Haiyang Wang, Tongyangzi Zhang, Li Yu, Xianghuai Xu
Patients with various etiologies of chronic cough may have psychological disorders, and those with psychological disorders may also exhibit physical symptoms such as coughing. The terminology “psychogenic cough” and “somatic cough syndrome” have been used to describe chronic cough patients with underlying psychological issues, but both terms lack clear definitions and diagnostic criteria. This article provides a review of the definition changes, pathogenesis, and diagnostic and therapeutic points related to chronic cough with comorbid psychological disorders based on relevant studies of psychogenic cough and somatic cough syndrome.
{"title":"From Psychogenic Cough to Somatic Cough Syndrome","authors":"Haiyang Wang, Tongyangzi Zhang, Li Yu, Xianghuai Xu","doi":"10.1111/crj.70152","DOIUrl":"10.1111/crj.70152","url":null,"abstract":"<p>Patients with various etiologies of chronic cough may have psychological disorders, and those with psychological disorders may also exhibit physical symptoms such as coughing. The terminology “psychogenic cough” and “somatic cough syndrome” have been used to describe chronic cough patients with underlying psychological issues, but both terms lack clear definitions and diagnostic criteria. This article provides a review of the definition changes, pathogenesis, and diagnostic and therapeutic points related to chronic cough with comorbid psychological disorders based on relevant studies of psychogenic cough and somatic cough syndrome.</p>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"20 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of this study was to examine the development of chronic thromboembolic pulmonary disease (CTEPD) incidence, risk factors, and coexisting medical conditions following an episode of acute pulmonary embolism (PE).
Materials
This retrospective, cross-sectional study analyzed data from 722 patients diagnosed with PE. Group I (n = 663), consisting of individuals who did not develop CTEPD, and Group II (n = 59), comprising those who progressed to CTEPD. CTEPD were divided into two subgroups as chronic thromboembolic pulmonary hypertension (CTEPH, n = 23) and without pulmonary hypertension (PH) (n = 36). The groups were compared based on demographic features, comorbid conditions, risk factors, and initial systolic pulmonary artery pressure (sPAP) values.
Results
CTEPD was observed in 59 patients (8.2%). Chronic obstructive pulmonary disease, coronary artery disease, and elevated baseline sPAP demonstrated a significant association with CTEPD (p = 0.003, p = 0.041, and p = 0.024, respectively). Immobilization was found to be significantly more prevalent in Group I (p = 0.032). In the multivariate logistic regression analysis, each 1 mmHg increase in baseline sPAP was associated with a 1.04-fold elevation in the risk of CTEPD development (95% confidence interval [CI]: 1.02–1.05; p < 0.001). Additionally, a 1-year decrease in age was linked to a 1.03-fold increase in the probability of developing CTEPD (95% CI: 1.01–1.05; p = 0.003). No significant differences were found between patients with CTEPH and those with CTEPD without PH.
Conclusion
These findings highlight the important role of comorbid conditions in the development of CTEPD. It is important to optimize the clinical management of patients with such comorbidities to reduce the risk of CTEPD development.
