Tuberculosis and Respiratory Diseases最新文献

{"title":"Single-Cell Analysis Identifies Factors Associated with Rheumatoid Arthritis-Related Interstitial Lung Disease in Comparison with Idiopathic Pulmonary Fibrosis.","authors":"Dongjun Kim, Hyun Lee, Sang-Heon Kim, Yeonghee Eun, Hyun Je Kim, Bo-Guen Kim","doi":"10.4046/trd.2026.0085","DOIUrl":"10.4046/trd.2026.0085","url":null,"abstract":"<p><strong>Background: </strong>Interstitial lung disease (ILD) is a common but serious extra-articular manifestation of rheumatoid arthritis (RA). RA-associated ILD (RA-ILD), which often presents with the usual interstitial pneumonia pattern, can resemble idiopathic pulmonary fibrosis (IPF), though the treatment and progression of these two conditions differ. However, the immunologic and molecular mechanisms associated with RA-ILD and IPF development have not been well elucidated at the single-cell level.</p><p><strong>Methods: </strong>To investigate the underlying mechanisms associated with RA-ILD and IPF development, we performed single-cell RNA sequencing (scRNA-seq) of peripheral blood mononuclear cells (PBMCs) from five RA-ILD patients and five patients with IPF with a matched age and sex distribution.</p><p><strong>Results: </strong>A high-quality scRNA-seq dataset comprising 31,416 peripheral immune cells was generated. Overall immune composition was similar between groups; however, a significant elevation of natural killer (NK) cells was seen among the RA-ILD PBMCs, with increased expression of cytotoxic and inflammation-related genes (GZMB, GZMH, PRF1) as well as interferon‑related genes (STAT1, STAT3, IRF9, IFNG). Myeloid subsets displayed distinct transcriptional programs in IPF and RA-ILD: IPF CD16+ monocytes were enriched for transforming growth factor beta (TGF‑β)-driven fibrotic signaling, whereas RA-ILD monocytes exhibited type I/II interferon pathway activation. Fibrosis‑related genes (TGFB1, SMAD3, SMAD7, TGIF1) were specifically upregulated in IPF.</p><p><strong>Conclusion: </strong>RA‑ILD and IPF share similar peripheral immune cell compositions, but exhibit distinct transcriptional activation patterns. RA‑ILD is characterized by increased NK‑cell-driven cytotoxic and interferon‑related responses, along with interferon‑activated monocytes. In contrast, IPF shows a TGF‑β-dominant fibrotic program, with transcriptional activation of CD16+ monocytes and upregulation of fibrosis‑related genes.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"542-552"},"PeriodicalIF":3.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated AbsΔX5 Identifies a Distinct COPD Phenotype with Peripheral Airway Dysfunction and Longitudinal Improvement in Oscillometric Parameters.","authors":"Jeong-Woong Park","doi":"10.4046/trd.2026.0155","DOIUrl":"https://doi.org/10.4046/trd.2026.0155","url":null,"abstract":"<p><strong>Background: </strong>Impulse oscillometry (IOS) is increasingly used to assess small airway dysfunction (SAD) in chronic obstructive pulmonary disease (COPD). However, the physiological significance of the absolute inspiratory-expiratory reactance difference (AbsΔX5) remains unclear. We investigated whether elevated AbsΔX5 identifies a distinct COPD phenotype associated with baseline physiological abnormalities and longitudinal physiological changes.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with COPD who underwent serial IOS and spirometry between January 2023 and February 2025. COPD was defined as a post-bronchodilator FEV₁/FVC <0.70, and SAD as R5-R20 >0.07 kPa/L/s and/or AX >0.33 kPa/L. Patients were classified into COPD without SAD, SAD+/AbsΔX5 <0.10, and SAD+/AbsΔX5 ≥0.10. The 0.10 cutoff was determined by an exploratory threshold analysis. Baseline characteristics and longitudinal changes in IOS and post-bronchodilator spirometric parameters were compared.</p><p><strong>Results: </strong>Among 710 patients who underwent both IOS and spirometry, 112 met the diagnostic criteria for COPD. Patients were classified into COPD without SAD (n=36), SAD+/AbsΔX5 <0.10 (n=46), and SAD+/AbsΔX5 ≥0.10 (n=30). Baseline IOS abnormalities progressively worsened across the groups. Patients with SAD+/AbsΔX5 ≥0.10 had significantly higher R5-R20, AX, and Fres values and more negative X5 than the other groups. During follow-up, they showed greater improvements in R5, R5-R20, and AX, whereas spirometric changes were modest, except for a greater increase in FVC than in COPD without SAD.