Respiratory medicine最新文献

{"title":"Old criteria, new intelligence: The evolution of ECG in pulmonary hypertension diagnosis","authors":"Nancy Herrera-Leaño ,&nbsp;Sandeep Sahay ,&nbsp;Raymond L. Benza ,&nbsp;Julian Barahona-Correa ,&nbsp;Francois Haddad","doi":"10.1016/j.rmed.2026.108646","DOIUrl":"10.1016/j.rmed.2026.108646","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary hypertension (PH) carries a significant mortality risk, highlighting the need for improved early detection strategies. This review examines the evolution of electrocardiographic assessment in PH diagnosis, from traditional criteria to artificial intelligence (AI) algorithms.</div></div><div><h3>Methods</h3><div>We conducted a literature review analyzing 24 studies published between 1986 and 2025, including 18 traditional ECG validation studies and 6 AI-based investigations. Methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and QUADAS-AI frameworks. Studies were categorized by approach and diagnostic performance metrics were systematically evaluated.</div></div><div><h3>Results</h3><div>Traditional ECG criteria demonstrated consistently high specificity (71–100 %) but low sensitivity (0–66 %) for detection of PH, limiting screening utility while maintaining confirmatory value. AI-based algorithms achieved superior balanced diagnostic performance with sensitivity of 74–85 % and specificity of 85 %. AI algorithms also demonstrated early detection capability, identifying PH up to 2–5 years before conventional clinical diagnosis.</div></div><div><h3>Conclusions</h3><div>Traditional criteria retain value for diagnosis and response to therapy, while AI can be leveraged for early detection of PH. Implementation requires addressing computational infrastructure, healthcare provider training, and regulatory approval.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108646"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978729","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":"Assessment and comparison of functional and cardiorespiratory responses between the six-minute walk test and the six-minute step test in individuals with heart failure","authors":"Fransuélida Da Conceição Soares ,&nbsp;José Heriston de Morais Lima ,&nbsp;Rafaela Pedrosa ,&nbsp;Victor Alexandre Trigueiro Arcoverde ,&nbsp;Daphnne Ingryd Fernandes do Nascimento ,&nbsp;Danielle Utah Queiroga Ramos ,&nbsp;Laís Felix da Silva Neves ,&nbsp;Maria Patrícia Cavalcante De Oliveira ,&nbsp;Larisse Xavier Almeida ,&nbsp;Eduardo Ériko Tenório de França ,&nbsp;Tatiana Onofre","doi":"10.1016/j.rmed.2026.108638","DOIUrl":"10.1016/j.rmed.2026.108638","url":null,"abstract":"<div><h3>Background</h3><div>Cardiorespiratory fitness, recognized as an important marker of cardiovascular health, is a key determinant in the prognosis of heart failure (HF). These individuals frequently present with reduced exercise tolerance, highlighting the importance of simple and accessible methods for its assessment. The 6-min walk test (6MWT) and the 6-min step test (6MST) are reliable tools to estimate functional capacity, although differences in their protocols may lead to distinct functional and cardiorespiratory responses.</div></div><div><h3>Objectives</h3><div>To evaluate and compare the functional and cardiorespiratory responses between the 6MWT and the 6MST in individuals with HF.</div></div><div><h3>Methods</h3><div>This observational study included individuals with HF of both sexes, aged 18 years or older. They performed the 6MWT and the 6MST to assess functional capacity. Statistical significance was set at p &lt; 0.05.</div></div><div><h3>Results</h3><div>A total of 60 individuals were included, showing reduced predicted percentage values in both tests, with lower performance in the 6MST compared to the 6MWT (69.7 % vs. 84.7 %; P &lt; 0.001). Cardiorespiratory responses differed between tests, with the maximum heart rate (HRmax) during the 6MST significantly higher than the 6MWT (114.8 bpm vs. 104.2 bpm; P &lt; 0.001). At the end of the tests, HR, systolic blood pressure (SBP), Borg dyspnea, and leg fatigue scores were significantly higher in the 6MST (P &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Individuals with HF demonstrated impaired functional capacity, with lower predicted values in the 6MST. This test induced greater cardiovascular stress than the 6MWT, resulting in higher HRmax and SBP, as well as increased dyspnea and leg fatigue.