Respirology最新文献_第9页

Differences in Endotypic Traits Between Obstructive Sleep Apnoea Patients With and Without Excessive Daytime Sleepiness. 阻塞性睡眠呼吸暂停患者与非阻塞性睡眠呼吸暂停患者的内源性特征差异

IF 7.2 2区医学

Respirology Pub Date : 2026-07-01 Epub Date: 2026-03-18 DOI: 10.1002/resp.70241

Lixia Wang, Xinjie Hui, Rong Huang, Yi Xiao

{"title":"Differences in Endotypic Traits Between Obstructive Sleep Apnoea Patients With and Without Excessive Daytime Sleepiness.","authors":"Lixia Wang, Xinjie Hui, Rong Huang, Yi Xiao","doi":"10.1002/resp.70241","DOIUrl":"10.1002/resp.70241","url":null,"abstract":"Background and objective: Obstructive sleep apnoea (OSA) is a heterogeneous disorder. Although excessive daytime sleepiness (EDS) is a hallmark symptom of OSA, many patients remain asymptomatic, and a subset continues to experience EDS despite optimal therapy. The endotypic traits underlying EDS in OSA remain poorly defined.Methods: We conducted a cross-sectional study of 694 adults at a Beijing sleep center, including 542 participants with AHI ≥ 5 events/h. EDS was defined as an Epworth Sleepiness Scale score > 10. Four endotypic traits were derived from full-night polysomnography using the \"Phenotyping Using Polysomnography\" method. Associations with EDS were assessed by multivariable logistic regression, and relationships with OSA severity by generalized linear regression.Results: Compared with OSA without EDS, OSA with EDS exhibited significantly higher loop gain (LG), arousal threshold (ArTH), and upper airway collapsibility, and lower upper airway muscle compensation (Vcomp) (all p < 0.05). Multivariable logistic regression identified ArTH as an independent correlate of comorbid EDS, with an odds ratio of 3.12 (95% CI: 1.24-8.02; p = 0.016) for the highest quartile of ArTH. In the fully adjusted linear regression model, collapsibility, LG, and ArTH were significant determinants of OSA severity in both subgroups, whereas Vcomp was predictive predominantly among patients with EDS.Conclusions: This study suggests that elevated ArTH is an over-expressed trait in OSA patients with EDS, potentially amplifying the link between respiratory pathophysiology and daytime sleepiness. While LG and collapsibility remain key determinants of OSA severity, these findings highlight the value of ArTH-targeted strategies and endotype-informed stratification for personalized management.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"756-767"},"PeriodicalIF":7.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481075","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}

引用次数: 0

Ambient Air Pollution and Risk of ARDS and Mortality in Moderate to Severe COVID-19. 环境空气污染与中重度COVID-19急性呼吸窘迫综合征和死亡率的风险

IF 7.2 2区医学

Respirology Pub Date : 2026-07-01 Epub Date: 2026-04-14 DOI: 10.1002/resp.70250

Seohyun Kim, Hyonsoo Joo, Hye Seon Kang, Chang Dong Yeo, Jong Min Lee, Hyung Woo Kim, Shin Young Kim, Yeon Hee Park, Myoungin Shin, Jangwon Lee, Chin Kook Rhee, Tai Joon An

{"title":"Ambient Air Pollution and Risk of ARDS and Mortality in Moderate to Severe COVID-19.","authors":"Seohyun Kim, Hyonsoo Joo, Hye Seon Kang, Chang Dong Yeo, Jong Min Lee, Hyung Woo Kim, Shin Young Kim, Yeon Hee Park, Myoungin Shin, Jangwon Lee, Chin Kook Rhee, Tai Joon An","doi":"10.1002/resp.70250","DOIUrl":"10.1002/resp.70250","url":null,"abstract":"Background and objective: Ambient air pollution is known to exacerbate respiratory illnesses. However, its impact on COVID-19 outcomes remains underexplored. We investigated the association between ambient air pollution and outcomes in patients with moderate to severe COVID-19.Methods: We analysed 1867 hospitalized patients from a multicentre Korean cohort. Individual-level exposure to five air pollutants (SO2, CO, NO2, PM10 and PM2.5) was assessed over short-term (3-day) and long-term (3-year) periods. The risks of acute respiratory distress syndrome (ARDS) and 30-day mortality were evaluated using models adjusted for clinical and meteorological factors. Pollutant exposure was analysed both as quartiles and continuous variables to estimate effects per unit increase.Results: Short-term CO exposure was associated with increased ARDS incidence (per 0.1 ppm increase OR 1.18) and 30-day mortality (HR 1.15). Long-term NO2 exposure was associated with higher ARDS risk (per 1 ppb OR 1.11). Long-term PM10 exposure was also associated with ARDS incidence (per 10 μg/m3 OR 2.24). For mortality, short-term NO2 (per 1 ppb HR 1.02) and PM2.5 (per 10 μg/m3 HR 1.14) exposure were additionally associated with increased risk. These associations were consistent in quartile-based analyses.Conclusion: Both short- and long-term exposure to ambient air pollution were associated with worse COVID-19 outcomes, including ARDS and mortality. CO, often overlooked in pollution surveillance, showed the most consistent impact. These findings highlight the importance of air quality in pandemic preparedness and public health policy.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"745-755"},"PeriodicalIF":7.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676072","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}

