Respiratory investigation最新文献

{"title":"Eosinophilic chronic rhinosinusitis as a predictor of super-responder and clinical remission in patients with uncontrolled type 2-high severe asthma treated with biologics","authors":"Satoshi Hamada ,&nbsp;Eriko Ogino ,&nbsp;Hirotaka Yasuba","doi":"10.1016/j.resinv.2025.02.003","DOIUrl":"10.1016/j.resinv.2025.02.003","url":null,"abstract":"<div><div>Identifying which biomarkers and comorbidities of type 2 (T2) inflammation to focus on when selecting biologics has remained challenging. We retrospectively examined which biomarkers and comorbidities could influence asthma control among T2-high severe asthma patients receiving biologics. Patients without any maintenance oral corticosteroids and exacerbations requiring systemic corticosteroids indicated super-responder (SR). Clinical remission (CR) was defined as fulfilling the following criteria in addition to achieving SR: asthma symptom improvement (asthma control test score ≥23) and pulmonary function improvement (%forced expiratory volume in 1 s ≥ 80%). We initiated and switched biologics to achieve SR and CR. In total, 111 patients were evaluated, among whom 85.6% and 27.0%–50.5% demonstrated SR and CR, respectively. CR was more frequently observed among patients with severe eosinophilic chronic rhinosinusitis (ECRS) than among those without it. Attention must be paid to the existence of severe ECRS to achieve CR in patients with uncontrolled T2-high severe asthma.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 3","pages":"Pages 247-251"},"PeriodicalIF":2.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403309","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":"One-minute sit-to-stand test to detect gas exchange capacity during exercise stress in patients with idiopathic or progressive pulmonary fibrosis: A randomized, crossover trial","authors":"Yoshito Miyata,&nbsp;Akihiko Tanaka,&nbsp;Yuiko Goto,&nbsp;Takaya Ebato,&nbsp;Hiromitsu Suganuma,&nbsp;Makoto Nojo,&nbsp;Hatsuko Mikuni,&nbsp;Tomoki Uno,&nbsp;Yoshitaka Uchida,&nbsp;Megumi Jinno,&nbsp;Shin Ohta,&nbsp;Tetsuya Homma,&nbsp;Yoshio Watanabe,&nbsp;Sojiro Kusumoto,&nbsp;Hironori Sagara","doi":"10.1016/j.resinv.2025.01.008","DOIUrl":"10.1016/j.resinv.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>The 6-min walk test (6MWT), used to monitor disease progression or exacerbation in interstitial lung disease, faces challenges such as requiring a 30-m walking path and difficulty assessing patients with gait disturbance. The 1-min sit-to-stand test (1STST) offers a convenient alternative, potentially addressing these issues. Despite its advantages, the effectiveness of the 1STST in patients with idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) still needs to be explored. We assessed 1STST's ability to detect exercise-induced desaturation in a randomized, crossover trial involving patients with IPF or PPF.</div></div><div><h3>Methods</h3><div>Participants were divided into group A (6MWT to 1STST) and B (1STST to 6MWT), with a 30-min rest period between the tests. The primary endpoint was the difference in nadir oxygen saturation (SpO₂) between the groups throughout the study. Secondary endpoints included the percentage of participants with a nadir SpO₂ &lt;88% during the tests, a decline of ≥4% in SpO_2, and the variation in Borg scores post-tests.</div></div><div><h3>Results</h3><div>Twenty-three participants (91.3% male; mean age ± standard deviation: 77.2 ± 7.4 years) diagnosed with IPF and PPF were enrolled in this study. The difference in nadir SpO₂ between the 1STST and 6MWT was 1.14% (95% confidence interval: −0.18, 2.48), with the 95% confidence intervals falling within the predefined equivalence range. No significant differences were observed in the secondary endpoints.</div></div><div><h3>Conclusions</h3><div>The results suggest that the 1STST is as effective as the 6MWT in detecting desaturation in patients with IPF and PPF.</div></div><div><h3>Trial registration</h3><div>This study was registered on the website of the Japan Registry of Clinical Trials (jRCT1032230037; URL: <span><span>https://jrct.niph.go.jp/</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 3","pages":"Pages 241-246"},"PeriodicalIF":2.