Respiratory investigation最新文献

{"title":"Impact of physical activity on respiratory disease: Current status and therapeutic implications","authors":"Kazuhisa Asai","doi":"10.1016/j.resinv.2025.09.020","DOIUrl":"10.1016/j.resinv.2025.09.020","url":null,"abstract":"<div><div>Regular physical activity (PA) modulates key pathophysiological mechanisms underlying the onset, progression, and symptoms of major respiratory diseases. Notably, low daily PA and high sedentary time independently predict faster lung function decline, poorer quality of life, and premature mortality in asthma, chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILDs), and post-coronavirus disease lung sequelae. Conversely, structured exercise training—and the increasingly popular, lifestyle-integrated “move-more–sit-less” programs—improve dyspnea, exercise capacity, airway and systemic inflammation, and healthcare utilization. Large cohort analyses corroborate a clear dose-response relationship: attaining ≥7500 steps/day or ≥150 min/week of moderate-to-vigorous activity yields the greatest clinical benefit, even in individuals with impaired pulmonary function. Mechanistic studies also revealed that exercise dampens type-2 airway inflammation in asthma, enhances the skeletal muscle oxidative phenotype in COPD, and counteracts ILD-related deconditioning. Recent randomized trials have shown that pulmonary rehabilitation can improve 5-year survival in fibrotic ILD, while telerehabilitation and gamified smartphone coaching can close access gaps without compromising efficacy. Additionally, major international guidelines such as the Global Initiative for Asthma 2024 and Global Initiative for Chronic Obstructive Lung Disease 2025 now explicitly recognize PA as a “treatable trait.” Nevertheless, PA uptake in routine care remains limited by behavioral, environmental, and policy barriers. Future work must refine personalized PA prescriptions, integrate wearable-derived metrics into decision-support algorithms, and test the synergistic effects with emerging biologics and anti-fibrotic agents. This review synthesizes contemporary evidence, highlights unanswered questions, and offers pragmatic recommendations for clinicians aiming to embed PA promotion in comprehensive respiratory care pathways.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 6","pages":"Pages 1187-1193"},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157839","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 between pleurodesis before immunotherapy and pneumonitis in non-small cell lung cancer","authors":"Megumi Mizutani ,&nbsp;Yasutaka Ihara ,&nbsp;Kenji Sawa ,&nbsp;Akira Sugimoto ,&nbsp;Hiroaki Nagamine ,&nbsp;Yoshiya Matsumoto ,&nbsp;Yoko Tani ,&nbsp;Takako Oka ,&nbsp;Hiroyasu Kaneda ,&nbsp;Tsubasa Bito ,&nbsp;Tomoya Kawaguchi ,&nbsp;Ayumi Shintani","doi":"10.1016/j.resinv.2025.09.016","DOIUrl":"10.1016/j.resinv.2025.09.016","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors are important in the treatment of advanced non-small cell lung cancer, with pneumonitis being a prevalent complication. Pneumonitis is a recognized adverse event of pleurodesis in lung cancer patients with pleural effusion. However, the association between pleurodesis and pneumonitis in patients with immunotherapy remains unclear.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used nationwide administrative claims data in Japan. Patients aged ≥18 years who underwent immunotherapy for newly diagnosed non-small cell lung cancer between December 2015 and January 2023 were included in the study. Patients who used talc or OK-432 within 60 days prior to immune checkpoint inhibitors treatment were defined as having undergone pleurodesis. The incidence rates of pneumonitis in patients with and without pleurodesis were compared using cumulative incidence functions against time, and by conducting a Fine–Gray analysis to account for death as a competing risk factor for pneumonitis incidence.</div></div><div><h3>Results</h3><div>Among the 16,538 patients with non-small cell lung cancer who received immune checkpoint inhibitors, 509 underwent pleurodesis. The incidence of pneumonitis was higher in patients who underwent pleurodesis than in those who did not. The sub-distribution hazard ratio quantified by Fine–Gray analysis was 1.168 (95 % confidence intercal, 1.062–1.286).</div></div><div><h3>Conclusions</h3><div>Pleurodesis before immunotherapy in patients with advanced non-small cell lung cancer was associated with an increased incidence of pneumonitis.