BMJ Open Respiratory Research最新文献

{"title":"Current use and future potential of oscillometry in UK lung function testing: a national survey.","authors":"Madison E Geeves, Michael J Hughes, Harry S Griffin, Karl P Sylvester, Zoe L Saynor","doi":"10.1136/bmjresp-2025-003786","DOIUrl":"10.1136/bmjresp-2025-003786","url":null,"abstract":"<p><strong>Background: </strong>Despite growing international momentum, uptake of oscillometry in routine lung function testing services in the United Kingdom (UK) is unclear.</p><p><strong>Objectives: </strong>Evaluate the current use of oscillometry in UK lung function services, identify key clinical applications, and explore barriers to wider adoption.</p><p><strong>Methods: </strong>A cross-sectional e-survey, including multiple-choice and free-text responses, was distributed to members of the Association for Respiratory Technology and Physiology (ARTP) and reported in line with the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).</p><p><strong>Results: </strong>A total of 42 National Health Service (NHS) respiratory services responded. Of these, 40% reported owning an oscillometry device, equally split between forced oscillation technique (Resmon Pro) and impulse oscillometry (Vyntus IOS), with one using both. Oscillometry is already used in clinical practice in 69% of these services, most commonly for adults (57%) but also in paediatrics (21%) and both (21%). It is primarily used in asthma (100%) and chronic obstructive pulmonary disease (57%), and in 86% of cases for patients unable to perform technically acceptable spirometry. Among services without a device, 50% were actively considering purchasing within five years. The main barrier cited was funding (67%). A lack of clinical understanding was identified, with 86% of services perceiving respiratory consultants to have 'little' understanding of oscillometry, and 10% reporting 'none'. Almost all respondents (95%) supported the development of national guidance from ARTP outlining benefits, limitations and reporting standards.</p><p><strong>Conclusion: </strong>Despite increasing interest, oscillometry is not yet routinely adopted across UK lung function services. It is predominantly used as an alternative to spirometry when technically acceptable results cannot be achieved and as an additional tool to support asthma care. This national survey highlights the need to improve awareness, training and standardisation. Collaboration with the ARTP to establish national guidance represents an important next step toward wider implementation in clinical practice.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GOLD 2026 COPD ABE assessment tool to identify individuals at high risk in a UK multicentre COPD cohort (ERICA).","authors":"Gbenga Adesoye, Alastair Watson, Tengyu Zhao, Charlotte E Bolton, Chris J Smith, Jonathan Fuld, Carmel McEniery, Joseph Cheriyan, John Cockcroft, William MacNee, Ruth Tal-Singer, Mike Polkey, Ian B Wilkinson, Marie Fisk","doi":"10.1136/bmjresp-2025-004075","DOIUrl":"10.1136/bmjresp-2025-004075","url":null,"abstract":"<p><p>Identifying people with chronic obstructive pulmonary disease (COPD) who are at high risk of significant health events such as exacerbations and hospital admissions is clinically important to guide optimisation of preventative interventions. We evaluated the utility of the Global Initiative for Obstructive Lung Disease (GOLD) 2026 ABE assessment tool which stratifies based on exacerbations or symptoms to distinguish these patients at high risk.</p><p><strong>Methods: </strong>664 participants from the ERICA (<i>E</i>valuation of the <i>R</i>ole of <i>I</i>nflammation in <i>C</i>hronic <i>A</i>irways Disease) COPD cohort were classified into GOLD ABE groups using both the Chronic Airways Assessment Tool (CAAT) score and the modified Medical Research Council (mMRC) breathlessness scale to define the degree of symptoms. National Health Service hospital episode statistics data were prospectively collected for a median follow-up of 4.75 years. Hospital admissions, including for acute exacerbations of COPD (H-AECOPD (hospitalised acute exacerbations of COPD)), were evaluated. Logistic regression analyses with ORs adjusted for potential confounding factors were performed.