American journal of respiratory and critical care medicine最新文献

{"title":"Reply to Itagaki et al.: Potential Risk of Eccentric Diaphragm Contraction in the STIMULUS Trial.","authors":"Idunn S Morris,Thiago Bassi,Catherine A Bellissimo,Ewan C Goligher","doi":"10.1164/rccm.202506-1568le","DOIUrl":"https://doi.org/10.1164/rccm.202506-1568le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"49 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077803","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":"A Simple Index for Predicting Mucus Plugs in Patients with COPD.","authors":"Wei Wang,Ruchita Borgaonkar,Sophia K Mettler,Andrew Yen,Scott Grumley,Sushilkumar Sonavane,Carrie L Pistenmaa,Pietro Nardelli,Raul San José Estépar,Alejandro A Diaz","doi":"10.1164/rccm.202503-0563rl","DOIUrl":"https://doi.org/10.1164/rccm.202503-0563rl","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"37 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077810","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":"Upper Airway Microbiome, Mucociliary Function, and Clinical Outcomes in Bronchiectasis: Data from the EMBARC-BRIDGE Study.","authors":"Hayoung Choi,Hollian Richardson,Chandani Hennayake,Morven Shuttleworth,Erin Cant,Mathieu Bottier,Arietta Spinou,Kara Robertson,Merete Long,Anthony De Soyza,Felix C Ringshausen,Pieter Goeminne,Natalie Lorent,Charles Haworth,Josje Altenburg,Michael R Loebinger,Daniela Alferes de Lima Headley,Alison J Dicker,Francesco Blasi,Michal Shteinberg,Stefano Aliberti,Eva Polverino,Oriol Sibila,Amelia Shoemark,James D Chalmers","doi":"10.1164/rccm.202504-0875oc","DOIUrl":"https://doi.org/10.1164/rccm.202504-0875oc","url":null,"abstract":"RATIONALEInfection is a key disease driver in bronchiectasis, and the upper airway microbiome has been known to shape the lower airway microbiome.OBJECTIVESTo evaluate the relationship between the upper airway microbiome, mucociliary function, and clinical outcomes in bronchiectasis.METHODSNasopharyngeal swabs were collected from 344 bronchiectasis patients enrolled across five European centers. A total of 104 patients had nasopharyngeal samples obtained at the 1-year follow-up. Microbiome composition was assessed according to BSI and severe exacerbations. The α- and β-diversity were measured using the Chao1 and Bray-Curtis indices, respectively. Random forest analysis was performed. Dysbiosis was defined as >10% relative abundance of pathogenic taxa comprising Pseudomonas, Haemophilus, and Staphylococcus.MEASUREMENTS AND MAIN RESULTSOf the 344 patients, 200 (58.1%) were female (median age, 68 years; interquartile range, 59-75 years). α-diversity significantly differed according to disease severity (P=0.002), and β-diversity analysis revealed distinct microbiome profiles associated with disease severity and severe exacerbation (PERMANOVA, P=0.021 and 0.001, respectively). Random forest analysis identified Pseudomonas as being associated with severe bronchiectasis (BSI≥9) and severe exacerbations. The genus-level relative taxon abundance of Pseudomonas was well correlated with Pseudomonas aeruginosa growth in the sputum culture. Patients with nasopharyngeal dysbiosis had more severe respiratory symptoms, showed epithelial disruption on nasal epithelial biopsy, and experienced more severe exacerbation over a 1-year follow-up period than those in the non-dysbiosis group. The microbiome profiles were relatively stable between baseline and 1-year follow-up (P=0.95).CONCLUSIONThe upper airway microbiome is associated with disease severity and severe exacerbation of bronchiectasis.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"36 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043695","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":"Oral Rinse as an Alternative Diagnostic Specimen for Detection of Tuberculosis.","authors":"Bhavna G Gordhan,Astika Sewcharran,Ziyaad Waja,Neil Martinson,Mariana Araujo-Pereira,Alessandra de Souza Saboia,Maria Cristina S Lourenço,Adriano Gomes-Silva,Valeria C Rolla,Bavesh Kana, ","doi":"10.1164/rccm.202503-0723rl","DOIUrl":"https://doi.org/10.1164/rccm.202503-0723rl","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"67 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035553","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":"Cardiopulmonary Hemodynamic Determinants of Long-Term Survival in Sickle Cell Disease: Insights from the ETENDARD