Thorax最新文献

{"title":"Lifetime lung function trajectories: insights into risk factors, consequences and implications","authors":"Dinh S Bui, Nur S Idrose, Shyamali C Dharmage","doi":"10.1136/thorax-2024-221544","DOIUrl":"https://doi.org/10.1136/thorax-2024-221544","url":null,"abstract":"Maintaining optimal lung function throughout life is important not only for respiratory health but also for overall health and longevity. With emerging evidence on the clinical significance of lung function at multiple windows throughout life, there has been an increasing number of studies on lung function trajectories1 including by Zhang et al in this issue.2 The term ‘lung function trajectory’ refers to how lung function tracks over time. The lungs start to develop from the first trimester of pregnancy, grow throughout childhood and adolescence, mature in early adulthood and then gradually age. As a result, lung function increases over time before reaching a peak in early adulthood, then plateaus for a while before declining with age. Lung function is influenced by adverse host factors and environmental exposures. Indeed, there are multiple and dynamic interactions between gene (G) and environment (E) throughout the lifespan (T), termed as GETomics,3 causing abnormalities at one or more life windows leading to impaired development, reduced growth, shortened plateau and accelerated decline. Due to varying GETomics, there can be substantial variation in change in lung function over time making up a range of lung function trajectories. Most studies on lung function trajectories were only able to capture either lung growth or decline phases.1 For example, studies from childhood to early adulthood (growth phase) including the Manchester Asthma and Allergy Study(MAAS, 5–16 years), the Avon Longitudinal Study of Parents and Children (ALSPAC, 8–24 years), the Australian Perth Infant Asthma Follow-up (PIAF, 1–18 years) and the Raine Study (6–22 years) reported multiple lung function trajectories that are parallel to the average trajectory.4 5 The Tasmanian Longitudinal Health Study (TAHS) was the first to investigate lung function trajectories that capture both lung growth and decline (7–53 years).6 7 It not only showed two …","PeriodicalId":23284,"journal":{"name":"Thorax","volume":null,"pages":null},"PeriodicalIF":10.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140953918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of time spent on social media with youth cigarette smoking and e-cigarette use in the UK: a national longitudinal study","authors":"Nicholas S Hopkinson, Charlotte Vrinten, Jennie C Parnham, Márta K Radó, Filippos Filippidis, Eszter P Vamos, Anthony A Laverty","doi":"10.1136/thorax-2023-220569","DOIUrl":"https://doi.org/10.1136/thorax-2023-220569","url":null,"abstract":"Background Social media may influence children and young people’s health behaviour, including cigarette and e-cigarette use. Methods We analysed data from participants aged 10–25 years in the UK Household Longitudinal Study 2015–2021. The amount of social media use reported on a normal weekday was related to current cigarette smoking and e-cigarette use. Generalised estimating equation (GEE) logistic regression models investigated associations of social media use with cigarette smoking and e-cigarette use. Models controlled for possible confounders including age, sex, country of UK, ethnicity, household income and use of cigarette/e-cigarettes by others within the home. Results Among 10 808 participants with 27 962 observations, current cigarette smoking was reported by 8.6% of participants for at least one time point, and current e-cigarette use by 2.5% of participants. In adjusted GEE models, more frequent use of social media was associated with greater odds of current cigarette smoking. This was particularly apparent at higher levels of use (eg, adjusted odds ratio (AOR) 3.60, 95% CI 2.61 to 4.96 for ≥7 hours/day vs none). Associations were similar for e-cigarettes (AOR 2.73, 95% CI 1.40 to 5.29 for ≥7 hours/day social media use vs none). There was evidence of dose–response in associations between time spent on social media and both cigarette and e-cigarette use (both p<0.001). Analyses stratified by sex and household income found similar associations for cigarettes; however, for e-cigarettes associations were concentrated among males and those from higher household income groups. Conclusions Social media use is associated with increased risk of cigarette smoking and e-cigarette use. There is a need for greater research on this issue as well as potential policy responses. Data are available in a public, open access repository. Data available from UK Data Service <https://ukdataservice.ac.uk>.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":null,"pages":null},"PeriodicalIF":10.