</p><p><strong>Results: </strong>Using CAAT, n=43/182/439 (7%/27%/66%) of participants were in groups A, B and E, respectively. By mMRC, n=144/81/439 (22%/12%/66%) were in groups A, B and E. The ABE tool derived using both CAAT and mMRC predicted H-AECOPD over follow-up. For group B versus group A by CAAT, the OR was 3.72 (95% CI 1.09 to 12.73, p=0.04), and for group E versus group A the OR was 8.13 (95% CI 2.45 to 26.92, p<0.001). By mMRC, for group B versus group A the OR was 2.69 (95% CI 1.36 to 5.32, p=0.005) and for group E versus group A the OR was 4.05 (95% CI 2.38 to 6.05, p<0.001).</p><p><strong>Conclusions: </strong>In this prospective real-world UK cohort, the simple GOLD 2026 ABE tool identified patients with high-risk COPD for severe exacerbations (H-AECOPD). The differences in groups A and B classification depending on whether the CAAT score or mMRC scale is used have clinical implications that need consideration.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting nurses to improve clinical trial discussions with patients with lung cancer using the Lung I-ACT tool: a mixed methods pilot study.","authors":"Benjamin Lond, Christopher Dodd, Zoe Davey, Iain Richard Williamson, Janette Rawlinson, John McPhelim, Liz Darlison, Catherine Henshall","doi":"10.1136/bmjresp-2025-003702","DOIUrl":"10.1136/bmjresp-2025-003702","url":null,"abstract":"<p><strong>Background: </strong>Empowering nurses to discuss clinical trials with patients can increase recruitment rates. Clinical trials are essential for improving lung cancer patient outcomes; in the short term, they provide individuals access to new treatments and care regimens which, longer term, have the potential to advance clinical care. However, recruitment into lung cancer clinical trials is as low as 5%, and lung cancer nurses feel ill-equipped to signpost clinical trial opportunities to patients. This study aimed to pilot and assess the acceptability and utility of the 'Lung I-ACT tool': a newly developed resource comprising a patient-facing leaflet and a nurse-facing poster, designed to help lung cancer nurses initiate clinical trial discussions with patients.</p><p><strong>Methods: </strong>A 6-month, mixed methods, pilot study was conducted at seven NHS hospital sites in the UK; four were intervention sites, three were control sites. Data on self-efficacy, knowledge, confidence, awareness and current practice were collected using online surveys for nurses at baseline, 3 and 6 months, and online interviews with lung cancer nurses and patients from intervention sites. Survey data were analysed using descriptive and inferential statistics, and interview data were thematically analysed via Framework Method.</p><p><strong>Results: </strong>Thirty-four nurse respondents were recruited to the survey. Survey findings indicated increased frequency of clinical trial discussions at the intervention sites, and increased nurse awareness, confidence and knowledge to navigate these discussions. Eleven nurses and four patients were interviewed; these data comprised five themes regarding lung cancer nurses' and patients' views of the Lung I-ACT tool: (1) content and format of the tool, (2) application and utility of the tool in practice, (3) perceived changes to practice, (4) knowledge, awareness and confidence to discuss clinical trials, (5) contextual and situational factors impacting the presentation of clinical trials.</p><p><strong>Conclusion: </strong>The Lung I-ACT tool improves nurses' confidence in discussing trials with patients through increasing their awareness of clinical trial opportunities and helping them to structure conversations.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education needs in oxygen therapy for individuals with interstitial lung disease.","authors":"Samira D Rowland, Heather Sharpe, Giovanni Ferrara, Kerri A Johannson, Meena Kalluri, Stephanie Thompson, Michael K Stickland","doi":"10.1136/bmjresp-2026-004205","DOIUrl":"10.1136/bmjresp-2026-004205","url":null,"abstract":"<p><strong>Background and rationale: </strong>The American Thoracic Society recommends long-term supplemental oxygen therapy (O₂) for individuals with interstitial lung disease who experience hypoxaemia due to its potential to improve symptoms. However, studies have shown that patient education regarding the use of O₂ is inadequate. Our aim was to explore the educational needs of individuals with interstitial lung disease (ILD) using O₂ therapy. Given that many educational tools are based on chronic obstructive pulmonary disease (COPD), a secondary aim was to examine how O₂ therapy education needs differ between ILD and COPD.