Respiratory medicine最新文献

{"title":"The bacterial lysate OM-85 reduces exacerbations and oral corticosteroid use in frequently exacerbating patients with T2-High asthma: The OMREXA real-world evidence study","authors":"Maria Elpida Christopoulou ,&nbsp;Lilia S. Panteli ,&nbsp;John Α. Moisidis ,&nbsp;Ioannis A. Christopoulos I ,&nbsp;Amalia S. Tryphonidou ,&nbsp;Antonios I. Christopoulos","doi":"10.1016/j.rmed.2026.108695","DOIUrl":"10.1016/j.rmed.2026.108695","url":null,"abstract":"<div><h3>Background</h3><div>Underlying immune modifications are offered by the Polyvalent Chemical Bacterial Lysate OM-85 (i.e., anti-viral properties, enhancement of the epithelium barrier function, and induction of a tolerance landscape in the lungs). This secondary <em>post hoc</em> analysis used data from the OMRIA study, to assess the effect of add-on OM-85 on reducing the risk for exacerbations of any origin in adults with difficult-to-treat T2-high asthma.</div></div><div><h3>Methods</h3><div>The Oral Bacterial Lysate <u>OM</u>-85 Prevents <u>R</u>espiratory Tract <u>I</u>nfections in <u>A</u>sthma (OMRIA) study enrolled adults with T2-high asthma frequently exacerbating, under standard of care asthma therapy (SoC), who were started on OM-85 (two 3-month courses with a 3-month treatment-off period in between). Patients were assigned to two groups (OM-85 plus SoC n = 70 and SoC group n = 67) and all AEXs and OCS bursts were recorded throughout a 12-month period. A clinical categorization to identify infectious and non-infectious AEXs was also applied: 1. Asthma symptoms alone (non-infectious), 2. Combined asthma and common cold symptoms (infectious), 3. Combined asthma and bronchitis, sinusitis, or pneumonia symptoms (infectious).</div></div><div><h3>Results</h3><div>The weighted with propensity scores analyses (Poisson and negative binomial regression model), verified the statistically significant decreases in the average numbers of AEXs and OCS bursts reported in OMRIA study, in patients treated with OM-85. Same tendencies were recorded in each AEX class (class 1-non-infectious: 50.5% decrease, classes 2 and 3-infectious: 72.2% and 89.8% decrease, respectively).</div></div><div><h3>Conclusion</h3><div>This secondary <em>post hoc analysis</em> supports the therapeutic benefit of OM-85 in patients with T2-high asthma who have frequent exacerbations despite adherence to SoC asthma therapy.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108695"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132762","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":"Under the surface: Unveiling the respiratory health crisis among mussel pickers in Kozhikode district, Southern India","authors":"Binub K ,&nbsp;Dhananjayan V ,&nbsp;Madayil D ,&nbsp;Akshaya K ,&nbsp;Ravichandran B ,&nbsp;Thamaraikannan M ,&nbsp;Panjakumar K ,&nbsp;Mala A ,&nbsp;Jaseer M","doi":"10.1016/j.rmed.2026.108653","DOIUrl":"10.1016/j.rmed.2026.108653","url":null,"abstract":"<div><div>Occupational respiratory diseases pose a considerable health challenge in various industries, especially within the global seafood processing sector. The intricate interactions between lifestyle, pre-existing medical disorders and occupational exposures pose a serious threat to respiratory health. This cross-sectional study explores the respiratory health crisis among mussel workers in Kozhikode District, Southern India. The study aimed to quantify lung function morbidity and the prevalence of respiratory illnesses in this population. Pulmonary function test revealed key finding, including a concerning prevalence of respiratory impairment among mussel workers (21.5 %). Cough with phlegm (14 %), sinusitis (11.8 %), wheezing (4.3 %), shortness of breath (4.3 %), epistaxis (6.5 %), and most significantly, hemoptysis (3 %), other symptoms vertigo (7.53 %) and ophthalmic complaints (4.3 %) were observed. Significant correlations between lung health and variables such as alcohol consumption, history of tuberculosis, smoking, adherence to personal protective equipment (PPE) were determined. The occupational practice of marine mussel harvesting through breath-hold free-diving imposes significant pulmonary risk. Our findings demonstrate that mussel pickers develop a mixed obstructive and restrictive pulmonary impairment. This pathology may be driven by the synergistic effects of repetitive mechanical lung injury.