Study.","authors":"Laurent Savale,Thomas D'humières,Athénaïs Boucly,Anoosha Habibi,François Lionnet,Gylna Loko,Jocelyn Inamo,Gonzalo De Luna,Salma Al Khaf,Christelle Chantalat-Auger,Bernard Maitre,Xavier Jaïs,David Montani,Olivier Sitbon,Florence Parent,Gérald Simonneau,Frederic Galacteros,Etienne Audureau,Pablo Bartolucci,Marc Humbert","doi":"10.1164/rccm.202502-0353oc","DOIUrl":"https://doi.org/10.1164/rccm.202502-0353oc","url":null,"abstract":"RATIONALEPulmonary hypertension (PH) is a serious cardiopulmonary complication of sickle cell disease (SCD), but the prognostic impact of hemodynamic parameters remains poorly defined.OBJECTIVESThis study aimed to assess the clinical and long-term prognostic relevance of hemodynamic parameters in SCD.METHODSData were analyzed from the French Etendard cohort. All 398 participants underwent echocardiography; those with tricuspid regurgitation velocity (TRV) ≥ 2.5 m/s proceeded to right heart catheterization. Over a minimum 10-year follow-up, we examined the clinical and prognostic significance of hemodynamic variables.MEASUREMENTS AND MAIN RESULTSPH defined by a mean pulmonary arterial pressure (mPAP) > 20 mmHg was identified in 44 patients (11%). Among them, 26 (6.5%) had a pulmonary arterial wedge pressure (PAWP) ≤ 5 mmHg, and 18 (4.5%) had a PAWP>15 mmHg. Mortality during follow-up was 11.1%. A significant association was found between pulmonary vascular resistance (PVR) levels and mortality risk, with a threshold identified at 1.5 Wood units through ROC analyses. In patients with mPAP > 20 mmHg and PVR ≥ 1.5 WU, the adjusted hazard ratio (HR) for mortality was 4.27 (95% CI: 1.88-9.74; p < 0.001). A hemolytic phenotype and the presence of systemic complications, including hypertension, left ventricular diastolic dysfunction, renal impairment, and leg ulcers, were associated with elevated PVR and increased mortality risk.CONCLUSIONA PVR threshold of 1.5 WU emerges as a key predictor of mortality in patients with a mPAP above 20 mmHg, particularly when assessed in conjunction with markers of hemolysis and systemic complications.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"35 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035625","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":"Oral Rinse versus Facemask Capture for Non-Sputum Diagnosis of Pulmonary Tuberculosis.","authors":"Simon C Mendelsohn,Gabriella T Jackson,Edmund Wessels,Elizabeth Beyers,Suzette Visagie,Marcia Steyn,Sudesh Sivarasu,Bavesh D Kana,Thomas J Scriba,Mark Hatherill, ","doi":"10.1164/rccm.202506-1477rl","DOIUrl":"https://doi.org/10.1164/rccm.202506-1477rl","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"29 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035552","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":"High Oscillometry-derived Airway Resistance Is Associated with FEV1 Decline and Future Abnormal Spirometry in Smokers with Initially Normal Spirometry.","authors":"Mustafa Abdo,Frederik Trinkmann,Ralf Ewert,Anne Obst,Henry Völzke,Claudia Flexeder,Margit Heier,Annette Paters,Felix Herth,Henrik Watz,Klaus F Rabe,Beate Stubbe,Stefan Karrasch","doi":"10.1164/rccm.202507-1645rl","DOIUrl":"https://doi.org/10.1164/rccm.202507-1645rl","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"43 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145036093","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":"Novel Genetic Loci for Nontuberculous Mycobacterial Pulmonary Disease and Potential Protective Effect of Body Mass Index.","authors":"Kyungtaek Park,Hyejin Kim,Hee Jae Huh,Ho Namkoong,Naoki Hasegawa,Tomoyasu Nishimura,Takanori Asakura,Kozo Morimoto,Atsuyuki Kurashima,Yosuke Omae,Yosuke Kawai,Katsushi Tokunaga,Joanne Berghout,Kevin P Fennelly,Steven M Holland,Jaeyoung Cho,Jae-Joon Yim,Sungho Won,Byung Woo Jhun,Hong-Hee Won","doi":"10.1164/rccm.202406-1253oc","DOIUrl":"https://doi.org/10.1164/rccm.202406-1253oc","url":null,"abstract":"RATIONALEAlthough nontuberculous mycobacteria (NTM) are widespread, only some individuals develop NTM-pulmonary disease (NTM-PD), suggesting the involvement of host factors.OBJECTIVESTo identify the genomic structure of NTM-PD and determine whether a definitive association exists between NTM-PD and nine risk factors.METHODSWe performed genome-wide association studies in two independent Korean cohorts involving 1,949 NTM-PD patients and 2,955 healthy participants. Significantly