Journal of thoracic disease最新文献

{"title":"Phenotypes and endotypes in bronchiectasis: a narrative review of progress toward precision medicine.","authors":"Hayoung Choi, Yong-Hua Gao","doi":"10.21037/jtd-2024-1945","DOIUrl":"10.21037/jtd-2024-1945","url":null,"abstract":"<p><strong>Background and objective: </strong>Bronchiectasis, which was previously regarded as a rare condition, has recently attracted increased attention with advancements in research and therapeutic strategies. However, heterogeneity remains a major challenge in the management of bronchiectasis. This review aims to elucidate the concepts of phenotypes and endotypes, facilitate a deeper understanding of bronchiectasis complexity, and pave the way for personalized treatment approaches.</p><p><strong>Methods: </strong>The PubMed database was searched for relevant articles published in English between January 1990 and August 2024 using keywords \"bronchiectasis\", \"phenotype\", \"endotype\", \"diagnosis\", \"disease management\", \"complexity\", \"eosino*\", \"neutrop*\", and \"precision medicine\".</p><p><strong>Key content and findings: </strong>We examined established clinical phenotypes, such as frequent exacerbator and chronic airway disease overlap, which significantly influence prognosis and therapeutic management. The significance of etiology-based phenotyping was also discussed while emphasizing how identifying specific underlying causes can guide targeted therapies. We further explored recent advancements in characterising bronchiectasis endotypes, particularly those marked by neutrophilic and eosinophilic inflammation. These endotypes provide valuable insights into underlying pathophysiological mechanisms and guide the selection of clinical management strategies. Recent cluster analysis research has identified distinct inflammatory endotypes in bronchiectasis, thereby improving the understanding of disease progression and identifying potential therapeutic targets. Integrating molecular endotyping with clinical phenotyping provides a more comprehensive perspective of the disease, underscoring the necessity of a dual approach to effectively address its inherent heterogeneity. Furthermore, we emphasize the significance of identifying treatable traits within these frameworks, which can enhance the precision of treatment strategies and improve patient outcomes. By exploring the interplay between clinical phenotypes, endotypes, and patient-specific characteristics, this review highlights the potential for advancing precision medicine for bronchiectasis.</p><p><strong>Conclusions: </strong>Enhancing our understanding of bronchiectasis through these concepts is essential for developing tailored interventions that target the underlying biological mechanisms, thereby improving disease management and patients' quality of life.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2640-2654"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120086","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":"Retrospective analysis of the sensitivity of reporting of thoracic computed tomography for pleural malignancy: an Australian multi-centre study.","authors":"Simon C Graffen, Louis C T Yeung, Jake Ball, Krishoban Baskaran, Reid Schofield, David J Arnold, Christopher L Grainge, Scott H Twaddell, Michael W Hayes, Najib M Rahman, Vineeth George","doi":"10.21037/jtd-24-1797","DOIUrl":"10.21037/jtd-24-1797","url":null,"abstract":"<p><strong>Background: </strong>Contrast-enhanced computed tomography (CE-CT) is crucial in the early detection of malignant pleural effusion (MPE) and has significant impacts on diagnosis, staging and guiding procedural intervention. In real world practice, the sensitivity of CE-CT for MPE is significantly lower than initially described in the literature. We aim to assess the sensitivity of CE-CT reporting in assessment of suspected MPE in a real-world setting.</p><p><strong>Methods: </strong>A multi-centre retrospective review of pleural procedures in the years 2019-2020 at two tertiary centres (John Hunter Hospital, Calvary Mater Hospital) in Newcastle, Australia was performed. Patients with new MPE and a CT performed before histocytological confirmation of malignancy were included. CT reports were reviewed based on the use of pre-determined terminology indicating MPE.</p><p><strong>Results: </strong>A total of 101 patients were included for analysis. Sixty-eight studies were arterial phase, 25 were CT pulmonary angiograms and 2 were delayed venous phase. Seventy-one patients had reports indicating a malignant cause, yielding a sensitivity of 70% [95% confidence interval (CI): 61-78%]. The sensitivity was similar regardless of the contrast phase used. When using only the presence of Leung criteria the overall sensitivity dropped to 42% (95% CI: 32-51%) with a greater decrease seen especially with CT pulmonary angiogram (sensitivity 16%, 95% CI: 6-35%).</p><p><strong>Conclusions: </strong>This is, to our knowledge, the first evaluation of CE-CT use and its sensitivity in MPE assessment outside of Western Europe. This study highlights the limitations of CT in diagnosing MPE and supports early histocytological sampling. Further studies to evaluate the role of CE-CT in the pleural diagnostic pathway are needed.