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108638"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927633","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 therapeutic bronchoscopic interventions in patients with unilateral total lung atelectasis secondary to lung cancer","authors":"Furkan Atasever ,&nbsp;Cengiz Ozdemir ,&nbsp;Celal Satici ,&nbsp;Sinem Nedime Sokucu ,&nbsp;Omer Ayten ,&nbsp;Levent Dalar","doi":"10.1016/j.rmed.2026.108635","DOIUrl":"10.1016/j.rmed.2026.108635","url":null,"abstract":"<div><h3>Purpose</h3><div>Malignant central airway obstruction (MCAO) secondary to lung cancer can result in unilateral total lung atelectasis, a life-threatening condition with limited data on survival outcomes and the role of therapeutic bronchoscopy. This study aimed to evaluate survival and prognostic factors in lung cancer patients with MCAO-induced total lung atelectasis and to assess the impact of bronchoscopic interventions.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 123 lung cancer patients with MCAO and unilateral total lung atelectasis treated at a single center. Of these, 84 underwent therapeutic bronchoscopic intervention, while 39 did not. Short-term survival (90-day mortality and median survival) was compared. Multivariate Cox regression was used to identify independent predictors of mortality.</div></div><div><h3>Results</h3><div>Overall, 60.2 % of patients died within 90 days. Bronchoscopic intervention was associated with lower 90-day mortality (52 % vs 77 %, p = 0.01) and longer median survival (88 vs 37 days, p &lt; 0.001). Independent predictors of higher 90-day mortality included ECOG performance status 3–4, small cell lung cancer histology, stage IV disease, pulmonary artery (PA) invasion, extended lesions, and failure to restore airway patency. Among patients with PA invasion, recanalization did not improve survival (p = 0.34).</div></div><div><h3>Conclusions</h3><div>MCAO-induced total lung atelectasis in lung cancer patients is associated with poor short-term survival. Therapeutic bronchoscopy improves survival in selected patients, but its benefit is limited in the presence of PA invasion. Careful patient selection is critical when planning bronchoscopic intervention.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108635"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952828","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":"Relationships between bronchodilator responsiveness, a COPD polygenic risk score, and COPD progression","authors":"Spyridon Fortis ,&nbsp;Alejandro P. Comellas ,&nbsp;Russell P. Bowler ,&nbsp;Surya P. Bhatt ,&nbsp;Craig P. Hersh ,&nbsp;Dawn L. Demeo ,&nbsp;Gregory Kinney ,&nbsp;Edwin K. Silverman ,&nbsp;Michael H. Cho ,&nbsp;Matthew Moll","doi":"10.1016/j.rmed.2026.108636","DOIUrl":"10.1016/j.rmed.2026.108636","url":null,"abstract":"<div><h3>Introduction</h3><div>Bronchodilator responsiveness (BDR) is associated with progression to COPD. Genetic risk for COPD, summarized by polygenic risk scores (PRS), predicts low lung function and COPD. However, it remains unclear whether genetic predisposition to COPD is related to BDR and whether PRS and BDR together influence lung function decline in individuals at risk for the disease.</div></div><div><h3>Methods</h3><div>We analyzed data from COPDGene participants with a smoking history and <strong>normal spirometry at study enrollment</strong>. We cross-sectionally examined the association of a PRS with 2005-BDR-FEV₁ % (change relative to pre-bronchodilator) and 2021-BDR-FEV₁ % (change relative to predicted). We also examined the association of PRS, 2005-BDR-FEV₁ %, and 2021-BDR-FEV₁ % with progression to COPD and longitudinal FEV₁ decline between enrollment and follow-up adjusted for demographics, smoking history, and FEV₁ at enrollment.</div></div><div><h3>Results</h3><div>PRS did not correlate with 2005-BDR-FEV₁ % in 1446 African Americans (AA) but PRS correlates with BDR in both unadjusted (rho = 0.01, P &lt; 0.001) and adjusted analysis in 3378 non-Hispanic Whites (NHW). NHW participants with BDR had higher PRS than those without. Models including 2005-BDR-FEV1 % demonstrated better accuracy than those including PRS (Area under the curve: 0.762 vs 0.743 in NHW; 0.693 vs 0.653 in AA). BDR models also outperformed PRS models for longitudinal FEV₁ decline. Mediation analysis showed that about one third of the PRS effect on FEV₁ decline in NHW was explained through BDR.</div></div><div><h3>Conclusions</h3><div>BDR is more strongly associated with progression to COPD and FEV₁ decline than PRS, and part of the PRS effect is mediated through BDR.