Canadian respiratory journal最新文献

{"title":"Plasma β-Endorphin and Neuropeptide Y as Candidate Biomarkers for Predicting Obstructive Sleep Apnea Syndrome: A Preliminary Study.","authors":"Meng-Lin Li, Yi Yang, Qian-Yun Huang, Jian-Yong Liu","doi":"10.1155/carj/4316574","DOIUrl":"10.1155/carj/4316574","url":null,"abstract":"<p><p><b>Background and Objective:</b> Given the involvement of neuropeptides in the pathophysiology of obstructive sleep apnea syndrome (OSAS), this study investigated the associations between plasma levels of β-endorphin (β-EP) and neuropeptide Y (NPY) and OSAS severity and evaluated their potential as predictive biomarkers. <b>Methods:</b> A total of 48 snoring patients undergoing polysomnography (PSG) were categorized into non-OSAS, mild, moderate, and severe OSAS groups (<i>n</i> = 12 per group) based on the apnea-hypopnea index (AHI). Plasma levels of β-EP and NPY were measured using ELISA. Statistical analyses included one-way ANOVA, Spearman's correlation, and receiver operating characteristic (ROC) curve analysis to assess predictive performance. <b>Results:</b> Plasma β-EP levels exhibited significant elevation in moderate (<i>p</i>=0.003) and severe OSAS groups (<i>p</i>=0.032) compared to the non-OSAS group. Notably, NPY levels demonstrated marked differences across all OSAS severity groups (<i>p</i> < 0.01), with significantly higher concentrations observed in mild, moderate, and severe OSAS patients versus non-OSAS controls (<i>p</i> < 0.01). A progressive increase in NPY levels was observed with advancing OSAS severity, accompanied by statistically significant intergroup differences (<i>p</i> < 0.01). Correlation analyses revealed strong positive associations between NPY levels and both BMI (<i>p</i> < 0.0001) and AHI (<i>p</i> < 0.0001). In contrast, β-EP correlated positively with AHI (<i>p</i> < 0.0001) but not with BMI (<i>p</i>=0.0931). ROC curve analysis identified β-EP (cutoff: 9.405 ng/L) as a moderate predictor of OSAS (AUC = 0.7986, <i>p</i> < 0.01; sensitivity: 72.22%, specificity: 83.33%). Strikingly, NPY (cutoff: 19.29 ng/L) exhibited perfect discriminative capacity (AUC = 1, <i>p</i> < 0.0001; sensitivity: 97.22%, specificity: 100%). <b>Conclusions:</b> Plasma β-EP and NPY levels are associated with OSAS severity and may serve as potential biomarkers. However, further validation in larger cohorts is needed to confirm their clinical utility.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"4316574"},"PeriodicalIF":2.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Altitude Pulmonary Embolism: Epidemiology, Pathophysiology, Diagnosis, and Management.","authors":"Zhen-Zhong Yang, Jing Li, Zhen-Long Chang, Xiao-Xia Liu, Jun-Peng Ran, Lin-Feng Liu","doi":"10.1155/carj/5519627","DOIUrl":"10.1155/carj/5519627","url":null,"abstract":"<p><p>Pulmonary embolism (PE) at high altitude (HA) is a potentially life-threatening but underrecognized condition. Unlike low-altitude PE, high-altitude pulmonary embolism (HA-PE) may result from unique hypoxia-driven mechanisms, including hemoconcentration, endothelial dysfunction, and a hypercoagulable state. In this narrative review, we summarize current evidence on the epidemiology, pathophysiology, diagnosis, management, and prognosis of HA-PE, based on the literature published between 2010 and 2025 retrieved from PubMed and CNKI. This review summarizes the epidemiological profile, clinical features, altitude-related diagnostic challenges, limitations of current therapeutic strategies, and the prognosis of HA-PE. A more comprehensive understanding of HA-PE is crucial for enhancing early detection and developing altitude-adapted management approaches.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"5519627"},"PeriodicalIF":2.