Pub Date : 2025-10-28DOI: 10.1164/rccm.202510-2490ed
Arnaud W Thille,Anaëlle Bichon,Nicolas Terzi
{"title":"Is Measurement of Inspiratory Effort and Respiratory Mechanics Before Ventilator Weaning a Step Towards Personalized Medicine?","authors":"Arnaud W Thille,Anaëlle Bichon,Nicolas Terzi","doi":"10.1164/rccm.202510-2490ed","DOIUrl":"https://doi.org/10.1164/rccm.202510-2490ed","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"43 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-28DOI: 10.1164/rccm.202502-0389im
Shuyun Wang,Binglin Lai
{"title":"Extramedullary Hematopoiesis in the Lower Lobe of the Right Lung.","authors":"Shuyun Wang,Binglin Lai","doi":"10.1164/rccm.202502-0389im","DOIUrl":"https://doi.org/10.1164/rccm.202502-0389im","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"150 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-28DOI: 10.1164/rccm.202508-1924le
Muhammad F A Chaudhary,Hira A Awan,Joseph M Reinhardt
{"title":"Reply to Zhou et al.: Refining the Utility of fSADTLC: Toward Generalizability, Cost-Effectiveness, and Longitudinal Insight.","authors":"Muhammad F A Chaudhary,Hira A Awan,Joseph M Reinhardt","doi":"10.1164/rccm.202508-1924le","DOIUrl":"https://doi.org/10.1164/rccm.202508-1924le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"6 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-27DOI: 10.1164/rccm.202410-1894oc
Celeste Porsbjerg,Eleanor M Dunican,Njira L Lugogo,Mario Castro,Alberto Papi,Vibeke Backer,Christopher E Brightling,Arnaud Bourdin,J Christian Virchow,Mei Zhang,Xavier Soler,Paul J Rowe,Yamo Deniz,Lucía de Prado Gómez,Harry J Sacks,Juby A Jacob-Nara
RATIONALEChronic mucus hypersecretion contributes to airway obstruction in asthma.OBJECTIVESAssess dupilumab efficacy by baseline mucus plug score.METHODSIn VESTIGE (NCT04400318), adults with moderate-to-severe asthma, baseline blood eosinophils ≥300 cells/μL, and fractional exhaled nitric oxide (FeNO) ≥25 ppb received dupilumab 300 mg (n=72) or placebo (n=37) every 2 weeks for 24 weeks. Post hoc analyses included mucus plug score change from baseline, and patient proportion achieving FeNO <25 ppb, percent predicted FEV1, and FVC stratified by baseline mucus plug score (high/low defined by score ≥4/0-3.5, respectively, derived from high-resolution computed tomography scans).MEASUREMENTS AND MAIN RESULTSFewer dupilumab-receiving patients had high mucus plug score at Week 24 than at baseline (32.8% vs 67.2%); proportions remained similar in placebo-receiving patients (76.7% vs. 73.3%). Dupilumab versus placebo recipients were more likely to achieve FeNO <25 ppb in high-/low-mucus-plug score subgroups (odds ratio: 6.64; P = 0.003/8.54; P = 0.024). Dupilumab versus placebo significantly increased pre-/post-bronchodilator percent predicted FEV1 (least squares mean difference (LSMD) [95% CI]: 16.77 percentage points [9.81-23.73]; P <0.0001/12.70 [3.87-21.52]; P = 0.0055) and pre-bronchodilator FVC (LSMD [95% CI]: 0.42 mL [0.17-0.66]; P = 0.001), and numerically improved post-bronchodilator FVC (LSMD [95% CI]: 0.30 mL [0.01-0.59]; P = 0.0399) in the high-mucus-plug score subgroup.CONCLUSIONSDupilumab reduced mucus plug scores and improved lung function in patients with moderate-to-severe asthma with high baseline mucus plug score, and increased the likelihood of achieving FeNO <25 ppb regardless of baseline mucus plug score. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/). Clinical trial registration available at www.CLINICALTRIALSgov, ID: NCT04400318.
