Therapeutic Advances in Respiratory Disease最新文献

{"title":"Real-world analysis on hemodynamic effectiveness and adverse events of selexipag in pulmonary arterial hypertension.","authors":"Ryotaro Asano, Takatoyo Kiko, Takanori Kawabata, Yuka Sano, Hiroyuki Endo, Ryo Takano, Shinya Fujisaki, Hiroya Hayashi, Jin Ueda, Akihiro Tsuji, Koichi Matsuoka, Kohji Murakami, Takeshi Ogo","doi":"10.1177/17534666261484754","DOIUrl":"10.1177/17534666261484754","url":null,"abstract":"<p><p>BackgroundSelexipag, an oral IP prostacyclin receptor agonist, improves outcomes in pulmonary arterial hypertension (PAH); however, real-world hemodynamic data and the relationship between adverse events (AEs) and treatment response are limited.ObjectivesThe aims of this study were to evaluate the efficacy and safety of selexipag in a Japanese cohort and assess whether treatment-emergent adverse events, particularly headache and diarrhea, were associated with subsequent hemodynamic responses.DesignWe conducted a retrospective observational study at the National Cerebral and Cardiovascular Center in Japan.MethodsWe retrospectively analyzed consecutive patients with PAH initiating selexipag at our institution between 2016 and 2022. Baseline and follow-up right heart catheterization, 6-minute walk distance (6MWD), and B-type natriuretic peptide (BNP) were assessed at 26, 52, and 104 weeks. AEs requiring treatment were recorded.ResultsOf the 97 included patients, 94% received dual or triple PAH therapies at baseline. At 52 weeks, selexipag was associated with reductions in pulmonary vascular resistance (-1.36±4.70 Wood units; <i>p</i>=0.036) and mean pulmonary artery pressure (mPAP; -4.27±9.61 mmHg; <i>p</i>=0.001) and an increase in 6MWD (+26.6±53.8 m; <i>p</i>=0.003), without significant changes in cardiac index or BNP. The proportion of patients at low ESC/ERS 3-strata risk increased from 63% to 78% (<i>p</i>=0.017). AEs occurred in 62% of patients, most commonly headache (42%) and diarrhea (29%). Headaches, typically developing during dose escalation, might be associated with a better prognosis through greater mPAP reduction.ConclusionSelexipag initiation improved pulmonary hemodynamics, exercise capacity, and risk profile, without new safety signals. Headache, a common prostacyclin-related AE, may indicate treatment responsiveness and predict therapeutic outcomes. Careful titration to the maximally tolerated dose with vigilant AE management may optimize outcomes.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261484754"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory activity as a predictor of clinical deterioration in interstitial pneumonia with autoimmune features: a comparative cohort study with connective tissue disease-associated interstitial lung disease.","authors":"Firdevs Ulutaş, Nilüfer Yiğit, Gülay Güngör, Veli Çobankara","doi":"10.1177/17534666261465583","DOIUrl":"10.1177/17534666261465583","url":null,"abstract":"<p><strong>Background: </strong>Interstitial pneumonia with autoimmune features (IPAF) represents a heterogeneous entity overlapping with connective tissue disease-associated interstitial lung disease (CTD-ILD); however, its clinical course and prognostic determinants remain incompletely characterized.</p><p><strong>Objective: </strong>This study aimed to compare baseline characteristics, outcomes, and predictors of poor prognosis between IPAF and CTD-ILD, and to evaluate the prognostic performance of selected inflammatory indices.</p><p><strong>Design: </strong>This study was designed as a single-center, retrospective cohort analysis evaluating clinical characteristics, radiological features, and prognostic outcomes in patients with interstitial lung disease.