Therapeutic Advances in Respiratory Disease最新文献

{"title":"BMP2 may be a promising biomarker for COPD.","authors":"Yiqiong Wen, Lingyu Li, Qiaoli Fu, Qingqing Qian, Min Li, Ting Li, Wei Ma, Yuanyuan Zheng, Shibo Sun","doi":"10.1177/17534666261501648","DOIUrl":"https://doi.org/10.1177/17534666261501648","url":null,"abstract":"<p><p>BackgroundDespite the substantial disease burden of chronic obstructive pulmonary disease (COPD), convenient and specific biomarkers for COPD remain lacking.ObjectivesTo explore plasma bone morphogenetic protein 2 (BMP2) levels in patients with COPD and the diagnostic value of BMP2 for COPD.DesignA single-center and cross-sectional observational study.MethodsNinety-one patients with COPD and 51 healthy subjects were prospectively recruited as the COPD group and control group, respectively. Plasma BMP2 levels of all subjects were detected. Correlations between BMP2 and other clinical indicators were analyzed. Logistic regression analysis was used to identify the risk factors of COPD. The ROC curve was used to evaluate the diagnostic value of BMP2 for COPD.ResultsPlasma BMP2 levels in COPD group were higher than that in control group (<i>P</i> < 0.001). The COPD group was divided into acute exacerbation of COPD (AECOPD) group (n=59) and stable COPD (SCOPD) group (n=32). Plasma BMP2 levels in the SCOPD group were higher than that in the AECOPD group (<i>P</i> < 0.001). In addition, plasma BMP2 levels in the control group and COPD group were negatively correlated with PEF, FEF₂₅, FEF₅₀, FEF₇₅, and DLCO (<i>P</i> < 0.05). Plasma BMP2 in the COPD group were positively correlated with FEV₁/FVC, FEV₁%pred, FEF₂₅, FEF₅₀, and FEF₇₅ (<i>P</i> < 0.05). Importantly, logistic regression analysis showed that BMP2 was an independent risk factor for COPD (adjusted OR = 1.115, 95% CI: 1.065-1.166, <i>P</i> < 0.001). Moreover, the AUC of BMP2 in distinguishing COPD group from control group was 0.763 (95% CI: 0.686-0.839, <i>P</i> < 0.001), and that in distinguishing AECOPD group from SCOPD group was 0.722 (95% CI: 0.610-0.834, <i>P</i> < 0.001).ConclusionsPlasma BMP2 level is elevated in patients with COPD. Moreover, BMP2 is an independent risk factor for COPD and has auxiliary diagnostic value for COPD. Consequently, BMP2 may be a promising biomarker for COPD.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261501648"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149246439","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":"Pregnancy in females with cystic fibrosis and chronic <i>Burkholderia cepacia</i> complex or non-tuberculous mycobacteria infection: A single centre case series.","authors":"Amy Downes, Ladina Weitnauer, Rachel Robinson, Sara Barakat, Elaine Bowman, Catherine Williamson, Andrew Jones, Nicholas J Simmonds, Rebecca Scott, Imogen Felton","doi":"10.1177/17534666261493710","DOIUrl":"https://doi.org/10.1177/17534666261493710","url":null,"abstract":"<p><p>Widespread availability of cystic fibrosis transmembrane conductance regulator modulator therapy (CFTRm) has resulted in improved health and quality of life for many people with cystic fibrosis (CF) and a subsequent rise in pregnancies among females with CF (FwCF). An increasing number of pregnancies are now occurring in women who are chronically infected with clinically significant respiratory pathogens, in particular the <i>Burkholderia cepacia</i> complex (BCC) and non-tuberculous mycobacteria (NTM), including <i>Mycobacterium abscessus</i> complex (MABC). These pathogens are associated with accelerated pulmonary decline, multi-drug antimicrobial resistance patterns and complex, prolonged treatment regimens making them important considerations in pregnancy management. Historically, chronic BCC infection has been linked to poorer obstetric and perinatal outcomes in FwCF, although much of the available evidence predates the CFTRm era and may not reflect the current clinical landscape. Similarly, while NTM infection, most significantly MABC, remains a major clinical challenge and contraindication for lung transplantation in people with cystic fibrosis (PwCF), there is a paucity of published data describing pregnancy outcomes in FwCF living with chronic NTM infection. As CFTRm has shifted disease trajectories and expanded reproductive possibilities, updated evidence describing risks and outcomes is urgently needed. This case series addresses this gap by examining CF-specific, obstetric, and neonatal outcomes in ten pregnancies: four in FwCF chronically infected with BCC and six with NTM infection. All pregnancies ended in live births: nine infants born at term, and one at 32+5 weeks from spontaneous premature labour, requiring the only admission to neonatal intensive care. CFTRm were used in nine pregnancies, and admission to hospital was required in two pregnancies for infective exacerbations of CF. There were no maternal deaths and no maternal intensive care admissions. These findings contribute essential new insights to guide counselling, risk assessment, and multidisciplinary management for pregnant FwCF with chronic infection by these high-risk pathogens.