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Sustained Tumor Response After Pembrolizumab Discontinuation Due to Severe Bullous Pemphigoid. 严重大疱性类天疱疮导致的派姆单抗停药后持续的肿瘤反应。
IF 9.2 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-12-22 DOI: 10.1016/j.arbres.2025.12.001
Sofia Magno Pinto, Gustavo Silva, Filipa Ferro
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引用次数: 0
Lessons From the ANTES B+ Study. 来自ANTES B+研究的经验教训。
IF 9.2 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-12-22 DOI: 10.1016/j.arbres.2025.12.004
Alvar Agusti, Juan José Soler-Cataluña
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引用次数: 0
Pulmonary Hypoplasia and Congenital Dextrocardia Presenting With Hypercapnia in Advanced Age. 老年伴高碳酸血症的肺发育不全和先天性右心。
IF 9.2 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-12-20 DOI: 10.1016/j.arbres.2025.11.013
Mónica Matute-Villacís, Macarena Lovera, Adriana Martín Pascual
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引用次数: 0
The Worldwide Puzzle of Bronchiectasis Etiology in Adults. 成人支气管扩张病因学的世界性难题。
IF 9.2 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-12-04 DOI: 10.1016/j.arbres.2025.11.012
Miguel Angel Martinez-Garcia, Timothy Aksamit, Takanori Asakura, Lucy Burr, Chang Chia-Ling, Rosa Maria Giron, Wei-Jie Guan, Deniz Kizilirmak, Yeon-Mok Oh, Miguel Penizzotto, Felix C Ringshausen, Anthony de Soyza, Christina Thornton, Conroy Wong

Bronchiectasis represents in frequency the third chronic inflammatory airway disease after chronic obstructive pulmonary disease (COPD) and asthma. It is produced by more than one hundred causes, both pulmonary and extrapulmonary. Despite advances in recent years in the understanding of this condition and the publication of several national and international guidelines on its management, in most cases the etiology remains unknown. Among the identified etiological forms, post-infectious and post-tuberculous are the most frequent. It is also striking how bronchiectasis associated with COPD and severe asthma has been progressively increasing over the years, probably due to greater awareness among healthcare professionals of the importance of such associations and the wider use of chest computed tomography (the diagnostic method of choice for bronchiectasis from a radiological perspective). However, it is remarkable, according to data obtained from national and international bronchiectasis registries, the considerable geographic heterogeneity in their etiology. Thus, in socially disadvantaged regions or in those with poorer healthcare access, post-infectious and particularly post-tuberculous forms clearly predominate. It is always necessary to perform the appropriate complementary tests, as highlighted in all bronchiectasis guidelines, to exclude at least the treatable etiologies (treatable trait), since this is undoubtedly associated with a better patient prognosis.

支气管扩张是继慢性阻塞性肺疾病(COPD)和哮喘之后的第三大慢性炎症性气道疾病。它是由一百多种原因产生的,包括肺和肺外。尽管近年来对这种情况的了解有所进展,并且出版了一些关于其管理的国家和国际指南,但在大多数情况下,病因仍然未知。在已确定的病因形式中,感染后和结核后是最常见的。同样令人惊讶的是,与COPD和严重哮喘相关的支气管扩张近年来逐渐增加,这可能是由于卫生保健专业人员对这种关联的重要性的认识提高以及胸部计算机断层扫描(从放射学角度诊断支气管扩张的首选方法)的广泛使用。然而,值得注意的是,根据国家和国际支气管扩张登记所获得的数据,其病因存在相当大的地理异质性。因此,在社会处境不利的地区或获得保健机会较差的地区,感染后形式,特别是结核后形式显然占主导地位。正如所有支气管扩张指南中所强调的那样,进行适当的补充检查总是必要的,以排除至少可治疗的病因(可治疗的特征),因为这无疑与更好的患者预后有关。
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引用次数: 0
Invasive Fungal Infections: No Trial, No Error, Just Uncertainty-Immunosuppression Diversifies, but Evidence Remains Anchored in Classical Models. 侵袭性真菌感染:没有试验,没有错误,只是不确定性免疫抑制多样化,但证据仍然锚定在经典模型。
IF 9.2 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-12-03 DOI: 10.1016/j.arbres.2025.11.010
Amparo Solé, Catherine Orla Morrissey, Patricia Muñoz
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引用次数: 0
Inside GEMA 5.5: Expert Insights on the Latest Changes in Asthma Management. GEMA 5.5内幕:哮喘管理最新变化的专家见解。
IF 9.2 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-12-02 DOI: 10.1016/j.arbres.2025.11.011
Carlos Almonacid, Santiago Quirce, Marina Blanco, Alfonso Del Cubillo, José Valverde-Molina, Vicente Plaza

