Respiration最新文献

{"title":"Novel Endobronchial Valve: A Case Series on the Technical Feasibility of the PulmValve in Severe Heterogeneous Emphysema.","authors":"Difei Chen, Jingwei Liu, Weizhan Luo, Lianyue Yang, Jinsheng Lin, Jing Zhang, Shiyue Li","doi":"10.1159/000552824","DOIUrl":"10.1159/000552824","url":null,"abstract":"<p><strong>Introduction: </strong>Bronchoscopic lung volume reduction with endobronchial valves is an established therapy for selected patients with severe heterogeneous emphysema. The PulmValve is a novel lobar endobronchial valve designed to achieve occlusion with larger-diameter valves. We present here its first-in-human exploratory experience.</p><p><strong>Case presentation: </strong>Six male patients underwent successful lobar valve implantation, with a median of 1 valve per treated lobe. No intraprocedural complications, device malfunctions, or valve migration were observed during follow-up. Four serious adverse events occurred, including 1 hydropneumothorax, 1 acute exacerbation of chronic obstructive pulmonary disease, 1 pulmonary infection in a non-treated lobe, and 1 sudden cardiac death. The fatal event was adjudicated as possibly unrelated. Early improvement in dyspnea was noted in most patients. Compared to baseline, at 3 months, forced expiratory volume in 1 s improved by 80 mL (30-310) and residual volume decreased by 200 mL (-890 to 430), accompanied by 6-min walk test increased by 34 m (-34 to 71) and St. George's Respiratory Questionnaire score dropped by 16 points (-4 to 23). At 6 months, pulmonary function changes were variable, while exercise capacity and symptom scores remained improved in selected cases.</p><p><strong>Conclusion: </strong>In this exploratory first-in-human case series, lobar PulmValve implantation was technically feasible and generated descriptive clinical signals. Larger controlled studies are required to define safety, durability, and clinical efficacy.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-9"},"PeriodicalIF":2.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Improvement after Lung Volume Reduction Surgery for Severe Emphysema Is Not Affected by Sex.","authors":"Christelle M Vandervelde, Stijn Vanstraelen, Stephanie Everaerts, Anthony Meyers, Anaïs David, Wim Janssens, Laurens J Ceulemans","doi":"10.1159/000552394","DOIUrl":"10.1159/000552394","url":null,"abstract":"<p><strong>Introduction: </strong>Lung volume reduction surgery (LVRS) is an established treatment for selected emphysema patients. Because Chronic obstructive pulmonary disease differs by sex in aetiology, symptom perception, and treatment response, we examined whether these differences affect LVRS outcomes.</p><p><strong>Methods: </strong>All consecutive LVRS patients (August 2019-May 2025) were included and stratified by sex (111 men, 96 women). Propensity-score matching (PSM) (caliper 0.01, optimal matching) balanced age, body mass index, forced expiratory volume in 1 s (FEV₁), RV, type of surgery, oxygen use, azithromycin, and emphysema morphology between groups. Endpoints were changes from baseline in pulmonary function (FEV₁, RV), exercise capacity (6-min walking distance [6MWD] and Quality of Life [QoL]) (St. George's respiratory questionnaire [SGRQ]) at 3 and 6 months; as well as transplant-free survival.</p><p><strong>Results: </strong>After PSM, 81 men and 81 women were included. Pack-years were similar (40 vs. 39; p = 0.060). Baseline characteristics were comparable after matching, but men had longer 6MWD (382 vs. 332 m; p = 0.011). At 3 months, improvements were comparable for FEV₁ %pred (+11% vs. +9%; p = 0.22), RV (-59% vs. -48%; p = 0.49), and 6MWD (+57 m vs. +54 m; p = 0.47), whereas SGRQ improved more in men (-19 vs. -11 points; p = 0.020). At 6 months, changes in FEV₁ %pred, 6MWD and SGRQ were similar between sexes. Three-year transplant-free survival was comparable (81% [95% CI: 70-94] vs. 83% [95% CI: 73-93], p = 0.70).</p><p><strong>Conclusion: </strong>Sex did not influence short-term postoperative functional outcome, QoL, or survival. Both sexes improved, with only a brief early QoL advantage in men. These findings indicate that sex should not guide expectations, as men and women benefit equally from LVRS.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-10"},"PeriodicalIF":2.6,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract Book SSP/SSTS Joint Annual Meeting 2026.","authors":"","doi":"10.1159/000552185","DOIUrl":"https://doi.org/10.1159/000552185","url":null,"abstract":"<p><p>see attachment.