European Respiratory Journal最新文献

{"title":"A phase 2a study with SPL84: A novel RNA-targeted approach to restore CFTR function in people with CF carrying the 3849+10 kb C→T mutation.","authors":"Szczepan Cofta, Daria Springer, Kęstutis Malakauskas, Virginija Kalinauskaitė-Žukauskė, Karen McCoy, Andrea Gramegna, Renske van der Meer, Eva Bérešová, Antonio Alvarez Fernandez, Almudena Felipe Montiel, Rebecca Cagnina, Henryk Mazurek, Pavel Drevinek, Stefano Costa, Lital Friedman, Gili Hart, Asaf Cohen, Efrat Ozeri-Galai, Batsehva Kerem, Stanley Fiel, Eitan Kerem, Carsten Schwarz","doi":"10.1183/13993003.00866-2026","DOIUrl":"https://doi.org/10.1183/13993003.00866-2026","url":null,"abstract":"<p><strong>Background: </strong>The 3849+10 kb C→T mutation in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene leads to aberrant splicing and the inclusion of a cryptic exon harboring a premature stop codon, resulting in the production of non-functional CFTR protein. SPL84 is an inhaled antisense oligonucleotide (ASO) designed to correct CFTR splicing and restore functional CFTR expression in people with CF (pwCF) carrying this mutation.</p><p><strong>Methods: </strong>This Phase 2a randomized, placebo-controlled, double-blind, multiple ascending dose study evaluated safety, tolerability, pharmacokinetics, and exploratory efficacy of inhaled SPL84 in pwCF carrying the 3849+10 kb C→T mutation. Participants received once-weekly inhalations of SPL84 (25 or 50 mg) or placebo for 9 weeks. Exploratory efficacy measures included changes in ppFEV1, ppFEF25-75, and CFQ-R respiratory symptom score.</p><p><strong>Results: </strong>Seventeen participants were included in the analysis, with fifteen completing all treatments. SPL84 was well tolerated with no drug-related serious adverse events. Most adverse events were mild or moderate and consistent with the underlying CF disease. Improvements in lung function, defined as change from baseline in ppFEV1≥5, were observed in up to 70% of the treated participants per cohort, accompanied by improvement of additional efficacy outcomes.</p><p><strong>Conclusions: </strong>Inhaled SPL84 demonstrated a favorable safety profile together with encouraging signals of clinical benefit in pwCF carrying the 3849+10 kb C→T mutation. These findings represent, to our knowledge, the first evidence of potential clinical benefit from a nucleic acid-based therapy targeting RNA in a pulmonary disease, supporting further evaluation of SPL84 as a mutation-specific, RNA-targeted treatment.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative lifecourse cardiovascular health and interstitial lung abnormalities.","authors":"Kavitha C Selvan, Elsie Bunyan, Laura A Colangelo, Anthony J Esposito, Gabrielle Y Liu, Sadiya S Khan, Kevin Grudzinski, Bradford Bemiss, Gary M Hunninghake, Raul San Jose Estepar, Bharat Thyagarajan, George Washko, Rachel Putman, Ravi Kalhan","doi":"10.1183/13993003.01207-2026","DOIUrl":"https://doi.org/10.1183/13993003.01207-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-cell multi-omics in IPF and COPD: from atlas to impact.","authors":"Puja Mehta, Chao He, Connar M A Mawar, Xiting Yan, Ivan O Rosas, Naftali Kaminski","doi":"10.1183/13993003.00023-2026","DOIUrl":"https://doi.org/10.1183/13993003.00023-2026","url":null,"abstract":"<p><p>Single-cell and spatial multi-omics technologies are transforming our understanding of the normal lung cellular repertoire as well the molecular and cellular networks of chronic lung diseases. In this review we focus on idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD). We briefly review technologies and discuss technical and analytical challenges, including strategies to optimise batch correction, dataset integration, and sample-aware differential gene expression; we describe global lung reference atlases, enabled by large-scale data-sharing, providing accessible frameworks for cross-study validation, lineage and trajectory inference, and inter-disease comparisons; and we outline the major findings in COPD and IPF. In IPF, mechanistic insights include: (i) loss of the normal alveolar niche (ii) aberrant basaloid epithelial cells linked to failed regeneration, expansion of (iii) profibrotic <i>SPP1+</i> macrophages and (iv) disease-associated <i>CTHRC1⁺</i> and <i>HAS1^hi</i> fibroblast subtypes, that localise to fibrotic niches, and (v) extensive vascular and immune remodelling. In COPD these approaches demonstrate: (i) loss of aerocytes; (ii) expansion of <i>MMP</i>-expressing macrophages, (iii) activated neutrophil influx and (iv) B-cell lymphoid follicle activation and endothelial inflammation (iv) some overlapping features with IPF. We highlight gaps and future opportunities, including under-representation of early disease stages, incomplete resolution of neutrophils, tissue-resident immune compartments, and cross-organ integration. Looking forward, integration with clinical phenotypes and imaging is accelerating translation towards precision medicine, enabling biomarker discovery, cellular endotyping, and therapeutic prioritisation. Advances in multimodal profiling, computational pipelines, next generation technologies, open science initiatives and artificial intelligence will propel the field toward predictive, patient-specific insight and mechanistically informed, stratified trial design.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sputum and oral microbiota profiles are associated with long COVID severity and phenotype post-hospitalisation: a UK multicentre, prospective cohort study.","authors":"Daniela Alferes de Lima Headley, Hollian Richardson, Chandani Hennayake, Zsofia Eke, Jamie Stobo, Merete B Long, Olivia C Leavy, Matthew Richardson, Omer Elneima, Hamish J C McAuley, Aarti Shikotra, Amisha Singapuri, Marco Sereno, Ruth M Saunders, Victoria C Harris, Linzy Houchen-Wolloff, Neil J Greening, Kimon Ntotsis, Daniel Lozano-Rojas, Beatriz Guillen-Guio, Ewen M Harrison, Annemarie B Docherty, Steven Kerr, Nazir I Lone, Jennifer K Quint, Aziz Sheikh, Mathew Thorpe, Bang Zheng, Claudia Efstathiou, Maxime Taquet, Iain D Stewart, Trudie Chalder, Melanie J Davies, Anthony De Soyza, John R Geddes, William Greenhalf, Luke S Howard, Joseph Jacob, R Gisli Jenkins, William D-C Man, Gerry P McCann, Stefan Neubauer, Peter J M Openshaw, Joanna C Porter, Matthew J Rowland, David Thomas, Mark Toshner, Simon Heller, Janet T Scott, Malcolm G Semple, Sally J Singh, Raminder Aul, Paul Beirne, Charlotte E Bolton, Jeremy S Brown, Gourab Choudhury, Nawar Diar Bakerly, Nicholas Easom, Carlos Echevarria, Jonathan Fuld, John R Hurst, Mark Jones, Dhruv Parekh, Paul Pfeffer, Najib M Rahman, Sarah Rowland-Jones, Ajay M Shah, Daniel G Wootton, Keir Lewis, Liam G Heaney, Ling-Pei Ho, Alex Horsley, Michael Marks, Krisnah Poinasamy, Betty Raman, Louise V Wain, Rachael A Evans, Christopher E Brightling, Philip L Molyneaux, James D Chalmers","doi":"10.1183/13993003.01162-2026","DOIUrl":"10.1183/13993003.01162-2026","url":null,"abstract":"<p><strong>Background: </strong>Acute COVID-19 alters the airway microbiota. Whether these changes persist post-COVID-19 and contribute to long COVID is unknown. We aimed to describe the microbiota by long COVID severity and subtype, and identify links with inflammation.</p><p><strong>Methods: </strong>Adults were prospectively recruited to the longitudinal UK Post-hospitalisation COVID-19 study (PHOSP-COVID). Patients were grouped by previously described \"severity clusters\" (of ongoing health impairments) and symptom subgroups. Oral and sputum microbiota (at 6 months post-discharge) were characterised through 16S ribosomal RNA gene amplicon sequencing, and microbiota diversity was assessed. Co-occurrence network analysis identified keystone taxa. Associations between keystone taxa and plasma inflammatory proteins were assessed through Spearman's rank correlations.