Respiratory investigation最新文献

{"title":"Serum soluble ST2: An effective prognostic biomarker for mortality in patients with severe acute exacerbation of chronic obstructive pulmonary disease requiring invasive mechanical ventilation","authors":"Yunxiang Lv ,&nbsp;JianLing Huang ,&nbsp;Kexing Han ,&nbsp;Beilei Gong ,&nbsp;Guiyun Jiang","doi":"10.1016/j.resinv.2026.101391","DOIUrl":"10.1016/j.resinv.2026.101391","url":null,"abstract":"<div><h3>Background</h3><div>For severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients unresponsive to initial treatment and at high mortality risk, early biomarker-based risk stratification may refine therapies and boost survival.</div></div><div><h3>Methods</h3><div>A total of 84 patients with severe AECOPD were prospectively enrolled. Serum soluble ST2 (sST2) levels were measured at baseline (day 0, diagnosis) and on days 3 and 7 after systemic therapy was initiated. The primary goals were to evaluate the prognostic value of sST2 for predicting all-cause in-hospital mortality and to determine its additive predictive effect when integrated with the DECAF score (Dyspnoea, Eosinopenia, Consolidation, Acidaemia, and atrial Fibrillation).</div></div><div><h3>Results</h3><div>Elevated sST2 levels on days 0, 3, and 7 demonstrated strong predictive value for in-hospital mortality, with area under the receiver operating characteristic curve (AUC) values of 0.799 (95% CI: 0.697–0.878), 0.856 (95% CI: 0.762–0.923), and 0.912 (95% CI: 0.831–0.963), respectively. In univariate Cox regression analysis, patients with higher sST2 levels at these time points exhibited significantly increased 60-day non-survival (hazard ratios [HRs]: 12.4 [95% CI:4.4–35.0], 11.9 [95% CI: 4.4–31.7], and 37.8 [95% CI: 12.7–113.0] for days 0, 3, and 7, respectively; <em>P</em> &lt; 0.001). Multivariate analysis revealed that combining sST2 levels ≥718 pg/mL on day 3 with the DECAF score enhanced mortality prediction accuracy (AUC: 0.920 vs. 0.654 for DECAF alone; <em>P</em> &lt; 0.001 for difference).</div></div><div><h3>Conclusions</h3><div>Early serum sST2 levels independently predict mortality in patients with severe AECOPD, and their integration with the DECAF score improves prognostic accuracy.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101391"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of respiratory syncytial virus and human metapneumovirus pneumonia in adults: A multicenter retrospective cohort study in Japan","authors":"Ryota Takao ,&nbsp;Takahiro Takazono ,&nbsp;Kiyoyasu Fukushima ,&nbsp;Nobuyuki Ashizawa ,&nbsp;Masataka Yoshida ,&nbsp;Kazuaki Takeda ,&nbsp;Naoki Iwanaga ,&nbsp;Shotaro Ide ,&nbsp;Asuka Umemura ,&nbsp;Norihito Kaku ,&nbsp;Kosuke Kosai ,&nbsp;Akira Kondo ,&nbsp;Tsutomu Kobayashi ,&nbsp;Noriho Sakamoto ,&nbsp;Toyomitsu Sawai ,&nbsp;Yoji Futsuki ,&nbsp;Kohji Hashiguchi ,&nbsp;Katsunori Yanagihara ,&nbsp;Hiroshi Mukae","doi":"10.1016/j.resinv.2026.101392","DOIUrl":"10.1016/j.resinv.2026.101392","url":null,"abstract":"<div><h3>Background</h3><div>Respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are increasingly being recognized as important viral pathogens in adults, particularly in advanced age and high-risk populations. However, epidemiological and clinical data on RSV and hMPV pneumonia in Japan are limited.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of adult patients diagnosed with RSV, hMPV, or influenza virus pneumonia at eight institutions in Nagasaki. Clinical information, including the Charlson Comorbidity Index (CCI), laboratory and radiological findings, were collected from medical records. Pneumonia severity was assessed using the A-DROP and Pneumonia Severity Index (PSI).