Respiratory medicine最新文献

{"title":"Relationships between bronchodilator responsiveness, a COPD polygenic risk score, and COPD progression","authors":"Spyridon Fortis ,&nbsp;Alejandro P. Comellas ,&nbsp;Russell P. Bowler ,&nbsp;Surya P. Bhatt ,&nbsp;Craig P. Hersh ,&nbsp;Dawn L. Demeo ,&nbsp;Gregory Kinney ,&nbsp;Edwin K. Silverman ,&nbsp;Michael H. Cho ,&nbsp;Matthew Moll","doi":"10.1016/j.rmed.2026.108636","DOIUrl":"10.1016/j.rmed.2026.108636","url":null,"abstract":"<div><h3>Introduction</h3><div>Bronchodilator responsiveness (BDR) is associated with progression to COPD. Genetic risk for COPD, summarized by polygenic risk scores (PRS), predicts low lung function and COPD. However, it remains unclear whether genetic predisposition to COPD is related to BDR and whether PRS and BDR together influence lung function decline in individuals at risk for the disease.</div></div><div><h3>Methods</h3><div>We analyzed data from COPDGene participants with a smoking history and <strong>normal spirometry at study enrollment</strong>. We cross-sectionally examined the association of a PRS with 2005-BDR-FEV₁ % (change relative to pre-bronchodilator) and 2021-BDR-FEV₁ % (change relative to predicted). We also examined the association of PRS, 2005-BDR-FEV₁ %, and 2021-BDR-FEV₁ % with progression to COPD and longitudinal FEV₁ decline between enrollment and follow-up adjusted for demographics, smoking history, and FEV₁ at enrollment.</div></div><div><h3>Results</h3><div>PRS did not correlate with 2005-BDR-FEV₁ % in 1446 African Americans (AA) but PRS correlates with BDR in both unadjusted (rho = 0.01, P &lt; 0.001) and adjusted analysis in 3378 non-Hispanic Whites (NHW). NHW participants with BDR had higher PRS than those without. Models including 2005-BDR-FEV1 % demonstrated better accuracy than those including PRS (Area under the curve: 0.762 vs 0.743 in NHW; 0.693 vs 0.653 in AA). BDR models also outperformed PRS models for longitudinal FEV₁ decline. Mediation analysis showed that about one third of the PRS effect on FEV₁ decline in NHW was explained through BDR.</div></div><div><h3>Conclusions</h3><div>BDR is more strongly associated with progression to COPD and FEV₁ decline than PRS, and part of the PRS effect is mediated through BDR.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108636"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of carbon footprint information on inhaler prescribing intentions by general practitioners: protocol for an online factorial randomised experiment","authors":"Luise Kazda ,&nbsp;Timothy E. Schlub ,&nbsp;Michelle Guppy ,&nbsp;Mike Forrester ,&nbsp;Debbie Rigby ,&nbsp;Alexandra Barratt ,&nbsp;Darlene Cox ,&nbsp;Michael J. Loftus ,&nbsp;Katy Bell","doi":"10.1016/j.rmed.2026.108657","DOIUrl":"10.1016/j.rmed.2026.108657","url":null,"abstract":"<div><h3>Background</h3><div>Many asthma patients experience suboptimal disease control and are disproportionally impacted by worsening environmental risk factors due to climate change. General practitioners (GPs) are well-placed and trusted to lead conversations to improve asthma management. The resulting treatment improvements have the potential to simultaneously reduce the significant greenhouse gas emissions from inhalers as a co-benefit.</div></div><div><h3>Objectives</h3><div>This study aims to explore whether adding environmental impact information for respiratory inhalers can influence clinician prescribing while improving quality of care and investigates optimal ways to communicate environmental impacts to GPs.</div></div><div><h3>Methods</h3><div>We will conduct a factorial (2 × 2 plus control) randomised online hypothetical experiment with Australian GPs. Following consent and baseline information on guideline-concordant maintenance-and-reliever-therapy (“MART”) prescribing, participants will be randomised 1:1:1:1:1 to five conditions: A. Emissions impact: collective action/with graphic; B. Emissions impact: single-action/with graphic; C. Emissions impact: collective action/no graphic; D. Emission impact: single-action/no graphic; E. Control: no further information. The required sample size is 250 GPs. The primary outcome is participant choice of inhaler type (binary choice of dry powder or pressurised metered dose). Secondary outcomes include participant level of confidence in their choice, management choice anxiety, acceptability and trustworthiness of information received (all measured on Likert scales) and reasons for inhaler choice (free text). Study duration will be less than 10 min. We will use t-tests and chi-squared tests for univariable analysis of continuous and binary outcomes respectively, and t, F or likelihood ratio tests for regression models as appropriate.