European Respiratory Journal最新文献

{"title":"Right Ventricular Adaptation after Pulmonary Endarterectomy and Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension: A comparative Cardiac MRI-Based Study.","authors":"Tamara C Rodenburg, Satoshi Higuchi, Stine Andersen, Elisa Stilling, Natalia J Braams, Azar Kianzad, Esther J Nossent, Jurjan Aman, Morten K Jensen, Won Y Kim, Marcel A M Beijk, Rutger J Lely, Jacobus A Winkelman, Lars B Ilkjær, Frances S de Man, Anton Vonk Noordegraaf, Mads J Andersen, Asger Andersen, Lilian J Meijboom, Harm Jan Bogaard","doi":"10.1183/13993003.02314-2025","DOIUrl":"https://doi.org/10.1183/13993003.02314-2025","url":null,"abstract":"<p><strong>Background: </strong>Chronic thromboembolic pulmonary hypertension (CTEPH) is associated with elevated right ventricular (RV) afterload and progressive RV remodeling. Balloon pulmonary angioplasty (BPA) has emerged as an established and increasingly used alternative to pulmonary endarterectomy (PEA). This study aimed to evaluate hemodynamic, functional and structural cardiac responses to PEA and BPA, with specific focus on RV reverse remodeling.</p><p><strong>Methods: </strong>In this prospective, multicenter cohort study, 93 patients with CTEPH (PEA; n=50, BPA; n=43) from the Netherlands and Denmark underwent cardiac magnetic resonance imaging, right heart catheterization, exercise testing and biomarker assessment at baseline and 6-months post-intervention. Longitudinal changes were assessed with repeated-measures ANOVA. A subgroup underwent analysis at 18 months.</p><p><strong>Results: </strong>BPA patients were older (68.9±10.1 <i>versus</i> 62.4±11.1 years, p<i>=</i>0.004), and used more PH medication. PEA-treated patients had higher RV mass index at baseline (40.1±13.5 <i>versus</i> 32.9±12.2 g·m^-2; p=0.017), and consistently higher relative RV wall thickness at baseline and follow-up (both 0.4±0.1 <i>versus</i> 0.3±0.1; <i>p</i><0.001). Both interventions improved RV afterload, function and exercise capacity (all <i>p</i><0.05). Larger hemodynamic improvement after PEA (mPAP and PVR; p-interaction≤0.001) was accompanied by more pronounced RV reverse remodeling, including lower follow-up indexed RV volumes (RVEDVi; 76.2±16.8 <i>versus</i> 92.2±20.2 mL·m^-2; <i>p</i><0.001 and RVESVi; 39.0±15.6 <i>versus</i> 49.0±18.8 mL·m^-2; p=0.014).</p><p><strong>Conclusions: </strong>In this multicenter European study, both therapies resulted in significant RV reverse remodeling. PEA was associated with larger absolute reductions in indexed RV mass and volumes than BPA. However, remodeling sensitivity to unloading appeared broadly similar across treatments. Despite favorable outcomes following both treatments, our findings emphasize the need for randomized controlled studies, to optimize treatment strategies for operable and inoperable patients.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835806","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":"On the interpretation of negative efficacy in the MUCOSA trial: is the role of eosinophils in refractory chronic cough truly dismissed?","authors":"Wenzhi Zhan, Jiaxing Xie, Wei Luo, Kefang Lai","doi":"10.1183/13993003.02663-2025","DOIUrl":"https://doi.org/10.1183/13993003.02663-2025","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"67 5","pages":""},"PeriodicalIF":21.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835754","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":"ERJ Viewpoint: vascular targeted therapies for fibrotic lung disease - Start of a new era?","authors":"Albina Tyker, Laura C Price, Steven D Nathan, Martin Kolb","doi":"10.1183/13993003.00285-2026","DOIUrl":"https://doi.org/10.1183/13993003.00285-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835756","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":"FEV₁Q: the quest for an optimised measure of lung function impairment goes to the Global South.","authors":"Stephen T Russell, Jordan A Kempker","doi":"10.1183/13993003.02697-2025","DOIUrl":"https://doi.org/10.1183/13993003.02697-2025","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"67 5","pages":""},"PeriodicalIF":21.