Clinical Respiratory Journal最新文献

{"title":"OM-85, a Bacterial Lysate, Reduces Pulmonary Nodule Malignant Probability: A Retrospective Study","authors":"Mengting Sun,&nbsp;Yuqing Ni,&nbsp;Xueling Wu,&nbsp;Hao Tian,&nbsp;Yijun Song,&nbsp;Yinzhou Feng,&nbsp;Yunxin Guo,&nbsp;Yong Zhang,&nbsp;Jun Yin,&nbsp;Charles A. Powell,&nbsp;Chunxue Bai,&nbsp;Yuanlin Song,&nbsp;Dawei Yang","doi":"10.1111/crj.70109","DOIUrl":"https://doi.org/10.1111/crj.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The current clinical management of pulmonary nodules relies heavily on CT follow-up, without early intervention. This retrospective study investigated the efficacy of OM-85, a standardized lysate of human respiratory bacteria, in the treatment of high-risk pulmonary nodules detected by computed tomography (CT) in patients with chronic bronchitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 72 patients (93 enrolled nodules) who underwent treatment with OM-85 and a matched control group of 90 patients (111 control nodules). The primary endpoint included reduced size of high-risk ground glass nodules based on thin-layer CT scans during follow-up. Flow cytometry, multiplex immunofluorescence (mIF) analysis, and scRNA-seq data were employed to determine differences in the immune cell subsets between the treatment and control groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Oral OM-85 treatment significantly reduced lung nodule diameter (<i>p</i> = 0.031), the risk probability of malignancy (<i>p</i> = 0.003), and the likelihood of clinical disease progression (<i>p</i> = 0.0091). The effects of OM-85 treatment were more pronounced in older patients (&gt; 65-year-old) (<i>p</i> = 0.029) and those with longer follow-up cycles (&gt; 200 days) (<i>p</i> = 0.011). The peripheral blood samples showed a significantly higher proportion of natural killer (NK) cells in the treatment group. Furthermore, mIF staining of the pulmonary nodules and scRNA-seq data demonstrated a higher percentage of NK cells in the treatment group compared with the control group (<i>p</i> = 0.0003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>OM-85 reduced the size of high-risk pulmonary nodules and decreased the risk of malignant probability and disease progression in patients with chronic bronchitis by increasing the proportion of NK cells. Therefore, OM-85 is a potential drug for the treatment of high-risk pulmonary nodules in patients with chronic bronchitis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pulmonary Abscess Caused by Porphyromonas gingivalis Infection: A Case Report and Literature Review","authors":"Xu Chen,&nbsp;Ling Wu,&nbsp;Ruoxi Wu,&nbsp;Jiajia Dong","doi":"10.1111/crj.70099","DOIUrl":"https://doi.org/10.1111/crj.70099","url":null,"abstract":"<p>Lung abscess is a common disease in respiratory medicine, which is a suppurative lesion caused by various pathogens, and microbiological examination is crucial for the treatment of lung abscess. Due to the widespread use of antibiotics, it is difficult to obtain reliable microbiological evidence through routine tests. There are various pathogens present in the oral cavity, and periodontitis is a risk factor for the formation of lung abscess. Enhancing understanding of lung abscesses caused by <i>Porphyromonas gingivalis</i> and the importance of accurately interpreting NGS reports. This article will present a case report of a lung abscess related to oral bacteria (<i>Porphyromonas gingivalis</i>). The patient was initially treated with empirical anti-infective therapy, which was ineffective, and despite multiple sputum cultures and bronchoalveolar lavage fluid analysis using metagenomic next-generation sequencing (mNGS), the pathogen could not be identified clearly. However, based on the significant presence of oral bacteria in the NGS of the bronchoalveolar lavage fluid, which guided the examination to discover periodontitis. Subsequently, a percutaneous lung tissue biopsy was performed for NGS testing, which further suggested <i>Porphyromonas gingivalis</i> as the pathogenic bacterium. This article summarizes the clinical manifestations, imaging findings, and characteristics of the pathogenic microorganisms in this case of lung abscess, reviews relevant literature to enhance the understanding of lung abscess caused by <i>Porphyromonas gingivalis</i>. It also confirms the importance of careful analysis of background bacteria in bronchoalveolar lavage fluid NGS based on objective risk factors, and highlights that combining patient clinical features with multisample NGS examination can promptly clarify the microbiology.