Respiratory investigation最新文献

{"title":"Pneumocystis jirovecii pneumonia in systemic rheumatic diseases: risk assessment and prophylaxis with emphasis on reduced-dose sulfamethoxazole/trimethoprim","authors":"Shin-ichiro Ohmura","doi":"10.1016/j.resinv.2026.101436","DOIUrl":"10.1016/j.resinv.2026.101436","url":null,"abstract":"<div><div><em>Pneumocystis jirovecii</em> pneumonia (PCP) is a serious opportunistic infection in patients with systemic rheumatic disease (SRD). Although less common than in HIV infection, PCP in patients with SRD worsens rapidly and is associated with high mortality, highlighting the importance of early recognition and prevention. However, risk stratification, indications for PCP prophylaxis, and optimal dosing regimens remain uncertain in patients with SRD. This review summarizes current evidence on the risk factors for PCP in patients with SRD, particularly clinically relevant determinants such as disease-specific risk profiles, glucocorticoid exposure, concomitant immunosuppressive therapies, biologics, and targeted agents. Based on these risk determinants, the current status of prophylactic strategies is discussed. In addition, current evidence on PCP prophylaxis is summarized, with particular attention to the effectiveness and safety of sulfamethoxazole/trimethoprim (SMX/TMP) and the use of reduced-dose regimens to improve tolerability. Overall, this narrative review highlights key challenges of reduced-dose SMX/TMP for PCP prophylaxis in patients with SRD, particularly in balancing efficacy and long-term tolerability.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 3","pages":"Article 101436"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802645","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":"Accuracy of the Pulsox-Me500, a pulse oximeter with built-in accelerometer, as an obstructive sleep apnea screening device: A pilot study","authors":"Satoshi Hamada ,&nbsp;Hironobu Sunadome ,&nbsp;Kimihiko Murase ,&nbsp;Maya Tojima ,&nbsp;Toyohiro Hirai ,&nbsp;Susumu Sato","doi":"10.1016/j.resinv.2026.101437","DOIUrl":"10.1016/j.resinv.2026.101437","url":null,"abstract":"<div><div>The Pulsox-Me500, a pulse oximeter equipped with a built-in three-axis accelerometer, was recently developed by Konica Minolta, Inc. However, its accuracy of screening obstructive sleep apnea (OSA) has not been investigated, and this was the aim of our study. Participants simultaneously used the Pulsox-Me500 and a SleepScope (a portable one-channel electroencephalography device) in the residential setting and wore this device during polysomnography in the inpatient setting. An interclass correlation coefficient (ICC) (2,1) value of 0.4–&lt;0.75 and ≥ 0.75 was considered fair to good and excellent level of reliability, respectively. Sleep time measured by the Pulsox-Me500 was closely associated with total sleep time measured by the SleepScope (ICC (2,1), 0.77). And, 3% oxygen desaturation index measured by the Pulsox-Me500 was more closely associated with that measured by polysomnography when corrected for sleep time measured by the Pulsox-Me500 (ICC (2,1), from 0.74 to 0.84). The Pulsox-Me500 can efficiently screen for OSA.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 3","pages":"Article 101437"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842032","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":"Localization of aspirated Asian sand dust corresponding with early inflammatory response in the lung using Raman spectroscopy","authors":"Akiko Honda ,&nbsp;Ken-ichiro Inoue ,&nbsp;Natsuko Miyasaka ,&nbsp;Hiromu Matsumoto ,&nbsp;Takamichi Ichinose ,&nbsp;Hirohisa Takano","doi":"10.1016/j.resinv.2026.101435","DOIUrl":"10.1016/j.resinv.2026.101435","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between the behavior of inhaled particulate matter and the inflammatory response in the lungs is not clear. In the present study, we investigated the localization of Asian sand dust (ASD) particles intratracheally instilled into the lungs and the responded activation of NF-κB.</div></div><div><h3>Methods</h3><div>One hour after intratracheal ASD administration, quantitative analysis of NF-κB in the nuclei of lung tissues, translocation of NF-κB protein, and ASD localization were examined by enzyme-linked immunosorbent assay, immunohistochemistry (bright field), dark field observation, and Raman technique.</div></div><div><h3>Results</h3><div>ASD exposure induced the nuclear translocation of NF-κB in type II alveolar epithelial cells, alveolar macrophages, and neutrophils within the alveolar wall. Dark field observation and Raman analyses revealed that the ASD components Fe₂O₃, TiO₂, and SiO₂ were detected in or near these cells in which immunoreactive NF-κB was present.