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108653"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003250","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":"Efficacy of therapies based on muscle strength training among individual with obstructive sleep apnea - a systematic review and meta-analysis","authors":"Szymon Siatkowski ,&nbsp;Jan Walencik ,&nbsp;Marcin Sikora ,&nbsp;Aleksandra Żebrowska","doi":"10.1016/j.rmed.2026.108702","DOIUrl":"10.1016/j.rmed.2026.108702","url":null,"abstract":"<div><h3>Background</h3><div>Exercise modalities that target upper-airway and respiratory muscles may modify obstructive sleep apnea (OSA) severity.</div></div><div><h3>Objective</h3><div>To synthesize randomized controlled trials (RCTs) of resistance training (RT), oropharyngeal training (OT), and respiratory muscle training (RMT) on OSA severity (apnea–hypopnea index, AHI) and daytime sleepiness (Epworth Sleepiness Scale, ESS).</div></div><div><h3>Methods</h3><div>PubMed, EBSCO, and Scopus were searched (1 Jan 2015–31 Jan 2025). Of 1805 records identified, 13 RCTs (n = 429) met eligibility. Random-effects meta-analyses were performed within modality.</div></div><div><h3>Results</h3><div>OT reduced AHI (mean difference, MD −7.55 events·h⁻¹, 95% CI −13.39 to −1.71; p = 0.02). RMT reduced AHI (MD −3.73 events·h⁻¹, −7.44 to −0.03; p = 0.049). RT showed no significant change (MD −5.88 events·h⁻¹, −17.25 to 5.49; p = 0.16). Across modalities, ESS showed no consistent, clinically meaningful improvement. Heterogeneity was substantial for RT trials for AHI and for OT trials in ESS, reflecting variability in protocols, duration, and participant characteristics.</div></div><div><h3>Conclusions</h3><div>When analyzed within modality, OT and RMT are associated with reductions in AHI, whereas RT alone does not demonstrate a significant effect. Symptom change measured by ESS was not consistently observed. These findings support OT and RMT as adjunctive options for reducing physiological OSA severity, while underscoring the need for standardized protocols, longer follow-up, and patient-important outcomes.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108702"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137748","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":"Comorbidities in pediatric cystic fibrosis: ABPA, celiac disease and prediabetes in Georgia","authors":"Nino Vardosanidze ,&nbsp;Dodo Agladze ,&nbsp;Lali Margvelashvili ,&nbsp;Oleg Kvlividze ,&nbsp;Nani Kavlashvili","doi":"10.1016/j.rmed.2026.108674","DOIUrl":"10.1016/j.rmed.2026.108674","url":null,"abstract":"<div><h3>Background</h3><div>Cystic fibrosis is a chronic autosomal-recessive disorder characterized by progressive lung disease, pancreatic insufficiency, and multiple systemic complications. Early identification and treatment of comorbidities such as allergic bronchopulmonary aspergillosis (ABPA), celiac disease (CD), and prediabetes/cystic fibrosis–related diabetes (CFRD) improves outcomes.</div></div><div><h3>Methods</h3><div>This prospective observational study included 68 pediatric CF patients registered in the Georgian National Monitoring Program of Rare Diseases (2022–2025). All children had a confirmed diagnosis of CF based on national criteria, established either through newborn screening (elevated IRT followed by sweat chloride and fecal elastase testing) or direct clinical referral for sweat chloride testing. Sweat chloride &lt;29 mmol/L was considered negative, 30–60 mmol/L borderline (requiring repeat testing), and ≥60 mmol/L abnormal and referred for CFTR gene testing [4]. All patients underwent three fasting plasma glucose tests, total IgE measurement, and Aspergillus-specific IgG testing. Anti-tissue transglutaminase IgA (anti-TTG IgA) was measured once for celiac disease screening. Age-specific reference ranges and established diagnostic criteria for ABPA, CD, and CFRD were applied.