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Sleep apnoea, cognition and aspirin's effects in healthy older people: an ASPREE substudy.
IF 4.3 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI: 10.1183/23120541.00581-2024
Stephanie A Ward, Robyn L Woods, Matthew T Naughton, Rory Wolfe, Danijela Gasevic, Garun S Hamilton, Walter P Abhayaratna, Katherine Webb, Fergal J O'Donoghue, Nigel Stocks, Ruth E Trevaks, Sharyn M Fitzgerald, Suzanne G Orchard, Christopher M Reid, Elsdon Storey

Importance: Obstructive sleep apnoea (OSA) may increase the risk of dementia; however, studies have reported variable findings. We investigated if undiagnosed OSA in healthy older adults is associated with cognitive decline, and whether low-dose aspirin could attenuate this.

Methods: This was conducted as a substudy of the ASPirin in Reducing Events in the Elderly study. Participants were aged 70 years and above, free of dementia, cardiovascular disease and known OSA. A limited channel home sleep study calculated the oxygen desaturation index. Participants were randomised to daily aspirin 100 mg or placebo. Outcomes were the association of OSA, and the interaction of aspirin with OSA, with change in the Modified Mini-Mental State examination (3MS), a test of global cognition, over 3 years. Secondary outcomes were changes in domain-specific cognitive tests. Analyses were adjusted for relevant demographic, lifestyle and cardiometabolic factors.

Results: Mild OSA, detected in 630 (49.0%) participants, and moderate/severe OSA, detected in 405 (31.5%) participants, were associated with lower 3MS scores over 3 years (mild OSA: β -0.58, 95% CI -1.15 to -0.00, p=0.049; moderate/severe OSA: β -0.69, 95% CI -1.32 to -0.05, p=0.035), compared to the 250 (19.5%) participants without OSA. No associations of OSA with decline in domain-specific cognitive tests were observed. Interaction terms were not significant for the effects of aspirin with OSA on change in any cognitive test score.

Conclusions: OSA was associated with a small decline in global cognition over 3 years in this healthy older cohort. This decline was not attenuated by aspirin.

{"title":"Sleep apnoea, cognition and aspirin's effects in healthy older people: an ASPREE substudy.","authors":"Stephanie A Ward, Robyn L Woods, Matthew T Naughton, Rory Wolfe, Danijela Gasevic, Garun S Hamilton, Walter P Abhayaratna, Katherine Webb, Fergal J O'Donoghue, Nigel Stocks, Ruth E Trevaks, Sharyn M Fitzgerald, Suzanne G Orchard, Christopher M Reid, Elsdon Storey","doi":"10.1183/23120541.00581-2024","DOIUrl":"https://doi.org/10.1183/23120541.00581-2024","url":null,"abstract":"<p><strong>Importance: </strong>Obstructive sleep apnoea (OSA) may increase the risk of dementia; however, studies have reported variable findings. We investigated if undiagnosed OSA in healthy older adults is associated with cognitive decline, and whether low-dose aspirin could attenuate this.</p><p><strong>Methods: </strong>This was conducted as a substudy of the ASPirin in Reducing Events in the Elderly study. Participants were aged 70 years and above, free of dementia, cardiovascular disease and known OSA. A limited channel home sleep study calculated the oxygen desaturation index. Participants were randomised to daily aspirin 100 mg or placebo<b>.</b> Outcomes were the association of OSA, and the interaction of aspirin with OSA, with change in the Modified Mini-Mental State examination (3MS), a test of global cognition, over 3 years. Secondary outcomes were changes in domain-specific cognitive tests. Analyses were adjusted for relevant demographic, lifestyle and cardiometabolic factors.</p><p><strong>Results: </strong>Mild OSA, detected in 630 (49.0%) participants, and moderate/severe OSA, detected in 405 (31.5%) participants, were associated with lower 3MS scores over 3 years (mild OSA: β <b>-</b>0.58, 95% CI -1.15 to -0.00, p=0.049; moderate/severe OSA: β -0.69, 95% CI -1.32 to -0.05, p=0.035), compared to the 250 (19.5%) participants without OSA. No associations of OSA with decline in domain-specific cognitive tests were observed. Interaction terms were not significant for the effects of aspirin with OSA on change in any cognitive test score.</p><p><strong>Conclusions: </strong>OSA was associated with a small decline in global cognition over 3 years in this healthy older cohort. This decline was not attenuated by aspirin.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440278","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}
引用次数: 0
Flexible bronchoscopy in the diagnosis of chronic cough causes in non-smoking adults.
IF 4.3 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI: 10.1183/23120541.00571-2024
Karolina Klimowicz, Marta Dąbrowska, Elżbieta M Grabczak, Katarzyna Białek-Gosk, Olga Truba, Aleksandra Rybka-Frączek, Magdalena Paplińska-Goryca, Patrycja Nejman-Gryz, Agata Cyran, Rafał Krenke

