ERJ Open Research最新文献

COPD can coexist with bronchiectasis (BE). These patients have different clinical profiles compared to those with BE with fixed airflow limitation. https://bit.ly/3Z9qNOb.

Nasal epithelial cells from young adults with a history of very preterm birth show delayed closure following scratch-wounding. Repair correlated with lung function, suggesting epithelial barrier integrity may play a role in preterm-associated lung disease. https://bit.ly/4dJnvWO.

The research presented at #ERSCongress 2024 offers promising strides towards improved ILD care through tailored technologies. These studies underscore the critical balance between human expertise and machine-driven solutions for effective implementation. https://bit.ly/3WAhw19.

Background: The radiology, obstruction, symptoms and exposure (ROSE) criteria provide a standardised approach for identifying the "COPD-bronchiectasis (BE) association." However, the clinical implications and outcomes of the COPD-BE association in East Asian populations remain unclear. Our study applied the ROSE criteria to assess the prevalence, clinical impact and outcomes of the COPD-BE association in an East Asian cohort, and compared that cohort with nonsmoking BE patients with fixed airflow obstruction (FAO) and those without FAO.

Methods: An integrated cohort analysis was conducted within a Taiwanese demographic, combining a prospective cohort of 147 participants with a multicentre retrospective cohort of 574 participants. Stratification was based on the ROSE criteria, distinguishing between nonsmoking BE, smoking BE, nonsmoking BE with FAO and BE in compliance with the ROSE criteria. Clinical, radiological and spirometric variables were assessed in conjunction with outcomes to validate the diagnostic utility of the criteria.

Results: Using the ROSE criteria, we found that 16.5% of participants had a COPD-BE association (22.4% in the prospective cohort and 14.9% in the retrospective cohort), predominantly in older male patients. These patients had escalated dyspnoea scores, higher COPD diagnosis rates and increased use of inhalation therapies, compared with those without FAO. Notably, patients with a COPD-BE association and nonsmoking BE with FAO displayed similar clinical symptoms, pulmonary function and disease severity, but differed slightly in airway microbiology. Furthermore, patients with a COPD-BE association had significantly higher risks of exacerbations and hospitalisations, even after adjusting for confounding factors, which highlights that they have poorer clinical outcomes than other groups.

Conclusion: The ROSE criteria effectively identify the COPD-BE association in East Asian populations, highlighting a significant future exacerbation risk compared with other BE groups. Future research is warranted to better understand BE progression, especially in FAO subgroups.

At #ERSCongress 2024, experts highlighted the need to address healthcare disparities, prevent disease progression and assess the value of AI-driven care to improve outcomes in paediatric respiratory health https://bit.ly/40944lv.

Rationale: Bronchoscopic lung volume reduction treatment using endobronchial valves (EBV) is an effective treatment for severe COPD patients by improving lung function and quality of life. However, little is known about its effects on systemic inflammation. Therefore, the aim of our study was to investigate whether EBV treatment impacts the inflammatory cytokine profile.

Methods: This study was a predefined sub-study of the SoLVE trial (NCT03474471) that investigated the combination of EBV treatment with pulmonary rehabilitation (PR). The sub-study included the collection of blood samples with assessment of 10 inflammatory markers prior to EBV treatment and 6 months after EBV or EBV+PR treatment.

Results: In 66 patients, 6 months after treatment a pro-inflammatory cytokine profile was observed, with an increase in all pro-inflammatory markers and a decrease in the anti-inflammatory cytokine interleukin-10. The changes in plasma cytokine profile were not associated with changes in clinical outcomes such as lung function or exercise capacity.

Discussion: In conclusion, our study demonstrated an elevation in systemic pro-inflammatory cytokine levels following successful EBV treatment, which was not associated with adverse clinical outcomes. It would be interesting to further explore whether this increase is attributed to a foreign body response or if other factors contribute to this phenomenon.

This article summarises highlights from #ERSCongress including 1) the rapidly advancing use of digital health and AI, 2) keys to effective self-management, and 3) an update on the ongoing debate on race and ethnicity in pulmonary function testing https://bit.ly/3ZPrlZw.

Natural killer (NK) cells are innate lymphoid cells which are present in the lung as circulating and resident cells. They are key players both in airway surveillance and in crosstalk with (COPD) pathogenesis, and they seem to contribute to the development of bronchiectasis. In asthma, NK cell dysfunction was observed mainly in severe forms, and it can lead to a biased type-2 immune response and failure in the resolution of eosinophilic inflammation that characterise both allergic and eosinophilic phenotypes. Moreover, aberrant NK cell functions may interfere with antimicrobial immune response contributing to the frequency and severity of virus-induced exacerbations. In COPD, lung NK cells exhibit increased cytotoxicity against lung epithelium contributing to lung tissue destruction and emphysema. This cell destruction may be exacerbated by viral infections and cigarette smoke exposure through NKG2D-dependent detection of cellular stress. Lastly, in bronchiectasis, the airway NK cells might both promote neutrophil survival following stimulation by proinflammatory cytokines and promote neutrophil apoptosis. Systemic steroid treatment seemingly compromises NK activity, while biologic treatment with benralizumab could enhance NK cell proliferation, maturation and activation. This narrative review gives an overview of NK cells in airway diseases focusing on pathophysiological and clinical implications. Together, our findings emphasise the pleiotropic role of NK cells in airway diseases underscoring their possible implications as to therapeutical approaches.

Rationale: Obstructive lung disease is increasingly common among persons living with HIV (PLWH). There are currently no validated biomarkers that identify individuals at risk of developing obstructive lung disease (OLD), and specific mechanisms contributing to HIV-associated OLD remain elusive, independent of smoking. We sought to identify biomarkers and biological pathways associated with OLD using a broad proteomic approach.

Methods: We performed tandem mass tagging and mass spectrometry (MS) analysis on bronchoalveolar lavage fluid samples from persons living with HIV with OLD (n=26) and without OLD (n=26). We combined untargeted MS with a targeted SomaScan aptamer-based approach. We used Pearson correlation tests to identify associations between each protein and lung function (forced expiratory volume in 1 s (FEV₁) % pred). We adjusted for multiple comparisons using a false discovery rate adjustment. Significant proteins were entered into a pathway over-representation analysis. Protein-driven endotypes were constructed using K-means clustering.

Measurements and main results: We identified over 3800 proteins by MS and identified 254 proteins that correlated with FEV₁ % pred when we combined the MS and SomaScan proteomes when adjusting for smoking status. Pathway analysis revealed cell adhesion molecules as significant.

Conclusions: Protein expression differs in the lung of PLWH and decreased lung function (FEV₁ % pred). Pathway analysis reveals cell adhesion molecules having potentially important roles in this process.

Digital inhalers: adequate subgroup targeting and cost-effective implementation in asthma care remain key challenges https://bit.ly/3UTWtWv.