</p><p><strong>Methods: </strong>This retrospective cohort study included 88 patients with ILD, categorized as IPAF (<i>n</i> = 30) or CTD-ILD (<i>n</i> = 58), including systemic sclerosis, rheumatoid arthritis, and Sjögren's disease-associated ILD. Baseline demographic, clinical, radiological, and laboratory data were systematically analyzed. Poor prognosis was defined as the occurrence of at least one of the following during follow-up: >10% decline in forced vital capacity (FVC), development of a radiological progression, or the need for treatment escalation. Univariable and multivariable logistic regression analyses were performed to identify predictors of poor prognosis. Discriminative performance of the Gender-Age-Physiology (GAP) score, Lung Immune Prognostic Index (LIPI), and derived neutrophil-to-lymphocyte ratio (dNLR) was evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Patients with IPAF were older at diagnosis compared with CTD-ILD (median 68.5 vs 56.0 years, <i>p</i> < 0.001), while female predominance was higher in CTD-ILD (81.0% vs 56.7%, <i>p</i> = 0.029). The GAP score was higher in IPAF, whereas anti-CCP positivity was more common in CTD-ILD. Despite these differences, clinical outcomes were comparable between groups, with no significant differences in FVC decline, development of radiological progression, treatment escalation, antifibrotic initiation, or composite poor prognosis. In univariable analysis, an increased persistent erythrocyte sedimentation rate (ESR) and C-reactive protein were associated with poor prognosis. In multivariable analysis, persistent ESR elevation remained an independent predictor (OR 3.25, 95% CI 1.15-9.23, <i>p</i> = 0.027). ROC analysis showed limited discriminative performance (AUC < 0.60) for GAP, LIPI, and dNLR.</p><p><strong>Conclusion: </strong>Although IPAF and CTD-ILD differ in baseline phenotype, their clinical trajectories appear similar. Persistent systemic inflammation, reflected by sustained ESR elevation, independently predicts adverse outcomes, while commonly used prognostic scores demonstrate limited utility.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261465583"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13351220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interstitial lung disease associated with novel anticancer agents in non-small cell lung cancer: a pharmacovigilance analysis using the FAERS database.","authors":"Yunfei Zhu, Jingjing Sun, Shuyun Xu","doi":"10.1177/17534666261444082","DOIUrl":"10.1177/17534666261444082","url":null,"abstract":"<p><strong>Background: </strong>Some novel anticancer agents are associated with drug-induced interstitial lung disease (ILD), a critical and potentially fatal adverse event. Lung cancer patients appear particularly susceptible, yet the risk and clinical characteristics remain incompletely analyzed.</p><p><strong>Objectives: </strong>To comprehensively evaluate ILD risk and characteristics induced by novel anticancer agents in non-small cell lung cancer (NSCLC) using large-scale real-world data.</p><p><strong>Design: </strong>A retrospective pharmacovigilance study based on spontaneous adverse event reports.</p><p><strong>Methods: </strong>Data from 2014 to 2024 were extracted from the Food and Drug Administration Adverse Event Reporting System (FAERS). Reports of NSCLC patients who developed ILD during treatment with FDA-approved novel anticancer agents (immune checkpoint inhibitors, targeted therapies, antibody-drug conjugates). The reporting odds ratio (ROR) was used to assess the disproportionate reporting signals for each drug. Statistical significance was defined when the lower 95% confidence interval (CI) exceeded 1 with at least three reports.</p><p><strong>Results: </strong>A total of 4712 NSCLC cases were analyzed. Eight agents were identified with positive signals for ILD: ROR and 95% CI for nivolumab was 1.28 (1.20-1.38), pembrolizumab 1.47 (1.36-1.59), durvalumab 7.38 (6.90-7.89), atezolizumab 1.25 (1.12-1.39), ipilimumab 1.96 (1.74-2.21), tremelimumab 3.58 (1.97-6.50), trastuzumab-deruxtecan 3.14 (2.29-4.30), osimertinib 1.12 (1.03-1.23). The median onset time was 33 days, with 48.59% of ILD events occurring within the first month. The fatal cases experienced a significantly shorter onset time than non-fatal cases. Older age, male sex, and lower body weight were identified as factors affecting ILD, whereas lower body weight, male sex, and a higher number of concomitant drugs were linked to increased mortality.</p><p><strong>Conclusion: </strong>Our study identifies positive signals for ILD with eight novel antineoplastic agents in NSCLC, including nivolumab, pembrolizumab, durvalumab, atezolizumab, ipilimumab, tremelimumab, trastuzumab-deruxtecan, and osimertinib, highlights the importance of monitoring during the first month of therapy, and identifies older male patients with lower body weight as a high-risk group.