Respiratory investigation最新文献

{"title":"Persistent COVID-19 improved with immunoglobulin replacement therapy in Good's syndrome","authors":"Ikumi Kashiwagi ,&nbsp;Miki Tasato ,&nbsp;Akihiko Sokai ,&nbsp;Wataru Kishimoto ,&nbsp;Toshiyuki Iwata ,&nbsp;Yasuyuki Hayashi ,&nbsp;Yuki Sakai ,&nbsp;Naoaki Yasuda ,&nbsp;Takashi Nishimura","doi":"10.1016/j.resinv.2024.11.009","DOIUrl":"10.1016/j.resinv.2024.11.009","url":null,"abstract":"<div><div>A 69-year-old man with a history of thymoma resection was diagnosed with COVID-19 pneumonia. Initially, the patient responded well to molnupiravir, but he experienced a relapse. Subsequent steroids for COVID-19-related organizing pneumonia (OP) led to temporary improvement, but his condition deteriorated when the steroids were tapered off. Further investigation revealed hypogammaglobulinemia, and Good's syndrome (GS) was diagnosed. Immunoglobulin replacement therapy was administered, significantly improving the pulmonary shadows, and no subsequent relapse occurred. GS is an immunodeficiency condition associated with thymoma. If COVID-19 recurs or is refractory despite steroid therapy for OP, COVID-19 itself may not be resolved due to immunodeficiency.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 7-9"},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and prognostic factors for MPO-ANCA positive interstitial lung disease: A comparative study of ANCA associated vasculitis (AAV)-ILD and pulmonary limited vasculitis","authors":"Takashi Shimamura ,&nbsp;Haruhiko Furusawa ,&nbsp;Masaru Ejima ,&nbsp;Akane Ozawa ,&nbsp;Takuya Adachi ,&nbsp;Ukihide Tateishi ,&nbsp;Yasunari Miyazaki","doi":"10.1016/j.resinv.2024.11.006","DOIUrl":"10.1016/j.resinv.2024.11.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Microscopic polyangiitis (MPA) with interstitial lung disease (ILD) has a significant impact on morbidity and mortality. This study evaluated the clinical characteristics, treatment responses, and prognostic factors of patients with ANCA-associated vasculitis with ILD (AAV-ILD) and pulmonary limited vasculitis (PLV).</div></div><div><h3>Patients and methods</h3><div>A retrospective chart review of ILD patients positive for MPO-ANCA was conducted from 2008 to 2021. Patients were classified into AAV-ILD or PLV groups. Data included laboratory test results, pulmonary function tests, and high-resolution computed tomography (HRCT) images. Statistical analyses were used to assess group differences and survival outcomes.</div></div><div><h3>Results</h3><div>Of 114 patients, 80 were diagnosed with PLV and 34 with AAV-ILD. The AAV-ILD group had higher corticosteroid treatment rates, higher serum creatinine levels, and better survival than the PLV group. The PLV group had higher KL-6 levels, lower %VC and % FVC in pulmonary function tests. Survival in the PLV group was significantly worse than that in the AAV-ILD group, and survival of patients with an alternative diagnosis on HRCT was better than that of patients with a UIP pattern. Cox regression analysis identified a diagnosis of MPA and HRCT classification as significant prognostic factors.</div></div><div><h3>Conclusions</h3><div>Patients with AAV-ILD had a better prognosis than those with PLV. HRCT patterns, particularly an alternative diagnosis on HRCT, were associated significantly with a favourable prognosis. The efficacy of corticosteroid treatment in PLV patients was limited. These findings highlight the importance of early and accurate diagnosis, as well as careful consideration of treatment strategies, for patients with in MPO-ANCA-positive ILD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 1-6"},"PeriodicalIF":2.4,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in the treatment of interstitial lung disease in systemic sclerosis with the approval of mycophenolate mofetil","authors":"Toshinori Takada ,&nbsp;Ami Aoki ,&nbsp;Kenjiro Shima ,&nbsp;Toshiaki Kikuchi","doi":"10.1016/j.resinv.2024.11.003","DOIUrl":"10.1016/j.resinv.2024.11.003","url":null,"abstract":"<div><div>Systemic sclerosis (SSc) is an autoimmune connective tissue disease characterized by widespread fibrosis affecting various organs. This disorder has two main subtypes based on the extent of cutaneous fibrosis (limited and