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140953455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening the evidence base to support stronger regulation of social media based advertising of e-cigarette products to youth","authors":"Kim L Lavoie","doi":"10.1136/thorax-2023-221169","DOIUrl":"https://doi.org/10.1136/thorax-2023-221169","url":null,"abstract":"Despite the early promise of e-cigarettes as a potential smoking cessation tool, the actual uptake of these products has been the source of much controversy. There have been growing concerns about the exponential rise in the use of e-cigarettes and vaping products among youth and adolescents, with the proportion of those aged 11–15, 16–17 and 18 years in Great Britain using e-cigarettes more than doubling between 2021 and 2023 to reach 4.6%, 15.0% and 18%, respectively.1 The 2023 US Annual National Youth Tobacco Survey has reported more than 2.1 million current e-cigarette users in the US, with 25% being daily users.2 E-cigarettes represent the most popular tobacco products among American youth for the 10th year in a row, feeding growing concerns from public health agencies worldwide about the potential health effects of e-cigarettes in this vulnerable demographic. In an era when direct tobacco advertising targeting youth has long been banned and strict regulation has led to smoking combustible cigarettes going largely out of fashion among youth,3–5 this begs the question: why are e-cigarettes so popular in this demographic? Aside from the obvious factors related to the fact that nicotine is addictive and e-cigarettes are discreet, cheap and easy to obtain, the answer may lie in the subtle and creative ways e-cigarette manufacturers have …","PeriodicalId":23284,"journal":{"name":"Thorax","volume":null,"pages":null},"PeriodicalIF":10.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140953448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Definition of diaphragmatic sleep disordered breathing and clinical meaning in Duchenne muscular dystrophy","authors":"Federica Trucco, Matthew Davies, Alberto Andrea Zambon, Deborah Ridout, Francois Abel, Francesco Muntoni","doi":"10.1136/thorax-2023-220729","DOIUrl":"https://doi.org/10.1136/thorax-2023-220729","url":null,"abstract":"Background Diaphragmatic sleep disordered breathing (dSDB) has been recently identified as sleep dysfunction secondary to diaphragmatic weakness in Duchenne muscular dystrophy (DMD). However, scoring criteria for the identification of dSDB are missing. This study aimed to define and validate dSDB scoring criteria and to evaluate whether dSDB severity correlates with respiratory progression in DMD. Methods Scoring criteria for diaphragmatic apnoea (dA) and hypopnoeas (dH) have been defined by the authors considering the pattern observed on cardiorespiratory polygraphy (CR) and the dSDB pathophysiology. 10 sleep professionals (physiologists, consultants) blinded to each other were involved in a two-round Delphi survey to rate each item of the proposed dSDB criteria (Likert scale 1–5) and to recognise dSDB among other SDB. The scorers’ accuracy was tested against the authors’ panel. Finally, CR previously conducted in DMD in clinical setting were rescored and diaphragmatic Apnoea–Hypopnoea Index (dAHI) was derived. Pulmonary function (forced vital capacity per cent of predicted, FVC%pred), overnight oxygen saturation (SpO2) and transcutaneous carbon dioxide (tcCO2) were correlated with dAHI. Results After the second round of Delphi, raters deemed each item of dA and dH criteria as relevant as 4 or 5. The agreement with the panel in recognising dSDB was 81%, kappa 0.71, sensitivity 77% and specificity 85%. 32 CRs from DMD patients were reviewed. dSDB was previously scored as obstructive. The dAHI negatively correlated with FVC%pred (r=−0.4; p<0.05). The total number of dA correlated with mean overnight tcCO2 (r 0.4; p<0.05). Conclusions dSDB is a newly defined sleep disorder that correlates with DMD progression. A prospective study to evaluate dSDB as a respiratory measure for DMD in clinical and research settings is planned. All data relevant to the study are included in the article or uploaded as online supplemental information.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":null,"pages":null},"PeriodicalIF":10.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140902878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of age at ivacaftor initiation on pulmonary outcomes among people with cystic fibrosis","authors":"Christian A Merlo, Lisa J McGarry, Teja Thorat, Catherine Nguyen, Maral DerSarkissian, Aruna Muthukumar, Joe Healy, M Alan Brookhart, Jaime L Rubin","doi":"10.1136/thorax-2023-220559","DOIUrl":"https://doi.org/10.1136/thorax-2023-220559","url":null,"abstract":"Background Ivacaftor (IVA) improves lung function and other extrapulmonary outcomes in people with cystic fibrosis (CF). However, the effect of initiating IVA at earlier versus later ages has not been studied. Methods We conducted an observational cohort study of people in the US CF Foundation Patient Registry aged ≥6 years with ≥1 CF transmembrane conductance regulator–gating mutation to compare the effects of initiating IVA at earlier ages on per cent predicted forced expiratory volume in 1 s (ppFEV1) and pulmonary exacerbation (PEx) outcomes. People with CF were grouped by age at IVA initiation (ages 6–10, 11–15, 16–20 and 21–25 years) to perform three analyses of younger versus older IVA initiation (6–10 vs 11–15, 11–15 vs 16–20 and 16–20 vs 21–25 years). For each analysis, baseline characteristics assessed over 1-year periods at the same age prior to IVA initiation were balanced by standardised mortality/morbidity ratio (SMR) weighting. For each analysis, outcomes were compared over a 5-year outcome assessment period when both groups were in the same age range and receiving IVA. Findings Baseline characteristics were well balanced between younger and older IVA initiator groups after SMR weighting. In the outcome assessment period, younger IVA initiators had significantly higher mean ppFEV1 than older initiators across all comparisons, and those initiating IVA between ages 6–10 and 11–15 years had significantly lower PEx rates. Interpretation Study findings showed the importance of early IVA initiation in people with CF. Data are available upon reasonable request. The data that support the findings of this study are available from the US Cystic Fibrosis Foundation Patient Registry at <https://www.cff.org/researchers/patient-registry-data-requests>. The US Cystic Fibrosis Foundation Patient Registry collects and manages its own data and maintains processes for researchers to request summarised data. Restrictions may apply to the availability of these data, which were used under a license agreement for this study.