Clinical Respiratory Journal最新文献_第2页

Association Between Respiratory Viral Infection and Peripheral T Lymphocyte Subsets in Elderly Patients With Acute Exacerbation of Bronchiectasis 老年支气管扩张急性加重患者呼吸道病毒感染与外周血T淋巴细胞亚群的关系

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-12-25 DOI: 10.1111/crj.70151

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.

背景：呼吸道病毒感染越来越被认为是支气管扩张（AEB）急性加重的重要诱因；老年患者的病毒学特征和免疫机制仍然不清楚。方法：对102例老年支气管扩张患者进行为期12个月的前瞻性随访。发生AEB后，取鼻咽拭子进行多重荧光定量PCR检测8种呼吸道病毒，同时用流式细胞术分析外周血T淋巴细胞亚群。比较首次AEB时病毒阳性组和病毒阴性组的临床特征、炎症标志物和T细胞亚群；ROC曲线分析评估T细胞亚群对病毒感染的预测价值。结果：68例患者在12个月的随访中共捕获93次AEB发作，检出病毒54.8%(51 / 93)，其中流感病毒为最常见的病原体（24 / 51,47.1%）。与病毒阴性组比较，病毒阳性组IL-6、TNF-α升高，CRP、WBC水平降低(p + T细胞计数（431.28±152.36∶508.42±158.94,p = 0.025）， CD4+/CD8+比值（1.41±0.44∶1.63±0.49,p = 0.013）。结论：病毒性感染在老年支气管扩张合并AEB患者中很常见，其特征是CD4+ t细胞计数降低，CD4+/CD8+比值降低，炎症反应增强，反映了潜在的年龄相关免疫脆弱性。

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引用次数: 0

Use of Sotatercept to Facilitate Transition From Intravenous to Oral Prostacyclin Therapy 使用索特西普促进从静脉到口服前列环素治疗的过渡。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-12-23 DOI: 10.1111/crj.70149

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.

肺动脉高压（PAH）是一种以肺血管阻力（PVR）增加为特征的进行性疾病，可导致右心室衰竭和高死亡率。肠外前列环素治疗仍然是高危患者的基石，但由于并发症和生活质量降低而受到限制。sotaterept是一种激活素信号抑制剂，最近作为PAH的有效辅助治疗出现，可改善功能和血流动力学结果。本病例系列评估了在8例高危PAH患者中加入索特西普是否能促进从静脉注射（IV）到口服前列环素的过渡，这些患者之前的过渡尝试失败。所有患者都接受了内皮素受体拮抗剂和磷酸二酯酶-5抑制剂的背景双重治疗，并在第五剂索特西普后从静脉注射过渡到口服曲前列汀。24周时，所有8例患者均成功维持口服治疗，未再次开始静脉注射前列环素。6分钟步行距离、WHO功能分级、右心室收缩压和PVR均有显著改善。未发生停药或严重不良事件。这些发现表明，辅助索特西普可以安全有效地从肠外治疗过渡到口服前列环素治疗，扩大治疗灵活性并改善高危PAH患者的生活质量。有必要进行前瞻性研究以确认长期结果。

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引用次数: 0

Endothelial-Derived Extracellular Vesicles During Exercise in COPD Patients COPD患者运动期间内皮来源的细胞外囊泡。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-12-07 DOI: 10.1111/crj.70146

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.

目前尚无直接针对慢性阻塞性肺疾病（COPD）肺血管的治疗方法，进一步表征潜在的内皮细胞（EC）异常可能有助于药物开发。方法：我们研究了运动和前列环素类似物伊洛前列素对15例中重度COPD患者内皮细胞外囊泡（eEVs）的影响，这些患者参加了一项随机、安慰剂对照的伊洛前列素交叉试验。结果：活跃吸烟者的特征与炎症源性EVs一致，而易于加重的COPD受试者的特征与细胞源性EVs一致。伊洛前列素对eEV水平无显著影响。然而，运动后1小时CD144+和CD31+/CD144+ ev显著增加。结论：内皮来源的EV谱因吸烟和加重史而异。伊洛前列素不影响脑电图水平，尽管最大运动可能通过剪切应力导致脑电图的延迟增加。

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引用次数: 0

Risk Factor Analysis of Mycoplasma pneumoniae Pneumonia Complicated With Plastic Bronchitis in Children: A Single-Center Retrospective Study 儿童肺炎支原体肺炎合并塑性支气管炎的危险因素分析：一项单中心回顾性研究

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-12-04 DOI: 10.1111/crj.70142

Jian-Min Dong, Chun-Qing Zhou, Yuan-Yuan Zhen

Objective

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.

