The high prevalence of poor sleep quality in patients with chronic respiratory diseases makes it an important clinical topic. However, the prevalence and characteristics of poor sleep quality in those with nontuberculous mycobacterial pulmonary disease and its association with clinical variables remain unclear.
Methods
This retrospective study involved patients with nontuberculous mycobacterial pulmonary disease between June 2017 and May 2022. The prevalence of poor sleep quality was measured by the Pittsburgh Sleep Quality Index was used to and its association with clinical variables including age, sex, laboratory data, pulmonary function, respiratory symptoms, mental health, health-related quality of life, and physical function was assessed.
Results
The median age of 233 participants was 65 years, with poor sleep quality present in 123 patients (52.8%) who were older, female, and unemployed with dyspnea, anxiety symptoms, low health-related quality of life, and low exercise capacity. Many reported that they "cannot get to sleep within 30 min," "wake up in the middle of the night or early morning," "have to get up to use the bathroom," "cannot breathe comfortably," or "cough or snore loudly." Multivariate logistic regression analysis indicated a significant association between poor sleep quality, female sex, and low health-related quality of life.
Conclusion
Our results suggested that for the patients in this study, a multidisciplinary management that considers poor sleep quality is required and assessment of sleep quality as a screening is needed.
{"title":"Association of poor sleep quality with clinical variables in nontuberculous mycobacterial pulmonary disease","authors":"Yuki Toyoda , Mitsuru Tabusadani , Yusuke Matsumura , Kosuke Mori , Kazuki Ono , Kazuma Kawahara , Shunya Omatsu , Koji Furuuchi , Keiji Fujiwara , Kozo Morimoto , Hideaki Senjyu , Ryo Kozu","doi":"10.1016/j.resinv.2025.01.005","DOIUrl":"10.1016/j.resinv.2025.01.005","url":null,"abstract":"<div><h3>Background</h3><div>The high prevalence of poor sleep quality in patients with chronic respiratory diseases makes it an important clinical topic. However, the prevalence and characteristics of poor sleep quality in those with nontuberculous mycobacterial pulmonary disease and its association with clinical variables remain unclear.</div></div><div><h3>Methods</h3><div>This retrospective study involved patients with nontuberculous mycobacterial pulmonary disease between June 2017 and May 2022. The prevalence of poor sleep quality was measured by the Pittsburgh Sleep Quality Index was used to and its association with clinical variables including age, sex, laboratory data, pulmonary function, respiratory symptoms, mental health, health-related quality of life, and physical function was assessed.</div></div><div><h3>Results</h3><div>The median age of 233 participants was 65 years, with poor sleep quality present in 123 patients (52.8%) who were older, female, and unemployed with dyspnea, anxiety symptoms, low health-related quality of life, and low exercise capacity. Many reported that they \"cannot get to sleep within 30 min,\" \"wake up in the middle of the night or early morning,\" \"have to get up to use the bathroom,\" \"cannot breathe comfortably,\" or \"cough or snore loudly.\" Multivariate logistic regression analysis indicated a significant association between poor sleep quality, female sex, and low health-related quality of life.</div></div><div><h3>Conclusion</h3><div>Our results suggested that for the patients in this study, a multidisciplinary management that considers poor sleep quality is required and assessment of sleep quality as a screening is needed.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 2","pages":"Pages 210-215"},"PeriodicalIF":2.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075319","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}
Pub Date : 2025-01-15DOI: 10.1016/j.resinv.2024.12.017
Hisao Imai
Pleural mesothelioma (PM) is a rare and highly aggressive malignancy originating from the pleural lining, with a median overall survival of merely 1 year. This cancer primarily arises from mesothelial cells following exposure to carcinogenic, biopersistent mineral fibers, particularly asbestos. The histological subtypes of mesothelioma are epithelioid (approximately 60%), sarcomatoid (20%), and biphasic (20%), exhibiting epithelioid and sarcomatoid characteristics. Classification is important for prognosis and guides the therapeutic strategy. Due to the typical late presentation, most patients with PM are ineligible for localized treatments such as surgery or radiotherapy. Systemic therapy, including cytotoxic chemotherapy, targeted therapies, and immunotherapy, is thus critical for managing advanced PM. For unresectable PM, decisions regarding systemic treatment are guided by patient suitability and histological characteristics. First-line therapies for advanced PM currently include the cisplatin–pemetrexed combination and the nivolumab–ipilimumab regimen. Historically, cisplatin–pemetrexed has been administered as first-line treatment, though recent advancements have introduced new therapies that significantly prolong patient survival. Innovative approaches combining immunotherapy and chemotherapy offer promising avenues for further improvement. Future treatment strategies should incorporate novel paradigms, such as combination chemo-immunotherapy, targeted agents, and potential cellular therapies, alongside companion biomarkers tailored to the histologic and molecular diversity of mesothelioma. This review explores the latest advancements in drug therapy for PM and provides an overview of current systemic treatment options.