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"1958-1966"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120228","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":"Machine learning-based model for the prediction of acute kidney injury following coronary artery bypass graft surgery in elderly Chinese patients.","authors":"Haiming Li, Hui Hu, Jingxing Li, Wenxing Peng","doi":"10.21037/jtd-2025-264","DOIUrl":"10.21037/jtd-2025-264","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a significant and prevalent complication of coronary artery bypass graft (CABG) surgery. Advanced age is an independent predictor of AKI; however, the existing research on AKI in elderly patients after CABG is limited. This study sought to employ machine-learning techniques to predict patients at high risk of developing AKI following CABG, using preoperative and intraoperative variables.</p><p><strong>Methods: </strong>Patients were retrospectively enrolled in this study between January 2019 and December 2020. The following nine machine-learning algorithms were used to predict postoperative AKI events: logistic regression (LR), simple decision tree (DT), random forest (RF), support vector machine (SVM), extreme gradient boosting (XGBoost), adaptive boosting (AdaBoost), gradient bosting, light gradient boosting machine (lightGBM), and K-nearest neighbor (KNN). SHapley Additive exPlanations (SHAP) values were employed to determine the contribution of each feature to the models and to assess feature importance. Receiver operating characteristic (ROC) curves were plotted, and the areas under the curves (AUCs) of the ROC curves were calculated to evaluate the predictive performance of the various machine-learning models for AKI.</p><p><strong>Results: </strong>A total of 2,155 participants were included in the study. The RF model had the highest AUC [0.737, 95% confidence interval (CI): 0.687-0.784], while the KNN model had the lowest AUC (0.644, 95% CI: 0.581-0.704). Certain variables, including age, the estimated glomerular filtration rate (eGFR), uric acid (UA), alanine aminotransferase (ALT), and B-type natriuretic peptide (BNP) at the baseline, as well as surgery duration and the intraoperative use of an intra-aortic balloon pump (IABP), were identified as significant risk factors for postoperative AKI.</p><p><strong>Conclusions: </strong>Machine-learning models can effectively predict the risk of AKI in elderly patients after CABG surgery. Among all the machine-learning models examined, the RF model showed the best performance.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2519-2527"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119987","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":"Computed tomography imaging features in Stanford type-A aortic dissection predict in-hospital rupture.","authors":"Jia-Rong Ma, Pian-Pian Yan, Sheng-Wen Guo, Xi-Jie Wu","doi":"10.21037/jtd-24-1702","DOIUrl":"10.21037/jtd-24-1702","url":null,"abstract":"<p><strong>Background: </strong>Aortic rupture is a leading cause of early mortality in patients with Stanford type A aortic dissection (TAAD). Current risk assessment models lack critical imaging features, which could enhance their accuracy and sensitivity. This study aimed to identify potential imaging-based risk factors for in-hospital aortic rupture in patients with TAAD.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study of TAAD cases treated medically between January 2020 and May 2021 at Xiamen Cardiovascular Hospital. A total of 45 patients were initially enrolled; however, 14 patients who did not undergo computed tomography angiography (CTA) at Xiamen Cardiovascular Hospital and 1 patient whose quality of image was poor were excluded. We analyzed clinical data, including basic characteristics, clinical presentations, and morphological features derived from CTA and reconstructed images for the remaining 30 patients.</p><p><strong>Results: </strong>Aortic rupture accounted for 82% (14/17) of in-hospital deaths among conservatively treated patients with TAAD. Patients who experienced rupture demonstrated a significantly higher proportion of dissected false lumen (P=0.04), a longer false lumen arc length (P=0.02), and an increased distance from the sinotubular junction to the origin of the celiac trunk (P=0.02). Single factor logistic regression analysis identified two risk factors: arc length ≥130 mm (odds ratio =5.78; 95% confidence interval: 1.12-29.85; P=0.04) and centerline distance from the sinotubular junction to the origin of the celiac trunk ≥391 mm (odds ratio =11; 95% confidence interval: 2-60.57; P=0.006).</p><p><strong>Conclusions: </strong>Morphological features observed on computed tomography imaging can serve as valuable predictors for the risk of aortic rupture in patients with TAAD. Incorporating these features into predictive models could improve risk stratification, allowing for earlier surgical intervention in patients at the highest risk of rupture.