A chronic cough (CC) is reported in 4-10% of the adult population and negatively affects quality of life [1-5]. Diagnosing and managing CC is challenging [3-5]. Initial evaluation typically includes chest radiography, spirometry, blood cell count (to detect blood eosinophils) and exhaled nitric oxide fraction, if available [4, 5]. Further diagnostic tests are warranted if clinical symptoms and basic tests cannot identify the cause of CC. Secondary diagnostic tests include oesophageal manometry or pH/impedance monitoring, induced sputum for eosinophils, laryngoscopy, bronchial provocation challenge, chest computed tomography (CT) and bronchoscopy [3-5].

{"title":"Flexible bronchoscopy in the diagnosis of chronic cough causes in non-smoking adults.","authors":"Karolina Klimowicz, Marta Dąbrowska, Elżbieta M Grabczak, Katarzyna Białek-Gosk, Olga Truba, Aleksandra Rybka-Frączek, Magdalena Paplińska-Goryca, Patrycja Nejman-Gryz, Agata Cyran, Rafał Krenke","doi":"10.1183/23120541.00571-2024","DOIUrl":"https://doi.org/10.1183/23120541.00571-2024","url":null,"abstract":"<p><p>A chronic cough (CC) is reported in 4-10% of the adult population and negatively affects quality of life [1-5]. Diagnosing and managing CC is challenging [3-5]. Initial evaluation typically includes chest radiography, spirometry, blood cell count (to detect blood eosinophils) and exhaled nitric oxide fraction, if available [4, 5]. Further diagnostic tests are warranted if clinical symptoms and basic tests cannot identify the cause of CC. Secondary diagnostic tests include oesophageal manometry or pH/impedance monitoring, induced sputum for eosinophils, laryngoscopy, bronchial provocation challenge, chest computed tomography (CT) and bronchoscopy [3-5].</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440310","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}
引用次数: 0
Medical hypnosis increases 6-min walking test distance in severe COPD patients: a case-control study.
IF 4.3 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI: 10.1183/23120541.00795-2024
Christian Straus, Gladys Beuze, Sophie Lavault, Antoine Guerder, Capucine Morélot-Panzini, Jésus Gonzalez-Bermejo, Thomas Similowski

This preliminary, monocentric, case-control, open-label study suggests that medical hypnosis increases 6-min walking distance in severe COPD patients https://bit.ly/4eFvWTV.

{"title":"Medical hypnosis increases 6-min walking test distance in severe COPD patients: a case-control study.","authors":"Christian Straus, Gladys Beuze, Sophie Lavault, Antoine Guerder, Capucine Morélot-Panzini, Jésus Gonzalez-Bermejo, Thomas Similowski","doi":"10.1183/23120541.00795-2024","DOIUrl":"https://doi.org/10.1183/23120541.00795-2024","url":null,"abstract":"<p><p><b>This preliminary, monocentric, case-control, open-label study suggests that medical hypnosis increases 6-min walking distance in severe COPD patients</b> https://bit.ly/4eFvWTV.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440314","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}
引用次数: 0
Activity behaviours and quality of life in patients with malignant pleural effusion.
IF 4.3 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI: 10.1183/23120541.00399-2024
Bianca M Iacopetta, David C L Lam, Jenny C L Ngai, Johnny W M Chan, Fifian K Y Chiang, Macy M S Lui, W L Law, Ken K P Chan, Joanne McVeigh, Carolyn J Peddle-McIntyre, Y C Gary Lee