</p><p><strong>Methods: </strong>Focus groups and semistructured interviews were used to understand the perspectives of individuals living with ILD or COPD and healthcare professionals (HCPs). Participants were recruited from Alberta, Canada. Individuals living with ILD or COPD were recruited through province-wide disease support groups while HCPs were recruited from a previous study. Separate focus groups were conducted for each participant category: (1) HCPs, (2) individuals with a lived experience with ILD and (3) individuals with a lived experience of COPD. An inductive coding approach was employed, guided by thematic analysis.</p><p><strong>Results: </strong>20 HCPs with a mean of 20.9 (SD±0.7) years of experience in healthcare and a mean of 12.8 (SD±8.4) years of experience working with individuals with ILD participated. 13 individuals with ILD and one ILD caregiver and 10 individuals with COPD participated in the study. Common themes among individuals with ILD and COPD were person-centred approaches to education, establishing ongoing support and building confidence through knowledge and learning. Compared with COPD, ILD-specific educational needs included the importance of more frequent assessments of O₂ therapy needs and an emphasis on maintaining higher flow rates when using O₂ therapy.</p><p><strong>Conclusion: </strong>We identified educational approaches that focus on empowerment, confidence-building and establishing support systems may facilitate the use of O₂ therapy in individuals with ILD.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining a diaphragm-focused and patient-acceptable inspiratory muscle training (IMT) load in difficult to wean, mechanically ventilated patients: a protocol for a prospective, mixed methods study.","authors":"Timothy O Jenkins, Mike I Polkey, David McWilliams, Cherry Kilbride, Vicky MacBean","doi":"10.1136/bmjresp-2026-004168","DOIUrl":"10.1136/bmjresp-2026-004168","url":null,"abstract":"<p><strong>Introduction: </strong>Diaphragm dysfunction is associated with failure to wean from mechanical ventilation. Inspiratory muscle training (IMT) may help improve outcomes for difficult-to-wean patients, yet the optimal approach remains unknown. High load IMT causes a training effect on the extra-diaphragmatic inspiratory muscles, but does not improve weaning success, questioning the utility of frequently cited high intensity IMT loads. Additionally, patients may find IMT unpleasant and distressing due to dyspnoea experienced during IMT. The aim of this study is to define a diaphragm-focused IMT load which is acceptable to patients.</p><p><strong>Methods: </strong>This study is designed as a prospective, mixed methods study. Forty difficult to wean, tracheostomised patients on mechanical ventilation will perform IMT at 15, 30, 45 and 60% of their maximal inspiratory pressure (PImax) in a randomised order using a tapered flow resistive loading device (POWERBreathe KH2, POWERBreathe, UK). Electrical activity of the diaphragm will be measured using an oesophageal multipair catheter (NAVA, Getinge, Sweden); extra-diaphragmatic (parasternal, scalene and sternocleidomastoid) muscle activity will be measured using surface electromyography. Patient experience of each load will be explored by measuring perceived breathing difficulty and unpleasantness using 0-10 numeric rating scales, verbal or written communication techniques in line with the participants' communication ability, and/or bespoke communication boards co-designed with the study patient and public involvement (PPI) group. Quantitative and qualitative data will be integrated to inform a diaphragm-focused, patient-acceptable IMT load.</p><p><strong>Ethics and dissemination: </strong>Ethical approval was obtained from Wales Research Ethics Committee 4 (Reference 25/WA/0242) on 30 October 2025. Results from this study will be presented at scientific meetings and published in peer-reviewed journals.</p><p><strong>Trial registration number: </strong>NCT07256821.