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261493710"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149273306","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":"The prevalence and unique clinical features of CPFE among patients with connective tissue disease-associated interstitial lung disease: a retrospective, real-world study.","authors":"Shuwan Huang, Aiyuan Zhou, Wei Cheng, Qing Song, Xiyan Zhang, Wenzhong Peng, Yanan Wang, Haiyuan Tang, Rongli Lu, Ruoxi He, Pinhua Pan","doi":"10.1177/17534666261471313","DOIUrl":"10.1177/17534666261471313","url":null,"abstract":"<p><strong>Background: </strong>Combined pulmonary fibrosis and emphysema (CPFE) is a distinct yet clinically underrecognised syndrome. Interstitial pneumonia is a common pulmonary manifestation of connective tissue diseases (CTDs), and some CTD-interstitial lung disease (CTD-ILD) patients have concurrent emphysema that is frequently overlooked clinically.</p><p><strong>Objectives: </strong>This study explored the clinical characteristics and factors associated with emphysema in CTD-ILD patients to guide clinical management.</p><p><strong>Design: </strong>This single-centre retrospective study included patients with CTD-related lung diseases from the ILD database of Xiangya Hospital. Patients were screened with standardised respiratory disease keywords and verified by chest HRCT. All eligible cases were stratified into CTD-ILD and CTD-CPFE groups based on emphysema presentation on re-assessed HRCT images.</p><p><strong>Methods: </strong>Admission data, including demographics, comorbidities, inflammatory biomarkers, autoimmune antibodies, HRCT findings, pulmonary function test results and in-hospital treatment information, were collected for subsequent grouped analysis.</p><p><strong>Results: </strong>445 CTD-ILD patients were included, and 48 (10.8%) were CPFE. Patients with CPFE were predominantly male (68.8%), had a higher prevalence of a smoking history (68.8% vs 31.2%, <i>p</i> < 0.001), a lower body mass index (BMI) (20.4 vs 22.2 kg/m², <i>P</i> = 0.004), and a higher prevalence of prior tuberculosis (TB) (14.6% vs 4.3%, <i>p</i> = 0.009). Multivariable regression analysis showed that sex, BMI, smoking status, and history of TB were independently associated with CPFE. Male sex was associated with a markedly increased likelihood of CPFE (<i>p</i> = 0.003). TB was associated with increased likelihood, whereas higher BMI was associated with reduced likelihood (odds ratio: 33 and 0.57, respectively).</p><p><strong>Conclusion: </strong>CTD-CPFE may represent a distinct subgroup within CPFE, with several characteristic features, including a relatively lower prevalence of smoking history. A low BMI and a history of TB were associated with the presence of CPFE, highlighting the potential importance of nutritional and immune status in patients with CTD-ILD.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261471313"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593211","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":"Arterial stiffness and wave reflection profiles in patients with asthma: the role of hemodynamic determinants.","authors":"Şaban Melih Şimşek, Gökhan Gök, Hayriye Bektaş Aksoy, Selda Günaydın, Numan Kılıç","doi":"10.1177/17534666261454200","DOIUrl":"10.1177/17534666261454200","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a heterogeneous inflammatory airway disease increasingly recognised to be associated with elevated cardiovascular risk. Arterial stiffness, commonly assessed by pulse wave velocity (PWV), is a well-established predictor of cardiovascular events. However, it remains unclear whether vascular involvement in asthma reflects true arterial stiffening or predominantly altered arterial wave reflection.</p><p><strong>Objectives: </strong>To investigate arterial stiffness and wave reflection characteristics in patients with controlled and uncontrolled asthma compared with healthy controls.</p><p><strong>Design: </strong>Cross-sectional observational study.