IF 7.2 2区医学

Respirology Pub Date : 2026-10-19 DOI: 10.1002/resp.70326

Chamara V Senaratna, Dinh S Bui, Jennifer L Perret, Caroline J Lodge, Adrian J Lowe, Michael J Abramson, Bircan Erbas, Paul Thomas, Robert Adams, David P Johns, Yaoyao Qian, George Washko, E Haydn Walters, Garun S Hamilton, Shyamali C Dharmage

{"title":"Lung Restriction From Childhood Is Associated With Obstructive Sleep Apnoea in Middle-Age.","authors":"Chamara V Senaratna, Dinh S Bui, Jennifer L Perret, Caroline J Lodge, Adrian J Lowe, Michael J Abramson, Bircan Erbas, Paul Thomas, Robert Adams, David P Johns, Yaoyao Qian, George Washko, E Haydn Walters, Garun S Hamilton, Shyamali C Dharmage","doi":"10.1002/resp.70326","DOIUrl":"https://doi.org/10.1002/resp.70326","url":null,"abstract":"Background and objective: Whether lifetime lung function trajectories and spirometry patterns are associated with Obstructive Sleep Apnoea (OSA) is unknown. We aimed to investigate this association to widen the understanding of OSA pathophysiology.Methods: We previously identified six FEV1/FVC (forced expiratory volume in the first second/forced vital capacity) and five FVC trajectories within a population-based prospective cohort (n = 2422) using spirometry assessed at ages 7, 13, 18, 43, 50, and 53 years. These trajectories were combined into four lifetime spirometry patterns: restrictive-only, obstructive-only, mixed, and reference (normal), which were our exposure variables. Outcomes were medically-confirmed OSA in midlife and probable-OSA defined using the STOP-Bang questionnaire. Associations were assessed using logistic regression models.Results: The 'restrictive-only' spirometry pattern was associated with medically-confirmed OSA (OR = 2.5; 95% CI 1.5, 4.3). In addition, restriction-confirmatory low total lung capacity and reduced functional residual capacity were associated with increased odds of medically-confirmed OSA (OR = 1.4; 0.9, 2.1 and OR = 1.7; 1.1, 2.6, respectively, per one SD reduction in volume). The results were similar for probable OSA. These associations held when controlled for BMI and central obesity and were independent of childhood lung function. Neither transfer factor for carbon monoxide (TLco) nor transfer coefficient (Kco) was associated with OSA.Conclusion: We provide first evidence that lifetime lung restriction is related to middle-age OSA. While this information may be used to incidentally flag middle-age OSA risk and vice versa, further research is encouraged to confirm the underlying pathophysiological mechanisms.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reply to "Sleep Position May Refine OSA Endotypic Phenotyping". 回复“睡眠姿势可能改善OSA内源性表型”。

IF 7.2 2区医学

Respirology Pub Date : 2026-10-18 DOI: 10.1002/resp.70332

Liang-Wen Hang, Eysteinn Finnsson, Wan-Ju Cheng

引用次数: 0

Sleep Position May Refine OSA Endotypic Phenotyping. 睡眠姿势可能改善OSA的内源性表型。

IF 7.2 2区医学

Respirology Pub Date : 2026-10-18 DOI: 10.1002/resp.70331

Nezihe Köker Özer, Ercan Yılmaz, Erdem Topal

引用次数: 0

Flow or Blow? Comparing Non-Invasive Ventilation and High Flow Nasal Cannula in Patients With Acute Pulmonary Oedema. 流还是吹？无创通气与高流量鼻插管治疗急性肺水肿的比较。

IF 7.2 2区医学

Respirology Pub Date : 2026-10-15 DOI: 10.1002/resp.70335

Amanda J Piper

引用次数: 0

The Microbiome-Gut-Lung axis in Respiratory Diseases: From Biological Mechanisms to Clinical Translation. 呼吸系统疾病中的微生物-肠-肺轴：从生物学机制到临床转化。