</div></div><div><h3>Results</h3><div>A total of 301 patients were included: 215 with influenza, 34 with RSV, and 52 with hMPV pneumonia. The median ages were 75, 82, and 69 years, respectively. Female predominance was observed in RSV and hMPV cases compared with influenza. RSV cases were more frequently associated with residence in long-term care facilities, lower BMI, and higher prevalence of chronic cardiopulmonary disease. Lower respiratory tract symptoms, particularly cough and sputum production, were significantly more frequent in patients with RSV infections. hMPV cases exhibited lower CCI scores and milder severity profiles. The A-DROP and PSI scores did not differ significantly between RSV and influenza, and the in-hospital mortality was comparable across the groups.</div></div><div><h3>Conclusions</h3><div>RSV and hMPV are clinically important causes of pneumonia in advanced aged Japanese population. RSV pneumonia is associated with prominent respiratory symptoms and radiological findings, with severity comparable to that of influenza. These findings underscore the need for increased awareness and large-scale, prospective studies.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101392"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and systemic treatment in patients with elderly-onset sarcoidosis: A retrospective single-centre study in Japan","authors":"Hitokazu Tsukao ,&nbsp;Michiru Sawahata ,&nbsp;Yoshitaka Yamanouchi ,&nbsp;Noritaka Sakamoto ,&nbsp;Masayuki Nakayama ,&nbsp;Koichi Hagiwara ,&nbsp;Makoto Maemondo","doi":"10.1016/j.resinv.2026.101381","DOIUrl":"10.1016/j.resinv.2026.101381","url":null,"abstract":"<div><h3>Background</h3><div>The mean age at diagnosis of sarcoidosis has been increasing worldwide, yet the clinical characteristics and treatment patterns of elderly-onset cases remain insufficiently defined, particularly in Asian populations.</div></div><div><h3>Methods</h3><div>We retrospectively investigated 187 consecutive Japanese patients newly diagnosed with sarcoidosis at Jichi Medical University Hospital between 2006 and 2018 who fulfilled the 2015 diagnostic criteria. Patients were classified as elderly (≥65 years, n = 49), middle-aged (45–64 years, n = 82), or younger (&lt;45 years, n = 56). Organ involvement was assessed based on the 2023 Japan Society of Sarcoidosis and Other Granulomatous Disorders standards and the 2014 WASOG criteria. The frequency and distribution of systemic therapy (corticosteroids, methotrexate, other immunosuppressants) and treatment indications were compared across age groups.</div></div><div><h3>Results</h3><div>The proportion of women was significantly higher in the elderly than in the younger group (81.6% vs. 41.1%, p &lt; 0.01), as was the frequency of cardiac involvement (12.2% vs. 3.6%, p &lt; 0.05). Systemic therapy was initiated less often in the elderly than in the middle-aged group (10.2% vs. 25.4%, p = 0.026), and all indications involved extrapulmonary lesions (cardiac, n = 3; neurological, n = 1; ocular, n = 1). Most treated patients received systemic corticosteroids, with a median duration of 7.0 months.</div></div><div><h3>Conclusion</h3><div>Elderly-onset sarcoidosis in Japan was characterised by a predominance of women and a higher frequency of cardiac involvement. Systemic therapy was infrequently initiated and only for extrapulmonary disease. These findings underscore the need for systematic evaluation of extrapulmonary organs—particularly the heart—and age-adapted multidisciplinary management.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101381"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137698","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":"Handgrip strength in Japanese patients with chronic obstructive pulmonary disease: a prospective cohort study","authors":"Seiichi Kobayashi,&nbsp;Manabu Ono,&nbsp;Masatsugu Ishida,&nbsp;Hikari Satoh,&nbsp;Masakazu Hanagama,&nbsp;Koji Okutomo,&nbsp;Masaru Yanai","doi":"10.1016/j.resinv.2026.101377","DOIUrl":"10.1016/j.resinv.2026.101377","url":null,"abstract":"<div><h3>Background</h3><div>Skeletal muscle dysfunction frequently accompanies chronic obstructive pulmonary disease (COPD). Handgrip strength (HGS) is a simple, reliable measure of muscle strength. This study aimed to evaluate its prognostic significance in COPD.