CHEST pulmonary最新文献

{"title":"CHEST Pulmonary Journal in 2026","authors":"Matthew C. Miles MD, MEd","doi":"10.1016/j.chpulm.2026.100236","DOIUrl":"10.1016/j.chpulm.2026.100236","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"4 1","pages":"Article 100236"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 48-Year-Old Woman With Shortness of Breath and a Recent Diagnosis of Breast Cancer","authors":"Sami M. Bennji FCP ,&nbsp;Brian Allwood PhD ,&nbsp;B. Jayakrishnan FRCP ,&nbsp;Adil Barakat Al-Riyami FRCP ,&nbsp;Intisar Yahya MD ,&nbsp;Khalid Al-Baimani FRCP ,&nbsp;Ahmed Basuoni PhD","doi":"10.1016/j.chpulm.2025.100226","DOIUrl":"10.1016/j.chpulm.2025.100226","url":null,"abstract":"<div><h3>Case Presentation</h3><div>A 48-year-old perimenopausal woman presented to our hospital in May 2024 with New York Heart Association functional class III dyspnea and a dry cough. Her symptoms had been ongoing for several months but worsened significantly in the weeks before admission. She reported fatigue but denied other constitutional symptoms such as fever, weight loss, or night sweats. There was no orthopnea or paroxysmal nocturnal dyspnea, and she was not taking any medications at the time. She had recently been diagnosed with treatment naïve de novo metastatic left breast cancer, stage cT4bN3cM1, with metastasis to the lungs, liver, bilateral ovaries, and bones. The pathology confirmed invasive ductal carcinoma, grade 1, with estrogen receptor and progesterone receptor positivity and human epidermal growth factor receptor 2-negative status. On presentation, she had not yet received any cancer treatment.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"4 1","pages":"Article 100226"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared Decision-Making for Lung Cancer Screening","authors":"Adrienne Landsteiner PhD, MPH ,&nbsp;Nicholas Zerzan MPH ,&nbsp;Kristen E. Ullman MPH ,&nbsp;Maylen Anthony MPH ,&nbsp;Amy M. Claussen MLIS ,&nbsp;Robertson Bayer MD, PhD ,&nbsp;Tam Do MSH, RN, PHN ,&nbsp;Allison M. Gustavson PT, DPT, PhD ,&nbsp;Anne C. Melzer MD ,&nbsp;Timothy J. Wilt MD, MPH","doi":"10.1016/j.chpulm.2025.100222","DOIUrl":"10.1016/j.chpulm.2025.100222","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer screening (LCS) with annual low-dose CT scanning is recommended for eligible individuals. The Centers of Medicare and Medicaid Services stipulates that counseling and shared decision-making (SDM) are a prerequisite for LCS reimbursement; however, SDM effects and optimal strategies are poorly understood.</div></div><div><h3>Research Question</h3><div>What are the effects of LCS SDM tools and strategies?</div></div><div><h3>Study Design and Methods</h3><div>This was a systematic review of US-based randomized controlled trials or observational studies of LCS SDM with a comparator. We searched Embase and MEDLINE via Ovid and CINAHL via EbscoHost for dates January 2010 through December 2023. We used dual abstraction and risk-of-bias (RoB) assessment with Cochrane RoB 2.0 tool for randomized controlled trials and Joanna Briggs Institute RoB for observational studies. Certainty of evidence (CoE) was based on Grading of Recommendations, Assessment, Development, and Evaluation.</div></div><div><h3>Results</h3><div>Thirty-one studies were eligible. Studies varied in design, intervention, comparator, and methodology precluding quantitative analysis. Few reports provided adequate information to assess if they met Centers of Medicare and Medicaid Services SDM criteria. We summarized findings by whether the tool was a health care provider- or patient-facing tool or material. Few studies addressed uptake, adherence, and harms. SDM, including by care coordinators or patient navigators, may increase LCS participation with acceptable information quality (low CoE) and does not increase decisional conflict/regret (high CoE). The choice of SDM tool may not affect LCS uptake (low CoE). Little evidence exists on whether effects vary by patient or clinic characteristics.