Respirology最新文献

{"title":"From Categories to Continua: Rethinking Usual Interstitial Pneumonia on HRCT.","authors":"Jonathan D Dodd","doi":"10.1002/resp.70225","DOIUrl":"10.1002/resp.70225","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"431-433"},"PeriodicalIF":6.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220908","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}

{"title":"Epigenetic Dysregulation of the NKX2-1/SPDEF Axis Drives Persistent Goblet Cell Differentiation and Epithelial Barrier Dysfunction in Chronic Obstructive Pulmonary Disease.","authors":"Ayaka Shiota, Keiko Kan-O, Yumiko Ishii, Tomoaki Koga, Takeshi Sawada, Kei-Ichiro Yasunaga, Shingo Usuki, Tatsuya Katsuno, Shigesato Inoue, Tomohiro Ogawa, Akihiro Jo, Satoru Fukuyama, Mitsuyoshi Nakao, Hiroaki Ogata, Mizuho A Kido, Sachiko Tsukita, Koichiro Matsumoto, Isamu Okamoto","doi":"10.1002/resp.70201","DOIUrl":"10.1002/resp.70201","url":null,"abstract":"<p><strong>Background and objective: </strong>Despite improved respiratory symptoms after smoking cessation, patients with chronic obstructive pulmonary disease (COPD) remain susceptible to exacerbations and persistent airway inflammation, wherein the underlying mechanisms for sustained inflammation remain unclear. To address this knowledge gap, we investigated the persistence of airway epithelial barrier dysfunction in ex-smokers with COPD and examined the relationship between goblet cell hyperplasia and barrier dysfunction.</p><p><strong>Methods: </strong>We analysed differentiated primary bronchial epithelial cells from never smokers with normal lung function, ex-smokers (> 10-year cessation), and current smokers with COPD using RNA sequencing, ATAC sequencing, and single-cell analyses to examine barrier function and cell differentiation.</p><p><strong>Results: </strong>Genes associated with ciliary formation and motility were progressively downregulated from never smokers to ex-smokers to current smokers with COPD. The expression of junction-associated molecules was decreased in both ex-smokers and current smokers, showing a significant inverse correlation with the proportion of MUC5AC-positive cells. Single-cell analyses revealed distinct alterations in cell differentiation trajectories, particularly persistent goblet cell hyperplasia associated with increased expression of the transcription factor SPDEF, linked to epigenetic changes in the NKX2-1 gene regulatory regions.</p><p><strong>Conclusion: </strong>Epigenetic mechanisms maintain persistent alterations in airway epithelial differentiation after smoking cessation, leading to mucus-producing cell hyperplasia through dysregulation of the NKX2-1/SPDEF axis. This hyperplasia correlates with reduced junction-associated molecule expression and subsequent barrier dysfunction. Therapeutic strategies targeting epithelial barrier restoration and/or normalisation of epigenetic dysregulation may benefit patients with COPD, even after smoking cessation.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"484-497"},"PeriodicalIF":6.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Brompton Breathing Pattern Assessment Tool (BPAT): A Journey to Identify the Unknown, a Decade on….","authors":"James H Hull, Lizzie Grillo","doi":"10.1002/resp.70245","DOIUrl":"10.1002/resp.70245","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"439-442"},"PeriodicalIF":6.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transplantation of Ex Vivo Amplified Mononuclear Cells From Peripheral Blood Improves Rat Pulmonary Hypertension via CD14- and CD163-Positive M2 Macrophages.","authors":"Yoshifumi Suzuki, Tetsutaro Nagaoka, Yuichi Nagata, Yuriko Terayama, Takashi Yoshida, Takeo Tsutsumi, Sachiko Kuriyama, Yujin Nishioka, Goh Murayama, Rie Ito-Hirano, Rica Tanaka, Kazuhisa Takahashi","doi":"10.1002/resp.70206","DOIUrl":"10.1002/resp.70206","url":null,"abstract":"<p><strong>Background and objective: </strong>The progression of pulmonary arterial hypertension (PAH) is associated with pulmonary artery (PA) remodelling by M2 macrophages through excessive tissue repair, although some M2 macrophages have a vascular protective role. A quality and quantity culture method (MNC-QQc) increases the number of M2 macrophages in mononuclear cells (MNCs) from peripheral blood. Several studies demonstrate that MNC-QQc has vascular protective effects in ischemic lesions. This study aimed to investigate whether MNC-QQc transplantation ameliorates PAH development in a rat model.