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 6","pages":"Pages 1194-1200"},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157836","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":"Artificial intelligence for diagnosis in interstitial lung disease and digital ontology for unclassified interstitial lung disease","authors":"Tomohisa Baba ,&nbsp;Tsubasa Goto ,&nbsp;Yoshiro Kitamura ,&nbsp;Tae Iwasawa ,&nbsp;Koji Okudela ,&nbsp;Tamiko Takemura ,&nbsp;Akira Osawa ,&nbsp;Takashi Ogura","doi":"10.1016/j.resinv.2025.09.007","DOIUrl":"10.1016/j.resinv.2025.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Multidisciplinary discussion (MDD) is the gold standard for diagnosis in interstitial lung disease (ILD). However, its inter-rater agreement is not satisfactory, and access to the MDD is limited due to a shortage of ILD experts. Therefore, artificial intelligence would be helpful for diagnosing ILD.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from 630 patients with ILD, including clinical information, CT images, and pathological results. The ILD classification into four clinicopathologic entities (i.e., idiopathic pulmonary fibrosis, non-specific interstitial pneumonia, hypersensitivity pneumonitis, connective tissue disease) consists of two stages: first, pneumonia pattern classification of CT images using a convolutional neural network (CNN) model; second, multimodal (clinical, radiological, and pathological) classification using a support vector machine (SVM). The performance of the classification algorithm was evaluated using 5-fold cross-validation.</div></div><div><h3>Results</h3><div>The mean accuracies of the CNN model and SVM were 62.4 % and 85.4 %, respectively. For multimodal classification using SVM, the overall accuracy was very high, especially with sensitivities for idiopathic pulmonary fibrosis and hypersensitivity pneumonitis exceeding 90 %. When pneumonia patterns from CT images, pathological results, or clinical information were not used, the SVM accuracy was 84.3 %, 70.3 % and 79.8 %, respectively, suggesting that pathological results contributed most to MDD diagnosis. When an unclassifiable interstitial pneumonia was input, the SVM output tended to align with the most likely diagnosis by the expert MDD team.</div></div><div><h3>Conclusions</h3><div>The algorithm based on multimodal information can assist in diagnosing interstitial lung disease and is suitable for ontology diagnosis. (242 words)</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 6","pages":"Pages 1179-1186"},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118670","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":"Cluster analysis of seasonal KL-6 variations in interstitial lung diseases","authors":"Yuki Iijima ,&nbsp;Tsukasa Okamoto ,&nbsp;Shiro Sonoda ,&nbsp;Tsuyoshi Shirai ,&nbsp;Masahiro Ishizuka ,&nbsp;Haruhiko Furusawa ,&nbsp;Tomoya Tateishi ,&nbsp;Tatsuhiko Anzai ,&nbsp;Kunihiko Takahashi ,&nbsp;Yasunari Miyazaki","doi":"10.1016/j.resinv.2025.09.018","DOIUrl":"10.1016/j.resinv.2025.09.018","url":null,"abstract":"<div><h3>Background</h3><div>Serum Krebs von den Lungen-6 (KL-6) is a biomarker that reflects the pathophysiology and activity of interstitial lung disease (ILDs); however, its fluctuation patterns remain understudied.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 910 patients with ILD with at least one year of regular KL-6 measurements. Cluster analysis was performed to identify the distinct annual KL-6 fluctuation patterns. Patient demographics, disease distribution, and prognostic outcomes were compared across clusters.</div></div><div><h3>Results</h3><div>Four distinct clusters of KL-6 patterns were identified: minimal change (cluster 1, n = 722), decrease in summer (cluster 2, n = 74), increase in autumn (cluster 3, n = 21), and increase in winter (cluster 4, n = 93). Mean KL-6 value of the first year (p &lt; 0.01), percent predicted forced vital capacity (p = 0.01), and diagnoses of idiopathic pulmonary fibrosis (p &lt; 0.01), nonfibrotic hypersensitivity pneumonitis (p &lt; 0.01), and fibrotic hypersensitivity pneumonitis (p = 0.04) were significantly associated with specific KL-6 fluctuation patterns. When seasonal trends were defined as belonging to the same cluster for two consecutive years, nonfibrotic hypersensitivity pneumonitis showed significant association with seasonal trends (p &lt; 0.01). Multivariate analysis, adjusted for age and etiology, showed a trend for cluster 4 to have a poorer prognosis compared to cluster 1 (hazard ratio: 1.62, 95 % confidence interval: 0.93–2.80, p = 0.09).