Respiratory investigation最新文献

{"title":"Possible impact of sputum viscoelastic changes and airway fungal colonization on asthma exacerbation: Observations from 7 patients with severe asthma receiving biologics.","authors":"Haruhiko Ogawa, Yuka Uchida","doi":"10.1016/j.resinv.2026.101385","DOIUrl":"https://doi.org/10.1016/j.resinv.2026.101385","url":null,"abstract":"<p><p>We report a case series of 7 patients with severe asthma who initiated biologic therapy due to frequent exacerbations. Sputum viscoelasticity was measured using a benchtop rheometer (Rheomuco®). After initiation of biologic therapy, sputum viscoelastic parameters, which are affected by cytokine-induced inflammation, generally decreased. However, 5 patients with asthma exacerbations showed abnormally elevated rheological parameters in the high-strain region (HSR), particularly γ_C, and positive sputum fungal culture results. After initiation of low-dose itraconazole therapy, a decrease in γ_C and improvement in asthma symptoms were observed. Two patients with suppressed rheological parameters in HSR did not experience exacerbations. These observations raise the possibility that fungal colonization in the airway of severe asthma may contribute to asthma exacerbations. Large prospective controlled trials are needed to determine whether eradicating fungi from the airways and suppressing HSR parameters can reduce exacerbations in patients with severe asthma with fungal colonization (here designated as SAFC).</p>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":" ","pages":"101385"},"PeriodicalIF":2.0,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628470","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":"Successful hemostasis of intractable hemoptysis with endobronchial Watanabe spigots following endoscopic thrombin injection into the bleeding bronchus in an inoperable patient.","authors":"Noboru Hamada, Hiroki Mino, Chisato Yamamoto, Mari Uno, Sachi Okawa, Hisao Higo, Kentaro Shibamoto, Syouta Yuzurio, Toshimitsu Suwaki","doi":"10.1016/j.resinv.2026.101388","DOIUrl":"https://doi.org/10.1016/j.resinv.2026.101388","url":null,"abstract":"<p><p>Patients with hemoptysis refractory to conventional treatments and ineligible for surgical intervention often have a poor prognosis. We report a 74-year-old man with intractable hemoptysis deemed inoperable, successfully treated using a novel approach. Initial management included bronchial artery embolization and endobronchial occlusion with Endobronchial Watanabe Spigots (EWSs), which achieved temporary hemostasis. However, hemoptysis recurred following the dislodgement of spigots. Replacement EWSs were then stabilized using fibrin formed by the reaction between fibrinogen in the bloody sputum and endoscopically administered thrombin. To our knowledge, this is the first reported case demonstrating successful control of intractable hemoptysis using this approach.</p>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":" ","pages":"101388"},"PeriodicalIF":2.0,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475072","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":"All-case post-marketing surveillance of delamanid for treating multidrug-resistant pulmonary tuberculosis in Japan","authors":"Toru Mori ,&nbsp;Kazunari Tsuyuguchi ,&nbsp;Takefumi Saito ,&nbsp;Yuka Sasaki ,&nbsp;Eriko Shigeto ,&nbsp;Hideaki Nagai ,&nbsp;Satoshi Komaniwa ,&nbsp;Hiroyuki Hashizume ,&nbsp;Kyoko Suzue ,&nbsp;Yuko Yamashige ,&nbsp;Takashi Yoshiyama","doi":"10.1016/j.resinv.2025.101363","DOIUrl":"10.1016/j.resinv.2025.101363","url":null,"abstract":"<div><h3>Background</h3><div>Delamanid is a nitro-dihydro-imidazooxazole derivative that possesses highly potent activity against <em>Mycobacterium tuberculosis</em>, including strains linked to multidrug-resistant tuberculosis (MDR-TB). We conducted an all-case post-marketing surveillance to assess the real-world safety and effectiveness of delamanid in treating MDR-TB in Japan.