{"title":"Current drug therapy for pleural mesothelioma","authors":"Hisao Imai","doi":"10.1016/j.resinv.2024.12.017","DOIUrl":"10.1016/j.resinv.2024.12.017","url":null,"abstract":"<div><div>Pleural mesothelioma (PM) is a rare and highly aggressive malignancy originating from the pleural lining, with a median overall survival of merely 1 year. This cancer primarily arises from mesothelial cells following exposure to carcinogenic, biopersistent mineral fibers, particularly asbestos. The histological subtypes of mesothelioma are epithelioid (approximately 60%), sarcomatoid (20%), and biphasic (20%), exhibiting epithelioid and sarcomatoid characteristics. Classification is important for prognosis and guides the therapeutic strategy. Due to the typical late presentation, most patients with PM are ineligible for localized treatments such as surgery or radiotherapy. Systemic therapy, including cytotoxic chemotherapy, targeted therapies, and immunotherapy, is thus critical for managing advanced PM. For unresectable PM, decisions regarding systemic treatment are guided by patient suitability and histological characteristics. First-line therapies for advanced PM currently include the cisplatin–pemetrexed combination and the nivolumab–ipilimumab regimen. Historically, cisplatin–pemetrexed has been administered as first-line treatment, though recent advancements have introduced new therapies that significantly prolong patient survival. Innovative approaches combining immunotherapy and chemotherapy offer promising avenues for further improvement. Future treatment strategies should incorporate novel paradigms, such as combination chemo-immunotherapy, targeted agents, and potential cellular therapies, alongside companion biomarkers tailored to the histologic and molecular diversity of mesothelioma. This review explores the latest advancements in drug therapy for PM and provides an overview of current systemic treatment options.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 2","pages":"Pages 200-209"},"PeriodicalIF":2.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-09DOI: 10.1016/j.resinv.2024.12.016
Yaling Liu , Hao Zhu , Hao Chen , Yang Gao , Tingyin Wang , Xiaodong Wang , Hong Xie
Background
The mechanism underlying necroptosis in pulmonary vessel endothelial cells (PVECs) resulting from long non-coding RNA (lncRNA)-induced alternative splicing (AS) of target genes in acute lung injury (ALI) remains unclear.
Methods
Lipopolysaccharide (LPS)-induced expression of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and lncRNAs was analyzed via RT-PCR in PVECs. Full-transcriptome sequencing was used to detect AS-related mRNAs. The interaction between lncRNA MALAT1 and target gene transmembrane BAX inhibitor motif-containing 6 (TMBIM6) was verified using a dual-luciferase reporter system. Necroptosis was measured as protein levels of phosphorylated receptor-interacting serine/threonine kinase 1 (RIPK1), RIPK3, and mixed-lineage kinase domain-like (MLKL) proteins, as well as flow cytometer measurement. Antisense of MALAT1, TMBIM6, TMBIM6-225 and RIPK1 inhibitor were transfected into a rat model of LPS-induced ALI. Hematoxylin and eosin (H&E) and immunohistochemical staining were performed to evaluate lung injury.
Results
LPS upregulated the expression of TNF-α, IL-1β, IL-6, p-RIPK1, p-RIPK3, p-MLKL, MALAT1, and TMBIM6-225 (an AS isoform of MALAT1-targeted gene TMBIM6) in PVECs. However, it downregulated the expression of TMBIM6. An antisense of MALAT1 inhibited TMBIM6-225 and downregulated p-MLKL. The pro-necroptotic effect of MALAT1 was verified in an LPS-induced MALAT1/shMALAT1-transfected ALI rat model in vivo. The necroptotic effect was reversed by treatment with necrostatin-1.
Conclusions
LPS-induced MALAT1 causes AS of TMBIM6, and the AS variant TMBIM6-225 aggravates ALI by promoting PVEC necroptosis via the p-RIPK1, p-RIPK3, and p-MLKL complex.
