Respirology最新文献

{"title":"Respiratory Muscle Strength as a Predictor of Exacerbations in Patients With Chronic Obstructive Pulmonary Disease.","authors":"Yuichiro Furukawa, Atsushi Miyamoto, Kazuhisa Asai, Masaya Tsutsumi, Kaho Hirai, Takahiro Ueda, Erika Toyokura, Misako Nishimura, Kanako Sato, Kazuhiro Yamada, Tetsuya Watanabe, Tomoya Kawaguchi","doi":"10.1111/resp.70003","DOIUrl":"10.1111/resp.70003","url":null,"abstract":"<p><strong>Background and objective: </strong>Chronic obstructive pulmonary disease (COPD) is closely related to skeletal muscle dysfunction, and the evaluation of respiratory muscle function has recently been recommended. We aimed to investigate the effects of respiratory muscle dysfunction on clinical outcomes.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of patients with COPD whose respiratory muscle strength was measured between June 2015 and December 2021. We then analysed the effects of respiratory muscle strength on moderate-to-severe exacerbations after adjusting for confounding factors, including sex, age, forced expiratory volume in 1-s percent predicted, hand grip strength, and skeletal muscle mass index. We also compared the temporal relationship between respiratory and systemic skeletal muscle dysfunctions.</p><p><strong>Results: </strong>Respiratory muscle weakness (RMW) was observed in 48.1% (100) of the 208 patients. Low percent predicted maximal inspiratory pressure was an independent risk factor for moderate-to-severe exacerbations within 1 year in the Cox regression analysis (adjusted hazard ratio per 1 standard deviation increase, 0.521; 95% confidence interval, 0.317-0.856). Approximately half of the patients already exhibited RMW at the mild systemic skeletal muscle dysfunction, while those with sarcopenia had higher RMW rates. More patients with RMW experienced progressive systemic skeletal muscle dysfunction within 1 year compared to those without RMW.</p><p><strong>Conclusion: </strong>Lower respiratory muscle strength is associated with an increased risk of exacerbation. Respiratory muscle function could serve as a marker of disease status and early prognosis in COPD.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"408-416"},"PeriodicalIF":6.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516598","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":"Early-to-Midlife Body Mass Index Trajectories and Obstructive Sleep Apnoea Risk 10 Years Later.","authors":"Yaoyao Qian, Jennifer L Perret, Garun S Hamilton, Michael J Abramson, Caroline J Lodge, Dinh S Bui, Gulshan B Ali, Anurika P De Silva, Robert J Adams, Bruce R Thompson, Bircan Erbas, Eugene H Walters, Chamara V Senaratna, Shyamali C Dharmage","doi":"10.1111/resp.70002","DOIUrl":"10.1111/resp.70002","url":null,"abstract":"<p><strong>Background and objective: </strong>While short-term weight changes are known to influence obstructive sleep apnoea (OSA), the impact of body mass index (BMI) changes over the life course has been poorly documented. We examined the association between BMI trajectories from childhood to middle age and adult OSA, 10 years later.</p><p><strong>Methods: </strong>Five BMI trajectories were previously identified in the population-based cohort Tasmanian Longitudinal Health Study (TAHS), using eight time-point BMI from age 5 to 43 years. The primary outcome was probable OSA at 53 years, defined using STOP-Bang questionnaire, with Berlin and OSA-50 questionnaires used to ensure consistency of findings. Clinically significant diagnosed OSA was defined as self-reported medical diagnosis or mild OSA with symptoms or moderate-to-severe OSA, using type-4 sleep studies. Associations were examined using multivariable logistic regression.</p><p><strong>Results: </strong>Compared with the average BMI trajectory, the child average-increasing (aOR = 5.28, 95% CI 3.38-8.27) and persistently high trajectories (aOR = 3.73, 2.06-6.74) were associated with increased risk of probable OSA. These associations were consistent when using clinically significant diagnosed OSA (child average-increasing trajectory: aOR = 2.95, 1.30-6.72; high trajectory: aOR = 2.23, 0.82-6.09). Individuals belonging to the low trajectory were less likely than the average trajectory to have OSA. Notably, the child high-decreasing trajectory was not associated with OSA.</p><p><strong>Conclusion: </strong>Physicians and the public should be aware of the potential risk of OSA in middle-aged adults when BMI is high or continuously increasing from childhood to mid-40s. Obese children who subsequently lose weight were not at higher risk of OSA in middle age-a novel and key finding.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"435-445"},"PeriodicalIF":6.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391659","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":"Letter From China.","authors":"Chenyang Lu, Qingling Zhang","doi":"10.1111/resp.70029","DOIUrl":"10.1111/resp.70029","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"448-451"},"PeriodicalIF":6.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701384","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":"Lung Function Course of Patients With Pulmonary Fibrosis After Initiation of Anti-Fibrotic Treatment: Real-World Data From the Dutch National Registry.","authors":"Mark G J P Platenburg, Gizal Nakshbandi, Catharina C Moor, Aernoud A van Batenburg, Rémy L M Mostard, Mareye Voortman, Linda A A Moonen, Nicolle Hekelaar, Maria J Overbeek, Brigitte A H A Bogaarts, Henk Kramer, Emiel R Marges, Bart B Boerrigter, Paul Bresser, Eveline L Schakenraad, Jan van der Maten, Niels C A van der Sloot, Stefan Walen, Pedro Miranda Afonso, Marlies S Wijsenbeek, Jan C Grutters","doi":"10.1111/resp.70030","DOIUrl":"10.1111/resp.70030","url":null,"abstract":"<p><strong>Background and objective: </strong>Real-world data on lung function course of patients with progressive pulmonary fibrosis (PPF) treated with anti-fibrotic medication are limited. We evaluated forced vital capacity (FVC) decline in patients with PPF and idiopathic pulmonary fibrosis (IPF) who started anti-fibrotic treatment.