</div></div><div><h3>Methods</h3><div>All patients diagnosed with MDR-TB were included if they started delamanid between September 2014 and February 2023. Case report forms were collected every 6 months during the treatment period and every 12 months during the follow-up period. Safety assessment included any adverse events that occurred during the treatment period. Effectiveness assessment included the proportion of patients with sputum-culture conversion and treatment success.</div></div><div><h3>Results</h3><div>In the safety analysis set, 61.6 % of patients (114/185) were males, and the median (interquartile range) age was 48.0 (32.0, 64.0) years. During the treatment period, 54.05 % of patients (100/185) experienced adverse drug reactions (ADRs), and 8.65 % (16/185) experienced serious ADRs. Electrocardiogram QT prolongation was reported in 8.65 % of patients (16/185) but was not associated with an increased risk of cardiovascular events. In the sputum-culture conversion analysis set, sputum-culture conversion was achieved in 86.0 % of patients (80/93). In the effectiveness analysis set, treatment success was achieved in 54.1 % of patients (99/183) by the end of the treatment period.</div></div><div><h3>Conclusions</h3><div>This surveillance showed the effectiveness of ≥6 months of delamanid treatment among patients with MDR-TB in real-world settings in Japan, with no new safety issues identified.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101363"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941428","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":"Response to the critical appraisal of “Effects of Daikin air purifiers on asthma control and pulmonary function: A multicenter, single-arm, observational pilot study”","authors":"Satoshi Hamada ,&nbsp;Susumu Sato ,&nbsp;Shota Hori ,&nbsp;Shiqi Yu ,&nbsp;Hironobu Sunadome ,&nbsp;Kimihiko Murase ,&nbsp;Toyohiro Hirai","doi":"10.1016/j.resinv.2026.101384","DOIUrl":"10.1016/j.resinv.2026.101384","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101384"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189590","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":"Current perspectives on imaging modalities in the diagnosis and management of pulmonary hypertension","authors":"Shota Yamamoto ,&nbsp;Fumio Sakamaki","doi":"10.1016/j.resinv.2026.101389","DOIUrl":"10.1016/j.resinv.2026.101389","url":null,"abstract":"<div><div>Pulmonary hypertension (PH) is a heterogeneous syndrome in which elevated pulmonary arterial pressure arises from diverse parenchymal, thromboembolic, and vasculopathic processes. Right heart catheterization remains the hemodynamic reference standard; however, clinicians increasingly turn to noninvasive imaging to triage candidates for invasive confirmation, to determine the disease phenotype, and to monitor the response to interventions such as pulmonary endarterectomy or balloon pulmonary angioplasty. In routine practice, chest computed tomography (CT), together with echocardiography and ventilation–perfusion (V/Q) scintigraphy, underpins the detection of chronic thromboembolic PH and provides pragmatic structural biomarkers, including the main pulmonary artery size relative to that of the ascending aorta, right ventricular remodeling, and lung parenchymal disease. Dual-energy CT expands anatomic assessment with iodine perfusion maps, whereas magnetic resonance imaging (MRI)-based techniques are used to quantify right ventricular function, flow, and lung perfusion without ionizing radiation. Phase-resolved functional lung MRI and 4D-flow MRI show promise for low- or non-contrast assessment of perfusion defects and conduit hemodynamics. Dynamic chest radiography, a flat-panel x-ray technique, has diagnostic performance comparable to that of V/Q scanning for chronic thromboembolic disease at a fraction of the radiation dose. Molecular imaging with positron emission tomography captures metabolic stress in the right ventricle and inflammatory or proliferative activity within the pulmonary vasculature; early data suggest its prognostic utility, although standardization is pending. We propose a pragmatic framework that preserves catheterization for diagnostic confirmation and hemodynamic problem-solving, while leveraging minimally invasive techniques for longitudinal follow-up and early trajectory detection in pulmonary vascular and parenchymal phenotypes.