American journal of respiratory and critical care medicine最新文献

{"title":"Reply to Takefuji: Limitations of Linear Dimensional Reduction Methods in COPD Phenotyping.","authors":"Alexander J Bell,Andrei Zinovyev,Alexander N Gorban","doi":"10.1164/rccm.202504-1019le","DOIUrl":"https://doi.org/10.1164/rccm.202504-1019le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"16 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370090","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 Annual Exposure to Air Pollution Mixture on Asthma Hospitalizations in the U.S.","authors":"Bryan N Vu,Heresh Amini,Xinye Qiu,Yijing Feng,Yaguang Wei,Joel Schwartz","doi":"10.1164/rccm.202409-1853oc","DOIUrl":"https://doi.org/10.1164/rccm.202409-1853oc","url":null,"abstract":"Rationale: Air pollutants have adverse effects on asthma exacerbation in people of all ages. However, fewer studies have examined long-term exposure to particle components in conjunction with nitrogen dioxide (NO2) and ozone (O3) to assess their mixture effects. Objectives: We utilized weighted quantile sum (WQS) regression to assess the cumulative effects of 15 particle components including organ compounds and metals, along with NO2 and O3, on counts of inpatient asthma hospitalizations for children ages 0-18 and adults ages 19-64 years. Methods: We conducted two separate WQS models for each age group with weights constrained between 0-1 while summing up to 1, q=10 deciles, and 100 bootstrap samples. Measurements: Inpatient records for asthma hospitalizations were collected from State Inpatient Databases from 11 U.S. states ranging in years from 2002 through 2016. We also included temperature and variables from the U.S. census to control for socio-economic status. All variables were aggregated to the annual ZIP-code level. Main Results: We observed an increase of 10.6% (95%CI: 10.0%,11.2%) and 8.0% (95%CI: 7.7%,8.4%) in the number of asthma inpatient hospitalizations each year for each decile increase of the pollutant mixture in children ages 0 to 18 and adults ages 19 to 64, respectively. Nickel, Vanadium, sulfate, nitrate, Bromine, and ammonium contributed the most weight to the pollutant mixture. Conclusions: Our results indicate that long-term exposure to pollutant mixtures is associated with increased risk of asthma hospitalization in both children and adults, and daily measurements of particle components data is needed to assess short-term exposure.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"43 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370096","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 Essential Role of Air Quality Monitoring at U.S. Embassies and Consulates.","authors":"Kevin R Cromar,Noussair Lazrak","doi":"10.1164/rccm.202503-0615vp","DOIUrl":"https://doi.org/10.1164/rccm.202503-0615vp","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"19 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370091","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":"Limitations of Linear Dimensional Reduction Methods in COPD Phenotyping.","authors":"Yoshiyasu Takefuji","doi":"10.1164/rccm.202504-0857le","DOIUrl":"https://doi.org/10.1164/rccm.202504-0857le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"242 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370093","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":"Clinical Remission by a Comprehensive Severe Asthma Management Strategy Guided by Airway Inflammometry and Bioimaging.","authors":"Santi Nolasco,Melanie Kjarsgaard,Sylvia Lauks,Owen Treleaven,Terence Ho,Chynna Huang,Katherine Radford,Taylor Swindall,Carmen Venegas Garrido,Anurag Bhalla,Sarita Thawanaphong,Yonni Friedlander,Lindsey Dyment,Michael Surette,Michael Trus,Roma Sehmi,Ehsan Haider,Nader Khalidi,Doron D Sommer,Susan Waserman,Manali Mukherjee,Sarah Svenningsen,Gerard Cox,Parameswaran Nair","doi":"10.1164/rccm.202412-2438oc","DOIUrl":"https://doi.org/10.1164/rccm.202412-2438oc","url":null,"abstract":"Rationale: Clinical remission is a multicomponent treatment goal in severe asthma. However, only about 30% of patients achieve clinical remission when treatment decisions are guided using blood eosinophil and FeNO levels. Objectives: To assess the effectiveness of a comprehensive, individualized treatment strategy in achieving clinical remission over 24 months