</p><p><strong>Methods: </strong>MNC-QQc extracted from GFP positive donor rats were administered into recipient rats with PAH via the cervical vein. Pulmonary haemodynamics and PA remodelling were assessed. Immunohistochemistry and flow cytometry analysis were performed to identify the donor-derived MNC-QQc cell types in the lungs. The effects of MNC-QQc on the functions of vascular constituent cells were evaluated, and gene expression related to the pathological abnormalities in PA was assessed using microarray analysis.</p><p><strong>Results: </strong>MNC-QQc transplantation reversed the PAH-induced pulmonary haemodynamics and PA remodelling. GFP-positive MNC-QQc cells, predominantly CD14-positive M2 macrophages, were found around the recipient's PAs. The therapeutic effect was reduced in MNC-QQc without M2 cells. MNC-QQc also enhanced angiogenesis in pulmonary endothelial cells. Microarray analysis of the lung tissue showed that MNC-QQc decreased the expression of Tachykinin Receptor 1, associated with PAH progression, with this reduction linked to CD14- and CD163-positive M2 macrophages.</p><p><strong>Conclusions: </strong>These findings suggest that MNC-QQc, particularly through CD14- and CD163-positive M2 macrophages, could be a novel treatment for PAH.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"530-540"},"PeriodicalIF":6.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119844","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}

{"title":"Stronger Muscles, Healthier Bones: A Case for Secondary Prevention in Bronchiectasis?","authors":"Anne E Holland, Annemarie L Lee","doi":"10.1002/resp.70232","DOIUrl":"10.1002/resp.70232","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"426-427"},"PeriodicalIF":6.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378436","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}

{"title":"Diagnostic Accuracy of Cough Frequency Monitors: A Systematic Review and Meta-Analysis.","authors":"Ana Lara Castro Rodrigues, Larisse Sousa Reis Passafaro, Daniele Oliveira Dos Santos, Marcos Gontijo da Silva, Noé Mitterhofer Eiterer Ponce de Leon da Costa, Janne Marques Silveira, Arietta Spinou, Ada Clarice Gastaldi","doi":"10.1002/resp.70229","DOIUrl":"10.1002/resp.70229","url":null,"abstract":"<p><strong>Background and objective: </strong>International guidelines emphasise the importance of objective cough assessment for evaluating therapeutic efficacy. Cough negatively impacts quality of life and generates high costs for healthcare systems. However, the accuracy of cough frequency monitors remains unclear. This study aimed to identify tools developed to monitor cough frequency and evaluate their accuracy.</p><p><strong>Methods: </strong>Observational studies involving adults, children, or infants who used cough frequency monitors were included from the Pubmed/MEDLINE, EMBASE, and Web of Science databases published up to 24 November 2024. Two independent reviewers performed the screening, data extraction, and quality assessment of the studies using QUADAS-2. Summary estimates of diagnostic accuracy were calculated with meta-analysis using bivariate mixed effects regression.</p><p><strong>Results: </strong>Nineteen studies were included in the review. In the 16 studies included in the meta-analysis with 52,612 events, sensitivity was 89% (95% CI 0.84-0.93, I ² 89.3%) and specificity was 99% (95% CI 0.98-1.00, I ² 88.2%). The area under the curve (AUC) of 0.96 indicated excellent discriminative capacity. In the 11 devices and 4 applications identified, individual accuracy was > 0.9.