IF 7.2 2区医学

Respirology Pub Date : 2026-10-12 DOI: 10.1002/resp.70329

Yuqiong Yang, Xin Tang, Rongchang Chen, Zhang Wang

{"title":"The Microbiome-Gut-Lung axis in Respiratory Diseases: From Biological Mechanisms to Clinical Translation.","authors":"Yuqiong Yang, Xin Tang, Rongchang Chen, Zhang Wang","doi":"10.1002/resp.70329","DOIUrl":"https://doi.org/10.1002/resp.70329","url":null,"abstract":"Respiratory diseases exhibit substantial heterogeneity in clinical phenotypes and underlying pathobiology that cannot be fully captured by conventional lung-centred frameworks. Accumulating evidence implicates a role for the microbiome-gut-lung axis in respiratory disease pathogenesis. Within this bidirectional axis, gut-derived microbial metabolites and structural components can modulate pulmonary immunity, whereas respiratory infection and exposures can reciprocally influence the gut microbiota. Dysregulation of the microbiome-gut-lung axis may influence respiratory disease susceptibility, progression, and clinical presentation. In this Review, we outline core mechanisms of gut-lung crosstalk, including metabolite-driven immunomodulation, pattern recognition receptor signalling and reciprocal immune-ecological remodelling. We synthesize phenotype-specific evidence linking the axis to major chronic inflammatory airway diseases (asthma, chronic obstructive pulmonary disease, cystic fibrosis and bronchiectasis) and acute respiratory disorders (pneumonia and sepsis-associated acute respiratory distress syndrome), emphasizing mechanistic and clinical evidence. We discuss the translational promise of gut-lung signatures as biomarkers and treatable traits and review current therapies with microbiome effects and emerging microbiome-targeted interventions. Finally, we address key challenges and propose future research priorities to advance clinical management leveraging the gut-lung axis.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Era of Precision Medicine: Exacerbation Phenotyping to Determine the Role of Inhaled Corticosteroids in COPD? 精准医学时代：加重表型确定吸入皮质类固醇在COPD中的作用？

IF 7.2 2区医学

Respirology Pub Date : 2026-10-12 DOI: 10.1002/resp.70333

Olivia R Ferry, Ian A Yang

引用次数: 0

Predictive Model for Identifying Fibrotic Interstitial Lung Abnormalities on Computed Tomography for Respiratory Specialists. 计算机断层扫描识别肺间质纤维化异常的预测模型。

IF 7.2 2区医学

Respirology Pub Date : 2026-10-07 DOI: 10.1002/resp.70330

Kazuya Ichikado, Hidenori Ichiyasu, Kazuhiro Iyonaga, Kodai Kawamura, Yuko Yasuda, Keisuke Anan, Zentaro Saito, Hiroko Okabayashi, Kimitaka Akaike, Noritaka Higashi, Takeshi Johkoh, Kiminori Fujimoto, Koutarou Matsumoto, Tetsuo Saito, Minoru Yoshida, Katsuhiko Mitsuzaki, Takuro Sakagami

{"title":"Predictive Model for Identifying Fibrotic Interstitial Lung Abnormalities on Computed Tomography for Respiratory Specialists.","authors":"Kazuya Ichikado, Hidenori Ichiyasu, Kazuhiro Iyonaga, Kodai Kawamura, Yuko Yasuda, Keisuke Anan, Zentaro Saito, Hiroko Okabayashi, Kimitaka Akaike, Noritaka Higashi, Takeshi Johkoh, Kiminori Fujimoto, Koutarou Matsumoto, Tetsuo Saito, Minoru Yoshida, Katsuhiko Mitsuzaki, Takuro Sakagami","doi":"10.1002/resp.70330","DOIUrl":"https://doi.org/10.1002/resp.70330","url":null,"abstract":"Background and objective: Interstitial lung abnormalities (ILAs) are often unreported, and fibrotic ILAs carry a worse prognosis. In this study, we aimed to develop and validate a prediction model for fibrotic ILAs using non-radiological factors.Methods: Using data from the Kumamoto ILA study (a multicenter prospective cohort in Japan), we developed a four-variable model (age, pack-years, fine crackles, elevated serum surfactant protein-D) in 164 patients (2022-2023, derivation cohort) and temporally validated it in 207 patients (2023-2024, validation cohort), with internal-external cross-validation for between-center heterogeneity. A simplified integer score was similarly assessed against 24-month functional decline and treatment initiation within 3 years.Results: Fibrotic ILAs comprised 82% of cases (approximately 60% subsequently met ATS-defined ILD criteria), consistent across cohorts. The four-variable model achieved an AUC of 0.79 (derivation) and 0.76 (validation; pooled 0.76, 95% CI 0.68-0.82), with good calibration and minimal between-center heterogeneity. The integer score performed similarly (AUC 0.79/0.75) and correlated with functional decline (%FVC ≥ 10% or %DLco ≥ 15%) and treatment initiation.Conclusion: Age, smoking exposure, fine crackles, and elevated serum surfactant protein-D are key predictors of progressive fibrotic ILAs, supporting early risk stratification and clinical decision-making.Trial registration: UMIN000045149/2021.12.1.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Asthma: From Phenotypes to Endotypes-Beyond Type 2 Inflammation. 哮喘：从表型到内源性-超越2型炎症。