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835816","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":"Natural language processing-based intervention to detect interstitial lung abnormalities.","authors":"Janelle V Pugashetti, Jennifer M Wang, Gabrielle Echt, Sahand Ghodrati, Noor Hammoud, Ahmadreza Ghasemiesfe, Michael Kadoch, Susan Murray, Ella A Kazerooni, Justin M Oldham","doi":"10.1183/13993003.00046-2026","DOIUrl":"https://doi.org/10.1183/13993003.00046-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812496","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":"Distribution of Blood Eosinophil Count in the Chinese General Population.","authors":"Peiji Yao, Lan Yang, Dan Liu, Dongyu He, Lei Li, Yifei Lin, Jin Huang, Weimin Li","doi":"10.1183/13993003.01570-2025","DOIUrl":"https://doi.org/10.1183/13993003.01570-2025","url":null,"abstract":"<p><strong>Background: </strong>Current clinical assessments of blood eosinophil (EOS) count often overlook demographic variability, particularly in Asian populations, where large-scale data remain scarce. We aimed to define demographic-specific distributions of EOS counts and identify factors associated with elevated levels in the general Chinese population.</p><p><strong>Methods: </strong>Using the large-scale Chinese health-check population dataset comprising over 680 000 participants (2010-2023), we conducted a cross-sectional study to characterize overall and demographic-stratified distributions of blood eosinophil counts and construct age- and sex-specific percentile curves. We then applied multivariable regression to quantify associations between EOS counts and selected respiratory and systemic conditions, adjusting for key demographic and clinical covariates. Robustness was evaluated through sensitivity analyses.</p><p><strong>Results: </strong>EOS counts showed a right-skewed distribution (median 100 cells·μL⁻¹, IQR 60-170) and were consistently higher in males than females (120 [80-200] <i>versus</i> 90 [50-140]). Age- and sex-specific centile curves defined population-based reference ranges and demonstrated a U-shaped trajectory across age. In multivariable analyses, higher EOS counts were associated with male sex, age <20 or ≥70, smoking, and higher BMI. EOS counts were positively associated with major respiratory conditions, including asthma and COPD, as well as selected systemic comorbidities (all <i>P</i>_Bonferroni <0.05). Findings were robust in sensitivity analyses.</p><p><strong>Conclusions: </strong>In this large Chinese health-check population, blood eosinophil counts showed substantial demographic heterogeneity. These findings support age- and sex-stratified reference ranges and may inform more context-specific thresholds for eosinophilia in clinical practice.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812918","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":"<i>ERJ</i> Podcast April 2026: Use of spirometry to define airflow obstruction and diagnose COPD.","authors":"","doi":"10.1183/13993003.E6704-2026","DOIUrl":"https://doi.org/10.1183/13993003.E6704-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"67 4","pages":""},"PeriodicalIF":21.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812485","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":"Obesity and asthma: obesity causes and aggravates asthma across the entire type-2 inflammation spectrum.","authors":"Sebastian Riemann, Imke Matthys, Tania Maes, Bruno Lapauw, Guy Brusselle","doi":"10.1183/13993003.02687-2025","DOIUrl":"10.1183/13993003.02687-2025","url":null,"abstract":"<p><p>Obesity affects more than 650 million adults worldwide, with prevalence continuing to rise across all age groups and continents. This trend has important implications for asthma: individuals with obesity have a 30-50% higher risk of developing asthma, and obesity is highly prevalent among people with established disease. Mean Body Mass Index (BMI) in clinical trials and registries of adults with asthma consistently ranges from 28-30 kg·m^-2, with up to 70% of patients being overweight or obese. These numbers highlight obesity as one of the most common comorbidities in asthma, consistently associated with poorer asthma control and a higher risk of exacerbations. Although obesity-associated asthma is often described as Type-2 (T2)-low phenotype, it is increasingly recognized as a heterogeneous condition not restricted to a single