{"title":"Evaluation of Predisposing Factors and Coexisting Diseases in the Development of Chronic Thromboembolic Pulmonary Disease","authors":"Ebru Sengul Parlak, Beyza Aybuke Aydin Uzun, Kubra Gungor, Eren Goktug Ceylan, Kubra Isik, Rabia Damla Kiziltas, Dina Serin, Umran Ozden Sertcelik, Serdal Bastug, Zeynep Hande Kocaer, Derya Sokmen, Izzet Selcuk Parlak, Ayşegül Karalezli","doi":"10.1111/crj.70147","DOIUrl":"10.1111/crj.70147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The objective of this study was to examine the development of chronic thromboembolic pulmonary disease (CTEPD) incidence, risk factors, and coexisting medical conditions following an episode of acute pulmonary embolism (PE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials</h3>\u0000 \u0000 <p>This retrospective, cross-sectional study analyzed data from 722 patients diagnosed with PE. Group I (<i>n</i> = 663), consisting of individuals who did not develop CTEPD, and Group II (<i>n</i> = 59), comprising those who progressed to CTEPD. CTEPD were divided into two subgroups as chronic thromboembolic pulmonary hypertension (CTEPH, <i>n</i> = 23) and without pulmonary hypertension (PH) (<i>n</i> = 36). The groups were compared based on demographic features, comorbid conditions, risk factors, and initial systolic pulmonary artery pressure (sPAP) values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CTEPD was observed in 59 patients (8.2%). Chronic obstructive pulmonary disease, coronary artery disease, and elevated baseline sPAP demonstrated a significant association with CTEPD (<i>p</i> = 0.003, <i>p</i> = 0.041, and <i>p</i> = 0.024, respectively). Immobilization was found to be significantly more prevalent in Group I (<i>p</i> = 0.032). In the multivariate logistic regression analysis, each 1 mmHg increase in baseline sPAP was associated with a 1.04-fold elevation in the risk of CTEPD development (95% confidence interval [CI]: 1.02–1.05; <i>p</i> < 0.001). Additionally, a 1-year decrease in age was linked to a 1.03-fold increase in the probability of developing CTEPD (95% CI: 1.01–1.05; <i>p</i> = 0.003). No significant differences were found between patients with CTEPH and those with CTEPD without PH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings highlight the important role of comorbid conditions in the development of CTEPD. It is important to optimize the clinical management of patients with such comorbidities to reduce the risk of CTEPD development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12744955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maitreyee Mohanty, Fei Tang, John Fastenau, Joseph Feliciano, Melanie Lauterio, Sebastian Fucile, Mahroz Haider, Ruxana T. Sadikot
Background
Although patients with bronchiectasis often have comorbidities, the impact of bronchiectasis on managing these is unknown. This study assessed the incremental burden of managing chronic obstructive pulmonary disease (COPD), asthma, and rheumatoid arthritis in patients with bronchiectasis.
Methods
This retrospective cohort study using Merative MarketScan US claims data included patients with a COPD, asthma, or rheumatoid arthritis diagnosis between January 2017 and December 2021. Within these cohorts, patients with a bronchiectasis diagnosis (excluding cystic fibrosis) were compared with nonbronchiectasis controls following 1:1 propensity score matching (1:2 for rheumatoid arthritis). Comorbid disease-specific inpatient, outpatient, and emergency room (ER) visits and direct medical costs were reported.
Results
After matching, 4291 patients with COPD, 2460 with asthma, and 566 with rheumatoid arthritis, all with bronchiectasis, and the corresponding controls, were included. For patients with COPD, proportions with COPD-related outpatient (66.5% vs. 56.8%), ER (7.5% vs. 5.8%), and inpatient visits (4.5% vs. 3.1%), as well as respiratory-related ($11 054 vs. $6961) and disease-specific ($1384 vs. $1107) costs were significantly higher in the bronchiectasis cohort (vs. control cohort). For patients with asthma, asthma-related outpatient visits (52.0% vs. 41.1%), respiratory-related ($10 327 vs. $5458), and disease-specific ($489 vs. $221) costs were significantly higher in the bronchiectasis cohort. For patients with rheumatoid arthritis, rheumatoid arthritis-specific PPPY outpatient (5.1 vs. 3.9) and specialist visits (3.5 vs. 2.5), and disease-specific ($4820 vs. $2592) costs were significantly higher in the bronchiectasis cohort (p < 0.05 for all comparisons).
Conclusions
Bronchiectasis is associated with higher comorbid disease-related healthcare resource utilization and costs and complicates the management of comorbid conditions.
