Interstitial lung disease (ILD) comprises a wide range of pulmonary disorders associated with high morbidity and mortality. Although idiopathic pulmonary fibrosis (IPF) has been the focus of much prior research, population-level data covering the full spectrum of ILD in Japan remain limited.
Methods
This retrospective cohort study used the National Database of Health Insurance Claims (NDB) in Japan to identify patients diagnosed with ILD from January 2015 to December 2023. We analyzed annual prevalence, incidence, patient demographics, and survival outcomes overall and by ILD subtypes.
Results
A total of 2,758,542 patients with ILD were identified during the study period. ILD prevalence nearly doubled, from 656 per 100,000 population in 2015 to 1301 per 100,000 in 2023, while incidence remained relatively stable (192 per 100,000 in 2015 to 212 per 100,000 in 2023), with a notable decline observed in 2020 (178 per 100,000). Males consistently had higher prevalence and incidence than females. Age and sex distributions differed substantially across ILD subtypes. The overall 5-year survival rate was 59.9 %, with IPF demonstrating the poorest survival (32.1 %).
Conclusions
This nationwide study provides the most comprehensive epidemiological overview of ILD in Japan to date. The insights gained can support evidence-based healthcare planning and help guide priorities for future research and clinical improvements.
{"title":"Epidemiology of interstitial lung diseases in Japan: A nationwide database analysis","authors":"Koichi Miyashita , Yusuke Inoue , Hideki Yasui , Yuzo Suzuki , Masato Karayama , Hironao Hozumi , Kazuki Furuhashi , Noriyuki Enomoto , Tomoyuki Fujisawa , Eiji Nakatani , Naoki Inui , Toshiyuki Ojima , Takafumi Suda","doi":"10.1016/j.resinv.2026.101367","DOIUrl":"10.1016/j.resinv.2026.101367","url":null,"abstract":"<div><h3>Background</h3><div>Interstitial lung disease (ILD) comprises a wide range of pulmonary disorders associated with high morbidity and mortality. Although idiopathic pulmonary fibrosis (IPF) has been the focus of much prior research, population-level data covering the full spectrum of ILD in Japan remain limited.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used the National Database of Health Insurance Claims (NDB) in Japan to identify patients diagnosed with ILD from January 2015 to December 2023. We analyzed annual prevalence, incidence, patient demographics, and survival outcomes overall and by ILD subtypes.</div></div><div><h3>Results</h3><div>A total of 2,758,542 patients with ILD were identified during the study period. ILD prevalence nearly doubled, from 656 per 100,000 population in 2015 to 1301 per 100,000 in 2023, while incidence remained relatively stable (192 per 100,000 in 2015 to 212 per 100,000 in 2023), with a notable decline observed in 2020 (178 per 100,000). Males consistently had higher prevalence and incidence than females. Age and sex distributions differed substantially across ILD subtypes. The overall 5-year survival rate was 59.9 %, with IPF demonstrating the poorest survival (32.1 %).</div></div><div><h3>Conclusions</h3><div>This nationwide study provides the most comprehensive epidemiological overview of ILD in Japan to date. The insights gained can support evidence-based healthcare planning and help guide priorities for future research and clinical improvements.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101367"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941427","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}
Adherence to peak expiratory flow monitoring in asthma management is low because of the burden of data recording. We developed a smartphone application that helps record and monitor patients’ daily PEF.
Methods
PEF recordings and application usage were assessed over 4 weeks. Respiratory function was measured in the laboratory. We analyzed the peak flow recording rates, variability, and correlations between the collected data.
Results
The recording rates for asthma and non-asthma groups were 83.9 % and 73.2 %, respectively, twice daily. Participants with asthma found the application more user-friendly than paper diaries, and 90 % wanted to continue using it. The maximum PEF recorded with the application and the PEF collected through spirometry were correlated.
Conclusion
Our application can be a useful tool for evaluating asthma. Future studies involving larger patient cohorts are needed to confirm the usefulness of this smartphone application.