</p><p><strong>Conclusions: </strong>Elevated AbsΔX5 was most clinically informative in patients with IOS-defined SAD, identifying a distinct COPD phenotype characterized by more severe baseline peripheral airway dysfunction and greater longitudinal improvement in IOS parameters.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation and airway clearance technique education in nontuberculous mycobacterial pulmonary disease: protocol for the NTM-Rehab study.","authors":"Hyung-Jun Kim, Jaewon Beom, Bou Choe, Myungki Ji, Haseul Jo, Kyu-Jin Lee, Areum Hwang, Hyeontaek Hwang, Byoung Soo Kwon, Jong Sun Park, Jae Ho Lee","doi":"10.4046/trd.2026.0164","DOIUrl":"https://doi.org/10.4046/trd.2026.0164","url":null,"abstract":"<p><strong>Background: </strong>Nontuberculous mycobacterial pulmonary disease (NTM-PD) is a chronic, often progressive, respiratory infection with an increasing global incidence that is frequently accompanied by bronchiectasis. Although antimicrobial therapy is the cornerstone of treatment, culture conversion is often incomplete, and structural lung disease persists; therefore, pulmonary rehabilitation (PR) and airway clearance techniques (ACTs) have been advocated as adjuncts. However, prospective cohort evidence of these measures in patients with NTM-PD is lacking.</p><p><strong>Methods: </strong>NTM-Rehab is a single-center, prospective, observational cohort study conducted at Seoul National University Bundang Hospital, Republic of Korea. Adults (≥20 years) with NTM-PD diagnosed according to the 2020 ATS/ERS/ESCMID/IDSA criteria are enrolled in a pragmatic 8-week PR and ACT education program delivered as five biweekly sessions comprising ACT education, individually tailored aerobic and resistance exercise, and reassessment. Assessments (spirometry, sputum microbiology, chest imaging, patient-reported outcomes, and physical performance testing) are performed at baseline, week 8, and month 6, with data collected through an electronic case report form. The co-primary outcomes are the change in forced expiratory volume in 1 s and forced vital capacity, sputum culture conversion rate, and six-minute walk distance; secondary outcomes are disease-specific and generic health-related quality of life. The analyses will characterize longitudinal changes and their determinants.</p><p><strong>Conclusion: </strong>NTM-Rehab will provide the first prospectively collected clinical data on structured PR and ACT education in NTM-PD and inform evidence-based, non-pharmacological management of this chronic respiratory disease. This study was approved by the Institutional Review Board of Seoul National University Bundang Hospital (B-2501-949-303) and registered at ClinicalTrials.gov (NCT06838442).</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression as a Risk of Lung Cancer in Women: a Nationwide Cohort Study.","authors":"Chiwook Chung, Kyu Na Lee, Kyungdo Han, Dong Wook Shin, Sei Won Lee","doi":"10.4046/trd.2026.0108","DOIUrl":"https://doi.org/10.4046/trd.2026.0108","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is a leading contributor to global cancer incidence and mortality. While depression has been linked to adverse health behaviors, particularly tobacco smoking, that may elevate cancer risk, the direct relationship between depression and lung cancer remains uncertain. We aimed to clarify this association in a large cohort of Korean women.</p><p><strong>Methods: </strong>We analyzed data from the Korean National Health Information Database for women who completed the national health screening in 2012. A total of 2,032,241 participants aged 20 years or older were followed until December 2022. Depression was defined using insurance claims within the year preceding the baseline exam. Lung cancer cases were ascertained through matched health insurance and critical illness registration records. Adjusted hazard ratios (aHR) were calculated using multivariable Cox proportional hazards models.