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":null,"pages":null},"PeriodicalIF":10.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140845042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic clock as the new hand of time for lung cancer in never smokers","authors":"David C Christiani","doi":"10.1136/thorax-2024-221393","DOIUrl":"https://doi.org/10.1136/thorax-2024-221393","url":null,"abstract":"Estimates of lung cancer among persons who never smoked are 10%–20% in the USA, translating into 20–40 000 cases annually. Globally, and especially in East Asia, the incidence of lung cancer among non-tobacco users is considerably higher than in the USA, especially in women.1 The causes of lung cancer in lifelong never-smokers are not well understood. Possibilities include exposure to other carcinogens such as air pollution, radon, occupational exposures, secondhand tobacco smoke, genetic mutations, infections and hormonal imbalances. A mechanistic explanation may include epigenetic modifications from accumulated DNA damage as part of the ageing process. Some studies have shown that epigenetic age, or DNA methylation markers may be a better indicator of biological age than simple chronological age.2 3 Genes that are silenced, like the tumour suppressor gene p53, can lead to increased cancer risk. DNA methylation, the addition of methyl groups to DNA mainly along sequences, results in silencing of gene expression. Hence, DNA methylation plays an important role in …","PeriodicalId":23284,"journal":{"name":"Thorax","volume":null,"pages":null},"PeriodicalIF":10.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140821614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenome-wide association study of lung cancer among never smokers in two prospective cohorts in Shanghai, China","authors":"Mohammad L Rahman, Charles E Breeze, Xiao-Ou Shu, Jason Y Y Wong, Batel Blechter, Andres Cardenas, Xuting Wang, Bu-Tian Ji, Wei Hu, Qiuyin Cai, H Dean Hosgood, Gong Yang, Jianxin Shi, Jirong Long, Yu-Tang Gao, Douglas A Bell, Wei Zheng, Nathaniel Rothman, Qing Lan","doi":"10.1136/thorax-2023-220352","DOIUrl":"https://doi.org/10.1136/thorax-2023-220352","url":null,"abstract":"Background The aetiology of lung cancer among individuals who never smoked remains elusive, despite 15% of lung cancer cases in men and 53% in women worldwide being unrelated to smoking. Epigenetic alterations, particularly DNA methylation (DNAm) changes, have emerged as potential drivers. Yet, few prospective epigenome-wide association studies (EWAS), primarily focusing on peripheral blood DNAm with limited representation of never smokers, have been conducted. Methods We conducted a nested case-control study of 80 never-smoking incident lung cancer cases and 83 never-smoking controls within the Shanghai Women’s Health Study and Shanghai Men’s Health Study. DNAm was measured in prediagnostic oral rinse samples using Illumina MethylationEPIC array. Initially, we conducted an EWAS to identify differentially methylated positions (DMPs) associated with lung cancer in the discovery sample of 101 subjects. The top 50 DMPs were further evaluated in a replication sample of 62 subjects, and results were pooled using fixed-effect meta-analysis. Results Our study identified three DMPs significantly associated with lung cancer at the epigenome-wide significance level of p<8.22×10−8. These DMPs were identified as cg09198866 ( MYH9 ; TXN2 ), cg01411366 ( SLC9A10 ) and cg12787323. Furthermore, examination of the top 1000 DMPs indicated significant enrichment in epithelial regulatory regions and their involvement in small GTPase-mediated signal transduction pathways. Additionally, GrimAge acceleration was identified as a risk factor for lung cancer (OR=1.19 per year; 95% CI 1.06 to 1.34). Conclusions While replication in a larger sample size is necessary, our findings suggest that DNAm patterns in prediagnostic oral rinse samples could provide novel insights into the underlying mechanisms of lung cancer in never smokers. All data relevant to the study are included in the article or uploaded as supplementary information. All data generated or analysed during this study are included in this published article and its supplementary information files. For original data, please contact the corresponding author, MLR, at mohammad.rahman2@nih.gov.","PeriodicalId":23284,"journal":{"name":"Thorax","volume":null,"pages":null},"PeriodicalIF":10.