IF 7.2 2区医学

Respirology Pub Date : 2026-10-07 DOI: 10.1002/resp.70322

Mario Fernando, Gregory G King

{"title":"Asthma: From Phenotypes to Endotypes-Beyond Type 2 Inflammation.","authors":"Mario Fernando, Gregory G King","doi":"10.1002/resp.70322","DOIUrl":"https://doi.org/10.1002/resp.70322","url":null,"abstract":"Asthma is a heterogeneous syndrome featuring variable pathophysiology, clinical presentation and treatment response. This review examines a comprehensive endotype-phenotype framework for asthma assessment with an emphasis on characteristics beyond T2 inflammatory status alone. Endo-phenotype assessment can be performed across three domains: clinical (symptoms, exacerbations, co-morbidities), structural and physiological, and inflammatory endotype. The clinical domain includes mucus hypersecretion, perception of airway narrowing, and obesity-related asthma. Airway remodelling is the central, structural endo-phenotype that defines asthma, given its relationship with fixed airflow limitation, airway hyperresponsiveness, small airway dysfunction, lung function decline, and asthma severity. However, it is the most difficult parameter to measure, and it is increasingly recognised that there is a critical need to be able to measure it longitudinally, beyond bronchial biopsy. Finally, T2-high asthma is relatively well characterised with several effective anti-inflammatory therapies available, including a range of biologics. In contrast, T2-low asthma remains a heterogenous and potentially difficult to characterise endo-phenotype, although some treatment studies have demonstrated benefit when subjects have been appropriately characterised and selected. Emerging multi-omic approaches may enhance the detailed characterisation of patients in future. Adopting an endo-phenotype framework allows clinicians and researchers to confront the complexity of asthma, better manage patients with a precision medicine approach and enhance mechanistic understanding, which is critical for new therapeutics to be developed for asthma.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Almost There: Approaching a Pragmatic Definition of Combined Pulmonary Fibrosis and Emphysema. 几乎在那里：接近合并肺纤维化和肺气肿的实用定义。

IF 7.2 2区医学

Respirology Pub Date : 2026-10-06 DOI: 10.1002/resp.70307

John Odackal, Jeffrey C Horowitz

引用次数: 0

Low-Dose CO₂ Inhalation to Improve Oxygenation and Exercise Capacity at High Altitude: A Double-Blind Pilot Study. 低剂量二氧化碳吸入改善高原氧合和运动能力：一项双盲先导研究。

IF 7.2 2区医学

Respirology Pub Date : 2026-10-01 Epub Date: 2026-07-10 DOI: 10.1002/resp.70278

Shanfeng Liang, Peter Catcheside, Andrew Wellman, Luguang Wu, Lishuang Wang, Joerg Steier, Baiting He, Alan R Schwartz, Danny J Eckert, Yuanming Luo

{"title":"Low-Dose CO2 Inhalation to Improve Oxygenation and Exercise Capacity at High Altitude: A Double-Blind Pilot Study.","authors":"Shanfeng Liang, Peter Catcheside, Andrew Wellman, Luguang Wu, Lishuang Wang, Joerg Steier, Baiting He, Alan R Schwartz, Danny J Eckert, Yuanming Luo","doi":"10.1002/resp.70278","DOIUrl":"10.1002/resp.70278","url":null,"abstract":"Background and objectives: Inhalation of CO2 might improve hypoxia and exercise performance at high altitude by increasing respiratory drive and offsetting hypocapnia. We developed a novel device with minimized dead space and respiratory resistance to deliver CO2 at precise concentrations at high altitude.Methods: Twenty-eight healthy lowlanders (aged 38 ± 13 years, male/female: 13/15) were recruited and taken from an altitude lower than 500 m to 4505 m in Tibet by airplane. A randomized double-blind study was performed to compare blood gases and endurance shuttle walk test (ESWT) during inhalation of ambient air and 2.5% CO2 using the device. Arterial blood gases were measured within 4 h of arrival at high altitude, and the ESWT was performed on the morning of the second day after arrival.Results: Both PaCO2 and PaO2 during CO2 inhalation were significantly higher than during ambient air breathing (PaCO2: 33.5 ± 4.0 vs. 31.4 ± 3.5 mmHg; PaO2: 42.3 ± 5.8 vs. 34.9 ± 5.1 mmHg; all p < 0.001) at high altitude. Compared with ambient air, CO2 inhalation was also associated with a lower heart rate. There was no difference in pH and respiratory rate during inhalation of 2.5% CO2 and ambient air. ESWT distance during inhaling 2.5% CO2 was significantly longer than that during inhalation of ambient air at high altitude (960.0 (713.2-1464.8) m vs. 677.0 (554.2-1026.9) m, p < 0.001).Conclusions: Our results suggest that inhalation of 2.5% CO2 increases both PaO2 and exercise performance at 4505 m.Trial registration: ClinicalTrials. gov identifier: NCT05798416.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"1041-1049"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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