phenotype. Excess adiposity influences asthma through multiple mechanisms, including dysregulated adipokine signaling, impaired ILC2-eosinophil-macrophage crosstalk in adipose tissue, systemic low-grade inflammation, metabolic dysfunction, and mechanical effects on lung volumes. This diversity complicates diagnosis, endotyping, and treatment stratification. Obesity should therefore be considered a treatable trait in asthma. Weight reduction - through lifestyle interventions, pharmacotherapy, or bariatric surgery - improves symptoms, lung function, and exacerbation risk across both T2-high and T2-low asthma. Importantly, patients with obesity experience similar reductions in exacerbations with anti-T2 biologics as their lean counterparts, though improvements in symptoms and lung function are variable. Future research should prioritize randomized, placebo-controlled trials evaluating GLP-1 and dual GLP-1/GIP-agonist therapies specifically in patients with asthma and obesity, and elucidate how obesity modifies inflammatory endotypes and treatment responses.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225881","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":"Lung-Targeted HGF mRNA Restores Alveolar Structure in Experimental Emphysema.","authors":"Dian Chen, Jeffrey L Curtis, Weijing Kong, Lanhe Chu, Yixia Jiang, Tongxinwei Sun, Huanyu Long, Zihang Pan, Qiyang Yao, Dayan Li, Yun Zhao, Simin Jiang, Rongbing Yi, Guangliang Qiang, Yongchang Sun, Ping Jiang, Aihong Meng, Xiaojuan Liu, Yahong Chen, Kai Wang","doi":"10.1183/13993003.02323-2025","DOIUrl":"https://doi.org/10.1183/13993003.02323-2025","url":null,"abstract":"<p><strong>Background: </strong>Emphysema, a major component of chronic obstructive pulmonary disease (COPD) characterized by progressive alveolar destruction, lacks effective medical therapies. Hepatocyte growth factor (HGF) possesses potent regenerative functions, but its therapeutic potential remains unrealized due to challenges in achieving targeted delivery and sustained lung expression.</p><p><strong>Methods: </strong>We first assessed associations between HGF expression and emphysema severity using human datasets, lung tissue, and both elastase-induced and cigarette-smoke-induced murine models. We repurposed a clinical-stage SM102 lipid nanoparticles (LNPs) platform to deliver human HGF mRNA in murine models, evaluating therapeutic efficacy <i>via</i> i.t. instillation in the elastase model. After optimizing nebulization, we assessed efficacy in the cigarette-smoke model. We investigated underlying mechanisms <i>via</i> single-cell RNA sequencing (scRNA-seq), which we validated in patient-derived lung organoids.</p><p><strong>Results: </strong>HGF expression displayed a biphasic pattern across the emphysema spectrum, with upregulation in milder disease states and marked reduction in advanced emphysema. i.t. delivery of HGF mRNA LNPs restored lung function and attenuated alveolar destruction in the elastase model. Nebulized delivery achieved efficient pulmonary distribution and demonstrated comparable therapeutic efficacy in the cigarette-smoke model, including improved lung function, reduced inflammation, and decreased apoptosis. scRNA-seq analysis detected enhanced alveolar type II (AT2) cell proliferation and differentiation in the elastase model and human organoids.</p><p><strong>Conclusion: </strong>This study provides proof-of-concept evidence for a therapeutic strategy for emphysema. Using a clinical-stage LNPs platform, we demonstrate that HGF mRNA therapy is effective <i>via</i> both direct instillation and optimized nebulization, prompting structural and functional recovery by activating endogenous repair pathways in AT2 cells.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812100","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":"Differential associations of high ambient temperatures with sleep apnea and snoring.","authors":"Bastien Lechat,Josh Fitton,Lucía Pinilla,Danny J Eckert","doi":"10.1183/13993003.00309-2026","DOIUrl":"https://doi.org/10.1183/13993003.00309-2026","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"145 1","pages":""},"PeriodicalIF":24.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147735302","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}