American journal of respiratory and critical care medicine最新文献

{"title":"Patient Factors and Clinical Efficacy of Early Identification and Treatment of COPD and Asthma.","authors":"Arianne Tardif,G A Whitmore,Katherine L Vandemheen,Celine Bergeron,Louis-Philippe Boulet,Andréanne Côté,R Andrew McIvor,Erika Penz,Stephen K Field,Catherine Lemière,Irvin Mayers,Mohit Bhutani,Tanweer Azher,M Diane Lougheed,Samir Gupta,Nicole Ezer,Christopher J Licskai,Paul Hernandez,Martha Ainslie,Gonzalo G Alvarez,Sunita Mulpuru,Shawn D Aaron","doi":"10.1164/rccm.202505-1260oc","DOIUrl":"https://doi.org/10.1164/rccm.202505-1260oc","url":null,"abstract":"RATIONALEThe Undiagnosed COPD and Asthma Population trial showed that early diagnosis and treatment of asthma and COPD by pulmonologists improved healthcare utilization, respiratory symptoms, and quality of life.OBJECTIVESTo determine if the benefits of early diagnosis and treatment were greater in individuals with more advanced disease, or in individuals with asthma as opposed to COPD. We also assessed whether pulmonologist-directed care benefited asthma and COPD subgroups equally.METHODSCase finding was used to identify undiagnosed adults with chronic respiratory symptoms in the community. Five hundred and eight newly diagnosed participants with COPD or asthma were randomized to a pulmonologist-care intervention or usual care. Low and high disease-burden categories for St. Georges Respiratory Questionnaire (SGRQ) and COPD Assessment Test (CAT) were defined using a median-split of baseline scores, and MCID thresholds were used to define significant responses. Benefits of pulmonologist care were assessed by evaluating treatment effects within subgroups and by assessing treatment-by-subgroup interactions.MEASUREMENTS AND MAIN RESULTSPatients with higher disease burden at diagnosis were more likely to benefit from early diagnosis and treatment compared to those with lower disease-burden. 71% of those with high disease-burden improved their CAT by ≥ 2 points over 12 months compared to 47% with low disease burden; OR 2.78, 95% CI: 1.90 to 4.07, p<0.001. Similar results were seen for SGRQ and FEV1 improvements. In contrast, responses to early diagnosis and treatment were similar for those with asthma vs COPD. Individuals with asthma randomized to pulmonologist-directed care showed greater one-year improvements in CAT, SGRQ, SF36 and FEV1 compared to individuals randomized to primary care. However, individuals with COPD experienced similar improvements regardless of whether their treatment was managed by a pulmonologist or primary care provider. Treatment-by-disease interaction terms were not statistically significant.CONCLUSIONSPatients with greater disease burden who exhibited more advanced and symptomatic asthma and COPD at the time of diagnosis, benefited more from earlier diagnosis and treatment. Patients with asthma tended to derive greater benefit from pulmonologist-directed care than patients with COPD.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"4 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241005","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":"Maternal Smoking and CC-16: Implications for Lung Development and COPD Across the Lifespan.","authors":"Joselyn Rojas-Quintero,Rosa Faner,Chia-Ying Chiu,Jeff T Kue,Yun Zhang,David Sanz Rubio,Adrianne S Colborg,Constanze A Jakwerth,Carsten B Schmidt-Weber,Anke-Hilse Maitland-van der Zee,Mahmoud I Abdel-Aziz,Aprile L Pilon,Caroline A Owen,Erin J Plosa,Gregory L Kinney,Sharon Mc-Grath Morrow,Mariacarolina G Gazzaneo,Nahir Cortes Santiago,Krithika Lingappan,Julie Ledford,Jason Spence,Jennifer M Sucre,Maor Sauler,Tianshi David Wu,Alvar Agusti,Asa Wheelock,Sabina Illi,Erika von Mutius,Russell P Bowler,Bartolome Celli,Steven H Abman,J Michael Wells,Francesca Polverino, ","doi":"10.1164/rccm.202504-0854oc","DOIUrl":"https://doi.org/10.1164/rccm.202504-0854oc","url":null,"abstract":"RATIONALEEarly-life lung function trajectories predict long-term respiratory health, including COPD risk. Club Cell protein 16 (CC16) is a key determinant of lung health, with low levels associated with impaired lung development, reduced lung function, and COPD. Cigarette smoking lowers CC16, but it is unknown whether maternal smoking leads to persistent CC16 deficiency from early life, thereby disrupting lung development and predisposing to COPD risk and progression Methods: CC16 expression was analyzed across 4 human cohorts, in plasma samples (COPDGene [n=1,062] and ECLIPSE [n=2,164]), nasal brushings (ALLIANCE [n=63]), and peripheral lung sections (LTRC [n=44]) from participants with and without