</div></div><div><h3>Results</h3><div>Not applicable – this is a study protocol.</div></div><div><h3>Conclusion</h3><div>This study will provide evidence on whether and how environmental impact information can influence prescribing intentions among GPs. Findings will inform future interventions aimed at aligning clinical and environmental goals in respiratory care.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108657"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway epithelial barrier integrity: an emerging treatable trait in asthma management","authors":"Milos Jesenak ,&nbsp;Anna Bobcakova ,&nbsp;Korneliusz Golebski ,&nbsp;Inge Kortekaas Krohn ,&nbsp;Sven F. Seys ,&nbsp;Zuzana Rennerova ,&nbsp;Peter Durdik ,&nbsp;Ellen Tufvesson ,&nbsp;Adam Markocsy ,&nbsp;Radovan Kosturiak ,&nbsp;Zuzana Diamant","doi":"10.1016/j.rmed.2025.108579","DOIUrl":"10.1016/j.rmed.2025.108579","url":null,"abstract":"<div><div>The airway epithelium not only acts as a physical barrier between the environment and the host, but also functions as an active immunological interface, facilitating crosstalk between the epithelial cells, immune cells and the microbiome aimed at protecting the host. Therefore, maintaining airway epithelial barrier integrity and its functions is crucial for prevention of chronic inflammatory airway diseases, such as allergy, asthma and chronic obstructive pulmonary disease.</div><div>The potential to restore the epithelial barrier by therapeutic interventions has increasingly gained interest over recent years. As part of their disease-modifying properties, various treatment modalities including small molecule drugs, biologics, bronchial thermoplasty and allergen immunotherapy, showed beneficial effects on epithelial barrier integrity in select patient populations.</div><div>In this review, we summarize current knowledge, discuss recent evidence of therapeutic interventions on restoring epithelial barrier function and highlight unmet needs and future research directions.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108579"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year lung function change and variability post allogeneic hematopoietic stem cell transplantation","authors":"Kaj E.C. Blokland ,&nbsp;Troy J. Cross ,&nbsp;Fei Ni Hau ,&nbsp;David Touma ,&nbsp;David G. Chapman ,&nbsp;G Kim Prisk ,&nbsp;Sandra Rutting ,&nbsp;Mark Barrios ,&nbsp;Matthew Greenwood ,&nbsp;Gregory G. King","doi":"10.1016/j.rmed.2026.108670","DOIUrl":"10.1016/j.rmed.2026.108670","url":null,"abstract":"<div><h3>Background and objective</h3><div>Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a well-established treatment for various haematologic and oncologic disorders, yet its clinical success is frequently compromised by complications such as pulmonary graft-versus-host disease (GvHD). Spirometry is the gold standard for monitoring and diagnosis, but it is insensitive to small airway changes. Oscillometry may complement spirometry as a way of detecting change in small airway function. This study assessed the longitudinal change and variability in spirometry and oscillometry following allo-HSCT and predictors of this change.</div></div><div><h3>Methods</h3><div>Longitudinal spirometry and oscillometry were retrospectively obtained from all patients (n = 374) who underwent allo-HSCT at Royal North Shore Hospital in Sydney, Australia, between January 2015 and December 2023.</div></div><div><h3>Results</h3><div>Baseline post allo-HSCT assessments showed significantly lower FEV₁ and FVC in the allo-HSCT group compared to controls. Over the follow-up period, oscillometric indices displayed significant worsening of Rrs₅ and Xrs₅, whereas FEV₁ did not significantly change. Severe cGvHD was associated with a modest decline in FEV₁/FVC and Xrs₅ trajectory. Notably, a subset of patients demonstrated discordant changes between spirometry and oscillometry, suggesting that oscillometry may capture early small airway dysfunction not evident on traditional spirometric measures.</div></div><div><h3>Conclusion</h3><div>These findings underscore the potential of oscillometry as a complementary tool in the routine monitoring of lung function post-allo-HSCT. By detecting subtle changes in small airway mechanics, oscillometry could facilitate earlier identification and intervention in patients at risk for developing pulmonary cGvHD, thereby improving long-term clinical outcomes.