European Respiratory Journal最新文献

{"title":"Ultrasonic Elastography-guided Pleural Biopsy versus Traditional Thoracic Ultrasound-guided Pleural Biopsy for the Diagnosis of Pleural Effusion: A Multicentre Randomized Trial.","authors":"Mingming Deng,Yang Xia,Xianwei Ye,Jiangwei Ma,Shuai Zhao,Qin Zhang,Jia Li,Jieru Lin,Anwei Jing,Zi-Yao Li,Bin Jiang,Jie Wu,Qing Wen,Jiaojiao Ma,Run Tong,Ziwen Zheng,Weidong Xu,Xuelian Li,Felix Jf Herth,Gang Hou","doi":"10.1183/13993003.01062-2025","DOIUrl":"https://doi.org/10.1183/13993003.01062-2025","url":null,"abstract":"BACKGROUNDTraditional thoracic ultrasound-guided pleural biopsy (TUSPB) is considered the initial method for histological diagnosis; however, its sensitivity for detecting malignant pleural effusion (MPE) is limited. Ultrasound elastography can be used to differentiate MPE from benign diseases by evaluating pleural stiffness. This study aimed to investigate whether ultrasonic elastography-guided pleural biopsy (UEPB) offers diagnostic accuracy superior to that of TUSPB for pleural effusions.METHODSIn this multicentre, randomised trial (ClinicalTrials.gov ID: NCT05781659), patients with pleural effusion of unknown origin were enrolled and randomized (1:1) to undergo either UEPB or TUSPB. The primary outcome measured was the sensitivity of UEPB in diagnosing MPE; the secondary outcomes were the diagnostic rate of the two methods in patients with different pleural thicknesses, and the safety of UEPB.FINDINGSIn total, 232 patients with pleural effusion were enrolled, 228 of whom were included in the analysis. The sensitivity for detecting MPE was significantly greater in the UEPB group than that in the TUSPB group (85.00% [51/60] versus 63.16% [36/57], p=0.007). Patients in the UEPB group had a significantly greater diagnostic yield than those in the TUSPB group did (87.83% [101/115] versus 76.99% [87/113], p=0.032). For patients with MPE and a pleural thickness ≤5 mm without who did not have pleural nodules, UEPB had a significantly greater sensitivity than did TUSPB (80.49% [33/41] versus 50.00% [15/30], p=0.007). The rates of procedure-related complications were similar between the UEPB and TUSPB groups (6.36% versus 8.33%, p=0.552).INTERPRETATIONUEPB was superior to TUSPB in the diagnosis of MPE with a similar safety profile.","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"106 1","pages":""},"PeriodicalIF":24.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035627","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":"The European Respiratory Society' Presidential Summit 2025 - Shifting the Focus on Prevention.","authors":"Silke Ryan,Monika Gappa,Barbara Hoffmann","doi":"10.1183/13993003.01762-2025","DOIUrl":"https://doi.org/10.1183/13993003.01762-2025","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"84 1","pages":""},"PeriodicalIF":24.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035634","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":"Absolute benefit measures are essential for guiding therapies in COPD in an era of precision medicine: a viewpoint on NNT.","authors":"Don D Sin,Ramin Rezaeianzadeh,Mohsen Sadatsafavi","doi":"10.1183/13993003.01165-2025","DOIUrl":"https://doi.org/10.1183/13993003.01165-2025","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"9 1","pages":""},"PeriodicalIF":24.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035626","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":"Trimodulin Supports Antibacterial Defence and Restricts Inflammation in Preclinical Pneumonia Models.","authors":"Geraldine Nouailles,Romina Bischoff,Kerstin Linke,Alexander Taylor,Birgitt Gutbier,Peter Pennitz,Cengiz Goekeri,Sandra Kunder,Anne Voß,Theresa C Brömel,Olivia Kershaw,Miha Milek,Vadim Farztdinov,Michael Mülleder,Sabrina Weissmüller,Corina C Heinz,Mayken Visser,Fabian Bohlaender,Katharina Ahrens,Dieter Beule,Achim D Gruber,Martin Koenig,Martin Witzenrath","doi":"10.1183/13993003.00392-2025","DOIUrl":"https://doi.org/10.1183/13993003.00392-2025","url":null,"abstract":"BACKGROUNDSevere pneumonia (sCAP) remains a global health challenge with high mortality despite advances in antibiotic therapy and supportive care. Immunoglobulin (Ig) therapies, especially IgM-containing ones, have shown promise in enhancing host defence and reducing inflammation. The CIGMA trial highlighted