{"title":"LPS-induced TMBIM6 splicing drives endothelial necroptosis and aggravates ALI","authors":"Yaling Liu , Hao Zhu , Hao Chen , Yang Gao , Tingyin Wang , Xiaodong Wang , Hong Xie","doi":"10.1016/j.resinv.2024.12.016","DOIUrl":"10.1016/j.resinv.2024.12.016","url":null,"abstract":"<div><h3>Background</h3><div>The mechanism underlying necroptosis in pulmonary vessel endothelial cells (PVECs) resulting from long non-coding RNA (lncRNA)-induced alternative splicing (AS) of target genes in acute lung injury (ALI) remains unclear.</div></div><div><h3>Methods</h3><div>Lipopolysaccharide (LPS)-induced expression of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and lncRNAs was analyzed via RT-PCR in PVECs. Full-transcriptome sequencing was used to detect AS-related mRNAs. The interaction between lncRNA MALAT1 and target gene transmembrane BAX inhibitor motif-containing 6 (TMBIM6) was verified using a dual-luciferase reporter system. Necroptosis was measured as protein levels of phosphorylated receptor-interacting serine/threonine kinase 1 (RIPK1), RIPK3, and mixed-lineage kinase domain-like (MLKL) proteins, as well as flow cytometer measurement. Antisense of MALAT1, TMBIM6, TMBIM6-225 and RIPK1 inhibitor were transfected into a rat model of LPS-induced ALI. Hematoxylin and eosin (H&E) and immunohistochemical staining were performed to evaluate lung injury.</div></div><div><h3>Results</h3><div>LPS upregulated the expression of TNF-α, IL-1β, IL-6, p-RIPK1, p-RIPK3, p-MLKL, MALAT1, and TMBIM6-225 (an AS isoform of MALAT1-targeted gene TMBIM6) in PVECs. However, it downregulated the expression of TMBIM6. An antisense of MALAT1 inhibited TMBIM6-225 and downregulated p-MLKL. The pro-necroptotic effect of MALAT1 was verified in an LPS-induced MALAT1/shMALAT1-transfected ALI rat model <em>in vivo</em>. The necroptotic effect was reversed by treatment with necrostatin-1.</div></div><div><h3>Conclusions</h3><div>LPS-induced MALAT1 causes AS of TMBIM6, and the AS variant TMBIM6-225 aggravates ALI by promoting PVEC necroptosis via the p-RIPK1, p-RIPK3, and p-MLKL complex.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 2","pages":"Pages 191-199"},"PeriodicalIF":2.4,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142954023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The prognostic factors in mild fibrosing interstitial lung disease (FILD) have not been established.
Methods
We retrospectively attempted to identify predictive factors of annual progression in mild FILD with gender-age-physiology (GAP) score of 3 or less using logistic regression analysis. Annual FILD progression was defined as meeting any two or more of the following conditions: 1, more than 10% decrease in forced vital capacity (FVC) or 15% decrease in diffusing capacity of the lungs for carbon monoxide (DLCO); 2, worsening of dyspnea; 3, worsening of fibrotic change on CT at 1 year after admission.
Results
Univariate analysis showed that diagnosis of connective tissue disease-associated ILD, CT-definite usual interstitial pneumonia (UIP) pattern, composite physiologic index, FVC, DLCO, lowest SpO2 and decrease in SpO2, and walk distance in the 6-minutes walk test (6MWT), chronic pulmonary emphysema assessment test (CAT) score, and some variables in Short-Form 36 were significantly associated with incidence of annual progression. Multivariate analysis showed that independent predictive factors were diagnosis of idiopathic pulmonary fibrosis (IPF) and fibrotic hypersensitivity pneumonitis (HP), CT-definite UIP pattern, lowest SpO2 and decrease in SpO2 in the 6MWT, and CAT score. In logistic regression analysis among 63 patients with non-IPF-ILD, diagnosis with fibrotic HP, lowest SpO2 and decrease in SpO2 in the 6MWT, and CAT score were also independent risk factors for annual FILD progression.
Conclusions
Exercise-induced hypoxia, patient-reported outcome, radiological UIP pattern, and diagnosis with fibrotic HP are independent predictors of annual progression in mild FILD.
{"title":"Predictive factors of progression in mild fibrosing interstitial lung disease patients with gender-age-physiology score of 3 or less","authors":"Masaki Okamoto , Kiminori Fujimoto , Tomonori Chikasue , Toyoshi Yanagihara , Kazuhiro Tabata , Yoshiaki Zaizen , Masaki Tominaga , Akiko Sumi , Hiroaki Takeoka , Norikazu Matsuo , Takashi Nouno , Atsushi Kawaguchi , Tomoaki Hoshino","doi":"10.1016/j.resinv.2024.12.005","DOIUrl":"10.1016/j.resinv.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>The prognostic factors in mild fibrosing interstitial lung disease (FILD) have not been established.</div></div><div><h3>Methods</h3><div>We retrospectively attempted to identify predictive factors of annual progression in mild FILD with gender-age-physiology (GAP) score of 3 or less using logistic regression analysis. Annual FILD progression was defined as meeting any two or more of the following conditions: 1, more than 10% decrease in forced vital capacity (FVC) or 15% decrease in diffusing capacity of the lungs for carbon monoxide (D<sub>LCO</sub>); 2, worsening of dyspnea; 3, worsening of fibrotic change on CT at 1 year after admission.</div></div><div><h3>Results</h3><div>Univariate analysis showed that diagnosis of connective tissue disease-associated ILD, CT-definite usual interstitial pneumonia (UIP) pattern, composite physiologic index, FVC, D<sub>LCO</sub>, lowest SpO<sub>2</sub> and decrease in SpO<sub>2</sub>, and walk distance in the 6-minutes walk test (6MWT), chronic pulmonary emphysema assessment test (CAT) score, and some variables in Short-Form 36 were significantly associated with incidence of annual progression. Multivariate analysis showed that independent predictive factors were diagnosis of idiopathic pulmonary fibrosis (IPF) and fibrotic hypersensitivity pneumonitis (HP), CT-definite UIP pattern, lowest SpO<sub>2</sub> and decrease in SpO<sub>2</sub> in the 6MWT, and CAT score. In logistic regression analysis among 63 patients with non-IPF-ILD, diagnosis with fibrotic HP, lowest SpO<sub>2</sub> and decrease in SpO<sub>2</sub> in the 6MWT, and CAT score were also independent risk factors for annual FILD progression.</div></div><div><h3>Conclusions</h3><div>Exercise-induced hypoxia, patient-reported outcome, radiological UIP pattern, and diagnosis with fibrotic HP are independent predictors of annual progression in mild FILD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 109-117"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847526","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}
Pub Date : 2025-01-01DOI: 10.1016/j.resinv.2024.12.012
Eeshal Fatima , Obaid Ur Rehman , Zain Ali Nadeem , Umar Akram , Riyan Imtiaz Karamat , Muhammad Omar Larik , Maurish Fatima , Joshua Chitwood , Arslan Ahmad , Sarah Esposito , Abdulqadir J. Nashwan
Background
We evaluated the efficacy and safety of Ensifentrine in COPD via a systematic review and meta-analysis of randomized controlled trials (RCTs).
