Respirology最新文献

{"title":"Heterogeneity of reduced FEV₁ in early adulthood: A looking forward, looking backwards analysis.","authors":"Nuria Olvera, Alvar Agusti, Judith M Vonk, Gang Wang, Jenny Hallberg, H Marike Boezen, Maarten van den Berge, Erik Melén, Rosa Faner","doi":"10.1111/resp.14876","DOIUrl":"10.1111/resp.14876","url":null,"abstract":"<p><strong>Background: </strong>Some individuals never achieve normal peak FEV₁ in early adulthood. It is unknown if this is due to airflow limitation and/or lung restriction.</p><p><strong>Methods: </strong>To investigate this, we: (1) looked forward in 19,791 participants in the Dutch Lifelines general population cohort aged 25-35 years with 5-year follow-up; and (2) looked backwards in 2032 participants in the Swedish BAMSE birth cohort with spirometry at 24 years of age but also at 16 and/or 8 years.</p><p><strong>Results: </strong>(1) In Lifelines 8.5% of participants had reduced FEV₁ at 25-35 years, 68% due to Preserved Ratio Impaired Spirometry ('PRISm') and 32% to airflow limitation ('low-limited'); besides, 3.8% participants with normal FEV₁ showed airflow-limitation ('normal-limited'). Low-limited and normal-limited, but not PRISm, reported higher smoking exposures and asthma diagnosis than normal (p < 0.05). At 5-year follow-up, 91.2% of participants remained in the same group, and FEV₁ decline was similar in normal and normal-limited participants, but statistically smaller (p < 0.05) in PRISm and low-limited; (2) these observations were largely reproduced in BAMSE at 24 years of age; and, (3) in BAMSE, low-limited or PRISm individuals were already identifiable at 8-16 years of age.</p><p><strong>Conclusion: </strong>Low peak FEV₁ in early adulthood is most often due to PRISm and results in a significant burden of respiratory symptoms. Only low-limited and normal-limited, but not PRISm, associate with a doctor diagnosis of asthma, and FEV₁ decline was statistically different in PRISm indicating a need for differentiated clinical approaches. These spirometric abnormalities can be already identified in childhood and adolescence.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"326-334"},"PeriodicalIF":6.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972177","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":"Associations Between Snoring, Body Mass Index and Coronary Artery Diseases: Observational and Mendelian Randomization Study in Asia.","authors":"Yunqing Zhu, Yongbing Lan, Jun Lv, Dianjianyi Sun, Pei Pei, Ling Yang, Iona Y Millwood, Robin G Walters, Yiping Chen, Huaidong Du, Jian Wang, Xiaoming Yang, Rebecca Stevens, Junshi Chen, Zhengming Chen, Liming Li, Canqing Yu","doi":"10.1111/resp.14893","DOIUrl":"10.1111/resp.14893","url":null,"abstract":"<p><strong>Background and objective: </strong>Previous observational studies reported a complex relationship between snoring and coronary artery disease (CAD). We aimed to estimate the causal associations between snoring and CAD among East Asian people, and the effects independent of BMI.</p><p><strong>Methods: </strong>Based on 497,250 adults from China Kadoorie Biobank (CKB), we performed a conventional prospective analysis between snoring and CAD outcomes, using the multivariable Cox regression. We also leveraged genome-wide association (GWAS) summary statistics of snoring and BMI from CKB (n = 100,626, 47,208 snorers) and CAD outcomes from Biobank of Japan (BBJ, 5891-25,892 cases, 142,336-168,186 controls). Single-variable and multivariable two-sample bi-directional Mendelian randomization (MR) analyses were performed.</p><p><strong>Results: </strong>During a median follow-up of 12.32 years, 48,997 participants developed CAD. Snoring and habitual snoring were associated with incident CAD and myocardial infarction (MI), habitual snoring was also associated with stable angina pectoris (SAP). The HRs (95% CIs) of habitual snoring were 1.06 (1.04, 1.08), 1.06 (1.04, 1.08) and 1.14 (1.03, 1.25). The associations remained among non-adiposity participants. Genetically predicted habitual snoring was associated with CAD and MI, the corresponding IVW-ORs (95% CIs) were 1.09 (1.005, 1.19) and 1.15 (1.05, 1.25). Further adjusted BMI, habitual snoring retained independent effects on MI and CAD, and showed impact on SAP (1.09 [1.01, 1.17]). No reverse associations were observed between CADs on snoring traits.</p><p><strong>Conclusion: </strong>Habitual snoring elevated the risks of total CAD, MI and SAP. The causal associations were independent of BMI. These findings indicated that snoring intervention might contribute to the decrease of CAD risk among Asians.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"346-358"},"PeriodicalIF":6.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256646","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":"Using an Eosinophil Count to Diagnose Asthma: Music to Your EARS?","authors":"John D Blakey, Sanjay Ramakrishnan","doi":"10.1111/resp.70007","DOIUrl":"10.1111/resp.70007","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"280-282"},"PeriodicalIF":6.