</p><p><strong>Results: </strong>771 participants had their microbiota assessed. Of participants with oral rinses and \"severity cluster\" assignment (mean age 57.5 years), 278 out of 722 (38.5%) were women. The \"very severe\" cluster, in which disease was predominantly pulmonary in nature, was associated with a distinct microbiota profile post-COVID-19. Reduced lung function was associated with a distinct oral microbiota profile. Persistent neurocognitive symptoms were associated with a distinct oral microbiota profile, while gastrointestinal symptoms were associated with a distinct sputum microbiota profile. Microbiota keystone taxa shifted to a higher prevalence of lactic acid bacteria associated with worse health outcomes. Lactic acid bacteria abundance was associated with elevated blood inflammatory proteins.</p><p><strong>Conclusion: </strong>Distinct oral and sputum microbiota profiles were associated with pulmonary function and with neurocognitive and gastrointestinal symptoms in long COVID. Shifts in keystone microbiota taxa linked with inflammation, based on worse health outcomes, suggest a potential role change for lactic acid bacteria, which may be associated with the host immune response.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1-based therapies in lung diseases.","authors":"Marissa O'Callaghan, Mariëtte R Boon, Gert-Jan Braunstahl, Thomas Koudstaal, Elisabeth F C van Rossum, Karen Moor, Marlies Wijsenbeek","doi":"10.1183/13993003.00643-2026","DOIUrl":"https://doi.org/10.1183/13993003.00643-2026","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), initially developed for the treatment of type 2 diabetes and obesity, are increasingly recognised as multi-system agents with cardiovascular, renal and anti-inflammatory benefits. Emerging evidence suggests that their pleiotropic metabolic and immunomodulatory effects may have therapeutic relevance in chronic lung diseases. The lung is a metabolically active organ in which obesity, insulin resistance and systemic inflammation contribute to disease susceptibility, progression and treatment response. Chronic lung diseases such as asthma, COPD, pulmonary hypertension and interstitial lung disease share overlapping inflammatory, vascular and fibrotic pathways that may be modifiable through GLP-1 RA-based therapies. Preclinical studies demonstrate that GLP-1R signalling influences airway inflammation, oxidative stress, endothelial function and fibroblast activation. Observational and early clinical data suggest potential benefits in asthma control, exacerbation reduction in COPD, vascular remodelling in pulmonary hypertension and a reduction in all-cause mortality in interstitial lung disease. In addition to weight loss and glycaemic improvement, GLP-1 RAs exert direct anti-inflammatory and immune-regulatory effects that may act independently of metabolic change. Despite promising mechanistic and translational signals, high-quality randomised controlled trials with GLP-1 RAs in pulmonary populations remain limited. Key questions include patient selection, interaction with established anti-inflammatory and antifibrotic therapies, and the relative contribution of metabolic <i>versus</i> direct pulmonary effects. This review aims to synthesise current mechanistic, experimental and clinical evidence supporting GLP-1 RA use in chronic lung disease and outlines future research priorities within a precision-medicine framework.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysregulated NK cell phenotype in exacerbation-prone severe asthma.","authors":"Melody G Duvall, Madison H Dorazio, Tania Chiha, Roisin B Reilly, Saïsha K Ramdour, Nandini Krishnamoorthy, R Elaine Cagnina, Wanda Phipatanakul, Elliot Israel, Bruce D Levy","doi":"10.1183/13993003.00317-2026","DOIUrl":"https://doi.org/10.1183/13993003.00317-2026","url":null,"abstract":"<p><strong>Background: </strong>Natural killer (NK) cell dysfunction and defective inflammation resolution pathways are associated with chronic airway inflammation in asthma. NK cells are targets for regulation by essential polyunsaturated fatty acid-derived specialized pro-resolving mediators (SPMs), including resolvin D2 (RvD2), to stimulate inflammation resolution.</p><p><strong>Methods: </strong>Multiparameter flow cytometry was utilized to examine expression patterns of select activating and inhibitory receptors, including the RvD2 receptor DRV2, on circulating NK cells in SARP3 severe and non-severe asthma subjects and healthy controls. Plasma RvD2 and serum amyloid A (SAA) was measured, and RvD2 and SAA regulation of NK cell cytotoxicity was examined <i>in vitro</i>.