目的：探讨肺炎支原体肺炎（MPP）合并塑性支气管炎（PB）的临床特点及危险因素，为该病的早期诊断和治疗提供参考。方法：回顾性分析2023年6月16日至12月31日在我院行支气管镜检查的75例小儿MPP患者的临床资料。根据支气管镜检查中是否有支气管石膏取出的情况，将患者分为PB组和非PB组。比较分析两组患者的临床特点。采用二元logistic回归分析确定MPP合并PB的相关危险因素。此外，从PB组获得的支气管铸体成分通过质谱技术使用蛋白质组学技术进行成分分析。结果：PB组以发热频次及发热病程≥10 d患儿为主。肺压实患儿组成比、中性粒细胞比、红细胞沉降率（ESR）及c反应蛋白、乳酸脱氢酶、降钙素原（PCT）、d -二聚体水平均显著高于非pb组（t = 2.290 ~ 3.793, χ2 = 5.548, 5.659, Z = -2.085, p）。与单纯MPP患儿相比，PB患儿炎症反应更强烈，ESR > 25.20 mm/1 h、PCT > 0.19 μg/L时应警惕MPP合并PB的可能性。PB患儿支气管塑料中含有大量纤维蛋白，可能与炎症引起的凝血和纤溶系统异常激活有关。

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引用次数: 0

What Is Known About Asthma Care and Management for Children and Young People Under 18 Years of age in New Zealand. A Scoping Review 关于新西兰18岁以下儿童和青少年哮喘护理和管理的了解。范围审查。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-12-02 DOI: 10.1111/crj.70139

J. Blamires, M. Foster, B. Kanengoni-Nyatara

Introduction

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.

简介：哮喘是影响新西兰奥特罗阿地区儿童最常见的慢性健康状况，Māori和太平洋地区儿童承受着不成比例的高发病率和不公平护理负担。尽管有临床指南和越来越多的研究，但诊断、治疗依从性和教育方面的不一致仍然存在。本综述确定并绘制了有关护理模式、服务提供、教育和支持策略以及儿童、年轻人及其家庭在新西兰奥特罗阿18岁以下人群哮喘护理和管理方面的经验的文献/whānau。方法：根据系统评价和荟萃分析扩展范围评价的首选报告项目（PRISMA-ScR）指南进行范围评价。我们检索了MEDLINE， CINAHL, Scopus， PsychINFO和灰色文献，检索了2014年至2024年间发表的关于新西兰Aotearoa 18岁以下儿童哮喘护理的文章。采用传统的内容分析方法对健康或社区环境中符合条件的文章进行主题分析。结果：21篇文章符合纳入标准，包括定性、定量、混合方法和政策或指导性文件。专题分析揭示了四个相互关联的主题：(1)药物和依从性；(2)教育和卫生素养；(3)儿童和whānau经验；(4)文化和信仰。研究结果反映了哮喘结局和护理可及性方面的持续不平等，特别是Māori和太平洋儿童，并强调了加强文化安全和家庭/whānau-centred护理以改善哮喘护理、治疗和管理的机会。结论：本综述确定了新西兰Aotearoa儿童哮喘护理方面的主要差距，并呼吁建立更具响应性和文化基础的模式，以改善不同环境下的哮喘结局。

{"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}

引用次数: 0

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 呼吸机相关肺炎的风险因素评估和预测建模：使用多源数据分析的人工智能增强早期检测框架的设计和临床实施。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-11-29 DOI: 10.1111/crj.70144

Jia Zhang, Yitong Wang, Yuwei Cao, Jiaxin Li, Shuangmei Dai, Yulin Li, Zhe Zhang, Xin Zhang, Rui Yang, Xinjun Zhang, Jichao Chen, Wailong Zou

Introduction

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.

导论：呼吸机相关性肺炎（VAP）与患者预后不良相关。早期识别高危患者仍然是一项重大的临床挑战。我们的目标是开发和验证多模态混合神经网络（MM-HNN），通过整合来自回顾性队列的多源数据来改进VAP预测。方法：本单中心回顾性研究分析了213例接受有创机械通气治疗bbbb48 h的成年患者的数据。MM-HNN包含三种数据类型：1)计算机断层扫描（CT）特征通过三维残差神经网络-50量化固结体积；2)通过长短期记忆网络分析呼吸机动态参数，包括吸入氧分数和呼气末正压；3)通过最小绝对收缩和选择算子回归对临床预测因子进行优化，确定六个关键变量。结果：模型曲线下面积为0.86(95%可信区间为0.80 ~ 0.91)，优于临床肺部感染评分（p = 0.021）。SHapley加性解释分析显示急性生理和慢性健康评估II评分和CT实变体积是主要影响因素。该系统提供的早期预警准确率为87.5%（中位提前期：1.5天），这与适当抗生素使用从68.3%显著增加到92.1%相关（p = 0.016）。结论：MM-HNN显示了通过多模态数据集成准确、可解释的VAP风险预测的可行性。这种人工智能框架为动态风险评估提供了临床可操作的工具，使先发制人的干预和改进的抗生素管理成为可能。

