Respiratory medicine最新文献

{"title":"Respiratory syncytial virus in high-risk adults: A critical appraisal of therapeutic options and unmet needs","authors":"Ilias Mariolis ,&nbsp;Kyriaki Ranellou ,&nbsp;Antonios-Periklis Panagiotopoulos ,&nbsp;Cleo Anastassopoulou ,&nbsp;Athanasios Tsakris","doi":"10.1016/j.rmed.2026.108639","DOIUrl":"10.1016/j.rmed.2026.108639","url":null,"abstract":"<div><div>Respiratory syncytial virus (RSV) has traditionally been viewed as a causative agent of pediatric illness, yet accumulating evidence shows substantial morbidity and mortality among adults, particularly older individuals, those with cardiopulmonary comorbidities, and the immunocompromised. Although recent vaccine approvals for older adults represent major progress in prevention, effective therapeutic options for established infection remain limited. Herein we provide a critical analysis of existing and emerging antiviral and monoclonal antibody (mAb) therapies for the management of RSV infection in adults, highlighting current options and compounds in clinical development. At present, ribavirin remains the only antiviral recommended for treatment in adults, and no mAb has received regulatory authorization for prophylaxis or therapy in this population. Several development programs for direct-acting antivirals have been discontinued for reasons unrelated to safety or efficacy in adults, contributing to an ongoing treatment gap. Nevertheless, newer drug candidates, including ziresovir, EDP-938, and S-337395, have shown encouraging antiviral activity and acceptable safety in adult studies. By examining both the scientific evidence and the structural factors shaping the current landscape, we emphasize the need for sustained adult-focused clinical development to complement preventive vaccination. Addressing this therapeutic gap will be essential to reduce the burden of RSV disease in high-risk adult populations, particularly as the global population ages.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108639"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934725","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":"Blood eosinophilia as a predictor of acute exacerbation in fibrotic interstitial lung diseases","authors":"Mélanie David ,&nbsp;Quentin Marquant ,&nbsp;Anne-Laure Brun ,&nbsp;Kewin Panel ,&nbsp;Alexandre Chabrol ,&nbsp;Helene Salvator ,&nbsp;Antoine Magnan ,&nbsp;Matthieu Groh ,&nbsp;Colas Tcherakian","doi":"10.1016/j.rmed.2026.108640","DOIUrl":"10.1016/j.rmed.2026.108640","url":null,"abstract":"<div><div>Fibrotic interstitial lung disease (fILD) is a heterogeneous group of rare diseases with a poor prognosis. Given the pro-fibrotic effects of eosinophils, we aimed to assess the distribution of blood eosinophil count (BEC) in patients with fILD and to investigate its potential association with outcomes.</div><div>Single-center retrospective study of patients diagnosed with fILD between January 1, 2017 and December 31, 2022. For each patient, BECs during follow-up (except for those sampled during treatment with high-dose glucocorticoids) were pooled to assign a unique number (median). Patients’ characteristics were analysed by BEC (Eo-high and Eo-low subgroups corresponding to BEC ≥75th percentile and &lt;75th percentile, respectively). Predictors of outcomes were assessed by multivariate logistic regression.</div><div>201 patients were included. BEC's median and 75th percentile were 0.2 × 10⁹/L and 0.3 × 10⁹/L, respectively. Baseline BEC and median BEC during follow-up were strongly correlated (r1 = 0.66, 95 % IC 0.52–0.78, p &lt; 0.001). Eo-high patients were significantly older (73 vs. 67 years, p = 0.014) and more likely to experience AE-ILD (36 % vs. 15 %, p = 0.002). In multivariate analysis, a diagnosis of IPF (OR 2.62, 95 % IC 1.05–7.02, p = 0.05), idiopathic NSIP (OR 3.69, 95 % IC 0.99–13.74, p = 0.05), baseline supplemental oxygen therapy (OR 4.71, 95 % IC 2.09–10.82, p &lt; 0.001) and median BEC ≥0.3 × 10⁹/L (OR 2.76, 95 % IC 1.25–6.14, p = 0.01) were associated with AE-ILD.</div><div>BEC can be associated with AE-ILD. These findings pave the way for future research regarding the role of eosinophils in fILD.