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Evaluation of Automatic Noncontact Ultra-Wideband Radar Combined With Oximeter for Obstructive Sleep Apnea in the South of China.","authors":"Shuyue Wang, Jian Wu, Haiyao Zheng, Yan Ruan, Feng Yu, Tao Liao","doi":"10.1155/carj/6631384","DOIUrl":"10.1155/carj/6631384","url":null,"abstract":"<p><p><b>Background:</b> Polysomnography (PSG) is the traditional technique for diagnosing obstructive sleep apnea (OSA) with some limitations. Ultra-wideband radar (UWB) is a new method for diagnosing OSA that combines multiple techniques including radar technology, artificial intelligence (AI), and big data algorithms. The accuracy of UWB in OSA diagnosis needs further scientific verification, especially in southern China. <b>Methods:</b> Fifty patients from southern China wore UWB with oximetry and PSG simultaneously overnight. UWB generated automated reports; PSG was manually interpreted. Lowest oxygen saturation (LSpO2) and apnea-hypopnea index (AHI) from both methods were compared. <b>Results:</b> High correlation was found between UWB and PSG for AHI (<i>r</i> = 0.925, <i>p</i> < 0.001) and LSpO2 (<i>r</i> = 0.990, <i>p</i> < 0.001). The average bias of AHI (-3.09, <i>p</i>=0.98, 95% CI -15.48 - 9.31) and LSpO2 (-0.34, <i>p</i> > 0.99, 95% CI -3.68 - 3.04) between the two methods was small. ROC analysis showed good diagnostic performance of UWB versus PSG (AUC = 0.979, <i>p</i> < 0.001), with 95.8% sensitivity and 100% specificity. <b>Conclusion:</b> The study demonstrated UWB combined with oximetry could be a reliable alternative to PSG for diagnosing OSA in the south of China.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"6631384"},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12422862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delta Neutrophil Index and Other Hematologic Parameters in Acute Exacerbations of COPD: A Retrospective Study.","authors":"Burcu Akkok, Evrim Gulderen Kuscu, Hatice Sahin","doi":"10.1155/carj/3647362","DOIUrl":"10.1155/carj/3647362","url":null,"abstract":"<p><p><b>Background:</b> Chronic obstructive pulmonary disease (COPD) is an increasing cause of morbidity and mortality worldwide, and acute exacerbations are the major health issues in COPD patients. In this study, we aimed to investigate the role of the delta neutrophil index (DNI) with other hematologic parameters in managing and guiding COPD patients admitted with acute exacerbations. <b>Methods:</b> In this retrospective study, COPD patients treated internally in pulmonology clinic, intensive care unit, and anesthesiology and reanimation unit with acute exacerbation between May 2021 and December 2023 were investigated. Records from daily visits were evaluated retrospectively. Patients were divided into two groups according to the causative organism: bacterial or nonbacterial. <b>Results:</b> Patients with cardiac failure were found to have significantly higher median DNI values (<i>p</i> : 0.026), whereas patients with other comorbidities that were not individually recorded have substantially lower median DNI values (<i>p</i> : 0.026). White blood cell (WBC), neutrophil, immature granulocyte values (both absolute value and percent), thrombocyte, platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin, positive blood culture, positive systemic inflammatory response syndrome (SIRS) criteria, and sepsis were significantly higher in patients with bacterial acute exacerbation. Hospitalization duration was also significantly longer in the same group (<i>p</i> :  0.006). No statistically significant correlation was found between median DNI values and early mortality rate (within 28 days), readmission within 30 days and 6 months. <b>Conclusion:</b> In this study, we have shown that the serum procalcitonin level, WBC, NLR, and PLR measurement can be used to distinguish bacterial and nonbacterial COPD exacerbations. The DNI revealed no prognostic predictive value regarding early mortality, mechanic ventilation need, or readmission in 30 days and 6 months.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"3647362"},"PeriodicalIF":2.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Etiological Diagnosis of Nonresolving or Slowly Resolving Pneumonia Through Combined Endobronchial Ultrasound-Guided Biopsy and Metagenomic Sequencing.","authors":"Qiang Li, Li Jian, Qiquan Zhao","doi":"10.1155/carj/7651699","DOIUrl":"10.1155/carj/7651699","url":null,"abstract":"<p><p><b>Background:</b> Nonresolving or slowly resolving pneumonia (NRP) poses a diagnostic challenge because infectious and noninfectious etiologies often mimic community-acquired pneumonia on imaging. Endobronchial ultrasound-guided transbronchial lung biopsy (EBUS-TBLB) improves tissue acquisition for peripheral lesions, whereas metagenomic next-generation sequencing (mNGS) offers culture-independent pathogen