Methods
We performed a detailed literature search on Medline (via PubMed), Scopus, Google Scholar, and Cochrane on the basis of pre-specified eligibility criteria. We used Review Manager to calculate pooled mean differences (MD) and 95% Confidence Interval (CI) using a random effects model. The Cochrane's Risk of Bias 2 (RoB-2) tool was used to assess the risk of bias in the included RCTs.
Results
A total of 4 studies, consisting of 2020 patients, were included in the meta-analysis. The mean age ranged from 62.5 years to 65.5 years in the included studies. All the included studies were at low risk of bias. Ensifentrine 3 mg dose significantly improved the mean peak Forced Expiratory Volume-1 (FEV-1), morning trough FEV-1, TDI score, ERS score, and SGRQ-C score as compared to the placebo, yielding a pooled MD of 149.76 (95% CI, 127.9 to 171.6), 43.93 (95% CI, 23.82 to 64.05), 0.92 (95% CI, 0.64 to 1.21, −1.20 (95% CI, −1.99 to −0.40), and −1.92 (95% CI, −3.24 to −0.59), respectively.
Conclusion
Ensifentrine is associated with improvements in outcomes related to COPD symptoms such as peak FEV-1, morning trough FEV-1 and TDI in the patients suffering from this chronic disease. It is also associated with improved quality of life as seen by E-RS score and SGRQ-C score.
{"title":"Efficacy and safety of ensifentrine, a novel phosphodiesterase 3 and 4 inhibitor, in chronic obstructive pulmonary disease: A systematic review and meta-analysis","authors":"Eeshal Fatima , Obaid Ur Rehman , Zain Ali Nadeem , Umar Akram , Riyan Imtiaz Karamat , Muhammad Omar Larik , Maurish Fatima , Joshua Chitwood , Arslan Ahmad , Sarah Esposito , Abdulqadir J. Nashwan","doi":"10.1016/j.resinv.2024.12.012","DOIUrl":"10.1016/j.resinv.2024.12.012","url":null,"abstract":"<div><h3>Background</h3><div>We evaluated the efficacy and safety of Ensifentrine in COPD via a systematic review and meta-analysis of randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>We performed a detailed literature search on Medline (via PubMed), Scopus, Google Scholar, and Cochrane on the basis of pre-specified eligibility criteria. We used Review Manager to calculate pooled mean differences (MD) and 95% Confidence Interval (CI) using a random effects model. The Cochrane's Risk of Bias 2 (RoB-2) tool was used to assess the risk of bias in the included RCTs.</div></div><div><h3>Results</h3><div>A total of 4 studies, consisting of 2020 patients, were included in the meta-analysis. The mean age ranged from 62.5 years to 65.5 years in the included studies. All the included studies were at low risk of bias. Ensifentrine 3 mg dose significantly improved the mean peak Forced Expiratory Volume-1 (FEV-1), morning trough FEV-1, TDI score, ERS score, and SGRQ-C score as compared to the placebo, yielding a pooled MD of 149.76 (95% CI, 127.9 to 171.6), 43.93 (95% CI, 23.82 to 64.05), 0.92 (95% CI, 0.64 to 1.21, −1.20 (95% CI, −1.99 to −0.40), and −1.92 (95% CI, −3.24 to −0.59), respectively.</div></div><div><h3>Conclusion</h3><div>Ensifentrine is associated with improvements in outcomes related to COPD symptoms such as peak FEV-1, morning trough FEV-1 and TDI in the patients suffering from this chronic disease. It is also associated with improved quality of life as seen by E-RS score and SGRQ-C score.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 146-155"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Subacute cough is subdivided and distinguished from chronic cough, because post-infectious cough is considered to be the main cause of subacute cough and differs from acute and chronic cough. However, the details of the spectrum and frequency of causes of subacute cough remain unclear because only two studies on subacute cough have been published.