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108640"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934606","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":"Clinical significance of detecting asbestos bodies in bronchoalveolar lavage fluid in diffuse lung disease","authors":"Yuji Inagaki ,&nbsp;Yoshinobu Matsuda ,&nbsp;Chikatoshi Sugimoto ,&nbsp;Tomoaki Teramoto ,&nbsp;Shigeki Shimizu ,&nbsp;Masanori Akira ,&nbsp;Toru Arai ,&nbsp;Yoshikazu Inoue","doi":"10.1016/j.rmed.2026.108642","DOIUrl":"10.1016/j.rmed.2026.108642","url":null,"abstract":"<div><h3>Background</h3><div>Asbestos bodies (ABs) in bronchoalveolar lavage fluid (BALF) are valuable markers for assessing past asbestos exposure. However, the clinical significance of detecting ABs at ≥1 AB/mL in patients with diffuse lung disease remains unclear. Herein, we investigated the clinical utility of detecting ABs at this threshold, focusing on its association with asbestos exposure history, bronchoalveolar lavage (BAL) cellular analysis, imaging findings, and the rate of respiratory function decline in patients with diffuse lung disease.</div></div><div><h3>Methods</h3><div>This retrospective single-center study included patients who underwent BAL and asbestos body (AB) quantification for respiratory disease evaluation. The relationship between the AB number (cutoff: 1 AB/mL) and clinical parameters was analyzed. Pulmonary function decline was assessed in patients with ≥1 year of follow-up.</div></div><div><h3>Results</h3><div>This study involved 304 patients. An AB number of ≥1 AB/mL was significantly associated with asbestos exposure history (p &lt; 0.001) and the presence of pleural plaques on computerized tomography (CT) imaging (p &lt; 0.001). However, no significant differences were found in BAL cellular patterns or respiratory function decline between patients with an AB number of ≥1 AB/mL and those with &lt;1 AB/mL.</div></div><div><h3>Conclusion</h3><div>The presence of ≥1 AB/mL in the BALF reflects substantial asbestos exposure and is associated with pleural plaques on CT imaging but not with BAL cellular patterns or the rate of decline in respiratory function. These findings suggest that AB detection in BALF has limited predictive value for respiratory function decline but could be valuable for identifying unrecognized asbestos exposure in patients with diffuse lung disease.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108642"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949038","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":"Clinical stability under FF/UMEC/VI triple inhaled therapy: A 12-month real life retrospective observational study","authors":"Mauro Maniscalco ,&nbsp;Claudio Candia ,&nbsp;Francesco Pennisi ,&nbsp;Alfio Pennisi ,&nbsp;Giuseppe De Simone ,&nbsp;Pasquale Ambrosino","doi":"10.1016/j.rmed.2026.108633","DOIUrl":"10.1016/j.rmed.2026.108633","url":null,"abstract":"<div><div>Chronic Obstructive Pulmonary Disease (COPD) remains a leading cause of morbidity and mortality worldwide. For patients with a high disease burden, triple therapy with fluticasone furoate/umeclidinium bromide/vilanterol trifenatate (FF/UMEC/VI) has demonstrated significant benefits in health-related quality of life (HRQoL), exacerbation reduction, and lung function improvement. Efforts have been made to define clinical stability (CS), yet real-world data on CS during FF/UMEC/VI therapy remain limited.</div><div>This retrospective study aimed to assess the prevalence of CS after 12 months (T12) of FF/UMEC/VI treatment in COPD patients. CS was defined as the concurrent presence at T12 of: no acute exacerbations in the prior 12 months, a ≥ 2-point improvement in COPD Assessment Test (CAT) score from baseline, and a forced expiratory volume in 1 s (FEV₁) decline &lt;100 mL.</div><div>A total of 47 patients was included. Of them, 10 (21.3 %) achieved CS. These individuals had a lower baseline exacerbation rate (P = 0.020) and a trend toward better baseline lung function. They also demonstrated greater improvement in 6-min walking distance compared with non-CS patients (P = 0.048).</div><div>These findings suggest that CS is attainable in routine clinical practice, with prevalence comparable to that observed in clinical trials. Patients achieving CS tended to have milder disease, indicating potential benefits of earlier FF/UMEC/VI initiation. This might have a relevant impact in clinical practice, especially in the setting of pulmonary rehabilitation. Nonetheless, further multicenter prospective studies are warranted to validate our findings and to identify predictors of treatment success.