detection. Whether their combination enhances etiological clarification of NRP remains uncertain. <b>Methods:</b> A total of 109 consecutive adults with NRP unresponsive to standard antimicrobial therapy were randomized to EBUS-TBLB alone (<i>n</i> = 66) or EBUS-TBLB + mNGS (<i>n</i> = 43). Baseline characteristics, diagnostic yield, and procedure-related complications were recorded. Diagnostic positivity, sensitivity for infectious agents, and safety profiles were compared using <i>χ</i> ² or Fisher's exact tests, with <i>p</i> < 0.05 considered significant. <b>Results:</b> Overall diagnostic yield increased from 50.0% with EBUS-TBLB to 72.1% with the combined approach (<i>χ</i> ² = 4.37, <i>p</i> < 0.05). mNGS significantly improved detection of bacterial/fungal pneumonia (0% vs. 13.9%; <i>p</i> < 0.05) and pulmonary <i>tuberculosis</i> (0% vs. 20.9%; <i>p</i> < 0.05). Malignancy remained the predominant diagnosis (57.8% of all cases); yields for most tumor subtypes were comparable between groups. Complication rates did not differ between the two groups: minor bleeding (19.7% vs. 23.3%), hypoxia (50.0% vs. 48.8%), pneumothorax (4.5% vs. 0%), and delayed recovery (4.5% vs. 7.0%) (<i>p</i> > 0.05). No severe adverse events occurred. <b>Conclusions:</b> EBUS-TBLB + mNGS represents a paradigm shift in the diagnosis of complex respiratory cases, integrating imaging with advanced genomics to enhance precision medicine. In practice, early implementation of the EBUS-TBLB + mNGS diagnostic protocol in patients with NRP can help exclude malignancy or confirm an infectious etiology.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"7651699"},"PeriodicalIF":2.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryobiopsy as a Salvage Technique Following Negative Flexible Forceps Biopsy of the Pleura Under Rapid On-Site Evaluation Guidance: A Prospective Study.","authors":"Jianlong Tan, Cuihua Zhang, Bing Liu, Yun Li, Zhiguang Liu, Weidong Zhang","doi":"10.1155/carj/6641774","DOIUrl":"https://doi.org/10.1155/carj/6641774","url":null,"abstract":"<p><p>A diffusely thickened or hard pleura is a special type of macroscopic appearance associated with benign or malignant conditions. Medical thoracoscopy (MT) is the gold standard for pleural pathology, but its diagnostic yield is imperfect. Although cryobiopsy may provide greater and deeper tissue, its impact on the diagnostic yield remains uncertain, and safety concerns persist. We evaluated the efficacy and safety of cryoprobe biopsy as a salvage technique following negative or inconclusive flexible forceps biopsy during MT under the guidance of rapid on-site evaluation (ROSE). This prospective study enrolled 280 patients with undiagnosed exudative pleural effusion who underwent MT. After the initial flexible forceps biopsy and ROSE, 37 patients with negative ROSE results underwent cryoprobe biopsy. A total of 37 (21 males and 16 females) patients, aged 56.43 ± 16.09 (range: 22-78) years with negative ROSE results, underwent cryoprobe biopsy. CB established a definitive histopathological diagnosis in 33/37 (89.2%) patients, which was significantly higher than that achieved with FFB, i.e., 21/37 (56.8%; <i>p</i>=0.002). CB resulted in significantly larger pleural specimens (9.86 ± 2.69 mm) in comparison to FFB (2.89 ± 1.15 mm, 95% confidence interval [CI]: 6.01-7.93; <i>p</i> < 0.001). Furthermore, CB was faster than FFB (median durations of 15 and 31 min, respectively; <i>p</i> < 0.001). CB had improved tissue quality for CGP testing in 20 NSCLC patients compared to FFB (18/20 versus 8/15, <i>p</i>=0.036). No significant complications were noted. Cryoprobe biopsy is a safe and effective salvage technique for patients with undiagnosed pleural effusion who show negative results on flexible forceps biopsy during MT. It provides larger, higher-quality specimens with a higher positivity rate, potentially avoiding the need for repeat procedures and facilitating timely diagnosis and treatment.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"6641774"},"PeriodicalIF":2.