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101389"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213890","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":"Performance validation of a closed loop fully automated AI model for lung nodule stratification in screening cases","authors":"A. Taha ,&nbsp;M.S. Muneer ,&nbsp;A. Kalra ,&nbsp;M. Muelly ,&nbsp;J. Reicher","doi":"10.1016/j.resinv.2026.101373","DOIUrl":"10.1016/j.resinv.2026.101373","url":null,"abstract":"<div><h3>Background</h3><div>Several limitations hinder the effectiveness of human-based lung cancer screening (LCS): high false-positive rates leading to unnecessary follow-up imaging, procedures, and surgeries; inter-reader variability; inconsistent Lung-RADS adherence; and fatigue-related diagnostic errors. Additionally, most artificial intelligence (AI) models address only one task (nodule detection or risk stratification) and require manual image processing, which is time-consuming and costly. We developed Bronchosolve, a closed-loop, fully-automated software that processes scans without manual input, aiming to improve consistency, accuracy, and throughput in LCS.</div></div><div><h3>Methods</h3><div>The software integrates pre-processing, analysis, and result generation, using a deep-learning convolutional neural network (CNN) for pulmonary nodule triaging. Inputs were full chest CT scans in DICOM format, without clinical or demographic data. Automated steps included: 1) optimal CT series selection, 2) normalization and preprocessing, 3) AI-based detection and classification of suspicious nodules, and 4) report generation. The model was trained on a multi-center high-prevalence set of 2358 cases (malignant and benign nodules). Validation used a U.S.-based, multi-site cohort (n = 184; 8 sites). Positive cases were biopsy-confirmed within 1 year; negatives had biopsy or ≥2-year follow-up.</div></div><div><h3>Results</h3><div>All cases completed automatically (100 % success). Median age was 62.5 years (IQR 58.5–66.5); 45 % former smokers, 55 % current smokers, and 40 % female. The model achieved an AUC of 0.898 [0.851–0.940], outperforming Lung-RADS (pAUC 0.669) and the Brock model (AUC 0.783). Sensitivity was 83.6 %; specificity was 86.3 %. Performance remained consistent across scanner types and slice thicknesses.</div></div><div><h3>Conclusions</h3><div>Bronchosolve enables accurate, fully-automated risk classification of lung nodules and may enhance non-invasive diagnostic workflows.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101373"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019445","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":"Diverse histopathological patterns in Fleischner-defined interstitial lung abnormalities: Radiologic-Pathologic correlation and reclassification using 2025 American Thoracic Society statement","authors":"Taiki Fukuda ,&nbsp;Kaori Ishida ,&nbsp;Tomonori Tanaka ,&nbsp;Kensuke Kataoka ,&nbsp;Reoto Takei ,&nbsp;Yuki Ko ,&nbsp;Yusei Nakamura ,&nbsp;Mikiko Hashisako ,&nbsp;Hiromitsu Sumikawa ,&nbsp;Ryoko Egashira ,&nbsp;Junya Tominaga ,&nbsp;Hiroya Ojiri ,&nbsp;Hiroto Hatabu ,&nbsp;Tomoki Kimura ,&nbsp;Yasuhiro Kondoh ,&nbsp;Junya Fukuoka ,&nbsp;Takeshi Johkoh","doi":"10.1016/j.resinv.2026.101374","DOIUrl":"10.1016/j.resinv.2026.101374","url":null,"abstract":"<div><h3>Background</h3><div>Interstitial lung abnormalities (ILA) are CT-detected interstitial abnormalities that may represent early-stage interstitial lung disease (ILD). However, histopathologic correlations remain limited, with previous studies reporting conflicting results. In 2025, the American Thoracic Society (ATS) established criteria defining the boundary between ILA and ILD. This study aimed to investigate the histopathological spectrum of Fleischner-defined ILA, correlate findings with CT features and outcomes, and reclassify cases according to 2025 ATS criteria.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 30 consecutive patients who underwent surgical lung biopsy between January 2010 and December 2021. All cases had ILA per Fleischner Society criteria and were reclassified using 2025 ATS criteria. Three pulmonary pathologists evaluated dominant and co-existing histopathological patterns. Two chest radiologists independently assessed CT findings. Overall survival was compared between usual interstitial pneumonia (UIP)-related and non-UIP-related groups using Kaplan-Meier analysis.