Respirology最新文献_第10页

Sympatho-Excitation in Pulmonary Hypertension: The Potential Role of Pulmonary Arterial Baroreceptors: An Acute Physiologic Intervention Study. 肺动脉高压的交感神经兴奋：肺动脉压力感受器的潜在作用：一项急性生理干预研究。

IF 7.2 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-02-03 DOI: 10.1002/resp.70207

Michael J Plunkett, Ana L C Sayegh, Robert A Lewis, Tanya J McWilliams, Sasiharan Sithamparanathan, Julian F R Paton, James P Fisher

{"title":"Sympatho-Excitation in Pulmonary Hypertension: The Potential Role of Pulmonary Arterial Baroreceptors: An Acute Physiologic Intervention Study.","authors":"Michael J Plunkett, Ana L C Sayegh, Robert A Lewis, Tanya J McWilliams, Sasiharan Sithamparanathan, Julian F R Paton, James P Fisher","doi":"10.1002/resp.70207","DOIUrl":"10.1002/resp.70207","url":null,"abstract":"Background and objective: Sympathetic nerve activity is heightened in pulmonary arterial hypertension (PAH), promotes deleterious pulmonary vascular and right ventricular remodelling, and is associated with worsened exercise capacity and mortality. Pulmonary arterial baroreceptors, activated by increased pulmonary arterial pressure and distension, could drive muscle sympathetic nerve activity (MSNA) in pulmonary hypertension (PH). We hypothesised that pulmonary arterial baroreceptor unloading using nebulised iloprost as a pulmonary arterial vasodilator would lower MSNA in clinically stable treated PAH and chronic thromboembolic PH (CTEPH) patients.Methods: In eleven PH patients (9 PAH, 2 CTEPH; 6 female; age 54 ± 14 years) common peroneal nerve microneurography was performed to record MSNA (n = 9) at baseline (10 min) and immediately following iloprost nebulisation (10 min). Concurrent measures of cardiorespiratory physiology and pulmonary haemodynamics (transthoracic echocardiography) were obtained.Results: Iloprost reduced systolic pulmonary artery pressure (50 ± 19 mmHg baseline vs. 44 ± 15 mmHg iloprost; p = 0.040), and increased right ventricular outflow tract acceleration time (RVOT AT; 99 ± 15 ms baseline vs. 117 ± 16 ms iloprost; p < 0.001). Although no overall change was seen in MSNA (p > 0.05), the magnitude of change in MSNA burst size was inversely associated with the increase in RVOT AT (R2 = 0.667, p = 0.0133).Conclusion: These findings provide evidence suggestive of possible pulmonary arterial baroreceptor influence of MSNA burst amplitude in some PH patients. Pulmonary arterial baroreceptor activation may be a contributory mechanism to adverse sympatho-excitation in PH.Clinical trial registration: ACTRN12622000494730.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"621-629"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107087","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

Predicting Postoperative Complications in Patients With Lung Cancer and Idiopathic Pulmonary Fibrosis. 预测肺癌和特发性肺纤维化患者术后并发症。

IF 7.2 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-02-17 DOI: 10.1002/resp.70227

Yunjoo Im, Man Pyo Chung, Hojoong Kim, Jong Sun Park, Myung Jin Song, Jin Woo Song, Bora Lee, Yong Soo Choi, Hong Kwan Kim, Jong Ho Cho, Seong Yong Park, Junghee Lee, Yeong Jeong Jeon, Kyunga Kim, Min-Ji Kim, Hongseok Yoo