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12364598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing AI for Improved Detection and Classification of Pleural Effusion: Insights and Innovations.","authors":"Geran Maule, Ahmad Alomari, Abdallah Rayyan, Ogbeide Aghahowa, Mohammad Khraisat, Luis Javier","doi":"10.1155/carj/2882255","DOIUrl":"10.1155/carj/2882255","url":null,"abstract":"<p><p>The detection and classification of pleural effusion present significant challenges in clinical practice, often contributing to delayed diagnoses and suboptimal patient outcomes. Recent advancements in artificial intelligence (AI) and machine learning (ML) techniques hold substantial promise for enhancing the accuracy and efficiency of pleural effusion diagnostics. This paper reviews the current landscape of AI applications in pleural effusion detection, synthesizing findings across diverse studies to illustrate the transformative potential of these technologies. We examine various ML models, including deep learning and ensemble methods, that leverage clinical, laboratory, and imaging data to improve diagnostic performance. Notably, models such as Light Gradient Boosting Machine (LGB) and XGBoost have achieved accuracy levels up to 96% and high AUC values (e.g., AUC = 0.883 for pleural effusion differentiation). This overview highlights the importance of integrating diverse diagnostic parameters to enhance pleural effusion diagnostic accuracy and outlines future research directions essential for optimizing patient management and outcomes.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"2882255"},"PeriodicalIF":2.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor-Stroma Ratio Is an Independent Prognostic Factor for Distant Metastasis in Squamous Cell Lung Cancer Following Resection.","authors":"Fuman Wang, Yue Zhang, Dawei Li, Yifan Chi","doi":"10.1155/carj/9963742","DOIUrl":"10.1155/carj/9963742","url":null,"abstract":"<p><p>Cancer distant metastasis is one of the main causes of cancer progression and difficulty in treatment (Rossi et al., 2020). This abstract aims to summarize the significance of tumor-stroma ratio (TSR) as a prognostic factor in the development of distant metastasis in squamous cell lung cancer (SQCLC) patients. The TSR has recently been recognized as a novel and independent prognostic parameter for a variety of solid tumor types (Lu et al., 2023). A total of 86 patients with SQCLC who had undergone surgery were included in the present study. Two independent observers visually identified TSR on hematoxylin and eosin (H&E)-stained pathological histologic sections. Patients were separated into two groups: stroma-rich, with a ratio of stroma as > 50%, and stroma-poor, with a ratio of stroma as ≤ 50%, which included a total of 36 and 50 patients, respectively. In the current study, the overall survival and no distant metastasis survival of patients in the stroma-poor group were improved compared with the stroma-rich group, and the overall risk of patients in the stroma-poor group was reduced compared with the stroma-rich group (<i>p</i> < 0.05). In the multivariable analyses, the TSR was recognized as an important prognostic indicator for overall survival (HR = 2.41; <i>p</i> < 0.001) and no distant metastasis survival (HR = 2.27; <i>p</i> < 0.001). The study revealed that in patients with SQCLC, stroma-rich tumors were associated with a shorter distant metastasis-free interval and poorer prognosis compared to stroma-poor tumors. These findings suggest that the TSR may serve as a novel prognostic indicator for predicting distant metastasis in SQCLC.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"9963742"},"PeriodicalIF":2.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144844516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression and the Risk of All-Cause and Cardiovascular Mortality in Patients With Chronic Obstructive Pulmonary Disease: A Study From NHANES 2005-2018.","authors":"Hui Wei, Fachao Shi, Qin We, Bin Wang, Guoqin Qiu, Caoyang Fang","doi":"10.1155/carj/8833533","DOIUrl":"10.1155/carj/8833533","url":null,"abstract":"<p><p><b>Objective:</b> At present, there is a lack of studies on depression and the likelihood for mortality among those suffering from chronic obstructive pulmonary disease (COPD). This research explores the connection between depression and the risks of overall mortality as well as cardiovascular mortality in individuals with COPD. <b>Methods:</b> A total of 1336 COPD patients from seven cycles of the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2018 