</p><p><strong>Methods: </strong>A total of 158 participants (56 healthy controls, 50 patients with controlled asthma, and 52 patients with uncontrolled asthma) underwent non-invasive arterial stiffness and hemodynamic assessments. Peripheral and central blood pressures, PWV, augmentation pressure, augmentation index and reflection magnitude were measured. Group comparisons were performed using unadjusted analyses and multivariable analysis of covariance (ANCOVA). Multivariate analysis of covariance (MANCOVA) was used to evaluate wave reflection parameters simultaneously, adjusting for age, body mass index, smoking status, heart rate and systolic blood pressure.</p><p><strong>Results: </strong>PWV differed significantly between groups in unadjusted analyses, with higher values observed in asthma groups. However, this association was no longer significant after multivariable adjustment, with age and systolic blood pressure emerging as the strongest independent determinants of PWV. In contrast, MANCOVA revealed a significant overall group effect on wave reflection parameters. Subsequent univariate analyses demonstrated that reflection magnitude remained significantly higher in both controlled and uncontrolled asthma groups compared with healthy controls after adjustment, whereas augmentation pressure and augmentation index did not show independent group effects.</p><p><strong>Conclusion: </strong>Vascular involvement in asthma appears to be characterised primarily by altered arterial wave reflection rather than overt arterial stiffening. These findings suggest that vascular alterations observed in asthma are primarily related to changes in arterial wave reflection and may be influenced by systemic hemodynamic factors (e.g. blood pressure and body composition), rather than asthma control itself.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261454200"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057044","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":"Validation of pre-flight algorithms in predicting hypoxic challenge testing (HCT) outcomes in interstitial lung disease (ILD).","authors":"Cameron Bonthrone, Beyazit Durdu, Sarah Mulholland, Naomi Rippon, Louis Luckwell, Michelle Westlake, Giles Dixon, Matthew Wells, Huzaifa Adamali, Shaney L Barratt","doi":"10.1177/17534666261431183","DOIUrl":"10.1177/17534666261431183","url":null,"abstract":"<p><strong>Background: </strong>The British Thoracic Society (BTS) currently recommends pre-flight clinical assessment of all symptomatic patients with interstitial lung disease (ILD). This may include hypoxic challenge testing (HCT) to determine whether supplemental in-flight oxygen is required, but it is not universally available.</p><p><strong>Objectives: </strong>(1) To validate a previously published pre-flight assessment algorithm in predicting outcomes of HCT in ILD. (2) Compare the sensitivity and specificity of the original algorithm to an amended version published in the BTS clinical statement on air travel.</p><p><strong>Design: </strong>Single centre, cohort study.</p><p><strong>Methods: </strong>A single-centre retrospective cohort analysis of ILD patients attending for HCT between March 2017 and April 2023.</p><p><strong>Results: </strong>A total of 126 patients with a diagnosis of ILD underwent HCT. Median forced vital capacity 75.0% predicted (interquartile range (IQR) 24.8) and transfer factor for carbon monoxide 45.8% predicted (IQR 18.6). Diagnosis of idiopathic pulmonary fibrosis in 50.8% (<i>n</i> = 64). A total of 18 individuals became hypoxic during the test (a fall of PaO₂ to <6.6 kPa or oxygen saturations (SpO₂) < 85% pO₂, 'failed HCT'). The pre-flight algorithm demonstrated moderate sensitivity (69.4%, identifying most 'passed' cases correctly, 43/62) and good specificity (83.3%, most 'failed' cases correctly identified, 10/12). A total of 52 (41.2%) patients would have been referred for HCT, with 11.5% (<i>n</i> = 6) requiring in-flight oxygen ('failed' HCT). The modified BTS algorithm demonstrated a moderate sensitivity of 70.3% (45/64) and good specificity of 83.3% (10/12). In both algorithms, 29 patients would have been advised in-flight oxygen, whilst only 10 of these required supplementary oxygen according to HCT. There were two divergences in algorithmic outcomes, both arising from patients without desaturation on exercise, resulting in two fewer HCT using the BTS algorithm and correctly advising 'no supplemental oxygen' was required.