the natural history of IPF.</p><p><strong>Results: </strong>The main molecular pathogenetic mechanisms involving vasculature (<i>i.e.</i> endothelial-to-mesenchymal transition, vascular remodelling, endothelial permeability, occult alveolar haemorrhage, vasoconstriction and hypoxia) and the genetic basis of vascular remodelling are described. The prevalence and clinical relevance of associated PH are highlighted with focus on the vasculature as a prognostic marker. The vascular effects of current antifibrotic therapies, the role of pulmonary vasodilators in the treatment of disease, and new pharmacological options with vascular-targeted activity are described.</p><p><strong>Conclusions: </strong>The vasculature plays a key role in the natural history of IPF from the early phases of disease until development of PH in a subgroup of patients, a complication related to a worse prognosis. Pulmonary vascular volume has emerged as a novel computed tomography finding and a predictor of mortality, independent of PH. New pharmacological options with concomitant vascular-directed activity might be promising in the treatment of IPF.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"10 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715144","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":"Enhanced diaphragm excursion and exercise tolerance in COPD patients through inspiratory muscle training after standardised pulmonary rehabilitation: randomised controlled trial.","authors":"Masashi Shiraishi, Yuji Higashimoto, Ryuji Sugiya, Hiroki Mizusawa, Yu Takeda, Masaya Noguchi, Osamu Nishiyama, Ryo Yamazaki, Shintarou Kudo, Tamotsu Kimura, Hisako Matsumoto","doi":"10.1183/23120541.00035-2024","DOIUrl":"10.1183/23120541.00035-2024","url":null,"abstract":"<p><strong>Objective: </strong>Inspiratory muscle training (IMT) is used to improve inspiratory muscle strength in patients with COPD. However, the effect of IMT on diaphragmatic function has not yet been thoroughly evaluated. This study aimed to evaluate the effect of IMT on maximum diaphragmatic excursion (DE_max) using ultrasonography in patients with COPD.</p><p><strong>Methods: </strong>This was a single-centre, randomised, prospective, parallel-group, unblinded controlled trial involving 38 participants with stable COPD. Participants underwent a standardised 12-week pulmonary rehabilitation (PR) programme followed by a 12-week IMT programme, consisting of home-based IMT and low-frequency outpatient PR sessions supervised by physiotherapists (once every 2 weeks), <i>versus</i> low-frequency outpatient PR alone as a control. The DE_max and exercise tolerance were measured.</p><p><strong>Results: </strong>Out of the 38 patients initially enrolled in the PR programme, 33 successfully completed it and were subsequently randomised to the IMT programme. Finally, 15 (94%) and 14 (88%) patients from the IMT and control groups, respectively, completed the study. Following the IMT programme, DE_max increased in the IMT group (mean±sd 50.1±7.6 mm to 60.6±8.0 mm, p<0.001), but not in the control group (47.4±7.9 mm to 46.9±8.3 mm, p=0.10). Changes in DE_max and exercise tolerance (peak oxygen uptake) were greater in the IMT group than in the control group (both p<0.01).</p><p><strong>Conclusions: </strong>IMT following the PR programme improved DE_max and exercise tolerance. Therefore, DE_max may be an important outcome of IMT.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"10 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715831","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":"Wearable technology for detection of COPD exacerbations: feasibility of the Health Patch.","authors":"Liz J A Cuperus, Lotte Bult, Cathelijne M van Zelst, Willem J van den Brink, Kristel R J M Kamstra, Tim J van den Broek, Meike A C van den Eijnden, Pradeep Panditha, Johannes C C M In 't Veen, Gert-Jan Braunstahl","doi":"10.1183/23120541.00396-2024","DOIUrl":"10.1183/23120541.00396-2024","url":null,"abstract":"<p><p><b>Wearable devices could offer valuable support for managing and preventing COPD exacerbations in the future</b> https://bit.ly/4cPnHUK.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"10 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715451","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 noninvasive ventilation outcomes score in patients requiring NIV for COPD exacerbation without prior evidence of airflow obstruction.","authors":"Nicholas D Lane, Tom M Hartley, John Steer, Stephen C Bourke","doi":"10.1183/23120541.00193-2024","DOIUrl":"https://doi.org/10.1183/23120541.00193-2024","url":null,"abstract":"<p><strong>Introduction: </strong>Exacerbation of COPD complicated by respiratory acidaemia is the commonest indication for noninvasive ventilation (NIV). The NIV outcomes (NIVO) score offers the best estimate of survival for those ventilated. Unfortunately, two-thirds of cases of COPD are unrecognised, and patients may present without COPD having been confirmed by spirometry.