Respirology最新文献

{"title":"Adding Weight to the Evidence: MMP-9 as a Predictor of COPD Development.","authors":"Niki L Reynaert, Didier Cataldo","doi":"10.1111/resp.70119","DOIUrl":"https://doi.org/10.1111/resp.70119","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966752","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":"Biodegradable Stents-A New Option for Benign Central Airway Stenosis.","authors":"Oğuz Karcıoğlu, Eda Burcu Boerner, Faustina Funke, Jane Winantea, Filiz Oezkan, Rudiger Karpf-Wissel, Kaid Darwiche","doi":"10.1111/resp.70117","DOIUrl":"https://doi.org/10.1111/resp.70117","url":null,"abstract":"<p><strong>Background and objective: </strong>Patients diagnosed with benign central airway stenosis who are ineligible for surgical intervention require airway stents. The high complication rates associated with conventional silicone and metallic stents have led to the development of new devices with lower complication rates and easier insertion and removal. This paper presents our results, including the indications, patient characteristics, and outcomes.</p><p><strong>Methods: </strong>We reviewed patients who underwent bronchoscopy for airway stenosis due to a benign cause between January 2015 and February 2023 in the interventional pulmonology unit of a tertiary university hospital. The causes and locations of stenosis, outcomes, and complications were analysed in patients who received a minimum of one biodegradable (BD) stent. All procedures were performed under general anaesthesia using a rigid bronchoscope.</p><p><strong>Results: </strong>A total of 136 BD stents were implanted at 22 airway sites in 18 patients, with a median age of 56. Thirteen patients, three with prior metal stents and 10 with prior silicone stents, had a history of non-BD stent usage. Twelve procedures (54.5%) used bronchial stents, whereas 10 procedures (45.4%) used tracheal stents. The median duration of BD stent use was 10.6 months (range: 0.1-72.0 months). Early complications included one moderate granulation formation and two dislocations that necessitated stent fixation: one using clips and the other sutured to an additional stent.</p><p><strong>Conclusion: </strong>The study indicates that BD stents are both safe and feasible for treating benign stenosis, offering a safer alternative to silicone and metallic stents while providing personalised treatment for patients.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966749","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":"'Physician, Heal Thyself': The Challenges of Self-Care for Clinicians.","authors":"Natasha Smallwood","doi":"10.1111/resp.70108","DOIUrl":"https://doi.org/10.1111/resp.70108","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966851","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":"Microplastics in Human Bronchoalveolar Lavage Fluid.","authors":"Takatomo Tokito, Takashi Kido, Osamu Nagafuchi, Koichi Tomoshige, Koyomi Nakazawa, Ken'ichi Shinozuka, Shuntaro Sato, Kumiko Kido, Yasuko Noguchi, Takamune Matsumoto, Satoshi Mizoguchi, Ritsuko Murakami, Hirokazu Yura, Hiroshi Ishimoto, Takahiro Takazono, Noriho Sakamoto, Yuji Ishimatsu, Yoshimasa Tanaka, Keitaro Matsumoto, Takeshi Nagayasu, Hiroshi Mukae","doi":"10.1111/resp.70107","DOIUrl":"https://doi.org/10.1111/resp.70107","url":null,"abstract":"<p><strong>Background and objective: </strong>Health impacts of inhaling airborne microplastics have been actively investigated. Although microplastics have been detected in lung tissues and bronchoalveolar lavage fluids, their detection requires substantial effort and is technically challenging, with existing studies demonstrating various limitations. Bronchoalveolar lavage fluid is a less invasive sampling method than surgical lung biopsy. This study aimed to establish a detection method for microplastics from bronchoalveolar lavage fluid and evaluate the relevant health impacts.</p><p><strong>Methods: </strong>Patients undergoing bronchoscopy for diffuse lung disease diagnosis were included. Microplastics were detected using Nile Red staining and fluorescence microscopy. Particle size, shape, and concentration were assessed through image analysis, and plastic types were identified via Raman spectroscopy. Correlations between microplastic findings and clinical laboratory data were evaluated.