{"title":"Feasibility testing of a smartphone application for visualizing and sharing peak flow monitoring data in asthma evaluation","authors":"Kotaro Sasahara, Yuma Sakai, Katsunori Masaki, Saki Tomiyasu, Ryuta Onozato, Shiori Mori, Kaoru Koyama, Yo Otsu, Momoko Kurihara, Emiko Matsuyama, Reina Nakamura, Keeya Sunata, Masato Asaoka, Yuto Akiyama, Misato Irie, Hiroki Kabata, Jun Miyata, Koichi Fukunaga","doi":"10.1016/j.resinv.2025.101364","DOIUrl":"10.1016/j.resinv.2025.101364","url":null,"abstract":"<div><h3>Background</h3><div>Adherence to peak expiratory flow monitoring in asthma management is low because of the burden of data recording. We developed a smartphone application that helps record and monitor patients’ daily PEF.</div></div><div><h3>Methods</h3><div>PEF recordings and application usage were assessed over 4 weeks. Respiratory function was measured in the laboratory. We analyzed the peak flow recording rates, variability, and correlations between the collected data.</div></div><div><h3>Results</h3><div>The recording rates for asthma and non-asthma groups were 83.9 % and 73.2 %, respectively, twice daily. Participants with asthma found the application more user-friendly than paper diaries, and 90 % wanted to continue using it. The maximum PEF recorded with the application and the PEF collected through spirometry were correlated.</div></div><div><h3>Conclusion</h3><div>Our application can be a useful tool for evaluating asthma. Future studies involving larger patient cohorts are needed to confirm the usefulness of this smartphone application.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101364"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998938","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 : 2026-03-01Epub Date: 2026-02-10DOI: 10.1016/j.resinv.2026.101383
Tatsuya Hirano , Ichidai Tanaka , Masahiro Morise , Junji Koyama , Takahiko Hashimoto , Kazumi Hori , Reiko Matsuzawa , Sho Hori , Kennosuke Karube , Takayasu Ito , Koji Sakamoto , Yuichiro Shindo , Mitsuo Sato , Toshihiko Yokoyama , Tomoki Kimura , Yasuhiro Kondoh , Makoto Ishii
Background
Non-small cell lung cancer (NSCLC) is diagnosed using small biopsy samples obtained by bronchoscopy or transthoracic lung core biopsy, and treated with immune checkpoint inhibitors, such as programmed cell death protein-1 (PD-1) and programmed cell death protein ligand-1 (PD-L1) inhibitors, as the first-line therapy. However, the clinical benefits of first-line PD-1/PD-L1 inhibitors in non-small cell carcinoma-not otherwise specified (NSCC–NOS) remain unclear. This study aimed to clarify the clinical efficacy of first-line PD-1/PD-L1 inhibitors in patients with NSCC-NOS.
Methods
We retrospectively enrolled patients with recurrent or unresectable advanced NSCLC treated with first-line PD-1/PD-L1 inhibitors, with or without chemotherapy, at three medical institutions. We adjusted for patient characteristics using propensity score matching (PSM) and analyzed the impact of the histological subtype, NSCC-NOS, on survival outcomes in patients with NSCLC treated with immunotherapy.
Results
Of the 312 eligible patients, 42 (13.5%) had a histological subtype of NSCC-NOS. Significantly more patients had PD-L1 ≥ 50% in the NSCC-NOS group than in the Non NSCC-NOS group (P = 0.01). After PSM, 41 patients with NSCC-NOS and 123 with other histological subtypes (Non NSCC-NOS) were analyzed. The median progression-free survival (PFS) and the median overall survival (OS) of patients with NSCC-NOS were significantly longer than those of patients with Non NSCC-NOS, respectively (median PFS: 14.8 vs. 6.1 months, P < 0.01; median OS: 33.4 vs. 15.1 months, P = 0.04, log-rank test).
Conclusions
NSCC-NOS is a histological subtype that is highly responsive to first-line PD-1/PD-L1 inhibitors with or without chemotherapy.
