American journal of respiratory and critical care medicine最新文献

{"title":"Diagnostic Bronchoscopy for Peripheral Lung Lesions: When Innovation Races to Meet Demand.","authors":"Jan Fouad, Anil Vachani","doi":"10.1164/rccm.202506-1374ED","DOIUrl":"10.1164/rccm.202506-1374ED","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1541-1542"},"PeriodicalIF":19.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The growing health burden of heat waves with focus on respiratory effects.","authors":"Krishna M Sundar, Bridget F Collins, Jane E Gross, W Graham Carlos, Shazia M Jamil","doi":"10.1164/rccm.v211i9p13","DOIUrl":"10.1164/rccm.v211i9p13","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"211 9","pages":"P13-P15"},"PeriodicalIF":19.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oscillometry-defined Small Airway Dysfunction in Tobacco-exposed Adults with Impaired or Preserved Airflow.","authors":"Mustafa Abdo, Henrik Watz, Frederik Trinkmann, Sabine Bohnet, Miriam Annabelle Marcella Guess, Johannes Roeben, Katharina May, Martin Reck, Benjamin-Alexander Bollmann, Susanne Stiebeler, Sabine Dettmer, Benjamin Waschki, Klaus F Rabe, Klaas Frederik Franzen, Jens Vogel-Claussen","doi":"10.1164/rccm.202501-0028OC","DOIUrl":"10.1164/rccm.202501-0028OC","url":null,"abstract":"<p><p><b>Rationale:</b> Small airway dysfunction (SAD) is a key feature of chronic obstructive pulmonary disease and might present in tobacco-exposed adults with normal spirometry. So far, the role of oscillometry-defined SAD in this population is largely unexplored. <b>Objective:</b> To investigate the prevalence of oscillometry-defined SAD and its associations with airway structural changes, quality of life (QoL), metabolic disease, and cardiovascular disease (CVD) in tobacco-exposed adults with impaired airflow or preserved airflow (PA). <b>Methods:</b> In a subcohort (<i>n</i> = 1,628) nested within a lung cancer screening trial, we assessed airway disease using pre-bronchodilator spirometry, oscillometry, and artificial intelligence-powered computed tomography. Impaired airflow included airflow obstruction (AFO) and preserved ratio impaired spirometry (PRISm). Subjects with PA, defined as FEV₁ and FEV₁:FVC greater than the lower limit of normal, were further stratified as PA with SAD (PA-SAD) or normal lung function. SAD was defined as the frequency dependence of resistance or reactance area greater than the upper limit of normal. Computed tomography biomarkers included airway wall thickness, luminal diameter, branch count, and emphysema. QoL was measured using the euroqol 5-dimension 5-level (EQ-5D-5L). <b>Measurements and Main Results:</b> The overall prevalence of SAD was 39%. SAD was present in 26% of subjects with PA and in 60% of those with impaired airflow. The frequency of AFO, PRISm, and PA-SAD was 21%, 15%, and 16%, respectively. Similar to those with impaired airflow, subjects with PA-SAD had lower EQ-5D-5L scores, greater airway wall thickness, narrower lumen, lower branch count, and higher rate of metabolic disease and CVD than those with normal lung function (<i>P</i> < 0.01 for all). However, they had minimal emphysema and significantly higher branch count than those with AFO. Subjects with AFO or PRISm and concurrent SAD had greater structural changes and more frequent CVD than those with AFO or PRISm alone. SAD was associated with CVD (odds ratio, 1.91 [95% confidence interval, 1.55-2.36]), even after adjusting for confounders and metabolic disease. <b>Conclusions:</b> SAD is highly prevalent among tobacco-exposed adults and is associated with airway structural changes, impaired QoL, and an increased rate of CVD, even among those with PA. PA-SAD is distinct from AFO by its preserved airway count and minimal emphysema.</p>","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":" ","pages":"1652-1661"},"PeriodicalIF":19.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Inhaled Tobacco and Cannabis Co-Use on Respiratory Health and Tobacco Cessation. An Official American Thoracic Society Research Statement.","authors":"Erin A McClure,Megan E Piper,Laura E Crotty Alexander,Ellen L Burnham,Tom P Freeman,Panagis Galiatsatos,Adam Edward Lang,Dustin C Lee,Frank T Leone,Anne C Melzer,Robin J Mermelstein,LaTrice Montgomery,Rachel A Rabin,Danielle M Smith,Gideon St Helen,Andrea H Weinberger,Hasmeena Kathuria","doi":"10.1164/rccm.202507-1792st","DOIUrl":"https://doi.org/10.1164/rccm.202507-1792st","url":null,"abstract":"BACKGROUNDTobacco and cannabis are among the most widely used substances globally, and rates of co-use are on the rise. Understanding the impact of inhaled tobacco-cannabis co-use on health outcomes and tobacco cessation is critical for guiding patients and clinicians.OBJECTIVESTo summarize the existing evidence, identify knowledge gaps, and prioritize research questions related to effects of inhaled tobacco-cannabis co-use on tobacco cessation and lung health.METHODSA multidisciplinary committee was convened to review the evidence, identify knowledge gaps, and develop research questions in four priority research areas: 1) common data elements and terminology; 2) patterns and prevalence of co-use; 3) impact of co-use on tobacco cessation; and 4) effects of co-use on lung health. A modified Delphi process was conducted in three rounds to reach consensus on prioritizing research questions.RESULTSThe evidence reviewed by the expert panel in four priority research areas yielded the following gaps in the