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2286-2294"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119996","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":"Establishment of a prognostic nomogram for evaluating non-adjuvant therapy in patients with stage I to III esophageal cancer: a population-based study.","authors":"Guanglei Zhang, Yan Zhang, Shu Chen, Hang Guo, Xiao Qi, Baofeng Li, Jincheng Wang, Chunguang Wang","doi":"10.21037/jtd-24-1377","DOIUrl":"10.21037/jtd-24-1377","url":null,"abstract":"<p><strong>Background: </strong>According to reports from China, esophageal cancer ranked sixth in terms of morbidity and accounted for 6.26% of all cancer cases in China. This study aimed to establish an effective prognostic nomogram for non-adjuvant therapy in patients with stage I to III esophageal cancer.</p><p><strong>Methods: </strong>We took up cases from 2010 to 2015 from the Surveillance, Epidemiology, and End Results (SEER) database and used R language software to perform Kaplan-Meier survival curve and multivariate Cox regression analysis. Furthermore, we established the nomogram for non-adjuvant therapy patients with stage I to III esophageal cancer to predict 3- and 5-year esophageal cancer-specific survival rate. The prognostic ability of the nomogram was assessed using the C-index, area under the receiver operating characteristic (ROC) curve, and calibration chart.</p><p><strong>Results: </strong>The esophageal cancer-specific survival rate of cancer in the lower third of the esophagus was significantly higher than that of cancers in the upper-third of the esophagus as per the Kaplan-Meier curve. Based on the multivariate Cox regression analysis, sub variables such as advanced age, stage II and III, squamous cell carcinoma, moderately differentiated (grade II), poorly differentiated (grade III), and undifferentiated (grade IV) cancer significantly increased risk of prognosis in all patients. With a total of 150 points in the nomogram, the 3- and 5-year esophageal cancer-specific survival rates were 50% and 40% respectively. The value of C-index of this model was 0.851 and the value of the area under receiver operating curve projected 1-, 3-, and 5-year esophageal cancer-specific survival rates of 0.884, 0.874, and 0.856, respectively.</p><p><strong>Conclusions: </strong>The established nomogram had good prediction ability for non-adjuvant therapy patients with stage I to III esophageal cancer.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2206-2216"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120036","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":"Photodynamic therapy as a promising treatment for long-segment and whole-circumferential early esophageal cancer.","authors":"Lin Yuan, Ruijin Zhang, Jie Hua, Guoxin Zhang, Xinmin Si, Weifeng Zhang, Jinliang Ni, Xueliang Li","doi":"10.21037/jtd-2024-1967","DOIUrl":"10.21037/jtd-2024-1967","url":null,"abstract":"<p><strong>Background: </strong>Photodynamic therapy (PDT) is an effective endoscopic therapy indicated for early esophageal cancer, but there have been few reports of PDT for circumferential lesions so far. The objective of this study is to investigate the clinical outcome of PDT for patients with whole-circumferential early esophageal squamous cell carcinoma (ESCC), especially the subsequent process of esophageal stricture.</p><p><strong>Methods: </strong>Twelve patients with whole-circumferential early ESCC, who received PDT between January 2020 and July 2022 at the First Affiliated Hospital with Nanjing Medical University were retrospectively evaluated. An analysis for comparisons between the results of PDT and contemporaneous endoscopic submucosal dissection (ESD) for similar esophageal lesions was conducted.</p><p><strong>Results: </strong>The complete response (CR) rate was 83.33% after PDT treatment for a median tumor length of 9.5 cm. A longer tumor length (>10 cm) was the risk factor of PDT failure (P=0.045). Compared to the ESD group, the procedure was significantly shorter for PDT, and postoperative fever and bleeding seemed to occur less. Without prophylactic measures, the esophageal stricture rate was 80% after PDT, which was close to that in the ESD group with steroid administration (76.9%, P>0.99). The mean onset time of obvious dysphagia was 7.63±4.34 and 4.29±2.49 weeks respectively after PDT and ESD (P=0.02). The post-PDT esophageal strictures were easily resolved with a simpler dilation modality and the estimated dysphagia duration tended to be shorter than that after ESD (12.72±3.04 <i>vs.</i> 23.69±3.24 months, P=0.08). Nevertheless, chest pain appeared more frequently in PDT than that in ESD.</p><p><strong>Conclusions: </strong>PDT can be expected to be an effective and safe endoscopic modality for long-segment and whole-circumferential early ESCC.