Background and objective: Accelerometery is used to measure activity behaviours in patients with malignant pleural effusion (MPE). This study aimed to evaluate physical activity and sedentary behaviour profiles of patients with MPE in Hong Kong, and to explore relationships between activity behaviours and quality of life (QoL). We also compared clinician-recorded performance status measures with objective measures of activity levels.

Methods: Participants wore an Actigraph GT3X+ accelerometer continuously for 7 consecutive days. The EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) was used to assess five dimensions of QoL and correlate with activity behaviours. The Eastern Cooperative Oncology Group (ECOG) performance status was documented by clinicians at baseline.

Results: Fifty-one patients with MPE received accelerometers; 94% had ≥1 valid day of data. Participants spent 76% (sd 2.32) of waking hours sedentary, 23% (sd 1.40) of waking hours in light activity and 0.3% (median, interquartile range 0.0-1.5) in moderate-to-vigorous physical activity (MVPA). Higher light activity and MVPA behaviours were associated with increased participation in self-care tasks (rs=-0.43, p=0.003; rs=-0.45, p=0.001, respectively) and usual activities (rs=-0.42, p=0.003; rs=-0.45, p=0.001, respectively). Patients with an ECOG status of 0 or 1 spent an average of 75% of waking hours sedentary.

Conclusion: This is the first report of physical activity behaviours in patients with MPE in Hong Kong, demonstrating high sedentary behaviours and low physical activity which correlated to dimensions of QoL. Clinician-rated performance status was not reflected in accelerometery data, suggesting a discrepancy between performance status measures and objective measures of activity in patients with MPE.

{"title":"Activity behaviours and quality of life in patients with malignant pleural effusion.","authors":"Bianca M Iacopetta, David C L Lam, Jenny C L Ngai, Johnny W M Chan, Fifian K Y Chiang, Macy M S Lui, W L Law, Ken K P Chan, Joanne McVeigh, Carolyn J Peddle-McIntyre, Y C Gary Lee","doi":"10.1183/23120541.00399-2024","DOIUrl":"https://doi.org/10.1183/23120541.00399-2024","url":null,"abstract":"<p><strong>Background and objective: </strong>Accelerometery is used to measure activity behaviours in patients with malignant pleural effusion (MPE). This study aimed to evaluate physical activity and sedentary behaviour profiles of patients with MPE in Hong Kong, and to explore relationships between activity behaviours and quality of life (QoL). We also compared clinician-recorded performance status measures with objective measures of activity levels.</p><p><strong>Methods: </strong>Participants wore an Actigraph GT3X+ accelerometer continuously for 7 consecutive days. The EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) was used to assess five dimensions of QoL and correlate with activity behaviours. The Eastern Cooperative Oncology Group (ECOG) performance status was documented by clinicians at baseline.</p><p><strong>Results: </strong>Fifty-one patients with MPE received accelerometers; 94% had ≥1 valid day of data. Participants spent 76% (sd 2.32) of waking hours sedentary, 23% (sd 1.40) of waking hours in light activity and 0.3% (median, interquartile range 0.0-1.5) in moderate-to-vigorous physical activity (MVPA). Higher light activity and MVPA behaviours were associated with increased participation in self-care tasks (r<sub>s</sub>=-0.43, p=0.003; r<sub>s</sub>=-0.45, p=0.001, respectively) and usual activities (r<sub>s</sub>=-0.42, p=0.003; r<sub>s</sub>=-0.45, p=0.001, respectively). Patients with an ECOG status of 0 or 1 spent an average of 75% of waking hours sedentary.</p><p><strong>Conclusion: </strong>This is the first report of physical activity behaviours in patients with MPE in Hong Kong, demonstrating high sedentary behaviours and low physical activity which correlated to dimensions of QoL. Clinician-rated performance status was not reflected in accelerometery data, suggesting a discrepancy between performance status measures and objective measures of activity in patients with MPE.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440308","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}
引用次数: 0
Laboratory-based surveillance of nontuberculous mycobacterial pulmonary disease in Japan.
IF 4.3 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI: 10.1183/23120541.00337-2024
Yuko Hamaguchi, Kozo Morimoto, Satoshi Mitarai