</div></div><div><h3>Interpretation</h3><div>LCS SDM evidence is limited due to study variability and short follow-up. SDM may increase LCS participation, has acceptable information quality, and does not increase decisional conflict/regret. Most studies reported on knowledge; few addressed clinical and patient-centered outcomes. Specific SDM tool choice may not impact LCS. A decision aid may be superior to an education tool. Implementation should consider feasibility and that delivery included print, web, in-person, and video, with most patient-facing.</div></div><div><h3>Clinical Trial Registration</h3><div>International Prospective Register of Systematic Reviews; No.: CRD42024511257; URL: <span><span>https://www.crd.york.ac.uk/prospero/</span><svg><path></path></svg></span></div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"4 1","pages":"Article 100222"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Partial Registration for Optimizing Robotic-Assisted Bronchoscopy Evaluations of Peripheral Lung Nodules (I-PROBE)","authors":"Bryce Duchman MD ,&nbsp;Jaskiran K. Khosa MD ,&nbsp;Liqin Xu MD ,&nbsp;Niral M. Patel MD ,&nbsp;Jorge A. Munoz Pineda MD ,&nbsp;Keriann Van Nostrand MD ,&nbsp;Russell J. Miller MD ,&nbsp;Ara A. Chrissian MD ,&nbsp;George Z. Cheng MD, PhD","doi":"10.1016/j.chpulm.2025.100229","DOIUrl":"10.1016/j.chpulm.2025.100229","url":null,"abstract":"<div><h3>Background</h3><div>Robotic-assisted bronchoscopy has transformed the diagnostic approach to lung cancer by improving access to peripheral pulmonary lesions (PPLs). Among these platforms, shape-sensing robotic-assisted bronchoscopy (ssRAB) relies on registration techniques to align virtual airway maps with patient anatomy. However, conventional full registration may not be essential for optimal accuracy and potentially add unnecessary time. We evaluated the novel technique of partial registration and assessed its feasibility and efficacy during ssRAB.</div></div><div><h3>Research Question</h3><div>During ssRAB, how does partial registration impact the technical accuracy in targeting PPLs compared to full registration?</div></div><div><h3>Study Design and Methods</h3><div>A prospective comparative study was conducted on 22 patients undergoing ssRAB for tissue diagnosis of PPLs &lt; 2 cm in size. The accuracy of lesion localization was determined by the target center distance (TCD), which is the difference between the plan’s predicted target center after registration and the intraprocedural cone-beam CT target center. The mean TCD values were calculated for full and partial registration techniques and compared.</div></div><div><h3>Results</h3><div>There was significant improvement in TCD with partial registration over full registration. Specifically, for full registration, the mean TCD was 9.23 mm. In contrast, partial registration achieved a mean TCD of 7.00 mm, suggesting enhanced accuracy with the partial registration technique (<em>P</em> = .0383). In subgroup analysis, this difference was most noticeable in the posterior lung fields (10.73 vs 6.32 mm) and lower lobes (9.15 vs 6.77 mm).</div></div><div><h3>Interpretation</h3><div>Our results indicate that partial registration offers a feasible and efficient alternative for targeting small PPLs during ssRAB. These findings suggest that the full registration may not be necessary, because partial registration demonstrates comparable lesion localization accuracy—and possibly superior in certain cases. Further research is warranted to confirm these technical advantages and to confirm whether they translate into improved diagnostic outcomes.