The Spanish Asthma Guideline (GEMA) 5.5 marks a significant conceptual and clinical advance in asthma management across Spanish-speaking healthcare systems. This updated edition incorporates the latest scientific insights into the pathophysiology, diagnosis, phenotyping, and treatment of asthma, while maintaining its practical, evidence-based orientation. A key innovation is the redefinition of therapeutic objectives: treatment is no longer limited to symptom control but is directed toward achieving and sustaining clinical remission, following the principles established by the Spanish REMAS consensus. The guideline also integrates recent evidence supporting the role of biologic therapies in specific inflammatory phenotypes, the implementation of maintenance and reliever therapy (MART) in adolescents, and a more rational approach to bronchodilator use in pediatric exacerbations. Further updates include refined recommendations on stepwise pharmacological strategies, expanded indications for advanced therapies in both adults and children, and updated management of associated conditions such as allergic bronchopulmonary aspergillosis and eosinophilic granulomatosis with polyangiitis. Organizationally, GEMA 5.5 strengthens the role of multidisciplinary asthma units, digital monitoring tools, and adherence-promoting interventions. Overall, GEMA 5.5 represents a paradigm shift toward personalized, remission-oriented asthma care, reinforcing its position as the leading Spanish-language reference for evidence-based clinical practice in respiratory medicine.

西班牙哮喘指南(GEMA) 5.5标志着整个西班牙语医疗保健系统在哮喘管理方面的重大概念和临床进展。这个更新版纳入最新的科学见解到病理生理学,诊断,表型,和治疗哮喘,同时保持其实用的,以证据为基础的方向。一个关键的创新是治疗目标的重新定义:治疗不再局限于症状控制,而是针对实现和维持临床缓解,遵循西班牙REMAS共识建立的原则。该指南还整合了最近的证据,支持生物疗法在特定炎症表型中的作用,在青少年中实施维持和缓解治疗(MART),以及在儿童病情加重中更合理地使用支气管扩张剂。进一步的更新包括对逐步药理策略的改进建议,扩大成人和儿童先进治疗的适应症,以及对相关疾病(如过敏性支气管肺曲霉病和嗜酸性肉芽肿病合并多血管炎)的最新管理。在组织上,GEMA 5.5加强了多学科哮喘单位、数字监测工具和促进依从性干预措施的作用。总体而言,GEMA 5.5代表了向个性化、缓解型哮喘护理的范式转变,巩固了其作为呼吸医学循证临床实践的领先西班牙语参考的地位。
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引用次数: 0
SPIRIT 2025 and CONSORT 2025 Statements: Guidance Tools to Ensure Clinical Trial Transparency SPIRIT 2025和CONSORT 2025声明:确保临床试验透明度的指导工具。
IF 9.2 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-12-01 DOI: 10.1016/j.arbres.2025.05.013
Rafael Dal-Ré , Arthur L. Caplan
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引用次数: 0
OSA and Accelerated Aging: An Overarching Pathway Driving End-Organ Morbidity and Mortality 阻塞性睡眠呼吸暂停和加速衰老:驱动终末器官发病率和死亡率的总体途径。
IF 9.2 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-12-01 DOI: 10.1016/j.arbres.2025.05.016
Mohammad Badran , David Gozal
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引用次数: 0
Right Cardiac Bronchus: An Uncommon Incidental Finding 右心支气管:一个不常见的偶然发现。
IF 9.2 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-12-01 DOI: 10.1016/j.arbres.2025.06.012
Álvaro Fuentes-Martín , María Rosa López Pedreira , Ángel Cilleruelo Ramos
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引用次数: 0
Immune Checkpoint Biomarkers Galectin-9 and TIM-3 Predict Melanoma and Lung Cancer Mortality in Obstructive Sleep Apnoea 免疫检查点生物标志物半凝集素-9和TIM-3预测阻塞性睡眠呼吸暂停患者黑色素瘤和肺癌死亡率。
IF 9.2 3区 医学 Q1 RESPIRATORY SYSTEM Pub Date : 2025-12-01 DOI: 10.1016/j.arbres.2025.03.018
Elena Díaz-García , Enrique Alfaro , Paula Pérez-Moreno , Cristina López-Fernández , Aldara García-Sánchez , Miguel Ángel Martínez-García , Eva Mañas , Irene Cano-Pumarega , Raquel Casitas , Francisco Campos-Rodríguez , Manuel Sánchez-de-la-Torre , Eduardo Nagore , Antonio Martorell-Calatayud , Luis Hernández Blasco , Esther Pastor , Jorge Abad-Capa , Josep María Montserrat , Valentín Cabriada-Nuño , Jaime Corral-Peñafiel , Eva Arias , Carolina Cubillos-Zapata