</p><p><strong>Methods: </strong>This was a nationwide multi-centre registry study in 16 hospitals throughout the Netherlands. Patients treated with anti-fibrotic medication, with at least two in-hospital pulmonary function tests before and after the initiation of anti-fibrotic treatment, were included. Linear mixed-effects modelling was used to analyse lung function trajectories 1 year before and after the start of anti-fibrotic treatment.</p><p><strong>Results: </strong>Data from 538 patients (n = 142 with PPF, n = 396 with IPF) were analysed. In PPF, the mean annualised FVC decline was 412 mL (95% confidence interval [CI]: 308-517 mL) before the initiation of anti-fibrotic treatment, and 18 mL (95% CI: 9-124 mL) in the first year after. The corresponding declines for IPF were 158 mL (95% CI: 78-239 mL) and 38 mL (95% CI: 24-101 mL). In both groups, treatment significantly slowed down FVC decline, although the change was larger in the PPF group (p = 0.0006). In the first year after treatment initiation, 23.9% of patients with PPF and 28.0% with IPF had disease progression.</p><p><strong>Conclusion: </strong>The FVC decline significantly slowed after the initiation of treatment for both IPF and PPF. Nevertheless, a significant proportion of patients exhibited disease progression, despite the start of anti-fibrotic treatment. Early identification of these patients is crucial for treatment adaptations and inclusion in clinical trials.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"417-423"},"PeriodicalIF":6.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693135","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":"Form Is Function: Predicting COPD Outcomes With Respiratory Muscle Dysfunction.","authors":"Bartolome R Celli","doi":"10.1111/resp.70019","DOIUrl":"10.1111/resp.70019","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"376-377"},"PeriodicalIF":6.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586520","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":"Looking Towards More Comprehensive Management of Interstitial Lung Disease.","authors":"Takuro Sakagami","doi":"10.1111/resp.70015","DOIUrl":"10.1111/resp.70015","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"378-379"},"PeriodicalIF":6.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658445","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":"Leading Women in Respiratory Clinical Sciences: Letter From Japan.","authors":"Minako Imado, Michiko Morimoto","doi":"10.1111/resp.70033","DOIUrl":"10.1111/resp.70033","url":null,"abstract":"<p><p>Special Series: Leading Women in Respiratory Clinical Sciences Series Editors: Anne-Marie Russell and Kathleen O Lindell See related editorial.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"452-454"},"PeriodicalIF":6.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658443","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":"A New Era in the Treatment of Autoimmune Pulmonary Alveolar Proteinosis.","authors":"Ryushi Tazawa, Koh Nakata","doi":"10.1111/resp.70048","DOIUrl":"https://doi.org/10.1111/resp.70048","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044888","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":"Add-On Dextromethorphan Improves the Effects of Pirfenidone in Bleomycin-Treated Mice and Patients With Pulmonary Fibrosis.","authors":"Jie Huang, Nana Liu, Yueyue Jin, Shuangyu Han, Lian Li, Yunze Du, Luqing Wei, Dongsheng Li, Yan Zhang, Yubao Wang, Jau-Shyong Hong, Wen Ning, Jing Feng","doi":"10.1111/resp.70043","DOIUrl":"https://doi.org/10.1111/resp.70043","url":null,"abstract":"<p><strong>Background and objective: </strong>Idiopathic pulmonary fibrosis is a progressive interstitial lung disease characterised by excessive activation of myofibroblasts. However, currently available antifibrotic drugs exhibit limited efficacy. The dysregulation of redox processes plays a significant role in the pathogenesis of idiopathic pulmonary fibrosis. Dextromethorphan (DM) is used in the treatment of various inflammation-related diseases. This study aimed to investigate the effectiveness of the combination of DM and pirfenidone (PFD) in treating idiopathic pulmonary fibrosis in both animal models and humans.</p><p><strong>Methods: </strong>In a bleomycin-induced pulmonary fibrosis mouse model, the anti-fibrotic effects of DM and/or PFD were assessed by evaluating fibrotic area, hydroxyproline levels, and fibrotic markers. In a transforming growth factor-β1-induced cell model, proliferation, migration, fibrosis markers, and oxidative stress were analysed to elucidate the mechanisms underlying the anti-fibrotic actions of DM and/or PFD. Finally, the efficacy of DM combined with PFD in patients with pulmonary fibrosis was evaluated by comparing pulmonary imaging scores and pulmonary function before and after treatment in the PFD group and the PFD + DM group.</p><p><strong>Results: </strong>We observed that even ultralow doses of DM, either alone or in combination with PFD, demonstrated substantial protective effects in mice. Notably, administration of DM or combined drugs at 2 weeks after bleomycin modelling still showed anti-fibrotic effects. In vitro, DM monotherapy and combination therapy restored the redox balance by suppressing nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 4/reactive oxygen species production and upregulating superoxide dismutase, contributing to their anti-fibrotic mechanisms. In the clinical study, add-on DM improved PFD in mitigating pulmonary function decline and improving chest high-resolution computed tomography imaging scores.</p><p><strong>Conclusions: </strong>Ultralow doses of dextromethorphan significantly alleviate pulmonary fibrosis in bleomycin-treated mice through restoring the redox balance. Add-on DM improves the effects of PFD in both bleomycin-treated mice and patients with pulmonary fibrosis.</p><p><strong>Trial registration: </strong>ChiCTR2000037602.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014409","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":"Simplifying CPAP Therapy: Is Fixed Pressure the Way Forward?","authors":"Ahmed S BaHammam","doi":"10.1111/resp.70042","DOIUrl":"https://doi.org/10.1111/resp.70042","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051127","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}