Background: Intractable pulmonary diseases with nontuberculous mycobacteria (NTM-PDs) and antimicrobial resistance have become increasingly concerning worldwide. Nevertheless, a surveillance system for NTM has not been established in most countries, thus requiring repeated, intermittent and time-consuming cross-sectional nationwide surveys.

Methods: To establish a nationwide surveillance system for NTM-associated diseases, we aimed to develop a prototype computer system primarily designed to continuously estimate NTM-PD incidence using a bacteriological case-defining algorithm through an automatic process of integrating bacteriological data collected from microbiology laboratories across Japan. To validate the accuracy of our study results, we compared the distribution of pulmonary tuberculosis cases between our laboratory data and the national surveillance data, which is representative of the Japanese population.

Results: Our estimates implied a 17.7% increase in NTM-PD incidence from 15.8 (14.9-16.8) in 2013 to 19.2 (18.2-20.4) in 2017, per 100 000 population. Moreover, 93.0% of the identified NTM-PD cases were dominated by the Mycobacterium avium-intracellulare complex, and the proportion of M. abscessus species exceeded that of M. kansasii for the first time in Japan. We also revealed significant age and sex differences in NTM-PDs. Notably, we found similar characteristics between our laboratory data and national surveillance data covering almost the entire Japanese population.

Conclusion: These findings, despite being laboratory-based, are extrapolatable to the general population in Japan and provide evidence that supports our system as a viable alternative to the nationwide NTM surveillance system.

{"title":"Laboratory-based surveillance of nontuberculous mycobacterial pulmonary disease in Japan.","authors":"Yuko Hamaguchi, Kozo Morimoto, Satoshi Mitarai","doi":"10.1183/23120541.00337-2024","DOIUrl":"https://doi.org/10.1183/23120541.00337-2024","url":null,"abstract":"<p><strong>Background: </strong>Intractable pulmonary diseases with nontuberculous mycobacteria (NTM-PDs) and antimicrobial resistance have become increasingly concerning worldwide. Nevertheless, a surveillance system for NTM has not been established in most countries, thus requiring repeated, intermittent and time-consuming cross-sectional nationwide surveys.</p><p><strong>Methods: </strong>To establish a nationwide surveillance system for NTM-associated diseases, we aimed to develop a prototype computer system primarily designed to continuously estimate NTM-PD incidence using a bacteriological case-defining algorithm through an automatic process of integrating bacteriological data collected from microbiology laboratories across Japan. To validate the accuracy of our study results, we compared the distribution of pulmonary tuberculosis cases between our laboratory data and the national surveillance data, which is representative of the Japanese population.</p><p><strong>Results: </strong>Our estimates implied a 17.7% increase in NTM-PD incidence from 15.8 (14.9-16.8) in 2013 to 19.2 (18.2-20.4) in 2017, per 100 000 population. Moreover, 93.0% of the identified NTM-PD cases were dominated by the <i>Mycobacterium avium</i>-<i>intracellulare</i> complex, and the proportion of <i>M. abscessus</i> species exceeded that of <i>M. kansasii</i> for the first time in Japan. We also revealed significant age and sex differences in NTM-PDs. Notably, we found similar characteristics between our laboratory data and national surveillance data covering almost the entire Japanese population.</p><p><strong>Conclusion: </strong>These findings, despite being laboratory-based, are extrapolatable to the general population in Japan and provide evidence that supports our system as a viable alternative to the nationwide NTM surveillance system.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440313","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}
引用次数: 0
Proteome signature for differential diagnosis of patients with bilateral lung infiltrates.
IF 4.3 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI: 10.1183/23120541.00762-2024
Yumi Oh, Kyunggon Kim, Ho Jeong Kim, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Hee-Sung Ahn, Jin Won Huh