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2056-2066"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120088","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 bibliometric analysis of the literature published on autophagy, ferroptosis, necroptosis, and pyroptosis in cardiovascular disease from 2009 to 2023.","authors":"Yan Zhang, Tianyi Long, Bo Wei, Huan Zhou, Xinhai Yin, Zhangrong Chen, Pietro Di Fazio, Wei Li, Haiyan Zhou","doi":"10.21037/jtd-2025-682","DOIUrl":"10.21037/jtd-2025-682","url":null,"abstract":"<p><strong>Background: </strong>Programmed cell death (PCD) plays a pivotal role in the development and progression of cardiovascular disease (CVD), which remains the leading cause of mortality worldwide. Among the various types of PCD, autophagy, ferroptosis, necroptosis, and pyroptosis have garnered increasing attention due to their involvement in inflammation, oxidative stress, and cardiomyocyte survival. Although numerous studies have explored the underlying mechanisms of these pathways, their therapeutic potential in clinical practice remains limited. With the rapid growth of publications in this field, a comprehensive understanding of research trends and influential studies is essential to guide future investigations. This study aimed to characterize the progress and research hotspots of autophagy in CVD, ferroptosis in CVD, necroptosis in CVD, and pyroptosis in CVD through a bibliometric analysis to provide a comprehensive overview of PCD in CVD.</p><p><strong>Methods: </strong>Publications from January 1, 2009, to December 31, 2023, were analyzed using the \"bibliometrix\" R package to assess research output, key contributors, and influential journals in each field.</p><p><strong>Results: </strong>For the topic of autophagy in CVD, 6,426 articles published by 4,891 institutions from 90 countries/regions were retrieved. For the topic of necroptosis in CVD, 393 articles from 616 organizations in 53 countries/regions were retrieved. For the topic of pyroptosis in CVD, 640 publications from 754 institutions in 48 countries/regions were retrieved. Finally, for the topic of ferroptosis in CVD, 687 articles from 827 institutions in 49 countries/regions were retrieved. Key contributors included Adriana A (22 publications on necroptosis), Ge J, and Ye B (8 publications each on pyroptosis), and Ren J (lead contributor in autophagy and ferroptosis, with 120 and 10 publications, respectively). The most frequently co-cited journals were <i>Cell</i>, <i>Nature</i>, <i>Free Radical Biology and Medicine</i>, and the <i>Journal of Biological Chemistry</i>.</p><p><strong>Conclusions: </strong>This bibliometric analysis highlights the growing interest in PCD in CVD research, with autophagy and pyroptosis being the central themes. Future studies should examine therapeutic strategies targeting ferroptosis and necroptosis to improve CVD treatment. The findings provide a roadmap for researchers to navigate emerging research hotspots and foster interdisciplinary collaboration.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2537-2562"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120142","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":"Prognosis and relapse patterns in patients with non-small cell lung cancer with pathologic complete response after neoadjuvant immunochemotherapy.","authors":"Yifan Fang, Wanpu Yan, Ze-Rui Zhao, Long Jiang, Xiangyang Yu, Xin Yang, Zhentao Yu, Qingquan Luo, Hao Long, Ke-Neng Chen","doi":"10.21037/jtd-2024-2200","DOIUrl":"10.21037/jtd-2024-2200","url":null,"abstract":"<p><strong>Background: </strong>Although neoadjuvant immunochemotherapy is associated with higher rates of pathologic complete response (pCR) among patients with locally advanced non-small cell lung cancer (NSCLC), data on long-term outcomes after pCR are lacking. Some patients with pCR still experience relapse of disease within a short period of time. Therefore, the aim of this study was to define the long-term survival and relapse patterns in this group of patients.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with stage IB to IIIB NSCLC who had pCR after treatment with immunochemotherapy and surgery at four high-volume medical centers from 2018 to 2022. Survival status and patterns of relapse were determined. Univariable and multivariable analyses were performed to identify risk factors associated with recurrence and survival.</p><p><strong>Results: </strong>In total, 130 patients were included in the study. Median follow-up was 23.3 months. Three-year disease-free survival (DFS) and overall survival (OS) were 84.6% and 93.5%, respectively. Eleven patients had relapse; the median time to relapse was 7.6 months. Six patients had intrathoracic relapse, and 5 had extrathoracic relapse; 1 patient died of progression of disease. Most patients [10/11 (90.9%)] had relapse within 18 months of surgery. On univariable analysis, no factors were associated with risk of relapse.</p><p><strong>Conclusions: </strong>Patients with NSCLC who have pCR after neoadjuvant immunochemotherapy followed by surgery have a good prognosis; however, some patients with pCR experience relapse within a short period of time. This finding suggests that a more comprehensive surveillance protocol may be beneficial for these patients. Molecular testing may be helpful for guiding postoperative therapy and predicting recurrence.