diffuse cutaneous SSc). Interstitial lung disease (ILD) occurs in approximately 50% and 25% of patients with diffuse cutaneous SSc and limited cutaneous SSc, respectively. In Japan, over 10,000 people are estimated to have ILD. Out of 10,000 SSc-ILD, at least 4000 patients may have slowly progressive ILD which leads to respiratory failure. Treatment of ILD in patients with SSc includes immunosuppressive and anti-fibrotic agents. Mycophenolate mofetil (MMF) is strongly recommended as a first-line immunosuppressive agent for the treatment of SSc-ILD according to recent American Thoracic Society clinical practice guidelines. However, as of February 2024, MMF was only approved in Japan for patients with organ transplants or lupus nephritis through health insurance policies. Cyclophosphamide is an alternative initial immunomodulatory agent for patients with the disease because it has an efficacy comparable to that of MMF. However, this agent had significantly higher toxicity than MMF. For patients with progressive pulmonary fibrosis, despite the use of immunosuppressive agents, adding nintedanib or rituximab to MMF or cyclophosphamide is recommended. This review explores the treatment of ILD associated with SSc in Japan with the approval of MMF based on the latest American Thoracic Society guideline.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1242-1246"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal changes over time in sputum rheological parameters after SARS-CoV-2 infection in two patients with chronic cough","authors":"Haruhiko Ogawa ,&nbsp;Yuka Uchida","doi":"10.1016/j.resinv.2024.09.018","DOIUrl":"10.1016/j.resinv.2024.09.018","url":null,"abstract":"<div><div>We report temporal changes in sputum rheological parameters after SARS-CoV-2 infection in two patients with chronic cough (71-year-old, male, sinobronchial syndrome; 80-year-old, female, cough variant asthma). Both patients complained of decreased cough-related quality of life and increased phlegm stickiness after infection. In parallel, their sputum showed decreases in linear viscoelastic region (LVR) parameters, such as viscoelastic modulus (<em>G</em>^∗), elastic modulus (<em>G</em>′), and viscous modulus (<em>G</em>″), and increased tack (tan <em>δ/G</em>′; tan <em>δ</em> = <em>G</em>″/<em>G</em>′) compared to pre-infection levels. Rheological parameters, such as <em>G</em>^∗ and tack, took at least several months to return to almost pre-infection levels after recovery from COVID-19. Further studies are needed to determine whether the viscoelastic fluctuations seen in these two patients are common to patients with post-COVID-19 cough and whether their delayed recovery is associated with prolonged clinical symptoms. A sputum rheology approach may provide new insights into post-COVID-19 cough.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1239-1241"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viability and diagnostic potential of tissues obtained through cryobiopsy","authors":"Ryotaro Kida ,&nbsp;Ryohei Yoshida ,&nbsp;Kiichi Nitanai ,&nbsp;Akari Yagita ,&nbsp;Taeka Naraoka ,&nbsp;Hiraku Yanada ,&nbsp;Ryota Shigaki ,&nbsp;Toshiyuki Tenma ,&nbsp;Chie Mori ,&nbsp;Yasuhiro Umekage ,&nbsp;Mamiko Mitsumoto ,&nbsp;Mishie Tanino ,&nbsp;Yoshinori Minami ,&nbsp;Takaaki Sasaki","doi":"10.1016/j.resinv.2024.10.011","DOIUrl":"10.1016/j.resinv.2024.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Transbronchial lung cryobiopsy is primarily used for diagnosing interstitial lung diseases and tumors, providing larger tissue samples with reduced tissue crushing than traditional biopsies. However, freezing during cryobiopsy may damage cells, potentially affecting diagnostic methods that require live cells, such as flow cytometry (FCM). We aimed to determine the extent of freezing-related cell damage in cryobiopsies using cells cultured <em>in vitro</em>.</div></div><div><h3>Methods</h3><div>To investigate the relationship between freezing duration and sample volume, Jurkat cells underwent freezing for durations ranging from 2 to 6 s, with 1-s intervals, using either 1-mm- or 1.7-mm cryoprobes. FCM was conducted to assess both cell viability (2, 4, and 6 s) and cell-surface molecule expression (3 and 6 s) over varying freezing times. Additionally, we describe a clinical case involving a 70-year-old man suspected of malignant lymphoma, in which tissue samples were obtained via both forceps biopsy and cryobiopsy methods to compare the pathological and cytological features between the methods.