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引用次数: 0

Lineage Tracing of Distal Lung Epithelial Progenitors in Injury-Induced Regeneration 损伤诱导再生中远端肺上皮祖细胞的谱系追踪。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-11-29 DOI: 10.1111/crj.70143

Jian Xu, Yuhan Wang, Cuiping Zhang, Xiaoyan Chen, Tianchang Wei, Weiqi Mao, Yuanlin Song

Background

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.

背景：谱系追踪是一项新兴技术，其突出的优势是在体内标记具有时间和空间特异性的干细胞及其后代。我们旨在通过谱系追踪策略系统地回顾远端肺上皮祖细胞的研究进展。结果：远端肺（包括细支气管和肺泡）担负呼吸功能，是急性呼吸窘迫综合征等疾病的中枢区域。许多内源性上皮干细胞/祖细胞谱系，如俱乐部细胞、肺泡II型细胞、细支气管肺泡干细胞和基底样祖细胞，有助于远端肺再生，并因各种原因参与肺损伤的修复。谱系追踪技术的进步为表征祖细胞谱系、鉴定新的祖细胞谱系以及发现其行为调控因子提供了巨大的支持。结论：近年来，远端肺上皮祖细胞的重要作用和谱系追踪方法得到了重视。相关研究为进一步深化肺祖细胞的谱系追踪研究提供了前景，为未来的内源性干细胞治疗奠定了基础。

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引用次数: 0

Extracellular Matrix and Endothelial Activation Markers in the Bronchial and Pulmonary Arteries in COPD 慢性阻塞性肺病患者支气管和肺动脉的细胞外基质和内皮活化标志物

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-11-29 DOI: 10.1111/crj.70141

Raquel Annoni, Jôse Mára de Brito, Salvatore Battaglia, Natália de Souza Xavier Costa, Ligia Braga Lopes Couceiro, Renata Calciolari Rossi, Marisa Dolhnikoff, Pieter S. Hiemstra, Klaus F. Rabe, Peter J. Sterk, Thais Mauad

Background

Vascular alterations contribute significantly to the chronic obstructive pulmonary disease (COPD) pathophysiology. Thirty-nine percent of patients with COPD develop pulmonary hypertension, especially patients with the severe form of the disease. Cigarette-induced endothelial dysfunction is important in the pathogenesis of vascular alterations, even in the mild forms of the disease. This study investigates extracellular matrix (ECM) remodelling and endothelial activation in pulmonary (PMA) and bronchial muscular arteries (BMA) from non-smokers (NS), nonobstructed smokers (NOS) and patients with mild/moderate COPD.

Methods

Lung tissue samples from 44 patients undergoing lung resection were analysed. Morphometric parameters, ECM components (collagens, fibronectin, elastic fibres, tenascin-C and versican) and endothelial markers (VCAM-1, ICAM-1 and endothelin-1) were quantified in BMA and PMA using immunohistochemistry and morphometric analysis. Group differences and correlations with clinical parameters were assessed.

Results

COPD patients showed increased intimal thickness and fibronectin deposition in PMA, and larger adventitial areas in BMA compared to NS. NOS exhibited higher VCAM-1 expression in BMA and increased elastic fibre content in PMA. In COPD, elastic fibres and type-III collagen negatively correlated with smoking history (pack-years), while fibronectin positively correlated with age. VCAM-1 expression in BMA correlated negatively with lung function (FEV₁ and FEV₁/FVC).

Conclusions

This study demonstrates for the first time ECM remodelling and endothelial activation in bronchial arteries of smokers and patients with COPD. Fibronectin emerges as a key ECM component in arterial remodelling in mild–moderate COPD. Understanding vascular changes may provide new insights into the regulation of bronchial circulation and the development of pulmonary hypertension in COPD.