Background: The differential diagnosis of bilateral lung infiltrates and prognosis prediction can be challenging for clinicians in the intensive care unit (ICU). We analysed the proteome from bronchoalveolar lavage fluid (BALF) and determined its usefulness for evaluating the infectious causes and mortality associated with bilateral lung infiltrates.

Methods: In the ICU cohort, 136 patients with bilateral infiltrate on chest radiographs were selected, and bronchoscopy with bronchoalveolar lavage (BAL) was performed. Proteomic profiling of the exosomes in the BALF (n=20) was conducted to identify candidate protein biomarkers potentially associated with infection or mortality. The BAL samples (n=116) were used to measure the candidate biomarker levels.

Results: The candidate biomarkers, CD20, CLIC4, SCFD1 and TAP1, were selected for the differential diagnosis of infection or mortality. The levels of CD20 were significantly elevated in patients with non-infectious causes, compared with those with infectious causes (248.6±154.5 versus 177.6±150.9 ng·mL-1, p=0.014). The levels of CLIC4, SCFD1 and TAP1 did not differ between the two groups. As per the receiver operating characteristic analysis, CD20 was a significant predictor of non-infectious causes (area under curve 0.668; 95% confidence interval 0.567-0.769; p=0.002; cut-off value 167.6 ng·mL-1; sensitivity 74.1%; specificity 63.2%). There were no significant differences in the concentrations of the biomarkers between survivors and non-survivors.

Conclusions: Our results suggest that CD20 levels in BALF might be a useful biomarker for differentiating non-infectious and infectious diseases in patients with bilateral lung infiltrates.

{"title":"Proteome signature for differential diagnosis of patients with bilateral lung infiltrates.","authors":"Yumi Oh, Kyunggon Kim, Ho Jeong Kim, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Hee-Sung Ahn, Jin Won Huh","doi":"10.1183/23120541.00762-2024","DOIUrl":"https://doi.org/10.1183/23120541.00762-2024","url":null,"abstract":"<p><strong>Background: </strong>The differential diagnosis of bilateral lung infiltrates and prognosis prediction can be challenging for clinicians in the intensive care unit (ICU). We analysed the proteome from bronchoalveolar lavage fluid (BALF) and determined its usefulness for evaluating the infectious causes and mortality associated with bilateral lung infiltrates.</p><p><strong>Methods: </strong>In the ICU cohort, 136 patients with bilateral infiltrate on chest radiographs were selected, and bronchoscopy with bronchoalveolar lavage (BAL) was performed. Proteomic profiling of the exosomes in the BALF (n=20) was conducted to identify candidate protein biomarkers potentially associated with infection or mortality. The BAL samples (n=116) were used to measure the candidate biomarker levels.</p><p><strong>Results: </strong>The candidate biomarkers, CD20, CLIC4, SCFD1 and TAP1, were selected for the differential diagnosis of infection or mortality. The levels of CD20 were significantly elevated in patients with non-infectious causes, compared with those with infectious causes (248.6±154.5 <i>versus</i> 177.6±150.9 ng·mL<sup>-1</sup>, p=0.014). The levels of CLIC4, SCFD1 and TAP1 did not differ between the two groups. As per the receiver operating characteristic analysis, CD20 was a significant predictor of non-infectious causes (area under curve 0.668; 95% confidence interval 0.567-0.769; p=0.002; cut-off value 167.6 ng·mL<sup>-1</sup>; sensitivity 74.1%; specificity 63.2%). There were no significant differences in the concentrations of the biomarkers between survivors and non-survivors.</p><p><strong>Conclusions: </strong>Our results suggest that CD20 levels in BALF might be a useful biomarker for differentiating non-infectious and infectious diseases in patients with bilateral lung infiltrates.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440328","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}
引用次数: 0
Neutrophilic inflammation in sputum or blood does not define a clinically distinct asthma phenotype in ATLANTIS.
IF 4.3 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-02-17 eCollection Date: 2025-01-01 DOI: 10.1183/23120541.00616-2024
Pauline J M Kuks, Tessa M Kole, Monica Kraft, Salman Siddiqui, Leonardo M Fabbri, Klaus F Rabe, Alberto Papi, Chris Brightling, Dave Singh, Thys van der Molen, Jan Willem W H Kocks, Kian Fan Chung, Ian M Adcock, Pankaj K Bhavsar, Nazanin Zounemat Kermani, Irene H Heijink, Simon D Pouwels, Huib A M Kerstjens, Dirk-Jan Slebos, Maarten van den Berge