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confocal laser endomicroscopy-assisted endobronchial ultrasound-guided needle aspiration in diagnosing mediastinal and/or hilar lymphadenopathy (COLLABORATION-III): protocol for a randomised controlled trial.","authors":"Ziwen Zheng, Li Xu, Chao Wu, Jiangrong Liao, Mingming Deng, Run Tong, Gang Hou","doi":"10.1136/bmjresp-2026-004263","DOIUrl":"10.1136/bmjresp-2026-004263","url":null,"abstract":"<p><strong>Introduction: </strong>Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an established first-line technique for sampling mediastinal and/or hilar lymphadenopathy (MHL). However, its diagnostic accuracy is constrained by the procurement of small-volume specimens, which may not reliably capture the diagnostically relevant tissue. Needle-based confocal laser endomicroscopy (nCLE) provides real-time in vivo microscopic imaging and has the potential to facilitate targeted tissue acquisition. EBUS-guided transbronchial mediastinal cryobiopsy (EBUS-TBMC) can yield larger and better-preserved specimens; however, its availability is limited. This study aims to evaluate whether nCLE-assisted EBUS-TBNA is non-inferior to EBUS-TBMC for diagnostic yield for MHL.</p><p><strong>Methods and analysis: </strong>The confocal laser endomicroscopy-assisted endobronchial ultrasound-guided needle aspiration (COLLABORATION III) trial is a prospective, multicentre, stratified, non-inferiority randomised controlled trial conducted across five centres in China. The study aims to enroll 640 adult participants presenting with unexplained MHL with a short-axis measurement ≥10 mm necessitating histopathological confirmation. Participants will be stratified based on the preprocedural likelihood of malignancy and randomised at a 1:1 ratio to undergo nCLE-assisted EBUS-TBNA or EBUS-TBMC. The primary endpoint is the overall diagnostic yield, defined as the proportion of procedures that obtain specimens sufficient for a definitive histological or cytological diagnosis, with a non-inferiority margin set at -10%. Secondary endpoints include diagnostic sensitivity for both malignant and benign conditions, rate of granuloma detection, procedure duration and incidence of adverse events. The primary analysis will be conducted on an intention-to-treat basis, supplemented by a per-protocol sensitivity analysis. Non-inferiority will be established if the difference in the diagnostic yield exceeds -10%.</p><p><strong>Ethics and dissemination: </strong>The study protocol was approved by the Institutional Review Board of the China-Japan Friendship Hospital (2025-KY-388). Written informed consent will be required from all participants. These findings will be disseminated through peer-reviewed journal publications and conference presentations.</p><p><strong>Trial registration number: </strong>COLLABORATION-III was prospectively registered at ClinicalTrials.gov (ID: NCT07040670, Date: 2025-6-26).</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient experiences of idiopathic pulmonary fibrosis (IPF) in China: a multicentre qualitative study.","authors":"Bixuan Yan, Ning Liu, Yunxian Zhou, Xiang Fang, Yue Zhang, Bo Yuan, Ping Ji, Xi Zhan, Yanling Ding, Xiaohan Xu, Xiaoxi Lu, Xinchun Gu, Vanashree Sexton, Fengwei Li, Siyan Zhan, Ying Ji, Hongling Chu","doi":"10.1136/bmjresp-2025-004083","DOIUrl":"10.1136/bmjresp-2025-004083","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease that profoundly impacts patients' daily lives. While pharmacological therapies continue to advance, less is known about how patients experience the burden of disease across different periods after IPF diagnosis, resulting in a lack of evidence for the development and optimisation of patient-centred intervention strategies. Therefore, this study aimed to explore how individuals with IPF experience the disease and its impact on daily life in China.</p><p><strong>Methods: </strong>This multicentre qualitative study was conducted using semistructured interviews with participants from six geographic regions in China between November 2024 and March 2025. Participants were grouped by time since diagnosis to reflect different periods following diagnosis. Data were collected and analysed inductively and iteratively by using practical thematic analysis until thematic saturation was achieved.