trimodulin's potential to lower mortality of sCAP patients with high C-reactive protein and low IgM levels.METHODSWe investigated the protective effects of trimodulin on clinical status, bacterial burden, lung integrity, and inflammatory responses in murine models of lung injury, including both ventilator-induced lung injury (VILI) and infection-induced models with non-sterile inflammation.FINDINGSIn mice, trimodulin significantly protected against lethal pneumococcal pneumonia by reducing bacterial burden and disease severity while preserving alveolar barrier integrity and limiting lung edema. The antibacterial action of trimodulin was mediated through opsonophagocytosis, and its anti-inflammatory effects operated independently of the latter. When combined with ampicillin, trimodulin exhibited enhanced suppression of inflammation.INTERPRETATIONOur findings in preclinical pneumonia models suggest that trimodulin could be a promising therapy for sCAP patients. We provide evidence that trimodulin enhances host defence, reduces detrimental pulmonary inflammation and barrier dysfunction, and limits pulmonary edema, which may explain its beneficial effects observed in sCAP patients.","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"24 1","pages":""},"PeriodicalIF":24.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035629","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":"Reduction in sputum inflammatory cells after a single dose of cepeprubart in COPD patients.","authors":"Dave Singh,Thomas Southworth,Alex Mulvanny,Nick Stefanko,Amy Ascher,Russell P Rother","doi":"10.1183/13993003.01295-2025","DOIUrl":"https://doi.org/10.1183/13993003.01295-2025","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"19 1","pages":""},"PeriodicalIF":24.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035628","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/EULAR clinical practice guidelines for connective tissue disease-associated interstitial lung diseaseDeveloped by the task force for connective tissue disease-associated interstitial lung disease of the European Respiratory Society (ERS) and the European Alliance of Associations for Rheumatology (EULAR)Endorsed by the European Reference Network on rare respiratory diseases (ERN-LUNG).","authors":"Katerina M Antoniou,Oliver Distler,Ana-Maria Gheorghiu,Catharina C Moor,Jens Vikse,Nikoleta Bizymi,Ilaria Galetti,Graham Brown,Elena Bargagli,Yannick Allanore,Tamera J Corte,Philippe Dieudé,Vincent Cottin,Benjamin A Fisher,Aurelie Fabre,Jon T Giles,Michael Kreuter,Ingrid E Lundberg,Venerino Poletti,Britta Maurer,Elisabetta A Renzoni,Ulf Müller-Ladner,Mary E Strek,Nicola Sverzellati,Paul Studenic,Jibril Mohammed,Blin Nagavci,Tanja Stamm,Thomy Tonia,Bruno Crestani,Anna-Maria Hoffmann-Vold","doi":"10.1183/13993003.02533-2024","DOIUrl":"https://doi.org/10.1183/13993003.02533-2024","url":null,"abstract":"BACKGROUNDInterstitial lung disease (ILD) is a frequent manifestation of connective tissue diseases (CTDs) and is associated with high morbidity and mortality. Clinical practice guidelines to standardise screening, diagnosis, treatment and follow-up for CTD-ILD are of high importance for optimised patient care.METHODSA European Respiratory Society and European Alliance of Associations for Rheumatology task force committee, composed of pulmonologists, rheumatologists, pathologists, radiologists, methodologists and patient representatives, developed recommendations based on PICO (Patients, Intervention, Comparison, Outcomes) questions with grading of the evidence according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology and complementary narrative questions agreed on by both societies. For both PICO and narrative questions, the Evidence to Decision framework was used to formulate the recommendations.RESULTSThe task force committee concluded with recommendations for 25 PICO and 28 narrative questions, regarding ILD in the context of systemic sclerosis, rheumatoid arthritis (RA), idiopathic inflammatory myopathies, Sjögren disease (SjD), systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD). In four narrative questions, regarding screening and assessment of risk for ILD progression in MCTD, SjD and SLE and one PICO question regarding pirfenidone in CTD-ILD other than RA-ILD, the task force had insufficient evidence to support recommendations. Screening, diagnostic, monitoring and treatment algorithms were developed based on the recommendations and usual clinical practice.CONCLUSIONSWe provide practical guidance by evidence-based recommendations to clinicians for each of the CTDs. In many cases there is low certainty or absence of evidence and we encourage further research to fill these gaps.","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"14 1","pages":""},"PeriodicalIF":24.