Respiratory investigation最新文献

{"title":"Need for reassessment of the diagnosis of interstitial lung disease using a multidisciplinary discussion approach","authors":"Naoki Inui","doi":"10.1016/j.resinv.2024.10.003","DOIUrl":"10.1016/j.resinv.2024.10.003","url":null,"abstract":"","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 33-34"},"PeriodicalIF":2.4,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745612","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 acid-suppressive therapy and tuberculosis: A causal or coincidental link to the infection?","authors":"Kun-Jing Hong ,&nbsp;Ting-Chuan Wang ,&nbsp;Kochung Tsui","doi":"10.1016/j.resinv.2024.11.004","DOIUrl":"10.1016/j.resinv.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Acid-suppressant proton-pump inhibitors (PPI) and histamine-2-receptor antagonists (H2RA) are associated with an increased risk of tuberculosis (TB). However, it remains unclear whether this association is causal or coincidental.</div></div><div><h3>Methods</h3><div>Patients newly diagnosed with TB between 2000 and 2013 were identified from the Taiwan National Health Insurance Database. Each patient with TB was matched in a 1:10 ratio with patients without TB by age, sex, and index date. The time lags from the end of PPI or H2RA treatment to the index date, and respective cumulative doses in the 90 days before the index date, were analyzed for association with TB.</div></div><div><h3>Results</h3><div>The age (mean [standard deviation] 60.8 [17.3] years) and sex ratio (69.4% males) were comparable between patients with TB (n = 6002) and patients without TB (n = 60,020). Previous PPI or H2RA treatment was more frequently observed in patients with TB (16.6% vs. 8.9%, p &lt; 0.001). Concurrent antacid therapy posed the highest risk for TB (odds ratio [OR] 4.21 for PPI and 2.24 for H2RA, both p &lt; 0.0001), and the closer to the end of the therapy, the more likely TB was detected (p for trend: 0.0077 for PPI and 0.0145 for H2RA). The cumulative doses of antacid in the 90 days before TB had an inverse relationship with TB risk. PPI, used either alone or in combination with H2RA, conferred a higher risk of TB than H2RA alone.</div></div><div><h3>Conclusions</h3><div>Tuberculosis should be considered in symptomatic patients receiving or recently ceased antacid therapy with PPI or H2RA in TB endemic areas.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 27-32"},"PeriodicalIF":2.4,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745611","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":"Severity and prognosis of COVID-19 complicated by autoimmune pulmonary alveolar proteinosis","authors":"Toru Arai ,&nbsp;Yoshikazu Inoue ,&nbsp;Keiichi Akasaka ,&nbsp;Aiko Masunaga ,&nbsp;Masaki Fujita ,&nbsp;Etsuo Yamaguchi ,&nbsp;Mika Saigusa ,&nbsp;Koji Murakami ,&nbsp;Yu Kurahara ,&nbsp;Kazunari Tsuyuguchi ,&nbsp;Takuji Suzuki ,&nbsp;Yasunari Miyazaki ,&nbsp;Masashi Bando ,&nbsp;Takafumi Suda","doi":"10.1016/j.resinv.2024.11.008","DOIUrl":"10.1016/j.resinv.2024.11.008","url":null,"abstract":"<div><h3>Background</h3><div>The prognosis of patients with coronavirus disease 2019 (COVID-19) was poor although its survival rate has been improved after the occurrence of the Omicron strain. Autoimmune pulmonary alveolar proteinosis (APAP), a lung disease caused by macrophage dysfunction induced by anti-granulocyte-macrophage colony-stimulating factor (GM–CSF)–neutralizing autoantibodies, is characterized by the deposition of proteinaceous material in the alveolar spaces. The clinical course of COVID-19 in patients with APAP remains unclear and this study aimed to clarify it.</div></div><div><h3>Methods</h3><div>The data of 23 patients with APAP, who were diagnosed with COVID-19 between January 2020 and May 2023 and collected through a nationwide questionnaire surveillance system, were retrospectively reviewed.</div></div><div><h3>Results</h3><div>Based on the epidemiological frequency at disease onset, suspected strains of severe acute respiratory syndrome coronavirus 2 were Omicron (n = 18) and non-Omicron (n = 5). Fifteen patients were vaccinated. Six and three patients received anti-viral drugs and corticosteroids, respectively. One patient in the third trimester of pregnancy died despite treatment in the intensive care unit. Six patients were complicated by pneumonia and/or required supplemental oxygen. These patients were suspected to have non-Omicron strains (p = 0.087). Vaccination status showed a significant association with suspected Omicron strains. The radiological findings in four patients and shortness of breath improved in two of the four patients after COVID-19.