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"4 1","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Xanthine Oxidoreductase Activity in Patients With Systemic Sclerosis-Associated Pulmonary Arterial Hypertension","authors":"Julie C. Coursen MD ,&nbsp;Tijana Tuhy MD ,&nbsp;Adrianne Woods CCRP ,&nbsp;Laura K. Hummers MD ,&nbsp;Ami A. Shah MD, MHS ,&nbsp;Paul M. Hassoun MD ,&nbsp;Rachel L. Damico MD, PhD ,&nbsp;Stephen C. Mathai MD, MHS ,&nbsp;Catherine E. Simpson MD, MHS","doi":"10.1016/j.chpulm.2025.100212","DOIUrl":"10.1016/j.chpulm.2025.100212","url":null,"abstract":"<div><h3>Background</h3><div>Preclinical studies have demonstrated the importance of xanthine oxidoreductase (XOR) in the pathobiology of pulmonary hypertension (PH) through generation of uric acid, reactive oxygen species, and vascular endothelial dysfunction.</div></div><div><h3>Research Question</h3><div>In 2 well-characterized cohorts of patients with systemic sclerosis (SSc), what is the relationship of systemic XOR enzymatic activity to PH diagnosis, development, and severity?</div></div><div><h3>Study Design and Methods</h3><div>Serum samples from 48 patients with systemic sclerosis-associated pulmonary hypertension (SSc-PH) were assayed for XOR activity using an enzyme-linked immunosorbent assay (ELISA) in a discovery cohort from the Johns Hopkins Pulmonary Hypertension Program, including 12 index treatment-naive patients with samples collected before and after 36 weeks of PH-specific therapy. Sixty-nine patients with SSc-PH were compared with patients with SSc without PH in a second cohort from the Johns Hopkins Scleroderma Center using a nested case-control design. Patients in the Johns Hopkins Scleroderma Center cohort were under longitudinal surveillance for development of right heart catheterization-confirmed PH, which allowed for serum collection at proximate and distant time points before PH diagnosis (1 proximate sample within 12 months of PH diagnosis and 1 distant sample within 5 years of PH diagnosis, with a minimum 6-month separation between samples).</div></div><div><h3>Results</h3><div>XOR activity temporally correlated with SSc with pulmonary arterial hypertension disease development, and increasing XOR activity over the time preceding PH diagnosis was associated with worse disease severity by invasive hemodynamics. In a small subset of patients, XOR activity increased after initiation of PH-specific therapy.</div></div><div><h3>Interpretation</h3><div>Taken together, these results suggest increased XOR activity and hyperuricemia may represent modifiable risk factors in SSc-PH.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"4 1","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Proof of Concept for the Use of Lung Ultrasound in the Diagnostic Approach of Pulmonary Hypertension","authors":"Benoit Aguado MD ,&nbsp;Thomas Lacoste-Palasset MD ,&nbsp;Florent Favard MD ,&nbsp;Sylvain Palat MD ,&nbsp;Victor Aboyans MD, PhD ,&nbsp;Marc Humbert MD, PhD ,&nbsp;David Montani MD, PhD","doi":"10.1016/j.chpulm.2025.100225","DOIUrl":"10.1016/j.chpulm.2025.100225","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"4 1","pages":"Article 100225"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Challenges of Treating Autoimmune-Inflammatory Myopathy-Related Interstitial Lung Disease With Nintedanib","authors":"Giorgio Monteleone MD ,&nbsp;Barbara Ruaro MD, PhD","doi":"10.1016/j.chpulm.2025.100233","DOIUrl":"10.1016/j.chpulm.2025.100233","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"4 1","pages":"Article 100233"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Pulmonary Complications After COVID-19","authors":"Tarek Mohamed M. Mansour MD ,&nbsp;Ahmed Abd elrady Ahmed teleb MD ,&nbsp;Hytham Abdalla MD ,&nbsp;Mohamad M. Abd elnaser MD ,&nbsp;Mohamed M. El-baroudy MD ,&nbsp;Hossam Abd El-Moez Mohammed MD","doi":"10.1016/j.chpulm.2025.100208","DOIUrl":"10.1016/j.chpulm.2025.100208","url":null,"abstract":"<div><h3>Background</h3><div>Long-term pulmonary complications after COVID-19 are increasingly recognized, but few studies have characterized their progression and risk factors over extended follow-up.