{"title":"Favorable clinical impact of histological subtype with non-small cell carcinoma-not otherwise specified in patients with non-small cell lung cancer receiving immune checkpoint inhibitors","authors":"Tatsuya Hirano , Ichidai Tanaka , Masahiro Morise , Junji Koyama , Takahiko Hashimoto , Kazumi Hori , Reiko Matsuzawa , Sho Hori , Kennosuke Karube , Takayasu Ito , Koji Sakamoto , Yuichiro Shindo , Mitsuo Sato , Toshihiko Yokoyama , Tomoki Kimura , Yasuhiro Kondoh , Makoto Ishii","doi":"10.1016/j.resinv.2026.101383","DOIUrl":"10.1016/j.resinv.2026.101383","url":null,"abstract":"<div><h3>Background</h3><div>Non-small cell lung cancer (NSCLC) is diagnosed using small biopsy samples obtained by bronchoscopy or transthoracic lung core biopsy, and treated with immune checkpoint inhibitors, such as programmed cell death protein-1 (PD-1) and programmed cell death protein ligand-1 (PD-L1) inhibitors, as the first-line therapy. However, the clinical benefits of first-line PD-1/PD-L1 inhibitors in non-small cell carcinoma-not otherwise specified (NSCC–NOS) remain unclear. This study aimed to clarify the clinical efficacy of first-line PD-1/PD-L1 inhibitors in patients with NSCC-NOS.</div></div><div><h3>Methods</h3><div>We retrospectively enrolled patients with recurrent or unresectable advanced NSCLC treated with first-line PD-1/PD-L1 inhibitors, with or without chemotherapy, at three medical institutions. We adjusted for patient characteristics using propensity score matching (PSM) and analyzed the impact of the histological subtype, NSCC-NOS, on survival outcomes in patients with NSCLC treated with immunotherapy.</div></div><div><h3>Results</h3><div>Of the 312 eligible patients, 42 (13.5%) had a histological subtype of NSCC-NOS. Significantly more patients had PD-L1 ≥ 50% in the NSCC-NOS group than in the Non NSCC-NOS group (<em>P</em> = 0.01). After PSM, 41 patients with NSCC-NOS and 123 with other histological subtypes (Non NSCC-NOS) were analyzed. The median progression-free survival (PFS) and the median overall survival (OS) of patients with NSCC-NOS were significantly longer than those of patients with Non NSCC-NOS, respectively (median PFS: 14.8 vs. 6.1 months, <em>P</em> < 0.01; median OS: 33.4 vs. 15.1 months, <em>P</em> = 0.04, log-rank test).</div></div><div><h3>Conclusions</h3><div>NSCC-NOS is a histological subtype that is highly responsive to first-line PD-1/PD-L1 inhibitors with or without chemotherapy.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101383"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166533","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 : 2026-03-01Epub Date: 2026-02-18DOI: 10.1016/j.resinv.2026.101387
Jing Gu , Yuxuan Chen , Rui Xiao , Lei Gu , Wei Liu , Jing Lin , Tao Chen , Jian Yue , Jian-he Gan
Background
Observational studies have suggested a bidirectional association between bronchiectasis and non-tuberculous mycobacteria (NTM) infections. However, the causal association between bronchiectasis and NTM infection remains unclear. This study is aimed to investigate whether bronchiectasis and NTM infection are causally related.
Methods
The data related to bronchiectasis and NTM infection were collected from the IEU Open GWAS project. A bi-directional Mendelian randomization (MR) analysis was performed to examine the direction of the causal relation between bronchiectasis and NTM infection. Meta-analysis would be conducted if the results of MR were inconsistent.
Results
Bronchiectasis increased NTM infection risk, with an odds ratio (OR) of 1.42 (Dataset:finn-b-MYCOBLUNGATYPICA, 95% CI: 1.09-1.85; p = 0.009) and 1.32 (Dataset: finn-b-AB1_OTHER_MYCOBAC, 95% CI: 1.02, 1.71; p = 0.036) from the bronchiectasis (1107 bronchiectasis cases and 186,723 controls) genome-wide association study, respectively. On the other hand, NTM infection (Dataset:finn-b-MYCOBLUNGATYPICA) increased the risk of bronchiectasis, with an OR of 1.06 (95% CI: 1.02-1.11; p = 0.007). However, there was no evidence of a causal effect of NTM infection (Dataset: finn-b-AB1_OTHER_MYCOBAC) on the risk of bronchiectasis, with an OR of 1.02 (95%CI: 0.96-1.08; p = 0.57). In meta-analysis based on the two datasets, NTM infection was associated with an increased risk of bronchiectasis, with an OR of 1.05 (95% CI: 1.01-1.08; p < 0.001).
Conclusions
Bronchiectasis increases the risk of NTM infection and vice versa, which indicate the need for vigilant monitoring and management of both conditions to mitigate their interrelated risks.