</div></div><div><h3>Conclusion</h3><div>KL-6 fluctuations were categorized into four seasonal patterns, which may provide insights for diagnosing ILD etiology and predicting the prognosis of patients with ILD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 6","pages":"Pages 1146-1152"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118667","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":"Rethinking routine chest drainage in pneumothorax management: Outcomes from a nationwide Japanese database","authors":"Yoshikane Yamauchi ,&nbsp;Yukinori Sakao ,&nbsp;Noriyoshi Sawabata ,&nbsp;Toshiro Obuchi ,&nbsp;Kenji Tsuboshima ,&nbsp;Noriyuki Matsutani ,&nbsp;Shouichi Okamoto ,&nbsp;Hitoshi Igai ,&nbsp;Akihiro Hayashi","doi":"10.1016/j.resinv.2025.09.015","DOIUrl":"10.1016/j.resinv.2025.09.015","url":null,"abstract":"<div><h3>Background</h3><div>The optimal management of pneumothorax remains controversial, with evolving evidence challenging the conventional approach of routine chest drainage.</div></div><div><h3>Methods</h3><div>We analyzed data of 1773 patients (956 with primary spontaneous pneumothorax [PSP], 817 with secondary spontaneous pneumothorax [SSP]) from a nationwide Japanese database. Multivariate and propensity score matching analyses identified factors associated with drainage requirement and compared outcomes between drainage and non-drainage groups.</div></div><div><h3>Results</h3><div>Pneumothorax grade was the most significant determinant of chest drainage requirement in both PSP (moderate: odds ratio [OR] 12.5, severe: OR 22.6 vs. mild, p &lt; 0.001) and SSP patients (moderate: OR 16.1, severe: OR 26.9 vs. mild, p &lt; 0.001), with chronic obstructive pulmonary disease being an additional factor in SSP (OR 3.04). PSP patients without drainage had shorter hospital stays (median: 6.0 vs. 8.0 days, p &lt; 0.001) and more frequently underwent surgery. SSP patients without drainage had lower ICU admission rates and shorter hospitalization (median: 11.0 vs. 14.0 days, p &lt; 0.001). The benefits of non-drainage were observed across all pneumothorax grades in PSP, while in severe SSP, drainage was associated with better outcomes. After matching for pneumothorax grade, non-drainage PSP patients had shorter stays in both non-surgical (median: 2 vs. 6 days, p &lt; 0.001) and surgical subgroups (median: 5 vs. 8 days, p &lt; 0.001). Mortality rates were comparable between groups.</div></div><div><h3>Conclusions</h3><div>While pneumothorax grade remains the key determinant for chest drainage, carefully selected patients may be successfully managed without drainage, with shorter hospital stays without compromising outcomes. Refined criteria for non-drainage management could improve resource utilization and patient experience.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 6","pages":"Pages 1153-1163"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118669","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":"Evaluation of inhalation device prescribing trends: A retrospective database study in Japan","authors":"Hiroyuki Ura ,&nbsp;Noriko Matsuoka ,&nbsp;Hiroyuki Furuya","doi":"10.1016/j.resinv.2025.09.011","DOIUrl":"10.1016/j.resinv.2025.09.011","url":null,"abstract":"<div><h3>Background</h3><div>Inhalation therapy is crucial in treating obstructive lung diseases, including asthma and chronic obstructive pulmonary disease (COPD). Improper inhalation techniques are associated with poor asthma and COPD management, increased exacerbation risk, and overutilization of healthcare resource. However, comprehensive analyses of prescription trends across diverse inhalation devices are limited. Therefore, we aimed to investigate inhalation device prescription trends in Japan from 2016 to 2022 using data from the National Database of Health Insurance Claims and Specific Health Checkups Open Data Japan.</div></div><div><h3>Methods</h3><div>Temporal changes in prescription patterns were analyzed across different device types, therapeutic categories, and patient demographics.</div></div><div><h3>Results</h3><div>Our findings revealed major shifts toward combination therapies, particularly triple combination therapy (inhaled corticosteroid [ICS]/long-acting beta2-agonist [LABA]/long-acting muscarinic antagonist [LAMA]), in addition to the preference for newer devices, such as the Ellipta dry powder and Aerosphere pressurized metered-dose inhalers. Age- and sex-specific patterns emerged, with distinct preferences observed across demographic groups. The pediatric population primarily received ICS mono- and ICS/LABA combination therapies, while older adults showed increased use of the triple combination therapy. Sex disparities were particularly pronounced in the older population, with older male patients requiring LABA/LAMA and triple combination therapies more often than older female patients. An economic analysis revealed that while dry powder inhalers had the highest overall cost, the introduction of generic formulations markedly reduced expenditures.