</p><p><strong>Results: </strong>Over a mean follow-up of 9.3 years, 11,706 women developed lung cancer. Those with depression experienced higher incidence rates (1.02 per 1,000 person-years) and a modestly increased risk (aHR 1.09, 95% confidence interval [CI] 1.02-1.16) compared with women without depression. Stratified analyses indicated stronger associations among women aged 40-64 years (aHR 1.13, 95% CI 1.04-1.24), and former smokers (aHR 2.33, 95% CI 1.66-3.28)-particularly former smokers with at least 20 pack-years of smoking exposure (aHR 4.93, 95% CI 2.55-9.51).</p><p><strong>Conclusion: </strong>Depression was associated with elevated lung cancer risk in women, with effects modified by age and smoking history. Targeted interventions addressing mental health may contribute to lung cancer prevention, especially in susceptible subgroups.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing Clinical Characteristics, Diagnostic Patterns, and Outcomes of Tuberculosis in South Korea: The Korean Tuberculosis Cohort, 2019-2024.","authors":"Jee Youn Oh, Ganghee Chae, Hyung Woo Kim, Jinsoo Min, Hyeon-Kyoung Koo, Yun-Jeong Jeong, Bumhee Yang, Goohyeon Hong, Jaehee Lee, Jonghoo Lee, Heung Bum Lee, Sung-Soon Lee, Jae Seuk Park, Ju Sang Kim","doi":"10.4046/trd.2026.0153","DOIUrl":"https://doi.org/10.4046/trd.2026.0153","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a public health concern in South Korea despite declining national notifications. We evaluated temporal changes in clinical characteristics, diagnostic patterns, and treatment outcomes in the Korean Tuberculosis Cohort (KTBC) from 2019 to 2024.</p><p><strong>Methods: </strong>We retrospectively analyzed prospectively collected data from the multicenter KTBC registry from January 2019 to December 2024. Overall analyses used the full cohort including extrapulmonary TB; radiographic, microbiologic, bronchoscopy, and drug-susceptibility analyses were restricted to patients with pulmonary involvement. Calendar year was treated as an ordinal variable, with trends tested by linear regression or the Cochran-Armitage test (P for trend).</p><p><strong>Results: </strong>Among 33,826 patients, the proportion aged ≥65 years increased from 46.9% in 2019 to 54.8% in 2024 and any comorbidity from 59.6% to 71.5%. Among 26,271 patients with pulmonary involvement, chest radiography (CXR) findings suspicious for TB decreased from 71.2% to 42.3% and CXR cavitation from 18.0% to 9.0%, whereas computed tomography-detected cavitation decreased only modestly (20.4% to 17.7%). Xpert MTB/RIF testing increased from 41.5% to 77.0%, bronchoscopic yield from 71.2% to 81.8%, and treatment success from 59.7% to 70.0%, whereas mortality decreased from 10.0% to 7.3% and isoniazid resistance from 9.1% to 6.5% (all P for trend ≤0.011).</p><p><strong>Conclusion: </strong>TB care in South Korea increasingly involves older and medically complex patients. Pulmonary TB became less recognizable on initial chest radiography, whereas molecular testing, bronchoscopic confirmation, and treatment outcomes improved. These findings support public-private mix-based quality monitoring, integrated care for vulnerable patients, and diagnostic pathways adapted to less typical radiographic presentations.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in tuberculosis care, treatment outcomes, and mortality during the early phase of COVID-19 pandemic in Korea.","authors":"Yun-Jeong Jeong, Jae Seuk Park, Bum Hee Yang, Hyeon-Kyoung Koo, Hyung Woo Kim, Jee Youn Oh, Ganghee Chae, Jiwon Lyu, Eun Hye Lee, Sung Soon Lee, Ju Sang Kim, Jinsoo Min","doi":"10.4046/trd.2025.0198","DOIUrl":"https://doi.org/10.4046/trd.2025.0198","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic disrupted global tuberculosis (TB) control, raising concerns about its impact on diagnosis, treatment outcomes, and latent infection management. Korea's Public-Private Mix (PPM) TB control project integrates private providers into national TB services. This study evaluated early pandemic trends in TB care and prevention within the PPM project.</p><p><strong>Methods: </strong>Nationwide PPM cohort data from July 2019 to December 2021 were analyzed across five semi-annual periods. Monitoring indicators included diagnostic coverage, treatment success and completion, all-cause death, contact investigation, and initiation of TB preventive treatment (TPT). Trends were assessed using chi-square tests for trend.