背景：观察性研究表明支气管扩张和非结核分枝杆菌（NTM）感染之间存在双向关联。然而，支气管扩张和NTM感染之间的因果关系尚不清楚。本研究旨在探讨支气管扩张与NTM感染是否存在因果关系。方法：收集IEU Open GWAS项目中与支气管扩张和NTM感染相关的资料。采用双向孟德尔随机化（MR）分析，探讨支气管扩张与NTM感染之间的因果关系。若MR结果不一致，将进行meta分析。结果：支气管扩张增加了NTM感染的风险，在支气管扩张（1107例支气管扩张病例和186,723例对照）全基因组关联研究中，比值比（OR）分别为1.42（数据集：fin -b- mycobrongatypica， 95% CI: 1.09-1.85; p = 0.009）和1.32（数据集：fin -b- ab1_other_mycobac， 95% CI: 1.02, 1.71; p = 0.036）。另一方面，NTM感染（Dataset:fin -b- mycobrongatypica）增加了支气管扩张的风险，OR为1.06 （95% CI: 1.02-1.11; p = 0.007）。然而，没有证据表明NTM感染（Dataset: fin -b- ab1_other_mycobac）与支气管扩张的风险有因果关系，OR为1.02 （95%CI: 0.96-1.08; p = 0.57）。在基于两个数据集的荟萃分析中，NTM感染与支气管扩张的风险增加相关，OR为1.05 （95% CI: 1.01-1.08; p）。结论：支气管扩张增加NTM感染的风险，反之亦然，这表明需要对这两种情况进行警惕监测和管理，以减轻其相关风险。
{"title":"The causal relationship between bronchiectasis and non-tuberculous mycobacteria infections: A bidirectional Mendelian randomization study and meta-analysis","authors":"Jing Gu , Yuxuan Chen , Rui Xiao , Lei Gu , Wei Liu , Jing Lin , Tao Chen , Jian Yue , Jian-he Gan","doi":"10.1016/j.resinv.2026.101387","DOIUrl":"10.1016/j.resinv.2026.101387","url":null,"abstract":"<div><h3>Background</h3><div>Observational studies have suggested a bidirectional association between bronchiectasis and non-tuberculous mycobacteria (NTM) infections. However, the causal association between bronchiectasis and NTM infection remains unclear. This study is aimed to investigate whether bronchiectasis and NTM infection are causally related.</div></div><div><h3>Methods</h3><div>The data related to bronchiectasis and NTM infection were collected from the IEU Open GWAS project. A bi-directional Mendelian randomization (MR) analysis was performed to examine the direction of the causal relation between bronchiectasis and NTM infection. Meta-analysis would be conducted if the results of MR were inconsistent.</div></div><div><h3>Results</h3><div>Bronchiectasis increased NTM infection risk, with an odds ratio (OR) of 1.42 (Dataset:finn-b-MYCOBLUNGATYPICA, 95% CI: 1.09-1.85; p = 0.009) and 1.32 (Dataset: finn-b-AB1_OTHER_MYCOBAC, 95% CI: 1.02, 1.71; p = 0.036) from the bronchiectasis (1107 bronchiectasis cases and 186,723 controls) genome-wide association study, respectively. On the other hand, NTM infection (Dataset:finn-b-MYCOBLUNGATYPICA) increased the risk of bronchiectasis, with an OR of 1.06 (95% CI: 1.02-1.11; p = 0.007). However, there was no evidence of a causal effect of NTM infection (Dataset: finn-b-AB1_OTHER_MYCOBAC) on the risk of bronchiectasis, with an OR of 1.02 (95%CI: 0.96-1.08; p = 0.57). In meta-analysis based on the two datasets, NTM infection was associated with an increased risk of bronchiectasis, with an OR of 1.05 (95% CI: 1.01-1.08; p < 0.001).</div></div><div><h3>Conclusions</h3><div>Bronchiectasis increases the risk of NTM infection and vice versa, which indicate the need for vigilant monitoring and management of both conditions to mitigate their interrelated risks.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101387"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220810","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}
Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive interstitial lung disease (RP-ILD) may deteriorate even after remission with initial multidrug therapy. We report two cases of chronic progressive changes after remission. Transbronchial lung cryobiopsy (TBLC) identified distinct pathological processes: advanced fibrosis in one case and inflammatory relapse in the other, which directly guided therapeutic decisions. Rising antibody titers preceded deterioration in both cases. TBLC enabled accurate differentiation between relapse and fibrotic progression, emphasizing its utility in long-term management. Persistent serologic activity warrants close follow-up, and TBLC may aid in selecting individualized treatment strategies in post-remission deterioration.