</div></div><div><h3>Conclusions</h3><div>The shift toward combination therapies and newer inhaler devices in Japan highlights the critical need for personalized treatment strategies that balance patient characteristics with economic factors.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 6","pages":"Pages 1164-1173"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118668","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":"Geographic variation in bronchoscopy use across Japan: A nationwide analysis using administrative claims data","authors":"Tomohiro Akaba ,&nbsp;Ken Arimura ,&nbsp;Keiko Kan-o ,&nbsp;Miki Kubo ,&nbsp;Mitsuko Kondo ,&nbsp;Musashi Ueda ,&nbsp;Osamitsu Yagi ,&nbsp;Atsushi Kurokawa ,&nbsp;Naoko Kawashima ,&nbsp;Yutaro Horie ,&nbsp;Yuno Shiota ,&nbsp;Etsuko Tagaya","doi":"10.1016/j.resinv.2025.09.017","DOIUrl":"10.1016/j.resinv.2025.09.017","url":null,"abstract":"<div><div>Bronchoscopy is a widely used diagnostic procedure in respiratory medicine. Despite recent advances in techniques and an ongoing aging population, detailed information regarding current bronchoscopy procedural patterns and practice settings remains limited for Japan. We analyzed bronchoscopic procedure volumes and settings across 47 Japanese prefectures over the 2023 fiscal year, using NDB Open Data. A total of 177,317 procedures were performed, with a nationwide rate of 142.6 per 100,000 population. Of these, 78.8 % were conducted during inpatient care. The procedural rate and proportion of inpatient cases varied substantially by prefecture. No significant correlation was observed between population aging rate and procedure volume, but a moderate positive correlation was identified between procedure volume and the density of board-certified respiratory specialists (Spearman's ρ = 0.517, <em>p</em> &lt; 0.001). This nationwide analysis highlights the substantial regional variations in bronchoscopy practices across Japan and suggests a possible role of specialist distribution in determining access to the procedure.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 6","pages":"Pages 1174-1178"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118070","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":"Recent advances in lung function standard value prediction equations: Comparison with the Global Lung Initiative prediction equation based on GAMLSS","authors":"Toshitaka Shomura,&nbsp;Yosuke Wada,&nbsp;Masayuki Hanaoka","doi":"10.1016/j.resinv.2025.09.010","DOIUrl":"10.1016/j.resinv.2025.09.010","url":null,"abstract":"<div><div>To accurately interpret lung function test (LFTs) results, it is necessary to appropriately select the lung function reference value prediction equation implemented in the measuring equipment of each medical institution.</div><div>The American Thoracic Society (ATS) and European Respiratory Society (ERS) task force, known as the Global Lung Function Initiative (GLI), recommends the use of a lung function standard value prediction equation that can calculate continuous standard values across a wide age range. Generalized additive models for location, scale, and shape (GAMLSS) are statistical techniques used to create accurate percentiles for a wide age range. This prediction equation was created using the lambda, mu, and sigma (LMS) method, a subtype of a statistical method known as generalized additive models for location, scale, and shape (GAMLSS). Lung function equations created using the LMS method can be used to calculate the z-score, which can contribute to a more accurate interpretation of the results. As for the contents of this review, an overview of the development of equations for predicting lung function using GAMLSS, such as spirometry, diffusion capacity, and static lung volume, is provided in the first portion of this review. The second section of this review compiles the statistical knowledge required to develop lung function reference-value prediction algorithms based on GAMLSS. This section briefly explains how to calculate the z-score and provides advice on addressing ethnic diversity in the lung function standard value prediction equations.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 6","pages":"Pages 1139-1145"},"PeriodicalIF":2.