</div></div><div><h3>Conclusions</h3><div>These results indicate that this combined technique, which takes advantage of Raman spectroscopy, may better evaluate the spatial relationship between the localization of particulate matter and the organ's early inflammatory response.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 3","pages":"Article 101435"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802642","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":"Blood flow restriction training in COPD: A systematic review with exploratory meta-analysis of emerging evidence","authors":"Carol Alonso-González ,&nbsp;Andressa Rodrigues de Souza ,&nbsp;Rafael Mesquita ,&nbsp;Edgar Hernández-Alvárez ,&nbsp;Magno F. Formiga","doi":"10.1016/j.resinv.2026.101443","DOIUrl":"10.1016/j.resinv.2026.101443","url":null,"abstract":"<div><h3>Objectives</h3><div>Chronic obstructive pulmonary disease (COPD) is often accompanied by skeletal muscle dysfunction, limiting exercise tolerance and quality of life. Blood flow restriction training (BFRT) is a low-load strategy that may induce adaptations comparable to conventional resistance training. This systematic review and meta-analysis evaluated the effects of BFRT in individuals with COPD.</div></div><div><h3>Methods</h3><div>PubMed, Embase, Web of Science and Google Scholar were searched to April 2025. Randomized controlled trials comparing BFRT with conventional training were included. Methodological quality was assessed with PEDro and TESTEX scales, and certainty of evidence with GRADE.</div></div><div><h3>Results</h3><div>Four studies (103 participants) were included, three eligible for meta-analysis. Pooled analyses did not demonstrate statistically significant differences between BFRT and conventional training for exercise capacity (6-Minute Walk Test: MD 6.76 m, 95% CI −31.80 to 45.31), health status (COPD Assessment Test: MD −0.11, 95% CI −3.65 to 3.43), or knee-extension strength (SMD −0.08, 95% CI −0.44 to 0.29). It is important to note that the absence of a statistically significant difference does not imply equivalence or non-inferiority. No adverse events were reported.</div></div><div><h3>Discussion</h3><div>BFRT may yield similar outcomes to conventional resistance training in COPD and may offer a safe, feasible alternative for patients unable to tolerate high loads. However, due to the limited number of studies and the exploratory nature of this meta-analysis, these findings should be considered inconclusive. Larger, high-quality trials are needed to strengthen the evidence base.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 3","pages":"Article 101443"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856995","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":"Emerging therapies and translational advances in small cell lung cancer: Overcoming resistance","authors":"Yuya Nishii ,&nbsp;Yoh Yamaguchi ,&nbsp;Tatsuya Yoshida","doi":"10.1016/j.resinv.2026.101434","DOIUrl":"10.1016/j.resinv.2026.101434","url":null,"abstract":"<div><div>Small-cell lung cancer (SCLC) is an aggressive neuroendocrine malignancy characterized by rapid proliferation, early metastasis, and poor prognosis. Although initially sensitive to chemotherapy and radiotherapy, most patients relapse rapidly, and long-term survival remains uncommon. Platinum–etoposide has long been the standard first-line therapy, and the recent incorporation of immune checkpoint inhibitors (ICIs) such as atezolizumab (IMpower133) and durvalumab (CASPIAN, ADRIATIC) has modestly improved survival, including a new role for durvalumab as a consolidation therapy in limited-stage SCLC. However, this benefit is restricted to a minority of patients, underscoring the need for novel therapeutic strategies. Emerging approaches include DLL3-directed bispecific T-cell engagers (BiTEs), such as tarlatamab and obrixtamig, which have shown promising efficacy in relapsed disease, and next-generation antibody–drug conjugates (ADCs) targeting DLL3, B7–H3, TROP2, and SEZ6. Additional modalities under investigation include chimeric antigen receptor (CAR) T-cell therapy and radioligand therapy (RLT), which aim to overcome the immunosuppressive tumor microenvironment and resistance to conventional treatments. Future therapeutic efforts will require biomarker-driven strategies that incorporate molecular subtyping (ASCL1, NEUROD1, POU2F3, and YAP1) and immune profiling to facilitate precise treatment selection. Combining ICIs, BiTEs, ADCs, and cellular or radioligand therapies in rational, evidence-based regimens represents a promising avenue to improve outcomes in this historically intractable disease.