{"title":"The efficacy of transbronchial lung cryobiopsy for chronic progressive changes after remission of anti-MDA5 antibody-positive interstitial lung disease: a report of two cases","authors":"Sanshiro Haga , Ryota Otoshi , Hiroe Aramaki , Akihiro Kanzawa , Akimasa Sekine , Tomohisa Baba , Tomoe Sawazumi , Tamiko Takemura , Daiga Kishimoto , Takashi Ogura","doi":"10.1016/j.resinv.2026.101390","DOIUrl":"10.1016/j.resinv.2026.101390","url":null,"abstract":"<div><div>Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive interstitial lung disease (RP-ILD) may deteriorate even after remission with initial multidrug therapy. We report two cases of chronic progressive changes after remission. Transbronchial lung cryobiopsy (TBLC) identified distinct pathological processes: advanced fibrosis in one case and inflammatory relapse in the other, which directly guided therapeutic decisions. Rising antibody titers preceded deterioration in both cases. TBLC enabled accurate differentiation between relapse and fibrotic progression, emphasizing its utility in long-term management. Persistent serologic activity warrants close follow-up, and TBLC may aid in selecting individualized treatment strategies in post-remission deterioration.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101390"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257952","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}
The measurement of diffusing capacity of the lung for carbon monoxide (DLCO) is an invaluable pulmonary function test for assessing gas exchange in the lungs. Typically, the test is conducted via the single-breath method, wherein after maximum inhalation of carbon monoxide and helium simultaneously, the breath is held for 10 s. The test provides the single value of DLCO, and sometimes, the DLCO corrected by alveolar volume (VA) at the measurement. However, DLCO is the product of two independent components in reality—the transfer coefficient for carbon monoxide (KCO) and VA. Conventionally, KCO has often been expressed as DLCO/VA. In this report, we will demonstrate the change in relationship of DLCO with KCO uniquely and characteristically due to emphysema, fibrosis, and their combined disease. Therefore, the assessment of both indices is highly desirable in the precise interpretation of the test. The term “KCO” is preferable to DLCO/VA to avoid misleading.
{"title":"Both DLCO and KCO are vital indices in assessment of diffusing capacity for carbon monoxide by the single-breath method","authors":"Masafumi Yamamoto , Masaharu Nishimura , Kaoruko Shimizu , Naoki Yamashita , Hideki Goto , Hironi Makita , Ichiro Kuwahira , Takanori Teshima , Satoshi Konno","doi":"10.1016/j.resinv.2026.101382","DOIUrl":"10.1016/j.resinv.2026.101382","url":null,"abstract":"<div><div>The measurement of diffusing capacity of the lung for carbon monoxide (DL<sub>CO</sub>) is an invaluable pulmonary function test for assessing gas exchange in the lungs. Typically, the test is conducted via the single-breath method, wherein after maximum inhalation of carbon monoxide and helium simultaneously, the breath is held for 10 s. The test provides the single value of DL<sub>CO</sub>, and sometimes, the DL<sub>CO</sub> corrected by alveolar volume (V<sub>A</sub>) at the measurement. However, DL<sub>CO</sub> is the product of two independent components in reality—the transfer coefficient for carbon monoxide (K<sub>CO</sub>) and V<sub>A</sub>. Conventionally, K<sub>CO</sub> has often been expressed as DL<sub>CO</sub>/V<sub>A</sub>. In this report, we will demonstrate the change in relationship of DL<sub>CO</sub> with K<sub>CO</sub> uniquely and characteristically due to emphysema, fibrosis, and their combined disease. Therefore, the assessment of both indices is highly desirable in the precise interpretation of the test. The term “K<sub>CO</sub>” is preferable to DL<sub>CO</sub>/V<sub>A</sub> to avoid misleading.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101382"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166482","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}
Olfactory stimulation with L-menthol may reduce certain discomfort sensations, including dyspnea. Chronic obstructive pulmonary disease (COPD) and idiopathic interstitial pneumonias (IIPs) have distinct physiological characteristics and may elicit different qualitative sensations of dyspnea. Therefore, the qualitative effects of L-menthol inhalation on dyspnea may differ between these chronic lung diseases (CLDs). This study aimed to determine which aspects of dyspnea are influenced by olfactory stimulation with L-menthol in patients with CLDs.
Methods
Thirty-four patients with stable COPD or IIPs (17 each) performed a 6-min walk test (6MWT) under two conditions: wearing a surgical mask alone (control) or wearing a mask with a peppermint oil aroma sticker (0.105 ml, containing 30% L-menthol). A modified Borg scale, the Multidimensional Dyspnea Profile (MDP), and the Language of Dyspnea Questionnaire (LDQ) were used to evaluate endpoints. The 6MWT was selected to induce breathlessness with and without L-menthol.