Methods
Patients who presented with cough that lasted for 3–8 weeks and visited respiratory clinics or hospitals affiliated with the Japan Cough Society during 2 years were studied.
Results
A total of 148 patients were prospectively enrolled, and those who did not meet the definition of subacute cough were excluded. Ninety-seven (68.3%) patients with subacute cough progressed to chronic cough, and the main causative diseases were cough variant asthma in 44 patients, atopic cough in 24 patients, sinobronchial syndrome in 13 patients, and post-infectious cough in seven patients. Patients with cough variant asthma complicated by atopic cough and those in whom the cause of subacute cough was unknown tended to develop chronic cough.
Conclusions
This study shows that post-infectious cough is less common than previously thought and the main causes of subacute cough are cough variant asthma, atopic cough, and sinobronchial syndrome and their complications. Cough variant asthma in combination with atopic cough also can be a precursor of refractory chronic cough. The careful diagnosis and treatment of two or more causative diseases is required in patients with subacute cough.
{"title":"Prevalence and causes of subacute cough in Japan","authors":"Yoshihisa Ishiura , Masaki Fujimura , Haruhiko Ogawa , Johsuke Hara , Hiromoto Shintani , Soichiro Hozawa , Ryo Atsuta , Kensuke Fukumitsu , Hideki Inoue , Takanobu Shioya , Masato Muraki , Tokunao Amemiya , Noriyuki Ohkura , Yoshitaka Oribe , Hiroshi Tanaka , Takechiyo Yamada , Mikio Toyoshima , Katsuya Fujimori , Tamotsu Ishizuka , Manabu Kagaya , Akio Niimi","doi":"10.1016/j.resinv.2024.11.007","DOIUrl":"10.1016/j.resinv.2024.11.007","url":null,"abstract":"<div><h3>Background</h3><div>Subacute cough is subdivided and distinguished from chronic cough, because post-infectious cough is considered to be the main cause of subacute cough and differs from acute and chronic cough. However, the details of the spectrum and frequency of causes of subacute cough remain unclear because only two studies on subacute cough have been published.</div></div><div><h3>Methods</h3><div>Patients who presented with cough that lasted for 3–8 weeks and visited respiratory clinics or hospitals affiliated with the Japan Cough Society during 2 years were studied.</div></div><div><h3>Results</h3><div>A total of 148 patients were prospectively enrolled, and those who did not meet the definition of subacute cough were excluded. Ninety-seven (68.3%) patients with subacute cough progressed to chronic cough, and the main causative diseases were cough variant asthma in 44 patients, atopic cough in 24 patients, sinobronchial syndrome in 13 patients, and post-infectious cough in seven patients. Patients with cough variant asthma complicated by atopic cough and those in whom the cause of subacute cough was unknown tended to develop chronic cough.</div></div><div><h3>Conclusions</h3><div>This study shows that post-infectious cough is less common than previously thought and the main causes of subacute cough are cough variant asthma, atopic cough, and sinobronchial syndrome and their complications. Cough variant asthma in combination with atopic cough also can be a precursor of refractory chronic cough. The careful diagnosis and treatment of two or more causative diseases is required in patients with subacute cough.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 74-80"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The prognosis of acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is extremely poor. However, recent clinical reports suggest that direct hemoperfusion with polymyxin B-immobilized fiber column (PMX) treatment may have beneficial effects in patients with AE-IPF. The aim of this multicenter prospective study was to investigate the effectiveness and safety of PMX treatment in AE-IPF.
Methods
We conducted a prospective study of patients with AE-IPF treated by PMX at two institutions in Japan. Each patient received 2–3 sessions of PMX treatment with a target duration of 6–24 h. The primary endpoint was the survival rate at day 28 after the PMX treatment.
Results
The survival rate of the patients on day 28 after PMX treatment was 65% [95% confidence interval (CI): 40.3–81.5%]. The lower limit of 95% CI in the study was higher than the survival rate of 40%, which was the upper limit of the survival rate in AE-IPF receiving conventional treatments, as reported previously. The survival rate of the patients 12 weeks after PMX was 50% (95% CI: 27.1–69.2%). The changes in the difference between alveolar and arterial oxygen tension and the partial pressure of arterial oxygen/fraction of inspired oxygen improved as the number of PMX sessions increased, and significant improvements were observed at the end of the second PMX session. The safety of PMX was clinically acceptable.
Conclusions
This prospective multicenter study suggests that PMX treatment is safe for patients with AE-IPF and may improve their oxygenation and prognosis.