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108633"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885888","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":"Sleep efficiency and disturbance is associated with cardiovascular risk in non-obese sleep disordered breathing: The Guangdong sleep health study","authors":"Miaochan Lao ,&nbsp;Guangliang Shan ,&nbsp;Tong Feng ,&nbsp;Ruohan Zhou ,&nbsp;Ping Yuan ,&nbsp;Yaoda Hu ,&nbsp;Qiong Ou","doi":"10.1016/j.rmed.2026.108644","DOIUrl":"10.1016/j.rmed.2026.108644","url":null,"abstract":"<div><h3>Background and objective</h3><div>We aimed to figure out the risk factors for cardiovascular disease (CVD) in the participants with non-obese sleep disordered breathing (SDB).</div></div><div><h3>Methods</h3><div>This was a cross-sectional study. Community residents in Guangdong were investigated. Sleep study was conducted with a type Ⅳ sleep monitoring. Cardiovascular risk was assessed by the China-PAR risk equations.</div></div><div><h3>Results</h3><div>1983 community residents with SDB were included, 92.4 % were non-obese. 270 (18.9 %) were with high risk of CVD in the non-obese SDB, while 33 (28.2 %) in the obese SDB (<em>P</em> = 0.021). In the non-obese SDB, the Pittsburgh sleep quality index (PSQI) was higher in participants with high risk of CVD comparing with those with low risk of CVD (<em>P</em> = 0.013). Sleep efficiency and sleep disturbance were independently associated with high risk of CVD in participants with non-obese SDB (<em>OR</em> = 1.369, <em>P</em> = 0.020; <em>OR</em> = 1.489, <em>P</em> = 0.027, respectively). Comparing with a normal sleep efficiency, the probability for high CVD risk increased 152 % in non-obese SDB with a sleep efficiency ≤64 %. Comparing with no sleep disturbance, the probability for high CVD risk increased 109 % in non-obese SDB with fairly bad sleep disturbance. There was no such relationship between PSQI components and CVD risk in the participants with obese SDB.</div></div><div><h3>Conclusion</h3><div>The majority of SDB was non-obese in the community in Guangdong. CVD risk was increased in non-obese SDB. A bad subjective sleep efficiency and sleep disturbance were associated with high CVD risk in non-obese SDB. Non-obese SDB may be treated as a specific phenotype.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108644"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949017","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":"Interstitial pneumonia with autoimmune features: A literature review","authors":"Apostolos Perelas ,&nbsp;Darryn L. Winter ,&nbsp;Jeffrey J. Swigris ,&nbsp;Mary E. Strek ,&nbsp;Kristin B. Highland","doi":"10.1016/j.rmed.2026.108641","DOIUrl":"10.1016/j.rmed.2026.108641","url":null,"abstract":"<div><div>Interstitial pneumonia with autoimmune features (IPAF) is a research classification for patients with an idiopathic interstitial pneumonia in whom clinical, serologic, and/or imaging features are consistent with an autoimmune process but criteria for a defined systemic autoimmune rheumatic disease are not met. Since the establishment of classification criteria in 2015, there has been research into the phenotypic and epidemiologic characteristics of the population, the implications of meeting IPAF criteria, the pathophysiologic processes at work, the factors associated with prognosis in patients meeting IPAF criteria, and its treatment. Despite this growing and evolving data, controversies remain around classification criteria, whether IPAF merits designation as a clinical diagnosis, and appropriate treatment regimens. In this review, we summarize the current state of knowledge about IPAF, discuss data that informs management decisions in patients meeting IPAF criteria, and highlight important questions for future research.