Archivos De Bronconeumologia最新文献

{"title":"Functional and Compositional Shifts in Lung and Gut Microbiota after One Year of Treatment with Highly Effective CFTR Modulators in Cystic Fibrosis.","authors":"Natalia Bastón-Paz, Carmen García-Durán, Doĝukan Bayraktar, Esther Palacios, Ana Moreno-Blanco, Janetta Top, María Garriga, Luis Máiz, Saioa Vicente-Santamaría, Antonio Oliver, Jesús Oteo-Iglesias, Rafael Cantón, Concha Gil, Anita C Schürch, Rosa Del Campo, Juan de Dios Caballero","doi":"10.1016/j.arbres.2026.08.007","DOIUrl":"https://doi.org/10.1016/j.arbres.2026.08.007","url":null,"abstract":"<p><strong>Background: </strong>Highly effective CFTR modulator therapy with elexacaftor-tezacaftor-ivacaftor (ETI) has revolutionized clinical outcomes in cystic fibrosis (CF), yet its effects on gut and lung microbiota, especially at the functional level, are poorly understood.</p><p><strong>Methods: </strong>In a 12-month prospective study, we enrolled 35 clinically stable CF patients initiating ETI. Paired fecal and sputum samples, collected at baseline and after 12 months, were analyzed using shotgun metagenomics, metaproteomics, and short-chain fatty acid (SCFA) quantification. Multi-omics data were integrated with clinical parameters assessing lung, hepatic, pancreatic, and intestinal function.</p><p><strong>Results: </strong>ETI drove significant clinical improvements, including increased ppFEV₁, higher fecal elastase, and better nutritional status, despite persistent major lung pathogens and minimal changes in liver or intestinal inflammation markers. Microbiota composition showed limited shifts: alpha diversity was stable, and beta diversity changes accounted for only small variance in both compartments. However, butyrate-producing genera enriched in feces, while oropharyngeal taxa increased in sputum. Metaproteomics revealed broad downregulation of host neutrophil-driven inflammatory proteins; sputum additionally showed increased abundance of extracellular matrix-related proteins. Microbial proteins linked to carbohydrate/lipid metabolism, particularly butanoate pathways, increased in feces alongside a trend for higher butyrate. In sputum, formaldehyde dehydrogenase enzymes rose, indicating enhanced oxidative microbial metabolism.</p><p><strong>Conclusions: </strong>ETI is associated with minimal compositional but substantial functional reprogramming in CF microbiota. These changes are accompanied by an increase in butyrate-producing taxa, attenuation of host pro-inflammatory pathways, and a shift in lung metabolism toward oxidation. Despite ongoing pathogenic colonization, these changes suggest CFTR modulation is associated with a less inflammatory, more stable host-microbiota ecosystem.</p>","PeriodicalId":8339,"journal":{"name":"Archivos De Bronconeumologia","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149057453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor Heterogeneity and Metastatic Potential in Lung Cancer: How Early Can a Tumor Become Metastatic?","authors":"Ariana Huebner","doi":"10.1016/j.arbres.2026.08.019","DOIUrl":"https://doi.org/10.1016/j.arbres.2026.08.019","url":null,"abstract":"","PeriodicalId":8339,"journal":{"name":"Archivos De Bronconeumologia","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-Induced Sarcoidosis-Like Reaction Associated With Trastuzumab Deruxtecan: An Emerging Adverse Event of a HER2-Directed Antibody-Drug Conjugate.","authors":"Paula Martín Almazán, Fernando Moreno Antón, Cristina Matesanz López","doi":"10.1016/j.arbres.2026.08.004","DOIUrl":"https://doi.org/10.1016/j.arbres.2026.08.004","url":null,"abstract":"","PeriodicalId":8339,"journal":{"name":"Archivos De Bronconeumologia","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"If the Only Tool you Have is Ultrasound - Current and Future Challenges of Cardiopulmonary Point-of-care Ultrasound.","authors":"Casper Falster","doi":"10.1016/j.arbres.2026.08.005","DOIUrl":"https://doi.org/10.1016/j.arbres.2026.08.005","url":null,"abstract":"","PeriodicalId":8339,"journal":{"name":"Archivos De Bronconeumologia","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Sensitivity to Safe Disposition: Defining the Clinical Value of sPESI-ECG.","authors":"Yuanxia Li, Shuyan