in patients with severe asthma. Methods: Treatment strategies-including anti-inflammatory therapies, biologics, antibiotics, immunomodulators, and bronchial thermoplasty-were guided by clinical assessment, airway physiology, airway inflammometry, and bioimaging. Clinical remission was defined as no exacerbations for 24 months, no oral corticosteroid (OCS) use, and partly/well-controlled symptoms, with or without lung function criteria. Measurements and Main Results: One-hundred seventy-eight patients with severe asthma were evaluated. Of these, 88.2% were treated with biologics alone or in combination with other strategies; 20.2% were treated with antibiotics, hypertonic saline, and/or immunoglobulins; and 9% underwent bronchial thermoplasty after controlling the inflammatory component. After 24 months, 89.9% of patients were exacerbation-free, 83.1% were OCS-free, 78.1% had partly/well-controlled symptoms, and 84.8% had preserved lung function. Clinical remission was achieved in 66.3% of patients based on the three primary criteria and in 61.6% when including FEV1% decline ≤5% from baseline. However, when the most stringent criteria were applied (ACQ-5 ≤0.75 and FEV1 ≥80%), the clinical remission rate was 29.1%. Residual disease activity was driven primarily by airway infections and airway hyperresponsiveness rather than T2 inflammation. Conclusions: By using a comprehensive set of biomarkers and employing a management strategy tailored to individual pathobiology, a high proportion of patients with severe asthma can achieve clinical remission, depending on the definitions used. Nonetheless, recurrent airway infections, mucus, and airway hyperresponsiveness remain key unmet needs in severe asthma.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"44 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335322","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":"Emergency Intubation-A High-Stakes Procedure with Critical Gaps in Understanding Team Impact.","authors":"Omar Hyder,Jeanine P Wiener-Kronish,Kenneth T Shelton","doi":"10.1164/rccm.202504-1043le","DOIUrl":"https://doi.org/10.1164/rccm.202504-1043le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"15 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335320","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":"Is Your Placebo Really Needed?","authors":"Andrew Bush, Fernando Holguin","doi":"10.1164/rccm.202504-0841VP","DOIUrl":"10.1164/rccm.202504-0841VP","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":19.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336243","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":"Increased Driving Pressure During Assisted Ventilation for Hypoxemic Respiratory Failure Is Associated with Lower ICU Survival: The ICEBERG Study.","authors":"Alice Grassi,Isabella Bianchi,Maddalena Teggia Droghi,Sara Miori,Ilaria Bruno,Eleonora Balzani,Idunn S Morris,Dirk Schaedler,Tobias Becher,Manuel Valdivia Marchal,Jose M Serrano,Oriol Caritg,Oriol Roca,Eduardo Costa,Marcelo Amato,Fernando Barriga,Rollin Roldan,Andrea Boffi,Lise Piquilloud,Gregory J Mitchon,Guido Musch,Simone Piva,Michele Bertoni,Luigi Castagna,Giacomo Grasselli,Matteo Riccardo,Savino Spadaro,Ciprian Nita,Bairbre McNicholas,Michael C Sklar,Aurora Magliocca,Emanuele Rezoagli,Giuseppe Foti,John Laffey,Laurent J Brochard,Ewan C Goligher,Giacomo Bellani","doi":"10.1164/rccm.202411-2146oc","DOIUrl":"https://doi.org/10.1164/rccm.202411-2146oc","url":null,"abstract":"RATIONALEDriving pressure is marker of severity and a possible target for lung protection during controlled ventilation, but its value during assisted ventilation is unknown. Inspiratory holds provide an estimate of driving pressure (quasi-static). Expiratory holds provide an estimate of the inspiratory effort, useful to estimate the transpulmonary dynamic driving pressure.OBJECTIVESTo assess the correlation between driving pressures measured during assisted ventilation and ICU outcomes.METHODSMulticenter prospective observational study. Patients with acute hypoxemic respiratory failure were enrolled within 48 hours of triggering the ventilator. Respiratory mechanics were measured daily and the variables of interest averaged over the first three days of partial assistance. ICU outcomes were collected until day 90.MEASUREMENTS AND MAIN RESULTSTwo-hundred