Clinical Respiratory Journal最新文献

Lung squamous cell carcinoma (LUSC) is one of the most common subtype of lung cancer and is associated with the poor prognoses. The fibroblast growth factor receptor (FGFR) family is known to be activated through fusions with various partners across multiple cancer types, including nonsmall cell lung cancer (NSCLC). FGFR inhibitors are currently undergoing clinical evaluation for the treatment of tumors harboring these fusions. While FGFR1 amplification has been well-documented in numerous NSCLC datasets, the characterization of specific FGFR fusion variants remains limited. In this study, we identified a novel PLPP5-FGFR1 fusion in a 65-year-old male patient with lung squamous cell carcinoma through targeted RNA sequencing. The fusion junction was located between exon 1 of PLPP5 and exon 5 of FGFR1, and the result was validated by Sanger sequencing. To our knowledge, this is the first reported case of a PLPP5-FGFR1 fusion coexisting with a TP53 mutation in LUSC. These findings broaden the spectrum of potential translocation partners in FGFR1 fusions, and the clinical implications of this novel fusion on treatment outcomes and prognosis warrant further investigation and long-term follow-up.

Obstructive sleep apnea (OSA) is closely associated with cardiovascular diseases, and its impact on coronary heart disease (CHD) has been increasingly investigated [1, 2]. The pathophysiological mechanisms of OSA, such as recurrent nocturnal hypoxemia and increased sympathetic nervous system activation, can lead to endothelial dysfunction and early atherosclerotic changes, thereby heightening the risk of CHD [2-4]. Additionally, OSA shares common characteristics with other major cardiovascular risk factors, including hypertension, obesity, and metabolic syndrome, further underscoring the strong relationship between these conditions [5, 6]. Therefore, effective screening and management of OSA may play a significant role in the prevention and treatment of CHD.

We have reviewed with great interest the study by Guo Pei et al., titled “Screening for Obstructive Sleep Apnea Before Coronary Angiography,” which highlights the importance of OSA screening prior to coronary angiography [7]. While this valuable study contributes to the literature, we believe it could yield more impactful results with some refinements.

First, since the primary focus of the study is the importance of OSA screening, selecting OSA rather than CHD as the primary endpoint might be more appropriate. This adjustment could better align the study with its focus on assessing the clinical implications of OSA and provide a more coherent framework for its objectives. Presenting and comparing the characteristics of OSA (+) and OSA (−) groups, along with conducting a multivariable analysis of these data, could also enhance the clarity and interpretability of the findings. Logistic regression analyses based on these groups could more effectively evaluate the independent predictors of OSA detection.

The current multivariable analysis model includes parameters with high collinearity (e.g., total cholesterol, LDL, HDL), which may adversely affect the model's accuracy and result in multicollinearity issues. Evaluating the model's fit using measures such as the Hosmer–Lemeshow test and considering alternative models could help better elucidate the independent effects of each parameter.

Lastly, performing a receiver operating characteristic (ROC) analysis to clarify the relationship between OSA screening and Gensini scores could provide a more precise determination of a cut-off value with high sensitivity for OSA. This additional analysis would facilitate a more practical interpretation of the results and enhance the study's clinical applicability.

Baris Demirkol and Celal Satici contributed to the study's design and implementation, the evaluation and analysis of the results, and the drafting of the manuscript.

The authors declare no conflicts of interest.

The distribution and the function of T lymphocyte subsets in pleural effusion (PE) and peripheral blood (PB) in tuberculous pleural effusion (TPE) patients remain unclear. In this study, we aimed to explore the expression patterns, regulatory mechanisms, and functions of T lymphocyte subsets in TPE patients, especially the distribution of T lymphocyte subsets at the single cell level. The CD3⁺ T cells were isolated from PE and PB of four TPE patients for single-cell RNA sequencing (scRNA-seq) to screen T cell subsets. T-SNE projection, Gene Set Variation Analysis (GSVA), and pseudotime analysis were performed to analyze the composition, molecular and functional properties, and developmental trajectories of T cell subsets. Finally, ELISA was carried out to identify the cytokines secreted by PE and PB. We found that CD4⁺CD8⁻ T lymphocytes (Th1, Th2, and FOXP3⁺ Treg cells) were preferentially enriched in PE. The proportion of exhausted CD4⁻CD8⁺ cells in PE was higher than that in PB, while the proportion of initial and effector CD4⁻CD8⁺ cells was quite the reverse. We also found a large number of unexpected double positive (DP) cells in PE and PB, among which the proportion of CD4⁺CD8⁺-C10-CCL3 cells was the most different between PE and PB. Meanwhile, CD4⁺CD8⁺-C10-CCL3 was the group with the largest number of interactions with other groups. CD4⁻CD8⁻ cells were mainly found in PE and may be involved in the immunomodulatory effect of PE. Furthermore, the concentrations of cytokines secreted by Th1, Th2, and Treg in PE were higher than those in PB. Our study is helpful to understand the distribution pattern and dynamic changes of T cells in PE and PB of TPE patients and further understand that the functional status and regulation of T cells will be crucial for the successful development of TPE immunotherapy.

Tuberculosis is a global public health threat as an infectious disease, and effective blocking of transmission relies on timely diagnosis. Although a number of laboratory tests are available in diagnosing Mycobacterium tuberculosis (MTB) and nontuberculous mycobacteria (NTM), it is still of great need to evaluate their diagnostic value in clinical samples. In this study, we evaluated five MTB diagnostic methods (including conventional sputum smear microscopy, sandwich cup sputum smear microscopy, sputum culture, Xpert-MTB/RIF, and CapitalBio TB/NTM kit detection test) in 3012 sputum specimens and compared their diagnostic performance of the single and combined tests. In the diagnosis of MTB, the Xpert-MTB/RIF had the highest sensitivity, 79.6% (0.770–0.819), among all the single diagnostic methods, and the combination of CapitalBio TB/NTM kit and culture approach significantly increased sensitivity to 88.4% (p < 0.05). In the diagnosis of NTM, the culture method has higher sensitivity (85.7%) compared with the Capital Bio TB/NTM kit method (45.7%). In the diagnosis of mycobacteria, the CapitalBio TB/NTM kit detection test has the highest sensitivity (77.1%) and combined with conventional sputum smear and culture significantly increased the sensitivity further to 84.2%. In conclusion, Xpert-MTB/RIF is a sensitive, rapid, and reliable method for TB detection in sputum samples, and other diagnostic methods including culture are still of great clinical values for improving the sensitivity of MTB diagnosis. The sensitivity of CapitalBio TB/NTM kit in diagnosing NTM is still insufficient in clinical practice.