</p><p><strong>Results: </strong>Microplastics were detected in the bronchoalveolar lavage fluid of all 30 patients. The median concentration of Nile Red-stained particles was 684.7 particles/mL, and over 80.0% of the particles were smaller than 10 μm, with 93.5% being particulate and 6.5% fibre. The most frequently identified microplastics were polyvinyl chloride, polystyrene, and polyethylene terephthalate. Microplastic concentration positively correlated with blood C-reactive protein levels (r_s = 0.39) and was higher in areas showing consolidation shadows (p = 0.024).</p><p><strong>Conclusions: </strong>We established a method for detecting microplastics in bronchoalveolar lavage fluid. Microplastics were found in all patients, with a potential link to inflammation. In addition, Nile Red staining was applied for the first time to detect plastics in the lung and appeared to be useful for screening and quantification.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966893","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":"Beyond Pretto and Towards Improved CPET in Clinical Practice.","authors":"Simon Green, Kate Drury, Belinda Cochrane, Rocco Cavaleri","doi":"10.1111/resp.70112","DOIUrl":"10.1111/resp.70112","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883528","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":"The FLATCAN Model: A Novel Score for Predicting Mortality Risk in Anti-Melanoma Differentiation-Associated Gene 5-Positive Dermatomyositis.","authors":"Chen Zong, Shiyu Wu, Longyang Zhu, Yiran Chen, Xinxin Zhang, Chao Sun, Xin Lu, Guochun Wang, Qinglin Peng","doi":"10.1111/resp.70106","DOIUrl":"https://doi.org/10.1111/resp.70106","url":null,"abstract":"<p><strong>Background and objective: </strong>Anti-melanoma differentiation-associated gene 5-positive dermatomyositis (MDA5 + DM) exhibits the worst prognosis among all subtypes of idiopathic inflammatory myopathies, with substantial heterogeneity in patient outcomes. This study aimed to investigate prognostic factors for MDA5 + DM and develop a scoring system to determine mortality risk.</p><p><strong>Methods: </strong>This retrospective study included 621 patients with MDA5 + DM. Variables were selected using univariable Cox regression and LASSO regression. Predictive models for mortality risks were constructed using machine learning-based algorithms. A simplified scoring system was established based on the optimal model with thorough validation to ensure predictive accuracy.</p><p><strong>Results: </strong>Seven variables emerged as key factors associated with mortality in MDA5 + DM and incorporated into the mortality risk prediction model: ferritin, lactate dehydrogenase, age at onset, CD8+ T-cell count, C-reactive protein, albumin, and lung computed tomography pattern of NSIP + OP. Among six models, the Cox proportional hazards model demonstrated superior discriminative ability and clinical utility and was translated into a simplified scoring system 'FLATCAN'. This model achieved a concordance index of 0.815 and time-dependent area under the receiver operating characteristic curves for predicting 3-, 6-, and 12-month mortality of 0.895, 0.855, and 0.850, respectively. Patients were effectively stratified into low-, intermediate-, and high-risk groups using the FLATCAN score. Further internal cross-validation, time-point splitting, and rapidly progressive interstitial lung disease-based splitting confirmed the FLATCAN score's robust predictive ability.</p><p><strong>Conclusion: </strong>The FLATCAN score provides an easy-to-use tool for predicting mortality risk in patients with MDA5 + DM and may facilitate improved risk stratification-based patient management.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875012","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":"Bronchoalveolar Lavage Lymphocytosis and Early Glucocorticoid Response: A Prospective Study of 150 Subjects With Interstitial Lung Disease.","authors":"Sahajal Dhooria, Harshith Rao, Nalini Gupta, Inderpaul Singh Sehgal, Ritesh Agarwal, Kuruswamy Thurai Prasad, Valliappan Muthu, Mandeep Garg, Amanjit Bal, Ashutosh Nath Aggarwal","doi":"10.1111/resp.70105","DOIUrl":"https://doi.org/10.1111/resp.70105","url":null,"abstract":"<p><strong>Background and objective: </strong>Bronchoalveolar lavage lymphocyte percentage (BLP) is considered a prognostic marker for interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis (IPF). Its association with an early glucocorticoid response (EGR) has not been studied systematically. We aimed to assess the association of BLP and other factors with EGR.