</div></div><div><h3>Results</h3><div>Three patients had elevated anti-TTG IgA; one was diagnosed with CD and treated with a gluten-free diet. Impaired fasting glucose was observed in 14 patients (22 %). Two patients with persistently elevated HbA1c (≥6.0 %) were referred to endocrinology for evaluation of prediabetes/CFRD. Aspergillus-specific IgG was elevated in two patients; one had markedly elevated total IgE (&gt;1500 IU/mL) and was diagnosed with ABPA requiring systemic corticosteroids and antifungal therapy. Several patients had elevated IgE without ABPA but due to sensitization to multiple allergens, they were referred to an allergologist.</div></div><div><h3>Conclusion</h3><div>Comorbidities including CD, prediabetes/CFRD, and ABPA are present in Georgian children with CF and can negatively affect nutrition and lung function if untreated. Routine screening for glucose abnormalities, CD, and ABPA should be implemented into national CF care protocols for timely treatment and better outcomes.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108674"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097163","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":"Profiles of circulating T follicular helper (cTfh) cell subpopulations in patients with asthma, COPD and asthma-COPD overlap (ACO)","authors":"Vanesa Cunill ,&nbsp;Valero Andreu ,&nbsp;Amanda Iglesias ,&nbsp;María Berman ,&nbsp;Núria Toledo-Pons ,&nbsp;Elisabet Pol-Pol ,&nbsp;Mireia Vicens ,&nbsp;Miguel A. Estévez ,&nbsp;Jaume Sauleda ,&nbsp;Javier Verdú ,&nbsp;Joana M. Ferrer ,&nbsp;Borja G. Cosío ,&nbsp;Jaime Pons","doi":"10.1016/j.rmed.2026.108672","DOIUrl":"10.1016/j.rmed.2026.108672","url":null,"abstract":"<div><h3>Background</h3><div>Asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD Overlap (ACO) are inflammatory diseases characterized by specific T helper (Th) phenotypes. CD4 T follicular helper (Tfh) cells constitute a heterogeneous subset of T cells (Tfh1, Tfh2, Tfh17, Tfh17.1 and Tfr) essential for B cell differentiation and immunoglobulin production. Although alterations in their distribution and/or function have been associated with several pathologies, little is known about their relevance in these airway diseases.</div></div><div><h3>Methods</h3><div>We sought to evaluate, by flow cytometry, the pattern of blood follicular and non-follicular Th cell subpopulations in patients with asthma, COPD and ACO.</div></div><div><h3>Results</h3><div>We found a distinct and characteristic T cell pattern in these three inflammatory conditions: a predominance of cTfh2 in asthma patients, a Th17.1 and cTfh17.1 inflammatory profile in COPD patients, and a Th1 pattern in ACO patients. Regarding tobacco smoke, COPD patients who were active smokers had a higher ratio Th1/Th17 compared to ex-smokers with COPD, a trend not observed in ACO patients.</div></div><div><h3>Conclusions</h3><div>These results suggest that the assessment of the characteristic inflammatory profile for each of these pathologies could help to understand the pathobiology and to identify the most appropriate therapeutic target.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108672"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100538","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":"Adherence to pulmonary rehabilitation in COPD patients: A systematic review of measurement tools","authors":"Fangrong Jia ,&nbsp;Chantra Promnoi ,&nbsp;Chuleeporn Prompahakul ,&nbsp;Waraporn Kongsuwan","doi":"10.1016/j.rmed.2026.108696","DOIUrl":"10.1016/j.rmed.2026.108696","url":null,"abstract":"<div><h3>Background</h3><div>Adherence is an important factor contributing to the effectiveness of pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD). However, there appears to be a lack of reliable and validated measures to assess adherence in PR.