</p><p><strong>Methods: </strong>In the 10-centre NIVO validation study there was no pre-admission spirometry in 111 of 844 consecutive patients (termed \"clinical diagnosis\" patients). We compared the performance of the NIVO, DECAF and CURB-65 scores for in-hospital mortality in the clinical diagnosis cohort. Usual clinical practice was not influenced, but confirmation of COPD in the year following discharge was captured.</p><p><strong>Results: </strong>In the clinical diagnosis cohort, in-hospital mortality was 19.8% and rose incrementally across the NIVO risk categories, consistent with the NIVO validation cohort. NIVO showed good discrimination in the clinical diagnosis cohort: area under the receiver operating curve 0.724, <i>versus</i> 0.79 in the NIVO validation cohort. At 1 year after discharge, 41 of 89 clinical diagnosis patients had undertaken diagnostic spirometry; 33 of 41 had confirmation of airflow obstruction (forced expiratory volume in 1 s/(forced) vital capacity <0.7), meaning the diagnosis of COPD was incorrect in 19.5% of cases.</p><p><strong>Discussion: </strong>These data support the use of the NIVO score in patients with a \"clinical diagnosis\" of COPD. NIVO can help guide shared decision-making, assess risk-adjusted outcomes by centre and challenge prognostic pessimism. Accurate diagnosis is critical to ensure that acute and long-term treatment is optimised; this study highlights failings in the follow-up of such patients.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"10 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616814","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":"A worldwide perspective of long COVID management: how can we END-COVID?","authors":"Hayoung Choi","doi":"10.1183/23120541.00500-2024","DOIUrl":"https://doi.org/10.1183/23120541.00500-2024","url":null,"abstract":"<p><p><b>A global survey revealed marked heterogeneity in long COVID management worldwide</b> https://bit.ly/4dVTJ2t.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"10 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616812","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":"Study protocol for evaluating the efficacy of early pulmonary rehabilitation combined with an internet-based patient management model in patients with COPD: a practical, multicentre, randomised controlled study from China.","authors":"Wang Ye, Li Danye, Cui Jingjing, Zhang Siyu, Wang Jiaxi, Wang Siyuan, Zhao Hongmei, Wang Chen","doi":"10.1183/23120541.00995-2023","DOIUrl":"10.1183/23120541.00995-2023","url":null,"abstract":"<p><strong>Background: </strong>COPD, a preventable and treatable disease, is characterised by persistent respiratory symptoms and airflow limitations, with high incidence, disability, mortality and disease burden. Currently, drug treatments mainly include bronchodilators and glucocorticoids, which are used to alleviate symptoms and improve lung function. Traditional medical care models and patients' lack of understanding of the disease result in regular and long-term hospitalisations, affect patients' quality of life and cause a need to explore more effective comprehensive intervention plans.</p><p><strong>Methods: </strong>This study is designed as a multicentre, randomised controlled trial consisting of three parallel groups. Group A will receive early pulmonary rehabilitation in the hospital and remote internet pulmonary rehabilitation after discharge. Group B will receive the same early pulmonary rehabilitation in the hospital but outpatient pulmonary rehabilitation after discharge for 8 weeks and routine follow-up management. Group C will receive outpatient pulmonary rehabilitation during a stable period of 3-4 weeks after discharge and routine follow-up management. 1482 patients will be enrolled from 10 centres in China. The primary outcome measures will be the readmission rate due to acute exacerbation at 90 days and the 12-month readmission rate due to acute exacerbation. The secondary outcomes will mainly include differences in all-cause mortality; the number of acute exacerbations; COPD Assessment Test, modified Medical Research Council scale and St George's Respiratory Questionnaire scores; the pulmonary rehabilitation treatment completion rate; patient compliance; and patient and physician satisfaction scores among the three groups at 3, 6 and 12 months after the different interventions. In addition, the proportion of people with ≥2 acute exacerbations within 12 months and the time of the first acute exacerbation will also be included.</p><p><strong>Conclusions: </strong>This study aims to further verify the substitutability of remote internet pulmonary rehabilitation for outpatient rehabilitation and its short-term and long-term effects in patients, providing comprehensive interventional evidence for the treatment of COPD.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"10 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11513996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521413","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}