{"title":"Predicting Postoperative Complications in Patients With Lung Cancer and Idiopathic Pulmonary Fibrosis.","authors":"Yunjoo Im, Man Pyo Chung, Hojoong Kim, Jong Sun Park, Myung Jin Song, Jin Woo Song, Bora Lee, Yong Soo Choi, Hong Kwan Kim, Jong Ho Cho, Seong Yong Park, Junghee Lee, Yeong Jeong Jeon, Kyunga Kim, Min-Ji Kim, Hongseok Yoo","doi":"10.1002/resp.70227","DOIUrl":"10.1002/resp.70227","url":null,"abstract":"Background and objective: Postoperative pulmonary complications are common and can be fatal in patients with IPF undergoing lung cancer surgery. This study aims to develop a novel scoring system for predicting postoperative pulmonary complications (PPCs) in patients with idiopathic pulmonary fibrosis (IPF) and non-small cell lung cancer (NSCLC) undergoing surgical resection and help establish optimal treatment strategies.Methods: We analysed data from 225 patients consisting of two cohorts who were diagnosed with IPF and who underwent curative resection for NSCLC. A scoring system was developed to predict postoperative pulmonary complications based on regression coefficients derived from a multivariable logistic regression model that included the following predictors: age, sex, diabetes, American Society of Anesthesiologists, diffusing capacity, and extent of surgery. Validation of the score was assessed through discrimination and calibration using a separate cohort of 51 patients.Results: Among the 276 patients analysed, 95 (34%) experienced postoperative pulmonary complications. The final model identified six predictors (with corresponding scores), resulting in a total score of 0-10 points: age ≥ 65 years (1 point), male (1 point), American Society of Anesthesiologists class ≥ 3 (1 point), diabetes (2 point), diffusing capacity ≤ 65% (2 point), and extent of surgery (3 points). The area under the curve for the scoring system was 0.75 (95% CI, 0.69-0.82) in the derivation cohort and 0.73 (95% CI, 0.57-0.88) in the validation cohort.Conclusions: This novel scoring system consisting of six easily accessible clinical variables may help predict postoperative pulmonary complications and guide treatment decisions.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"590-598"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213548","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

Thoracic Ultrasound as a Useful Adjunct to Examination of the Respiratory System. 胸部超声在呼吸系统检查中的辅助作用。

IF 6.3 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-05-01 DOI: 10.1002/resp.70260

Fifian Ka-Yan Chiang, Macy Mei-Sze Lui

引用次数: 0

Lower CLAD and Good Survival in Lung Transplant Recipients With Pneumoconiosis: A Spanish National Multicentre Case-Control Study. 肺移植受者肺尘肺低负荷和良好生存率：一项西班牙国家多中心病例对照研究

IF 7.2 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-02-11 DOI: 10.1002/resp.70224

Víctor Manuel Mora-Cuesta, Isabel Otero-González, Paula Barquero-Dueñas, Beatriz Montull-Veiga, Marta Erro-Iribarren, Estefanía Mira-Padilla, Rodrigo Alonso-Moralejo, Carlos Andrés Quezada-Loaiza, Sandra Dorado-Arenas, Cristina Martínez-González, Antonio León-Jiménez

{"title":"Lower CLAD and Good Survival in Lung Transplant Recipients With Pneumoconiosis: A Spanish National Multicentre Case-Control Study.","authors":"Víctor Manuel Mora-Cuesta, Isabel Otero-González, Paula Barquero-Dueñas, Beatriz Montull-Veiga, Marta Erro-Iribarren, Estefanía Mira-Padilla, Rodrigo Alonso-Moralejo, Carlos Andrés Quezada-Loaiza, Sandra Dorado-Arenas, Cristina Martínez-González, Antonio León-Jiménez","doi":"10.1002/resp.70224","DOIUrl":"10.1002/resp.70224","url":null,"abstract":"Background and objective: Pneumoconiosis are irreversible fibrosing pulmonary diseases resulting from the inhalation of inorganic dusts. Lung transplantation (LT) is an option in advanced stages, but evidence on outcomes-especially early postoperative outcomes-remains limited. This national multicentre study evaluates LT outcomes in pneumoconiosis patients, almost all with silicosis.Methods: A retrospective case-control study was conducted in 7 LT centres in Spain (2010-2023). A total of 81 LT cases due to pneumoconiosis (78 silicosis and 3 coal workers' pneumoconiosis) and 152 controls matched for age, sex, LT type, and LT date were included. Demographic, perioperative, and long-term follow-up variables were recorded. Postoperative complications, survival, and Chronic Lung Allograft Dysfunction (CLAD) were compared between groups.Results: Pneumoconiosis LT recipients (1.77% of LTs performed) had greater surgical complexity, but no differences in immediate postoperative complications, long-term survival, or reinterventions. However, they presented a lower incidence of CLAD (p = 0.007) and a higher proportion of restrictive allograft syndrome (RAS) (p = 0.015) compared to controls. Median survival was 9.1 years (95% CI 4.9-13.2) in the silicosis group and 7.9 years (95% CI 5.2-10.6) in controls (p = 0.839).Conclusion: LT in well-selected pneumoconiosis patients, predominantly with silicosis, is a viable alternative with outcomes comparable to other chronic lung diseases. Despite surgical complexity, no differences were identified in postoperative outcomes or survival. The lower CLAD incidence opens new research avenues on underlying immunopathogenic mechanisms.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"639-650"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166298","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