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108670"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image-guided shape-sensing robotic-assisted bronchoscopy for subaortic and paraaortic mediastinal lesion sampling","authors":"Vanessa E. Josef ,&nbsp;David M. Wisa ,&nbsp;Brie E. Kezlarian-Sachs ,&nbsp;Bryan C. Husta ,&nbsp;Robert P. Lee ,&nbsp;Rami Naaman ,&nbsp;Catherine L. Oberg ,&nbsp;Matthew J. Bott ,&nbsp;Rastko Rakočević ,&nbsp;Mohit Chawla ,&nbsp;Or Kalchiem-Dekel","doi":"10.1016/j.rmed.2026.108669","DOIUrl":"10.1016/j.rmed.2026.108669","url":null,"abstract":"<div><h3>Background</h3><div>Mediastinal sampling of the subaortic - station 5 - and paraaortic - station 6 - lymph nodes and mediastinal lesions traditionally requires surgical access. Image-guided shape-sensing robotic-assisted bronchoscopy (ssRAB) extends endoscopic reach and may offer an alternative sampling approach. We evaluated the feasibility, diagnostic yield, and safety of ssRAB-guided sampling of these anatomically challenging lesions.</div></div><div><h3>Methods</h3><div>All ssRAB procedures performed from October 2019 to September 2025 were reviewed retrospectively. Procedures in which a subaortic or paraaortic mediastinal lesion was targeted were included in the final analysis. Abstracted variables included patient data, pre-operative imaging, procedural details, peri-operative complications, and sampling results. The primary endpoint was conservative diagnostic yield, defined as the rate of procedures establishing a specific diagnosis.</div></div><div><h3>Results</h3><div>A total of 16 procedures targeting a subaortic or paraaortic mediastinal lesion were identified for the final analysis. The conservative diagnostic yield rate was 69 %. After elimination in one case in which sampling was planned but not pursued, the lenient diagnostic yield rate was 73 %. The conservative diagnostic yield rate was 75 % and 62 % for the subaortic and paraaortic samplings, respectively. One instance of grade 1 pneumothorax was documented. No additional complications were observed.</div></div><div><h3>Conclusion</h3><div>This single-center retrospective case series demonstrated that image-guided ssRAB may represent a feasible, safe, and minimally invasive approach for sampling subaortic and paraaortic mediastinal lymph nodes and lesions, potentially obviating the need for surgical procedures.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108669"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical stability under FF/UMEC/VI triple inhaled therapy: A 12-month real life retrospective observational study","authors":"Mauro Maniscalco ,&nbsp;Claudio Candia ,&nbsp;Francesco Pennisi ,&nbsp;Alfio Pennisi ,&nbsp;Giuseppe De Simone ,&nbsp;Pasquale Ambrosino","doi":"10.1016/j.rmed.2026.108633","DOIUrl":"10.1016/j.rmed.2026.108633","url":null,"abstract":"<div><div>Chronic Obstructive Pulmonary Disease (COPD) remains a leading cause of morbidity and mortality worldwide. For patients with a high disease burden, triple therapy with fluticasone furoate/umeclidinium bromide/vilanterol trifenatate (FF/UMEC/VI) has demonstrated significant benefits in health-related quality of life (HRQoL), exacerbation reduction, and lung function improvement. Efforts have been made to define clinical stability (CS), yet real-world data on CS during FF/UMEC/VI therapy remain limited.</div><div>This retrospective study aimed to assess the prevalence of CS after 12 months (T12) of FF/UMEC/VI treatment in COPD patients. CS was defined as the concurrent presence at T12 of: no acute exacerbations in the prior 12 months, a ≥ 2-point improvement in COPD Assessment Test (CAT) score from baseline, and a forced expiratory volume in 1 s (FEV₁) decline &lt;100 mL.</div><div>A total of 47 patients was included. Of them, 10 (21.3 %) achieved CS. These individuals had a lower baseline exacerbation rate (P = 0.020) and a trend toward better baseline lung function. They also demonstrated greater improvement in 6-min walking distance compared with non-CS patients (P = 0.048).</div><div>These findings suggest that CS is attainable in routine clinical practice, with prevalence comparable to that observed in clinical trials. Patients achieving CS tended to have milder disease, indicating potential benefits of earlier FF/UMEC/VI initiation. This might have a relevant impact in clinical practice, especially in the setting of pulmonary rehabilitation. Nonetheless, further multicenter prospective studies are warranted to validate our findings and to identify predictors of treatment success.