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 3","pages":"Article 101434"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779618","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":"The guide for the diagnosis and treatment of connective tissue disease-associated interstitial lung disease 2025","authors":"Yasuhiro Kondoh ,&nbsp;Masashi Bando ,&nbsp;Yutaka Kawahito ,&nbsp;Takashi Ogura ,&nbsp;Shinji Sato ,&nbsp;Takafumi Suda ,&nbsp;Hiromi Tomioka ,&nbsp;Hirofumi Amano ,&nbsp;Noriyuki Enomoto ,&nbsp;Takao Fujii ,&nbsp;Tomoyuki Fujisawa ,&nbsp;Takahisa Gono ,&nbsp;Tomohiro Handa ,&nbsp;Shintaro Hirata ,&nbsp;Kaori Ishida ,&nbsp;Takeshi Johkoh ,&nbsp;Hideto Kameda ,&nbsp;Kensuke Kataoka ,&nbsp;Masaru Kato ,&nbsp;Yasuhiro Katsumata ,&nbsp;Masataka Kuwana","doi":"10.1016/j.resinv.2026.101412","DOIUrl":"10.1016/j.resinv.2026.101412","url":null,"abstract":"<div><div>This is the official English summary of the Japanese 2025 guide. The first edition of the guide for the diagnosis and management of connective tissue disease (CTD) associated with interstitial lung disease (ILD) was published in 2020 as a joint initiative by the Japanese Respiratory Society and the Japanese College of Rheumatology. This updated edition reflects major advances over the past five years, incorporating the latest international guidelines, consensus statements, and considerations unique to the Japanese healthcare reimbursement system. The guide is structured to facilitate timely clinical decision-making by highlighting key diagnostic and therapeutic milestones. The newly added content includes a conceptual framework for understanding ILD in CTD, practical clinical flowcharts, screening strategies, and risk factors, an overview of acute exacerbations, and a comprehensive approach to rehabilitation. Notably, treatment algorithms for ILD associated with polymyositis/dermatomyositis and systemic sclerosis have been revised to align with the most recent evidence and disease-specific recommendations, thereby enhancing their relevance to real-world practice. In addition, a provisional algorithm was proposed for the management of rheumatoid arthritis-associated ILD. The updated guide aims to standardize the multidisciplinary management of CTD-associated ILD and offers future perspectives to guide research and improve patient outcomes.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 3","pages":"Article 101412"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842007","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":"Volume-assured pressure support versus bilevel positive airway pressure in non-invasive ventilation: A systematic review of clinical effectiveness","authors":"Narat Srivali ,&nbsp;Federica De Giacomi","doi":"10.1016/j.resinv.2026.101441","DOIUrl":"10.1016/j.resinv.2026.101441","url":null,"abstract":"<div><h3>Background</h3><div>Volume-assured pressure support (VAPS) modes automatically adjust inspiratory pressure to maintain target ventilation, theoretically improving upon traditional bilevel positive airway pressure (BiPAP). However, their comparative effectiveness across different clinical contexts remains incompletely characterized.</div></div><div><h3>Methods</h3><div>We systematically reviewed MEDLINE, EMBASE, and Cochrane databases through May 2025, comparing VAPS with BiPAP. Studies were stratified a priori by clinical setting (acute vs chronic/stable) due to differing CO₂ dynamics. Primary endpoints: blood gas parameters, particularly PaCO₂). Secondary endpoints included clinical success rates, patient comfort, adherence, and mortality.</div></div><div><h3>Results</h3><div>Fifteen studies (763 participants) were analyzed. In acute settings, VAPS demonstrated faster PaCO₂ correction in two studies (0.18 kPa/h faster, p &lt; 0.001; 83.3% vs 66.6% normalization at 30 min, p = 0.015); four showed equivalent response. Intubation rates favored VAPS in hypercapnic failure (6.4% vs 15.2%) but a single study (n = 89) suggested potential harm in hypoxemic failure (60% vs 42%, p &gt; 0.05). In chronic settings, both modes achieved equivalent gas exchange (six of seven studies). Patient adherence predicted survival better than mode selection (HR 0.34, 95% CI: 0.18-0.64).