ERJ Open Research最新文献

Background: Low-grade systemic inflammation is linked to abnormal spirometry. Impulse oscillometry (IOS) is sensitive in detecting peripheral airway dysfunction, but inflammation in relation to IOS is poorly studied. The objectives of the present study were to analyse associations between C-reactive protein (CRP), blood eosinophils (B-Eos), blood neutrophils (B-Neu), blood lymphocytes (B-Lym), blood leukocytes (B-Leu), blood monocytes (B-Mono) and IOS.

Methods: Blood biomarkers and IOS were assessed in 10 602 adults (aged 50-65 years) within the Swedish CardioPulmonary bioImage Study (SCAPIS). Upper tertiles for CRP (>1.80 mg·L^-1), B-Eos (>0.20 10⁹·L^-1), B-Neu (>3.40 10⁹·L^-1), B-Lym (>2.00 10⁹·L^-1), B-Leu (>6.10 10⁹·L^-1) and B-Mono (>0.50 10⁹·L^-1) were analysed in relation to the following abnormal IOS indices: resistance at 5 Hz, resistance at 20 Hz, area of reactance, resonant frequency (>95th percentile) and reactance at 5 Hz (<5th percentile), based on healthy, never-smoking SCAPIS participants.

Results: Abnormal IOS was observed in 1715 (16.2%), of which 580 (33.8%) also had abnormal spirometry. Having several blood biomarkers in the upper tertile (1, 2-3 or 4-6 versus 0) was overall associated with abnormal IOS; adjusted odds ratios (OR) and 95% confidence intervals (CI) ranging from 1.19 (1.02-1.38) to 2.27 (1.79-2.89). Furthermore, having 2-3 or more blood biomarkers versus 0 in the upper tertile was overall linked to abnormal IOS in participants with normal spirometry; adjusted OR (95% CI) ranging from 1.43 (1.17-1.75) to 1.75 (1.29-2.38).

Conclusions: Low-grade systemic inflammation was related to abnormal IOS and appeared consistent even when participants had normal spirometry.

In people with chronic respiratory disease undertaking pulmonary rehabilitation, approximately 1/3 developed an exacerbation; however, there was no difference between telerehabilitation and centre-based group settings, and no effect on programme completion https://bit.ly/4bXe2dy.

Background: Lung function outcomes in pulmonary Langerhans cell histiocytosis (PLCH) patients are variable and difficult to predict. Our goal was to identify different forced expiratory volume in 1 s (FEV₁) trajectories in these patients during long-term follow-up.

Methods: All newly diagnosed adult PLCH patients seen between January 2004 and April 2018 were eligible for inclusion in our prospective cohort. The primary end-point was the identification of FEV₁ trajectories using a joint latent class model for longitudinal and time-to-event data. Internal validation was performed via bootstrapping.

Results: Among the 191 patients included (mean age of 39±12 years, 59% females, 96% current smokers), who were followed for a median of 5.1 years (interquartile range 3.2-6.0), two FEV₁ trajectories were identified. Patients with trajectory 1 (n=157, 82.2%) were characterised by a normal FEV₁ at diagnosis (mean predicted value (pred) of 95±3%) that remained stable over time (annual variation of 0.2% pred, 95% CI -0.8-0.4). Patients with trajectory 2 (n=34, 17.8%) had a decreased initial FEV₁ (63±7% pred) and an annual decrease of -1.8% pred (-3.4--0.2). Trajectory 2 was associated with increased mortality (hazard ratio 9.46, 95% CI 1.24-72.2; p=0.03).

Conclusions: FEV₁ remained stable in most PLCH patients, but the subgroup of patients that experienced a significant decrease in FEV₁ over time had a poorer prognosis. These patients should be closely monitored for early therapeutic intervention. These results need to be confirmed in an external validation cohort.

ERJ Open Research has reached an important milestone: its 10th anniversary. The journal remains dedicated to fostering innovation, collaboration and mentorship in the decade ahead. https://bit.ly/3PS6UXk.

Background: The ECLIPSE study was a large, international, prospective, controlled, observational study that included COPD patients (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 2-4), as well as smoking and non-smoking participants with normal spirometry, aged 40-75 years, who were followed-up regularly for 3 years. Here we sought to contrast the clinical and biological characteristics of young COPD versus controls of similar age and older COPD patients included in ECLIPSE.

Methods: We compared 106 young (<50 years) and 488 old (>70 years) COPD patients, as well as 119 young smokers and 92 nonsmoker controls (<50 years) with normal spirometry.

Results: Young COPD patients: 1) were more symptomatic than young controls, often reported a family history of chronic bronchitis, emphysema and asthma, as well as a personal history of asthma and bronchitis, and suffered from a similar disease burden to older patients; 2) were at higher risk of substantial forced expiratory volume in 1 s decline over time; and 3) had reduced serum levels of CC16 (a lung-derived anti-inflammatory protein that relates to lung damage) and, at the same time, reduced pro-inflammatory markers compared to older COPD patients.

Conclusions: Young COPD patients suffer from significant disease burden, display an altered biomarker and disease progression profile reflected by an accelerated risk of lung function decline highlighting the need for early life diagnosis, prevention approaches and treatment.

IMPACT post hoc analysis identified higher COPD exacerbation rates in winter versus summer. Exacerbation risk was significantly reduced with FF/UMEC/VI versus dual therapy regardless of season, highlighting the durability of response with triple therapy. https://bit.ly/47KAhmK.

People living with interstitial lung disease and chronic cough have unique experiences in their cough characteristics, triggers, management strategies and overall impact on quality of life https://bit.ly/4e8vNZl.

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.

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].

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.