</div></div><div><h3>Results</h3><div>Twenty patients (66.7 %) were men; mean age was 63.6 ± 6.5 years; 27 (90 %) had fibrotic ILA. The most common dominant pattern was UIP (43.3 %), followed by nonspecific interstitial pneumonia (NSIP) and bronchiolocentric interstitial pneumonia (BIP) (20 % each). Overall, 96.7 % of cases met 2025 ATS criteria for ILD (subclinical ILD). On CT, all UIP and NSIP cases showed reticular opacity and traction bronchiectasis, while BIP typically exhibited branching linear opacities. During median follow-up of 92.1 months, overall survival did not differ significantly between UIP-related and non-UIP-related groups (<em>p</em> = 0.595).</div></div><div><h3>Conclusions</h3><div>This study of Fleischner-defined ILA, predominantly reclassified as subclinical ILD by 2025 ATS criteria, demonstrates diverse histopathological patterns beyond UIP, including BIP, highlighting pathological heterogeneity.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101374"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038518","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":"Efficacy and safety of brensocatib in Japanese patients with non-cystic fibrosis bronchiectasis: Analysis of the ASPEN trial","authors":"Kozo Morimoto ,&nbsp;James D. Chalmers ,&nbsp;Pierre-Régis Burgel ,&nbsp;Charles L. Daley ,&nbsp;Anthony De Soyza ,&nbsp;David Mauger ,&nbsp;Mark L. Metersky ,&nbsp;Xiangmin Zhang ,&nbsp;Sherry Li ,&nbsp;Yuhei Goto ,&nbsp;Ariel Teper ,&nbsp;Carlos Fernandez ,&nbsp;Naoki Hasegawa","doi":"10.1016/j.resinv.2025.101357","DOIUrl":"10.1016/j.resinv.2025.101357","url":null,"abstract":"<div><h3>Background</h3><div>In the ASPEN trial (NCT04594369), brensocatib 10 mg and 25 mg significantly reduced the burden of pulmonary exacerbations (annualized rate [primary endpoint], time to first, proportion exacerbation-free) over 52 weeks vs placebo in patients with bronchiectasis; brensocatib 25 mg significantly reduced lung function decline and nominally significantly improved patient-reported symptoms. Here we report efficacy and safety for Japanese patients.</div></div><div><h3>Methods</h3><div>Adults with bronchiectasis with ≥2 exacerbations in the 12 months before screening were randomized to once-daily brensocatib (10 mg or 25 mg) or placebo for 52 weeks. Endpoints included annualized exacerbation rate, time to first exacerbation, proportion remaining exacerbation-free, change from baseline in lung function, severe exacerbation rate, and change from baseline in patient-reported symptoms.</div></div><div><h3>Results</h3><div>Baseline characteristics of Japanese patients (n = 87) were generally consistent across groups. Brensocatib 10 mg and 25 mg reduced the annualized exacerbation rate vs placebo (rate ratio, 0.37 [95 % CI, 0.16–0.87]; 0.32 [0.14–0.75]), prolonged time to first exacerbation, and increased odds of remaining exacerbation-free. The annualized severe exacerbation rate was lower with brensocatib 10 mg and 25 mg vs placebo (rate ratio, 0.11 [0.01–1.04]; 0.30 [0.06–1.62]). Brensocatib, particularly at the 25 mg dose, also reduced lung function decline vs placebo (LS mean difference: forced expiratory volume in 1 s, 97 mL [95 % CI, 32–162]; forced vital capacity, 164 mL [84−244]) and improved patient-reported symptoms. Adverse events were similar across groups.</div></div><div><h3>Conclusions</h3><div>Consistent with overall ASPEN results, brensocatib 10 mg and 25 mg reduced exacerbation frequency vs placebo in Japanese patients with bronchiectasis. Lung function, patient-reported symptoms, and safety data were consistent with overall ASPEN trial results.</div></div><div><h3>Clinical trial registration</h3><div>NCT04594369.