</div></div><div><h3>Objective</h3><div>The purpose of this study was to systematically review and analyze existing PR adherence assessment tools, describe their application effects in different contexts, and explore the scientific validity and applicability of each assessment method.</div></div><div><h3>Methods</h3><div>MEDLINE, PubMed, Web of Science and other data sources were searched for target articles. To ensure all pertinent papers were included, reference lists from articles that met the inclusion criteria were reviewed. A combination of EndNote 21 software and manual screening of the literature was used for quality assessment, employing the JBI Critical Appraisal Checklist. Both researchers conducted the entire process independently, without interfering with each other.</div></div><div><h3>Results</h3><div>Three studies were included, reporting three tools in three different countries. The quality and validity of these three articles are high. Two of the tools were developed specifically for the COPD population, one tool was developed initially for athlete participant but used to assess the adherence of PR in patients with COPD.</div></div><div><h3>Conclusion</h3><div>The results show a gap in the literature for well-developed tools that capture adherence for PR of patients with COPD.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108696"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119661","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":"Functional recovery after pulmonary embolism: A pilot study using metabolic monitoring during the 6-minute walk test","authors":"Dominick Roto,&nbsp;Deborah Haight,&nbsp;Kyle Norton,&nbsp;R James White,&nbsp;Daniel Lachant","doi":"10.1016/j.rmed.2026.108707","DOIUrl":"10.1016/j.rmed.2026.108707","url":null,"abstract":"<div><h3>Introduction</h3><div>Disability after acute pulmonary embolism is common. Functional testing is not routinely performed in early follow-up and typically occurs only when symptoms persist after three months of anticoagulation.</div></div><div><h3>Methods</h3><div>This pilot study was a single center, prospective, observational study as part of a larger rehabilitation clinical trial. We recruited patients hospitalized for intermediate or high risk acute pulmonary embolism. Baseline (within 2 weeks of discharge) and follow up (3 months later) testing included 6-min walk test with metabolic monitoring, Cardiac Effort (number of heart beats used/walk distance), two weeks of actigraphy, and PE-mb Quality of Life Questionnaire. Non-parametric and mixed method repeated measures regression were performed.</div></div><div><h3>Results</h3><div>Twenty-five participants completed paired 6-min walk testing after acute PE. No safety concerns emerged when performing the walk test. There was significant improvement in walk distance, +58 m (29, 108), and Cardiac Effort, −0.2 beats/m (−0.4, −0.1), at 3-month follow up. Metabolic monitoring showed improvement in oxygen consumption, +1.8 ml/kg/min (0.8, 4.9), and respiratory efficiency, −2.9 (−7.7, −0.5). Actigraphy showed increased moderate activity time, +10 min/day (4, 21), and quality of life improved, −20% (−24, −7). Both 6-min walk distance and actigraphy parameters were associated with metabolic parameters.</div></div><div><h3>Conclusion</h3><div>For a group of participants that were asymptomatic at 3 months after hospitalization for acute pulmonary embolism, early functional assessments that can be obtained and repeated in an office setting demonstrated recovery in function and physiology (gas exchange and heart rate). Early testing could help better characterize recovery after acute pulmonary embolism.