</p>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of COPD With Clinical Outcomes After Hospital Admission in SARS-CoV-2 Patients During the Omicron Variant Period: A Retrospective Cohort Study","authors":"Rui Tang,&nbsp;Lijuan Li,&nbsp;Shuwei Wang,&nbsp;Fen Zhou,&nbsp;Renwei Li,&nbsp;Yue Zhao,&nbsp;Li Zhou,&nbsp;Wanying Tian,&nbsp;Yadong Yuan","doi":"10.1111/crj.70104","DOIUrl":"https://doi.org/10.1111/crj.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pre-Omicron studies identified chronic obstructive pulmonary disease (COPD) as a significant risk factor for adverse COVID-19 outcomes. Given Omicron's altered pathogenicity and widespread population-level immunity, the association between COPD and COVID-19 outcomes warrants reassessment in light of the variant's distinct clinical profile. We evaluated whether COPD remained a risk factor for poor clinical outcomes among hospitalized patients with SARS-CoV-2 infection during Omicron predominance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a two-center retrospective cohort study of 1176 adults hospitalized with confirmed Omicron infection between January 2022 and December 2023 in Northern China. Patients were stratified by pre-existing COPD status. To address confounding by treatment selection, inverse probability weighting (IPW) was applied based on the likelihood of receiving inhaled corticosteroids. Multivariable logistic regression models, adjusted for comorbidities, disease severity (as measured by the PSI), inflammatory markers (CRP, D-dimer, NLR, LDH), and treatment regimens, were used to evaluate the associations between COPD and in-hospital outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1176 patients (337 COPD; 839 non-COPD), COPD patients had significantly lower PSI scores and lower levels of systemic inflammation despite a higher prevalence of respiratory comorbidities. In unadjusted models, COPD was associated with reduced odds of mortality (OR 0.52), respiratory failure (OR 0.24), and ventilatory support. However, after IPW adjustment, these associations were no longer statistically significant (mortality: adjusted OR 0.90, 95% CI 0.22–3.74, <i>p</i> = 0.887).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>COPD was not independently associated with increased risk of mortality, respiratory failure, or ventilatory support in hospitalized Omicron-infected patients after rigorous adjustment for confounding. These findings suggest a shifting risk profile for COPD during Omicron predominance, likely influenced by variant tropism, treatment effects, and altered inflammatory responses. Future prospective studies are warranted to validate these findings and explore the mechanisms underlying this observed shift.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Effects of Switching COPD Patients From LAMA/LABA Therapy to ICS/LAMA/LABA Therapy Using the Impulse Oscillation System (IOS) Capable of Separating Inspiratory and Expiratory Measurements","authors":"Yosuke Tanaka,&nbsp;Ken Okamura,&nbsp;Shota Kaburaki,&nbsp;Toru Tanaka,&nbsp;Akiko Yoshikawa,&nbsp;Ayumi Shimizu,&nbsp;Akihiko Miyanaga,&nbsp;Namiko Taniuchi,&nbsp;Koichiro Kamio,&nbsp;Kazuo Kasahara,&nbsp;Masahiro Seike,&nbsp;Mitsunori Hino","doi":"10.1111/crj.70105","DOIUrl":"https://doi.org/10.1111/crj.70105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Noninvasive evaluation of airway conditions is considered useful in the management of COPD, although assessing airway remodeling remains difficult in routine clinical practice. The impulse oscillometry system used in this study allows separate analysis of inspiratory and expiratory phases, offering detailed insights into airway function. This study examined the effects of inhaled corticosteroids (ICSs) on airway remodeling and assessed the utility of this system in COPD management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Stable COPD patients on LAMA/LABA for over a year were assessed by spirometry and impulse oscillometry at baseline and after 48 weeks of ICS/LAMA/LABA therapy. Symptoms, imaging, and blood tests were also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 52 patients (mean baseline %FEV1/predicted: 56.9% ± 22.1%), all had one to two moderate exacerbations in the past year despite LAMA/LABA therapy. Significant correlations were observed between spirometry and MostGraph (e.g., baseline FEV1 vs. R5: <i>r</i> = −0.54). Although spirometry showed no significant changes, Fres improved