Breathomics Analysis for Early Diagnosis of Lung Cancer Based on PTR-TOF MS: A Large Sample Size Cross-Sectional Study. 基于PTR-TOF质谱的呼吸组学分析用于肺癌早期诊断：一项大样本横断面研究。

IF 7.2 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-02-15 DOI: 10.1002/resp.70223

Yan Huang, Wenwen Li, Hanlu Yue, Yanting Yang, Chenyu Tian, Yixiang Duan, Chen Huang, Qiang Pu, Shuai Yuan, Panwen Tian, Weimin Li

{"title":"Breathomics Analysis for Early Diagnosis of Lung Cancer Based on PTR-TOF MS: A Large Sample Size Cross-Sectional Study.","authors":"Yan Huang, Wenwen Li, Hanlu Yue, Yanting Yang, Chenyu Tian, Yixiang Duan, Chen Huang, Qiang Pu, Shuai Yuan, Panwen Tian, Weimin Li","doi":"10.1002/resp.70223","DOIUrl":"10.1002/resp.70223","url":null,"abstract":"Introduction: Lung cancer remains a leading cause of cancer mortality globally, emphasising the critical need for non-invasive and cost-effective early screening methods. Breath analysis, detecting disease-specific volatile organic compounds (VOCs), presents a promising diagnostic avenue.Methods: This cross-sectional study enrolled 4515 participants, including 4099 nonmalignant controls and 416 lung cancer patients. Exhaled breath samples were analysed using proton transfer reaction time-of-flight mass spectrometry (PTR-TOF MS). Machine learning algorithms, particularly Light Gradient Boosting Machine (LGBM), were employed to construct classification models for distinguishing lung cancer from healthy controls and early-stage lung cancer from benign pulmonary nodules. Model interpretability was assessed using SHAP values.Results: The LGBM model demonstrated superior performance, achieving 95% sensitivity, 98% specificity, and 98% accuracy for discriminating lung cancer from healthy controls. For the clinically challenging task of distinguishing early-stage lung cancer from benign nodules, LGBM achieved 97% sensitivity, 98% specificity, and 98% accuracy. SHAP analysis identified alpha-pinene (m/z 137) and methyl methacrylate (m/z 101) as the most significant VOCs.Conclusion: This large-scale study validates PTR-TOF MS based breath analysis combined with machine learning as a robust, non-invasive tool for early lung cancer detection. The LGBM model, supported by SHAP interpretability, offers high diagnostic accuracy in large cohorts. Future work will expand to diverse histological subtypes and multicenter validation.Trial registration: ChiCTR2500101879.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"610-620"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202559","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

Novel Therapeutics for Chronic Obstructive Pulmonary Disease: From Empirical Bronchodilation to Precision Medicine. 慢性阻塞性肺疾病的新疗法：从经验性支气管扩张到精准医学。

IF 7.2 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-03-25 DOI: 10.1002/resp.70244

Naoya Fujino, Hisatoshi Sugiura

{"title":"Novel Therapeutics for Chronic Obstructive Pulmonary Disease: From Empirical Bronchodilation to Precision Medicine.","authors":"Naoya Fujino, Hisatoshi Sugiura","doi":"10.1002/resp.70244","DOIUrl":"10.1002/resp.70244","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) remains the third leading cause of death worldwide, and conventional bronchodilator-based therapies have limited efficacy in preventing exacerbations and disease progression. The 2024-2026 period represents a historic inflection point: three mechanistically distinct agents received Food and Drug Administration approval, marking the first substantive pharmacological innovation in over two decades and catalyzing a fundamental paradigm shift from empirical symptom management towards biomarker-driven, pathobiology-aligned precision medicine. In this comprehensive review, we synthesized emerging evidence on novel COPD therapeutics, encompassing dual phosphodiesterase-3/4 inhibitors, biologics targeting type 2 inflammatory pathways (interleukin [IL]-4/IL-13 and IL-5 axes), upstream alarmin antagonists (IL-33 and thymic stromal lymphopoietin), and emerging technologies including gene editing and senolytic therapy. We evaluated randomized controlled trials reporting reductions in exacerbations with biologic therapy in eosinophil-enriched populations. Central to this transformation is the \"treatable traits\" framework, in which COPD management shifts from categorical diagnosis towards identification and targeting of specific, modifiable pathobiological characteristics. We provide respiratory physicians with evidence-based guidance for treatment selection by leveraging validated biomarkers, discussing pharmacoeconomic considerations and implementation barriers in resource-limited settings, and identifying critical knowledge gaps requiring resolution. The convergence of biologics, small molecules, and emerging technologies positions COPD therapeutics at the threshold of disease modification.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"561-577"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513906","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