Liu","doi":"10.1016/j.arbres.2026.08.016","DOIUrl":"https://doi.org/10.1016/j.arbres.2026.08.016","url":null,"abstract":"","PeriodicalId":8339,"journal":{"name":"Archivos De Bronconeumologia","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized, Open-Label, Parallel Group Study of Alpha-1 Antitrypsin Therapy in Hospitalized Patients With COVID-19.","authors":"Luis Puente Maestu, Myriam Calle Rubio, Silvia Martín Bote, Lourdes Lázaro-Asegurado, Carlos Martínez-Rivera, Elsa Mondou, Mireia Torres, Natalia Afonso, Marc Miravitlles","doi":"10.1016/j.arbres.2026.08.006","DOIUrl":"https://doi.org/10.1016/j.arbres.2026.08.006","url":null,"abstract":"<p><strong>Background: </strong>Alpha-1 antitrypsin (AAT) reduces production of several pro-inflammatory cytokines. Increased inflammatory cytokines are prominent in the hyperinflammatory state associated with severe COVID-19 infection. The study objective was to determine if administration of AAT reduced the severity of COVID-19 pneumonia in hospitalized patients.</p><p><strong>Methods: </strong>This multi-center, randomized (1:1), open-label, pilot study was designed to investigate if AAT with standard medical treatment (SMT) could reduce the severity of COVID-19 pneumonia compared to SMT alone. Randomized patients received intravenous AAT (120mg/kg on days 1 and 8)+SMT or SMT alone. The study ran between July 29, 2020, and June 10, 2021, at six sites in Spain. The primary efficacy outcome was the proportion of subjects dying or requiring ICU admission on or before day 15 or were dependent on invasive mechanical ventilation on day 15. Several other secondary or exploratory endpoints were studied.</p><p><strong>Results: </strong>Of 100 patients randomized, 85 completed the study (AAT+SMT: n=41; SMT: n=44). Demographically the groups were similar. No significant difference was observed between the treatment groups in the composite primary endpoint: 14.0% AAT+SMT versus 22% SMT (p=0.4356) nor for death (6% versus 8%); ICU admission (8% versus 14%); requiring invasive mechanical ventilation (6% versus 4%), respectively. No significant differences were seen with secondary or exploratory endpoints.</p><p><strong>Conclusions: </strong>AAT+SMT showed no significant effects on severe COVID-19 pneumonia when compared to SMT alone. Although results were not positive, testing potential therapies with a sound theoretical basis is an important step in development of therapies for emerging diseases when no treatment exists.</p>","PeriodicalId":8339,"journal":{"name":"Archivos De Bronconeumologia","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Long-Term Mortality in Bronchiectasis.","authors":"Grace Oscullo, Raúl Méndez, Casilda Olveira, Rosa Girón, Marta García-Clemente, Luis Máiz, Oriol Sibila, Lidia Perea, Rafael Golpe, Juan Luis Rodríguez-Hermosa, Esther Barreiro, Concepción Prados, Juan Rodriguez-Lopez, David de la Rosa, Miguel Ángel Martinez-García","doi":"10.1016/j.arbres.2026.08.008","DOIUrl":"https://doi.org/10.1016/j.arbres.2026.08.008","url":null,"abstract":"<p><strong>Introduction: </strong>There are scarce data on long-term mortality in bronchiectasis in studies including a high number of bronchiectasis subjects. The objective of this study was to investigate risk factors of all-cause mortality in a large series of bronchiectasis patients with a long follow-up.</p><p><strong>Methods: </strong>Historical cohort series from the Spanish Registry of Bronchiectasis in 2057 patients with a median follow-up of 84 (IQR: 72-102) months. A wide set of data from all the dimensions of bronchiectasis (general, clinical, etiological, complementary test, peripheral biomarkers, functional, microbiological, and therapeutic) was collected. 408 patients died during follow-up. Multivariable Cox survival analysis was used.</p><p><strong>Results: </strong>Thirteen variables (Condition/HR): COPD/3.16; Chronic bronchial infection (CBI) by Pseudomonas aeruginosa (PA)/2.57; peripheral neutrophilia (>80%)/2.53; Previous and follow-up hospitalization rate/2.01 and 1.93 respectively; Previous and follow-up exacerbation rate/1.05 and 2.01 respectively; Charlson index/1.24; age/1.06; Baseline FEV₁%pred/0.98; Previous pneumonia episodes/1.04 and dyspnea/1.16 were independently associated with greater mortality. FACED, E-FACED and BSI were analyzed separately, with HR of 2.3, 2.2 and 1.7, respectively.