Julien Guiot, Jonne Engelberts, Monique Henket, Benoit Ernst, Quentin Maloir, Renaud Louis, David A Lynch, Stephen M Humphries, Jean-Paul Charbonnier
{"title":"Fibrotic and vascular abnormalities quantified by an AI-based model are associated with outcomes in patients with idiopathic pulmonary fibrosis.","authors":"Julien Guiot, Jonne Engelberts, Monique Henket, Benoit Ernst, Quentin Maloir, Renaud Louis, David A Lynch, Stephen M Humphries, Jean-Paul Charbonnier","doi":"10.1186/s12890-025-03949-7","DOIUrl":"https://doi.org/10.1186/s12890-025-03949-7","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease associated with high morbidity and mortality despite specific anti-fibrotic therapies. Management of IPF is complex and relies on pulmonary function tests (PFT) to evaluate severity and monitor progression. CT provides non-invasive morphologic assessment and emerging software techniques enable quantitative analysis.</p><p><strong>Methods: </strong>We included 319 individuals with IPF from the OSIC dataset. A cross-sectional analysis was made for all patients, with a longitudinal evaluation for 143 of them. We used LungQ software (Thirona, The Netherlands) to quantify lung and pulmonary vessel volumes, as well as the extent of interstitial lung disease and to assess correlation with PFT and mortality.</p><p><strong>Results: </strong>Quantitative extent of fibrotic abnormalities was correlated with baseline FVC and DLCO (r -0.47, p < 0.0001 and r -0.55, p < 0.0001 respectively) and longitudinal modifications over time (r -0.48, p < 0.0001 and r-0.43 p < 0.0001, respectively). Median baseline extent of ILD, expressed as a percentage of lung volume, was 16.5% (10.8-25.5) and increased to 17.3% (11.6-29) on follow-up (p < 0.001). The median ILD progression was of 9.8% (-9.5-40.0). Vascular enlargement quantification as well as ILD quantification were predictive marker of death (p < 0.0001). However, vascular abnormalities' independent predictive value could not be assessed in multivariate models due to multicollinearity with other variables.</p><p><strong>Conclusions: </strong>LungQ allows to quantify interstitial and vascular lung features and their changes over time in a large cohort of patients with IPF. Imaging markers were negatively correlated with PFT at baseline and follow-ups were predictive of mortality confirming their potential as disease quantifiers. Further clinical validation is needed to specify the potential clinical use.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"488"},"PeriodicalIF":2.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367549","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}
Rundi Gao, Suqun Zheng, Xiao Shen, Liying Xu, Huihua Hong
{"title":"Nonlinear association between blood eosinophil counts and clinical outcomes in ICU-Admitted patients with acute exacerbation of COPD: a retrospective observational study.","authors":"Rundi Gao, Suqun Zheng, Xiao Shen, Liying Xu, Huihua Hong","doi":"10.1186/s12890-025-03959-5","DOIUrl":"https://doi.org/10.1186/s12890-025-03959-5","url":null,"abstract":"<p><strong>Background: </strong>This retrospective cohort study aimed to examine the association between blood eosinophil counts and in-hospital mortality among patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to the intensive care unit (ICU).</p><p><strong>Methods: </strong>Data were retrieved from the MIMIC-IV 2.2 database. AECOPD patients with blood eosinophil counts measured within the first 24 h following ICU admission were included. Kaplan-Meier (KM) survival analysis compared in-hospital mortality across eosinophil thresholds (0.10, 0.15, 0.20, and 0.30 × 10⁹/L). Four Cox regression models adjusted for confounders, with patients categorized into three eosinophil groups: eosinophil counts < 0.1 × 10⁹/L (Group I), 0.1 × 10⁹/L ≤ eosinophil counts < 0.3 × 10⁹/L (Group II), and eosinophil counts ≥ 0.3 × 10⁹/L (Group III), with the Group I serving as the reference group. Restricted cubic spline (RCS) analysis based on a Cox proportional hazards model was used to assess the non-linear relationship between eosinophil counts and in-hospital mortality.</p><p><strong>Results: </strong>A total of 1,855 patients were analyzed. KM survival curves showed significant mortality differences at eosinophil thresholds of 0.10, 0.15, and 0.20 × 10⁹/L. Compared with Group I, Group II consistently exhibited a significantly lower risk of in-hospital mortality across all Cox models. Group III showed a mortality reduction only in the unadjusted model, which lost statistical significance after adjustment. RCS analysis revealed an \"L\"-shaped association, with an inflection point around 0.042 × 10⁹/L.</p><p><strong>Conclusion: </strong>Lower eosinophil counts were associated with increased in-hospital mortality among critically ill AECOPD patients. Absolute eosinophil counts may serve as a prognostic biomarker to support personalized ICU management. Prospective studies are needed to validate these findings and inform clinical decision-making.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"489"},"PeriodicalIF":2.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367627","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}