associated genetic variants were validated in Japanese (1,137 cases, 1,546 controls) and European (243 cases, 570 controls) cohorts, respectively. Genes associated with lead variants were identified using several methods including quantitative trait loci analyses and their roles in NTM-PD were supported by single-cell transcriptome datasets. Genetic correlations and Mendelian randomization between NTM-PD and nine risk factors were examined.MEASUREMENTS AND MAIN RESULTSWe identified two novel loci and replicated a locus associated with NTM-PD: rs60084385 (odds ratio (OR), 1.34; 95% confidence interval (CI), 1.21-1.48; P, 6.97×10-9); rs1479595 (OR, 1.40; 95% CI, 1.27-1.55; P, 7.08×10-11); and rs194792 (OR, 1.70; 95% CI, 1.50-1.93; P, 1.39×10-16). These associations were replicated in the independent cohorts. The three loci were significantly associated with expression levels of IL1Rs, PDE8B, and PRKCB, respectively, whose involvement in the pathogenesis of NTM-PD were further validated. Among the risk factors, only body mass index demonstrated both a significant genetic correlation with NTM-PD (rg, -0.57; false discovery rate [FDR], 1.33×10-5) and a potential causal relationship (OR, 0.38; 95% CI, 0.24-0.59; FDR, 8.55×10-5).CONCLUSIONSOur study identified three genetic loci associated with NTM-PD and a negative association of BMI with NTM-PD.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"41 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035624","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":"Targeting Treatable Traits Across the Lifespan in Preterm-Born Individuals with Chronic Lung Disease of Prematurity.","authors":"Lorenzo Zanetto,Luca Bonadies,Chiara Pertoldi,Alberto Papi,Eugenio Baraldi","doi":"10.1164/rccm.202505-1157vp","DOIUrl":"https://doi.org/10.1164/rccm.202505-1157vp","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"16 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031791","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":"Differential Effects of Wildfire Smoke Pm2.5 Exposure on Respiratory Disease Emergency Department Visits in the Western United States.","authors":"Wenhao Wang,Linzi Li,Qingyang Zhu,Rohan Richard D'Souza,Danlu Zhang,Haisu Zhang,Stefanie Ebelt,Howard H Chang,Alvaro Alonso,Yang Liu","doi":"10.1164/rccm.202502-0350oc","DOIUrl":"https://doi.org/10.1164/rccm.202502-0350oc","url":null,"abstract":"BACKGROUNDWildfires significantly affect air quality in the Western United States. Although prior research has linked wildfire smoke PM2.5 to respiratory health outcomes, these studies typically have limited geographic and temporal coverage, lacking evidence from multiple states over extended periods.METHODSWe obtained data on over 6 million emergency department (ED) visits for respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), upper respiratory infections (URI), and bronchitis, from five states in the Western US during 2007-2018. Daily exposure to wildfire smoke and non-smoke PM2.5 was estimated using a state-of-the-art model system. A time-stratified case-crossover design with conditional logistic regression models was used to assess the acute respiratory effects of smoke and non-smoke PM2.5 exposure.FINDINGSThe odds ratios associated with a 1 µg/m3 increase in the 3-day average wildfire smoke PM2.5 were 1.016 (1.015-1.016) for asthma, 1.004 (1.003-1.005) for COPD, 1.001 (1.000-1.011) for upper respiratory infections (URI), and 1.004 (1.004-1.004) for bronchitis. Wildfire smoke PM2.5 had stronger estimated effects than non-smoke PM2.5, particularly for asthma (non-smoke PM2.5: OR 1.002, 1.001-1.004). Stratified analyses showed greater vulnerability among women and adults. Sensitivity analyses confirmed robust associations across exposure windows, while concentration-response functions suggested no clear threshold for adverse effects.CONCLUSIONWildfire smoke PM2.5 was associated with elevated risks of acute respiratory outcomes. Stronger effects were observed from smoke PM2.5 than non-smoke PM2.5, particularly for asthma and upper respiratory infections. These findings underscore the need for targeted public health interventions and further research into the unique toxicological properties of wildfire emissions.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"24 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031821","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}