引用次数: 0

Microbial Phenotyping in COPD Exacerbations: One Step Closer to Precision-Based Management. COPD恶化中的微生物表型：向精准管理迈进了一步。

IF 7.2 2区医学

Respirology Pub Date : 2026-07-01 Epub Date: 2026-05-05 DOI: 10.1002/resp.70259

Carlos Andrés Celis-Preciado, Simon Couillard

引用次数: 0

Recommendations From the Medical Education Editor. 医学教育编辑推荐。

IF 7.2 2区医学

Respirology Pub Date : 2026-07-01 Epub Date: 2026-06-04 DOI: 10.1002/resp.70269

Mark Lavercombe

引用次数: 0

Contemporary Concise Review 2025: Asthma. 当代简明评论2025：哮喘。

IF 7.2 2区医学

Respirology Pub Date : 2026-07-01 DOI: 10.1002/resp.70270

Jun Miyata, Koichi Fukunaga

{"title":"Contemporary Concise Review 2025: Asthma.","authors":"Jun Miyata, Koichi Fukunaga","doi":"10.1002/resp.70270","DOIUrl":"10.1002/resp.70270","url":null,"abstract":"Asthma research in 2025 further advanced a multidimensional view of asthma, integrating disease trajectory, exacerbation risk, structural airway changes, comorbidities, and treatment responsiveness. In mild asthma, studies published in 2025 further reinforced the importance of anti-inflammatory reliever strategies over SABA-only treatment by supporting timely inhaled corticosteroid delivery at symptom worsening to reduce exacerbation risk, particularly in adults and adolescents, while providing emerging but still nuanced evidence in child. In severe asthma, the therapeutic focus expanded beyond exacerbation reduction towards disease modification, including oral corticosteroid sparing, improvement or normalisation of lung function, reduction of mucus plugging, and attainment of clinical remission. Clinical remission became more clearly defined and increasingly positioned as a treatment target and research endpoint, supported by emerging consensus definitions, real-world data, and analyses of biologic trials. Real-world asthma management increasingly emphasised implementation, including treatable-traits-based care, biomarker-informed stratification, digital inhaler technologies, and approaches to persistent ethnic, social, and age-related inequities in outcomes. Advances in pathobiology highlighted the central role of the airway epithelium, inflammatory cellular ecosystems, microbiome-associated endotypes, mucus-plug biology, and early-life origins of airway remodelling in shaping asthma heterogeneity and progression.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"693-701"},"PeriodicalIF":7.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369580","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}

引用次数: 0

Determinants of Improved Dyspnea and Exercise Tolerance With Nasal High-Flow O₂ Therapy in Fibrotic Interstitial Lung Disease: A Pilot Physiological Study. 在纤维化间质性肺疾病中鼻高流量氧治疗改善呼吸困难和运动耐量的决定因素：一项初步生理学研究。

IF 7.2 2区医学

Respirology Pub Date : 2026-07-01 Epub Date: 2026-04-09 DOI: 10.1002/resp.70251

Sarah Thivent, Marylise Ginoux, Samuel Verges, Frédéric Hérengt, Mathieu Marillier

引用次数: 0

Association of Endotypic Traits and Their Interaction With Severity of Obstructive Sleep Apnea. 内型特征与阻塞性睡眠呼吸暂停严重程度的关联及其相互作用。

IF 7.2 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-03-11 DOI: 10.1002/resp.70235