血管改变对慢性阻塞性肺疾病（COPD）的病理生理有重要影响。39%的慢性阻塞性肺病患者会发展为肺动脉高压，尤其是病情严重的患者。香烟诱导的内皮功能障碍在血管改变的发病机制中是重要的，即使在轻微的疾病形式中也是如此。本研究探讨了非吸烟者（NS）、非阻塞性吸烟者（NOS）和轻/中度COPD患者肺（PMA）和支气管肌肉动脉（BMA）的细胞外基质（ECM）重塑和内皮细胞活化。方法对44例肺切除术患者肺组织标本进行分析。利用免疫组织化学和形态计量学分析，定量BMA和PMA中的形态计量参数、ECM成分（胶原、纤维连接蛋白、弹性纤维、tenascin-C和versican）和内皮标志物（VCAM-1、ICAM-1和内皮素-1）。评估组间差异及与临床参数的相关性。结果COPD患者PMA内膜厚度增加，纤维连接蛋白沉积增加，BMA外膜面积增大。NOS在BMA中VCAM-1表达增加，PMA中弹性纤维含量增加。在COPD中，弹性纤维和iii型胶原蛋白与吸烟史（包年）负相关，而纤维连接蛋白与年龄正相关。BMA中VCAM-1的表达与肺功能（FEV1和FEV1/FVC）呈负相关。结论本研究首次证实了吸烟者和COPD患者支气管动脉的ECM重构和内皮细胞激活。纤连蛋白在轻中度COPD的动脉重构中成为关键的ECM成分。了解血管变化可能为COPD患者支气管循环的调节和肺动脉高压的发生提供新的见解。

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引用次数: 0

Serum Proteomic Profiling Uncovers LGALS3BP as a Potential Biomarker for Idiopathic Pulmonary Arterial Hypertension 血清蛋白质组学分析揭示LGALS3BP是特发性肺动脉高压的潜在生物标志物

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-11-27 DOI: 10.1111/crj.70138

Mingfei Li, Qi Jin, Wenzhi Pan, Dan Tian, Peng Wang, Dandan Chen, Yuan Zhang, Shasha Chen, Daxin Zhou, Lihua Guan, Junbo Ge

Background

Idiopathic pulmonary arterial hypertension (IPAH) is a progressive and fatal disease characterized by pathological pulmonary vascular remodeling and right heart failure. Current biomarkers for IPAH demonstrate limited clinical utility, necessitating the discovery of noninvasive serum biomarkers to facilitate early diagnosis and prognosis.

Objective

To identify novel serum biomarkers for IPAH using tandem mass tag–based quantitative proteomics and validate their clinical relevance.

Methods

Serum samples from five IPAH patients and five age/sex-matched healthy controls (discovery cohort) were analyzed by tandem mass tag proteomics to screen differentially expressed proteins (DEPs). Functional enrichment and protein–protein interaction network analyses were performed. Serum galectin-3 binding protein (LGALS3BP) levels were validated by enzyme-linked immunosorbent assay (ELISA) in an expanded cohort (30 IPAH patients vs. 30 controls).

Results

Proteomic analysis identified 401 proteins and 1554 peptide fragments, with 114 DEPs between groups (47 up-regulated and 67 down-regulated). In biological processes, DEPs are primarily enriched in adaptive immune response, followed by signal transduction. Extracellular exosome and extracellular region are the most commonly enriched cell components. For molecular function, DEPs are mainly involved in antigen binding and calcium ion binding, with the top 30 Gene Ontology terms exhibiting similar distribution patterns between up- and down-regulated DEPs. Pathway analysis revealed significant enrichment in complement/coagulation cascades, immune response, and extracellular matrix remodeling. LGALS3BP was observed to be significantly up-regulated in IPAH serum compared with controls (fold change = 1.36, p < 0.001), a finding validated by independent ELISA (IPAH: 6.43 ± 1.73 μg/mL vs. controls: 2.33 ± 1.06 μg/mL; p < 0.001).

Conclusions

Integrated proteomic profiling and clinical validation provide the first evidence of elevated serum LGALS3BP in IPAH, indicating its putative role in pathogenesis and translational medicine.