Maria Pikoula, Jennifer K Quint, Constantinos Kallis, Albert Henry, Spiros Denaxas
{"title":"Identification of clinically meaningful, overlapping obstructive respiratory disease subtypes via data-driven approaches in a primary care population.","authors":"Maria Pikoula, Jennifer K Quint, Constantinos Kallis, Albert Henry, Spiros Denaxas","doi":"10.1186/s12890-025-03953-x","DOIUrl":"https://doi.org/10.1186/s12890-025-03953-x","url":null,"abstract":"<p><strong>Background: </strong>Obstructive respiratory conditions, including asthma, bronchiectasis, and chronic obstructive pulmonary disease (COPD), are increasingly recognised as heterogeneous syndromes with significant overlap. Multiple disease pathways contribute to phenotypes that do not always align with textbook definitions, limiting the effectiveness of a one-size-fits-all approach. This study aims to identify, validate, and characterise clinically meaningful airway disease subtypes using electronic healthcare records (EHR) and unsupervised machine learning clustering techniques.</p><p><strong>Methods: </strong>We applied k-means clustering to 626,651 patients with a diagnosis of asthma, bronchiectasis, or COPD, using linked national structured EHRs in England. Twenty-one clinical features, including risk factors and comorbidities, were analysed, with dimensionality reduction via principal component and multiple correspondence analyses. Associations between cluster membership and exacerbations, as well as respiratory and cardiovascular mortality, were assessed. Over 3,696,962 person-years of follow-up, 102,522 deaths were recorded. Cluster stability was evaluated after five years, and genome-wide association studies (GWAS) were conducted to explore genetic associations with cluster membership.</p><p><strong>Results: </strong>Seven clusters were identified, each encompassing patients across traditional diagnostic labels. Distinct clinical patterns emerged as follows: (1) High BMI female predominant, (2) Older male-predominant with diabetes and cardiovascular disease, (3) Eosinophilic atopic, (4) Older non-comorbid, (5) Non-comorbid low BMI, (6) Neutrophilic smoker, (7) Anxious/depressed female-predominant.The cluster with cardiovascular comorbidities showed the highest rates of hospital admissions for exacerbations. Neutrophilic cluster 6 is a potential novel subtype marked by persistent neutrophilia and poor outcomes. Cluster stability over five years ranged from 38% to 78%. GWAS revealed significant genetic loci in a cluster enriched for allergic disease and eosinophilia, suggesting shared genetic mechanisms.</p><p><strong>Conclusions: </strong>This study provides a data-driven dissection of the heterogeneity underlying obstructive airway diseases in a large, real-world population. Unsupervised machine learning applied to national-scale EHR data revealed distinct and partially stable subtypes that transcend conventional diagnostic boundaries. These findings highlight the complexity and overlap of airway disease phenotypes and demonstrate the value of clustering approaches for uncovering clinically and biologically meaningful subgroups. This work lays the foundation for further exploration into mechanisms and prognosis within and across airway disease phenotypes.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"487"},"PeriodicalIF":2.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367489","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}
Hongyuan Kong, Kexin Dong, Yuan Wang, Yan Bian, Lin Wang, Limei Qian, Zhaoxing Cui, Jin Yang, Rui Fu, Zhenkun Li
{"title":"Characteristics and risk factors for thrombocytopenia in malignancy patients with pulmonary embolism: a case control study.","authors":"Hongyuan Kong, Kexin Dong, Yuan Wang, Yan Bian, Lin Wang, Limei Qian, Zhaoxing Cui, Jin Yang, Rui Fu, Zhenkun Li","doi":"10.1186/s12890-025-03946-w","DOIUrl":"10.1186/s12890-025-03946-w","url":null,"abstract":"","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"483"},"PeriodicalIF":2.8,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343369","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":"Global, regional, and national burden of asthma from 1990 to 2021: analysis of data from global disease burden in 2021.","authors":"Cong Hu, Shuxiong Nong, Yixin Chen, Lin Zhang, Yongfeng Chen, Chenang Liu, Ping Li, Chilin Liao, Meng Wu","doi":"10.1186/s12890-025-03816-5","DOIUrl":"10.1186/s12890-025-03816-5","url":null,"abstract":"<p><strong>Background: </strong>Asthma is one of the diseases that pose a serious threat to human health globally. The Global Burden of Disease (GBD) study from 1990 to 2021 conducted a comprehensive assessment of the prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALY) of asthma. This study particularly focuses on the integration of prevalence data with other indicators and carries out stratified analyses at the global, regional, and national levels based on gender, age, and Socio-Demographic Index (SDI).