{"title":"Direct hemoperfusion with polymyxin B immobilized fiber column (PMX) treatment for acute exacerbation of idiopathic pulmonary fibrosis: A prospective multicenter cohort study","authors":"Shinji Abe , Arata Azuma , Yoshinobu Saito , Hiroki Hayashi , Takeru Kashiwada , Toru Tanaka , Tomohisa Baba , Akimasa Sekine , Hideya Kitamura , Ryo Okuda , Satoshi Ikeda , Takashi Ogura","doi":"10.1016/j.resinv.2024.11.017","DOIUrl":"10.1016/j.resinv.2024.11.017","url":null,"abstract":"<div><h3>Background</h3><div>The prognosis of acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is extremely poor. However, recent clinical reports suggest that direct hemoperfusion with polymyxin B-immobilized fiber column (PMX) treatment may have beneficial effects in patients with AE-IPF. The aim of this multicenter prospective study was to investigate the effectiveness and safety of PMX treatment in AE-IPF.</div></div><div><h3>Methods</h3><div>We conducted a prospective study of patients with AE-IPF treated by PMX at two institutions in Japan. Each patient received 2–3 sessions of PMX treatment with a target duration of 6–24 h. The primary endpoint was the survival rate at day 28 after the PMX treatment.</div></div><div><h3>Results</h3><div>The survival rate of the patients on day 28 after PMX treatment was 65% [95% confidence interval (CI): 40.3–81.5%]. The lower limit of 95% CI in the study was higher than the survival rate of 40%, which was the upper limit of the survival rate in AE-IPF receiving conventional treatments, as reported previously. The survival rate of the patients 12 weeks after PMX was 50% (95% CI: 27.1–69.2%). The changes in the difference between alveolar and arterial oxygen tension and the partial pressure of arterial oxygen/fraction of inspired oxygen improved as the number of PMX sessions increased, and significant improvements were observed at the end of the second PMX session. The safety of PMX was clinically acceptable.</div></div><div><h3>Conclusions</h3><div>This prospective multicenter study suggests that PMX treatment is safe for patients with AE-IPF and may improve their oxygenation and prognosis.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 102-108"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822525","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}
Progressive pulmonary fibrosis (PPF) is a critical concern in interstitial lung disease (ILD) management. The HAL score, which incorporates honeycombing (H), age >75 years (A), and serum lactate dehydrogenase >222 U/L (L), can predict acute exacerbations in patients with idiopathic interstitial pneumonia (IIP). This study aims to evaluate the predictive utility of the HAL score for PPF development.
Methods
This study was a post-hoc analysis of a multicenter prospective cohort study involving patients with IIP. PPF was diagnosed if at least two of the following three criteria were met: worsening respiratory symptoms, radiological progression, and physiological progression.
Results
Among the 144 patients, 29 (22.3%) developed PPF during the observation period. Among the three criteria for PPF, a higher HAL score significantly correlated with worsening respiratory symptoms (p = 0.001) and radiological progression (p = 0.022), but not with physiological progression (p = 0.717). Therefore, a higher HAL score significantly correlated with an increased PPF risk (12.5% for a score of 0, 25.9% for a score of 1, and 33.3% for a score of ≥2; p = 0.032). The HAL score also correlated with overall survival (p < 0.001). For the 92 patients (70.8%) with non-idiopathic pulmonary fibrosis (IPF), the HAL score was significantly associated with PPF development (p = 0.021), while not for the 38 patients (29.2%) with IPF (p = 0.872).
Conclusion
In patients with non-IPF, the HAL score correlated with PPF development and could be useful to monitor those patients and to avoid missed treatment opportunities.
{"title":"Association between the HAL score and the development of progressive pulmonary fibrosis in idiopathic interstitial pneumonia: A prospective observational study","authors":"Hiromasa Nakayasu , Masato Karayama , Noriyuki Enomoto , Yusuke Inoue , Hideki Yasui , Yuzo Suzuki , Hironao Hozumi , Kazuki Furuhashi , Masato Kono , Mikio Toyoshima , Shiro Imokawa , Masato Fujii , Taisuke Akamatsu , Naoki Koshimizu , Koshi Yokomura , Hiroyuki Matsuda , Yusuke Kaida , Yutaro Nakamura , Masahiro Shirai , Masafumi Masuda , Takafumi Suda","doi":"10.1016/j.resinv.2024.12.011","DOIUrl":"10.1016/j.resinv.2024.12.011","url":null,"abstract":"<div><h3>Background</h3><div>Progressive pulmonary fibrosis (PPF) is a critical concern in interstitial lung disease (ILD) management. The HAL score, which incorporates honeycombing (H), age >75 years (A), and serum lactate dehydrogenase >222 U/L (L), can predict acute exacerbations in patients with idiopathic interstitial pneumonia (IIP). This study aims to evaluate the predictive utility of the HAL score for PPF development.</div></div><div><h3>Methods</h3><div>This study was a post-hoc analysis of a multicenter prospective cohort study involving patients with IIP. PPF was diagnosed if at least two of the following three criteria were met: worsening respiratory symptoms, radiological progression, and physiological progression.</div></div><div><h3>Results</h3><div>Among the 144 patients, 29 (22.3%) developed PPF during the observation period. Among the three criteria for PPF, a higher HAL score significantly correlated with worsening respiratory symptoms (<em>p</em> = 0.001) and radiological progression (<em>p</em> = 0.022), but not with physiological progression (<em>p</em> = 0.717). Therefore, a higher HAL score significantly correlated with an increased PPF risk (12.5% for a score of 0, 25.9% for a score of 1, and 33.3% for a score of ≥2; <em>p</em> = 0.032). The HAL score also correlated with overall survival (<em>p</em> < 0.001). For the 92 patients (70.8%) with non-idiopathic pulmonary fibrosis (IPF), the HAL score was significantly associated with PPF development (<em>p</em> = 0.021), while not for the 38 patients (29.2%) with IPF (<em>p</em> = 0.872).</div></div><div><h3>Conclusion</h3><div>In patients with non-IPF, the HAL score correlated with PPF development and could be useful to monitor those patients and to avoid missed treatment opportunities.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 138-145"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855160","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}
Functional exercise capacity in pulmonary hypertension (PH) is routinely assessed using the 6-min walking test (6MWT). However, alternative tests are useful because of resource requirements. This study aimed to evaluate whether the 1-min sit-to-stand test (1STST) is useful and safe in PH and whether it can replace the 6MWT.