</div></div><div><h3>Conclusions</h3><div>The severity and prognosis of the patients were not worse than those predicted based on the results of a previous study. The transition from a non-Omicron strain to an Omicron strain and the vaccination status may have affected these results.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 20-26"},"PeriodicalIF":2.4,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745610","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":"Effects of immunosuppressants in patients with mild fibrotic hypersensitivity pneumonitis","authors":"Ryo Okuda ,&nbsp;Tamiko Takemura ,&nbsp;Toshihiro Misumi ,&nbsp;Shigeru Komatsu ,&nbsp;Eri Hagiwara ,&nbsp;Takashi Ogura","doi":"10.1016/j.resinv.2024.11.011","DOIUrl":"10.1016/j.resinv.2024.11.011","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of immunosuppressants in patients with fibrotic hypersensitivity pneumonitis (HP) is controversial. We hypothesized that pretreatment and posttreatment disease progression in immunosuppressant with prednisolone group and the immunosuppressant-naive prednisolone group would show a significant difference.</div></div><div><h3>Methods</h3><div>This was a single-center, retrospective, observational study. Patients with histopathological examination between January 2005 and March 2021, a diagnosis of fibrotic HP at multidisciplinary discussion and a diagnosis of fibrotic HP according to international guidelines were investigated. Propensity score matching which had covariates: age, gender, and forced vital capacity, was performed, and disease progression between the two groups was compared.</div></div><div><h3>Results</h3><div>Forty-two patients were included in this study. The mean change in forced vital capacity (FVC) in the 12 months prior to treatment was significantly decreased in the immunosuppressant with prednisolone group compared with the immunosuppressant-naive prednisolone (−8.2% and −2.7%, respectively, <em>P</em> = 0.033). During 12 months of treatment, the two groups did not differ significantly with regards to FVC change (−1.1% and 0.5%, respectively, <em>P</em> = 0.675). Between the two groups, the annual change in Krebs von den Lungen-6 before treatment and after treatment were not significantly different (<em>P</em> = 0.626 and 0.844, respectively). Transplant-free survival from the treatment in the two groups did not differ significantly (HR: 1.09, 95%CI (0.41–2.88), <em>P</em> = 0.873).</div></div><div><h3>Conclusions</h3><div>No significant differences were observed in FVC changes between the two groups following treatment, although the immunosuppressant with prednisolone group exhibited a greater decrease in FVC before treatment.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 13-19"},"PeriodicalIF":2.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745613","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 cognitive impairment on end-of-life care in patients with respiratory cancers","authors":"Katsutoshi Ando ,&nbsp;Ayumi Suzuki ,&nbsp;Hiroki Yoshida","doi":"10.1016/j.resinv.2024.11.012","DOIUrl":"10.1016/j.resinv.2024.11.012","url":null,"abstract":"<div><h3>Backgrounds</h3><div>With the aging population of Japan, an increase in patients with respiratory cancers coexisting with dementia is anticipated; however, the characteristics and terminal courses of these patients remain unclear.</div></div><div><h3>Methods</h3><div>We retrospectively assessed 142 patients with respiratory cancers receiving home health care, grouping them based on the presence of cognitive impairment and comparing their backgrounds.</div></div><div><h3>Results</h3><div>Cognitive impairment was confirmed in 38 patients (26.8%), and these individuals were older and had a higher incidence of brain metastases than those without cognitive impairment. There was no statistically significant difference in 3-month survival rates. Patients with cognitive impairment exhibited significantly lower opioid use (23.5 vs. 76.4 mg/day, p &lt; 0.001) and lower utilization of patient-controlled analgesia (43.3% vs. 67.4%, p = 0.029).</div></div><div><h3>Discussion</h3><div>Our data reflect either milder symptoms or difficulty in accurately expressing pain or discomfort among patients with cognitive impairment, underscoring the importance of careful observation and management.