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261444082"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing clinical strategies for nutritional and immune indices prediction of chronic lung diseases: a cross-sectional study from NHANES 2007-2012.","authors":"Song He, Cong Chen, Jianqi Hao, Yueli Shu, Cheng Yu, Xiaojun Liu, Xiaoqing Wu, Nanzhi Luo, Wenjing Zhou, Zhengyu Zha","doi":"10.1177/17534666261432503","DOIUrl":"10.1177/17534666261432503","url":null,"abstract":"<p><strong>Background: </strong>Composite nutritional and immune indices (NIIs) have been associated with chronic lung diseases (CLDs). However, systematic research on their associations with different CLD subtypes and potential threshold patterns remains limited.</p><p><strong>Objectives: </strong>To examine cross-sectional associations between multiple NII and CLD subtypes, and to explore potential linear/nonlinear relationships and threshold ranges using a representative dataset.</p><p><strong>Design: </strong>Cross-sectional, population-based study using National Health and Nutrition Examination Survey (NHANES) data.</p><p><strong>Methods: </strong>Data were obtained from the US NHANES from 2007 to 2012. Participants aged 18-79 years with complete blood and baseline data were included. Survey-weighted regression models were used to assess associations between NIIs and CLDs. Restricted cubic spline (RCS) regression models were employed to explore linear/nonlinear relationships and potential threshold ranges.</p><p><strong>Results: </strong>The study included 5837 participants (mean age 49.82 ± 16.15). Regression analyses revealed significant associations between NIIs and CLDs across different ranges. RCS analysis identified thresholds for each NII: prognostic nutritional index (PNI) levels > 46.04 showed a significant inverse association with emphysema and chronic bronchitis. Elevated platelet-to-lymphocyte ratio (PLR) (>113.57) and MLR (>0.14) were positively associated with these conditions. systemic immune-inflammation index (SII) (>429.43) and neutrophil-to-lymphocyte ratio (NLR) (>0.99) were associated with a higher prevalence of asthma, emphysema, and chronic bronchitis.</p><p><strong>Conclusion: </strong>In this cross-sectional population-based study, NIIs were associated with different CLD subtypes, with evidence of potential threshold patterns. These findings may help inform future epidemiological studies and hypothesis generation, while causal inference and clinical application require further longitudinal validation.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261432503"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural and urban environmental exposures and the risk of progressive pulmonary fibrosis.","authors":"Maeve G MacMurdo, Yifan Wang, Amanda Morgan, Xiaofeng Wang, Daniel A Culver","doi":"10.1177/17534666261471968","DOIUrl":"10.1177/17534666261471968","url":null,"abstract":"<p><strong>Background: </strong>Non-occupational exposures are increasingly recognized as a driver of poor outcomes in patients with interstitial lung disease (ILD), including urban and rural populations. However, both populations also experience barriers to care and higher social vulnerability that may be associated with higher risk for progression. The impact of agricultural antigen exposure and concomitant social vulnerability has not been well characterized.</p><p><strong>Objectives: </strong>To evaluate the risk of progression in both urban and agricultural antigen-exposed communities in patients with ILD.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>We identified individuals with a diagnosis of ILD in a large health system. Proximity to agricultural antigens was mapped utilizing satellite-derived crop data. Residence in a community impacted by structural disadvantage was estimated using the social vulnerability index (SVI). We used geographically weighted regression analysis to estimate the risk of progression, defined as a greater than 10% relative decrease in forced vital capacity within the 24 months from first documented diagnosis.</p><p><strong>Results: </strong>Residence in a high SVI community was associated with an increased risk of disease progression by FVC criteria in both agriculturally exposed and urban communities. The greatest risk of progression was seen in those residing in high SVI, rural communities (HR 1.19, CI: 1.09-1.31).