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995625","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":"European Respiratory Society statement on advanced telemedicine for obstructive sleep apnoea (e-Sleep).","authors":"Johan Verbraecken,Emanuele Amodio,Ozen K Basoglu,Riccardo Bellazzi,Matteo Bradicich,Marie Bruyneel,Refika Hamutcu Ersu,Francesco Fanfulla,Brigitte Fauroux,Ludger Grote,Carolina Lombardi,Walter T McNicholas,Carla Miltz,Yüksel Peker,Sofia Schiza,Monique Carolina Suarez,Renaud Tamisier,Hui-Leng Tan,Dries Testelmans,Thomy Tonia,Piet-Heijn van Mechelen,Bart Vrijsen,Maria R Bonsignore","doi":"10.1183/13993003.00557-2025","DOIUrl":"https://doi.org/10.1183/13993003.00557-2025","url":null,"abstract":"Telemedicine (TM) as a means of remote patient-physician interaction is gaining popularity in nearly every field, and (respiratory) sleep medicine is no exception. Because obstructive sleep apnoea (OSA) is a chronic condition, and requires a continuous treatment and monitoring of therapy success, telematic communications could be useful to establish diagnostic and therapeutic strategies. This Statement summarises the evidence and efficacy of TM options in OSA. An interdisciplinary European Respiratory Society (ERS) Task Force (TF) evaluated the scientific literature based on a systematic search and two step screening process (title/abstract and full text). Although the TF does not make recommendations for clinical practice, it describes its current practice of TM applications in OSA. Literature shows that TM has been studied in different areas of OSA management, with potential benefits. TM also served as a major research tool to provide big data related to PAP therapy. TM results in similar or improved compliance when compared with traditional face-to-face encounters. TM-based targeted troubleshooting and support based on individual patient data, and a combination via smartphone apps or coaching websites, are feasible and effective. Expanding evidence suggests that TM is likely cost-effective. However, data do not consistently support staff time savings through TM-based solutions. The potential benefits of TM include improved access to health care, and increased adherence to (chronic illness) treatment plans. Benefits should be weighed against the overall costs of TM and risks related to suboptimal compliance.","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":"136 1","pages":""},"PeriodicalIF":24.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995624","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":"The increasing burden of bronchiectasis in the United Kingdom.","authors":"Eleni Bacopanos, Douglas L Forrester, Ella Girdler, Francesca Gonnelli, Jennifer K Quint, Vidya Navaratnam","doi":"10.1183/13993003.00909-2025","DOIUrl":"https://doi.org/10.1183/13993003.00909-2025","url":null,"abstract":"","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948313","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":"Respiratory Event-related Physiological Biomarkers and Cognitive Performance in Obstructive Sleep Apnea.","authors":"Mohammadreza Hajipour, Joshua B Hicks, A J Hirsch Allen, Andrew E Beaudin, Jill K Raneri, Zahra Izadi, Rachel Jen, Fréderic Series, Robert P Skomro, Rebecca Robillard, R John Kimoff, Mehrdad Mehrjoo, Sidney Fels, Amrit Singh, Eric E Smith, Patrick J Hanly, Ali Azarbarzin, Najib T Ayas","doi":"10.1183/13993003.00201-2025","DOIUrl":"https://doi.org/10.1183/13993003.00201-2025","url":null,"abstract":"<p><strong>Rationale: </strong>Individuals with obstructive sleep apnea (OSA) are at increased risk of cognitive impairment. However, the physiologic mechanisms that link OSA to this impairment are unclear. We assessed the association between novel physiologic biomarkers (<i>i.e.</i>, respiratory event-related electroencephalographic (EEG) activity and autonomic responses) and the risk of cognitive impairment.