Results
In the COPD group, L-menthol significantly improved Mental breathing effort on the MDP, and Rapid, Gasping, and Air hunger on the LDQ. In the IIPs group, L-menthol improved only the MDP Hyperpnea dimension. No significant differences were observed in the modified Borg scale before and after the 6MWT between L-menthol and control conditions in either group.
Conclusions
Olfactory stimulation with L-menthol selectively improved aspects of dyspnea in patients with COPD and IIPs, likely reflecting differences in the pathophysiology and severity of each disease.
Trial registration
Japan Registry of Clinical Trials (jRCTs031200400).
{"title":"Effects of olfactory stimulation with L-menthol on sensations of discomfort on exertion in patients with chronic lung diseases","authors":"Soh Imamura , Takeshi Inagaki , Koichiro Tatsumi , Mitsuhiro Abe , Jun Ikari , Takeshi Kawasaki , Hideki Katsura , Yuri Suzuki , Megumi Katsumata , Takuro Imamoto , Yoshihito Ozawa , Seiichiro Sakao , Takuji Suzuki","doi":"10.1016/j.resinv.2026.101380","DOIUrl":"10.1016/j.resinv.2026.101380","url":null,"abstract":"<div><h3>Background</h3><div>Olfactory stimulation with L-menthol may reduce certain discomfort sensations, including dyspnea. Chronic obstructive pulmonary disease (COPD) and idiopathic interstitial pneumonias (IIPs) have distinct physiological characteristics and may elicit different qualitative sensations of dyspnea. Therefore, the qualitative effects of L-menthol inhalation on dyspnea may differ between these chronic lung diseases (CLDs). This study aimed to determine which aspects of dyspnea are influenced by olfactory stimulation with L-menthol in patients with CLDs.</div></div><div><h3>Methods</h3><div>Thirty-four patients with stable COPD or IIPs (17 each) performed a 6-min walk test (6MWT) under two conditions: wearing a surgical mask alone (control) or wearing a mask with a peppermint oil aroma sticker (0.105 ml, containing 30% L-menthol). A modified Borg scale, the Multidimensional Dyspnea Profile (MDP), and the Language of Dyspnea Questionnaire (LDQ) were used to evaluate endpoints. The 6MWT was selected to induce breathlessness with and without L-menthol.</div></div><div><h3>Results</h3><div>In the COPD group, L-menthol significantly improved Mental breathing effort on the MDP, and Rapid, Gasping, and Air hunger on the LDQ. In the IIPs group, L-menthol improved only the MDP Hyperpnea dimension. No significant differences were observed in the modified Borg scale before and after the 6MWT between L-menthol and control conditions in either group.</div></div><div><h3>Conclusions</h3><div>Olfactory stimulation with L-menthol selectively improved aspects of dyspnea in patients with COPD and IIPs, likely reflecting differences in the pathophysiology and severity of each disease.</div></div><div><h3>Trial registration</h3><div>Japan Registry of Clinical Trials (jRCTs031200400).</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 2","pages":"Article 101380"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137736","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}
The 6-min walk test (6MWT) is a widely used functional test that assesses desaturation on exercise. However, the clinical impact of desaturation on progressive pulmonary fibrosis (PPF) has been insufficiently studied. We aimed to evaluate the association between desaturation and future progression in patients with fibrotic interstitial lung disease (FILD).
Methods
We retrospectively analysed consecutive patients with FILD from 2008 to 2015. Desaturation was defined as oxygen saturation measured by pulse oximetry (SpO2) at the end of the 6MWT being less than 90 %. It was divided into two groups: mild (SpO2 was 89 %) and moderate desaturation (SpO2 was 88 % or less).
Results
Among 810 patients, 498 (61.5 %) had desaturation (45 mild and 453 moderate). Multivariable Cox proportional hazard analysis showed desaturation was associated with a higher mortality (HR: 1.69, 95 % CI: 1.37–2.08, p < 0.0001). Both mild and moderate desaturation were also associated with a higher mortality compared with no desaturation, although there was no significant difference between them. Multivariable logistic regression analysis showed that desaturation was associated with PPF in the overall cohort (OR: 2.20, 95 % CI: 1.59–3.05, p < 0.0001), in patients with idiopathic pulmonary fibrosis (IPF) (OR: 2.59, 95 % CI: 1.56–4.29, p = 0.0002), and in patients with non-IPF FILD (OR: 1.86, 95 % CI: 1.17–2.96, p = 0.0091).