</p><p><strong>Conclusion: </strong>In this validation study, the practical pre-flight algorithm demonstrates good specificity and moderate sensitivity for predicting HCT outcomes. The BTS modified algorithm demonstrates comparable sensitivity and specificity. Additional work is required to further develop practical guidance to reduce both the number of HCT advised and the proportion of patients incorrectly advised to arrange supplemental in-flight oxygen.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261431183"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463882","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 role of transbronchial lung cryobiopsy in multidisciplinary discussion for interstitial lung diseases: a dual-center retrospective study.","authors":"Qi Liu, Ting Wang, Qing Chang, Ning Xu, Ruolin Mao, Mengnan Li, Ding Sun, Yuqing Chen, Hai Zhang, Hongying Zhang, Feng Li","doi":"10.1177/17534666261438213","DOIUrl":"10.1177/17534666261438213","url":null,"abstract":"<p><strong>Background: </strong>Interstitial lung diseases (ILDs) are a heterogeneous group of disorders with complex etiologies and nonspecific clinical manifestations, often requiring histopathological confirmation for accurate diagnosis. Transbronchial lung cryobiopsy (TBLC) has emerged as a less invasive alternative to surgical lung biopsy (SLB) for obtaining lung tissue, yet its role in multidisciplinary discussion (MDD) remains underevaluated.</p><p><strong>Objectives: </strong>This study aimed to assess the diagnostic yield and safety of TBLC when integrated into MDD for diagnosing ILDs.</p><p><strong>Design: </strong>A retrospective dual-center study was conducted on 208 patients with undiagnosed ILDs who underwent TBLC at Shanghai Chest Hospital and Fuzhou Pulmonary Hospital from May 2021 to December 2024.</p><p><strong>Methods: </strong>TBLC procedures were performed under general anesthesia, with samples evaluated by pathologists and integrated into MDD involving pulmonologists, radiologists, and rheumatologists. Diagnostic yield, complication rates, and concordance were analyzed.</p><p><strong>Results: </strong>TBLC achieved a histological diagnostic yield of 88.9% (185/208 cases), which improved to 97.6% (203/208 cases) after MDD. The most common diagnosis was hypersensitivity pneumonitis (HP, 18.3%) followed by idiopathic nonspecific interstitial pneumonia (iNSIP, 15.4%). Complications were rare, with pneumothorax occurring in 5.3% of cases and moderate bleeding in 3.4%. No procedure-related mortality was observed.</p><p><strong>Conclusion: </strong>TBLC is a safe and effective diagnostic tool for ILDs, with high diagnostic yield when integrated into MDD. TBLC reduces the need for SLB while maintaining low complication rates. These findings support TBLC as a valuable component of the MDD approach for ILDs.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261438213"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609753","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":"Feasibility and preliminary clinical outcomes of medical thoracoscopic bulla volume reduction for giant emphysematous bulla.","authors":"Rui Xu, Xinmiao Du, Ling Zuo, Jingyu Shi, Yongxiao Luo, Tao Zhang, Dan Liu, Kaige Wang","doi":"10.1177/17534666261465491","DOIUrl":"10.1177/17534666261465491","url":null,"abstract":"<p><strong>Background: </strong>Giant emphysematous bulla (GEB) is a form of emphysematous lung destruction and patients experience progressive dyspnea and decline in quality of life. Conventional surgical reduction is not available for all patients, especially those in poor condition, and a less invasive approach is needed.</p><p><strong>Objectives: </strong>This study aimed to evaluate the feasibility and preliminary clinical outcomes of medical thoracoscopic bulla volume reduction for GEB.</p><p><strong>Design: </strong>Single-center retrospective observational study.</p><p><strong>Methods: </strong>A total of 35 GEB patients who underwent medical thoracoscopic bulla volume reduction were retrospectively analyzed. Preoperative and postoperative clinical data and chest computed tomography were collected. The feasibility of the technique was evaluated by radiological changes (bullae volume and diameter) and postoperative complications. Improvement in dyspnea was assessed using the modified Medical Research Council (mMRC) dyspnea scale. Accessible six-minute walk distance (6MWD) and spirometry test follow-up data were analyzed to assess preliminary clinical functional improvement.