背景：虽然支气管扩张患者经常有合并症，但支气管扩张对治疗这些合并症的影响尚不清楚。本研究评估了支气管扩张患者管理慢性阻塞性肺疾病（COPD）、哮喘和类风湿关节炎的增量负担。方法：这项回顾性队列研究使用美国Merative MarketScan索赔数据，包括2017年1月至2021年12月期间诊断为COPD、哮喘或类风湿关节炎的患者。在这些队列中，诊断为支气管扩张的患者（不包括囊性纤维化）与非支气管扩张的对照组进行1:1倾向评分匹配（类风湿关节炎1:2）。报告了合并症特定的住院、门诊和急诊室（ER）就诊和直接医疗费用。结果：匹配后纳入COPD患者4291例，哮喘患者2460例，类风湿关节炎患者566例，均为支气管扩张患者，并纳入相应对照。对于COPD患者，COPD相关门诊（66.5% vs. 56.8%）、急诊（7.5% vs. 5.8%）和住院（4.5% vs. 3.1%）以及呼吸相关（11,054美元vs. 6961美元）和疾病特异性（1384美元vs. 1107美元）费用的比例在支气管扩张队列中显著高于对照组。对于哮喘患者，哮喘相关门诊就诊（52.0%对41.1%）、呼吸相关（10327美元对5458美元）和疾病特异性（489美元对221美元）的费用在支气管扩张队列中显著更高。对于类风湿关节炎患者，类风湿关节炎特异性PPPY门诊（5.1 vs. 3.9）和专科就诊（3.5 vs. 2.5）以及疾病特异性（$4820 vs. $2592）费用在支气管扩张队列中显著更高(p结论：支气管扩张与更高的合并症疾病相关的医疗资源利用和成本相关，并使合并症的管理复杂化。
{"title":"Impact of Bronchiectasis on Healthcare Resource Utilization and Direct Medical Costs of Managing Comorbid Chronic Obstructive Pulmonary Disease, Asthma, and Rheumatoid Arthritis in the United States","authors":"Maitreyee Mohanty, Fei Tang, John Fastenau, Joseph Feliciano, Melanie Lauterio, Sebastian Fucile, Mahroz Haider, Ruxana T. Sadikot","doi":"10.1111/crj.70150","DOIUrl":"10.1111/crj.70150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although patients with bronchiectasis often have comorbidities, the impact of bronchiectasis on managing these is unknown. This study assessed the incremental burden of managing chronic obstructive pulmonary disease (COPD), asthma, and rheumatoid arthritis in patients with bronchiectasis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study using Merative MarketScan US claims data included patients with a COPD, asthma, or rheumatoid arthritis diagnosis between January 2017 and December 2021. Within these cohorts, patients with a bronchiectasis diagnosis (excluding cystic fibrosis) were compared with nonbronchiectasis controls following 1:1 propensity score matching (1:2 for rheumatoid arthritis). Comorbid disease-specific inpatient, outpatient, and emergency room (ER) visits and direct medical costs were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After matching, 4291 patients with COPD, 2460 with asthma, and 566 with rheumatoid arthritis, all with bronchiectasis, and the corresponding controls, were included. For patients with COPD, proportions with COPD-related outpatient (66.5% vs. 56.8%), ER (7.5% vs. 5.8%), and inpatient visits (4.5% vs. 3.1%), as well as respiratory-related ($11 054 vs. $6961) and disease-specific ($1384 vs. $1107) costs were significantly higher in the bronchiectasis cohort (vs. control cohort). For patients with asthma, asthma-related outpatient visits (52.0% vs. 41.1%), respiratory-related ($10 327 vs. $5458), and disease-specific ($489 vs. $221) costs were significantly higher in the bronchiectasis cohort. For patients with rheumatoid arthritis, rheumatoid arthritis-specific PPPY outpatient (5.1 vs. 3.9) and specialist visits (3.5 vs. 2.5), and disease-specific ($4820 vs. $2592) costs were significantly higher in the bronchiectasis cohort (<i>p</i> < 0.05 for all comparisons).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Bronchiectasis is associated with higher comorbid disease-related healthcare resource utilization and costs and complicates the management of comorbid conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12740571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guoping Zhang, Yuan Zhuang, Sai Wang, Qun Wang, Jun Qin, Zhi Yuan, Jing Zheng
Background
Respiratory viral infections are increasingly recognized as important triggers of acute exacerbations in bronchiectasis (AEB); the virological profiles and immunological mechanisms in elderly patients remain poorly characterized.
Methods
A prospective cohort of 102 elderly bronchiectasis patients was followed for 12 months. Upon AEB occurrence, nasopharyngeal swabs were obtained for multiplex fluorescence quantitative PCR detection of eight respiratory viruses, while peripheral blood samples were analyzed for T lymphocyte subsets by flow cytometry. Clinical characteristics, inflammatory markers, and T cell subsets were compared between virus-positive and virus-negative groups at first AEB; ROC curve analysis evaluated the predictive value of T cell subsets for viral infection.