were selected. We created a multivariate Cox proportional hazards model and performed a subgroup analysis to investigate the connection between depression and both overall and cardiovascular mortality. Additionally, we used restricted cubic spline (RCS) curves to examine the relationship between depression and both overall and cardiovascular mortality to better reveal the association between the two. The Kaplan-Meier technique was employed to determine the likelihood of survival. <b>Results:</b> Over the course of a mean follow-up period of 91 months, 1336 COPD patients were studied, of which 340 patients experienced overall mortality, and 82 had cardiovascular-related deaths. Using RCSs, we found that depression was positively correlated with both all-cause and cardiovascular mortality in COPD patients. In the multivariable-adjusted model, individuals suffering from moderate to severe depression had a greater likelihood of overall and cardiovascular mortality compared to those without depression. The results were consistent in subgroup analyses based on age, gender, body mass index (BMI), and poverty income ratio (PIR), and there was no significant interaction between these traits and depression (<i>p</i> for interaction > 0.05). <b>Conclusion:</b> In COPD patients, depression is associated with higher risks of both cardiovascular and overall mortality. However, further validation of this finding is needed in large-scale prospective studies with sufficient follow-up time.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"8833533"},"PeriodicalIF":2.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Understanding of Pulmonary Fibrosis: Pathogenesis, Diagnosis, and Therapeutic Approaches.","authors":"Dinglu Cui, Xiangguo Che, Rongxian An, Lei Li, Xinying Cui, Long Jiang, Jingchun Jin","doi":"10.1155/carj/3183241","DOIUrl":"10.1155/carj/3183241","url":null,"abstract":"<p><p>Pulmonary fibrosis (PF) is a terminal-stage lung change in interstitial lung disease. It is characterized by proliferation of fibroblasts and deposition of a large amount of extracellular matrix, accompanied by inflammatory damage and structural destruction, caused by various reasons. The prognosis of PF is poor, and the average survival time after diagnosis is 2.5-3.5 years. The pathogenesis of PF is not yet fully understood. Its main mechanisms are diverse and include damage to alveolar epithelial cells, aggregation and activation of inflammatory cells and chemokines, proliferation of fibroblasts, transformation of myofibroblasts, production and deposition of large amounts of collagen, autophagy, epithelial-mesenchymal transition (EMT), mitochondrial quality-control disorders, microRNA, and circular RNA. The diagnosis of PF is mainly based on the comprehensive evaluation of clinical manifestations, imaging characteristics, and histopathological examination. Medical and family history to determine all potential causes of PF. For PF of unknown etiology, one can refer to the Official Clinical Practice Guideline of idiopathic pulmonary fibrosis (IPF) for definitive diagnosis. In terms of treatment, modern medications such as pirfenidone and nintedanib can inhibit the progression of PF to some extent and improve lung function. However, there is no drug that can significantly improve PF, except for lung transplantation. In addition, many patients are forced to stop taking medication due to adverse reactions in clinical practice. Therefore, to better control the progression of disease, some new drugs have been developed based on the pathogenesis of PF. However, there is still controversy over their efficacy and widespread clinical application in PF, and the evidence is limited. The results of in vitro and in vivo experiments, as well as randomized clinical trials, indicate that traditional Chinese medicine (TCM) can improve PF by intervening in multiple pathways and targets. This study combines the pathogenesis and diagnosis of PF, focusing on the intervention mechanism and targets of TCM in the treatment of PF, so as to provide more options for clinical treatment and provide scientific basis for a new approach to better management of PF.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2025 ","pages":"3183241"},"PeriodicalIF":2.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}