Methods
Adult patients with PH were recruited from our hospital between September 2023 and April 2024. The correlations between the number of 1STST repetitions (1STSTr) and 6-min walk distance (6MWD), pulmonary hemodynamic parameters, and quadriceps muscle strength; adverse events; and vital sign fluctuations during the tests were evaluated, and a questionnaire with an 11-point Likert scale (−5, 6MWT favor; 5, 1STST favor) was administered.
Results
Twenty-one patients with PH were enrolled in this study. The 1STSTr and 6MWD were 23.8 ± 7.8/min and 425.8 ± 116.8 m, respectively, with a strong correlation (r = 0.771). 1STSTr was significantly correlated with brain natriuretic peptide, but not with other pulmonary hemodynamic markers, respiratory function, or quadriceps muscle strength. No serious adverse events or motor impairments occurred with the 1STST.
The minimum SpO2 during the tests was significantly lower with the 6MWT (92.6 ± 3.1 vs. 88.0 ± 11.0). The questionnaire showed a predominant preference for the 1STST (3.2 ± 2.6).
Conclusions
To our knowledge, this is the first study in Japan to adapt the 1STST to PH patients. The 1STST is a reliable alternative to the 6MWT for measuring exercise capacity in PH patients.
Trial registration
This study was registered with the UMIN-CTR (number UMIN000052010).
背景：肺动脉高压（PH）患者的功能性运动能力通常通过6分钟步行试验（6MWT）进行评估。但是，由于资源需求，替代测试是有用的。本研究旨在评估1分钟坐立试验（1STST）在PH下是否有用和安全，是否可以取代6MWT。方法：于2023年9月至2024年4月在我院招募成年PH患者。1STST重复次数（1STSTr）与6分钟步行距离（6MWD）、肺血流动力学参数、股四头肌力量的相关性；不良事件;并采用李克特11分量表(- 5,6 mwt赞成；5, 1STST支持)。结果：21例PH患者入组本研究。1STSTr和6MWD分别为23.8±7.8 m /min和425.8±116.8 m，相关性较强（r = 0.771）。1STSTr与脑利钠肽显著相关，但与其他肺血流动力学指标、呼吸功能或股四头肌力量无关。1STST未发生严重不良事件或运动障碍。试验期间的最小SpO2明显低于6MWT（92.6±3.1 vs. 88.0±11.0）。问卷调查结果显示，1STST（3.2±2.6）占主导地位。结论：据我们所知，这是日本第一个将1STST应用于PH患者的研究。1STST是测量PH患者运动能力的可靠替代方案。试验注册：本研究已在UMIN-CTR注册（编号为UMIN000052010）。
{"title":"The utility and safety of one-minute sit-to-stand test in pulmonary hypertension: A prospective study","authors":"Kenichiro Takeda , Ayako Shigeta , Takeshi Inagaki , Nami Hayama , Chiaki Kawame , Yasuyuki Naraki , Akira Naito , Ayumi Sekine , Rika Suda , Toshihiko Sugiura , Nobuhiro Tanabe , Takuji Suzuki","doi":"10.1016/j.resinv.2024.12.003","DOIUrl":"10.1016/j.resinv.2024.12.003","url":null,"abstract":"<div><h3>Background</h3><div>Functional exercise capacity in pulmonary hypertension (PH) is routinely assessed using the 6-min walking test (6MWT). However, alternative tests are useful because of resource requirements. This study aimed to evaluate whether the 1-min sit-to-stand test (1STST) is useful and safe in PH and whether it can replace the 6MWT.</div></div><div><h3>Methods</h3><div>Adult patients with PH were recruited from our hospital between September 2023 and April 2024. The correlations between the number of 1STST repetitions (1STSTr) and 6-min walk distance (6MWD), pulmonary hemodynamic parameters, and quadriceps muscle strength; adverse events; and vital sign fluctuations during the tests were evaluated, and a questionnaire with an 11-point Likert scale (−5, 6MWT favor; 5, 1STST favor) was administered.</div></div><div><h3>Results</h3><div>Twenty-one patients with PH were enrolled in this study. The 1STSTr and 6MWD were 23.8 ± 7.8/min and 425.8 ± 116.8 m, respectively, with a strong correlation (<em>r</em> = 0.771). 1STSTr was significantly correlated with brain natriuretic peptide, but not with other pulmonary hemodynamic markers, respiratory function, or quadriceps muscle strength. No serious adverse events or motor impairments occurred with the 1STST.</div><div>The minimum SpO<sub>2</sub> during the tests was significantly lower with the 6MWT (92.6 ± 3.1 vs. 88.0 ± 11.0). The questionnaire showed a predominant preference for the 1STST (3.2 ± 2.6).</div></div><div><h3>Conclusions</h3><div>To our knowledge, this is the first study in Japan to adapt the 1STST to PH patients. The 1STST is a reliable alternative to the 6MWT for measuring exercise capacity in PH patients.</div></div><div><h3>Trial registration</h3><div>This study was registered with the UMIN-CTR (number UMIN000052010).</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 61-66"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Coughing and other distress during bronchoscopy are undesirable for both patients and bronchoscopists. The efficacy of local anesthetics administered via aerosol sprays in the airways has been documented; however, the optimal administration method remains unclear. Furthermore, the efficacy of continuous salivary aspiration in reducing cough and other distress has not yet been evaluated.