</p><p><strong>Results: </strong>53 participants were interviewed to explore the patient experience at different periods following IPF diagnosis. Thematic analysis identified that participants commonly reported the influence of IPF on quality of life, including (1) symptom experience, (2) sleep, (3) eating habits, (4) physical activity, (5) social participation, (6) psychological well-being and (7) financial status. Cough and breathlessness were consistently reported as the most troubling symptoms, often accompanied by psychological challenges related to diagnosis and disease progression.</p><p><strong>Conclusions: </strong>The findings highlight the experience and need for patient-centred care across China that addresses not only clinical symptoms but also emotional and social dimensions of living with IPF. Enhancing public awareness may also help reduce stigma and social isolation.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical validation of the Rapid Cough Questionnaire across diverse lung diseases.","authors":"Hyeon-Kyoung Koo, Tai Joon An, Hyonsoo Joo, Chin Kook Rhee, Yee Hyung Kim, Sung-Kyoung Kim, Kyung Hoon Min, Deog Kyeom Kim, Jong Wook Shin, Hyoung Kyu Yoon, Seung Hun Jang, Yong Bum Park, Jin Woo Kim, Ji-Yong Moon","doi":"10.1136/bmjresp-2026-004163","DOIUrl":"10.1136/bmjresp-2026-004163","url":null,"abstract":"<p><strong>Background: </strong>The Rapid Cough Questionnaire (RCQ) is a simplified three-item instrument developed as a pragmatic alternative to the Leicester Cough Questionnaire (LCQ). However, its performance across diverse respiratory diseases, particularly structural lung diseases, has not been sufficiently validated. This study evaluated the performance of the RCQ across major respiratory disease subgroups.</p><p><strong>Methods: </strong>A total of 300 adult patients with chronic cough were prospectively enrolled from multiple respiratory centres. Participants completed five cough-specific instruments: Numeric Rating Scale (NRS), Cough Symptom Score (CSS), COugh Assessment Test (COAT), LCQ and RCQ. Construct validity was evaluated using correlation analyses across disease subgroups, including chronic obstructive pulmonary disease, asthma, idiopathic pulmonary fibrosis (IPF) and bronchiectasis.</p><p><strong>Results: </strong>The RCQ showed strong correlations with the LCQ (r=0.93), COAT (r=-0.75), CSS (r=-0.62) and NRS (r=-0.59). These relationships remained robust among all aetiologies, with the correlation coefficients between RCQ and LCQ exceeding 0.88 in each subgroup. Bland-Altman plots and an intraclass correlation analysis indicated a high level of concordance between the RCQ and LCQ scores. The RCQ aligned closely with multidimensional symptom burden and maintained strong correlation with the LCQ even for IPF, where LCQ correlations with unidimensional tools (NRS or CSS) were attenuated.</p><p><strong>Conclusions: </strong>The RCQ demonstrated strong cross-sectional concordance with the LCQ across heterogeneous respiratory conditions. Its brevity and consistent performance support its suitability in routine clinical practice and large-scale or longitudinal research settings. Further studies are warranted to evaluate its responsiveness and longitudinal performance.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of oral bacteria composition and functional gene profiles in respiratory diseases.","authors":"Christine Cramer, Ian Philip George Marshall, Michael J Abramson, Nils Oskar Jõgi, Maryia Khomich, Shyamal D Peddada, Bente Sved Skottvoll, Vivi Schlünssen, Randi Jacobsen Bertelsen","doi":"10.1136/bmjresp-2025-003938","DOIUrl":"10.1136/bmjresp-2025-003938","url":null,"abstract":"<p><strong>Introduction: </strong>The oral microbiome has been shown to be associated with respiratory health, primarily in adult case studies or among children. This relationship has been scarcely investigated in adult population-based cohorts.</p><p><strong>Objectives: </strong>To investigate the association between oral microbiome and respiratory health, more specifically asthma, chronic rhinosinusitis (CRS), lung function and fractional exhaled nitric oxide (FeNO) in a population-based cross-continental multicentre study among adults.