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379301","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 significance of histological inflammation in systemic sclerosis-associated interstitial lung disease","authors":"Shuko Hirota ,&nbsp;Yasuhiko Yamano ,&nbsp;Reoto Takei ,&nbsp;Jun Fukihara ,&nbsp;Hajime Sasano ,&nbsp;Toshiaki Matsuda ,&nbsp;Kensuke Kataoka ,&nbsp;Tomoki Kimura ,&nbsp;Hisao Sano ,&nbsp;Junya Fukuoka ,&nbsp;Takeshi Johko ,&nbsp;Yasuhiro Kondoh","doi":"10.1016/j.resinv.2025.01.001","DOIUrl":"10.1016/j.resinv.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is known to have a poor prognosis and the relationships between histological findings and response to anti-inflammatory therapy or prognosis have not been well investigated.</div></div><div><h3>Methods</h3><div>We examined SSc-ILD patients who underwent surgical lung biopsy at a single respiratory center between 2008 and 2021 and received anti-inflammatory therapy (corticosteroids and/or immunosuppressive drugs). These patients were classified into two groups: an inflammation group, where histological evidence of inflammation defined as “lymphoid aggregates with germinal centers” or “plasmacytosis” was observed, and a non-inflammation group, where these findings were not observed. The correlation of the histological conclusions of inflammation with treatment response and prognosis was retrospectively investigated.</div></div><div><h3>Results</h3><div>Twenty-seven patients were included in the study; 15 (55.6%) were allocated to the inflammation group and 12 (44.4%) to the non-inflammation group. Patient backgrounds did not differ between the groups. The first annual increase in % predicted FVC was significantly larger in the inflammation group than in the non-inflammation one (from 74.3% to 85.9% vs. 75.0%–74.7%, respectively; p = 0.021). The inflammation group took significantly longer to reach end-stage lung disease, defined as an FVC &lt;50%, needing continuous oxygen, or death (p = 0.011). They also had a trend towards longer overall survival compared to the non-inflammation group (median survival: not reached vs. 6.6 years, p = 0.083).</div></div><div><h3>Conclusions</h3><div>Approximately half of the SSc-ILD patients showed histological evidence of inflammation, which may influence treatment response and long-term disease progression.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 2","pages":"Pages 233-239"},"PeriodicalIF":2.4,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372224","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 refined approach to chest tube removal: Impact of preoperative pleural fluid culture and nutritional status in non-fistulous empyema surgery","authors":"Yasoo Sugiura ,&nbsp;Toshinori Hashizume ,&nbsp;Hiroyuki Fujimoto ,&nbsp;Seiji Omura ,&nbsp;Nozomi Watanobe","doi":"10.1016/j.resinv.2025.01.004","DOIUrl":"10.1016/j.resinv.2025.01.004","url":null,"abstract":"<div><h3>Background</h3><div>The acute pleural empyema guidelines recommend thoracoscopic-assisted surgery. However, there is no clear guideline for chest tube removal after surgery. This study aimed to evaluate the duration from surgery to chest tube removal, identify associated factors.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted in 95 patients having non-fistulous empyema due to pulmonary infection caused by common bacteria who underwent surgery at our hospital from January 2011 to March 2023. Postoperative lavage was conducted until two consecutive pleural fluid cultures were negative. The chest tube was clamped and removed if there was no exacerbation of fever or inflammatory findings for 2 days.</div></div><div><h3>Results</h3><div>Seventy-eight patients (82.1%) were men with a mean age of 72 years. The median duration from surgery to chest tube removal was 14 (interquartile range: 8–22) days. In the multivariable analysis, the independent factors associated with the duration from surgery to chest tube removal were lower prognostic nutritional index (hazard ratio [HR], 1.753; 95% confidence interval [CI], 1.101–2.792; P = 0.018) and positive preoperative pleural fluid culture (HR, 1.867; 95% CI, 1.069–3.261; P = 0.028). Ninety-two (96.8%) patients did not require additional treatment or rehospitalization.</div></div><div><h3>Conclusions</h3><div>Positive preoperative pleural fluid culture and nutritional status were significant independent factors associated with the duration from surgery to chest tube removal. Almost all patients did not require chest tube reinsertion in our approach. These findings using our approach may guide optimal management of chest tube removal in non-fistulous empyema.