Introduction: Neutrophilic asthma has been suggested to be a clinically distinct phenotype characterised by more severe airflow obstruction and higher exacerbation risk. However, this has only been assessed in few and smaller studies, using different cut-offs to define neutrophilia, and with conflicting results. We used data from ATLANTIS, an observational longitudinal study including a large number of patients with asthma and healthy controls. The aim of the present study was to examine whether neutrophilic inflammation, either in sputum or blood, is more prevalent in asthma and whether it correlates with disease severity.

Methods: ATLANTIS included 773 asthma patients, with blood collected from 767 (99%) and sputum from 228 patients (30%). Data were available from 244 healthy controls, all providing blood and 126 (52%) providing sputum. Asthma patients were characterised, including parameters of large and small airways disease at baseline and after 6 and 12 months of follow-up. Sputum and blood neutrophilia were defined as values exceeding the upper quartile in asthma patients.

Results: The prevalence of sputum neutrophilia did not differ between asthma patients and healthy controls. Asthma patients with sputum neutrophilia did not display more severe symptoms, large or small airways disease or more frequent exacerbations. Blood neutrophilia was more common in asthma and was associated with higher body mass index, female sex, current smoking and systemic corticosteroid use. Patients with blood neutrophilia had a statistically significant, but small, increase in residual volume/total lung capacity. Blood neutrophilia was not associated with large or small airways disease or exacerbation risk.

Conclusion: Sputum and blood neutrophilia do not define a distinct clinical phenotype in asthma.

{"title":"Neutrophilic inflammation in sputum or blood does not define a clinically distinct asthma phenotype in ATLANTIS.","authors":"Pauline J M Kuks, Tessa M Kole, Monica Kraft, Salman Siddiqui, Leonardo M Fabbri, Klaus F Rabe, Alberto Papi, Chris Brightling, Dave Singh, Thys van der Molen, Jan Willem W H Kocks, Kian Fan Chung, Ian M Adcock, Pankaj K Bhavsar, Nazanin Zounemat Kermani, Irene H Heijink, Simon D Pouwels, Huib A M Kerstjens, Dirk-Jan Slebos, Maarten van den Berge","doi":"10.1183/23120541.00616-2024","DOIUrl":"https://doi.org/10.1183/23120541.00616-2024","url":null,"abstract":"<p><strong>Introduction: </strong>Neutrophilic asthma has been suggested to be a clinically distinct phenotype characterised by more severe airflow obstruction and higher exacerbation risk. However, this has only been assessed in few and smaller studies, using different cut-offs to define neutrophilia, and with conflicting results. We used data from ATLANTIS, an observational longitudinal study including a large number of patients with asthma and healthy controls. The aim of the present study was to examine whether neutrophilic inflammation, either in sputum or blood, is more prevalent in asthma and whether it correlates with disease severity.</p><p><strong>Methods: </strong>ATLANTIS included 773 asthma patients, with blood collected from 767 (99%) and sputum from 228 patients (30%). Data were available from 244 healthy controls, all providing blood and 126 (52%) providing sputum. Asthma patients were characterised, including parameters of large and small airways disease at baseline and after 6 and 12 months of follow-up. Sputum and blood neutrophilia were defined as values exceeding the upper quartile in asthma patients.</p><p><strong>Results: </strong>The prevalence of sputum neutrophilia did not differ between asthma patients and healthy controls. Asthma patients with sputum neutrophilia did not display more severe symptoms, large or small airways disease or more frequent exacerbations. Blood neutrophilia was more common in asthma and was associated with higher body mass index, female sex, current smoking and systemic corticosteroid use. Patients with blood neutrophilia had a statistically significant, but small, increase in residual volume/total lung capacity. Blood neutrophilia was not associated with large or small airways disease or exacerbation risk.</p><p><strong>Conclusion: </strong>Sputum and blood neutrophilia do not define a distinct clinical phenotype in asthma.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440324","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}
引用次数: 0
Laryngeal mask airway or high-flow nasal cannula versus nasal cannula for advanced bronchoscopy: a randomised controlled trial.
IF 4.3 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-02-10 eCollection Date: 2025-01-01 DOI: 10.1183/23120541.00421-2024
Regina Pikman Gavriely, Ophir Freund, Boaz Tiran, Tal Moshe Perluk, Eyal Kleinhendler, Idit Matot, Amir Bar-Shai, Evgeni Gershman