Results
A total of 93 AEB episodes were captured from 68 patients during 12-month follow-up, with viruses detected in 54.8% (51 of 93) of episodes, influenza virus being the most common pathogen (24 of 51, 47.1%). Compared with the virus-negative group, the virus-positive group showed higher IL-6 and TNF-α and lower CRP and WBC levels (p < 0.05), higher sputum culture positivity with Haemophilus influenzae predominating, along with increased use of intravenous antibiotics and respiratory support, while quality of life, pulmonary function, and oxygenation remained comparable. The virus-positive group showed lower CD4+ T cell counts (431.28 ± 152.36 vs. 508.42 ± 158.94, p = 0.025) and CD4+/CD8+ ratios (1.41 ± 0.44 vs. 1.63 ± 0.49, p = 0.013).
Conclusions
Viral infections are frequent in elderly bronchiectasis patients with AEB and are characterized by reduced CD4+ T-cell counts, lower CD4+/CD8+ ratios, and heightened inflammatory responses, reflecting underlying age-related immune vulnerability.
{"title":"Association Between Respiratory Viral Infection and Peripheral T Lymphocyte Subsets in Elderly Patients With Acute Exacerbation of Bronchiectasis","authors":"Guoping Zhang, Yuan Zhuang, Sai Wang, Qun Wang, Jun Qin, Zhi Yuan, Jing Zheng","doi":"10.1111/crj.70151","DOIUrl":"10.1111/crj.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Respiratory viral infections are increasingly recognized as important triggers of acute exacerbations in bronchiectasis (AEB); the virological profiles and immunological mechanisms in elderly patients remain poorly characterized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective cohort of 102 elderly bronchiectasis patients was followed for 12 months. Upon AEB occurrence, nasopharyngeal swabs were obtained for multiplex fluorescence quantitative PCR detection of eight respiratory viruses, while peripheral blood samples were analyzed for T lymphocyte subsets by flow cytometry. Clinical characteristics, inflammatory markers, and T cell subsets were compared between virus-positive and virus-negative groups at first AEB; ROC curve analysis evaluated the predictive value of T cell subsets for viral infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 93 AEB episodes were captured from 68 patients during 12-month follow-up, with viruses detected in 54.8% (51 of 93) of episodes, influenza virus being the most common pathogen (24 of 51, 47.1%). Compared with the virus-negative group, the virus-positive group showed higher IL-6 and TNF-α and lower CRP and WBC levels (<i>p</i> < 0.05), higher sputum culture positivity with <i>Haemophilus influenzae</i> predominating, along with increased use of intravenous antibiotics and respiratory support, while quality of life, pulmonary function, and oxygenation remained comparable. The virus-positive group showed lower CD4<sup>+</sup> T cell counts (431.28 ± 152.36 vs. 508.42 ± 158.94, <i>p</i> = 0.025) and CD4<sup>+</sup>/CD8<sup>+</sup> ratios (1.41 ± 0.44 vs. 1.63 ± 0.49, <i>p</i> = 0.013).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Viral infections are frequent in elderly bronchiectasis patients with AEB and are characterized by reduced CD4<sup>+</sup> T-cell counts, lower CD4<sup>+</sup>/CD8<sup>+</sup> ratios, and heightened inflammatory responses, reflecting underlying age-related immune vulnerability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12740622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chebly Dagher, Maria Akiki, Kristen Swanson, Brett Carollo, Elizabeth Chernobelsky, Harrison W. Farber, Raj Parikh
Pulmonary arterial hypertension (PAH) is a progressive disease characterized by increased pulmonary vascular resistance (PVR) leading to right ventricular failure and high mortality. Parenteral prostacyclin therapy remains the cornerstone for high-risk patients but is limited by complications and reduced quality of life. Sotatercept, an activin signaling inhibitor, has recently emerged as an effective adjunct therapy in PAH, improving functional and hemodynamic outcomes. This case series evaluated whether the addition of sotatercept could facilitate the transition from intravenous (IV) to oral prostacyclin in eight high-risk PAH patients who had previously failed transition attempts. All patients received background dual therapy with endothelin receptor antagonists and phosphodiesterase-5 inhibitors and were transitioned from IV to oral treprostinil following the fifth dose of sotatercept. At 24 weeks, all eight patients successfully maintained oral therapy without re-initiation of IV prostacyclin. Significant improvements were observed in 6-min walk distance, WHO functional class, right ventricular systolic pressure, and PVR. No treatment discontinuations or serious adverse events occurred. These findings suggest that adjunctive sotatercept may enable safe and effective transition from parenteral to oral prostacyclin therapy, expanding treatment flexibility and improving quality of life in high-risk PAH patients. Prospective studies are warranted to confirm long-term outcomes.