慢性粘液分泌过多可导致哮喘患者气道阻塞。目的通过基线粘液堵塞评分评估dupilumab的疗效。方法在VESTIGE （NCT04400318）中，基线血嗜酸性粒细胞≥300个细胞/μL，分数呼出一氧化氮(FeNO)≥25 ppb的中重度哮喘成人每2周接受dupilumab 300 mg （n=72）或安慰剂（n=37），持续24周。事后分析包括粘液塞评分从基线的变化，达到FeNO <25 ppb的患者比例，预测FEV1的百分比，以及根据基线粘液塞评分分层的FVC（高/低分别由评分≥4/0-3.5定义，来自高分辨率计算机断层扫描）。在第24周接受双单抗治疗的患者中，粘液堵塞评分高的患者比基线时少（32.8% vs 67.2%）；安慰剂组患者的比例保持相似（76.7% vs. 73.3%）。在高/低黏液堵塞评分亚组中，Dupilumab与安慰剂接受者更有可能达到FeNO <25 ppb（优势比：6.64;P = 0.003/8.54; P = 0.024）。Dupilumab与安慰剂相比，使用支气管扩张剂前/后预测FEV1的百分比显著增加(最小二乘平均差（LSMD） [95% CI]: 16.77个百分点[9.81-23.73]；P <0.0001/12.70 [3.87-21.52]；P = 0.0055)和支气管扩张剂前FVC (LSMD [95% CI]: 0.42 mL [0.17-0.66]; P = 0.001)，以及支气管扩张剂后FVC （LSMD [95% CI]: 0.30 mL [0.01-0.59]; P = 0.0399）在高黏液堵塞评分亚组中的数值改善。结论dupilumab降低了粘液堵塞评分，改善了基线粘液堵塞评分高的中重度哮喘患者的肺功能，并增加了实现FeNO <25 ppb的可能性，无论基线粘液堵塞评分如何。本文在知识共享署名非商业禁止衍生品许可4.0 （http://creativecommons.org/licenses/by-nc-nd/4.0/）的条款下开放获取和分发。临床试验注册可在www.CLINICALTRIALSgov, ID: NCT04400318。
{"title":"Effect of Dupilumab on Mucus Burden in Patients with Moderate-to-Severe Asthma: The VESTIGE Trial.","authors":"Celeste Porsbjerg,Eleanor M Dunican,Njira L Lugogo,Mario Castro,Alberto Papi,Vibeke Backer,Christopher E Brightling,Arnaud Bourdin,J Christian Virchow,Mei Zhang,Xavier Soler,Paul J Rowe,Yamo Deniz,Lucía de Prado Gómez,Harry J Sacks,Juby A Jacob-Nara","doi":"10.1164/rccm.202410-1894oc","DOIUrl":"https://doi.org/10.1164/rccm.202410-1894oc","url":null,"abstract":"RATIONALEChronic mucus hypersecretion contributes to airway obstruction in asthma.OBJECTIVESAssess dupilumab efficacy by baseline mucus plug score.METHODSIn VESTIGE (NCT04400318), adults with moderate-to-severe asthma, baseline blood eosinophils ≥300 cells/μL, and fractional exhaled nitric oxide (FeNO) ≥25 ppb received dupilumab 300 mg (n=72) or placebo (n=37) every 2 weeks for 24 weeks. Post hoc analyses included mucus plug score change from baseline, and patient proportion achieving FeNO <25 ppb, percent predicted FEV1, and FVC stratified by baseline mucus plug score (high/low defined by score ≥4/0-3.5, respectively, derived from high-resolution computed tomography scans).MEASUREMENTS AND MAIN RESULTSFewer dupilumab-receiving patients had high mucus plug score at Week 24 than at baseline (32.8% vs 67.2%); proportions remained similar in placebo-receiving patients (76.7% vs. 73.3%). Dupilumab versus placebo recipients were more likely to achieve FeNO <25 ppb in high-/low-mucus-plug score subgroups (odds ratio: 6.64; P = 0.003/8.54; P = 0.024). Dupilumab versus placebo significantly increased pre-/post-bronchodilator percent predicted FEV1 (least squares mean difference (LSMD) [95% CI]: 16.77 percentage points [9.81-23.73]; P <0.0001/12.70 [3.87-21.52]; P = 0.0055) and pre-bronchodilator FVC (LSMD [95% CI]: 0.42 mL [0.17-0.66]; P = 0.001), and numerically improved post-bronchodilator FVC (LSMD [95% CI]: 0.30 mL [0.01-0.59]; P = 0.0399) in the high-mucus-plug score subgroup.CONCLUSIONSDupilumab reduced mucus plug scores and improved lung function in patients with moderate-to-severe asthma with high baseline mucus plug score, and increased the likelihood of achieving FeNO <25 ppb regardless of baseline mucus plug score. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/). Clinical trial registration available at www.CLINICALTRIALSgov, ID: NCT04400318.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"12 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-24DOI: 10.1164/rccm.202508-1935le
Ali H Ziyab,Su Chen,A Daniel Jones,Wilfried Jj Karmaus
{"title":"Diversity of Metabolomic Findings Regarding Lung Function in Children and Young Adults.","authors":"Ali H Ziyab,Su Chen,A Daniel Jones,Wilfried Jj Karmaus","doi":"10.1164/rccm.202508-1935le","DOIUrl":"https://doi.org/10.1164/rccm.202508-1935le","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"1 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-24DOI: 10.1164/rccm.202508-1859ed
Tilo Winkler,Sean B Fain
{"title":"Mucus Plugs and Remodeling in the Small Airways: Considerations for Complex Airway Behavior and Instability in Asthma.","authors":"Tilo Winkler,Sean B Fain","doi":"10.1164/rccm.202508-1859ed","DOIUrl":"https://doi.org/10.1164/rccm.202508-1859ed","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"31 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-24DOI: 10.1164/rccm.202506-1350rr
Ashika A Chacko,Yasmine Khairandish,John M Suder,Kevin C Proud
{"title":"Recent Investigations in Pharmacotherapy for Bronchiectasis.","authors":"Ashika A Chacko,Yasmine Khairandish,John M Suder,Kevin C Proud","doi":"10.1164/rccm.202506-1350rr","DOIUrl":"https://doi.org/10.1164/rccm.202506-1350rr","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"110 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-24DOI: 10.1164/rccm.202507-1769ed
Yoanna Skrobik,May Hua
{"title":"Proceed with Caution: Assessing the Impact of Restricting ICU Visitation.","authors":"Yoanna Skrobik,May Hua","doi":"10.1164/rccm.202507-1769ed","DOIUrl":"https://doi.org/10.1164/rccm.202507-1769ed","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"41 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-24DOI: 10.1164/rccm.202509-2319ed
Jan-Willem C Alffenaar
{"title":"Isoniazid for Preventive Treatment among Contacts of Multidrug-Resistant Tuberculosis; Does It Make Sense?","authors":"Jan-Willem C Alffenaar","doi":"10.1164/rccm.202509-2319ed","DOIUrl":"https://doi.org/10.1164/rccm.202509-2319ed","url":null,"abstract":"","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"52 1","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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