</div></div><div><h3>Methods</h3><div>We conducted a prospective observational study in a cohort of Japanese patients with COPD, stratified by HGS. Patient characteristics, exacerbations, and mortality were evaluated over 5 years. Low HGS was defined as &lt;28 kg in men and &lt;18 kg in women.</div></div><div><h3>Results</h3><div>Among 300 patients, 89 (29.7 %) had low HGS. Compared with patients with normal HGS, these patients had a lower body mass index, worse pulmonary function, more severe dyspnea, poorer health status, and reduced physical activity. Exacerbation rates were similar between the groups. Low HGS was associated with an increased risk of all-cause mortality (hazard ratio, 1.79; 95 % confidence interval, 1.03–3.13).</div></div><div><h3>Conclusions</h3><div>Low HGS was associated with adverse clinical outcomes in Japanese patients with COPD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101377"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038519","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":"Identifying high-risk smokers without airflow limitation using new COPD criteria: pooled analysis of two Japanese cohorts","authors":"Naoya Tanabe ,&nbsp;Shotaro Chubachi ,&nbsp;Kunihiko Terada ,&nbsp;Takashi Shimada ,&nbsp;Yoshinori Seri ,&nbsp;Hidetoshi Nakamura ,&nbsp;Koichiro Asano ,&nbsp;Atsuyasu Sato ,&nbsp;Susumu Sato ,&nbsp;Koichi Fukunaga ,&nbsp;Toyohiro Hirai","doi":"10.1016/j.resinv.2026.101368","DOIUrl":"10.1016/j.resinv.2026.101368","url":null,"abstract":"<div><h3>Background</h3><div>Recently proposed multidimensional chronic obstructive pulmonary disease (COPD) diagnostic criteria incorporate computed tomography (CT) findings and symptoms beyond airflow limitation. These criteria, developed using North American cohorts, require validation in Asian populations in which COPD phenotypes differ. We examined whether these criteria identify Japanese smokers at increased exacerbation risk, particularly those without airflow limitation.</div></div><div><h3>Methods</h3><div>This retrospective analysis pooled data from two prospective Japanese cohorts (Kyoto-Himeji and K-CCR) that included 517 smokers aged ≥40 years undergoing chest CT and COPD assessment test (CAT). The criteria included one major criterion (airflow limitation) and five minor criteria (emphysema [low attenuation area percent, LAA% ≥5 %], airway wall thickening [wall area percent ≥60 %], symptoms, dyspnea, and chronic bronchitis). COPD was defined as meeting the major criterion plus ≥1 minor criterion or ≥3 minor criteria alone. Negative binomial regression examined three-year exacerbation risk.</div></div><div><h3>Results</h3><div>Among 517 smokers, 364 had major criteria COPD, 26 had minor criteria-only COPD, 40 had airflow limitation without meeting COPD criteria, and 87 had neither (non-COPD group). Exacerbation rates were 0.270, 0.259, 0.161, and 0.069 per person-year, respectively. Both COPD groups had a significantly greater exacerbation risk than the non-COPD group (adjusted IRR: 4.95 [95 %CI: 1.79–14.62] for minor criteria-only; 3.95 [2.06–7.79] for major criteria). Higher CAT scores and LAA % were independently associated with a greater exacerbation risk in patients with COPD.</div></div><div><h3>Conclusion</h3><div>The new multidimensional COPD criteria successfully identified Japanese smokers at increased exacerbation risk, including those without airflow limitation, supporting their applicability across different populations. Registered at UMIN (UMIN000028387).</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101368"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941426","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":"Appreciation to reviewers in 2025","authors":"","doi":"10.1016/S2212-5345(26)00035-3","DOIUrl":"10.1016/S2212-5345(26)00035-3","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101401"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448552","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 case of synchronous multiple primary lung cancers each harboring an EGFR mutation or an ALK fusion gene alone that responded to osimertinib with chemotherapy","authors":"Doppo