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108641"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952831","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":"Relationship of body composition and lung function in adult and elderly males and females","authors":"Alina Ofenheimer ,&nbsp;Emiel F.M. Wouters ,&nbsp;Christoph Gross ,&nbsp;Oliver Helk ,&nbsp;Tobias Mraz ,&nbsp;Mohammad Azizzadeh ,&nbsp;Sylvia Hartl ,&nbsp;Robab Breyer-Kohansal ,&nbsp;Marie-Kathrin Breyer","doi":"10.1016/j.rmed.2025.108610","DOIUrl":"10.1016/j.rmed.2025.108610","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between body compartments and lung function including lung volumes as well as the effects of aging on this relationship remains to be explored. The aim of this study is to evaluate the association between appendicular lean mass index (ALMI), lean mass index (LMI), fat mass index (FMI), and visceral adipose tissue index (VATI) on spirometric and body plethysmographic lung function in the adult and elderly population.</div></div><div><h3>Methods</h3><div>This observational, cross-sectional study used data from 10.616 adults (≥18–82 years) from the prospective population-based LEAD cohort, conducted between 2011 and 2022 in Vienna, Austria. In total, 1923 participants were elderly (age &gt;65 years). Body compartments were measured by dual-energy X-ray absorptiometry scans and indexed by height squared to account for differences related to body height. Lung function was measured by spirometry (forced expiratory volume in the 1st second; FEV1 and forced vital capacity; FVC) and by body plethysmography (total lung capacity; TLC, fractional residual capacity; FRC, and residual volume; RV).</div></div><div><h3>Findings</h3><div>In the overall study population, ALMI was positively associated with FEV1, FVC and TLC and negatively with RV and FRC. In contrast, VATI showed a negative association with all lung function parameters investigated. These effects can also be found in the elderly population.</div></div><div><h3>Conclusion</h3><div>The present study confirms significant associations between body compartments and lung function in adults and in elderly and shows the need to consider body compartments in the assessment and interpretation of lung function results.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108610"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850681","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":"Managing obesity as a treatable trait of obstructive airway diseases","authors":"Vanessa M. McDonald ,&nbsp;Tamara Blickisdorf ,&nbsp;Joice M. de Oliveira ,&nbsp;Hayley A. Scott","doi":"10.1016/j.rmed.2025.108606","DOIUrl":"10.1016/j.rmed.2025.108606","url":null,"abstract":"<div><div>Obesity is a non-communicable chronic disease that is growing in prevalence in all regions of the world. In adult populations obesity rates have doubled since the 1990s. Defined as an excess in fat deposits that deleteriously effect health, obesity is complex and leads to multimorbidity, and death from disease. In people with obstructive airway diseases, obesity is even more common and negatively impacts outcomes for people living with these coexisting diseases.</div><div>Treatable Traits is a personalised medicine approach to managing obstructive airway diseases, focusing on clinically relevant traits that are identified in individuals followed by the application of individualised interventions. In airway diseases traits are grouped within three domains: pulmonary, extra-pulmonary and behavioural/risk-factors. Obesity is a key extra-pulmonary trait which we purpose to be a super trait due to its impact on individuals living with the disease and the major improvements gained from successful treatment.</div><div>In this review we explore the clinical relevance of obesity as a treatable trait of obstructive airway diseases, the optimal approach to measuring and treating obesity, the mechanisms, and the person-centred recommendations for shared decision making. All these areas enable the management of obesity as a treatable trait.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108606"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811097","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":"Association of sleep apnea syndrome with respiratory infections: insights from NHANES and Mendelian randomization","authors":"Yingqi Yang ,&nbsp;Xia Tang ,&nbsp;Tianchi Zhuang ,&nbsp;Chang You ,&nbsp;Hongkai Yu ,&nbsp;Lu Hu ,&nbsp;Haokun Mei ,&nbsp;Ting Xu ,&nbsp;Haili Ren ,&nbsp;Hairong Yu ,&nbsp;Yibo Gu ,&nbsp;Xiaoying Duan ,&nbsp;Ning Li ,&nbsp;Minghui Ji","doi":"10.1016/j.rmed.2025.108626","DOIUrl":"10.1016/j.rmed.2025.108626","url":null,"abstract":"<div><h3>Background</h3><div>Sleep apnea syndrome (SAS) affects one billion people worldwide and is a potential risk factor for a range of diseases. However, its association with respiratory infections is currently unknown.