Respirology最新文献

{"title":"Hypoglycaemic Agents and Risk of Exacerbations in Patients With Chronic Obstructive Pulmonary Disease.","authors":"Mario Cazzola, Maria Gabriella Matera","doi":"10.1002/resp.70293","DOIUrl":"10.1002/resp.70293","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"955-958"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607014","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":"Same Diagnosis, Different Disease: Why Sex Matters in Lung Cancer.","authors":"Tracy L Leong, Asha Bonney","doi":"10.1002/resp.70289","DOIUrl":"10.1002/resp.70289","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"951-954"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621439","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":"Pulmonary Alveolar Proteinosis in Greece-Türkiye-Cyprus: Answers in a Real-Life Comparison.","authors":"Spyros A Papiris, Efsun Gonca Uğur Chousein, Maria Kallieri, Nesrin Mogulkoc, Andriana I Papaioannou, Frangiskos Frangopoulos, Tonia Adamide, Lykourgos Kolilekas, Burak Gökçe, Nesrin Ocal, Despina Papakosta, Berna Akıncı Özyürek, Vasilios Tzilas, Enver Yalnız, Georgia Kontonasiou, Ezgi Demirdöğen, Emmanouil Verykakis, Ahmet Ursavaş, Elvira-Markela Antonogiannaki, Pelin Pınar Deniz, Vasiliki Apollonatou, Ismail Hanta, Dimitrios Chatzis, Anastasia Levounets, Nicoletta Olympiou, Kalliopi Vandorou, Ilias Dimeas, Zoe Daniil, Nikolaos Roussakis, Andrea Schams, Delphine Monnier, Christina Rampiadou, Paschalis Steiropoulos, Katerina Markopoulou, Nikolaos Tzanakis, Konstantinos Gourgoulianis, Spyridon Prountzos, Demosthenes Bouros, Brenna Carey, Bruce Trapnell, Matthias Griese, Erdoğan Çetinkaya, Effrosyni D Manali","doi":"10.1002/resp.70288","DOIUrl":"10.1002/resp.70288","url":null,"abstract":"<p><strong>Background and objective: </strong>Pulmonary alveolar proteinosis (PAP) is a rare disease of inappropriate alveolar surfactant accumulation. The study objective was to compare Greece-Türkiye-Cyprus cohorts, followed-up for 20 years.</p><p><strong>Methods: </strong>Data were retrieved retrospectively by chart review.</p><p><strong>Results: </strong>One hundred and thirty patients, Greece 39, Türkiye 87, Cyprus 4, were included; 115 (89%) autoimmune (a)PAP, 13 (10%) secondary, 1 (1%) hereditary. Abnormal anti-GM-CSF antibody titre was available in 86/115 patients, further analyzed for aPAP. Forty (46%) were male, with median (IQR) age at diagnosis of 40 (31-50) years. At median (IQR) duration of clinical follow-up of 39 (18-78) months, three patients died. Non-survivors had higher rates of cardiovascular disease [67% vs. 5%, p < 0.001], LTOT (67% vs. 13%, p = 0.001), pulmonary fibrosis [67% vs. 5%] and worse functional status at follow-up [FVC% pred 49 (29) vs. 87 (74-97); p = 0.026, DLCO% pred 21 (46) vs. 72 (58-82); p = 0.016]. aPAP patients were stratified by therapy group (no WLL-no i-GM-CSF, WLL alone, i-GMCSF alone and both WLL and iGM-CSF). WLL was more frequently performed in Türkiye and i-GMCSF alone in Greece (p = 0.006). All therapies were effective. No difference was detected on outcome when sole iGM-CSF was compared to WLL alone or in combination with iGM-CSF [deceased/alive 0%/100% vs. 7%/93%, p = 0.491]. Sole iGM-CSF significantly ameliorated clinical and functional parameters of disease severity [DLCO% (p = 0.013), SatO₂ (p = 0.002), 6MWT (p = 0.026)]. Across all therapy groups, pulmonary fibrosis eliminated beneficial response to treatment.</p><p><strong>Conclusion: </strong>This first real-life comparison of aPAP cohorts originating from three countries showed the non-inferiority of sole iGM-CSF treatment. Fibrosis negatively affects response to treatment and survival.