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 10-12"},"PeriodicalIF":2.4,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745614","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":"Persistent COVID-19 improved with immunoglobulin replacement therapy in Good's syndrome","authors":"Ikumi Kashiwagi ,&nbsp;Miki Tasato ,&nbsp;Akihiko Sokai ,&nbsp;Wataru Kishimoto ,&nbsp;Toshiyuki Iwata ,&nbsp;Yasuyuki Hayashi ,&nbsp;Yuki Sakai ,&nbsp;Naoaki Yasuda ,&nbsp;Takashi Nishimura","doi":"10.1016/j.resinv.2024.11.009","DOIUrl":"10.1016/j.resinv.2024.11.009","url":null,"abstract":"<div><div>A 69-year-old man with a history of thymoma resection was diagnosed with COVID-19 pneumonia. Initially, the patient responded well to molnupiravir, but he experienced a relapse. Subsequent steroids for COVID-19-related organizing pneumonia (OP) led to temporary improvement, but his condition deteriorated when the steroids were tapered off. Further investigation revealed hypogammaglobulinemia, and Good's syndrome (GS) was diagnosed. Immunoglobulin replacement therapy was administered, significantly improving the pulmonary shadows, and no subsequent relapse occurred. GS is an immunodeficiency condition associated with thymoma. If COVID-19 recurs or is refractory despite steroid therapy for OP, COVID-19 itself may not be resolved due to immunodeficiency.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 7-9"},"PeriodicalIF":2.4,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704048","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 prognostic factors for MPO-ANCA positive interstitial lung disease: A comparative study of ANCA associated vasculitis (AAV)-ILD and pulmonary limited vasculitis","authors":"Takashi Shimamura ,&nbsp;Haruhiko Furusawa ,&nbsp;Masaru Ejima ,&nbsp;Akane Ozawa ,&nbsp;Takuya Adachi ,&nbsp;Ukihide Tateishi ,&nbsp;Yasunari Miyazaki","doi":"10.1016/j.resinv.2024.11.006","DOIUrl":"10.1016/j.resinv.2024.11.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Microscopic polyangiitis (MPA) with interstitial lung disease (ILD) has a significant impact on morbidity and mortality. This study evaluated the clinical characteristics, treatment responses, and prognostic factors of patients with ANCA-associated vasculitis with ILD (AAV-ILD) and pulmonary limited vasculitis (PLV).</div></div><div><h3>Patients and methods</h3><div>A retrospective chart review of ILD patients positive for MPO-ANCA was conducted from 2008 to 2021. Patients were classified into AAV-ILD or PLV groups. Data included laboratory test results, pulmonary function tests, and high-resolution computed tomography (HRCT) images. Statistical analyses were used to assess group differences and survival outcomes.</div></div><div><h3>Results</h3><div>Of 114 patients, 80 were diagnosed with PLV and 34 with AAV-ILD. The AAV-ILD group had higher corticosteroid treatment rates, higher serum creatinine levels, and better survival than the PLV group. The PLV group had higher KL-6 levels, lower %VC and % FVC in pulmonary function tests. Survival in the PLV group was significantly worse than that in the AAV-ILD group, and survival of patients with an alternative diagnosis on HRCT was better than that of patients with a UIP pattern. Cox regression analysis identified a diagnosis of MPA and HRCT classification as significant prognostic factors.</div></div><div><h3>Conclusions</h3><div>Patients with AAV-ILD had a better prognosis than those with PLV. HRCT patterns, particularly an alternative diagnosis on HRCT, were associated significantly with a favourable prognosis. The efficacy of corticosteroid treatment in PLV patients was limited. These findings highlight the importance of early and accurate diagnosis, as well as careful consideration of treatment strategies, for patients with in MPO-ANCA-positive ILD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 1-6"},"PeriodicalIF":2.4,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704049","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":"Advancements in the treatment of interstitial lung disease in systemic sclerosis with the approval of mycophenolate mofetil","authors":"Toshinori Takada ,&nbsp;Ami Aoki ,&nbsp;Kenjiro Shima ,&nbsp;Toshiaki Kikuchi","doi":"10.1016/j.resinv.2024.11.003","DOIUrl":"10.1016/j.resinv.2024.11.003","url":null,"abstract":"<div><div>Systemic sclerosis (SSc) is an autoimmune connective tissue disease characterized by widespread fibrosis affecting various organs. This disorder has two main subtypes based on the extent of cutaneous fibrosis (limited and diffuse cutaneous SSc). Interstitial lung disease (ILD) occurs in approximately 50% and 25% of patients with diffuse cutaneous SSc and limited cutaneous SSc, respectively. In Japan, over 10,000 people are estimated to have ILD. Out of 10,000 SSc-ILD, at least 4000 patients may have slowly progressive ILD which leads to respiratory failure. Treatment of ILD in patients with SSc includes immunosuppressive and anti-fibrotic agents. Mycophenolate mofetil (MMF) is strongly recommended as a first-line immunosuppressive agent for the treatment of SSc-ILD according to recent American Thoracic Society clinical practice guidelines. However, as of February 2024, MMF was only approved in Japan for patients with organ transplants or lupus nephritis through health insurance policies. Cyclophosphamide is an alternative initial immunomodulatory agent for patients with the disease because it has an efficacy comparable to that of MMF. However, this agent had significantly higher toxicity than MMF. For patients with progressive pulmonary fibrosis, despite the use of immunosuppressive agents, adding nintedanib or rituximab to MMF or cyclophosphamide is recommended. This review explores the treatment of ILD associated with SSc in Japan with the approval of MMF based on the latest American Thoracic Society guideline.