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nocturnal Hypoxaemia in PAH Patients Living at High Altitude Relocated to Low Altitude.","authors":"Esther I Schwarz, Joël J Herzig, Meret Bauer, Elizabeth Cajamarca, Michael Furian, Mona Lichtblau, Julian Mueller, Diego Saragoni, Stephanie Saxer, Mirjam Schmucki, Simon R Schneider, Rodrigo Hoyos, Silvia Ulrich","doi":"10.1159/000552738","DOIUrl":"10.1159/000552738","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with pulmonary arterial hypertension (PAH) living at high altitudes experience exacerbated hypoxaemia. This study aimed to assess the effects of relocating PAH patients from high altitude (2,850 m) to sea level on nocturnal hypoxaemia, sleep-disordered breathing, and autonomic cardiovascular function.</p><p><strong>Methods: </strong>In a repeated measures design, PAH patients underwent evaluations near their living altitude at 2,850 m and at sea level. The primary outcome was the change in mean nocturnal SpO₂, while secondary outcomes included changes in time spent with SpO₂ <90% (t < 90), apnoea-hypopnoea index (AHI), heart rate variability (HRV), and blood pressure. Measurements were taken using cardio-respiratory polygraphy at 2,850 m and during the first two nights following relocation f to sea level.</p><p><strong>Results: </strong>A total of 8 patients (86% women) with a mean mean pulmonary artery pressure of 52 ± 17 mm Hg and PVR of 16.6 ± 8.8 Wood units were included. Relocation to sea level resulted in significant improvements in nocturnal hypoxaemia, with mean SpO₂ increasing by 6.9% (95% CI 5.9-7.9) and t < 90 decreasing by -53% (95% CI -67.1 to -39.0). AHI and supine AHI decreased, and sleep quality significantly improved. HRV analysis showed increased parasympathetic activity, with root mean square of successive differences, pRR50, low frequency (LF), and high frequency (HF) rising, and the LF/HF ratio decreasing. Morning P_aO₂ increased by 3.0 kPa (95% CI 2.3-3.7), and blood pressure significantly decreased.</p><p><strong>Conclusion: </strong>Relocation of PAH patients from high to low altitude led to significant improvements in nocturnal oxygenation and SDB, and enhanced parasympathetic activity, suggesting that short-term exposure to sea level may offer benefits for PAH-patients living at high altitude.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-12"},"PeriodicalIF":2.6,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nontuberculous Mycobacteria in Primary Ciliary Dyskinesia: A National Multicenter Cohort Study.","authors":"Ophir Bar-On, Saharon Less Elazari, Haim Ben Zvi, Karin Yaacoby-Bianu, Idit Raz, Ronen Bar-Yoseph, Michal Gur, Inbal Golan Tripto, Dvir Gatt, Huda Mussaffi, Moshe Heching, Dario Prais, Miri Dotan","doi":"10.1159/000552722","DOIUrl":"10.1159/000552722","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence and clinical significance of nontuberculous mycobacteria (NTM) in individuals with primary ciliary dyskinesia (PCD) remain unclear, with most data extrapolated from cystic fibrosis. This first national multicenter cohort study evaluating NTM in PCD patients aimed to determine the prevalence, species distribution, and clinical impact of NTM isolation.</p><p><strong>Methods: </strong>A retrospective, longitudinal study was conducted across four tertiary centers in Israel (2010-2024). Patients with confirmed PCD were evaluated for demographic, clinical, microbiological, and longitudinal lung function data. NTM species were classified by growth rate and pathogenicity. Each NTM-positive PCD patient was matched 1:1 to an NTM-negative PCD patient.</p><p><strong>Results: </strong>Of 231 patients with PCD, 24 (10.4%) had ≥1 positive NTM culture. Most isolates were slow-growing species, predominantly Mycobacterium simiae. Rapid-growing species, mainly Mycobacterium abscessus, were identified in patients with significantly lower forced expiratory volume in 1 s (FEV1) at the time of NTM isolation when compared with those harboring slow-growing species (43.5% vs. 82.3%, p = 0.03). Chronic isolation occurred in 25% of NTM-positive individuals. Longitudinal analysis showed no significant association between NTM status and FEV1 decline. Intravenous antibiotic use was not higher in NTM-positive patients and did not increase following NTM isolation. Only one patient fulfilled the criteria for NTM pulmonary disease.