Fukui ,&nbsp;Daisuke Morinaga ,&nbsp;Jun Sakakibara-Konishi ,&nbsp;Yukiko Yoshida ,&nbsp;Masahiro Kashima ,&nbsp;Shotaro Ito ,&nbsp;Megumi Furuta ,&nbsp;Yuta Takashima ,&nbsp;Zenichi Tanei ,&nbsp;Satoshi Konno","doi":"10.1016/j.resinv.2026.101375","DOIUrl":"10.1016/j.resinv.2026.101375","url":null,"abstract":"<div><div>A comprehensive pathological evaluation is useful for diagnosing synchronous multiple primary lung cancer (sMPLC). However, a consensus regarding treatment for sMPLC with different driver mutations is lacking. We present a case of sMPLC harboring an epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) fusion gene. For the advanced EGFR-positive tumor, osimertinib plus chemotherapy was initiated, the latter also covering ALK-positive tumor. A marked response and slight reduction occurred in the EGFR-positive and ALK-positive tumors, respectively. Surgical resection of the ALK-positive tumor achieved negative margins. Targeted therapy with chemotherapy may effectively treat sMPLC with different driver mutations.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101375"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and severity of primary ciliary dyskinesia caused by large homozygous deletion including exons 1–4 of DRC1: A multicenter retrospective cohort study","authors":"Masashi Ito ,&nbsp;Atsuko Nakano ,&nbsp;Yukiko Arimoto ,&nbsp;Mitsuko Kondo ,&nbsp;Yusuke Matsuda ,&nbsp;Miki Abo ,&nbsp;Takashi Kido ,&nbsp;Masashi Morishita ,&nbsp;Takeshige Honma ,&nbsp;Hisashi Nishimori ,&nbsp;Yuzaburo Inoue ,&nbsp;Keisuke Iwamoto ,&nbsp;Yuichiro Hashida ,&nbsp;Kazuhiko Takeuchi ,&nbsp;Miyabayashi Akiko ,&nbsp;Keiko Wakabayashi ,&nbsp;Hiroyuki Yamada ,&nbsp;Minako Hijikata ,&nbsp;Naoto Keicho ,&nbsp;Kozo Morimoto","doi":"10.1016/j.resinv.2026.101376","DOIUrl":"10.1016/j.resinv.2026.101376","url":null,"abstract":"<div><h3>Background</h3><div>Approximately half of primary ciliary dyskinesia (PCD) patients in Japan carry a large homozygous deletion encompassing exons 1–4 of <em>DRC1</em> gene. However, the clinical manifestations of PCD patients with <em>DRC1</em> variants remain poorly characterized.</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective cohort study at 12 hospitals across Japan. Patients with <em>DRC1</em> variants were included, and their clinical characteristics, disease severity, and radiological features were compared with those of patients with outer dynein arm (ODA) defects.</div></div><div><h3>Results</h3><div>A total of 43 patients with <em>DRC1</em> variants and 21 with ODA defects were included. The median age at PCD diagnosis was 27 years (IQR: 17–41) for patients with <em>DRC1</em> variants and 26 years (IQR: 8–31) for those with ODA defects. The median PICADAR score was significantly lower in patients with <em>DRC1</em> variants than those with ODA defects (4 vs. 8, p &lt; 0.001). The radiological severity and distribution of bronchiectasis did not differ between the two groups, while the median mucous plugging score (bronchiolitis/tree-in-bud) was significantly higher in patients with <em>DRC1</em> variants (5, IQR: 4–6 vs. 3, IQR: 2–4, p = 0.044). In patients with <em>DRC1</em> variants, the FEV₁ z score was negatively correlated with age (r = −0.37, p = 0.028), and the modified Reiff score was positively correlated with age (r = 0.47, p = 0.010).</div></div><div><h3>Conclusions</h3><div>Although the sensitivity of the PICADAR score was low in these patients, most clinical and radiological features of <em>DRC1</em>-related PCD were relatively typical of PCD. Given that <em>DRC1</em>-related PCD appears to worsen with age, early diagnosis and timely intervention are crucial.