</p><p><strong>Results: </strong>Diagnostic coverage increased significantly across most modalities (P < 0.001), except phenotypic drug susceptibility testing. Twelve-month treatment completion rate improved overall (P = 0.005), particularly among people < 65 years (P < 0.001) and new cases (P = 0.039). Treatment success rate remained stable (P = 0.123) but declined in those > 65 years (P = 0.030). All-cause death rate increased from 12.2% to 14.9% (P < 0.001), largely due to non-TB-related deaths. Contact investigation coverage peaked in early 2020 and subsequently declined, whereas TPT coverage rose steadily throughout the study period (P < 0.001).</p><p><strong>Conclusion: </strong>Despite global disruptions, Korea's PPM project maintained essential TB services during the early pandemic, with improvements in diagnostic testing and TPT uptake. However, increased death rates and declining treatment success among older adults warrant careful interpretation and suggest the need for continued monitoring and tailored support. Ongoing monitoring of TB indicators will be important to understand the longer-term impact of the pandemic on TB care and prevention.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation and Psychometric Properties of the Vietnamese Versions of the Test of Adherence to Inhalers (TAI) and Inhaler Medication Adherence Scale (IMAS) in Patients with Chronic Obstructive Pulmonary Disease.","authors":"Thi Quy Chu, Minh Sinh Do, Thi Hoa Huyen Nguyen","doi":"10.4046/trd.2025.0200","DOIUrl":"https://doi.org/10.4046/trd.2025.0200","url":null,"abstract":"<p><strong>Background: </strong>Reliable assessment of adherence to inhaled maintenance therapy is important in COPD management, yet no validated Vietnamese instruments have been available. This study translated and validated the Vietnamese versions of the Test of Adherence to Inhalers (TAI) and the Inhaler Medication Adherence Scale (IMAS).</p><p><strong>Methods: </strong>A mixed-methods design was used. Phase 1 included forward-back translation, expert review, and cognitive testing to ensure semantic and cultural equivalence. Phase 2 was a cross-sectional survey of 210 clinically stable COPD patients at a tertiary outpatient clinic. Content validity, exploratory factor analysis (EFA), internal consistency, and four-week test-retest reliability were assessed. Content validity indexes were calculated from independent expert ratings using a four-point relevance scale. Associations with clinical indicators were examined using Spearman correlation.</p><p><strong>Results: </strong>Content validity was high for both instruments (TAI S-CVI/Ave = 1.00; IMAS S-CVI/Ave = 0.96), and patient comprehension was excellent. EFA identified two components for the TAI, explaining 65.25% of variance, and four components for the IMAS, accounting for 74.27% of variance. Internal consistency was strong (TAI alpha = 0.87; IMAS alpha = 0.91), and reliability across age and symptom subgroups remained robust. Test-retest stability was high (ICC: TAI = 0.88; IMAS = 0.89). A moderate correlation between TAI and IMAS (rho = 0.43, p < 0.001) indicated that the two scales capture related but distinct behavioral and psychological aspects of adherence.</p><p><strong>Conclusion: </strong>The Vietnamese TAI and IMAS demonstrate good reliability, validity, and cultural suitability for assessing inhaler adherence in COPD. Their combined use may support routine evaluation, patient counseling, and adherence-focused research in Vietnam.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PM10 Exposure Impairs Differentiation and Induces Inflammation in Human Small Airway Epithelial Cells Cultured at the Air-Liquid Interface.","authors":"Mi Hyeon Heo, Eun Suk Son, So Young Park, Ui Won Ko, Jeong-Woong Park, Sung Hwan Jeong, Sun Young Kyung","doi":"10.4046/trd.2026.0072","DOIUrl":"https://doi.org/10.4046/trd.2026.0072","url":null,"abstract":"<p><strong>Background: </strong>Particulate matter with an aerodynamic diameter ≤10 μm (PM10) is a major environmental pollutant implicated in chronic airway injury and remodeling. This study investigated the effects of chronic PM10 exposure on epithelial barrier integrity, cellular differentiation, surfactant expression, and inflammatory signaling in a human small airway epithelial air-liquid interface (ALI) model.