</p><p><strong>Conclusion: </strong>NTM isolation is not uncommon in PCD patients and is often intermittent, mostly by slow-growing species. NTM status was not associated with accelerated FEV1 decline, although rapid growers occurred predominantly in patients with poorer baseline lung function. Routine annual NTM surveillance appears reasonable to better determine prevalence and monitor outcomes.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-10"},"PeriodicalIF":2.6,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of the S³-NIV Patient Questionnaire Added to Telemonitoring Data for the First 6 Months of Home Noninvasive Ventilation.","authors":"Zubair Owadally, Mathilde Guillemot, Romain Barthes, Dan Adler, Jean-Christian Borel, Marius Lebret, Mehdi Rahim, Joëlle Texereau, Sandrine Pontier","doi":"10.1159/000551463","DOIUrl":"10.1159/000551463","url":null,"abstract":"<p><strong>Introduction: </strong>Optimal management of long-term home noninvasive ventilation (NIV) therapy is not clearly defined. This study determined whether patient experience of disease and NIV therapy (S3-NIV score) in the first month was associated with successful NIV delivery and termination rate at 6 months.</p><p><strong>Methods: </strong>Participants were adults starting home nocturnal NIV for chronic respiratory failure in 2019-2022, who used telemonitoring, completed ≥1 S3-NIV questionnaire in the first month of NIV, and were followed by the same home service provider. As no S3-NIV score thresholds are defined, participants were grouped by S3-NIV score quartiles (Q) (Q1 = most negative impact of symptoms/NIV; Q4 = lowest impact of disease/treatment). Factors associated with successful NIV delivery at 6 months were determined using multivariate logistic regression analysis.</p><p><strong>Results: </strong>One hundred fifty-three patients were included (mean age 65.9 ± 12.9 years, 60% male). The proportion of patients with successful NIV delivery at 6 months increased as initial S3-NIV score increased: Q1 42%, Q2 60%, Q3 63%, and Q4 63% (p = 0.007). Individuals with lower S3-NIV scores had more home interventions and mask changes during follow-up, regardless of whether NIV was successful or not. Termination rate was higher in S3-NIV score Q1 versus Q4 (29% vs. 11%). The probability of successful NIV delivery at 6 months increased by 1.14-fold for each 1-point increase in the initial S3-NIV score, independent of the association between the score and NIV data at 1 month.</p><p><strong>Conclusion: </strong>The S3-NIV questionnaire helped identify patients at higher risk of therapy termination more effectively than relying only on objective ventilator data.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-11"},"PeriodicalIF":2.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Physician-Independent Screening for Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Case-Control and Cohort Study.","authors":"Robin Tiede, Frank Reichenberger, Carina Fischinger, Martin Schwaiblmair, F Joachim Meyer, Josef Benedikter, Florian Popp, Claudia Dechant, Susanna Spaethling-Mestekemper, Klaus Thürmel, Matthias Wahle, Sven Wassmann, Alessandro Ghiani, Werner von Wulffen, Martin Welcker, Nikolaus Kneidinger","doi":"10.1159/000551381","DOIUrl":"10.1159/000551381","url":null,"abstract":"<p><strong>Introduction: </strong>Interstitial lung disease (ILD) is a leading cause of death in rheumatoid arthritis (RA) patients. Given RA's high prevalence, a physician-independent screening tool is needed. This study aimed to develop a patient-based, cost-effective questionnaire for RA-associated ILD (RA-ILD).</p><p><strong>Methods: </strong>A 26-item ILD symptom questionnaire was evaluated, adapted, and validated in two steps. Missing data were handled via multiple imputation. Step one involved item and principal component analyses in a multicenter cohort of ILD patients and healthy controls. Internal consistency was measured with McDonald's omega, and score differences assessed with independent t tests and Cohen's d. Step two validated the questionnaire in monocentrically recruited anti-citrullinated protein antibodies- and rheumatoid factor-positive RA patients without prior pulmonary exams. RA-ILD was defined as abnormal lung ultrasound across 14 intercostal spaces with forced vital capacity or DLCO <80% predicted. ROC, sensitivity, and specificity were calculated.