{"title":"Use of Sotatercept to Facilitate Transition From Intravenous to Oral Prostacyclin Therapy","authors":"Chebly Dagher, Maria Akiki, Kristen Swanson, Brett Carollo, Elizabeth Chernobelsky, Harrison W. Farber, Raj Parikh","doi":"10.1111/crj.70149","DOIUrl":"10.1111/crj.70149","url":null,"abstract":"<p>Pulmonary arterial hypertension (PAH) is a progressive disease characterized by increased pulmonary vascular resistance (PVR) leading to right ventricular failure and high mortality. Parenteral prostacyclin therapy remains the cornerstone for high-risk patients but is limited by complications and reduced quality of life. Sotatercept, an activin signaling inhibitor, has recently emerged as an effective adjunct therapy in PAH, improving functional and hemodynamic outcomes. This case series evaluated whether the addition of sotatercept could facilitate the transition from intravenous (IV) to oral prostacyclin in eight high-risk PAH patients who had previously failed transition attempts. All patients received background dual therapy with endothelin receptor antagonists and phosphodiesterase-5 inhibitors and were transitioned from IV to oral treprostinil following the fifth dose of sotatercept. At 24 weeks, all eight patients successfully maintained oral therapy without re-initiation of IV prostacyclin. Significant improvements were observed in 6-min walk distance, WHO functional class, right ventricular systolic pressure, and PVR. No treatment discontinuations or serious adverse events occurred. These findings suggest that adjunctive sotatercept may enable safe and effective transition from parenteral to oral prostacyclin therapy, expanding treatment flexibility and improving quality of life in high-risk PAH patients. Prospective studies are warranted to confirm long-term outcomes.</p>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samuel C. Okpechi, Dorota Wyczechowska, Bennett DeBoisblanc, Jessica L. Johnson, Mohamed A. Ghonim, Natalie Bauer, Hamid A. Boulares, Matthew R. Lammi
Introduction
There are no treatments directly targeting the pulmonary vasculature in chronic obstructive pulmonary disease (COPD), and further characterization of the underlying endothelial cell (EC) abnormalities could be helpful in drug development.
Methods
We investigated the influence of exercise and the prostacyclin analog iloprost on extracellular vesicles derived from ECs (eEVs) in 15 moderate–severe COPD patients who were enrolled in a randomized, placebo-controlled crossover trial of iloprost.
Results
Active smokers had a profile consistent with inflammatory-derived EVs, while exacerbation-prone COPD subjects had a profile consistent with apoptosis-derived eEVs. There were no significant effects of iloprost on eEV levels. However, there was a significant increase in CD144+ and CD31+/CD144+ EVs 1 h after exercise.
Conclusions
Endothelial-derived EV profiles differed based on smoking and exacerbation history. Iloprost did not affect eEV levels, although maximal exercise induced a delayed increase in a subset of eEVs, possibly through shear stress.
{"title":"Endothelial-Derived Extracellular Vesicles During Exercise in COPD Patients","authors":"Samuel C. Okpechi, Dorota Wyczechowska, Bennett DeBoisblanc, Jessica L. Johnson, Mohamed A. Ghonim, Natalie Bauer, Hamid A. Boulares, Matthew R. Lammi","doi":"10.1111/crj.70146","DOIUrl":"10.1111/crj.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There are no treatments directly targeting the pulmonary vasculature in chronic obstructive pulmonary disease (COPD), and further characterization of the underlying endothelial cell (EC) abnormalities could be helpful in drug development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We investigated the influence of exercise and the prostacyclin analog iloprost on extracellular vesicles derived from ECs (eEVs) in 15 moderate–severe COPD patients who were enrolled in a randomized, placebo-controlled crossover trial of iloprost.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Active smokers had a profile consistent with inflammatory-derived EVs, while exacerbation-prone COPD subjects had a profile consistent with apoptosis-derived eEVs. There were no significant effects of iloprost on eEV levels. However, there was a significant increase in CD144+ and CD31+/CD144+ EVs 1 h after exercise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Endothelial-derived EV profiles differed based on smoking and exacerbation history. Iloprost did not affect eEV levels, although maximal exercise induced a delayed increase in a subset of eEVs, possibly through shear stress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12682462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the clinical features and risk factors for Mycoplasma pneumoniae pneumonia (MPP) complicated with plastic bronchitis (PB) and to provide a reference for the early diagnosis and treatment of this disease.