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2113-2125"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120213","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":"Serum IgA levels and survival in patients with idiopathic pulmonary fibrosis: association with serum cytokine levels and peripheral monocyte counts.","authors":"Toru Arai, Masaki Hirose, Kazuyoshi Hatsuda, Tomoko Kagawa","doi":"10.21037/jtd-2024-2142","DOIUrl":"10.21037/jtd-2024-2142","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is an idiopathic fibrotic interstitial lung disease with poor prognosis. Recently, the prognostic value of serum platelet-derived growth factor (PDGF) levels in patients with IPF has been clarified. Monocyte counts in the peripheral blood have also been reported to be an important predictor of survival in IPF. This study aimed to clarify the prognostic value of serum immunoglobulin (Ig) A levels in patients with IPF to predict survival and occurrence of acute exacerbations (AE).</p><p><strong>Methods: </strong>This retrospective study included 71 patients diagnosed with IPF based on the 2022 guidelines. Serum PDGF and interleukin (IL)-10 levels were measured using the Bio-Plex method. IgA levels were measured by a clinical testing company.</p><p><strong>Results: </strong>Of the enrolled patients, 59 were male, and the median age of the sample was 67 [interquartile range (IQR): 61-72] years. The median serum IgA level was 307 (IQR: 232-408) mg/dL and 18 patients had serum IgA levels of >400 mg/dL. Univariate Cox proportional hazard regression analysis revealed that high IgA levels (>400 mg/dL) were a significant predictor of poor prognosis; however, monocyte counts were not. A high IgA level was a significant prognostic factor after adjusting for the percent predicted value of forced vital capacity, age, gender, and body mass index. Serum PDGF levels tended to be higher in patients with high IgA levels than in those with low IgA levels. IL-10 was not significantly correlated with IgA levels; however, IgA levels tended to be negatively correlated with monocyte counts. High IgA levels did not significantly predict AE. High monocyte counts (>600/µL) significantly predicted the early incidence of AE by univariate Cox analysis but was not confirmed by multivariate analysis. However, monocyte counts, and a monocyte count of >600/µL were significant predictors of AE occurrence for patients with low IgA ≤400 mg/dL.</p><p><strong>Conclusions: </strong>The serum IgA level is an independent prognostic predictor of survival in patients with IPF. Serum IgA levels might suggest serum fibrogenic cytokine levels. Serum IgA levels might be associated with prognosis differently from peripheral monocyte counts. The pathophysiological role of IgA needs to be elucidated in future studies.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 4","pages":"2038-2049"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120229","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 synergistic effects of PM_2.5 and high-fat diet on Th1/Th2 balance in model mice with asthma.","authors":"Ruifeng Bai, Bingqian Liu, Tianshui Li, Heng Zhou, Xinyang Yue, Ying Liu, Yining Shan, Zhigang Li, Yongjie Wei, Jun Wu","doi":"10.21037/jtd-24-1139","DOIUrl":"https://doi.org/10.21037/jtd-24-1139","url":null,"abstract":"<p><strong>Background: </strong>Particulate matter, ambient particulate matter with an aerodynamic equivalent diameter ≤2.5 µm (PM_2.5) is closely associated with asthma, and a high-fat diet is also a risk factor for the condition. In many cities in China, exposure to PM_2.5 and consumption of a high-fat diet coexist. The Th1/Th2 balance is the immunological foundation for the onset and progression of asthma, and it is more accurate to describe asthma symptoms in terms of changes in this balance. Therefore, the aim of this study was to investigate the effects of PM_2.5 and high-fat diet the combined effects on Th1/Th2 balance in asthma immune.</p><p><strong>Methods: </strong>Given this background, our study examined the effects of PM_2.5 and high-fat diets on the Th1/Th2 balance and proposed potential molecular mechanisms for asthma development induced by these factors. In this study, male BALB/c mice and ovalbumin (OVA)-sensitized asthma mice subjected to either a normal or high-fat diet were exposed to PM_2.5 or filtered air for one month. We evaluated the effects of PM_2.5 and high-fat diets on asthma using histopathology, enzyme-linked immunosorbent assays, transcriptome sequencing, and quantitative polymerase chain reaction (PCR).</p><p><strong>Results: </strong>We found that PM_2.5 exposure increased the secretion of Th2-related inflammatory mediators, while a high-fat diet increased the secretion of Th1-related inflammatory mediators. However, the combined effects still predominantly favored a Th2 skew. PM_2.5 exposure shifted the Th1/Th2 balance toward Th2, whereas a high-fat diet shifted it toward Th1. The combination of PM_2.5 exposure and a high-fat diet resulted in a less pronounced Th2 polarization compared to PM_2.5 exposure alone.</p><p><strong>Conclusions: </strong>PM_2.5 exposure and short-term high-fat diet both exacerbate asthma but there is an opposite direction of modulation of the Th1/Th2 balance.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"17 3","pages":"1502-1511"},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031948","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}