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101376"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030642","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":"Real-world clinical data on adult respiratory syncytial virus infection in a Japanese community hospital: Emphasis on positivity rate, older adults, and pneumonia cases","authors":"Hiroyuki Honda ,&nbsp;Koji Kuronuma ,&nbsp;Yutaro Nagano ,&nbsp;Kanami Nagano ,&nbsp;Kojirou Uemura ,&nbsp;Midori Hashimoto ,&nbsp;Kaoru Nishiyama ,&nbsp;Hirofumi Chiba","doi":"10.1016/j.resinv.2026.101371","DOIUrl":"10.1016/j.resinv.2026.101371","url":null,"abstract":"<div><h3>Background</h3><div>Information on the incidence and clinical characteristics of respiratory syncytial virus (RSV) infections among adults remains limited in Japan. In this study, we aimed to clarify these aspects among adult outpatients at our institution.</div></div><div><h3>Methods</h3><div>This single-center, retrospective observational study included outpatients aged 18 years and older who presented with fever or respiratory symptoms and underwent multiplex PCR testing of nasopharyngeal specimens between April 2021 and March 2025. We assessed the RSV positive rate, underlying comorbidities, and hospitalization rate. For those with pneumonia, we analyzed their imaging findings and sputum culture results. Clinical characteristics were also compared between hospitalized and nonhospitalized patients aged 60 years or older.</div></div><div><h3>Results</h3><div>The overall positive rate of RSV infection over the 4 years was 2.3 %. Among individuals aged 60 years and older, the positive rate was 2.3 %. Of the 31 hospitalized cases, 29 were aged 60 years or older, accounting for 36.3 % of all RSV-positive patients in this age group. Age significantly differed between the hospitalized and nonhospitalized groups aged 60 and older. Among 24 patients with pneumonia who underwent computed tomography scans, 11 had positive sputum cultures. Consolidation was significantly more frequent in the 11 culture-positive cases than in the remaining 13 cases.</div></div><div><h3>Conclusions</h3><div>RSV infection accounted for 2.3 % of adult outpatient cases, with a notably high hospitalization rate in older adults. These findings highlight RSV as an important respiratory pathogen in older adults, underscoring the need to expand diagnostic testing and preventive strategies in this population.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101371"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966725","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 prevalence of patients who mistakenly referred to upper respiratory tract secretions as sputum","authors":"Tadao Nagasaki ,&nbsp;Masato Muraki ,&nbsp;Soichiro Hanada ,&nbsp;Ken Shirahase ,&nbsp;Yoshiyuki Kawabata ,&nbsp;Masamichi Iwai ,&nbsp;Akiko Sano ,&nbsp;Osamu Nishiyama ,&nbsp;Takashi Iwanaga ,&nbsp;Hiroyuki Sano ,&nbsp;Ryuta Haraguchi ,&nbsp;Yuji Tohda ,&nbsp;Hisako Matsumoto","doi":"10.1016/j.resinv.2026.101378","DOIUrl":"10.1016/j.resinv.2026.101378","url":null,"abstract":"<div><h3>Background</h3><div>Patients sometimes misidentify upper respiratory tract secretions or saliva as “sputum.” The objective of this study was to investigate the prevalence of such misidentification and its clinical associations.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study of adults with cough and/or sputum symptoms, examining how often patients referred to upper respiratory tract secretions or saliva as “sputum,” and explored related clinical features.</div></div><div><h3>Results</h3><div>Of 72 patients with sputum symptoms, 32% and 13% referred to upper respiratory tract secretions and saliva, respectively, as “sputum.” Patients who misidentified upper respiratory secretions more often reported post-nasal drip (41.2% vs. 6.1%) and rhinitis (64.7% vs. 26.5%) than those who did not, which remained significant after adjustment for covariates (<em>p</em> &lt; 0.05). Saliva misidentification was more common in older patients (<em>p</em> = 0.03).</div></div><div><h3>Conclusions</h3><div>32% of the patients with sputum production referred to upper respiratory tract secretions as “sputum,” highlighting a potential source of miscommunication in clinical practice.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101378"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158129","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}