</p><p><strong>Methods: </strong>Differentiated ALI cultures were exposed to PM10 for 7, 14, and 21 days. Transepithelial electrical resistance (TEER), epithelial lineage markers, surfactant proteins, inflammatory cytokines, and signaling pathways were analyzed using RT-PCR, ELISA, and western blotting.</p><p><strong>Results: </strong>PM10 exposure significantly reduced TEER over time indicating progressive epithelial barrier dysfunction. Club cell and ciliated cell markers decreased, whereas basal cell markers remained relatively preserved, suggesting impaired epithelial differentiation. Surfactant mRNA levels, particularly SP-A and SP-B, were reduced, while secreted SP-A paradoxically increased and SP-B secretion decreased. Pro-inflammatory cytokines, including IL-1β, IL-6, IL-8, and TNF-α, were significantly elevated. In addition, cleaved Notch1, Notch3, phosphorylated NF-κB and IκBα, and the downstream Notch targets HES1 and HEY1 were increased in PM10 -exposed cells.</p><p><strong>Conclusion: </strong>Chronic PM10 exposure disrupts airway epithelial barrier integrity and impairs epithelial differentiation and function, accompanied by inflammatory activation through the Notch and NF-κB signaling pathways. These findings suggest a biologically plausible mechanistic link between environmental PM10 exposure and chronic airway epithelial dysfunction.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Neutrophil Elastase in Affected Lobes of Bronchiectasis and Correlation of Its Levels between Sputum and Bronchial Lavage Fluid.","authors":"Lam Nguyen-Ho, Hoang Kim Tu Trinh, Vu Le-Thuong, Kieu-Minh Le, Van Thanh Niem Vo, Diem My Vu, Ngoc Tran-Van, James D Chalmers","doi":"10.4046/trd.2024.0078.r","DOIUrl":"10.4046/trd.2024.0078.r","url":null,"abstract":"","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":"89 3","pages":"434"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative Tools and Perspectives in Cough Management: Cancer and Cough.","authors":"Juwhan Choi, Sung Yong Lee","doi":"10.4046/trd.2025.0166","DOIUrl":"10.4046/trd.2025.0166","url":null,"abstract":"<p><p>Cough is a prevalent symptom in lung cancer that impairs quality of life. Postoperative cough after pulmonary resection (CAP) has an incidence of approximately 21.1%-55.8%. CAP tends to peak around 1-month post-surgery, and often improves by 3 months. Risk factors for persistent CAP include female sex, extensive resection (e.g., lobectomy or lymph node dissection), and postoperative gastroesophageal reflux. Pulmonary rehabilitation programs significantly reduce postoperative cough incidence and improve cough-specific quality of life. In patients with lung cancer, cough occurs in over 50% of cases, regardless of stage or histology. A stepwise management algorithm is recommended: first treat the cancer and any contributing comorbidities, then use simple demulcents to soothe airways. If needed, add centrally acting antitussives such as codeine or dextromethorphan, followed by peripherally acting agents (e.g., levodropropizine, benzonatate, or levocloperastine). In refractory cases, the neurokinin- 1 (NK1) receptor antagonist aprepitant reduced cough frequency in a randomized trial. Substance P, which activates NK1 receptors in vagal sensory pathways, appears to drive cough; aprepitant blocks this activation in preclinical models. Cough is a common and burdensome symptom in lung cancer, whether post-surgical or disease-related. This narrative review outlines a stepwise approach to evaluation and treatment, starting with cancer-directed therapy and supportive care, followed by evidence-backed antitussives. Emerging therapies like NK1 receptor antagonists show promise for refractory cases. High-quality trials are needed to further validate these approaches and integrate them into standard care to improve the quality of life of patients with lung cancer.</p>","PeriodicalId":23368,"journal":{"name":"Tuberculosis and Respiratory Diseases","volume":" ","pages":"391-402"},"PeriodicalIF":3.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13334111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147504761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}