Methods
Clinical data from 75 pediatric patients diagnosed with MPP who underwent bronchoscopy at our hospital between June 16 and December 31, 2023, were retrospectively analyzed. Patients were stratified into PB and non-PB groups based on the presence or absence of bronchial cast removal during bronchoscopy. Comparative analysis of clinical characteristics was performed between the two groups. Binary logistic regression analysis was employed to identify risk factors associated with MPP complicated by PB. Additionally, bronchial cast components obtained from the PB group underwent compositional analysis using proteomic techniques via mass spectrometry.
Results
The composition ratio of children with fever frequency and a heat course ≥ 10 days in the PB group. The composition ratio, neutrophil ratio, erythrocyte sedimentation rate (ESR) and levels of C-reactive protein, lactate dehydrogenase, procalcitonin (PCT) and D-dimer in children with lung compaction were significantly greater than those in the non-PB group (t = 2.290–3.793, χ2 = 5.548, 5.659, Z = −2.085, p < 0.05). Multivariate logistic regression analysis revealed that the PCT level (OR = 1.071, 95% CI = 1.015–1.130, p < 0.05) and ESR (OR = 1.088, 95% CI = 1.033–1.146, p < 0.05) were risk factors for PB. Protein mass spectrometry showed that the bronchial plastic was rich in fibrinogen.
Conclusions
Compared with children with MPP alone, children with PB have a more intense inflammatory response, and the possibility of MPP with PB should be vigilant when the ESR > 25.20 mm/1 h and PCT > 0.19 μg/L. Bronchial plastics in children with PB contain a large amount of fibrin, which may be related to the abnormal activation of coagulation and fibrinolysis systems caused by inflammation.
{"title":"Risk Factor Analysis of Mycoplasma pneumoniae Pneumonia Complicated With Plastic Bronchitis in Children: A Single-Center Retrospective Study","authors":"Jian-Min Dong, Chun-Qing Zhou, Yuan-Yuan Zhen","doi":"10.1111/crj.70142","DOIUrl":"10.1111/crj.70142","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the clinical features and risk factors for <i>Mycoplasma pneumoniae</i> pneumonia (MPP) complicated with plastic bronchitis (PB) and to provide a reference for the early diagnosis and treatment of this disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical data from 75 pediatric patients diagnosed with MPP who underwent bronchoscopy at our hospital between June 16 and December 31, 2023, were retrospectively analyzed. Patients were stratified into PB and non-PB groups based on the presence or absence of bronchial cast removal during bronchoscopy. Comparative analysis of clinical characteristics was performed between the two groups. Binary logistic regression analysis was employed to identify risk factors associated with MPP complicated by PB. Additionally, bronchial cast components obtained from the PB group underwent compositional analysis using proteomic techniques via mass spectrometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The composition ratio of children with fever frequency and a heat course ≥ 10 days in the PB group. The composition ratio, neutrophil ratio, erythrocyte sedimentation rate (ESR) and levels of C-reactive protein, lactate dehydrogenase, procalcitonin (PCT) and D-dimer in children with lung compaction were significantly greater than those in the non-PB group (<i>t</i> = 2.290–3.793, χ<sup>2</sup> = 5.548, 5.659, <i>Z</i> = −2.085, <i>p</i> < 0.05). Multivariate logistic regression analysis revealed that the PCT level (OR = 1.071, 95% CI = 1.015–1.130, <i>p</i> < 0.05) and ESR (OR = 1.088, 95% CI = 1.033–1.146, <i>p</i> < 0.05) were risk factors for PB. Protein mass spectrometry showed that the bronchial plastic was rich in fibrinogen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared with children with MPP alone, children with PB have a more intense inflammatory response, and the possibility of MPP with PB should be vigilant when the ESR > 25.20 mm/1 h and PCT > 0.19 μg/L. Bronchial plastics in children with PB contain a large amount of fibrin, which may be related to the abnormal activation of coagulation and fibrinolysis systems caused by inflammation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asthma is the most common chronic health condition affecting children in Aotearoa New Zealand, with Māori and Pacific children disproportionately burdened by high morbidity and inequitable care. Despite clinical guidelines and growing research, inconsistencies in diagnosis, treatment adherence, and education persist. This scoping review identifies and maps literature on care models, service delivery, education and support strategies, and experiences of children, young people, and their family/whānau in asthma care and management for those under 18 in Aotearoa New Zealand.