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 2","pages":"Pages 226-232"},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143222485","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":"Corrigendum to “Efficacy and safety of long-term macrolide therapy for non-cystic fibrosis bronchiectasis: A systematic review and meta-analysis” [Respir Invest Volume 62 (2024) 1079-1087]","authors":"Natsuki Nakagawa ,&nbsp;Masashi Ito ,&nbsp;Takanori Asakura ,&nbsp;Nobuyuki Horita ,&nbsp;Yasushi Obase ,&nbsp;Hiroshi Mukae","doi":"10.1016/j.resinv.2025.01.002","DOIUrl":"10.1016/j.resinv.2025.01.002","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 2","pages":"Pages 224-225"},"PeriodicalIF":2.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173652","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":"Prevalence and clinical features of progressive pulmonary fibrosis in patients with unclassifiable idiopathic interstitial pneumonia: A post hoc analysis of prospective multicenter registry","authors":"Masato Kono ,&nbsp;Noriyuki Enomoto ,&nbsp;Yusuke Inoue ,&nbsp;Hideki Yasui ,&nbsp;Masato Karayama ,&nbsp;Yuzo Suzuki ,&nbsp;Hironao Hozumi ,&nbsp;Kazuki Furuhashi ,&nbsp;Mikio Toyoshima ,&nbsp;Shiro Imokawa ,&nbsp;Masato Fujii ,&nbsp;Taisuke Akamatsu ,&nbsp;Naoki Koshimizu ,&nbsp;Koshi Yokomura ,&nbsp;Hiroyuki Matsuda ,&nbsp;Yusuke Kaida ,&nbsp;Yutaro Nakamura ,&nbsp;Masahiro Shirai ,&nbsp;Masafumi Masuda ,&nbsp;Tomoyuki Fujisawa ,&nbsp;Takafumi Suda","doi":"10.1016/j.resinv.2025.01.007","DOIUrl":"10.1016/j.resinv.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>Idiopathic interstitial pneumonias (IIPs) may remain unclassifiable owing to inadequate, nonspecific, or conflicting clinical, radiological, or histopathological findings despite multidisciplinary discussion (MDD). Unclassifiable IIP (UCIIP) is a heterogeneous disease that can present with progressive pulmonary fibrosis (PPF). This study aimed to investigate the prevalence and clinical features of PPF in patients with UCIIP.</div></div><div><h3>Methods</h3><div>In this post hoc analysis of a prospective multicenter registry of 222 patients with IIPs, 71 with UCIIP diagnosed using MDD were enrolled. PPF was defined based on worsening symptoms and radiological and physiological progression using the guideline criteria within 12 months or the criteria from the INBUILD trial within 24 months.</div></div><div><h3>Results</h3><div>The median age was 72 years, and surgical lung biopsy was performed in 19.7%. Of the 66 patients with adequate follow-up data, 30 (45.5%) met either criterion and were diagnosed with PPF. UCIIP patients with PPF had significantly higher serum surfactant protein-D level and percentage of bronchoalveolar fluid neutrophils, lower %forced vital capacity and %diffusing capacity for carbon monoxide, and a higher proportion of honeycombing on high-resolution computed tomography and desaturation on exertion than those without PPF. Additionally, they had significantly more anti-fibrotic therapy and long-term oxygen therapy, a higher incidence of acute exacerbation, and a poorer prognosis than those without PPF. Cox proportional hazards analysis revealed that PPF was a significant poor prognostic factor, regardless of the criteria.</div></div><div><h3>Conclusions</h3><div>PPF is common and associated with poor prognosis in patients with UCIIP. Appropriate evaluation and management of PPF are essential for UCIIP.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 2","pages":"Pages 216-223"},"PeriodicalIF":2.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075333","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 poor sleep quality with clinical variables in nontuberculous mycobacterial pulmonary disease","authors":"Yuki Toyoda ,&nbsp;Mitsuru Tabusadani ,&nbsp;Yusuke Matsumura ,&nbsp;Kosuke Mori ,&nbsp;Kazuki Ono ,&nbsp;Kazuma Kawahara ,&nbsp;Shunya Omatsu ,&nbsp;Koji Furuuchi ,&nbsp;Keiji Fujiwara ,&nbsp;Kozo Morimoto ,&nbsp;Hideaki Senjyu ,&nbsp;Ryo Kozu","doi":"10.1016/j.resinv.2025.01.005","DOIUrl":"10.1016/j.resinv.2025.01.005","url":null,"abstract":"<div><h3>Background</h3><div>The high prevalence of poor sleep quality in patients with chronic respiratory diseases makes it an important clinical topic. However, the prevalence and characteristics of poor sleep quality in those with nontuberculous mycobacterial pulmonary disease and its association with clinical variables remain unclear.