</div></div><div><h3>Results</h3><div>Harvested cell count increased with freezing duration, with a notable increase in viable cell percentage. Moreover, cells distant from the cryoprobe exhibited higher survival rates under milder freezing conditions. FCM revealed significantly higher marker expression levels in viable cryobiopsy samples than in non-viable samples. The clinical case demonstrated that cryobiopsy yields a significant proportion of live cells (&gt;90%), with cytological findings consistent with those of non-frozen samples.</div></div><div><h3>Conclusions</h3><div>Cryobiopsy may be beneficial for histopathological diagnosis, providing sufficient viable cells for FCM, and can be used for diagnosing malignant lymphomas and other pulmonary conditions.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1220-1226"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of factors associated with poor prognosis despite appropriate antibiotics usage for pneumonia","authors":"Akihiko Goto ,&nbsp;Kentaro Ishikawa ,&nbsp;Kosaku Komiya","doi":"10.1016/j.resinv.2024.10.012","DOIUrl":"10.1016/j.resinv.2024.10.012","url":null,"abstract":"<div><div>Treatment with appropriate antibiotics does not seem to be associated with prognosis among elderly patients with pneumonia. Identifying factors associated with poor prognosis despite the use of appropriate antibiotics might help withhold aggressive antibiotic treatment in patients with pneumonia. This systematic review aims to identify the risk factors associated with unfavored outcomes despite using appropriate antibiotics for pneumonia. The PubMed database was searched for studies focusing on appropriate antibiotic use in patients with pneumonia (assessed on Aug 7, 2024). Appropriate antibiotics were defined as those sensitive to microorganisms isolated from patients. The risk of bias was evaluated using the Risk of Bias Assessment tool for nonrandomized Studies utilized for controlled observational studies.</div><div>A total of 1563 studies were identified from the database, and eight observational studies were included in this review: ventilator-associated pneumonia (n = 4), community-onset pneumonia (n = 2), <em>P. aeruginosa</em> pneumonia (n = 1), and <em>S. maltophilia</em> pneumonia (n = 1). Advanced age was the most commonly evaluated factor associated with mortality. Additionally, high severity scores were related to the unfavored outcomes even after treatment with appropriate antibiotics. Advanced age and high severity scores may be associated with increased mortality despite appropriate antibiotic usage for pneumonia. Broad-spectrum antibiotics might not be indicated in elderly pneumonia patients with high severity status who do not wish to receive aggressive antibiotic treatments.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1215-1219"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary investigation of the significance of cavitary lesions in recurrent hemoptysis following bronchial artery embolization for nontuberculous mycobacterial pulmonary disease","authors":"Hiroto Hatano,&nbsp;Manabu Suzuki,&nbsp;Mio Sugino,&nbsp;Mikako Nakamura,&nbsp;Yusaku Kusaba,&nbsp;Yoshie Tsujimoto,&nbsp;Akane Ishida,&nbsp;Masao Hashimoto,&nbsp;Eriko Morino,&nbsp;Jin Takasaki,&nbsp;Naoki Nishimura,&nbsp;Hiroshi Nokihara,&nbsp;Shinyu Izumi,&nbsp;Masayuki Hojo","doi":"10.1016/j.resinv.2024.11.001","DOIUrl":"10.1016/j.resinv.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Nontuberculous mycobacterial pulmonary disease (NTM-PD) varies widely in clinical presentation, and some patients experience hemoptysis. Bronchial artery embolization (BAE) is a treatment option for hemoptysis caused by NTM-PD. However, the association between post-BAE rebleeding risk and the presence of cavitary lesions has not been fully elucidated.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted on patients with NTM-PD who had undergone BAE at our institution. Patients were classified into Cavitary and Non-cavitary groups, and baseline characteristics and clinical outcomes were compared.