Methods
This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. We searched MEDLINE, CINAHL, Scopus, PsychINFO, and grey literature for articles published between 2014 and 2024 on asthma care for children under 18 in Aotearoa New Zealand. Eligible articles from health or community settings were thematically analysed using conventional content analysis.
Results
Twenty-one articles met inclusion criteria, including qualitative, quantitative, mixed-methods, and policy or guideline documents. Thematic analysis revealed four interconnected themes: (1) medications and adherence, (2) education and health literacy, (3) children and whānau experiences, and (4) culture and beliefs. Findings reflect persistent inequities in asthma outcomes and care access, especially for Māori and Pacific children and highlight opportunities to strengthen culturally safe and family/whānau-centred care to improve asthma care, treatment and its management.
Conclusion
This review identifies key gaps in asthma care for children in Aotearoa New Zealand and calls for more responsive, culturally grounded models to improve asthma outcomes across diverse settings.
{"title":"What Is Known About Asthma Care and Management for Children and Young People Under 18 Years of age in New Zealand. A Scoping Review","authors":"J. Blamires, M. Foster, B. Kanengoni-Nyatara","doi":"10.1111/crj.70139","DOIUrl":"10.1111/crj.70139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Asthma is the most common chronic health condition affecting children in Aotearoa New Zealand, with Māori and Pacific children disproportionately burdened by high morbidity and inequitable care. Despite clinical guidelines and growing research, inconsistencies in diagnosis, treatment adherence, and education persist. This scoping review identifies and maps literature on care models, service delivery, education and support strategies, and experiences of children, young people, and their family/whānau in asthma care and management for those under 18 in Aotearoa New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. We searched MEDLINE, CINAHL, Scopus, PsychINFO, and grey literature for articles published between 2014 and 2024 on asthma care for children under 18 in Aotearoa New Zealand. Eligible articles from health or community settings were thematically analysed using conventional content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one articles met inclusion criteria, including qualitative, quantitative, mixed-methods, and policy or guideline documents. Thematic analysis revealed four interconnected themes: (1) medications and adherence, (2) education and health literacy, (3) children and whānau experiences, and (4) culture and beliefs. Findings reflect persistent inequities in asthma outcomes and care access, especially for Māori and Pacific children and highlight opportunities to strengthen culturally safe and family/whānau-centred care to improve asthma care, treatment and its management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review identifies key gaps in asthma care for children in Aotearoa New Zealand and calls for more responsive, culturally grounded models to improve asthma outcomes across diverse settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12672922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ventilator-associated pneumonia (VAP) is associated with poor patient outcomes. Early identification of high-risk patients remains a major clinical challenge. We aimed to develop and validate a multimodal hybrid neural network (MM-HNN) for improved VAP prediction by integrating multisource data from a retrospective cohort.
Methods
This single-center, retrospective study analyzed data from 213 adult patients who received invasive mechanical ventilation for >48 h. The MM-HNN incorporated three data types: 1) computed tomography (CT) features quantifying consolidation volume through three-dimensional residual neural network-50; 2) dynamic ventilator parameters including fraction of inspired oxygen and positive end-expiratory pressure analyzed via long short-term memory networks; and 3) clinical predictors refined via least absolute shrinkage and selection operator regression to identify six key variables.
Results
The model achieved an area under the curve of 0.86 (95% confidence interval: 0.80–0.91), outperforming the clinical pulmonary infection score (p = 0.021). SHapley Additive exPlanation analysis revealed Acute Physiology and Chronic Health Evaluation II score and CT consolidation volume as primary contributors. The system provided early warnings with 87.5% accuracy (median lead time: 1.5 days), which was associated with a significant increase in appropriate antibiotic use from 68.3% to 92.1% (p = 0.016).
Conclusion
The MM-HNN demonstrates the feasibility of accurate, interpretable VAP risk prediction through multimodal data integration. This artificial intelligence framework provides a clinically actionable tool for dynamic risk assessment, enabling preemptive interventions and improved antibiotic stewardship.