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140821692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung function trajectories from school age to adulthood and their relationship with markers of cardiovascular disease risk","authors":"Raquel Granell, Sadia Haider, Matea Deliu, Anhar Ullah, Osama Mahmoud, Sara Fontanella, Lesley Lowe, Angela Simpson, James William Dodd, Seyed Hasan Arshad, Clare S Murray, Graham Roberts, Alun Hughes, Chloe Park, John W Holloway, Adnan Custovic","doi":"10.1136/thorax-2023-220485","DOIUrl":"https://doi.org/10.1136/thorax-2023-220485","url":null,"abstract":"Rationale Lung function in early adulthood is associated with subsequent adverse health outcomes. Objectives To ascertain whether stable and reproducible lung function trajectories can be derived in different populations and investigate their association with objective measures of cardiovascular structure and function. Methods Using latent profile modelling, we studied three population-based birth cohorts with repeat spirometry data from childhood into early adulthood to identify trajectories of forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC). We used multinomial logistic regression models to investigate early-life predictors of the derived trajectories. We then ascertained the extent of the association between the derived FEV1/FVC trajectories and blood pressure and echocardiographic markers of increased cardiovascular risk and stroke in ~3200 participants at age 24 years in one of our cohorts. Results We identified four FEV1/FVC trajectories with strikingly similar latent profiles across cohorts (pooled N=6377): above average (49.5%); average (38.3%); below average (10.6%); and persistently low (1.7%). Male sex, wheeze, asthma diagnosis/medication and allergic sensitisation were associated with trajectories with diminished lung function in all cohorts. We found evidence of an increase in cardiovascular risk markers ascertained by echocardiography (including left ventricular mass indexed to height and carotid intima-media thickness) with decreasing FEV1/FVC (with p values for the mean crude effects per-trajectory ranging from 0.10 to p<0.001). In this analysis, we considered trajectories as a pseudo-continuous variable; we confirmed the assumption of linearity in all the regression models. Conclusions Childhood lung function trajectories may serve as predictors in the development of not only future lung disease, but also the cardiovascular disease and multimorbidity in adulthood. Data are available upon reasonable request. The informed consent obtained from all included participants does not allow the data to be made freely available through any third party maintained public repository. However, data used for this submission can be made available on request to the corresponding cohort executive. The ALSPAC website provides information on how to request and access its data (<http://www.bristol.ac.uk/alspac/researchers/access/>). For queries regarding access of data from MAAS, IoW, SEATON or Ashford contact Philip Couch philip.couch@manchester.ac.uk).","PeriodicalId":23284,"journal":{"name":"Thorax","volume":null,"pages":null},"PeriodicalIF":10.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140821109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Journal club","authors":"Beenish Iqbal","doi":"10.1136/thorax-2024-221582","DOIUrl":"https://doi.org/10.1136/thorax-2024-221582","url":null,"abstract":"Malignant pleural effusion (MPE) is a common problem in advanced malignancies and causes debilitating breathlessness leading to poor quality of life. There are two treatment options available to ‘definitively’ manage MPE which include chest drain with talc pleurodesis and indwelling pleural catheters (IPCs). Although both treatments have been in use for a long time, there has been limited research on the impact of these treatments on patient quality of life. Sivakumar and colleagues (Eur Respir J 2023, DOI: 10.1183/13993003.01215–2022) evaluated the impact of outpatient indwelling pleural catheter with talc slurry vs inpatient chest drain with talc pleurodesis on the quality of life of MPE patients in a multicentre, randomised controlled trial (OPTIMUM). This study was undertaken at 11 hospitals in the UK and one in Australia. 142 patients were randomised 1:1 to the IPC or chest drain. The primary outcome was global health status, measured by a validated EORTC-QLQ C-30 questionnaire at 30 days post-randomisation. An 8-point difference in the score was considered clinically meaningful. There was a statistically significant improvement in the global health status at 30-days in both IPC (mean difference 13.11 [95% CI 5.6 to 21.1]; p=0.001) and chest drain arms (mean difference …","PeriodicalId":23284,"journal":{"name":"Thorax","volume":null,"pages":null},"PeriodicalIF":10.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140556558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: RAGE-induced ILC2 expansion in acute lung injury due to haemorrhagic shock","authors":"BMJ Publishing Group Ltd and British Thoracic Society","doi":"10.1136/thoraxjnl-2019-213613corr1","DOIUrl":"https://doi.org/10.1136/thoraxjnl-2019-213613corr1","url":null,"abstract":"Zhang K, Jin Y, Lai D, et al . RAGE-induced ILC2 expansion in acute lung injury due to haemorrhagic shock. Thorax 2020;75:209–19. In the original version of this article, some H&E images in …","PeriodicalId":23284,"journal":{"name":"Thorax","volume":null,"pages":null},"PeriodicalIF":10.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140556511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}