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"1014-1028"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456622","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":"Recommendations From the Medical Education Editor.","authors":"Mark Lavercombe","doi":"10.1002/resp.70311","DOIUrl":"10.1002/resp.70311","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"948-950"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913206","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":"Role of Lung Marking in the Age of Sublobar Resection.","authors":"Muhammad Sajawal Ali, Nasser Altorki, Ali Musani, Uzair Ghori, Hasnain Bawaadam","doi":"10.1002/resp.70301","DOIUrl":"10.1002/resp.70301","url":null,"abstract":"<p><p>In light of recent clinical trials, we are witnessing a paradigm shift towards lung parenchyma-preserving, sublobar resection for early-stage lung cancers. When performing sublobar resection via thoracoscopy, sometimes locating the lesion can be challenging. Thoracoscopy does not provide the same exposure and tactile feedback as open thoracotomy; as a result, detecting subsolid, small, and deep lesions can be difficult for the thoracic surgeon. This problem can be obviated by preprocedural marking of lesions. Various CT-guided transthoracic and bronchoscopic techniques have been reported. Transthoracic techniques include injecting dye into the lesions and placing fiducials and hook wires. Although these procedures are widely performed, complications, such as pneumothorax, air embolism, dye dissipation and extravasation, and hook-wire dislodgement have been reported. Conventional bronchoscopy can be used in conjunction with real-time 3-dimensional imaging for transbronchial marking of pulmonary lesions. However, given the limitations of conventional bronchoscopy, navigating to peripheral lesions can be tough. Robotic bronchoscopy, with or without real-time 3-dimensional imaging, is a safe and accurate modality for marking pulmonary lesions. Robotic bronchoscopy can be used to perform dye injection into the lesion, potentially in the same setting as the resection. Robotic bronchoscopy can also be used to bronchoscopically deploy dye-soaked coils. Robotic bronchoscopy may not be widely available and may have a learning curve. Ultimately, the choice of lung marking modality depends on available resources, institutional expertise, and the specific advantages and disadvantages of each modality.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"983-992"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797198","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":"Bridging the Gap: High Flow Nasal Oxygen to Aid Early Home-Based Pulmonary Rehabilitation Following Hospitalisation in Lung Disease.","authors":"Collette Menadue, Amanda Piper","doi":"10.1002/resp.70295","DOIUrl":"10.1002/resp.70295","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"944-945"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913269","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":"Targeting EGFR-Mutant Non-Small Cell Lung Cancer in Asia: An Update on Monotherapy and Combination Therapy With EGFR Inhibitors.","authors":"Noriaki Sunaga, Yoshinori Hasegawa, Mitsuo Sato","doi":"10.1002/resp.70315","DOIUrl":"10.1002/resp.70315","url":null,"abstract":"<p><p>EGFR-mutant lung cancer represents a major subtype of non-small cell lung cancer in Asia, with particularly high prevalence in never-smokers, women, and patients with adenocarcinoma histology. Although this clinicopathologic enrichment has been recognized for more than two decades, the mechanisms underlying the excess frequency of EGFR-mutant disease in Asian populations remain only partially understood. Accumulating evidence suggests a multifactorial basis involving host genetic susceptibility and diversity, endogenous mutational processes and exogenous exposures such as ambient particulate matter. In particular, recent genomic and experimental studies support a tumour-promotion framework in which inflammatory microenvironmental cues may facilitate the outgrowth of pre-existing oncogenic clones, while mutational signatures provide genomic footprints of these processes. In parallel, the treatment landscape for EGFR-mutant non-small cell lung cancer has evolved substantially with successive generations of EGFR tyrosine kinase inhibitors (EGFR-TKIs), leading to marked improvements in survival. However, acquired resistance remains inevitable