</div></div><div><h3>Research Question</h3><div>What are the prevalence, progression, and predictors of chronic pulmonary complications in COVID-19 survivors over a 24-month period?</div></div><div><h3>Study Design and Methods</h3><div>We conducted a prospective observational cohort study of 355 adults (20-55 years of age) with polymerase chain reaction-confirmed COVID-19 in Egypt, followed at 6, 12, and 24 months after infection. Assessments included pulmonary function tests, high-resolution CT scan, and standardized symptom questionnaires. Multivariable logistic regression was used to identify independent predictors of interstitial fibrosis and pulmonary embolism (PE).</div></div><div><h3>Results</h3><div>Chronic cough prevalence decreased from 45% at 6 months to 7% at 24 months (<em>P</em> &lt; .001). Asthma-like symptoms declined from 30% to 15% (<em>P</em> = .002). Conversely, PE prevalence increased from 10% to 19% (<em>P</em> = .014), and interstitial fibrosis rose from 3% to 25% (<em>P</em> &lt; .001). Patients with severe acute COVID-19 had lower diffusing capacity for carbon monoxide throughout follow-up (mean difference, −12.8%; <em>P</em> = .002). Independent predictors of PE at 24 months included age (OR, 1.05 per year; 95% CI, 1.02-1.08), unvaccinated status (OR, 2.3; 95% CI, 1.4-3.9), and comorbidities (OR, 1.8; 95% CI, 1.1-3.1). Vaccinated participants had significantly lower rates of fibrosis (12% vs 28%, <em>P</em> &lt; .01) and PE (10% vs 22%, <em>P</em> = .001), and more rapid symptom resolution.</div></div><div><h3>Interpretation</h3><div>Most COVID-19 survivors experienced symptomatic and functional improvement over 2 years. However, a substantial subset, particularly those unvaccinated or with severe initial illness, developed progressive interstitial fibrosis and increased risk of PE. Long-term pulmonary surveillance and vaccination may reduce these chronic sequelae.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"4 1","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a COPD Bundled Payments for Care Innovation Program on Readmissions and Inpatient Care Quality","authors":"Nathan C. Nowalk MD ,&nbsp;Juan C. Rojas MD ,&nbsp;William F. Parker MD, PhD ,&nbsp;Ashley Smith-Nunez MD ,&nbsp;Sarah E. Gray MD, MPH ,&nbsp;Ria Sood MPH ,&nbsp;Devon O. Lewis BS ,&nbsp;Stephanie Chia BS ,&nbsp;Rajlakshmi Krishnamurthy MD ,&nbsp;Valerie G. Press MD, MPH","doi":"10.1016/j.chpulm.2025.100219","DOIUrl":"10.1016/j.chpulm.2025.100219","url":null,"abstract":"<div><h3>Background</h3><div>One-fifth of US patients hospitalized for acute exacerbations of COPD (AECOPDs) are readmitted within 30 days, contributing to high morbidity and costs. Medicare included COPD in their Hospital Readmissions Reduction Program (HRRP) in 2014 and offered voluntary value-based COPD care programs (Bundled Payments for Care Innovation [BPCI]).</div></div><div><h3>Research Question</h3><div>Was our COPD HRRP effective in preventing hospital readmissions and improving inpatient care quality at our medical center?</div></div><div><h3>Study Design and Methods</h3><div>We performed a single-center, retrospective cohort study using Medicare data of BPCI-eligible hospitalizations for AECOPDs occurring pre-BPCI (October 2013-September 2014) and during BPCI (October 2015-September 2018) implementation. Our interprofessional COPD HRRP includes inpatient consultation and postdischarge interventions. We compared outcomes between BPCI program recipients and nonrecipients including inpatient COPD care quality metrics derived from international COPD guidelines and program-specific interventions using multivariable regressions. We evaluated 30- and 90-day all-cause readmission rates with multivariable logistic regression and 2-stage least squares instrumental variable analysis.