</p><p><strong>Methods: </strong>Subgingival samples from 355 adult European Community Respiratory Health Survey participants from Norway, Australia and Estonia underwent metagenomic sequencing. Respiratory disease was defined from questionnaires and sensitisation from specific immunoglobulin E (IgE)/skin prick tests. Spirometry and FeNO were measured. The associations between alpha diversity and disease status were evaluated in cross-sectional analyses using logistic regression adjusting for sex, smoking and study centre. Differential abundance analyses were performed using analysis of compositions of microbiomes with bias correction.</p><p><strong>Results: </strong>Alpha diversity differed by study centre and sensitisation status and was associated with non-allergic CRS (richness: 1.12, 95% CI 1.03 to 1.22). A similar though not statistically significant pattern was seen for forced vital capacity (FVC) below the lower limit of normal (LLN). <i>Lachnospiraceae</i> and <i>Xanthomonas</i> were more abundant in the oral microbiome of non-asthmatics and individuals without CRS, respectively, as compared with asthmatics and CRS patients. Several functional genes (1477-3391) and genera (54-98) were only present in the non-case groups, whereas individuals with affected respiratory health had 0-74 unique functional genes, but no unique genera present only in their respective groups.</p><p><strong>Conclusion: </strong>Increased alpha diversity was associated with non-allergic CRS and a similar trend was seen for FVC below LLN. Bacterial composition and functional profiles of the oral microbiome differed by respiratory health status. This study is novel in exploring functional gene profiling in relation to asthma and FeNO.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148275617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between mental health and chronic obstructive pulmonary disease (COPD) outcomes: systematic review and meta-analysis.","authors":"Sulaiman Alsaab, Michael Newnham, Alice M Turner, Hayyaf Aldossary, Abdullah Albukhary, Amanda Farley","doi":"10.1136/bmjresp-2025-003977","DOIUrl":"10.1136/bmjresp-2025-003977","url":null,"abstract":"<p><strong>Objective: </strong>To systematically synthesise evidence on the associations between presence of a mental health condition and chronic obstructive pulmonary disease (COPD) outcomes in people diagnosed with COPD, including lung function, symptom burden, functional status and clinical events.</p><p><strong>Methods: </strong>A systematic search of MEDLINE, Embase, PubMed, PsycINFO and CINAHL identified studies comparing COPD outcomes in adults (≥18 years) with and without comorbid mental illnesses. Eligible studies reported at least one relevant outcome comparing these groups. The protocol was pre-registered and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>58 studies including 707 037 participants were included. Comorbid mental illness was associated with worse outcomes: lower forced expiratory volume in 1 s (mean difference (MD)=-2.92%, 95% CI -4.35% to -1.48%), lower diffusing capacity of the lungs for carbon monoxide (MD=-3.79%, 95% CI -5.72% to -1.86%), reduced 6-minute walking test distance (MD=-30.42 m, 95% CI -41.03 to -19.82) and higher modified Medical Research Council scores (MD=0.64, 95% CI 0.45 to 0.84). Quality of life was worse (higher St George's Respiratory Questionnaire (MD=15.23 points, 95% CI 13.25 to 17.22), COPD Assessment Test (MD=7.28, 95% CI 5.81 to 8.74)). Mental illness increased exacerbations (MD=0.87, 95% CI 0.24 to 1.50; adjusted risk ratio=1.58, 95% CI 1.05 to 2.37; incidence rate ratio (IRR)=1.64, 95% CI 1.38 to 1.96), hospitalisations (adjusted OR=1.61, 95% CI 1.43 to 1.81; adjusted IRR=2.22, 95% CI 1.30 to 3.78) and mortality (adjusted HR=1.34, 95% CI 1.07 to 1.69). Depression and anxiety showed the strongest associations; evidence for severe mental illness was limited.</p><p><strong>Conclusion: </strong>Comorbid mental illness in COPD is linked to worse lung function, greater symptom burden, higher risks of exacerbation, hospitalisation and possibly mortality. Addressing the causes of this and integrating mental healthcare into COPD management may improve outcomes and reduce preventable admissions.</p><p><strong>Prospero registration number: </strong>CRD42024567680.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"13 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}