</div></div><div><h3>Conclusions</h3><div>These hypothesis-generating findings show VAPS provides faster early stabilization in acute hypercapnic respiratory failure and equivalent outcomes in chronic stable conditions. However, substantial within-strata heterogeneity limits granular guidance, particularly in chronic settings combining mechanistically distinct diseases (Chronic obstructive pulmonary disease, Obesity hypoventilation syndrome, neuromuscular disorders). The intubation difference in hypoxemic failure (single study, n = 89) requires replication. Disease-specific randomized trials are needed before definitive recommendations.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 3","pages":"Article 101441"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802644","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":"Differences in chest HRCT findings in relation to ANCA subtypes in ANCA-associated vasculitis","authors":"Yusuke Usui ,&nbsp;Susumu Sakamoto ,&nbsp;Sakae Homma ,&nbsp;Atsuko Kurosaki ,&nbsp;Yasuyuki Kurihara ,&nbsp;Keita Sato ,&nbsp;Aika Suzuki ,&nbsp;Toshihiro Nanki ,&nbsp;Yoshihiro Arimura ,&nbsp;Seiichi Matsuo ,&nbsp;Hirofumi Makino ,&nbsp;Yasunori Okada ,&nbsp;Masayoshi Harigai ,&nbsp;Kunihiro Yamagata ,&nbsp;Hitoshi Sugiyama ,&nbsp;Hiroaki Dobashi ,&nbsp;Akihiro Ishizu ,&nbsp;Naotake Tsuboi ,&nbsp;Joichi Usui ,&nbsp;Ken-ei Sada ,&nbsp;Kazuma Kishi","doi":"10.1016/j.resinv.2026.101442","DOIUrl":"10.1016/j.resinv.2026.101442","url":null,"abstract":"<div><h3>Background</h3><div>Differences in chest HRCT findings between myeloperoxidase (MPO)- antineutrophil cytoplasmic antibody (ANCA) and proteinase 3 (PR3)-ANCA in Japanese patients with ANCA-associated vasculitis (AAV) remain unclear.</div></div><div><h3>Methods</h3><div>We reviewed chest HRCT findings at diagnosis in 195 patients with AAV enrolled in the Remission Induction Therapy in Japanese Patients with ANCA-associated Vasculitis and Rapidly Progressive Glomerulonephritis (RemIT-JAV-RPGN) observational cohort study (2011–2013). Findings were classified by ANCA subtype and compared.</div></div><div><h3>Results</h3><div>Abnormal chest HRCT findings were observed in 172 of 195 patients. Main findings included ground-glass opacity (n = 92, 47%), reticulation (n = 79, 41%), traction bronchiectasis (n = 67, 34%), and honeycombing (n = 4 9, 25%). Honeycombing (n = 46, 29%) and reticulation (n = 70, 43%) predominated in patients with positive MPO-ANCA, whereas nodules (n = 4, 44%) and cavities (n = 3, 33%) were more frequent in those with positive PR3-ANCA. Interstitial pneumonia (IP) was diagnosed in 89 patients, with HRCT patterns of definite usual interstitial pneumonia (UIP) in 31 (35%), possible UIP in 22 (25%), and inconsistent with UIP in 36 (40%). IP was more frequent in patients with positive MPO-ANCA than in those with positive PR3-ANCA (47% vs 11%, respectively; <em>p</em> = 0.003). Definite UIP was more common in MPO-ANCA positivity than in other subtypes (41% vs 0%, respectively; <em>p</em> = 0.023).</div></div><div><h3>Conclusions</h3><div>In Japanese patients with AAV, IP with a definite UIP pattern was more frequent in patients with MPO-ANCA positivity while nodules and cavities were more frequent in patients with positive PR3-ANCA.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 3","pages":"Article 101442"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802737","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":"Detection of respiratory viruses in air samples: An overview of technologies","authors":"Benita Ortega-Berlanga,&nbsp;Rubén López-Revilla,&nbsp;Ángel G. Alpuche-Solís","doi":"10.1016/j.resinv.2026.101439","DOIUrl":"10.1016/j.resinv.2026.101439","url":null,"abstract":"<div><div>Airborne viruses cause millions of deaths and significant economic losses around the world, especially in developing countries. Since viral particles are transmitted through airborne routes and can remain viable for hours, monitoring and timely detection of airborne viruses is a crucial strategy to prevent and control outbreaks of respiratory infections. This review compares various sampling devices and methods used for detecting infectious airborne viruses.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 3","pages":"Article 101439"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842011","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":"Do current data justify the framing of respiratory fluoroquinolones and lascufloxacin in the 2024 JRS adult pneumonia guideline digest?","authors":"Kazuki Miyaue","doi":"10.1016/j.resinv.2026.101433","DOIUrl":"10.1016/j.resinv.2026.101433","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 3","pages":"Article 101433"},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802643","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}