Background: Advanced bronchoscopic procedures have become a widely prevalent evaluation and treatment modality. These procedures require appropriate sedation and respiratory support. This study directly compares three respiratory support methods during advanced bronchoscopy.

Methods: This three-arm, prospective, block randomised trial included 60 consenting adult patients that were referred for advanced bronchoscopy involving endobronchial ultrasound (EBUS) with transbronchial needle aspiration and met inclusion/exclusion criteria. Patients were randomised to undergo bronchoscopy through a laryngeal mask airway (LMA) or with a high-flow nasal cannula (HFNC) or low-flow nasal cannula (NC), with bronchoscopy performed through a bite block. Demographic, procedural and clinical parameters were compared between the three groups, including complications, oxygenation, ventilation and need for intervention.

Results: Analysis according to intention to treat was made for the 20 patients in each arm. There were no significant differences in demographic parameters, pre-morbidities and procedure type and duration between groups. Hypoxia was significantly more common in the NC group (90%) compared with the LMA (45%) and HFNC (26%) groups (p<0.01). The need for interventions and their number were also lower in the LMA (40%) and HFNC (52.6%) groups compared with the NC group (90%, p<0.01). A multivariate analysis confirmed both HFNC and LMA as independent predictors of a lower rate of recurrent desaturation events and fewer complications in general compared with NC.

Conclusion: In this prospective randomised trial, we demonstrated the advantages of using LMA or HFNC over NC during advanced bronchoscopy with EBUS.

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引用次数: 0
Respiratory sequelae in patients with bronchial asthma after SARS-CoV-2 pneumonia: a retrospective study in a large academic centre in 2020.
IF 4.3 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-02-10 eCollection Date: 2025-01-01 DOI: 10.1183/23120541.00510-2024
David Espejo, Florencia Pilia, Christian Romero-Mesones, Inigo Ojanguren, María-Jesús Cruz, Xavier Muñoz

Patients with asthma do not present more respiratory sequelae than a control population after SARS-CoV-2 pneumonia. However, patients with asthma do seem to present more symptoms and a distinct involvement of the airway https://bit.ly/47E6Hze.

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引用次数: 0
Cough frequency has a high daily variation in patients with chronic cough.
IF 4.3 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-02-10 eCollection Date: 2025-01-01 DOI: 10.1183/23120541.00670-2024
Alyn Morice, Mitja Alge, Laura Kuett, Simon Hart, Alan Rigby, David Elkayam

Continuous cough monitoring using a wearable device analysed by machine learning for automated cough detection has revealed considerable day-to-day variability in cough counts. Single-day recording is thus subject to error. https://bit.ly/3yYCRbX.

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引用次数: 0
期刊
ERJ Open Research
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