</p><p><strong>Conclusion: </strong>The tools are accurate in distinguishing between cough and non-cough sounds, but their clinical application still presents technical challenges and requires investment. Future research should improve the monitors, maintaining high accuracy but allowing for agile, cost-effective assessment.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"459-470"},"PeriodicalIF":6.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Likelihood of Usual Interstitial Pneumonia: A Novel Approach to Prognosis for Pulmonary Fibrosis.","authors":"John A Mackintosh, Simon L F Walsh, Mario Silva, Lucio Calandriello, Stephen M Humphries, David A Lynch, Helen E Jo, Ian Glaspole, Christopher Grainge, Nicole Goh, Peter M A Hopkins, Yuben Moodley, Paul N Reynolds, Christopher Zappala, Gregory Keir, Wendy A Cooper, Annabelle M Mahar, Samantha Ellis, Athol U Wells, Tamera J Corte","doi":"10.1002/resp.70196","DOIUrl":"10.1002/resp.70196","url":null,"abstract":"<p><strong>Background and objectives: </strong>In fibrotic lung disease, radiological features of usual interstitial pneumonia (UIP) are associated with adverse outcomes. The aim of this study was to evaluate the likelihood of definite UIP on HRCT as a determinant of outcome in patients with pulmonary fibrosis.</p><p><strong>Methods: </strong>All available HRCT from the Australian IPF Registry (AIPFR) were retrospectively reviewed by two radiologists. The radiologists were asked to assign a likelihood (%) within each of the four ATS/ERS/JRS/ALAT 2018 UIP categories, summating to 100%, enabling them to not be constrained by a single UIP category (e.g., 5% definite UIP, 95% alternative to UIP). Likelihood of UIP was defined as the percentage likelihood score for the definite UIP category. Semi-quantitative features were also estimated. Cox proportional hazards regression was performed to evaluate the prognostic utility of the likelihood scores.</p><p><strong>Results: </strong>HRCT was available for analysis in 515 patients. Median follow-up of the cohort was 4.1 years (IQR 2.0-6.2 years). Median total ILD extent was 30% (IQR20-45%), with traction bronchiectasis and honeycombing present in 96.3% and 45.4% of cases respectively, and all three variables were associated with worse transplant-free survival. A pattern of definite or probable UIP was favoured in 26.4% and 32.4% of cases respectively. Likelihood of definite UIP was independently associated with both reduced transplant-free survival (HR1.12, 95% CI 1.04-1.20; p = 0.002) and 12-month progression (HR1.19, 95% CI 1.04-1.35; p = 0.009) and was superior to the ATS/ERS/JRS/ALAT 2018 guideline-based categories for these associations.</p><p><strong>Conclusions: </strong>We demonstrate that estimation of the likelihood of definite UIP is strongly associated with transplant-free survival and 12-month disease progression.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"521-529"},"PeriodicalIF":6.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934767","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}

{"title":"Body Composition and Muscle Function in Bronchiectasis: A Comparative Longitudinal Study.","authors":"Joice Mara de Oliveira, Amber Smith, Paola D Urroz Guerrero, Laura Cordova Rivera, Dennis Thomas, Vanessa L Clark, Peter G Gibson, Vanessa M McDonald","doi":"10.1002/resp.70202","DOIUrl":"10.1002/resp.70202","url":null,"abstract":"<p><strong>Background and objective: </strong>Adults with bronchiectasis often present with altered body composition and muscle strength, yet prognostic value of peripheral muscle strength are not well understood. This study compared body composition and muscle function between adults with bronchiectasis and healthy controls and examined whether peripheral muscle strength estimates one-year clinical outcomes.</p><p><strong>Methods: </strong>Adults with HRCT-confirmed bronchiectasis and controls underwent assessments including DXA (body composition), dynamometry (leg and shoulder strength), and core endurance tests. Participants with bronchiectasis were classified as having retained or impaired leg strength based on the 10^th percentile of control values and were reassessed after one year for exacerbations, dyspnoea, quality of life, anxiety and depression, and exercise capacity.