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108707"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149991","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":"Detection of SARS-CoV-2 in aerosol and surface samples in high acuity hospital settings during community epidemic waves – implications for risk-based infection control","authors":"C Raina MacIntyre ,&nbsp;Adriana Notaras ,&nbsp;Noor Bari ,&nbsp;Con Doolan ,&nbsp;Mohamed Mahmoud Abdelkareem Mahmoud ,&nbsp;Damian Honeyman ,&nbsp;Andre Fellipe Vilanova de Araujo Aquino ,&nbsp;Ian Seppelt ,&nbsp;Mark Nicholls ,&nbsp;Stuart Turville ,&nbsp;Anupriya Aggarwal ,&nbsp;Mohana Kunasekaran ,&nbsp;Rebecca Gresham ,&nbsp;Gregory Walker ,&nbsp;Andrea Sevendal ,&nbsp;William Rawlinson ,&nbsp;Isla E. Emmen ,&nbsp;Shelby L. O'Connor ,&nbsp;David H. O'Connor ,&nbsp;Charitha de Silva","doi":"10.1016/j.rmed.2026.108712","DOIUrl":"10.1016/j.rmed.2026.108712","url":null,"abstract":"<div><h3>Rationale</h3><div>Nosocomial transmission of SARS-CoV-2 is multifactorial and may vary between clinical sites.</div></div><div><h3>Objectives</h3><div>To measure SARS-CoV-2 in the air and on surfaces within the Intensive Care Unit (ICU) and Emergency Department (ED).</div></div><div><h3>Methods</h3><div>We conducted an air and surface-sampling study of SARS-CoV-2 in the ED and ICU of a hospital in Sydney.</div></div><div><h3>Measurements</h3><div>We sampled air, patient equipment, and personal protective equipment during two community COVID-19 epidemics. SARS-CoV-2 was detected using quantitative reverse transcription polymerase chain reaction (RT-qPCR). Carbon dioxide (CO₂₎ was measured simultaneously, with &lt;800 ppm indicating good air quality.</div></div><div><h3>Main results</h3><div>SARS-CoV-2 genetic material was detected in 39% of 51 aerosol samples, with mean CO₂ levels consistently &lt;800 ppm for positive samples. The ED had more detections than the ICU (80% vs. 20%; p &lt; 0.0027) and a higher mean CO₂ level than the ICU (669 ppm vs. 522 ppm; p &lt; 0.05). The ED waiting room, acute ward, and ICU staff tearoom showed higher detection rates than the ICU ward area. SARS-CoV-2 was detected in air samples in the ED a week before an outbreak was declared, and both inside and outside a COVID-19 patient's negative-pressure ICU room, where high-flow nasal prongs and a glove tested positive.</div></div><div><h3>Conclusion</h3><div>During community epidemics, SARS-CoV-2 genetic material is detected in hospital air despite good ventilation. Enhanced protection with masks, vaccines, and portable air purifiers, especially in high-risk areas, may mitigate nosocomial transmission, including among staff. Air sampling can provide an early warning of an outbreak and help identify areas that need enhanced infection control.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108712"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202499","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":"The match 2 study: Robotic assisted bronchoscopy with integrated imaging with assessment of digital tomosynthesis (DT) and augmented fluoroscopy (AF): Three-Dimensional accuracy as confirmed by cone beam computed tomography (CBCT)","authors":"Amit K. Mahajan ,&nbsp;Duy K. Duong ,&nbsp;Johanna Cortes ,&nbsp;Krish Bhadra","doi":"10.1016/j.rmed.2026.108693","DOIUrl":"10.1016/j.rmed.2026.108693","url":null,"abstract":"<div><h3>Purpose</h3><div>Robotic-assisted bronchoscopy (RAB) with embedded digital tomosynthesis (DT) provides real-time, intraoperative nodule localization. This study examines the performance of RAB with embedded DT and integrated AF to achieve tool-in-lesion (TIL) confirmation via cone beam computer tomography (CBCT).</div></div><div><h3>Methods</h3><div>This was a prospective, bicentric, single-arm, non-randomized observational trial. Thirty-one patients with peripheral pulmonary nodules underwent RAB with embedded DT. Navigation was guided by DT and augmented fluoroscopy (AF). Primary endpoints were successful navigation to target lesions and successful TIL as confirmed by CBCT. Secondary endpoints included diagnostic yield based on the strict Delphi consensus definition of diagnostic yield along with serious device or procedure-related adverse events.