</p><p><strong>Results: </strong>Expansion of circulating NK cells with downregulated activating receptors NKp30 and NKp46 and inhibitory receptor CD161 were linked with exacerbation susceptibility and longitudinal lung function trajectory in asthma. Circulating SAA levels were higher in severe asthma patients (median 8.8 μg·mL^-1) than healthy individuals (2.2 μg·mL^-1; p=0.003). In contrast, plasma RvD2 levels were lower in severe asthma (153 pg·mL^-1 <i>versus</i> 208 pg·mL^-1 in health; p=0.041), concomitant with a two-fold higher NK cell DRV2 receptor expression than in non-severe asthma subjects (3973 MFI <i>versus</i> 1798; p=0.003). High-dose SAA exposure downregulated NK cell triggering receptors and resulted in a 22% suppression of cytotoxicity (48.9±9.7% <i>versus</i> 62.5±9.2% in vehicle; p=0.001). In contrast, RvD2 enhanced NK cell cytotoxicity (38.1±8.8% <i>versus</i> 33.1±8.3%; p=0.007) and partially reversed SAA-mediated suppression (5.4±2.7% change; p=0.031).</p><p><strong>Conclusions: </strong>These findings identify a perturbed counterregulatory network for inflammation resolution in severe asthma comprised of excess pro-inflammatory SAA, deficient pro-resolving RvD2, and altered NK cell immune signatures that were associated with increased asthma morbidity. The beneficial impact of RvD2 in counteracting SAA-mediated suppression of NK cell effector function supports a pivotal mechanistic role for SPMs to enhance cell-type specific resolution pathways to combat persistent airway inflammation in asthma.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pleuroparenchymal fibroelastosis in a monogenic mitochondrial DNA depletion syndrome.","authors":"Sandra von Hardenberg, Pia Maier, Leonard Christian, Anibh Martin Das, Lavinia Neubert, Jannik Ruwisch, Katrin Peters, Dirk Schramm, Matthias Griese, Britta Skawran, Marlies Eilers, Danny Jonigk, Norman Junge, Aiden Haghikia, Tobias Hegelmaier, Winfried Hofmann, Benjamin Seeliger, Diane Miriam Renz, Amelie Stalke, Lara Hartmayer, Alexander Duscha, Martin Schulze, Nataliya DiDonato, Holger Prokisch, Bernd Auber, Lars Knudsen, Jonas C Schupp, Nicolaus Schwerk","doi":"10.1183/13993003.00791-2026","DOIUrl":"https://doi.org/10.1183/13993003.00791-2026","url":null,"abstract":"<p><strong>Background: </strong>Pleuroparenchymal fibroelastosis (PPFE) is a rare, most often idiopathic fibrotic lung disease with poor prognosis, mainly affecting adults. Biallelic pathogenic variants in the deoxyguanosine kinase gene (<i>DGUOK</i>) cause a mitochondrial DNA (mtDNA) depletion syndrome, predominantly affecting infants with severe hepatic and neurological disease. Neither detailed pulmonary manifestations nor a pulmonary-dominant phenotype has been reported.</p><p><strong>Methods: </strong>We describe nine patients with PPFE and <i>DGUOK</i>-associated mitochondriopathy. Clinical, radiological, histopathological, and genetic data were systematically collected from all patients. Functional studies, single-nucleus RNA sequencing (snRNAseq), immunofluorescence staining, transmission electron microscopy, respiratory chain enzyme activity assays and mtDNA recovery experiment were conducted on patient-derived fibroblasts, muscle or lung tissues. mtDNA content quantification was performed on whole genome sequencing data.</p><p><strong>Results: </strong>All patients (ages 5-36 years) carried biallelic pathogenic <i>DGUOK</i> variants, including an unreported intronic alteration in seven. All presented with progressive dyspnea, weight loss and some with pneumothoraces. Chest computed tomography and lung biopsies demonstrated features of PPFE. snRNAseq of lung tissue from four pediatric patients identified Aberrant Basaloid cells at the fibrotic edge, together with a transcriptional signature of nuclear DNA damage response. Ultrastructural analysis confirmed mitochondrial abnormalities in alveolar type 2 and Aberrant Basaloid cells.