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503647","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":"Diagnostic Modalities in Sleep Disordered Breathing: Current and Emerging Technology and Its Potential to Transform Diagnostics.","authors":"Lucía Pinilla, Ching Li Chai-Coetzer, Danny J Eckert","doi":"10.1111/resp.70012","DOIUrl":"10.1111/resp.70012","url":null,"abstract":"<p><p>Underpinned by rigorous clinical trial data, the use of existing home sleep apnoea testing is now commonly employed for sleep disordered breathing diagnostics in most clinical sleep centres globally. This has been a welcome addition for the field given the considerable burden of disease, cost, and access limitations with in-laboratory polysomnography testing. However, most existing home sleep apnoea testing approaches predominantly aim to replicate elements of conventional polysomnography in different forms with a focus on the estimation of the apnoea-hypopnoea index. New, simplified technology for sleep disordered breathing screening, detection/diagnosis, or monitoring has expanded exponentially in recent years. Emerging innovations in sleep monitoring technology now go beyond simple single-night replication of varying numbers of polysomnography signals in the home setting. These novel approaches have the potential to provide important new insights to overcome many of the existing limitations of sleep disordered breathing diagnostics and transform disease diagnosis and management to improve outcomes for patients. Accordingly, the current review summarises the existing evidence for sleep study testing in people with suspected sleep-related breathing disorders, discusses novel and emerging technologies and approaches according to three key categories: (1) wearables (e.g., body-worn sensors including wrist and finger sensors), (2) nearables (e.g., bed-embedded and bedside sensors), and (3) airables (e.g., audio and video recordings), and outlines their potential disruptive role to transform sleep disordered breathing diagnostics and care.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"286-302"},"PeriodicalIF":6.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543311","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":"Interplay of Polygenic Risk Score, Smoking Statuses, and Air Pollution on Lung Adenocarcinoma Risk in a Taiwanese Population.","authors":"I-Chieh Chen, Yi-Ming Chen, Hui-Wen Yang, Jeng-Sen Tseng, Tsung-Ying Yang","doi":"10.1111/resp.70004","DOIUrl":"10.1111/resp.70004","url":null,"abstract":"<p><strong>Background and objective: </strong>We determined the impact of genetic susceptibility and its interaction with smoking and air pollution on the risk of developing lung adenocarcinoma.</p><p><strong>Methods: </strong>This retrospective case-control study utilised data from Taiwan Precision Medicine Initiative (TPMI) project conducted between June 2019 and November 2022. The study population consisted of lung adenocarcinoma patients and 1:4 age-, gender-, and index year-matched non-lung cancer controls. We analysed polygenic risk scores (PRS), smoking status, as well as PM_2.5 and PM₁₀ exposures.</p><p><strong>Results: </strong>A total of 681 lung adenocarcinoma patients and 2724 non-lung cancer participants were included. PRS was significantly higher among lung adenocarcinoma patients than controls (p < 0.001). Overall, a higher PRS was associated with a higher risk of lung adenocarcinoma. A high PM_2.5 exposure was associated with a higher risk of lung adenocarcinoma (OR 1.88 [95% CI 1.12-3.14], p = 0.0163) among never-smokers with low genetic risk. Never-smokers with a higher genetic risk were associated with a higher OR for lung adenocarcinoma with the highest OR among Q4 participants with high PM_2.5 exposure (4.97 [95% CI 3.10-7.97], p < 0.001). There was no significant impact of PM_2.5 exposure among individuals with higher genetic risks. Similar phenomena were observed in the PM₁₀ analyses. There were no significant correlations of PRS with risk of lung adenocarcinoma among smokers.</p><p><strong>Conclusion: </strong>PRS significantly predicted lung adenocarcinoma incident cases in a dose-dependent manner among never-smokers. The PRS effect was not noted in smokers. The results were consistent among participants exposed to different air pollution levels.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"317-325"},"PeriodicalIF":6.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433573","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":"Limitations of Self-Reported Data in Evaluating COPD Phenotypes and Cardiovascular Risk.","authors":"Ibrahim Nagmeldin Hassan","doi":"10.1111/resp.70027","DOIUrl":"10.1111/resp.70027","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"366"},"PeriodicalIF":6.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670769","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":"Pathological Examination and Genetic Mutation Testing: Bridging Their Best Practices Using MINtS.","authors":"Hiroyoshi Tsubochi, Koichi Hagiwara","doi":"10.1111/resp.70017","DOIUrl":"10.1111/resp.70017","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"283-285"},"PeriodicalIF":6.