</p><p><strong>Conclusion: </strong>Within a large cohort of geographically diverse patients with ILD, residential social vulnerability increased the risk of ILD progression with effects similar in individuals with agricultural antigen exposure and urban exposures.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261471968"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary intravascular large B-cell lymphoma misdiagnosed as allergic pneumonia: a case report and literature review.","authors":"Hao Deng, Bingpeng Guo, Gengjia Chen, Qiexinhao Li, Du Feng, Chuoqi Yang, Xiaolu Zhong, Qun Luo, Shiyue Li, Qian Han","doi":"10.1177/17534666261424374","DOIUrl":"10.1177/17534666261424374","url":null,"abstract":"<p><p>Pulmonary intravascular large B-cell lymphoma (PIVLBCL) is an extremely rare subtype of extranodal diffuse large B-cell lymphoma (DLBCL). This hematologic malignancy exhibits nonspecific radiological features, including ground glass opacities (GGOs), often leading to misdiagnosis as interstitial lung disease (ILD). We present a 51-year-old female hairdresser with progressive dyspnea and 20 years of occupational hair dye exposure. Initially, she was misdiagnosed with chronic bronchitis due to a persistent dry cough. Then her initial chest CT demonstrated diffuse bilateral GGOs with isolated diffusion capacity of the lungs for carbon monoxide (DLCO) reduction (46.1% predicted) and normal spirometry, which led to a second misdiagnosis as hypersensitivity pneumonitis (HP). Despite initial improvement with corticosteroids, respiratory deterioration occurred during tapering. Finally, transbronchial lung cryobiopsy (TBCB) confirmed PIVLBCL, showing intravascular lymphoid proliferation (CD20+/BCL-6+/Ki-67≈80%). The R-CHOP chemotherapy treatment led to a complete remission for her, and the DLCO improved to 68% of the predicted value at the 6-month follow-up. A literature review of 75 PIVLBCL patients revealed that fever (74.7%) and dyspnea (65.3%) were the predominant presentations. GGOs were observed in 54.7% of cases, with frequent misdiagnosis as ILD (31.8%) or pneumonia (31.8%). TBCB provided definitive diagnostic evidence, demonstrating its clinical utility in resolving ambiguous pulmonary opacities. Clinicians should maintain high suspicion for PIVLBCL when encountering diffuse GGOs with isolated DLCO reduction, even without classic risk factors.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261424374"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral hypoperfusion in pulmonary arterial hypertension: Association with right ventricular dysfunction and risk stratification.","authors":"Peng Hou, Miao Ke, Qian Jiang, Ning Lai, Shaonan Zhong, Ruiyue Zhao, Chang Sun, Guanli Wang, Jiahui Zhang, Yiqiang Geng, Yimin Fu, Chunli Liu, Xinlu Wang","doi":"10.1177/17534666261485141","DOIUrl":"10.1177/17534666261485141","url":null,"abstract":"<p><p>BackgroundPulmonary arterial hypertension (PAH) is a progressive disease that affects the central nervous system. The cardiopulmonary-brain axis hypothesis links right ventricular dysfunction to cerebral hypoperfusion, yet the association between regional cerebral blood flow (CBF) alterations, right heart dysfunction, and the clinical utility of CBF for risk stratification remains poorly understood.ObjectivesTo investigate the association between CBF and right heart dysfunction in patients with PAH, and to evaluate the potential of CBF as a non-invasive biomarker for risk stratification.DesignCross-sectional, retrospective study.MethodsThirty PAH patients and 51 age- and sex-matched healthy controls (HCs) were retrospectively identified. Brain MRI data, including 3D arterial spin labeling (ASL) at 3.0 T for CBF quantification were analyzed. For the PAH cohort, clinical assessment included right heart catheterization (RHC) and transthoracic echocardiography (TTE) to evaluate the structure of the right ventricle (RV) and hemodynamics. Patients were stratified into low and intermediate/high-risk groups according to the 2022 ESC/ERS guidelines. Receiver operating characteristic (ROC) analysis was used to evaluate the discriminatory value of