特发性肺动脉高压（IPAH）是一种以病理性肺血管重构和右心衰为特征的进行性致命疾病。目前IPAH的生物标志物临床应用有限，需要发现无创血清生物标志物以促进早期诊断和预后。目的利用串联质量标记定量蛋白质组学技术鉴定IPAH的新型血清生物标志物，并验证其临床意义。方法采用串联质量标签蛋白质组学方法对5例IPAH患者和5例年龄/性别匹配的健康对照组（发现队列）的血清样本进行分析，筛选差异表达蛋白（DEPs）。功能富集和蛋白相互作用网络分析。在扩大的队列（30例IPAH患者和30例对照组）中，通过酶联免疫吸附试验（ELISA）验证血清半乳糖凝集素-3结合蛋白（LGALS3BP）水平。结果通过蛋白质组学分析，共鉴定出401个蛋白和1554个肽段，组间共鉴定出114个dep，其中上调47个，下调67个。在生物过程中，DEPs主要富集于适应性免疫反应，其次是信号转导。胞外外泌体和胞外区是最常见的富集细胞成分。在分子功能上，DEPs主要参与抗原结合和钙离子结合，前30个基因本体术语在上调和下调DEPs之间表现出相似的分布模式。通路分析显示补体/凝血级联、免疫反应和细胞外基质重塑显著富集。与对照组相比，IPAH血清中LGALS3BP明显上调（倍增变化= 1.36,p < 0.001），独立ELISA验证了这一发现（IPAH: 6.43±1.73 μg/mL，对照组：2.33±1.06 μg/mL, p < 0.001）。综合蛋白质组学分析和临床验证提供了IPAH患者血清LGALS3BP升高的第一个证据，表明其在发病机制和转化医学中的推测作用。

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引用次数: 0

COVID-19 Pandemic: A Comprehensive Meta-Review of Global Impacts, Responses, and Future Preparedness 2019冠状病毒病大流行：全球影响、应对和未来准备的综合meta综述。

IF 2.3 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal

Pub Date : 2025-11-21 DOI: 10.1111/crj.70134

Rulin Wang, Muhammad Ahsan Naeem

Introduction

The COVID-19 pandemic due to SARS-CoV-2 has initiated historically unparalleled global health, social, and economic impacts. Syntheses of the multivariable interdependent effects on the multiple clinical, immunologic, psychosocial, and health service realms are required to guide current and future public health preparedness and policy.

Methods

A systematic review of a meta-analysis was conducted using the PubMed, Scopus, and Web of Science databases from December 2019 to 2025 to identify observational studies and randomized controlled trials. Quantitative reporting studies of COVID-19 outcomes were included. Random-effects model aggregated effect sizes were estimated and tested for heterogeneity with Cochran's Q, τ², and I². Subgroup, moderator, publication bias, sensitivity, and leave-one-out analyses were conducted for exploration and validation.

Results

Twenty-four studies were classified into three categories: clinical outcomes (15 studies), immunogenicity (4 studies), and psychosocial/health service outcomes (5 studies). There was no statistically significant pooled effect (effect ratio 0.95, 95% CI: 0.55–1.62) with severe heterogeneity (I² > 99%). Immunogenicity showed a statistically significant positive effect (pooled estimate 0.77, 95% CI: 0.38–1.16) with high heterogeneity (I² ~96%). Psychosocial effects were highly heterogeneous with non-significant overall effects (estimate −1.03, 95% CI: −5.74 to 3.69). Sample size was an influential moderator that explained significant between-group heterogeneity.

Discussion

The outcomes reveal robust immunogenic vaccine impacts and indeterminate psychosocial and clinical impacts, consistent with the heterogeneity and complexity of COVID-19 effects. Great heterogeneity highlights methodological standardization and cautious interpretation. This present meta-analysis offers key lessons to guide subsequent study design and manufacture of fair health policy and pandemic readiness.

由SARS-CoV-2引起的COVID-19大流行对全球卫生、社会和经济造成了前所未有的影响。需要综合临床、免疫、心理社会和卫生服务领域的多变量相互依存影响，以指导当前和未来的公共卫生准备和政策。方法：从2019年12月至2025年12月，使用PubMed、Scopus和Web of Science数据库对一项荟萃分析进行系统回顾，以确定观察性研究和随机对照试验。纳入了COVID-19结局的定量报告研究。随机效应模型的综合效应大小估计和检验的异质性与科克伦的Q， τ2和I2。进行了亚组分析、调节因素分析、发表偏倚分析、敏感性分析和遗漏分析，以进行探索和验证。结果：24项研究被分为三类：临床结果（15项研究）、免疫原性（4项研究）和社会心理/卫生服务结果（5项研究）。合并效应无统计学意义（效应比0.95,95% CI: 0.55-1.62），异质性严重（I2 bb0 99%）。免疫原性表现出统计学上显著的阳性效应（合并估计0.77,95% CI: 0.38 ~ 1.16），异质性高（I2 ~96%）。心理社会效应高度异质性，总体效应不显著（估计为-1.03,95% CI: -5.74至3.69）。样本量是解释组间显著异质性的有影响力的调节因子。讨论：结果显示免疫原性疫苗的强大影响和不确定的社会心理和临床影响，这与COVID-19效应的异质性和复杂性相一致。巨大的异质性突出了方法论的标准化和谨慎解释。本荟萃分析为指导后续的研究设计和制定公平的卫生政策和流行病准备提供了关键的经验教训。

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引用次数: 0