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108636"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952820","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":"Airway epithelial barrier integrity: an emerging treatable trait in asthma management","authors":"Milos Jesenak ,&nbsp;Anna Bobcakova ,&nbsp;Korneliusz Golebski ,&nbsp;Inge Kortekaas Krohn ,&nbsp;Sven F. Seys ,&nbsp;Zuzana Rennerova ,&nbsp;Peter Durdik ,&nbsp;Ellen Tufvesson ,&nbsp;Adam Markocsy ,&nbsp;Radovan Kosturiak ,&nbsp;Zuzana Diamant","doi":"10.1016/j.rmed.2025.108579","DOIUrl":"10.1016/j.rmed.2025.108579","url":null,"abstract":"<div><div>The airway epithelium not only acts as a physical barrier between the environment and the host, but also functions as an active immunological interface, facilitating crosstalk between the epithelial cells, immune cells and the microbiome aimed at protecting the host. Therefore, maintaining airway epithelial barrier integrity and its functions is crucial for prevention of chronic inflammatory airway diseases, such as allergy, asthma and chronic obstructive pulmonary disease.</div><div>The potential to restore the epithelial barrier by therapeutic interventions has increasingly gained interest over recent years. As part of their disease-modifying properties, various treatment modalities including small molecule drugs, biologics, bronchial thermoplasty and allergen immunotherapy, showed beneficial effects on epithelial barrier integrity in select patient populations.</div><div>In this review, we summarize current knowledge, discuss recent evidence of therapeutic interventions on restoring epithelial barrier function and highlight unmet needs and future research directions.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108579"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800657","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":"One-year lung function change and variability post allogeneic hematopoietic stem cell transplantation","authors":"Kaj E.C. Blokland ,&nbsp;Troy J. Cross ,&nbsp;Fei Ni Hau ,&nbsp;David Touma ,&nbsp;David G. Chapman ,&nbsp;G Kim Prisk ,&nbsp;Sandra Rutting ,&nbsp;Mark Barrios ,&nbsp;Matthew Greenwood ,&nbsp;Gregory G. King","doi":"10.1016/j.rmed.2026.108670","DOIUrl":"10.1016/j.rmed.2026.108670","url":null,"abstract":"<div><h3>Background and objective</h3><div>Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a well-established treatment for various haematologic and oncologic disorders, yet its clinical success is frequently compromised by complications such as pulmonary graft-versus-host disease (GvHD). Spirometry is the gold standard for monitoring and diagnosis, but it is insensitive to small airway changes. Oscillometry may complement spirometry as a way of detecting change in small airway function. This study assessed the longitudinal change and variability in spirometry and oscillometry following allo-HSCT and predictors of this change.</div></div><div><h3>Methods</h3><div>Longitudinal spirometry and oscillometry were retrospectively obtained from all patients (n = 374) who underwent allo-HSCT at Royal North Shore Hospital in Sydney, Australia, between January 2015 and December 2023.</div></div><div><h3>Results</h3><div>Baseline post allo-HSCT assessments showed significantly lower FEV₁ and FVC in the allo-HSCT group compared to controls. Over the follow-up period, oscillometric indices displayed significant worsening of Rrs₅ and Xrs₅, whereas FEV₁ did not significantly change. Severe cGvHD was associated with a modest decline in FEV₁/FVC and Xrs₅ trajectory. Notably, a subset of patients demonstrated discordant changes between spirometry and oscillometry, suggesting that oscillometry may capture early small airway dysfunction not evident on traditional spirometric measures.</div></div><div><h3>Conclusion</h3><div>These findings underscore the potential of oscillometry as a complementary tool in the routine monitoring of lung function post-allo-HSCT. By detecting subtle changes in small airway mechanics, oscillometry could facilitate earlier identification and intervention in patients at risk for developing pulmonary cGvHD, thereby improving long-term clinical outcomes.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108670"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023127","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":"Image-guided shape-sensing robotic-assisted bronchoscopy for subaortic and paraaortic mediastinal lesion sampling","authors":"Vanessa E. Josef ,&nbsp;David M. Wisa ,&nbsp;Brie E. Kezlarian-Sachs ,&nbsp;Bryan C. Husta ,&nbsp;Robert P. Lee ,&nbsp;Rami Naaman ,&nbsp;Catherine L. Oberg ,&nbsp;Matthew J. Bott ,&nbsp;Rastko Rakočević ,&nbsp;Mohit Chawla ,&nbsp;Or Kalchiem-Dekel","doi":"10.1016/j.rmed.2026.108669","DOIUrl":"10.1016/j.rmed.2026.108669","url":null,"abstract":"<div><h3>Background</h3><div>Mediastinal sampling of the subaortic - station 5 - and paraaortic - station 6 - lymph nodes and mediastinal lesions traditionally requires surgical access. Image-guided shape-sensing robotic-assisted bronchoscopy (ssRAB) extends endoscopic reach and may offer an alternative sampling approach. We evaluated the feasibility, diagnostic yield, and safety of ssRAB-guided sampling of these anatomically challenging lesions.