</div></div><div><h3>Results</h3><div>Of 287 AECOPD hospitalizations (pre-BPCI: n = 57; BPCI: n = 230), 132 received the COPD HRRP. Patients were more likely to receive inhaler education (pre-BPCI: 12.0% vs BPCI: 71.8%; <em>P</em> &lt; .01), tobacco cessation therapy (pre-BPCI: 24.3% vs BPCI: 71.8%; <em>P</em> &lt; .01), and predischarge oxygen walk test (pre-BPCI: 49% vs BPCI: 81.0%; <em>P</em> &lt; .01). In instrumental variable analysis, controlling for unobserved confounders correlated with receiving the COPD HRRP, our intervention was associated with a significantly lower adjusted 30-day all-cause readmission rate (pre-BPCI: 28.6% vs BPCI: 6.6%; <em>P</em> &lt; .05; absolute decrease, −22.0%; 95% CI, −43.6 to −0.5) but not in 90-day readmissions.</div></div><div><h3>Interpretation</h3><div>The implementation of an evidence-based BPCI COPD program was associated with significant decrease in 30-day all-cause readmissions. Future studies are needed to assess individual interventions that may impact readmission reduction.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"4 1","pages":"Article 100219"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tolerability and Safety of Nintedanib and Immunosuppression in Autoimmune Inflammatory Myopathy-Associated Progressive Pulmonary Fibrosis","authors":"Deborah Assayag MD ,&nbsp;Benoit Brilland MD, PhD ,&nbsp;Marie Hudson MD ,&nbsp;Ilan Azuelos MD ,&nbsp;David Langlais PhD ,&nbsp;Andrew Hirsch MD","doi":"10.1016/j.chpulm.2025.100230","DOIUrl":"10.1016/j.chpulm.2025.100230","url":null,"abstract":"<div><h3>Background</h3><div>Autoimmune-inflammatory myopathy-related interstitial lung diseases (AIM-ILDs) are often progressive and fibrotic. Given their rarity, little is known about the safety and tolerability of antifibrotic nintedanib in combination with immunosuppression in AIM-ILD.</div></div><div><h3>Research Question</h3><div>Is the addition of nintedanib to immunosuppression safe and tolerable in patients with AIM-ILD, and does nintedanib administration induce peripheral blood cell gene expression changes?</div></div><div><h3>Study Design and Methods</h3><div>This was a single-arm, open-label trial to assess safety and tolerability of nintedanib with immunosuppression. Patients with progressive, fibrotic AIM-ILD on background immunosuppression were given nintedanib for 24 weeks. The primary end point was the percentage of patients who took ≥ 90% study drug doses. The secondary end points included safety (adverse events) and efficacy (lung function) outcomes. Bulk RNA sequencing of peripheral blood was performed at baseline and each subsequent visit to examine gene expression.</div></div><div><h3>Results</h3><div>A total of 11 participants were enrolled; of these, 9 completed the study visits as per protocol. The trial was discontinued due to slow recruitment. Three participants (27%) took ≥ 90% doses of nintedanib. Drug compliance ranged from 27% to 95%. The most common adverse events were diarrhea, nausea/vomiting, and abdominal pain. There were no overall significant changes in lung function, or difference in gene expression in peripheral blood over time identified.</div></div><div><h3>Interpretation</h3><div>Tolerability of combined nintedanib and immunosuppression in AIM-ILD appears challenging. Nintedanib treatment did not induce measurable gene expression changes in peripheral blood. However, the study’s small sample size, compounded by recruitment difficulties leading to early discontinuation, restricts the robustness and generalizability of the findings.</div></div><div><h3>Clinical Trial Registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; No.: NCT05335278; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"4 1","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147385657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}