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108633"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory syncytial virus in high-risk adults: A critical appraisal of therapeutic options and unmet needs","authors":"Ilias Mariolis ,&nbsp;Kyriaki Ranellou ,&nbsp;Antonios-Periklis Panagiotopoulos ,&nbsp;Cleo Anastassopoulou ,&nbsp;Athanasios Tsakris","doi":"10.1016/j.rmed.2026.108639","DOIUrl":"10.1016/j.rmed.2026.108639","url":null,"abstract":"<div><div>Respiratory syncytial virus (RSV) has traditionally been viewed as a causative agent of pediatric illness, yet accumulating evidence shows substantial morbidity and mortality among adults, particularly older individuals, those with cardiopulmonary comorbidities, and the immunocompromised. Although recent vaccine approvals for older adults represent major progress in prevention, effective therapeutic options for established infection remain limited. Herein we provide a critical analysis of existing and emerging antiviral and monoclonal antibody (mAb) therapies for the management of RSV infection in adults, highlighting current options and compounds in clinical development. At present, ribavirin remains the only antiviral recommended for treatment in adults, and no mAb has received regulatory authorization for prophylaxis or therapy in this population. Several development programs for direct-acting antivirals have been discontinued for reasons unrelated to safety or efficacy in adults, contributing to an ongoing treatment gap. Nevertheless, newer drug candidates, including ziresovir, EDP-938, and S-337395, have shown encouraging antiviral activity and acceptable safety in adult studies. By examining both the scientific evidence and the structural factors shaping the current landscape, we emphasize the need for sustained adult-focused clinical development to complement preventive vaccination. Addressing this therapeutic gap will be essential to reduce the burden of RSV disease in high-risk adult populations, particularly as the global population ages.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108639"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood eosinophilia as a predictor of acute exacerbation in fibrotic interstitial lung diseases","authors":"Mélanie David ,&nbsp;Quentin Marquant ,&nbsp;Anne-Laure Brun ,&nbsp;Kewin Panel ,&nbsp;Alexandre Chabrol ,&nbsp;Helene Salvator ,&nbsp;Antoine Magnan ,&nbsp;Matthieu Groh ,&nbsp;Colas Tcherakian","doi":"10.1016/j.rmed.2026.108640","DOIUrl":"10.1016/j.rmed.2026.108640","url":null,"abstract":"<div><div>Fibrotic interstitial lung disease (fILD) is a heterogeneous group of rare diseases with a poor prognosis. Given the pro-fibrotic effects of eosinophils, we aimed to assess the distribution of blood eosinophil count (BEC) in patients with fILD and to investigate its potential association with outcomes.</div><div>Single-center retrospective study of patients diagnosed with fILD between January 1, 2017 and December 31, 2022. For each patient, BECs during follow-up (except for those sampled during treatment with high-dose glucocorticoids) were pooled to assign a unique number (median). Patients’ characteristics were analysed by BEC (Eo-high and Eo-low subgroups corresponding to BEC ≥75th percentile and &lt;75th percentile, respectively). Predictors of outcomes were assessed by multivariate logistic regression.</div><div>201 patients were included. BEC's median and 75th percentile were 0.2 × 10⁹/L and 0.3 × 10⁹/L, respectively. Baseline BEC and median BEC during follow-up were strongly correlated (r1 = 0.66, 95 % IC 0.52–0.78, p &lt; 0.001). Eo-high patients were significantly older (73 vs. 67 years, p = 0.014) and more likely to experience AE-ILD (36 % vs. 15 %, p = 0.002). In multivariate analysis, a diagnosis of IPF (OR 2.62, 95 % IC 1.05–7.02, p = 0.05), idiopathic NSIP (OR 3.69, 95 % IC 0.99–13.74, p = 0.05), baseline supplemental oxygen therapy (OR 4.71, 95 % IC 2.09–10.82, p &lt; 0.001) and median BEC ≥0.3 × 10⁹/L (OR 2.76, 95 % IC 1.25–6.14, p = 0.01) were associated with AE-ILD.</div><div>BEC can be associated with AE-ILD. These findings pave the way for future research regarding the role of eosinophils in fILD.