</p><p><strong>Conclusion: </strong>This study provides evidence that mitochondrial dysfunction can contribute to early-onset PPFE independent of age, with a DNA damage response signature in aberrant epithelial cell populations previously described only in adult fibrotic lung disease. DGUOK deficiency and other hereditary mitochondrial disorders should be considered in children and young adults presenting with PPFE of unknown origin.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eurotransplant experience with Model for End-Stage Liver Disease standard exceptions for hepatopulmonary syndrome and portopulmonary hypertension.","authors":"Maïté Verstraeten, Axel J T Jens, Gabriela Berlakovich, Martina Sterneck, Felix Braun, Caroline M den Hoed, Blaž Trotovšek, Danko Mikulic, Tamas Benkoe, Anja Geerts, Xavier Verhelst, Hans Van Vlierberghe, Sarah Raevens","doi":"10.1183/13993003.00816-2026","DOIUrl":"https://doi.org/10.1183/13993003.00816-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ERS/ESRS clinical practice guideline for continuous positive airway pressure for the treatment of adult obstructive sleep apnoea.","authors":"Dries Testelmans, Esther Irene Schwarz, Ulla Anttalainen, Özen Kacmaz Basoglu, Matteo Bradicich, Sonja Craig, Marta Drummond, Alberto Giannoni, Raphael Heinzer, Hennie Janssen, Valérie Labonté, Mirjam Ljunggren, Miguel Angel Martinez Garcia, Stefan Mihaicuta, Gabriel Natan Pires, Gianfranco Parati, Jean Louis Pepin, Luca Roberti, Silke Ryan, Andreja Sajnic, Ingrid Toews, Piet-Heijn van Mechelen, Johan Verbraecken, Clare Williams, Winfried Randerath","doi":"10.1183/13993003.01186-2026","DOIUrl":"https://doi.org/10.1183/13993003.01186-2026","url":null,"abstract":"<p><strong>Background: </strong>Continuous positive airway pressure (CPAP) is the primary treatment for obstructive sleep apnoea (OSA), although its effectiveness may vary across OSA subtypes. This joint European Respiratory Society (ERS)/European Sleep Research Society (ESRS) clinical practice guideline evaluates CPAP's impact on patient-centred and prognostically relevant outcomes, comparing it to no or sham treatment in different OSA subgroups.</p><p><strong>Methods: </strong>The joint ERS/ESRS Task Force consisted of experts in pulmonology, cardiology and respiratory sleep medicine, patient representatives and methodologists. Questions were formulated using the PICO (Population, Intervention, Comparator, Outcomes) framework. A systematic review assessing the effects of CPAP on critical outcomes was performed. The certainty of evidence for all outcomes was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Consensus on the direction and strength of the recommendation was informed by Evidence-to-Decision frameworks and achieved through discussions and voting.</p><p><strong>Recommendations: </strong>The Task Force generally suggests CPAP treatment for OSA because of its beneficial effects on sleepiness, other patient-reported outcomes and blood pressure (conditional recommendations). CPAP is recommended in patients with excessive daytime sleepiness (EDS) (strong recommendation). Additional specific conditional recommendations are given for patients with moderate-to severe OSA, the elderly, and patients with arterial and treatment-resistant hypertension. The Task Force suggests either CPAP or no treatment in patients without EDS (but taking into account other OSA-related symptoms), in patients with atrial fibrillation with the aim of reducing its recurrence and in patients with impaired glucose metabolism to improve glycaemic control.</p><p><strong>Conclusion: </strong>CPAP is an effective treatment for adults with OSA. However, recommendations for its use vary across different patient subgroups.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haemodynamic remission and transition off epoprostenol after upfront triple therapy in PAH.","authors":"Takeshi Ogo, Hiroya Hayashi, Ryo Takano, Shinya Fujisaki, Atsushi Kuraishi, Koh Orita, Ryotaro Asano","doi":"10.1183/13993003.01507-2026","DOIUrl":"https://doi.org/10.1183/13993003.01507-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":23.8,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}