</div></div><div><h3>Methods</h3><div>This retrospective study involved patients with nontuberculous mycobacterial pulmonary disease between June 2017 and May 2022. The prevalence of poor sleep quality was measured by the Pittsburgh Sleep Quality Index was used to and its association with clinical variables including age, sex, laboratory data, pulmonary function, respiratory symptoms, mental health, health-related quality of life, and physical function was assessed.</div></div><div><h3>Results</h3><div>The median age of 233 participants was 65 years, with poor sleep quality present in 123 patients (52.8%) who were older, female, and unemployed with dyspnea, anxiety symptoms, low health-related quality of life, and low exercise capacity. Many reported that they \"cannot get to sleep within 30 min,\" \"wake up in the middle of the night or early morning,\" \"have to get up to use the bathroom,\" \"cannot breathe comfortably,\" or \"cough or snore loudly.\" Multivariate logistic regression analysis indicated a significant association between poor sleep quality, female sex, and low health-related quality of life.</div></div><div><h3>Conclusion</h3><div>Our results suggested that for the patients in this study, a multidisciplinary management that considers poor sleep quality is required and assessment of sleep quality as a screening is needed.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 2","pages":"Pages 210-215"},"PeriodicalIF":2.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075319","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 drug therapy for pleural mesothelioma","authors":"Hisao Imai","doi":"10.1016/j.resinv.2024.12.017","DOIUrl":"10.1016/j.resinv.2024.12.017","url":null,"abstract":"<div><div>Pleural mesothelioma (PM) is a rare and highly aggressive malignancy originating from the pleural lining, with a median overall survival of merely 1 year. This cancer primarily arises from mesothelial cells following exposure to carcinogenic, biopersistent mineral fibers, particularly asbestos. The histological subtypes of mesothelioma are epithelioid (approximately 60%), sarcomatoid (20%), and biphasic (20%), exhibiting epithelioid and sarcomatoid characteristics. Classification is important for prognosis and guides the therapeutic strategy. Due to the typical late presentation, most patients with PM are ineligible for localized treatments such as surgery or radiotherapy. Systemic therapy, including cytotoxic chemotherapy, targeted therapies, and immunotherapy, is thus critical for managing advanced PM. For unresectable PM, decisions regarding systemic treatment are guided by patient suitability and histological characteristics. First-line therapies for advanced PM currently include the cisplatin–pemetrexed combination and the nivolumab–ipilimumab regimen. Historically, cisplatin–pemetrexed has been administered as first-line treatment, though recent advancements have introduced new therapies that significantly prolong patient survival. Innovative approaches combining immunotherapy and chemotherapy offer promising avenues for further improvement. Future treatment strategies should incorporate novel paradigms, such as combination chemo-immunotherapy, targeted agents, and potential cellular therapies, alongside companion biomarkers tailored to the histologic and molecular diversity of mesothelioma. This review explores the latest advancements in drug therapy for PM and provides an overview of current systemic treatment options.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 2","pages":"Pages 200-209"},"PeriodicalIF":2.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010590","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":"LPS-induced TMBIM6 splicing drives endothelial necroptosis and aggravates ALI","authors":"Yaling Liu ,&nbsp;Hao Zhu ,&nbsp;Hao Chen ,&nbsp;Yang Gao ,&nbsp;Tingyin Wang ,&nbsp;Xiaodong Wang ,&nbsp;Hong Xie","doi":"10.1016/j.resinv.2024.12.016","DOIUrl":"10.1016/j.resinv.2024.12.016","url":null,"abstract":"<div><h3>Background</h3><div>The mechanism underlying necroptosis in pulmonary vessel endothelial cells (PVECs) resulting from long non-coding RNA (lncRNA)-induced alternative splicing (AS) of target genes in acute lung injury (ALI) remains unclear.