</p><p><strong>Conclusions: </strong>The presence of COPD, CBI by PA, peripheral neutrophilia, and hospitalizations were the four most important variables independently associated with greater long-term mortality in bronchiectasis.</p>","PeriodicalId":8339,"journal":{"name":"Archivos De Bronconeumologia","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelial Cell Transcriptomics Reveal Activation of Ribosomal-related Pathways in Chronic Thromboembolic Pulmonary Hypertension.","authors":"Míriam Peracaula, Daniel Aguilar, Àngela Vea, Cristina Rodríguez, Miquel Gratacós-Aurich, Júlia Cabrera-Serra, Jeisson Osorio, Isabel Blanco, Victor I Peinado, Joan Carles Garcia-Pagan, Héctor García Calderó, Virginia Hernández Gea, Ana Paula Dantas, Maribel Diaz-Ricart, Fatima Crispi, Joan Albert Barberà, Olga Tura-Ceide","doi":"10.1016/j.arbres.2026.08.018","DOIUrl":"https://doi.org/10.1016/j.arbres.2026.08.018","url":null,"abstract":"<p><strong>Objectives: </strong>Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are rare, severe forms of pulmonary hypertension (PH) characterized by elevated mean pulmonary arterial pressure (mPAP) and ∼20% mortality at 3 years. PAH is defined by progressive obliterative vasculopathy, whereas CTEPH results from persistent pulmonary artery obstruction by fibrotic thrombotic material, leading to vascular remodelling, right ventricular hypertrophy, and heart failure.</p><p><strong>Methods: </strong>Endothelial colony-forming cells (ECFCs) derived from PAH and CTEPH patients and healthy-controls were analysed to identify disease-specific molecular and functional alterations. Transcriptomic profiling was integrated with functional assays, including global protein synthesis, mitochondrial bioenergetics, intracellular Ca²⁺ dynamics, and cellular ultrastructural assessment by transmission electron microscopy (TEM). The effects of riociguat, the approved therapy for inoperable or persistent post-surgical CTEPH, were also evaluated.</p><p><strong>Results: </strong>Significant differences in gene expression profiles were observed among PAH-ECFCs, CTEPH-ECFCs, and control-ECFCs. CTEPH-ECFCs, exhibited a unique upregulation of ribosomal and translation-related genes, accompanied by increased global protein synthesis. Network analysis revealed a highly connected ribosomal-translational hub within CTEPH transcriptome signature. CTEPH-ECFCs also exhibited mitochondrial remodelling, increased endoplasmic reticulum-mitochondria contacts, altered intracellular Ca²⁺ handling, and reduced maximal respiratory capacity. Riociguat did not reverse these abnormalities.</p><p><strong>Conclusions: </strong>Dysregulated protein biosynthesis is a characteristic feature of CTEPH, distinguishing them from PAH. Our findings highlight a coordinated translation-mitochondria-MAM axis potentially involved in endothelial dysfunction and vascular remodelling, supporting the need for therapies targeting disease-specific molecular pathways beyond soluble guanylate cyclase stimulation.</p>","PeriodicalId":8339,"journal":{"name":"Archivos De Bronconeumologia","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Respiratory Medicine: Applications, Methodological Challenges, and Clinical Translation.","authors":"Daniel López-Padilla, Sara Lumbreras, Àlvar Agustí, Joseph Jacob, Gaetano Rocco, Atul Malhotra, Joan B Soriano","doi":"10.1016/j.arbres.2026.08.013","DOIUrl":"10.1016/j.arbres.2026.08.013","url":null,"abstract":"<p><p>Artificial intelligence (AI) is rapidly transforming respiratory medicine by enabling the integration and analysis of complex multimodal data, including imaging, physiological signals, electronic health records, and patient-generated information. This invited state-of-the-art review synthesizes current evidence on AI applications across chronic airway diseases, lung imaging, thoracic surgery and oncology, and sleep medicine and non-invasive ventilation, with a strong focus on clinically meaningful use cases. We highlight how AI can support earlier and more accurate diagnosis, refined phenotyping and endotyping, improved risk stratification, and more individualized therapeutic strategies. Representative