literature with high priority to address with future research: 1) lack of consensus on terminology and recommended co-use data elements; 2) limited research on co-use and tobacco-related disparities; 3) insufficient evidence on how cannabis use affects tobacco cessation; and 4) alarming yet inconsistent findings on the effects of co-use on lung health.CONCLUSIONSThis statement outlines and guides a research agenda on the effects of inhaled tobacco-cannabis co-use on tobacco cessation and lung health. Consensus-driven recommendations include adopting harmonized terms and minimum data elements; studying the prevalence of co-use among populations experiencing tobacco-related disparities; evaluating the impact of co-use on tobacco cessation pharmacotherapies; and assessing the effects of co-use on the development and progression of lung diseases.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"31 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930242","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":"X-Ray Velocimetry Predicts Pneumothorax Risk after Bronchoscopic Lung Volume Reduction Using Endobronchial One-Way Valves.","authors":"Gerard J Criner,Nina Eikelis,Nathaniel Marchetti,Marium Rashid,Priya Walia,Lii-Yoong Criner,Charles Hatt,Kristopher Nilsen","doi":"10.1164/rccm.202501-0285rl","DOIUrl":"https://doi.org/10.1164/rccm.202501-0285rl","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"27 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930239","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":"Hitting the Sweet Spot: The Impact of ETI on Glucose Tolerance in CF.","authors":"Tonia A Douglas,Sarah K McMahon,Claire E Wainwright","doi":"10.1164/rccm.202508-1884ed","DOIUrl":"https://doi.org/10.1164/rccm.202508-1884ed","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"44 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930241","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":"Treatment Initiation as a Marker of Quality of OSA Care Among Active-Duty Military Personnel in the U.S.","authors":"Emerson M Wickwire,Vincent F Capaldi,Jeph Herrin,Benoit Stryckman,Connie Thomas,Scott G Williams,Wendy Funk,J Kent Werner,Jennifer S Albrecht","doi":"10.1164/rccm.202503-0725rl","DOIUrl":"https://doi.org/10.1164/rccm.202503-0725rl","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"15 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930248","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":"Mucus Plugs Correlate with Small Airway Remodelling in Asthma: A Case-Control Study.","authors":"Aileen Hsieh,Dragoş M Vasilescu,Jenna Barker-Mulleder,May Fouadi,Stacey Ledoux,David J Erle,Maude A Liegeois,John V Fahy,Tillie-Louise Hackett","doi":"10.1164/rccm.202501-0310oc","DOIUrl":"https://doi.org/10.1164/rccm.202501-0310oc","url":null,"abstract":"RATIONALEThe observation that mucus plugs in proximal airways on computed tomography (CT) correlate with disease severity and airflow obstruction has highlighted their role in asthma. Due to the resolution of CT, it is unknown if mucus plugs within the distal small airways (<2mm in diameter) also contribute to asthma severity.OBJECTIVESTo assess the prevalence of distal mucus plugs and their association with small airway remodelling in asthma.METHODS12 control, 5 non-fatal, and 11 fatal asthma lungs underwent systematic uniform random sampling to obtain 239 lung tissue samples that were imaged using micro-CT and matched histology to assess mucus plugs, airway wall remodelling and mucus composition.MAIN RESULTSWithin the distal lung of non-fatal and fatal asthmatics, 30% and 38% of pre-terminal bronchioles, 29% and 34% of terminal bronchioles, and 33% and 21% of transitional bronchioles contained mucus plugs, with a high coefficient of variation in their spatial location. Mucus plugs were comprised of 84% and 82% MUC5AC and 16% and 18% MUC5B in non-fatal and fatal asthma, and 67% extended over 80% of the bronchiole pathlength. In asthmatic lungs, mucus-plugged airways had thickened airway walls, narrowed airway lumens, and luminal folding compared to unplugged airways, due to increased epithelial, basement membrane, and smooth muscle thickening.CONCLUSIONIn asthma, mucus plugs are a prominent and spatially heterogeneous feature within the distal small airways, and are associated with airway wall remodelling and lumen narrowing, making them a key target for improving lung ventilation and patient outcomes.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"66 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930246","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":"From Chaos to Clarity: Reassessing ILD Terminology.","authors":"Justin M Oldham,Philip L Molyneaux","doi":"10.1164/rccm.202508-1898ed","DOIUrl":"https://doi.org/10.1164/rccm.202508-1898ed","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"24 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930247","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 Zhou et al.: Methodological Pitfalls Undermine Industrial Emission-related Lung Cancer Risk Assessment.","authors":"Jessica M Madrigal,Jared A Fisher,Caroline N Pruitt,Linda M Liao,Barry I Graubard,Mary H Ward,Debra T Silverman,Rena R Jones","doi":"10.1164/rccm.202507-1584le","DOIUrl":"https://doi.org/10.1164/rccm.202507-1584le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"31 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144930234","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}