CBF for risk stratification. Generalized Linear Models were applied to analyze associations between CBF, cardiac and hemodynamic parameters, and neuropsychological metrics.ResultsCompared with HCs, PAH patients exhibited significant regional hypoperfusion, predominantly in the right hippocampus, frontal gyri, and insula. Regional CBF values correlated inversely with RV area (systolic RV area and right caudate: r = -0.569, <i>P</i> = 0.006, systolic RV area and right thalamus: r = -0.587, <i>P</i> = 0.004, diastolic RV area and right caudate: r = -0.513, <i>P</i> = 0.012, diastolic RV area and right thalamus: r = -0.545, <i>P</i> = 0.007) and septal thickness (right superior frontal gyrus: r = -0.528, <i>P</i> = 0.015, left anterior cingulate: r = -0.495, <i>P</i> = 0.024). Notably, intermediate/high-risk patients demonstrated significantly lower CBF compared to low-risk patients, particularly in the parietal and frontal cortices. ROC analysis indicated that regional CBF, in addition to patient sex and age, could distinguish intermediate/high-risk patients from low-risk patients (right superior frontal region: AUC = 0.793, Sensitivity = 71%). Additionally, reduced CBF in the insula was associated with lower Mini-Mental State Examination (MMSE) scores.ConclusionThis study demonstrates that cerebral hypoperfusion in PAH is closely associated with right ventricular dysfunction and disease severity. ASL-derived CBF holds promise as a non-invasive biomarker to refine risk stratification, offering novel insights into the cardiopulmonary-brain interaction.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261485141"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic and prognostic role of MMP-1 and MMP-9 plasma concentrations in idiopathic pulmonary fibrosis.","authors":"Ioannis Tomos, Aris Spathis, Stylianos Argentos, Anna Karakatsani, Effrosyni D Manali, Spyros Papiris","doi":"10.1177/17534666261493434","DOIUrl":"https://doi.org/10.1177/17534666261493434","url":null,"abstract":"<p><p>BackgroundIdiopathic pulmonary fibrosis (IPF) represents a chronic and irreversible progressive disease, while acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) represents a catastrophic event in the course of the disease with high mortality. So far, there is no known accurate biomarker with a diagnostic or prognostic role in IPF. Matrix metalloproteases (MMPs), belonging to the family of zinc-containing metallopeptidases, play an active role in extracellular matrix remodeling and in regulating fibrogenesis.ObjectivesThe study's aim was to assess the potential diagnostic and prognostic role of plasma MMP-1 and MMP-9 in IPF and their association to disease progression, acute exacerbation development, and death.DesignConsecutive stable and exacerbated patients referred to our department from October 2013 until December 2017 were enrolled in the study.MethodsDemographic, clinical, and laboratory data were collected. MMP-1 and MMP-9 plasma concentrations were measured. All patients were followed-up until death or until 1^st July 2020. We analyzed data using tobit regression analysis, Kaplan-Meier analysis, Cox regression analysis, and fractional polynomials.ResultsOne hundred twenty-eight patients were included in the study [74 stable IPF patients, mean age (SD) 71.5 years (8.05) and 54 exacerbated, mean age (SD) 71.8 years (10.15)] as well as 26 healthy controls, mean age (SD) 61.4 years (10.4). At baseline, both stable IPF and exacerbated patients presented higher concentrations of MMP-9 in plasma compared to healthy controls independently of age, sex, and smoking (p=0.006 and p=0.002, respectively). In stable IPF, each 1 µg/L increase in plasma MMP-1 concentration at baseline was associated with an increase in the hazard rate of death by 20% (95%CI: 2% to 42%; adjusted for age, sex, smoking and FVC).ConclusionIn our patients with stable IPF, MMP-1 concentration is prognostic for death, whereas MMP-9 has diagnostic value for IPF. These results may lead to better patient stratification and personalized therapeutic approaches.