applications include AI-assisted spirometry interpretation, multimodal exacerbation prediction, advanced quantitative imaging, perioperative risk modelling, wearable-based sleep apnoea detection, and AI-assisted respiratory support decision-making. Alongside these opportunities, we discuss cross-cutting challenges that currently limit routine implementation, including data quality and representativeness, insufficient external validation and generalizability, algorithmic bias, limited explainability of complex models, and concerns regarding privacy and data governance. Throughout the review, we argue that AI should be conceived as a tool to augment, rather than replace clinical judgment, embedded within human-in-the-loop frameworks that preserve transparency, fairness, and accountability. We conclude by outlining priorities for future research and policy, such as prospective clinical evaluation, multicenter validation in diverse populations, and closer collaboration between clinicians, data scientists, and regulators, which will be essential to translate the promise of AI into tangible improvements in respiratory outcomes and patient-centered care.</p>","PeriodicalId":8339,"journal":{"name":"Archivos De Bronconeumologia","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference Equations for Maximal Sniff Nasal Inspiratory Pressure in Healthy Children and Adolescents.","authors":"Margarita Barral-Fernández, María Amalia Jácome Pumar, Luz González-Doniz, Sonia Souto-Camba, María Antonia Ramón Belmonte, Marta Amor-Barbosa, Ane Arbillaga-Etxarri, Guillermo Mazzucco, Pilar Bravo Cortés, Tamara Del Corral, Rocío Martín-Valero, Carlos Llorca Cerdà, Fabiola Murcia Lillo, Jose Antonio Sanchez-Santos, Marina Francín-Gallego, Concepción Martín Cortijo, Esther García Delgado, Cristina Serrano Veguillas, Ana B Varas de la Fuente, Paula San José Herranz, Carolina González Montañez, Elena Gimeno-Santos, Rodrigo Torres-Castro, Guilherme A F Fregonezi, Mireia Pardàs Peraferrer, Jordi Vilaró Casamitjana, Angeles Fernandez-Cadenas, Antonio T Ríos-Cortes, María José Moreno Valera, Daniel Langer, Ana Lista-Paz","doi":"10.1016/j.arbres.2026.07.014","DOIUrl":"https://doi.org/10.1016/j.arbres.2026.07.014","url":null,"abstract":"<p><strong>Objectives: </strong>Inspiratory muscle weakness presents significant diagnostic challenges, particularly in children. Maximal sniff nasal inspiratory pressure (SNIP) is complementary to maximal inspiratory pressure (PImax) for assessing inspiratory muscle strength. This study aims to establish reference equations and lower limits of normal (LLN) for SNIP in paediatric population and to compare SNIP and PImax values.</p><p><strong>Methods: </strong>A multicentre cross-sectional study was conducted across 14 Spanish centres. Healthy children aged 6-18 years, stratified by sex and age, were recruited. Anthropometric and spirometric data were collected, and PImax and SNIP were measured following standardized procedures. Reference equations for SNIP were derived using multiple linear regression analysis. Sex- and age-specific LLN were calculated using Z-scores≥1.645 standard deviation (SD) below group means. Statistical comparisons between SNIP and PImax were performed using t-tests.</p><p><strong>Results: </strong>The final sample included 499 subjects (250 girls; 11.5 [SD 3.5] years). SNIP reference equations are: girls=123.6+0.72*age-0.38*age²-4.80*body mass index (BMI)+0.46*age*BMI; boys=58.71+0.13*age+2.22*BMI. LLN ranged from 51 to 62 and 49 to 51cmH₂O for boys and girls, respectively. SNIP values were significantly lower than PImax in both sexes (p<.001).</p><p><strong>Conclusions: </strong>This study presents the largest paediatric SNIP dataset worldwide, enabling the derivation of reference equations and sex- and age-specific LLN for SNIP. These findings have important clinical implications, particularly for assessing inspiratory muscle strength in patients unable to perform PImax. Furthermore, the comparison between SNIP and PImax suggests that these tests are not interchangeable in the paediatric population, but rather provide complementary information.</p>","PeriodicalId":8339,"journal":{"name":"Archivos De Bronconeumologia","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}