</p><p><strong>Methods: </strong>We prospectively enrolled subjects with non-IPF ILDs and treated them with glucocorticoids. We defined EGR as a composite response in symptoms and pulmonary function tests 2 months after glucocorticoid initiation. Cases were those with EGR (responders), while non-responders (without EGR) formed the controls. The primary exposure was the BLP expressed on an ordinal scale: 0%-19%, 20%-29%, 30%-39%, ≥ 40%. Confounders included age, sex, body mass index, smoke exposure, %pred FVC, symptom duration, inflammatory and/or fibrotic phenotype on chest computed tomography. We also assessed factors associated with progressive disease at 6 months.</p><p><strong>Results: </strong>We included 150 subjects (mean age, 51.2 years; 39% men); 73% had either hypersensitivity pneumonitis or connective tissue disease-related ILD. One hundred and thirty-one subjects (69 responders; 62 non-responders) followed up at 2 months. The BLP (adjusted odds ratio [aOR], 1.64; 95% confidence intervals [CI], 1.03-2.63; p = 0.04) and symptom duration (aOR, 0.60; 95% CI, 0.40-0.92; p = 0.02) were independently associated with EGR. A BLP < 20% (aOR, 4.37; 95% CI, 1.37-13.96; p = 0.01) and history of smoke exposure (aOR, 4.59; 95% CI, 1.25-16.91; p = 0.02) independently predicted progressive disease at 6 months.</p><p><strong>Conclusion: </strong>Higher BLPs and shorter symptom duration were associated with EGR, while BLP < 20% and smoke exposure predicted progressive disease despite glucocorticoid treatment.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875010","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":"Comprehensive Strategies for Prevention and Management of Antimicrobial Resistance in Respiratory Infections.","authors":"Takahiro Takazono, Hiroshi Mukae","doi":"10.1111/resp.70111","DOIUrl":"https://doi.org/10.1111/resp.70111","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875011","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":"Patients' and Health Professionals' Views on Using Oral Corticosteroids for Asthma: Priorities, Trade-Offs and Shared Decision-Making.","authors":"Christine F McDonald","doi":"10.1111/resp.70102","DOIUrl":"https://doi.org/10.1111/resp.70102","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837505","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":"Reliability of Rapid On-Site Evaluation Achieved by Remote Sharing Systems (E-ROSE) and AI Algorithms (AI-ROSE) Compared With the Gold Standard in the Diagnosis of Lung Cancer.","authors":"Pasquale Tondo, Giuseppe Antonio Palmiotti, Giancarlo D'Alagni, Terence Campanino, Giulia Scioscia, Francesco Inglese, Renato Giua, Leonardo Monteleone, Maria Cristina Colanardi, Gianluca Libero Ciliberti, Armando Leone, Antonio Notaristefano, Ruggiero Torraco, Grazia Napoli, Grazia Marangi, Michele Pirrelli, Maria Pia Foschino Barbaro, Crescenzio Gallo, Donato Lacedonia","doi":"10.1111/resp.70104","DOIUrl":"https://doi.org/10.1111/resp.70104","url":null,"abstract":"<p><strong>Background and objective: </strong>In recent decades, artificial intelligence has seen significant development in various fields of medicine, including interventional pulmonology. The study aims to evaluate the diagnostic performance of innovative approaches to detect lung cancer on biopsy sample images (Rapid On-Site Evaluation, ROSE) compared to the diagnostic gold standard.</p><p><strong>Methods: </strong>We conducted a multicentric study, comparing remote anatomopathological evaluation (E-ROSE) and machine learning algorithms (AI-ROSE) reliability in diagnosing lung cancer, evaluating 277 biopsy sample images, 25 of which were doubtful; to compare them with the definitive histological examination performed by the pathologist.</p><p><strong>Results: </strong>E-ROSE achieved a diagnostic accuracy of 95.5%, with a sensitivity of 99.0% and specificity of 88.7%, including doubtful cases respectively 91.4%, 97.1%, and 81%. AI-ROSE showed a sensitivity of 96.4% and a specificity of 78.9%, with an accuracy of 92.5%. Including the doubtful cases, the best model achieved an accuracy of 85%, sensitivity of 97.4%, and specificity of 75.4%. The discriminative ability of the tests was compared both for positive/negative cases, showing Area Under ROC Curve (AUC) of 93.9% for E-ROSE and 87.6% for AI-ROSE; while including doubtful, AUC was 89.1% for E-ROSE and 86.4% for AI-ROSE.</p><p><strong>Conclusions: </strong>The study suggests that the application of innovative methods such as E-ROSE and AI-ROSE could provide valuable support to interventional pulmonologists in the diagnostic process.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817442","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}