</p><p><strong>Results: </strong>The targeted bulla volume was 1183.8 ± 636.7 mL preoperatively and decreased to 169.2 ± 237.2 mL postoperatively, representing an 87.7 ± 17.1% decrease compared to the baseline. A total of 91.4% (32/35) of the patients achieved more than 50% volume reduction relative to baseline, and the diameter of the targeted bulla also showed a significant decrease (<i>p</i> < 0.0001). Nine subcutaneous emphysema cases and one thoracic infection case were reported as postoperative complications. In the overall population, the mMRC score decreased by 1.2 ± 0.6 points at the 6-month follow-up. Available follow-up data on 6MWD and spirometry tests also showed improvement.</p><p><strong>Conclusion: </strong>Medical thoracoscopic bulla volume reduction may represent a feasible and less invasive therapeutic option for patients with GEB and demonstrated preliminary clinical outcomes.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261465491"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431055","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 effectiveness of the AI-based RehabLung mobile rehabilitation system on cardiopulmonary function and user satisfaction in lung cancer patients undergoing thoracic surgery: a protocol for a two-arm randomized clinical trial.","authors":"Hsin-Lun Yang, Ching-Hsia Hung, Yu-Ting Huang, Hui-Ching Cheng, Yau-Lin Tseng, Jun-Ming Su, Kun-Ling Tsai","doi":"10.1177/17534666261427319","DOIUrl":"10.1177/17534666261427319","url":null,"abstract":"<p><strong>Background: </strong>Postoperative recovery following lung cancer surgery can be challenging owing to various cardiorespiratory complications. Pulmonary rehabilitation is crucial during both the preoperative and postoperative periods. However, because of limited resources and accessibility, innovative approaches are necessary to improve rehabilitation outcomes. This study aimed to evaluate the effectiveness of the RehabLung App, a novel AI-based mobile application integrating vision recognition, gamified feedback, and web-based patient management to support personalized lung rehabilitation through telerehabilitation and real-time monitoring.</p><p><strong>Objectives: </strong>This study outlines the protocol for a randomized controlled trial involving patients with lung cancer undergoing thoracic surgery.</p><p><strong>Design: </strong>Assessor-blinded (single-blind), two-arm, parallel-group randomized controlled trial (1:1 allocation) conducted at a single medical center.</p><p><strong>Methods and analysis: </strong>The intervention will include individualized exercise prescriptions delivered five times per week for 8 weeks via the App, which adapts based on weekly assessments of clinical parameters and real-time performance data. Primary outcomes include forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), as well as cardiopulmonary fitness assessed at baseline and at postoperative weeks 5 and 8. Secondary outcomes include respiratory muscle strength, diaphragmatic function, and user satisfaction, which are evaluated using a custom questionnaire informed by technology acceptance models. In addition, clinically meaningful endpoints will be collected, including morbidity, mortality, and length of stay. Frailty will be assessed preoperatively using the Clinical Frailty Scale, and validated patient-reported outcomes (EORTC QLQ-C30) will be administered to evaluate quality of life and symptom burden.</p><p><strong>Ethics: </strong>The study has been approved by the Institutional Review Board at National Cheng Kung University Hospital (A-ER-111-055).</p><p><strong>Discussion: </strong>We hypothesize that patients using the RehabLung App may demonstrate improvements in pulmonary function, exercise tolerance, diaphragmatic function, and rehabilitation adherence compared with those receiving standard care. The system's real-time feedback and risk alerts may facilitate timely intervention and could potentially improve engagement.</p><p><strong>Conclusion: </strong>The implementation of the RehabLung App in lung cancer surgery care may enhance the effectiveness and accessibility of pulmonary rehabilitation. This protocol describes an AI-enhanced telerehabilitation system that may support individualized recovery strategies and could potentially improve both clinical outcomes and patient engagement.</p><p><strong>Trial registration: </strong>Registration Date;2024,09,19; ClinicalTrials.gov (Identifier: NCT06600503).