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586574","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":"Turning Limitations Into Insights: The Path Forward for COPD and Cardiovascular Risk Research.","authors":"Paula Rodriguez-Miguelez, Youngdeok Kim","doi":"10.1111/resp.70028","DOIUrl":"10.1111/resp.70028","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"367-368"},"PeriodicalIF":6.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664399","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":"Clinical Presentation and Diagnostic Evaluation of Vaping Related Lung Injury in Youth.","authors":"Eleanor D Muise, Rachel Gordon, Jacqueline Steiding, Keri Sullivan, Catherine A Sheils, Alicia M Casey","doi":"10.1111/resp.70034","DOIUrl":"https://doi.org/10.1111/resp.70034","url":null,"abstract":"<p><strong>Background and objectives: </strong>The vaping epidemic is a public health crisis worldwide. E-cigarette, or vaping product, use-associated lung injury (EVALI) was recognised in the summer of 2019 and resulted in more than 2800 hospitalizations and 60 deaths per the Centres for Disease Control and Prevention (CDC). Vaping refers to the use of E-cigarettes, which are electronic nicotine delivery systems (ENDS) and mimic smoking without combustion. Over 40 million people in the United States vape, of which youth and young adults represent over half. We describe the evaluation and pulmonary complications in a large cohort of adolescents and young adults referred to a Pulmonary Complications of Vaping Clinic.</p><p><strong>Methods: </strong>Youth ages 10-35 with a vaping history and respiratory symptoms underwent a comprehensive diagnostic evaluation. All patients were counselled for vaping cessation. Patients who met criteria for EVALI or probable EVALI with concurrent infection were reported to the Department of Health.</p><p><strong>Results: </strong>One hundred and thirty patients were referred, and 103 patients underwent comprehensive diagnostic evaluation. Eighty-four percent of patients reported vaping both marijuana and nicotine products. Forty-six percent of patients were diagnosed with EVALI or probable EVALI.</p><p><strong>Conclusions: </strong>The evolving vaping epidemic demonstrates a need for subject matter expertise in the evaluation and diagnosis of youth with vaping-related lung injury, including EVALI. We report a higher number of youth who met criteria for EVALI with the implementation of a standardised vaping questionnaire and evaluation inclusive of outpatients.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711167","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":"Fixed CPAP at 10 cmH₂O May Replace Manual Titration in Moderate to Severe OSA Patients: A Preliminary Randomised Controlled Trial.","authors":"Wang Lu, Yan Chen, Qishan Wei, Yingxin Wu, Cuizhen Huang, Shanfeng Liang, Joerg Steier, Peter Catcheside, Danny Eckert, Andrew Wellman, Yuanming Luo","doi":"10.1111/resp.70037","DOIUrl":"https://doi.org/10.1111/resp.70037","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patient compliance with continuous positive airway pressure (CPAP) is similar using manual-titrated pressure compared to auto-titration, although auto-titration pressures are usually 2-5 cmH₂O higher than manual pressure, indicating that CPAP moderately higher than the optimal pressure will not necessarily impair compliance. We try to find the tolerable highest CPAP which does not increase respiratory effort based on changes in lung volume, diaphragm electromyography (EMG) and breathing sensations in healthy volunteers and OSA patients to simplify pressure titration.</p><p><strong>Methods: </strong>Part 1, 12 healthy subjects and 16 OSA patients were enrolled in the measurement of expiratory reserve volume, diaphragm EMG, and expiratory muscle EMG at different CPAP levels. Breathing difficulty during different CPAP levels was assessed using a customised questionnaire in 35 healthy subjects and 33 OSA patients. Part 2, a two-night randomised crossover double-blind trial using the tolerable highest CPAP (10 cmH₂O) based on the results derived from Part 1 and the manually titrated pressure was performed in 25 OSA patients.</p><p><strong>Results: </strong>End expiratory lung volume increased significantly with increasing CPAP. In general, diaphragm EMG changed little when CPAP ≤ 10 cmH₂O. Expiratory muscle activity appeared when CPAP > 12 cmH₂O. There was no significant difference in subjective sensation of breathing difficulty with CPAP ≤ 10 cmH₂O. Sleep structure, AHI, and patient preference with 10 cmH₂O CPAP were not different from those under titrated pressure.</p><p><strong>Conclusions: </strong>This study suggests that most patients with moderate to severe OSA can be effectively treated with CPAP at an initial pressure of 10 cmH₂O without pressure titration.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT04925466.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701383","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}