ninety-eight patients from 16 centers were enrolled. Tidal volume, peak airway pressure, positive-end-expiratory-pressure and inspiratory effort during the first three days of assisted ventilation did not differ between survivors and non-survivors. Quasi-static driving pressure and transpulmonary dynamic driving pressure were higher in non-survivors than in survivors (13 [11,14] vs 11 [9,13] cmH2O, p<0.001 and 19 [16,23] vs 16 [13,18] cmH2O, p<0.001, respectively), while compliance normalized to predicted body weight was lower (0.65 [0.54,0.84] vs 0.79 [0.64,0.97] ml/cmH2O/kg, p<0.001). Multivariable analysis confirmed the association with outcome. Over study days, static driving pressure significantly diverged between survivors and non-survivors.CONCLUSIONSDuring assisted ventilation driving pressure and normalized compliance are associated with ICU outcome, despite some overlap. Albeit our study does not allow to estimate if driving pressure is a marker of severity, or a cause of lung injury, it highlights the potential value of monitoring and targeting it during spontaneous assisted breathing.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"23 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335323","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 Hyder et al.: Emergency Intubation-A High-Stakes Procedure with Critical Gaps in Understanding Team Impact.","authors":"Stephanie C DeMasi,Jonathan D Casey,Matthew W Semler","doi":"10.1164/rccm.202505-1165le","DOIUrl":"https://doi.org/10.1164/rccm.202505-1165le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"14 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335337","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 Analysis Identifies Pollution-Sensitive Loci in Fibrotic Interstitial Lung Disease.","authors":"Gillian C Goobie,Najmeh Assadinia,Chen Xi Yang,Fanny Chu,Rachel L Clifford,Joel D Cooper,James P Fabisiak,Kevin F Gibson,Kerri A Johannson,Daniel J Kass,Sharon Kim,Xiaoyun Li,Kathleen O Lindell,Daniel-Costin Marinescu,Dragos M Vasilescu,Victoria Wang,Christopher Carlsten,S Mehdi Nouraie,Christopher J Ryerson,Tillie L Hackett,Yingze Zhang","doi":"10.1164/rccm.202407-1504oc","DOIUrl":"https://doi.org/10.1164/rccm.202407-1504oc","url":null,"abstract":"RATIONALEParticulate matter <=2.5um (PM2.5) adversely impacts patients with fibrotic interstitial lung disease (fILD).OBJECTIVETo determine whether PM2.5-associated epigenetic alterations contribute to the environmental pathogenesis of fILD.METHODSRetrospective two-cohort study applying satellite-derived PM2.5 and constituent exposure matching to the residential location of patients with fILD. Robust linear regressions evaluated cohort-specific epigenome-wide differential blood DNA methylation with increasing pollutant exposures (Illumina MethylationEPIC BeadChip). Cox and linear regressions evaluated associations of cytosine-phosphate-guanine (CpG) loci with transplant-free survival and lung function. Wilcoxon test evaluated cartilage-associated protein (CRTAP) levels in fILD and control lungs.RESULTSThe University of Pittsburgh (UPitt) cohort (n=306) had 5-year median PM2.5 exposures of 12.1ug/m3 compared with 5.1ug/m3 in the University of British Columbia (UBC) cohort (n=170). Higher pollutant exposures in the UPitt cohort were associated with lower methylation at cg25354716, annotated to CRTAP, a critical extracellular matrix remodeling enzyme. Higher exposures in the UBC cohort were associated with higher methylation at cg01019301, annotated to TLN2 (talin-2), a cytoskeletal protein involved in fibroblast migration. A 10% increase in cg25354716 methylation was associated with a hazard ratio (HR) of 0.81 for death or lung transplantation in the meta-analyzed cohorts (95%CI 0.69-0.96, p=0.01), whereas the same change in cg01019301 was associated with a HR of 1.36 (95%CI 1.07-1.74, p=0.01). CRTAP protein was more abundant in lungs from patients with fILD compared with donor controls (p<0.001).CONCLUSIONSPM2.5 is associated with altered blood DNA methylation in fILD. This work identifies novel pollution-sensitive targets that hold potential for therapeutic modulation in fILD.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"195 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335321","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}