Conclusions
Desaturation in the 6MWT was associated with future risk of progression in patients with newly diagnosed FILD.
6分钟步行测试（6MWT）是一种广泛使用的功能测试，用于评估运动时的去饱和。然而，去饱和对进行性肺纤维化（PPF）的临床影响尚未得到充分研究。我们旨在评估纤维化间质性肺疾病（field）患者去饱和与未来进展之间的关系。方法回顾性分析2008 - 2015年连续发生的field患者。去饱和定义为在6MWT结束时通过脉搏血氧仪（SpO2）测量的氧饱和度小于90%。分为轻度（SpO2为89%）和中度（SpO2为88%或以下）两组。结果810例患者中有498例（61.5%）发生过血饱和度过低，其中轻度45例，中度453例。多变量Cox比例风险分析显示，去饱和与较高的死亡率相关（HR: 1.69, 95% CI: 1.37-2.08, p < 0.0001）。与不去饱和相比，轻度和中度去饱和也与更高的死亡率相关，尽管两者之间没有显著差异。多变量logistic回归分析显示，在整个队列（OR: 2.20, 95% CI: 1.59-3.05, p < 0.0001）、特发性肺纤维化（IPF）患者（OR: 2.59, 95% CI: 1.56-4.29, p = 0.0002）和非IPF field患者（OR: 1.86, 95% CI: 1.17-2.96, p = 0.0091）中，去饱和与PPF相关。结论：6MWT的去饱和与新诊断的field患者未来的进展风险相关。
{"title":"Desaturation in the six-minute walk test predicts progressive pulmonary fibrosis in fibrotic interstitial lung disease","authors":"Reoto Takei , Jun Fukihara , Yasuhiko Yamano , Kensuke Kataoka , Tomoki Kimura , Fumiko Watanabe , Taiki Furukawa , Junya Fukuoka , Takeshi Johkoh , Yasuhiro Kondoh","doi":"10.1016/j.resinv.2025.11.013","DOIUrl":"10.1016/j.resinv.2025.11.013","url":null,"abstract":"<div><h3>Background</h3><div>The 6-min walk test (6MWT) is a widely used functional test that assesses desaturation on exercise. However, the clinical impact of desaturation on progressive pulmonary fibrosis (PPF) has been insufficiently studied. We aimed to evaluate the association between desaturation and future progression in patients with fibrotic interstitial lung disease (FILD).</div></div><div><h3>Methods</h3><div>We retrospectively analysed consecutive patients with FILD from 2008 to 2015. Desaturation was defined as oxygen saturation measured by pulse oximetry (SpO<sub>2</sub>) at the end of the 6MWT being less than 90 %. It was divided into two groups: mild (SpO<sub>2</sub> was 89 %) and moderate desaturation (SpO<sub>2</sub> was 88 % or less).</div></div><div><h3>Results</h3><div>Among 810 patients, 498 (61.5 %) had desaturation (45 mild and 453 moderate). Multivariable Cox proportional hazard analysis showed desaturation was associated with a higher mortality (HR: 1.69, 95 % CI: 1.37–2.08, p < 0.0001). Both mild and moderate desaturation were also associated with a higher mortality compared with no desaturation, although there was no significant difference between them. Multivariable logistic regression analysis showed that desaturation was associated with PPF in the overall cohort (OR: 2.20, 95 % CI: 1.59–3.05, p < 0.0001), in patients with idiopathic pulmonary fibrosis (IPF) (OR: 2.59, 95 % CI: 1.56–4.29, p = 0.0002), and in patients with non-IPF FILD (OR: 1.86, 95 % CI: 1.17–2.96, p = 0.0091).</div></div><div><h3>Conclusions</h3><div>Desaturation in the 6MWT was associated with future risk of progression in patients with newly diagnosed FILD.</div></div>","PeriodicalId":20934,"journal":{"name":"Respiratory investigation","volume":"64 1","pages":"Article 101334"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616017","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 : 2026-01-01Epub Date: 2025-11-18DOI: 10.1016/j.resinv.2025.11.004
Parth Aphale, Himanshu Shekhar, Shashank Dokania
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