</div></div><div><h3>Results</h3><div>Among the 155 BAE cases between 2013 and 2023, 18 were included in the analysis, and four experienced rebleeding. The Cavitary group tended to have a higher rebleeding rate 24 months after BAE (37.5% vs. 10.0%, p = 0.27). Furthermore, the Cavitary group showed a significantly higher number of non-bronchial arteries involved (median number: 1.5 vs. 0.0, p = 0.02), a higher proportion of patients with a prior antibiotic treatment history (100% vs. 20%, p = 0.001), and longer duration from diagnosis to BAE (median year: 9.0 vs. 0.6, p = 0.02). The Kaplan-Meier curves showed a tendency for shorter rebleeding-free survival in the Cavitary group (p = 0.10).</div></div><div><h3>Conclusions</h3><div>Cavitary lesions in patients with NTM-PD may predict higher rebleeding rates after BAE. Further research with larger cohorts is needed to better understand rebleeding risk factors in BAE for NTM-PD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1227-1232"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of constipation with the survival of patients with idiopathic interstitial pneumonias","authors":"Sho Takuma ,&nbsp;Kazutaka Mori ,&nbsp;Masato Karayama ,&nbsp;Yusuke Inoue ,&nbsp;Hideki Yasui ,&nbsp;Hironao Hozumi ,&nbsp;Yuzo Suzuki ,&nbsp;Kazuki Furuhashi ,&nbsp;Tomoyuki Fujisawa ,&nbsp;Noriyuki Enomoto ,&nbsp;Naoki Inui ,&nbsp;Takafumi Suda","doi":"10.1016/j.resinv.2024.10.010","DOIUrl":"10.1016/j.resinv.2024.10.010","url":null,"abstract":"<div><h3>Background</h3><div>Constipation is associated with the prognosis of several chronic diseases. However, the effect of constipation on the prognosis of idiopathic interstitial pneumonias (IIPs) remains unclear. This study aimed to investigate the association between constipation and the prognosis of patients with IIPs.</div></div><div><h3>Methods</h3><div>In this single-center, observational study, the association between constipation and survival of patients with IIPs was retrospectively investigated using a marginal structural model (MSM) analysis with weighting of age, sex, body mass index, treatment (corticosteroids, immunosuppressants, and antifibrotic agents), and pulmonary function (percent predicted forced vital capacity and diffusing capacity of the lungs for carbon monoxide).</div></div><div><h3>Results</h3><div>A total of 433 patients with IIPs (148 and 285 patients with idiopathic pulmonary fibrosis [IPF] and those without IPF) were included in the study. During the observation period, 238 patients developed constipation. The MSM analysis showed that constipation was significantly associated with shorter overall survival (hazard ratio [HR], 2.374; 95% confidence interval, 1.924–2.928, <em>p</em> &lt; 0.001). When the use of antifibrotic agents was weighted separately as nintedanib or pirfenidone, constipation was significantly associated with shorter survival (HR, 2.427; 95% CI, 1.972–2.988, <em>p</em> &lt; 0.001; and HR, 2.395; 95% CI, 1.940–2.957, <em>p</em> &lt; 0.001, respectively). Furthermore, a subgroup analysis showed that constipation was associated with worse survival in patients with IPF and in those without IPF, regardless of the disease severity.</div></div><div><h3>Conclusions</h3><div>This study shows that constipation is an independent prognostic factor for patients with IIPs, suggesting its potential clinical utility.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1204-1208"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine for long-term continuous positive airway pressure therapy: A six-month follow-up study in Japan using propensity score matching","authors":"Toshiki Akahoshi ,&nbsp;Daisuke Endo ,&nbsp;Kenichi Nagaoka ,&nbsp;Ayako Hori ,&nbsp;Tatsuya Ito ,&nbsp;Akihito Uematsu ,&nbsp;Yutaka Kozu ,&nbsp;Yasuhiro Gon ,&nbsp;Kazuo Chin ,&nbsp;Ryuji Furihata","doi":"10.1016/j.resinv.2024.11.002","DOIUrl":"10.1016/j.resinv.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>During the coronavirus disease (COVID-19) pandemic, Japan's health insurance system allowed continuous positive airway pressure (CPAP) telephone consultations to extend clinic visit intervals. This study aimed to determine whether 6-month CPAP adherence in the telemedicine (TM) group was inferior to that in the standard care group.