{"title":"Risk Factor Assessment and Predictive Modeling for Ventilator-Associated Pneumonia: Design and Clinical Implementation of an Artificial Intelligence-Enhanced Early Detection Framework Using Multisource Data Analytics","authors":"Jia Zhang, Yitong Wang, Yuwei Cao, Jiaxin Li, Shuangmei Dai, Yulin Li, Zhe Zhang, Xin Zhang, Rui Yang, Xinjun Zhang, Jichao Chen, Wailong Zou","doi":"10.1111/crj.70144","DOIUrl":"10.1111/crj.70144","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Ventilator-associated pneumonia (VAP) is associated with poor patient outcomes. Early identification of high-risk patients remains a major clinical challenge. We aimed to develop and validate a multimodal hybrid neural network (MM-HNN) for improved VAP prediction by integrating multisource data from a retrospective cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, retrospective study analyzed data from 213 adult patients who received invasive mechanical ventilation for >48 h. The MM-HNN incorporated three data types: 1) computed tomography (CT) features quantifying consolidation volume through three-dimensional residual neural network-50; 2) dynamic ventilator parameters including fraction of inspired oxygen and positive end-expiratory pressure analyzed via long short-term memory networks; and 3) clinical predictors refined via least absolute shrinkage and selection operator regression to identify six key variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The model achieved an area under the curve of 0.86 (95% confidence interval: 0.80–0.91), outperforming the clinical pulmonary infection score (<i>p</i> = 0.021). SHapley Additive exPlanation analysis revealed Acute Physiology and Chronic Health Evaluation II score and CT consolidation volume as primary contributors. The system provided early warnings with 87.5% accuracy (median lead time: 1.5 days), which was associated with a significant increase in appropriate antibiotic use from 68.3% to 92.1% (<i>p</i> = 0.016).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The MM-HNN demonstrates the feasibility of accurate, interpretable VAP risk prediction through multimodal data integration. This artificial intelligence framework provides a clinically actionable tool for dynamic risk assessment, enabling preemptive interventions and improved antibiotic stewardship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12664907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lineage tracing is an emerging technology with the outstanding advantage of labeling stem cells and their descendants with temporal and spatial specificity in vivo. We aimed to systematically review the research advances of distal lung epithelial progenitors via lineage tracing strategies.
Results
The distal lung, including bronchioles and alveoli, carries the respiratory function and is the central region involved in acute respiratory distress syndrome and other diseases. Many endogenous epithelial stem cell/progenitor lineages such as Club cells, alveolar type II cells, bronchioalveolar stem cells, and basal-like progenitors that contribute to distal lung regeneration have been identified and are engaged in repairing lung injury for various reasons. Advances in lineage tracing technology have provided tremendous support in characterizing progenitor lineages, identifying new progenitor cell lineages, and discovering regulators of their behaviors.
Conclusions
The important role of distal lung epithelial progenitors and lineage tracing methods has been highlighted in recent years. Relevant studies provide a perspective for further deepening lineage tracing in lung progenitor research and laying the groundwork for endogenous stem cell therapies in the future.
{"title":"Lineage Tracing of Distal Lung Epithelial Progenitors in Injury-Induced Regeneration","authors":"Jian Xu, Yuhan Wang, Cuiping Zhang, Xiaoyan Chen, Tianchang Wei, Weiqi Mao, Yuanlin Song","doi":"10.1111/crj.70143","DOIUrl":"10.1111/crj.70143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lineage tracing is an emerging technology with the outstanding advantage of labeling stem cells and their descendants with temporal and spatial specificity in vivo. We aimed to systematically review the research advances of distal lung epithelial progenitors via lineage tracing strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The distal lung, including bronchioles and alveoli, carries the respiratory function and is the central region involved in acute respiratory distress syndrome and other diseases. Many endogenous epithelial stem cell/progenitor lineages such as Club cells, alveolar type II cells, bronchioalveolar stem cells, and basal-like progenitors that contribute to distal lung regeneration have been identified and are engaged in repairing lung injury for various reasons. Advances in lineage tracing technology have provided tremendous support in characterizing progenitor lineages, identifying new progenitor cell lineages, and discovering regulators of their behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The important role of distal lung epithelial progenitors and lineage tracing methods has been highlighted in recent years. Relevant studies provide a perspective for further deepening lineage tracing in lung progenitor research and laying the groundwork for endogenous stem cell therapies in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"19 12","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12664906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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