in most patients with advanced disease and is driven by both genetic and non-genetic mechanisms, including secondary EGFR alterations, bypass pathway activation, TP53-associated genomic instability, adaptive mutagenesis, and drug-tolerant persister states. These insights have provided a strong rationale for combination strategies beyond EGFR-TKI monotherapy. In this review, we summarize current understanding of the epidemiology and biological basis of EGFR-mutant lung cancer in Asia and discuss the preclinical rationale and emerging clinical evidence supporting combination approaches with chemotherapy, anti-angiogenic agents, and EGFR/MET-directed therapies.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"959-973"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983568","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":"Biomarkers of Pre-COPD Lung Function Trajectories in Middle Age: A Prospective Study From 1st to 6th Decade.","authors":"Dinh S Bui, Don Vicendese, Jonathan Pham, Nur Sabrina Idrose, Adrian Lowe, Caroline Lodge, Raisa Cassim, Chamara Senaratna, Gayan Bowatte, Garun Hamilton, Alan James, Paul Thomas, Richard Wood-Baker, Peter Frith, Gary Anderson, Philip M Hansbro, Graeme Zosky, George Washko, Michael J Abramson, Rosa Faner, Alvar Agusti, Jennifer Perret, E Haydn Walters, Shyamali C Dharmage","doi":"10.1002/resp.70279","DOIUrl":"10.1002/resp.70279","url":null,"abstract":"<p><strong>Background and objective: </strong>Identifying impaired lifetime lung function trajectories and their underlying biological pathways is key to characterising the preclinical phase of COPD (Pre-COPD) and its progression. However, this is challenging in practice as repeated spirometry measurements from childhood are rarely available. We investigated potential blood biomarkers associated with pre-COPD trajectories.</p><p><strong>Methods: </strong>The Tasmanian Longitudinal Health Study has unique lung function data from 7 to 53 years, from which lifetime FEV₁/FVC trajectories were modelled (n = 2442). Serum levels of CC16, sRAGE, CRP, ECP, SPD, fibrinogen and a range of cytokines were quantified at 53 years of age. These were related to respective FEV₁/FVC trajectories. Classification And Regression Tree (CART) analysis was used to investigate biomarker combinations in relation to the distribution of pre-COPD FEV₁/FVC trajectories.</p><p><strong>Results: </strong>Among six FEV₁/FVC trajectories, three trajectories at increased risk of COPD (pre-COPD trajectories) were 'Early Low-Rapid Decline', 'Early Normal-Rapid Decline' and 'Early Low-Normal Decline'. CC16, sRAGE, SPD, IL-17A, IL-5 and IL-10 differed significantly between these three pre-COPD and the normal trajectory. Notably, within the pre-COPD trajectories, these biomarkers also differentiated two rapid decline trajectories from the relatively stable one. CART analysis identified different combinations of biomarkers that distinguish different pre-COPD trajectories.</p><p><strong>Conclusion: </strong>This is the first study to show that established COPD biomarkers are already active during the pre-COPD phase and could distinguish pre-COPD lung function trajectories. Biomarkers, particularly together with clinical history, may have the potential to identify those at risk and optimise management of both Pre-COPD and COPD.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"993-1002"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437677","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":"Frailty, Chronological Age, and Clinical Outcomes in COPD: A Nationwide Cohort Study.","authors":"Taeyun Kim, Hyunsoo Kim, Seoyoung Choi, Sun Hye Shin, Eunji Jeong, Chaiyoung Lee, Juhee Cho, Danbee Kang, Hye Yun Park","doi":"10.1002/resp.70324","DOIUrl":"https://doi.org/10.1002/resp.70324","url":null,"abstract":"<p><strong>Background and objectives: </strong>Frailty and chronological age are major prognostic factors in chronic obstructive pulmonary disease (COPD), yet their combined effects have not been fully examined in large population-based cohorts. We investigated whether low frailty attenuates the adverse impact of aging on COPD outcomes.