</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261427319"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322202","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":"Neutrophil elastase activity in bronchial lavage fluid and the one-year follow-up outcomes in bronchiectasis patients: A multicenter prospective cohort study.","authors":"Lam Nguyen-Ho, Quoc-Khanh Tran-Le, Hoang Kim Tu Trinh, Diem My Vu, Vu Le-Thuong, Ngoc Tran-Van, James D Chalmers","doi":"10.1177/17534666261473487","DOIUrl":"10.1177/17534666261473487","url":null,"abstract":"<p><p>BackgroundBronchiectasis is increasingly recognized as an inflammatory disease in which \"disease activity\" is not fully captured by radiology or composite severity scores. Although sputum neutrophil elastase (NE) activity is a validated biomarker, the prognostic value of segment-specific NE activity in bronchial lavage fluid (BLF) remains limited.ObjectivesTo evaluate NE activity in BLF collected from affected bronchi and determine its association with one-year bronchiectasis outcomes.DesignMulticenter prospective cohort study.MethodsAdults with stable bronchiectasis undergoing bronchoscopy at two hospitals in Ho Chi Minh City were enrolled between April 2022 and January 2024. BLF was collected from the most affected bronchus (ABLF) and a reference bronchus (NBLF). NE activity was quantified using a fluorogenic assay. Participants were followed for 12 months to assess exacerbations and time to first exacerbation.ResultsOf 168 screened patients, 139 were enrolled and 121 completed follow-up. Post-tuberculosis bronchiectasis was the most common etiology. NE activity was detectable in all BLF samples and was higher in ABLF than NBLF (median 2.0 vs. 0.4 μg/mL). Exacerbations occurred in 42.1% of patients. ABLF NE activity was higher in patients with chronic bacterial infection than in those without (median 3.6 vs. 1.8 μg/mL; p=0.001), and in patients who developed exacerbations compared with those who did not (median 3.0 vs. 1.2 μg/mL; p<0.001). After adjustment for baseline severity indices, higher ABLF NE activity remained associated with increased exacerbation risk. Kaplan-Meier analysis showed shorter exacerbation-free survival with increasing ABLF NE activity, with estimated mean exacerbation-free survival times of 10.5, 8.5, and 6.9 months in the mild, moderate, and high NE groups, respectively (log-rank p=0.001).ConclusionSegment-specific NE activity in BLF is elevated in affected bronchi and is an independent predictor of exacerbations in this TB-endemic Asian bronchiectasis cohort, supporting BLF NE as a clinically meaningful biomarker of disease activity.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261473487"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832667","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":"Patient-reported adverse events and management of antifibrotic therapy in IPF: A multicenter, cross-sectional real-world study.","authors":"Onur Turan, Erhan Uğurlu, Özge Oral Tapan, Nurhan Sarıoğlu, Gülru Polat, Şule Çilekar, Özgür Batum, Şule Taş Gülen","doi":"10.1177/17534666261475558","DOIUrl":"10.1177/17534666261475558","url":null,"abstract":"<p><p>BackgroundAntifibrotic agents slow disease progression and improve survival in IPF, yet real-life data on their use in Turkey are limited.ObjectivesThis study aimed to compare the side effects of antifibrotics in IPF patients.DesignA cross-sectional survey was conducted in 8 centers across 6 provinces in the Aegean Region.MethodsThere were 470 IPF patients who completed a 30-item face-to-face questionnaire. Adverse events and their management were compared between pirfenidone and nintedanib users.ResultsAmong 470 patients, 50.6% used pirfenidone and 49.4% nintedanib. Overall, 70.6% reported at least one side effect (75.5% nintedanib vs. 66% pirfenidone, p=0.023). Medical treatment was required in 30.9% and dose reduction in 18.9%. The most common side effects were diarrhea (30.6%), appetite loss (24.9%), and nausea (22.3%). Diarrhea (p<0.001) and weight loss (p=0.010) were more frequent with nintedanib, while rash, photosensitivity, and fatigue were more common with pirfenidone (all p<0.001). Nausea, vomiting, appetite loss, and fatigue were more frequently reported in women, and vomiting, anorexia, and rash were more frequently observed in patients with comorbidities.ConclusionAdverse events are frequent in IPF patients receiving antifibrotics. Nintedanib mainly causes gastrointestinal symptoms, whereas pirfenidone leads to skin reactions and fatigue. Female sex and the presence of comorbidities were associated with a higher frequency of certain adverse events. Supportive treatment and dose adjustments are crucial for maintaining adherence.</p>","PeriodicalId":22884,"journal":{"name":"Therapeutic Advances in Respiratory Disease","volume":"20 ","pages":"17534666261475558"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866525","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}