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108640"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of detecting asbestos bodies in bronchoalveolar lavage fluid in diffuse lung disease","authors":"Yuji Inagaki ,&nbsp;Yoshinobu Matsuda ,&nbsp;Chikatoshi Sugimoto ,&nbsp;Tomoaki Teramoto ,&nbsp;Shigeki Shimizu ,&nbsp;Masanori Akira ,&nbsp;Toru Arai ,&nbsp;Yoshikazu Inoue","doi":"10.1016/j.rmed.2026.108642","DOIUrl":"10.1016/j.rmed.2026.108642","url":null,"abstract":"<div><h3>Background</h3><div>Asbestos bodies (ABs) in bronchoalveolar lavage fluid (BALF) are valuable markers for assessing past asbestos exposure. However, the clinical significance of detecting ABs at ≥1 AB/mL in patients with diffuse lung disease remains unclear. Herein, we investigated the clinical utility of detecting ABs at this threshold, focusing on its association with asbestos exposure history, bronchoalveolar lavage (BAL) cellular analysis, imaging findings, and the rate of respiratory function decline in patients with diffuse lung disease.</div></div><div><h3>Methods</h3><div>This retrospective single-center study included patients who underwent BAL and asbestos body (AB) quantification for respiratory disease evaluation. The relationship between the AB number (cutoff: 1 AB/mL) and clinical parameters was analyzed. Pulmonary function decline was assessed in patients with ≥1 year of follow-up.</div></div><div><h3>Results</h3><div>This study involved 304 patients. An AB number of ≥1 AB/mL was significantly associated with asbestos exposure history (p &lt; 0.001) and the presence of pleural plaques on computerized tomography (CT) imaging (p &lt; 0.001). However, no significant differences were found in BAL cellular patterns or respiratory function decline between patients with an AB number of ≥1 AB/mL and those with &lt;1 AB/mL.</div></div><div><h3>Conclusion</h3><div>The presence of ≥1 AB/mL in the BALF reflects substantial asbestos exposure and is associated with pleural plaques on CT imaging but not with BAL cellular patterns or the rate of decline in respiratory function. These findings suggest that AB detection in BALF has limited predictive value for respiratory function decline but could be valuable for identifying unrecognized asbestos exposure in patients with diffuse lung disease.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108642"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep efficiency and disturbance is associated with cardiovascular risk in non-obese sleep disordered breathing: The Guangdong sleep health study","authors":"Miaochan Lao ,&nbsp;Guangliang Shan ,&nbsp;Tong Feng ,&nbsp;Ruohan Zhou ,&nbsp;Ping Yuan ,&nbsp;Yaoda Hu ,&nbsp;Qiong Ou","doi":"10.1016/j.rmed.2026.108644","DOIUrl":"10.1016/j.rmed.2026.108644","url":null,"abstract":"<div><h3>Background and objective</h3><div>We aimed to figure out the risk factors for cardiovascular disease (CVD) in the participants with non-obese sleep disordered breathing (SDB).</div></div><div><h3>Methods</h3><div>This was a cross-sectional study. Community residents in Guangdong were investigated. Sleep study was conducted with a type Ⅳ sleep monitoring. Cardiovascular risk was assessed by the China-PAR risk equations.</div></div><div><h3>Results</h3><div>1983 community residents with SDB were included, 92.4 % were non-obese. 270 (18.9 %) were with high risk of CVD in the non-obese SDB, while 33 (28.2 %) in the obese SDB (<em>P</em> = 0.021). In the non-obese SDB, the Pittsburgh sleep quality index (PSQI) was higher in participants with high risk of CVD comparing with those with low risk of CVD (<em>P</em> = 0.013). Sleep efficiency and sleep disturbance were independently associated with high risk of CVD in participants with non-obese SDB (<em>OR</em> = 1.369, <em>P</em> = 0.020; <em>OR</em> = 1.489, <em>P</em> = 0.027, respectively). Comparing with a normal sleep efficiency, the probability for high CVD risk increased 152 % in non-obese SDB with a sleep efficiency ≤64 %. Comparing with no sleep disturbance, the probability for high CVD risk increased 109 % in non-obese SDB with fairly bad sleep disturbance. There was no such relationship between PSQI components and CVD risk in the participants with obese SDB.</div></div><div><h3>Conclusion</h3><div>The majority of SDB was non-obese in the community in Guangdong. CVD risk was increased in non-obese SDB. A bad subjective sleep efficiency and sleep disturbance were associated with high CVD risk in non-obese SDB. Non-obese SDB may be treated as a specific phenotype.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"252 ","pages":"Article 108644"},"PeriodicalIF":3.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}