a history of maternal smoking exposure. Lung histology and respiratory mechanics were assessed in WT and Cc16-/- mice with and without maternal smoking exposure. Recombinant human (rh)CC16 effects on lung maturation were assessed in embryonic murine lung explants.RESULTSMaternal smoking was linked to reduced circulating and airway CC16 in COPD patients, controls, and a preclinical murine COPD model. In human adults, lower CC16 correlated with accelerated lung function decline and emphysema progression, while in children it was associated with obstructive physiology and early small airway impairment. In both mice and humans, maternal smoking-induced CC16 reduction was accompanied by greater epithelial injury (fibrosis, inflammation, apoptosis, oxidative stress). In murine explants, smoking impaired lung branching, whereas rhCC16 restored branching via α2-integrin binding Conclusions: Maternal smoking reduces CC16 levels, disrupting lung development in ways that predispose to lifelong impairment of lung function and worse COPD outcomes. Defining the mechanisms by which CC16 regulates lung maturation is essential for establishing reliable outcome measures and designing trials aimed at preventing early COPD. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"86 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241101","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":"Reply to Moor et al. and Egashira et al.","authors":"Anna J Podolanczuk,Gary M Hunninghake,David A Schwartz,Christopher J Ryerson","doi":"10.1164/rccm.202508-1841le","DOIUrl":"https://doi.org/10.1164/rccm.202508-1841le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"106 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235899","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":"ILA or ILD in CTD: The Alphabet Soup Continues.","authors":"Catharina C Moor,Michael Kreuter,Anna-Maria Hoffmann-Vold","doi":"10.1164/rccm.202506-1373le","DOIUrl":"https://doi.org/10.1164/rccm.202506-1373le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"5 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235902","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":"The Bidirectional Modification Effects Between Non-Optimum Temperatures and Fine Particulate Matter Pollution on Lower Respiratory Infections.","authors":"Jian Lei,Huimeng Liu,Yang Lan,Xi Chen,Jing Wei,Chen Wei,Furong Deng,Xinbiao Guo,Yuewei Liu,Shaowei Wu","doi":"10.1164/rccm.202506-1520rl","DOIUrl":"https://doi.org/10.1164/rccm.202506-1520rl","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"54 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235908","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":"Patterns, Features and Extents: Radiological Dilemmas in the ATS Statement Approach to Interstitial Lung Abnormalities.","authors":"Ryoko Egashira,Daisuke Yamada,Joseph Jacob","doi":"10.1164/rccm.202506-1442le","DOIUrl":"https://doi.org/10.1164/rccm.202506-1442le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"81 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235900","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":"Can a Spark Light an Eternal Flame? Lessons from Physical Activity Coaching in COPD.","authors":"Rainer Gloeckl","doi":"10.1164/rccm.202507-1688ed","DOIUrl":"https://doi.org/10.1164/rccm.202507-1688ed","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"28 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235907","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":"Positioning Dipeptidyl Peptidase-1 Inhibitors in Bronchiectasis: No Drug Is an Island.","authors":"Mattia Nigro,Stefano Aliberti","doi":"10.1164/rccm.202508-2056vp","DOIUrl":"https://doi.org/10.1164/rccm.202508-2056vp","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"21 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235911","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":"The SOOTHE Trial of Camlipixant in RCC: A Cautionary Note on Stratification and Relevance.","authors":"Xiangxia Zeng","doi":"10.1164/rccm.202506-1519le","DOIUrl":"https://doi.org/10.1164/rccm.202506-1519le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"107 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235912","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":"Methodological Considerations in the Iloprost for Septic Shock Trial.","authors":"Guanyu Yang,Qinjun Chu","doi":"10.1164/rccm.202507-1727le","DOIUrl":"https://doi.org/10.1164/rccm.202507-1727le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"52 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145235906","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}