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105483","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 prognosis of lung transplant candidates with progressive pulmonary fibrosis","authors":"Takafumi Yamaya ,&nbsp;Tatsuya Muraoka ,&nbsp;Miho Yamaguchi ,&nbsp;Mitsuaki Kawashima ,&nbsp;Chihiro Konoeda ,&nbsp;Masaaki Sato","doi":"10.1016/j.resinv.2025.09.009","DOIUrl":"10.1016/j.resinv.2025.09.009","url":null,"abstract":"<div><h3>Background</h3><div>Interstitial lung disease with progressive fibrosis is now defined as progressive pulmonary fibrosis (PPF), and often requires lung transplantation. However, the prognosis of lung transplant candidates with PPF is unclear.</div></div><div><h3>Methods</h3><div>We retrospectively investigated fibrotic ILD patients who were candidates for lung transplantation. Based on the clinical data, we classified the patients into idiopathic pulmonary fibrosis (IPF), PPF, and non-PPF groups. We investigated the patient characteristics, transplant-free survival (TFS), and cumulative waiting list mortality in each group.</div></div><div><h3>Results</h3><div>In total, 194 patients were included in the study: 51 IPF patients, 121 PPF patients, and 22 non-PPF patients, respectively. PPF patients tended to show a lower forced vital capacity (47.0 ± 16.2 %) and a shorter 6-min walk distance than IPF patients [310 (233–400) m]. The TFS of PPF patients was shorter than that of non-PPF patients and comparable to that of IPF patients (<em>p</em> &lt; 0.001, 0.132, respectively). A similar trend was observed for cumulative waiting list mortality (<em>p</em> = 0.001, 0.062, respectively). Pleuroparenchymal fibroelastosis (PPFE) patients exhibited worse waiting list mortality than IPF patients (<em>p</em> = 0.019). Multivariate analysis revealed no statistically significant risk factors for mortality in the PPF group.</div></div><div><h3>Conclusions</h3><div>Among lung transplant candidates, PPF patients exhibited worse TFS and waiting list mortality than non-PPF patients, and were comparable to IPF patients. In addition, PPFE patients demonstrated significantly higher mortality rates than IPF patients. Early lung transplantation should be considered for PPF patients, especially PPFE patients.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 6","pages":"Pages 1132-1138"},"PeriodicalIF":2.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102779","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":"Impact of Pseudomonas aeruginosa on the outcomes after lung transplantation: a single-center study","authors":"Takashi Kanou,&nbsp;Hideki Nagata,&nbsp;Kenji Kimura,&nbsp;Eriko Fukui,&nbsp;Toru Kimura,&nbsp;Naoko Ose,&nbsp;Yasushi Shintani","doi":"10.1016/j.resinv.2025.09.002","DOIUrl":"10.1016/j.resinv.2025.09.002","url":null,"abstract":"<div><h3>Background</h3><div>Lung transplantation (LTX) is an established treatment for end-stage pulmonary diseases. However, infections, particularly those caused by <em>Pseudomonas aeruginosa,</em> remain a major challenge, contributing to morbidity, mortality, and complications such as acute cellular rejection (ACR). This study aimed to investigate the relationship between the postoperative detection of <em>P. aeruginosa</em> in respiratory samples and post-LTX outcomes, including the incidence of ACR and overall survival.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 63 patients who underwent cadaveric LTX at our institution between 1999 and 2021. Patient characteristics, perioperative factors, and microbiological data were collected, and the association of <em>P. aeruginosa</em> detection within three months post-LTX with ACR and survival outcomes was analyzed. ACR was diagnosed by surveillance bronchoscopy and histological assessment.</div></div><div><h3>Results</h3><div><em>P. aeruginosa</em> was detected in the respiratory samples of 21 patients (33 %) within three months post-LTX. Patients with the history of <em>P. aeruginosa</em> detection after LTX exhibited a significantly higher incidence of ACR (p = 0.02) and poorer 5-year overall survival rates (p = 0.03). A multivariate analysis confirmed that <em>P. aeruginosa</em> detection and older recipient age were independent risk factors for poor survival.</div></div><div><h3>Conclusions</h3><div>The detection of <em>P. aeruginosa</em> in respiratory samples was associated with an increased risk of ACR and poorer overall survival following LTX. These findings underscore the importance of vigilant monitoring for <em>P. aeruginosa</em> detection and development of targeted antimicrobial strategies to improve post-transplant outcomes. Further studies are warranted to explore the mechanisms linking <em>P. aeruginosa</em> to adverse outcomes and evaluate the efficacy of novel therapeutic interventions.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 6","pages":"Pages 1127-1131"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092392","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}