</div></div><div><h3>Results</h3><div>Thirty-one patients were enrolled across two sites. Thirty-one lung nodules were successfully biopsied. The mean lesion size measured by longest cross-sectional diameter was 16 mm (±6.7 mm). DT demonstrated TIL in 30 of 31 nodules (96.7 %), with one case resulting in tool-touching-lesion (TTL). Of the 30 nodules demonstrating TIL by DT, TIL was confirmed in 29 nodules by CBCT (concordance rate of 96.7 %). Overall TIL confirmed by CBCT was 29 of 31 nodules (93.5 %). A diagnosis was obtained in 30 of 31, resulting in a 96.7 % diagnostic yield by strict definition. Pneumothorax occurred in 1 of 31 cases (3 %).</div></div><div><h3>Conclusions</h3><div>RAB with embedded DT demonstrated a high rate of TIL confirmed by CBCT. The strong concordance between the DT with AF and CBCT demonstrates the reliability of DT and AF for real-time intraprocedural guidance.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108693"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097155","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":"Genetically predicted associations between blood cell perturbation responses and bronchiectasis through immune mediation: A Mendelian Randomization study","authors":"Jiahui Han ,&nbsp;Yibo Yan ,&nbsp;Zhongye Du ,&nbsp;Haizhu Huang ,&nbsp;Xuexin Yan ,&nbsp;Chuanlin Zhou ,&nbsp;Yanmei Lei ,&nbsp;Shaochu Zheng ,&nbsp;Chongxi Bao ,&nbsp;Yun Jiang ,&nbsp;Xiaopu Wu ,&nbsp;Wei Lu ,&nbsp;Yue Zhou ,&nbsp;Liangmin Zhang ,&nbsp;Rongquan He ,&nbsp;Gang Chen ,&nbsp;Jin Luo ,&nbsp;Jinliang Kong","doi":"10.1016/j.rmed.2026.108701","DOIUrl":"10.1016/j.rmed.2026.108701","url":null,"abstract":"<div><h3>Background</h3><div>Bronchiectasis is a chronic airway disease characterized by persistent inflammation and structural damage, with substantial clinical and etiologic heterogeneity. Although previous studies have identified associations between blood cells and bronchiectasis, the causal relationships remain unclear. Moreover, the mechanisms underlying blood cell perturbation responses and their potential mediation by immune cells in disease progression are largely unexplored.</div></div><div><h3>Methods</h3><div>Two-sample Mendelian randomization (MR) analysis was used to explore genetically predicted associations among immune cell traits, blood cell perturbation response phenotypes, and bronchiectasis, based on genome-wide association study summary data. Mediation MR analysis was further applied to assess whether immune cells mediate these associations. Multiple sensitivity analyses, including tests for heterogeneity and horizontal pleiotropy, were performed to evaluate the validity and robustness.</div></div><div><h3>Results</h3><div>Five blood cell perturbation response phenotypes and twenty-nine immune cell traits showed significant genetically predicted associations with bronchiectasis. Mediation analysis showed that natural killer (NK) cell absolute count partially mediated the causal effect between the eosinophil perturbation response and bronchiectasis, with a mediation proportion of 9.626%. CD38 on transitional B cells mediated the causal effect between the monocyte perturbation response and bronchiectasis, with a mediation proportion of 10.580%. Additionally, CD45 on NK cells played a mediating role in the association between the white blood cell perturbation response and bronchiectasis, with a mediation proportion of 10.651%.</div></div><div><h3>Conclusion</h3><div>This study systematically explores genetically predicted associations between blood cell perturbation responses and bronchiectasis and highlights potential immune-mediated pathways. These exploratory findings provide novel genetic insights into the pathogenesis of bronchiectasis and identify potential therapeutic targets for future strategies.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"253 ","pages":"Article 108701"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126275","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}