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261493434"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric comorbidities in patients with interstitial lung diseases: A narrative review of epidemiology, clinical impact, and integrated care strategies.","authors":"Zhixuan Wu, Bo Wang, Hengtao Lin, Lian Liu, Diandian Li","doi":"10.1177/17534666261488597","DOIUrl":"10.1177/17534666261488597","url":null,"abstract":"<p><p>Interstitial lung diseases (ILDs) represent a group of chronic respiratory diseases characterized by inflammation and/or fibrosis of the lung parenchyma with poor prognosis and high mortality. Psychiatric comorbidities, particularly anxiety and depression, are common in patients with ILDs but are frequently underestimated. In this review, we summarize the most current evidence demonstrating that psychiatric comorbidities are prevalent across various ILD subtypes. The coexistence of ILDs and psychiatric comorbidities is associated with a complex interplay of factors, including disease-related symptoms, functional disability, psychosocial stressors, treatment-related factors and potential biological factors involving chronic hypoxia and genetic susceptibility. The presence of anxiety or depression is correlated with worse symptoms, reduced physical activity and impaired health-related quality of life. Despite this, validated, ILD-specific screening tools for psychiatric comorbidity remain inadequate. Furthermore, this review discusses the efficacy and limitations of both pharmacological and non-pharmacological interventions in ILD patients with psychiatric comorbidities. Future studies should focus on the development of standardized assessment tools and the establishment of integrated and personalized management protocols using larger longitudinal studies with diverse ILD populations.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261488597"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between systemic immune-inflammation index and in-hospital mortality in ICU patients with aspiration pneumonia: A retrospective cohort study based on MIMIC-IV database.","authors":"Na Liu, Hong Zhou","doi":"10.1177/17534666261485139","DOIUrl":"10.1177/17534666261485139","url":null,"abstract":"<p><p>BackgroundAspiration pneumonia is a common and life-threatening condition among critically ill patients, with mortality reaching 20-50%. The Systemic Immune-Inflammation Index (SII), derived from the routine complete blood count, has shown prognostic value in various inflammatory and infectious diseases, but its association with outcomes in ICU patients with aspiration pneumonia is unknown.ObjectivesTo investigate the association between SII and in-hospital mortality in ICU patients with aspiration pneumonia and to characterize the dose-response relationship.DesignRetrospective cohort study using a large publicly available critical care database.MethodsAdult patients (≥18 years) admitted to the ICU with aspiration pneumonia and an ICU stay ≥24 hours were identified in the MIMIC-IV database (version 3.1). SII (neutrophil × platelet/lymphocyte count) was derived from laboratory values obtained within the first 24 hours of admission and stratified into quartiles. Multivariable logistic regression with sequential adjustment evaluated the association with in-hospital mortality; restricted cubic splines characterized the dose-response relationship, and subgroup and sensitivity analyses assessed robustness.ResultsA total of 2,132 patients were included (median age 66 years, IQR 54-78; 62.2% male); overall in-hospital mortality was 25.5%. Mortality across SII quartiles was 24.6% (Q1), 20.5% (Q2), 26.1% (Q3) and 31.0% (Q4), exhibiting a U-shaped pattern. Using Q2 as reference, the highest quartile was independently associated with increased mortality (adjusted OR 1.53, 95% CI 1.14-2.06; P=0.005), and restricted cubic spline analysis confirmed a non-linear U-shaped relationship (P for trend = 0.003). Results were consistent after additional adjustment for vasopressor use and mechanical ventilation (adjusted OR 1.70, 95% CI 1.11-2.60; P=0.014) and across age, sex and comorbidity subgroups, with no significant interactions.ConclusionIn ICU patients with aspiration pneumonia, SII showed a U-shaped association with in-hospital mortality. Pending prospective and external validation, SII may represent a promising candidate biomarker for risk stratification.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261485139"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}