</p><p><strong>Results: </strong>Step one included 174 ILD patients (46% female, mean age 62 ± 13, mean score 39 [95% CI: 35-43]) and 67 controls (49% female, mean age 59 ± 12, mean score 8 [95% CI: 4-12]). Internal consistency was excellent (ω = 0.93). Scores differed significantly (t = -11.71, p < 0.001, d = 1.36). Step two included 105 RA patients (76% female, mean age 59 ± 12, mean disease duration 9 ± 6 years, mean score 14 [95% CI: 10-17]); 11 were suspected of RA-ILD (mean score 18 [95% CI: 8-28]). A cut-off of 7.5 points yielded ROC 0.58, sensitivity 70.3%, specificity 47.7%, positive predictive value 13.6%, and negative predictive value 93.2%.</p><p><strong>Conclusion: </strong>The questionnaire demonstrated potential as a physician-independent, low-cost RA-ILD screening tool suitable for routine clinical use.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-11"},"PeriodicalIF":2.6,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Diagnosis of Severe Paediatric Lymphobronchial Tuberculosis Using Segmentation and Deep Learning on Chest X-Rays.","authors":"Marthinus Basson, Pierre Goussard, André George Gie, Megan Palmer, Susan Elizabeth Purchase, Jacomine Grobler","doi":"10.1159/000552594","DOIUrl":"10.1159/000552594","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnosing intra-thoracic tuberculosis (TB) in children under 5 years of age remains challenging. Clinical symptoms often overlap with those of other common childhood illnesses, and microbiological confirmation is frequently difficult to obtain in this age group. Despite advances in diagnostic technologies, few studies focus specifically on children younger than 5 years, the population in whom diagnosis is most complex. Intra-thoracic lymphadenopathy on chest X-ray (CXR) is the hallmark radiological features of TB in this age group, but identification by trained physicians currently demonstrates only moderate diagnostic performance, with reported sensitivities ranging from 67% to 74% and specificities between 39% and 59%. We aimed to develop and evaluate an automated deep learning-based approach for identifying severe pulmonary lymphobronchial tuberculosis (LBTB) in children under 5 years of age using anterior-posterior (AP) CXR images, with confirmed airway compression serving as the primary radiographic reference.</p><p><strong>Methods: </strong>A total of 402 AP CXR images were included in this study. Half of the images were obtained from children diagnosed with intra-thoracic TB and with confirmed airway obstruction on bronchoscopy and/or chest computed tomography. The remaining half of images were normal AP CXRs from children without TB disease. Three convolutional neural network (CNN) architectures - VGG16, ResNet50, and InceptionV3 - were evaluated and compared for their ability to classify pulmonary LBTB based on radiographic features.</p><p><strong>Results: </strong>A fine-tuned ResNet50 model achieved a statistically significant mean test sensitivity of 94.43% and a mean test specificity of 94.79% in identifying TB-positive cases. The model classified disease presence by detecting radiographic manifestations of LBTB affecting the trachea and main bronchi on CXR images.</p><p><strong>Conclusion: </strong>Deep learning models were successfully developed to detect significant airway obstruction secondary to pulmonary TB in children under 5 years of age. The best performing model, a customised ResNet50 architecture, achieved a statistically significant mean test sensitivity of 94.43% and a specificity of 94.79%. While these findings highlight the potential of CNN-based approaches for automated detection of paediatric LBTB, the limited sample size restricts definitive conclusions. Further validation using larger, multi-centre datasets is warranted.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-13"},"PeriodicalIF":2.6,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Azithromycin in Addition to Inhaled Corticosteroids in Severe Preschool Wheeze: A Retrospective Cohort Study.","authors":"Meryl Dumenil, Julien Grosjean, Laure Couderc, Marc Lubrano-Lavadera, Lamia Medghoul, Isabelle Michelet, Juliette Raghani, Christophe Marguet, Hortense Petat","doi":"10.1159/000552395","DOIUrl":"10.1159/000552395","url":null,"abstract":"<p><strong>Introduction: </strong>Preschool wheeze is common, and treatment options are limited, consisting mainly of inhaled corticosteroids (ICS). We report here a retrospective study in severe preschool wheezers not controlled by high doses of ICS, who were given azithromycin as long-term additional therapy.