Liang-Wen Hang, Eysteinn Finnsson, Jón S Ágústsson, Scott A Sands, Wan-Ju Cheng

{"title":"Association of Endotypic Traits and Their Interaction With Severity of Obstructive Sleep Apnea.","authors":"Liang-Wen Hang, Eysteinn Finnsson, Jón S Ágústsson, Scott A Sands, Wan-Ju Cheng","doi":"10.1002/resp.70235","DOIUrl":"10.1002/resp.70235","url":null,"abstract":"Background and objective: Endotypic traits of obstructive sleep apnea (OSA) are being increasingly identified as potential treatment targets. Nevertheless, their clinical relevance remains debated, as they are not consistently associated with OSA severity. This study aimed to examine endotypic traits' associations and their interaction effects with OSA severity.Methods: A total of 1167 adults with moderate-to-severe OSA were prospectively recruited from a sleep center and underwent in-laboratory full-night polysomnographic studies. Endotypic traits-collapsibility (Vpassive, ventilation at eupenic drive), loop gain, arousal threshold, and compensation-were estimated using polysomnographic signals, and OSA severity was examined by apnea-hypopnea index (AHI) and hypoxic burden. The associations between individual endotypic traits and OSA severity were visualised using generalised additive models. The interaction between arousal threshold and compensation on OSA severity was examined.Results: A more collapsible upper airway and higher loop gain were linearly associated with greater OSA severity. Arousal threshold was positively associated with hypoxic burden, whereas the relationship between arousal threshold and AHI followed an inverse U-shaped pattern. Among patients with a relatively low arousal threshold (< 173.5 %eupnea), favourable upper airway patency was observed, and AHI increased with rising arousal threshold. The combination of a high arousal threshold and high compensation was associated with elevated AHI during NREM sleep, where the high compensation resulted from a very low Vpassive.Conclusions: A higher arousal threshold predicted a more severe hypoxic burden but showed a nonlinear association with AHI. Arousal threshold and compensation should be considered together when evaluating OSA severity.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"630-638"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147435174","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}

引用次数: 0

Longitudinal Subphenotyping of Acute Respiratory Distress Syndrome: Implications in Prognostic Prediction and Clinical Intervention. 急性呼吸窘迫综合征的纵向亚表型：在预后预测和临床干预中的意义。

IF 7.2 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-03-22 DOI: 10.1002/resp.70239

Yanan Zhou, Ying Wang, Linlin Wang, Jing Bi, Yanping Yang, Wenyu Xing, Yuanlin Song, Weibing Wang, Dongni Hou

{"title":"Longitudinal Subphenotyping of Acute Respiratory Distress Syndrome: Implications in Prognostic Prediction and Clinical Intervention.","authors":"Yanan Zhou, Ying Wang, Linlin Wang, Jing Bi, Yanping Yang, Wenyu Xing, Yuanlin Song, Weibing Wang, Dongni Hou","doi":"10.1002/resp.70239","DOIUrl":"10.1002/resp.70239","url":null,"abstract":"Background and objective: To identify the longitudinal subphenotypes (LSPs) in patients with acute respiratory distress syndrome (ARDS) and their transitions, and to evaluate their potential for prognostic prediction and guiding interventions.Methods: This retrospective multicohort study derived its cohort from Zhongshan Hospital, Fudan University, China. Feature selection was performed using univariate analysis, recursive feature elimination, and correlation analysis, followed by longitudinal latent profile analysis. Cox regression model was used to compare differences in mortality and responses to interventions. A predictive model was developed through selection from nine candidate machine learning algorithms followed by grid search optimization and subsequently applied to an independent validation cohort.Results: Nine hundred ninety seven patients were included in the derivation dataset. Utilizing the 20 most prognostically relevant variables, three distinct LSPs were identified. Based on Day 1, the LSPs accounted for 36.41%, 36.71%, and 26.88%, respectively. LSP 1 (HR 5.119; 95% CI: 3.657-7.165) and LSP 2 (HR 2.922; 95% CI: 2.063-4.139) were associated with higher mortality. Both high-dose corticosteroids and invasive mechanical ventilation failed to elicit a treatment response in LSP 2 and LSP 3. Conversely, prone positioning proved to be an effective intervention for LSP 2. An early shift from LSP 1 to LSP 2 was associated with increased mortality (HR 1.679; 95% CI: 1.051-2.683). Furthermore, the optimized random forest model demonstrated superior performance in differentiating the three LSPs and could identify consistent subphenotypes in validation cohort.Conclusions: Our findings underscore the importance of incorporating temporal subphenotype evolution into prognostic stratification and personalized treatment.","PeriodicalId":21129,"journal":{"name":"Respirology","volume":" ","pages":"578-589"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499863","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}

引用次数: 0

Breathing New Life Into Lung Cancer Detection: The Emerging Role of Breathomics. 为肺癌检测注入新的活力：呼吸组学的新作用。

IF 6.3 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-03-17 DOI: 10.1002/resp.70240

Chui Lyn Leong, Tracy Leong

引用次数: 0

From Residency to Tissue Inflammatory Memory: HLF as a Transcriptional Gatekeeper of CD4 ⁺ Tissue-Resident Memory T Cells. 从驻留到组织炎症记忆：HLF作为CD4+组织驻留记忆T细胞的转录守门人。

IF 6.3 2区医学

Respirology Pub Date : 2026-06-01 Epub Date: 2026-04-23 DOI: 10.1002/resp.70257

Masahiro Nemoto, Masahiro Kiuchi, Kiyoshi Hirahara

引用次数: 0