significantly (−2.11 ± 0.35, <i>p</i> &lt; 0.0001), with reductions in both expiratory and inspiratory phases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Fres measured by MostGraph significantly improved after ICS addition, whereas no significant changes were observed in spirometry or resistance parameters. Fres also showed significant correlations with FEV1, suggesting that it may capture airway changes not detected by spirometry. These findings support further investigation into its role as a noninvasive marker in COPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>UMIN-CTR Clinical Trial: UMIN000040764 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042394)</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrical Impedance Tomography–Guided Airway Clearance in Elderly Patients With Severe Pneumonia: A Prospective Study","authors":"Jiaping Zhao,&nbsp;Wenchao Mao,&nbsp;Yi Zhang,&nbsp;Saichan Xu,&nbsp;Fei Qian,&nbsp;Liang Wu,&nbsp;Shijin Gong,&nbsp;Weihang Hu,&nbsp;Changyun Zhao","doi":"10.1111/crj.70110","DOIUrl":"https://doi.org/10.1111/crj.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Elderly patients are prone to secretion retention and exacerbated lung infections due to weakened respiratory muscle strength and reduced ability to cough and expectorate. Airway clearance techniques (ACTs) can help to clear airway secretions, but objective bedside assessment of secretion clearance efficacy is lacking. Electrical impedance tomography (EIT) can dynamically monitor lung ventilation and provide a basis for clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was a prospective randomized controlled trial that included 50 elderly patients with severe pneumonia, who were randomized into EIT and non-EIT groups. The EIT group received personalized ACTs guided by real-time EIT imaging with dynamic adjustment of posture, percussion intensity, and active circulatory breathing technique (ACBT) frequency, whereas the non-EIT group received fixed-schedule ACTs (postural drainage every 2 h + percussion/vibration twice daily) without EIT feedback. The main observation indices included Clinical Pulmonary Infection Score (CPIS), respiratory mechanics indices, blood gas analysis indices, and extubation success rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The EIT group showed significantly lower CPIS scores (<i>p</i> = 0.0137 on Day 7), higher dynamic compliance (<i>p</i> = 0.0193), lower airway resistance (<i>p</i> = 0.0039), lower peak airway pressure (<i>p</i> = 0.0288), and higher oxygenation index (<i>p</i> = 0.0143 on Day 5 and <i>p</i> = 0.0005 on Day 7) than the non-EIT group. The extubation success rate was significantly higher in the EIT group (88% vs. 56%, <i>p</i> = 0.0255). Additionally, the EIT group demonstrated progressive improvements in ventilation in specific regions (D7 vs. D1: <i>p</i> = 0.0004 for region of interest [ROI]3; <i>p</i> = 0.0059 for ROI4) and a significant decrease in the global inhomogeneity index at D7 (D7 vs. D1: <i>p</i> = 0.0025).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EIT-guided ACT is safe and enhances treatment efficacy by significantly improving respiratory function and extubation success rate in elderly patients with severe pneumonia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal Associations Between Cystatin and Lung Cancer: A Two-Sample Mendelian Randomization Study","authors":"Chunling Zhang,&nbsp;Riya Wu,&nbsp;Hang Liu,&nbsp;Shihuan Yu","doi":"10.1111/crj.70112","DOIUrl":"https://doi.org/10.1111/crj.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The cystatin family is particularly relevant in lung cancer research due to its links to inflammation, protease balance, and tumor progression. Although population-based studies have documented associations between cystatin and lung cancer, causal relationships remain undetermined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on genomic statistics of seven different cystatins and three subtypes of lung cancer, we conducted a two-sample Mendelian randomization (MR) study. The inverse-variance weighted (IVW) method was the main approach for causality estimation. The weighted median, simple mode, weighted mode, and MR-Egger regression methods were further employed to validate the main findings. In the sensitivity analysis, horizontal pleiotropy was assessed by MR-Egger regression and Cochran’s Q test. MR-PRESSO and Radial MR methods were used to identify heterogeneity and remove outliers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Genetically