</p><p><strong>Methods: </strong>The data for this study is drawn from the 2021 Global Burden of Disease (GBD) study, which provides comprehensive data on diseases, injuries, and risk factors. This study aims to explore the temporal trends of asthma and assess the dynamics of age-standardized prevalence rates (ASPR), incidence rates (ASIR), death rates (ASDR), and disability-adjusted life years (DALYs) for asthma, with the goal achieved by estimating the annual percentage change (EAPC) over the study period. The study conducted a detailed stratification based on gender, 20 age groups, 21 GBD regions, 204 countries and territories, and 5 SDI quintiles.</p><p><strong>Results: </strong>In 2021, asthma continued to impose a substantial burden on the global health landscape, with a total of 260479186.9 (227209547.5-297967236.9) cases and an ASPR of 3340.1 (2905.2-3832.2 per 100,000 people. The ASIR was 37864175.4 (31381241-46919993.7), translating to 516.7 (425.4-646.1) per 100,000 people. In 2021, the number of disability-adjusted life years (DALYs) attributed to asthma was 21422859.9 (16956877.7-26887091.7), and the ASDR was 264.6 (208.3-333.4) per 100,000 people. Analyzing regional disparities, it was observed that High SDI regions had the highest ASPR, and ASIR, while Low SDI regions had the lowest ASDR and Age-standardized DALY rates. Geographically, Kazakstan and Pakistan stood out with the high ASPR, and Papua New Guinea stood out with the highest ASDR, and Age-standardized DALY rates. Asthma primarily affects minors, with no significant difference between males and females. High BMI has emerged as the most important risk factor for asthma-related DALYs globally.</p><p><strong>Conclusion: </strong>This pattern indicates a complex relationship between socio-economic development and health outcomes. Regions with higher Socio-Demographic Index (SDI), which typically represent more developed areas, tend to have a higher prevalence of asthma but lower mortality rates and disease burden. These patterns highlight the necessity for low-income regions to learn from the targeted public health measures of high-income areas in developing asthma management plans, in order to address the inequalities in asthma outcomes.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"481"},"PeriodicalIF":2.8,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343423","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 analysis of the efficacy of bronchial artery embolization with gelatin sponge in our hospital for cryptogenic hemoptysis: a single-center, retrospective, observational study.","authors":"Manabu Suzuki, Satoki Hatano, Chie Morita, Akinari Tsukada, Akane Ishida, Yusaku Kusaba, Masao Hashimoto, Go Naka, Jin Takasaki, Hiroshi Nokihara, Shinyu Izumi, Yuichiro Takeda, Masayuki Hojo, Haruhito Sugiyama","doi":"10.1186/s12890-025-03948-8","DOIUrl":"10.1186/s12890-025-03948-8","url":null,"abstract":"<p><strong>Background and objective: </strong>Hemoptysis is a life-threatening condition requiring urgent treatment. Bronchial artery embolization (BAE), established as the primary intervention, is an effective treatment for hemoptysis. Common etiologies include bronchiectasis, tumors, tuberculosis, aspergilloma, and cystic fibrosis. Approximately 20% of hemoptysis cases are categorized as cryptogenic. We conducted a retrospective observational study to understand the clinical characteristics of patients with cryptogenic hemoptysis (CH).</p><p><strong>Methods: </strong>The clinical characteristics, angiographic findings, and immediate and long-term efficacies of BAE were retrospectively analyzed in 36 consecutive patients between January 2010 and December 2022. Superselective BAE was successfully performed in all patients by using a gelatin sponge (GS).</p><p><strong>Results: </strong>The median age was 68 years, and 21 patients (58.3%) were male. Among them, 15 patients (41.7%) presented with massive hemoptysis, and 7 (19.4%) required intubation. Angiographic evaluation revealed the treatment of total 57 vessels, comprising 51 (89.5%) bronchial arteries, 5 (8.8%) intercostal arteries, and 1 (1.8%) inferior transverse artery. The recurrence-free rates were 100% at 1 month, 94.4% at 3 months, 94.4% at 12 months, and 86.1% at more than 12 months. Only one patient required a second BAE for hemoptysis, while others were managed for recurrences with oral hemostatic agents. No serious complications, such as spinal cord infarction, were observed during the study period.</p><p><strong>Conclusion: </strong>BAE treatment with GS for CH proved to be a suitable therapeutic modality, demonstrating high efficacy in halting bleeding in both the short and long terms, with the absence of severe complications, including spinal cord infarction.</p><p><strong>Trial registration: </strong>This study was retrospectively registered for the UMIN Clinical Trial Registry (UMIN000042050) on October 8th, 2020.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"480"},"PeriodicalIF":2.8,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343436","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}