Letter from the Singapore Thoracic Society: Vapours, Vapes, and Vaccines-Advancing Population Lung Health in Singapore. 来自新加坡的信：蒸汽、电子烟和疫苗——促进新加坡人口肺部健康。

IF 6.3 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-04-17 DOI: 10.1002/resp.70249

Jeffrey Shuen Kai Ng, Shera Tan, Sean Chee Hong Loh

引用次数: 0

Characterising Patient Pathways Prior to the Diagnosis of Interstitial Lung Disease. 间质性肺疾病诊断前的患者通路特征

IF 7.2 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-03-11 DOI: 10.1002/resp.70230

Caitlin C Fermoyle, John Townend, Vidya Navaratnam, Nicole Goh, Francesca Gonnelli, Neva Eleangovan, Ursie Smith, Heath Heatley, Victoria Carter, David B Price, Richard Hubbard, Tamera J Corte

{"title":"Characterising Patient Pathways Prior to the Diagnosis of Interstitial Lung Disease.","authors":"Caitlin C Fermoyle, John Townend, Vidya Navaratnam, Nicole Goh, Francesca Gonnelli, Neva Eleangovan, Ursie Smith, Heath Heatley, Victoria Carter, David B Price, Richard Hubbard, Tamera J Corte","doi":"10.1002/resp.70230","DOIUrl":"10.1002/resp.70230","url":null,"abstract":"Background and objective: Interstitial lung diseases (ILDs) lead to breathlessness, cough, deteriorating quality of life and early death. Patients are typically diagnosed late in their disease course when existing lung damage cannot be reversed. Accordingly, early diagnosis is the best strategy for preserving lung function and extending lifespan. Our aim was to identify signs, symptoms and health patterns and determine when they arise in the years preceding ILD diagnosis.Methods: We identified incident ILD cases from a large primary care electronic medical record database from the United Kingdom. Prevalence and timing of symptoms, signs and health patterns were compared to matched controls in the 10 years preceding diagnosis.Results: ILD patients (N = 18,914) had symptoms of dyspnoea, cough, fatigue, weight loss and loss of appetite recorded more frequently compared to controls (N = 60,156). Most patients (73%) reported cough or dyspnoea at least once at a primary care visit, with 13%-17% recording symptoms on ≥ 5 separate occasions (dyspnoea: 13% cases, 5% controls; cough: 17% cases, 7% controls). ILD patients had a greater cumulative incidence of cough and dyspnoea even 10 years before diagnosis (OR: 1.73 [1.58, 1.89], p < 0.001), with the odds ratio increasing to 2.38 at 1 year before diagnosis. Most ILD patients were initially diagnosed with another respiratory condition (95%-97%) or heart failure (4%-9%).Conclusion: Gradual onset of non-specific symptoms over 10 years, coupled with referrals to other specialities and misdiagnoses, delays ILD diagnosis. Improving awareness of ILD among primary care practitioners may shorten the time to diagnosis and expedite access to treatments.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"599-609"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435136","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

Overcoming Missed Opportunities and Diagnostic Delay in Interstitial Lung Disease. 克服错过的机会和诊断延迟间质性肺疾病。

IF 6.3 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-05-05 DOI: 10.1002/resp.70258

Gin Tsen Chai

引用次数: 0

Epigenetic Scarring and a Vulnerable Mucus-Barrier Axis in Ex-Smokers With COPD. 慢性阻塞性肺病戒烟者的表观遗传瘢痕和脆弱的黏液屏障轴。

IF 6.3 2区医学

Respirology Pub Date : 2026-05-01 Epub Date: 2026-03-10 DOI: 10.1002/resp.70231

Mitsuo Sato

引用次数: 0