</p><p><strong>Results: </strong>Seventy-one participants with bronchiectasis and 92 controls were included; 43 bronchiectasis participants completed follow-up. Females with bronchiectasis had lower appendicular muscle index (p = 0.018) and both sexes had lower bone mineral density compared to their control counterparts (p < 0.001). Osteopenia was 3 times more prevalent in females with bronchiectasis compared to their counterparts (54% versus 18%). Females with bronchiectasis have poorer lateral core endurance than those without (p ≤ 0.003). Leg strength was reduced in bronchiectasis compared to controls, regardless of sex (mean difference [95% CI] for males -25 [-50; -1] Kg and females -18 [-29; -7] Kg). Reduced leg strength is associated with worse dyspnoea, health related quality of life, and functional capacity over one year, explaining up to 33% of the variance (p ≤ 0.001).</p><p><strong>Conclusion: </strong>Individuals with bronchiectasis exhibit impaired muscle function and bone health, with leg strength showing a significant association with clinical outcomes over one year.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"471-483"},"PeriodicalIF":6.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal PM₂ _.5 Exposure and Airway Mechanics in Taiwanese Schoolchildren: Identifying Critical Windows of Susceptibility.","authors":"Hsin-Yi Huang, Hui-Ju Tsai, Chih-Da Wu, Yinq-Rong Chern, Shen-Hao Lai, Chi-Yen Hung, Chia-Hua Ho, Nai-Chia Fan, Yu-Lun Tseng, Wen-Chi Pan, Tsung-Chieh Yao","doi":"10.1002/resp.70253","DOIUrl":"https://doi.org/10.1002/resp.70253","url":null,"abstract":"<p><strong>Background and objective: </strong>Exposure to ambient particulate matter ≤2.5 μm (PM_2.5) is associated with lung function impairment, particularly in children. However, the impact of prenatal PM_2.5 exposure on childhood airway mechanics remains unclear. We aimed to assess associations between prenatal PM_2.5 exposure and airway mechanics in school-age children.</p><p><strong>Methods: </strong>Data from 1324 singleton children (745 boys, 56.3%; mean age, 6.5 years) participating in a population-based cohort in Taiwan were analysed. Prenatal ambient PM_2.5 exposure near residence was estimated using hybrid kriging-land use regression models with an XGBoost algorithm. Airway mechanics were measured by impulse oscillometry.</p><p><strong>Results: </strong>Each 10 μg/m³ increase in prenatal PM_2.5 exposure across the entire pregnancy was associated with higher total airway resistance (R₅: β, 0.67; 95% CI, 0.30-1.03), proximal airway resistance (R₂₀: β, 0.37; 95% CI, 0.12-0.62), peripheral airway resistance (R₅-R₂₀: β, 0.30; 95% CI, 0.05-0.55), and airway impedance (Z₅) (β, 0.58; 95% CI, 0.21-0.94). Distributed lag nonlinear models identified sensitive windows during late pregnancy: 30-34 gestational weeks for R₅, 30-34 gestational weeks for Z₅, and at 26-33 gestational weeks for AX, respectively. Stratified analyses indicated stronger associations in girls, children exposed to prenatal environmental tobacco smoke, and those not breastfed.</p><p><strong>Conclusion: </strong>Higher prenatal PM_2.5 exposure, particularly during late pregnancy, may be associated with adverse changes in airway mechanics in school-age children, especially girls, children exposed to prenatal environmental tobacco smoke, and those not breastfed, highlighting the importance of minimizing PM_2.5 exposure during late pregnancy to protect long-term respiratory health.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779750","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}

{"title":"From Residency to Tissue Inflammatory Memory: HLF as a Transcriptional Gatekeeper of CD4⁺ Tissue-Resident Memory T Cells.","authors":"Masahiro Nemoto, Masahiro Kiuchi, Kiyoshi Hirahara","doi":"10.1002/resp.70257","DOIUrl":"https://doi.org/10.1002/resp.70257","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779622","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}