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101357"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941429","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 proposed pathological diagnosis flowchart for adult interstitial lung disease with transbronchial lung cryobiopsy: Position paper from the Japanese research group on diffuse lung disease","authors":"Yoshiaki Zaizen ,&nbsp;Ryoko Saito-Koyama ,&nbsp;Koji Okudela ,&nbsp;Yasuhiro Terasaki ,&nbsp;Tomonori Tanaka ,&nbsp;Kazuhiro Tabata ,&nbsp;Mikiko Hashisako ,&nbsp;Shinobu Kunugi ,&nbsp;Kaori Ishida ,&nbsp;Mai Matsumura ,&nbsp;Masashi Kitani ,&nbsp;Tomoe Sawazumi ,&nbsp;Tomohisa Baba ,&nbsp;Takashi Ogura ,&nbsp;Tamiko Takemura ,&nbsp;Akira Hebisawa ,&nbsp;Junya Fukuoka","doi":"10.1016/j.resinv.2026.101393","DOIUrl":"10.1016/j.resinv.2026.101393","url":null,"abstract":"<div><div>Transbronchial lung cryobiopsy for interstitial lung disease is described in guidelines as an “acceptable alternative” to surgical lung biopsy. However, the pathological diagnosis of interstitial lung disease by transbronchial lung cryobiopsy is difficult compared with surgical lung biopsy because of the small sample size, leading to diagnostic disagreement not only in pathological diagnosis but also in multidisciplinary discussion diagnosis. Therefore, a standardized approach for the pathological diagnosis of ILD using transbronchial cryobiopsy is necessary. We developed a diagnostic flowchart for the pathological diagnosis of ILD using transbronchial cryobiopsy based on the consensus reached by the Pathology and Cryobiopsy Subcommittee within the Study Group on Diffuse Pulmonary Disorders, Scientific Research/Research on Intractable Diseases of the Ministry of Health, Labour, and Welfare of Japan. This study reports the diagnostic flowchart.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101393"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348975","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":"Post-bronchoscopy sputum culture improves detection of nontuberculous mycobacterial pulmonary disease: A retrospective Study","authors":"Kohei Yamamoto ,&nbsp;Tatsuya Imabayashi ,&nbsp;Toshiyuki Tanaka ,&nbsp;Kazuki Jinno ,&nbsp;Shunya Tanaka ,&nbsp;Sayaka Uda ,&nbsp;Tatsuya Yuba ,&nbsp;Chieko Takumi","doi":"10.1016/j.resinv.2026.101379","DOIUrl":"10.1016/j.resinv.2026.101379","url":null,"abstract":"<div><h3>Background</h3><div>In the diagnosis of <em>Mycobacterium tuberculosis</em>, collecting post-bronchoscopy sputum (PBS), as recommended by major guidelines, enhances the microbiological yield; however, evidence for PBS in nontuberculous mycobacterial pulmonary disease (NTM-PD) remains limited. Therefore, we aimed to investigate whether adding PBS increases the yield in suspected NTM-PD.</div></div><div><h3>Methods</h3><div>This single-center retrospective study included adults who underwent bronchoscopy for suspected NTM-PD between January 2017 and December 2023. After excluding 41 patients due to a lack of PBS submission and 14 with <em>M. tuberculosis</em>, 220 patients were analyzed. All patients underwent bronchial washing or bronchoalveolar lavage, and PBS was collected within 24 h. We compared culture positivity between bronchoscopic specimens and PBS and assessed the incremental yield obtained by adding PBS.</div></div><div><h3>Results</h3><div>NTM was successfully cultured from bronchoscopic specimens in 71/220 (32.3 %). Before bronchoscopy, sputum cultures were positive in 38/220 (17.3 %), whereas PBS cultures were positive in 72/220 (32.7 %; p &lt; 0.01). PBS was the only positive specimen in 18/220 (8.2 %). Combining bronchoscopic specimens with PBS increased overall culture positivity to 89/220 (40.5 %). The most frequent species were <em>Mycobacterium avium</em> (52/220, 23.6 %) and <em>Mycobacterium intracellulare</em> (32/220, 14.5 %).</div></div><div><h3>Conclusions</h3><div>Adding PBS following bronchoscopy provided a modest yet clinically meaningful incremental yield in NTM-PD and resembled diagnostic outcomes reported in tuberculosis. PBS collection is a simple and low-burden strategy that enhances the diagnostic information from a single procedure, requiring minimal resources and no additional invasive procedures.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101379"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078955","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}