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1242-1246"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639667","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":"Temporal changes over time in sputum rheological parameters after SARS-CoV-2 infection in two patients with chronic cough","authors":"Haruhiko Ogawa ,&nbsp;Yuka Uchida","doi":"10.1016/j.resinv.2024.09.018","DOIUrl":"10.1016/j.resinv.2024.09.018","url":null,"abstract":"<div><div>We report temporal changes in sputum rheological parameters after SARS-CoV-2 infection in two patients with chronic cough (71-year-old, male, sinobronchial syndrome; 80-year-old, female, cough variant asthma). Both patients complained of decreased cough-related quality of life and increased phlegm stickiness after infection. In parallel, their sputum showed decreases in linear viscoelastic region (LVR) parameters, such as viscoelastic modulus (<em>G</em>^∗), elastic modulus (<em>G</em>′), and viscous modulus (<em>G</em>″), and increased tack (tan <em>δ/G</em>′; tan <em>δ</em> = <em>G</em>″/<em>G</em>′) compared to pre-infection levels. Rheological parameters, such as <em>G</em>^∗ and tack, took at least several months to return to almost pre-infection levels after recovery from COVID-19. Further studies are needed to determine whether the viscoelastic fluctuations seen in these two patients are common to patients with post-COVID-19 cough and whether their delayed recovery is associated with prolonged clinical symptoms. A sputum rheology approach may provide new insights into post-COVID-19 cough.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1239-1241"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627094","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":"Viability and diagnostic potential of tissues obtained through cryobiopsy","authors":"Ryotaro Kida ,&nbsp;Ryohei Yoshida ,&nbsp;Kiichi Nitanai ,&nbsp;Akari Yagita ,&nbsp;Taeka Naraoka ,&nbsp;Hiraku Yanada ,&nbsp;Ryota Shigaki ,&nbsp;Toshiyuki Tenma ,&nbsp;Chie Mori ,&nbsp;Yasuhiro Umekage ,&nbsp;Mamiko Mitsumoto ,&nbsp;Mishie Tanino ,&nbsp;Yoshinori Minami ,&nbsp;Takaaki Sasaki","doi":"10.1016/j.resinv.2024.10.011","DOIUrl":"10.1016/j.resinv.2024.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Transbronchial lung cryobiopsy is primarily used for diagnosing interstitial lung diseases and tumors, providing larger tissue samples with reduced tissue crushing than traditional biopsies. However, freezing during cryobiopsy may damage cells, potentially affecting diagnostic methods that require live cells, such as flow cytometry (FCM). We aimed to determine the extent of freezing-related cell damage in cryobiopsies using cells cultured <em>in vitro</em>.</div></div><div><h3>Methods</h3><div>To investigate the relationship between freezing duration and sample volume, Jurkat cells underwent freezing for durations ranging from 2 to 6 s, with 1-s intervals, using either 1-mm- or 1.7-mm cryoprobes. FCM was conducted to assess both cell viability (2, 4, and 6 s) and cell-surface molecule expression (3 and 6 s) over varying freezing times. Additionally, we describe a clinical case involving a 70-year-old man suspected of malignant lymphoma, in which tissue samples were obtained via both forceps biopsy and cryobiopsy methods to compare the pathological and cytological features between the methods.</div></div><div><h3>Results</h3><div>Harvested cell count increased with freezing duration, with a notable increase in viable cell percentage. Moreover, cells distant from the cryoprobe exhibited higher survival rates under milder freezing conditions. FCM revealed significantly higher marker expression levels in viable cryobiopsy samples than in non-viable samples. The clinical case demonstrated that cryobiopsy yields a significant proportion of live cells (&gt;90%), with cytological findings consistent with those of non-frozen samples.</div></div><div><h3>Conclusions</h3><div>Cryobiopsy may be beneficial for histopathological diagnosis, providing sufficient viable cells for FCM, and can be used for diagnosing malignant lymphomas and other pulmonary conditions.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"62 6","pages":"Pages 1220-1226"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586506","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}