Methods
Patients scheduled for bronchoscopy were assigned to 1 of 4 groups—group A (intrabronchial local anesthesia using a syringe without continuous oral suction); group B (intrabronchial local anesthesia using a spray catheter without continuous oral suction); group C (intrabronchial local anesthesia using a syringe with continuous oral suction using a saliva ejector); group D (intrabronchial local anesthesia using a spray catheter with continuous oral suction using a saliva ejector). The distress levels of the patients were evaluated using a questionnaire with a visual analog scale, and cough counts were quantified during bronchoscopy. Additionally, we assessed the total amount of lidocaine consumed and changes in vital signs.
Results
Local anesthesia in the airway using a spray catheter did not reduce patient distress; however, it reduced cough frequency (P = 0.03) and lidocaine dosage (P = 0.0004). Continuous suctioning of saliva did not reduce the patients’ distress or cough frequency.
Conclusion
The use of a spray catheter rather than a syringe is recommended for administering local anesthesia with lidocaine during bronchoscopy. Conversely, continuous suctioning of saliva is not routinely recommended for all patients.
{"title":"Effectiveness of intrabronchial local anesthesia with a spray catheter and continuous oral suction in reducing cough during bronchoscopy: A prospective study","authors":"Kazuo Tsuchiya, Tomotsugu Nuki, Tomo Tsunoda, Taisuke Ito, Rie Mori, Takuro Akashi, Yoshiyuki Oyama, Masaki Ikeda","doi":"10.1016/j.resinv.2024.12.002","DOIUrl":"10.1016/j.resinv.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Coughing and other distress during bronchoscopy are undesirable for both patients and bronchoscopists. The efficacy of local anesthetics administered via aerosol sprays in the airways has been documented; however, the optimal administration method remains unclear. Furthermore, the efficacy of continuous salivary aspiration in reducing cough and other distress has not yet been evaluated.</div></div><div><h3>Methods</h3><div>Patients scheduled for bronchoscopy were assigned to 1 of 4 groups—group A (intrabronchial local anesthesia using a syringe without continuous oral suction); group B (intrabronchial local anesthesia using a spray catheter without continuous oral suction); group C (intrabronchial local anesthesia using a syringe with continuous oral suction using a saliva ejector); group D (intrabronchial local anesthesia using a spray catheter with continuous oral suction using a saliva ejector). The distress levels of the patients were evaluated using a questionnaire with a visual analog scale, and cough counts were quantified during bronchoscopy. Additionally, we assessed the total amount of lidocaine consumed and changes in vital signs.</div></div><div><h3>Results</h3><div>Local anesthesia in the airway using a spray catheter did not reduce patient distress; however, it reduced cough frequency (<em>P</em> = 0.03) and lidocaine dosage (<em>P</em> = 0.0004). Continuous suctioning of saliva did not reduce the patients’ distress or cough frequency.</div></div><div><h3>Conclusion</h3><div>The use of a spray catheter rather than a syringe is recommended for administering local anesthesia with lidocaine during bronchoscopy. Conversely, continuous suctioning of saliva is not routinely recommended for all patients.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"63 1","pages":"Pages 67-73"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792271","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}
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