predicted Cystatin 8 was causally associated with squamous cell lung carcinoma (OR = 1.062, 95% CI: 1.004–1.124, <i>p</i> = 0.035). No causal relationships were found for genetically predicted cystatin 8, -B, -D, -F, or -M with squamous cell lung carcinoma, lung adenocarcinoma, and NSCLC. However, outliers were identified between Cystatin D, -M, and -F using MR-PRESSO and Radial MR. After the removal of outliers, the association between Cystatin D and lung adenocarcinoma turned significant (OR = 1.178, 95% CI: 1.023–1.358, <i>p</i> = 0.023). Sensitivity analyses confirmed the robustness of main results after outliers removal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Genetically predicted Cystatin 8 was causally associated with squamous cell lung carcinoma. Future population-based studies are required to substantiate these results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144598307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Analysis of Lung Cancer Metastasis: Sites, Rates, Survival, and Risk Factors—A Systematic Review and Meta-Analysis","authors":"Shilin Wang,&nbsp;Wen Tang,&nbsp;Fu Jin,&nbsp;Huanli Luo,&nbsp;Han Yang,&nbsp;Ying Wang","doi":"10.1111/crj.70107","DOIUrl":"https://doi.org/10.1111/crj.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Lung cancer metastasis constitutes a critical aspect of disease progression and patient outcomes. It is imperative to illuminate the complex landscape of lung cancer metastasis, offering a thorough evaluation of sites, rates, risk factors, and survival implications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Studies on the prevalence of lung cancer metastasis, the risk factors, the overall survival (OS) after metastasis, or the risk factors for OS were included. Two independent reviewers used a standardized data extraction and quality assessment form. Hazard ratios and confidence intervals were calculated using random-effects or fixed-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This systematic meta-analysis included 115 clinical trials. Prevalent metastatic sites in non-small cell lung carcinoma (NSCLC) encompassed brain (29%), bone (25%), adrenal gland (15%), liver (13%), and skin (3%). However, small cell lung carcinoma (SCLC) primarily metastasized to liver (33%), brain (30%), bone (27%), adrenal gland (10%), and pericardium (3%). The risk factors for brain metastases in NSCLC included lung adenocarcinoma, EGFR mutations, and prophylactic cranial irradiation (PCI); in SCLC brain metastasis, age and PCI were influential. The median OS after brain metastasis in NSCLC and SCLC was 21.3 and 10.5 months, respectively, while liver or bone metastases were notably linked to poorer survival. The factors influencing OS in NSCLC brain metastasis included age, EGFR mutations, and stereotactic radiosurgery. For SCLC brain metastasis, OS was notably impacted by gender, smoking status, the number of brain metastases, and radiotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provided insights into lung cancer metastasis. The results revealed the metastatic rates, risk factors, and OS to assist clinical decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144606487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Immune Cells in Mediating the Effect of Hypothyroidism on Idiopathic Pulmonary Fibrosis","authors":"Zhengling Liu,&nbsp;Chengkun Kou,&nbsp;Xiaobo Chen,&nbsp;Jing Yang,&nbsp;Huan Zhu,&nbsp;Yongning Jiao,&nbsp;Dongyan Zhang,&nbsp;Wencui Zhang,&nbsp;Liang Li","doi":"10.1111/crj.70111","DOIUrl":"https://doi.org/10.1111/crj.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Idiopathic pulmonary fibrosis (IPF) leads to irreversible scarring of lung tissue, resulting in deteriorating respiratory function, particularly in older adults. We aimed to explore the causative link between hypothyroidism and IPF, particularly focusing on immune cell phenotypes as mediating factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A two-sample Mendelian randomization (MR) approach was utilized to investigate the influence of hypothyroidism on IPF and the role of 731 distinct immune cell phenotypes as mediators. The mediating effects were quantified using the coefficient product method. Various sensitivity analyses, including Cochran's <i>Q</i> test for heterogeneity, MR–Egger for pleiotropy, and the “leave-one-out” method, were conducted to verify the robustness of single-nucleotide polymorphism–derived casual estimates. Statistical analyses were carried out using the R software (Version 