</div></div><div><h3>Methods</h3><div>We first employed a multi-model logistic regression approach to control confounding factors and explore the association between SAS and respiratory infections with data from NHANES. Subsequently, a Mendelian randomization (MR) analysis was employed to investigate the causal relationship between SAS and 15 respiratory infections outcomes. Heterogeneity tests were conducted and MR-Egger and MR-PRESSO were used to test for horizontal pleiotropy. Leave-one-out analysis was performed to identify influential SNPs. The study adhered to STROBE-MR guidelines for reporting MR results.</div></div><div><h3>Results</h3><div>In data from NHANES, we observed that SAS was an independent risk factor for respiratory infections (Model 2: P = 0.031, OR = 1.147, 95 % CI = 1.012–1.299). MR analysis showed that SAS was a risk factor for acute upper respiratory infections (<em>P</em> = 0.014, OR = 1.049, 95 % CI = 1.010–1.090) and other acute lower respiratory infections (<em>P</em> = 0.001, OR = 1.128, 95 % CI = 1.052–1.210). In the reverse MR analysis, COVID-19 (very severe respiratory confirmed vs. population) (<em>P</em> = 0.013, OR = 0.969, 95 % CI = 0.945–0.993), anti-influenza virus subtype H3N2 IgG levels (<em>P</em> = 0.028, OR = 0.974, 95 % CI = 0.952–0.997) and respiratory tuberculosis (<em>P</em> = 0.047, OR = 0.972, 95 % CI = 0.946–1.000) were protective factors for SAS.</div></div><div><h3>Conclusion</h3><div>SAS is a causal risk factor for respiratory infections and certain infections or specific immune responses may in turn reduce the risk of SAS, revealing a complex bidirectional relationship between them. Future studies are needed to validate the underlying mechanisms.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108626"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888334","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":"Evaluation of an air quality Alert–Based intervention in patients with stable chronic obstructive pulmonary Disease: A prospective randomized controlled trial","authors":"Xiaohua Zhang ,&nbsp;Shasha Xie ,&nbsp;Xueshuai Cao ,&nbsp;Qingqing Liu ,&nbsp;Xiaoying Hu ,&nbsp;Yanan Zhang ,&nbsp;Yan Ge ,&nbsp;Juan Xie","doi":"10.1016/j.rmed.2026.108668","DOIUrl":"10.1016/j.rmed.2026.108668","url":null,"abstract":"<div><h3>Background</h3><div>Air pollution is a key modifiable trigger of acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but the efficacy of real-time air quality alert interventions for community-dwelling stable COPD patients remains unvalidated.</div></div><div><h3>Methods</h3><div>This prospective stratified randomized controlled trial (RCT) enrolled 255 stable COPD patients from 3 Shanghai community health centers, randomly assigned (1:1:1) to Control (routine management), Education (routine + pollution education), or Alert (routine + WeChat-based real-time AQI alerts) Groups. The primary outcome was 12-month AECOPD frequency. Secondary outcomes included pulmonary function, symptom scores (SGRQ/CAT/mMRC), and biomarkers. Analyses used negative binomial regression, nonparametric tests, and Generalized Estimating Equations (GEE) model.</div></div><div><h3>Results</h3><div>226 patients (88.6 % follow-up rate) completed the study. Compared to Control Group, Alert Group had 39.3 % lower AECOPD risk (IRR = 0.607, 95 % CI:0.401–0.924); Education Group showed no significant reduction (IRR = 0.819, 95 % CI: 0.543–1.236). Both intervention groups significantly improved SGRQ scores (Education: B = −7.192, 95 % CI: −11.664, −2.720; Alert: B = −6.059, 95 % CI: −10.518, −1.599). After GEE adjustment, only Alert Group had lower IL-8 (B = −0.950, 95 % CI: −1.795, −0.104); pulmonary function was mostly unchanged, with no CD4⁺/CD8⁺ T-cell differences.</div></div><div><h3>Conclusions</h3><div>WeChat-based air quality alerts reduced AECOPD risk and improved symptoms in stable COPD, outperforming pollution education, supporting digital environmental management in community COPD care.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108668"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041367","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}