</div></div><div><h3>Methods</h3><div>Lipopolysaccharide (LPS)-induced expression of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and lncRNAs was analyzed via RT-PCR in PVECs. Full-transcriptome sequencing was used to detect AS-related mRNAs. The interaction between lncRNA MALAT1 and target gene transmembrane BAX inhibitor motif-containing 6 (TMBIM6) was verified using a dual-luciferase reporter system. Necroptosis was measured as protein levels of phosphorylated receptor-interacting serine/threonine kinase 1 (RIPK1), RIPK3, and mixed-lineage kinase domain-like (MLKL) proteins, as well as flow cytometer measurement. Antisense of MALAT1, TMBIM6, TMBIM6-225 and RIPK1 inhibitor were transfected into a rat model of LPS-induced ALI. Hematoxylin and eosin (H&amp;E) and immunohistochemical staining were performed to evaluate lung injury.</div></div><div><h3>Results</h3><div>LPS upregulated the expression of TNF-α, IL-1β, IL-6, p-RIPK1, p-RIPK3, p-MLKL, MALAT1, and TMBIM6-225 (an AS isoform of MALAT1-targeted gene TMBIM6) in PVECs. However, it downregulated the expression of TMBIM6. An antisense of MALAT1 inhibited TMBIM6-225 and downregulated p-MLKL. The pro-necroptotic effect of MALAT1 was verified in an LPS-induced MALAT1/shMALAT1-transfected ALI rat model <em>in vivo</em>. The necroptotic effect was reversed by treatment with necrostatin-1.</div></div><div><h3>Conclusions</h3><div>LPS-induced MALAT1 causes AS of TMBIM6, and the AS variant TMBIM6-225 aggravates ALI by promoting PVEC necroptosis via the p-RIPK1, p-RIPK3, and p-MLKL complex.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 2","pages":"Pages 191-199"},"PeriodicalIF":2.4,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954023","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":"Predictive factors of progression in mild fibrosing interstitial lung disease patients with gender-age-physiology score of 3 or less","authors":"Masaki Okamoto ,&nbsp;Kiminori Fujimoto ,&nbsp;Tomonori Chikasue ,&nbsp;Toyoshi Yanagihara ,&nbsp;Kazuhiro Tabata ,&nbsp;Yoshiaki Zaizen ,&nbsp;Masaki Tominaga ,&nbsp;Akiko Sumi ,&nbsp;Hiroaki Takeoka ,&nbsp;Norikazu Matsuo ,&nbsp;Takashi Nouno ,&nbsp;Atsushi Kawaguchi ,&nbsp;Tomoaki Hoshino","doi":"10.1016/j.resinv.2024.12.005","DOIUrl":"10.1016/j.resinv.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>The prognostic factors in mild fibrosing interstitial lung disease (FILD) have not been established.</div></div><div><h3>Methods</h3><div>We retrospectively attempted to identify predictive factors of annual progression in mild FILD with gender-age-physiology (GAP) score of 3 or less using logistic regression analysis. Annual FILD progression was defined as meeting any two or more of the following conditions: 1, more than 10% decrease in forced vital capacity (FVC) or 15% decrease in diffusing capacity of the lungs for carbon monoxide (D_LCO); 2, worsening of dyspnea; 3, worsening of fibrotic change on CT at 1 year after admission.</div></div><div><h3>Results</h3><div>Univariate analysis showed that diagnosis of connective tissue disease-associated ILD, CT-definite usual interstitial pneumonia (UIP) pattern, composite physiologic index, FVC, D_LCO, lowest SpO₂ and decrease in SpO₂, and walk distance in the 6-minutes walk test (6MWT), chronic pulmonary emphysema assessment test (CAT) score, and some variables in Short-Form 36 were significantly associated with incidence of annual progression. Multivariate analysis showed that independent predictive factors were diagnosis of idiopathic pulmonary fibrosis (IPF) and fibrotic hypersensitivity pneumonitis (HP), CT-definite UIP pattern, lowest SpO₂ and decrease in SpO₂ in the 6MWT, and CAT score. In logistic regression analysis among 63 patients with non-IPF-ILD, diagnosis with fibrotic HP, lowest SpO₂ and decrease in SpO₂ in the 6MWT, and CAT score were also independent risk factors for annual FILD progression.</div></div><div><h3>Conclusions</h3><div>Exercise-induced hypoxia, patient-reported outcome, radiological UIP pattern, and diagnosis with fibrotic HP are independent predictors of annual progression in mild FILD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 109-117"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847526","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}