</p><p><strong>Methods: </strong>We conducted a nationwide retrospective cohort study using the Korean National Health Insurance Service database. Patients aged ≥ 40 years diagnosed with COPD between 2010 and 2021 were included. Frailty was assessed using a claims-based frailty index and categorized as low, intermediate, or high. The primary outcome was all-cause mortality, and the secondary outcome was severe exacerbation. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs).</p><p><strong>Results: </strong>Among 1,505,638 patients with COPD, 784,962 were aged < 70 years and 720,676 were aged ≥ 70 years. Over a median follow-up of 7.0 years (interquartile range, 3.0-10.3), 500,097 deaths and 169,102 severe exacerbations occurred. Compared with older patients (≥ 70 years) with low frailty, intermediate frailty was associated with higher mortality risk in both younger (HR 1.19; 95% CI 1.17-1.21) and older patients (HR 1.21; 95% CI 1.20-1.21). High frailty showed highest risk (HR 2.66; 95% CI 2.54-2.78 in < 70 years; HR 1.90; 95% CI 1.87-1.93 in ≥ 70 years). Similar graded associations were observed for severe exacerbations.</p><p><strong>Conclusion: </strong>In patients with COPD, frailty risk provided prognostic information beyond chronological age, highlighting the importance of biological vulnerability in determining outcomes in COPD.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114329","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":"Prediction of Total Lung Capacity and Residual Volume Eligibilities for Endobronchial Valve Treatment Using Measurements by the Helium Dilution Technique, CT-Based Lung Volume Analysis, and Spirometry.","authors":"Daisuke Kinose, Yasutaka Nakano, Masamichi Mineshita","doi":"10.1002/resp.70321","DOIUrl":"https://doi.org/10.1002/resp.70321","url":null,"abstract":"<p><strong>Background and objective: </strong>Endobronchial valve (EBV) placement reduces hyperinflation in patients with severe COPD. Eligibility criteria of EBV include total lung capacity (TLC_pleth) ≥ 100% and residual volume (RV_pleth) ≥ 175% by body plethysmography. In this study, we evaluated the performance of alternative modalities for predicting EBV criteria in clinical settings where body plethysmography is unavailable.</p><p><strong>Methods: </strong>This is a single centre observational study. We recruited 41 patients with COPD at St. Marianna University Hospital. The participants underwent spirometry for VC, FVC, and FEV₁, body plethysmography for TLC_pleth and RV_pleth, and the helium dilution technique for TLC_He and RV_He as well as CT scanning at full inspiration and expiration to calculate air volume (AV) and total lung volume (TLV), which includes both air and tissue volumes. We also estimated TLV_pleth and RV_pleth by using previously proposed formulas from the University of Groningen (TLC_Groningen and RV_Groningen) and from the University of Pittsburgh (RV_Pittsburgh).</p><p><strong>Results: </strong>The alternative measurements, that is, TLC_He, AV_{inspiratory CT}, TLV_{inspiratory CT}, TLC_Groningen, RV_He, AV_{inspiratory CT} - VC, AV_{expiratory CT}, TLV_{inspiratory CT} - VC, TLV_{expiratory CT}, RV_Groningen, and RV_Pittsburgh, correlated well with TLC_pleth and RV_pleth. Receiver operating characteristic analysis to predict TLC_pleth ≥ 100%, RV_pleth ≥ 175%, or RV_pleth ≥ 150% by these alternatives yielded high area under the curve (AUC) values around 0.924-0.937. We also determined the threshold values for sensitivity = 100% (Rule-out threshold) and specificity = 100% (Rule-in threshold) to predict TLC_pleth ≥ 100%, RV_pleth ≥ 175%, or RV_pleth ≥ 150%.</p><p><strong>Conclusion: </strong>Our findings indicate that, when body plethysmography is not feasible, these measurements may help identify patients likely or unlikely to meet plethysmography-defined EBV eligibility criteria.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114400","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}