</div></div><div><h3>Methods</h3><div>All ssRAB procedures performed from October 2019 to September 2025 were reviewed retrospectively. Procedures in which a subaortic or paraaortic mediastinal lesion was targeted were included in the final analysis. Abstracted variables included patient data, pre-operative imaging, procedural details, peri-operative complications, and sampling results. The primary endpoint was conservative diagnostic yield, defined as the rate of procedures establishing a specific diagnosis.</div></div><div><h3>Results</h3><div>A total of 16 procedures targeting a subaortic or paraaortic mediastinal lesion were identified for the final analysis. The conservative diagnostic yield rate was 69 %. After elimination in one case in which sampling was planned but not pursued, the lenient diagnostic yield rate was 73 %. The conservative diagnostic yield rate was 75 % and 62 % for the subaortic and paraaortic samplings, respectively. One instance of grade 1 pneumothorax was documented. No additional complications were observed.</div></div><div><h3>Conclusion</h3><div>This single-center retrospective case series demonstrated that image-guided ssRAB may represent a feasible, safe, and minimally invasive approach for sampling subaortic and paraaortic mediastinal lymph nodes and lesions, potentially obviating the need for surgical procedures.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108669"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023251","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":"Impact of carbon footprint information on inhaler prescribing intentions by general practitioners: protocol for an online factorial randomised experiment","authors":"Luise Kazda ,&nbsp;Timothy E. Schlub ,&nbsp;Michelle Guppy ,&nbsp;Mike Forrester ,&nbsp;Debbie Rigby ,&nbsp;Alexandra Barratt ,&nbsp;Darlene Cox ,&nbsp;Michael J. Loftus ,&nbsp;Katy Bell","doi":"10.1016/j.rmed.2026.108657","DOIUrl":"10.1016/j.rmed.2026.108657","url":null,"abstract":"<div><h3>Background</h3><div>Many asthma patients experience suboptimal disease control and are disproportionally impacted by worsening environmental risk factors due to climate change. General practitioners (GPs) are well-placed and trusted to lead conversations to improve asthma management. The resulting treatment improvements have the potential to simultaneously reduce the significant greenhouse gas emissions from inhalers as a co-benefit.</div></div><div><h3>Objectives</h3><div>This study aims to explore whether adding environmental impact information for respiratory inhalers can influence clinician prescribing while improving quality of care and investigates optimal ways to communicate environmental impacts to GPs.</div></div><div><h3>Methods</h3><div>We will conduct a factorial (2 × 2 plus control) randomised online hypothetical experiment with Australian GPs. Following consent and baseline information on guideline-concordant maintenance-and-reliever-therapy (“MART”) prescribing, participants will be randomised 1:1:1:1:1 to five conditions: A. Emissions impact: collective action/with graphic; B. Emissions impact: single-action/with graphic; C. Emissions impact: collective action/no graphic; D. Emission impact: single-action/no graphic; E. Control: no further information. The required sample size is 250 GPs. The primary outcome is participant choice of inhaler type (binary choice of dry powder or pressurised metered dose). Secondary outcomes include participant level of confidence in their choice, management choice anxiety, acceptability and trustworthiness of information received (all measured on Likert scales) and reasons for inhaler choice (free text). Study duration will be less than 10 min. We will use t-tests and chi-squared tests for univariable analysis of continuous and binary outcomes respectively, and t, F or likelihood ratio tests for regression models as appropriate.</div></div><div><h3>Results</h3><div>Not applicable – this is a study protocol.</div></div><div><h3>Conclusion</h3><div>This study will provide evidence on whether and how environmental impact information can influence prescribing intentions among GPs. Findings will inform future interventions aimed at aligning clinical and environmental goals in respiratory care.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108657"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019588","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":"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}