</div></div><div><h3>Methods</h3><div>Patients receiving long-term CPAP therapy for at least 6 months for obstructive sleep apnea (OSA) from two clinics in Japan were recruited between May and July 2020. The TM group consisted of patients who had not visited the clinic in person for 6 months, with physicians providing telephone consultations every 1–2 months. The standard care group included patients who visited the clinic monthly for physician consultation. In both groups, physicians reviewed CPAP usage data via telemonitoring. Patients were classified into three groups according to change in adherence: ≤ −5%, &gt; −5 to &lt;5%, and ≥5%. The primary outcome was the number of patients with worsened CPAP adherence (≤−5%).</div></div><div><h3>Results</h3><div>Of the 479 patients in the TM group and 146 in the standard care group, 120 were matched using propensity score 1:1 nearest neighbor matching and selected from both groups. Adherence worsened in 41 (34.2%) and 32 (26.7 %) patients in the TM and standard care groups, respectively. The TM group was not inferior to the standard care group in terms of the proportion of patients with worsened CPAP adherence (χ² = 1.81, df = 1, <em>P</em> = 0.178).</div></div><div><h3>Conclusions</h3><div>This study found no significant difference in the 6-month CPAP adherence between the TM and standard care groups.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1233-1238"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A protocol for a Japanese prospective cohort evaluating the features of patients with uncontrolled asthma achieving clinical remission: J-CIRCLE","authors":"Naoya Tanabe ,&nbsp;Yu Hara ,&nbsp;Kaoruko Shimizu ,&nbsp;Satoshi Marumo ,&nbsp;Jun Miyata ,&nbsp;Kyohei Morita ,&nbsp;Tetsuya Watanabe ,&nbsp;Keiji Oishi ,&nbsp;Masafumi Yamaguchi ,&nbsp;Kazuhisa Asai ,&nbsp;Yasutaka Nakano ,&nbsp;Tsunahiko Hirano ,&nbsp;Kazuto Matsunaga ,&nbsp;Toshiyuki Koya ,&nbsp;Hisako Matsumoto ,&nbsp;Koichi Fukunaga ,&nbsp;Satoshi Konno ,&nbsp;Takeshi Kaneko ,&nbsp;Toyohiro Hirai","doi":"10.1016/j.resinv.2024.10.009","DOIUrl":"10.1016/j.resinv.2024.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Increasing expectations that biologics can be used as disease-modifying agents have introduced the concept of clinical remission (CR) in managements of severe asthma. Given the clinical relevance of computed tomography (CT) and blood biomarkers, we hypothesized that further refinement of CR criteria as well as incorporation of CT and blood biomarkers as indicators for structural and biological remission (SR, BR) would enable predicting long-term disease stability in patients with severe asthma treated with biologics.</div></div><div><h3>Methods</h3><div>This Japanese multicenter prospective observational cohort will enroll patients with severe asthma who will start a new biologic (including a change from another biologic). The enrolled patients will be longitudinally followed up for 3 years. At enrollment, patients will undergo postbronchodilator spirometry, blood tests, fractional exhaled nitric oxide, chest and sinus CT, and patient-reported outcome questionnaires. Follow-up examinations will be performed at 1, 3, 6, 12, 24, and 36 months. The rates of CR resulting from different criteria after 1 year of treatment with biologics will be compared, and factors associated with long-term disease stability after 3 years of biologic treatments will be identified.</div></div><div><h3>Discussion</h3><div>This multicenter study in Japan will provide data that will help establish more appropriate criteria for CR, structural remission, and biological remission to predict long-term disease stability in patients with severe asthma who receive biologic therapy.</div></div><div><h3>Ethics and dissemination</h3><div>The study was approved by the Ethics Committee of Kyoto University (No. R4419, approval date June 11th, 2024).</div></div><div><h3>Trial registration</h3><div>The University Hospital Medical Information Network (UMIN000053771).</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1209-1214"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}