Jing Lin, Wenchao Xu, Leiming Xia, Congshu Zhang, Lei Ge, Junfeng Gao, Jian Bao, Yang Xu, Xiang Sun, Hongxia Li, Yi Wang
{"title":"A phase I trial of combination CAR-NK92MI immunotherapy by dual targeting MUC-1 and PD-L1 for patients with relapsed or refractory solid tumors: focus on non-small cell lung cancer.","authors":"Jing Lin, Wenchao Xu, Leiming Xia, Congshu Zhang, Lei Ge, Junfeng Gao, Jian Bao, Yang Xu, Xiang Sun, Hongxia Li, Yi Wang","doi":"10.1186/s12890-025-03944-y","DOIUrl":"10.1186/s12890-025-03944-y","url":null,"abstract":"","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"482"},"PeriodicalIF":2.8,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343319","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}
Ruihan Li, Hui Guo, Qian Wu, Jinhuan Han, Shuqin Kang
{"title":"Deep learning based CT images for lung function prediction in patients with chronic obstructive pulmonary disease.","authors":"Ruihan Li, Hui Guo, Qian Wu, Jinhuan Han, Shuqin Kang","doi":"10.1186/s12890-025-03957-7","DOIUrl":"10.1186/s12890-025-03957-7","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization predicts that by 2030, chronic obstructive pulmonary disease (COPD) will be the third leading cause of death and the seventh leading cause of morbidity worldwide. Pulmonary function tests (PFT) are the gold standard for COPD diagnosis. Since COPD is an incurable disease that takes a considerable amount of time to diagnose, even by an experienced specialist, it becomes important to provide an analysis of abnormalities in a simple manner. Although many deep learning (DL) methods based on computed tomography (CT) have been developed to identify COPD, the pathological changes of COPD based on CT are multi-dimensional and highly spatially heterogeneous, and their predictive performance still needs to be improved.</p><p><strong>Objective: </strong>The purpose of this study was to develop a DL-based multimodal feature fusion model to accurately estimate PFT parameters from chest CT images and verify its performance.</p><p><strong>Materials and methods: </strong>In this retrospective study, participants underwent chest CT examination and PFT at the Fourth Clinical Medical College of Xinjiang Medical University between January 2018 and July 2024. In this study, the 1-s forced expiratory volume (FEV1), forced vital capacity (FVC), 1-s forced expiratory volume ratio forced vital capacity (FEV1/FVC), 1-s forced expiratory volume to predicted value (FEV1%), and forced vital capacity to predicted value (FVC%) of PFT parameters were used as predictors and the corresponding chest CT of 3108 participants. The data were randomly assigned to the training group and the validation group at a ratio of 9:1, and the model was cross-validated using 10-fold cross-validation. Each parameter was trained and evaluated separately on the DL network. The mean absolute error (MAE), mean squared error (MSE), and Pearson correlation coefficient (r) were used as evaluation indices, and the consistency between the predicted and actual values was analyzed using the Bland-Altman plot. The interpretability of the model's prediction process was analyzed using the Grad-CAM visualization technique.</p><p><strong>Results: </strong>A total of 2408 subjects were included (average age 66 ± 12 years; 1479 males). Among these, 822 cases were used for encoder training to extract image features, and 1,586 cases were used for the development and validation of a multimodal feature fusion model based on a multilayer perceptron (MLP). The MAE, MSE, and r predicted between PFT and model estimates for FEV1 were 0.34, 0.20, and 0.84, respectively. For FVC, the MAE, MSE, and r were 0.42, 0.31, and 0.81, respectively. For FEV1/FVC, the MAE, MSE, and r were 6.64, 0.73, and 0.77, respectively. For FEV1%, the MAE, MSE, and r were 13.42, 3.01, and 0.73, respectively. For FVC%, the MAE, MSE, and r were 13.33, 2.97, and 0.61, respectively. It was observed that there was a strong correlation between the measured and predicted indices of FEV1, FVC, FEV","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"484"},"PeriodicalIF":2.8,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12542279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343443","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}