4.3.1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Hypothyroidism was significantly associated with increased IPF risk (odds ratio [OR] = 1.13, 95% confidence interval [CI] = 1.06–1.21, <i>p</i> = 1.34 × 10⁻⁴). Of the 36 immune cell phenotypes associated with IPF, those related to the mean fluorescence intensity of B cells were the most prevalent. Mediation analysis showed that CD19 on IgD− CD27− accounted for approximately 3.68% of the effect of hypothyroidism on IPF, whereas herpesvirus entry mediator (HVEM) on T cells accounted for approximately 3.83% of this effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We identified a marked association between hypothyroidism and IPF. Specific immune cell phenotypes may partially mediate this relationship, although the observed effect sizes were modest. Further research is needed to validate these results in diverse populations and larger clinical trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “SIRT3 Inhibits Cell Proliferation of Nonsmall Cell Lung Carcinoma by Inducing ROS Production”","authors":"","doi":"10.1111/crj.70106","DOIUrl":"https://doi.org/10.1111/crj.70106","url":null,"abstract":"<p>\u0000 <span>Z. Yu</span>, <span>H. Liao</span>, <span>G. Wu</span>, <span>Y. Liu</span>, <span>G. Zhang</span>, <span>L. Xiao</span>, <span>S. Yang</span>, <span>J. Liu</span>, <span>G. Yang</span>, “ <span>SIRT3 Inhibits Cell Proliferation of Nonsmall Cell Lung Carcinoma by Inducing ROS Production</span>,” <i>Clinical Respiratory Journal</i> <span>18</span>, no. <span>11</span> (<span>2024</span>), https://doi.org/10.1111/crj.70033.\u0000 </p><p>We apologize for this error.</p>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 Albumin Corrected Anion Gap and 28-Day All-Cause Mortality in Patients With Acute Respiratory Failure in ICU: A Retrospective Study Based on the MIMIC-IV Database","authors":"Jianmin Qu,&nbsp;Xiahong Tang,&nbsp;Yi Cheng,&nbsp;Wei Xiong,&nbsp;Yunfeng Zhao","doi":"10.1111/crj.70100","DOIUrl":"https://doi.org/10.1111/crj.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>For critically ill patients in the intensive care unit (ICU), acute respiratory failure (ARF) stands as a prominent cause of mortality. Anion gap (AG) denotes the disparity between unmeasured cations and anions. Adjusting AG for albumin levels results in the albumin corrected anion gap (ACAG), which provides a more accurate representation of the body's acid–base status. Elevated ACAG may arise from ARF-induced cellular hypoxia and metabolic acidosis. However, limited research has investigated the association between ACAG and the 28-day all-cause mortality of ARF patients in critical care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the Medical Information Mart for Intensive Care (MIMIC-IV 2.2) database, a retrospective data analysis was conducted, specifically targeting critically ill patients diagnosed with ARF. Serum ACAG was collected within 24 hours of the patient's admission to the ICU. The association between ACAG levels and 28-day all-cause mortality was investigated using smooth curve fitting, a multivariate Cox proportional hazard regression model, and Kaplan–Meier survival curve analysis. Furthermore, the consistency of these relationships was assessed through interaction and subgroup analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study involved the enrollment of 3888 eligible participants in total. After adjusting for confounding variables in the multivariable Cox regression analysis model, we noticed a positive linear relationship between the ACAG value and the ICU's 28-day all-cause mortality rate. When ACAG was used as a continuous variable, a 3.1% increase in 28-day all-cause mortality was associated with a 1.0-mmol/L increase in ACAG (adjusted HR = 1.037, 95% CI: 1.025–1.048, <i>p</i> &lt; 0.001). In the 28-day all-cause mortality, the highest and intermediate ACAG groups (adjusted HR 1.483, 95% CI: 1.244–1.768 and adjusted HR 1.244, 95% CI: 1.062–1.457, respectively) were notably higher than the lowest ACAG group when ACAG was utilized as a tertiles categorical variable. The substantial association between ACAG and 28-day all-cause mortality in the ICU was consistently demonstrated through subgroup analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among ICU patients with ARF, an elevated ACAG is linked to an elevated risk of 28-day all-cause mortality. There exists a linearly positive relationship between the 28-day all-cause mortality and ACAG.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}