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective study between 2020 and 2025, including children less than 6 years old with severe recurrent wheeze, partially or uncontrolled despite a high dose of ICS and who were given azithromycin three times a week for 6 months as maintenance treatment.</p><p><strong>Results: </strong>Thirty-eight children with a mean age of 2.3 ± 1.2 years were retrospectively included in our center. We found an improvement in the control of wheezing and a decrease of exacerbations, daily respiratory symptoms, and dose of daily ICS after 6 months of azithromycin treatment, without major secondary effect declared.</p><p><strong>Conclusion: </strong>Azithromycin could therefore be considered as an adjunctive treatment in young children with persistent asthma and frequent exacerbations despite high doses of inhaled steroids. This conclusion is from a retrospective study, and it is needed to perform controlled prospective studies to validate these findings.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-5"},"PeriodicalIF":2.6,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Dependent Integration of Symptoms and Functional Vulnerability in Interstitial Lung Disease: eurILDreg Study.","authors":"Silke Tello, Anita C Windhorst, Heva Mustafa, Poornima Mahavadi, Tobias Veit, Juergen Behr, Bruno Crestani, Carlo Vancheri, Maria Molina Molina, Andreas Guenther, Ekaterina Krauss","doi":"10.1159/000552396","DOIUrl":"10.1159/000552396","url":null,"abstract":"<p><strong>Introduction: </strong>In interstitial lung diseases (ILDs), patient-centred disease burden is only partly explained by physiological impairment, with considerable variability in symptoms, psychological distress, and functional limitation among patients with similar lung function. We investigated whether sex modifies longitudinal patient-centred outcomes in ILD and whether differences emerge in outcome structure and cross-domain integration.</p><p><strong>Methods: </strong>In a prospective multicentre eurILDreg cohort, repeated measures of lung function, patient-reported outcome measures (K-BILD, EQ-5D-5L, LCQ), and the Clinical Frailty Scale (CFS) were analysed. Longitudinal trajectories and time × sex interactions were assessed using linear mixed-effects models. Sex-stratified correlation analyses examined cross-domain outcome structure and symptom-physiology integration.</p><p><strong>Results: </strong>Baseline global PROM scores and functional vulnerability were comparable between women and men, including EQ-5D-5L index (p = 0.337), K-BILD total (66.4 ± 19.9 vs. 68.2 ± 18.6; p = 0.271), LCQ total (7.2 ± 3.0 vs. 7.0 ± 3.0; p = 0.107), and CFS (mean 3.24 in both sexes). Despite similar global scores, EQ-5D-5L domain profiles differed: women reported greater limitations in usual activities (2.04 vs. 1.90) and higher pain/discomfort (2.27 vs. 2.07), while mobility and self-care were similar. Anxiety/depression (AD ≥2) was more frequent in women, reaching borderline significance (χ2 = 3.71, p = 0.054). Sex differences were most evident in cross-domain outcome structure. Coupling between global health perception and ILD-specific psychological domains was stronger in women (EQ-5D × K-BILD psychological: r = 0.452 vs. 0.380; EQ-5D anxiety/depression × K-BILD psychological: r = -0.555 vs. -0.486), whereas men showed stronger coupling between psychological and physical cough domains (LCQ psychological × LCQ physical: r = 0.635 vs. 0.560). Longitudinal trajectories were largely similar by sex: EQ-5D-5L (p = 0.330) and LCQ (p = 0.105) remained stable. A borderline sex interaction was observed for K-BILD (time × sex -0.243 points/month; p = 0.053). CFS increased modestly over time (+0.0172 points/month; p = 0.0084) without sex differences.</p><p><strong>Conclusions: </strong>Sex differences in ILD are not primarily reflected in overall disease severity, functional vulnerability, or average PROM trajectories, but in how patient-centred outcomes are organised and interconnected. These findings suggest sex-specific patterns in the experience of ILD, with women showing stronger links between global health perception and psychological burden and men between psychological and physical symptom domains. Recognising sex as a modifier of patient-reported outcomes may help refine interpretation of PROMs and support more personalised, sex-informed ILD care.</p>","PeriodicalId":21048,"journal":{"name":"Respiration","volume":" ","pages":"1-15"},"PeriodicalIF":2.6,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13225801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}