</p><p><strong>Methods: </strong>Participants with OSA (AHI≥5) from the Canadian Sleep and Circadian Network observational cohort were studied. Brain Response to Event (BReTE) was derived from EEG power (defined as mean [post-event power/pre-event power][frequency-range:0.5-50 Hz]) for each individual. Event-related autonomic responses were measured by heart rate response to events (ΔHR; the difference between maximum post-event heart rate and minimum heart rate during event) and photoplethysmography-derived -derived vasoconstriction activity (event-related area and depth of photoplethysmography decline). Cognitive performance was assessed using the Montreal Cognitive Assessment(MoCA), Wechsler Digit Symbol Coding(DSC), and Rey Auditory Verbal Learning Test-Delayed Recall(RAVLT-DR). Multiple logistic regression examined the independent associations between biomarkers and outcomes.</p><p><strong>Results: </strong>We studied 537 individuals (42%female) with a median age of 55 years. In fully adjusted models, each standard deviation(sd) decrease in BReTE was associated with higher odds of poor cognitive performance indicated by MoCA<26 (OR[95%CI]=1.42[1.13,1.79];p=0.003), DSC< 25th percentile (OR[95%CI]=1.35[1.02,1.84];p=0.04), and RAVLT-DR<25th percentile (OR [95%CI]=1.50[1.13,2.02];p=0.007). Additionally, those with low ΔHR compared to the mid-range group were at increased risk of poor cognitive performance. Vasoconstriction indices were not associated with cognitive performance.</p><p><strong>Conclusion: </strong>Blunted EEG and heart rate responses to respiratory events are linked to poorer cognitive performance in OSA, highlighting the value of EEG in identifying individuals at risk for cognitive impairment.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948340","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":"Pregnancy, asthma and exacerbations: a population-based cohort.","authors":"Bohee Lee, Ernie Wong, Tricia Tan, Hitasha Rupani, Chloe I Bloom","doi":"10.1183/13993003.01327-2025","DOIUrl":"https://doi.org/10.1183/13993003.01327-2025","url":null,"abstract":"<p><strong>Background: </strong>Asthma exacerbations during pregnancy are associated with adverse maternal and perinatal outcomes. Identifying modifiable risk factors are essential for improving health outcomes. We aimed to describe exacerbation patterns during pregnancy and identify exacerbation risk factors, particularly modifiable risk factors such as inhaled corticosteroid (ICS) use.</p><p><strong>Methods: </strong>A cohort study using UK primary care and hospital data (2004-2020) to identify pregnant women with asthma. Exacerbations were defined as a short course of oral corticosteroids, emergency department visit, or unscheduled hospital admission. Multivariable logistic regression was used to assess associations between maternal characteristics and exacerbations (primary outcome) and ICS use (secondary outcome).</p><p><strong>Results: </strong>Among 40 196 pregnant women with asthma, total exacerbations declined by ∼30% during pregnancy. However, exacerbations associated with hospital admission increased by 30-45% during the second and third trimesters, declining abruptly after delivery. ICS prescriptions were reduced in 31% of women during pregnancy. Decreased ICS use was associated with suboptimal asthma control pre-pregnancy, age, ethnicity and smoking. The strongest exacerbation risk factors were a history of exacerbations (adjusted-OR, 95% CI: 4.09, 3.81-4.39), reduced ICS during pregnancy (2.29, 2.12-2.47) and ≥4 prescriptions/year for ICS+another-preventer before pregnancy (2.11, 1.87-2.37). Additional risk factors included blood eosinophilia, smoking and obesity.</p><p><strong>Conclusions: </strong>Despite fewer total exacerbations, exacerbations associated with a hospital admission increased during pregnancy. One-third of women reduced ICS use during pregnancy, yet this was the second largest exacerbation risk factor, and completely modifiable. Other major risk factors were type-2 inflammation and another modifiable risk factor, suboptimal asthma control pre-pregnancy.</p>","PeriodicalId":12265,"journal":{"name":"European Respiratory Journal","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948358","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}