Objectives

Obstructive sleep apnoea (OSA) has been associated with increased cancer risk and mortality, yet specific biomarkers for patient stratification remain lacking. This study explores the role of immune checkpoint biomarkers, soluble Galectin-9 (sGalectin-9) and TIM-3 (sTIM-3), in identifying OSA patients at higher risk of cancer-related mortality.

Methods

We conducted a multicohort, prospective observational study including 684 patients, with and without cancer, who underwent sleep studies. Plasma levels of sGalectin-9 and sTIM-3 were assessed using bead-based multiplexed assays. In vitro and ex vivo models were employed to investigate the pathogenic mechanisms underlying biomarker upregulation and their immunological impact.

Results

In severe OSA patients with melanoma or lung cancer, sGalectin-9 and sTIM-3 were associated with tumour aggressiveness and with an increased mortality risk. In the three study cohorts, biomarker levels were higher in severe OSA patients than in the other groups. In non-cancer OSA patients’ monocyte intracellular Galectin-9 and T-lymphocyte membrane-bound TIM-3 were upregulated. Experimental data revealed that intermittent hypoxia drove the expression of these biomarkers, which were positively associated with inflammatory mediators and inversely related to T-cell proliferation and infiltration. These findings underscore a mechanistic link between hypoxemia and immune suppression.

Interpretation

sGalectin-9 and sTIM-3 are promising prognostic biomarkers for medium- to long-term survival in OSA patients with melanoma or lung cancer. Their upregulation highlights a potential pathophysiological pathway connecting OSA-induced hypoxemia to cancer aggressiveness through immune modulation. Further validation could inform risk stratification and personalised therapeutic strategies.
目的:阻塞性睡眠呼吸暂停(OSA)与癌症风险和死亡率增加有关,但仍缺乏用于患者分层的特异性生物标志物。本研究探讨了免疫检查点生物标志物可溶性半乳糖凝集素-9 (sGalectin-9)和TIM-3 (sTIM-3)在识别OSA患者癌症相关死亡率较高风险中的作用。方法:我们进行了一项多队列、前瞻性观察研究,包括684例患者,有或无癌症,他们接受了睡眠研究。血浆中半乳糖凝集素-9和sTIM-3的水平采用基于头部的多重检测方法进行评估。采用体外和离体模型研究生物标志物上调的致病机制及其免疫学影响。结果:在伴有黑色素瘤或肺癌的严重OSA患者中,sGalectin-9和sTIM-3与肿瘤侵袭性和死亡风险增加相关。在三个研究队列中,重度OSA患者的生物标志物水平高于其他组。非癌性OSA患者单核细胞内半乳糖凝集素-9和t淋巴细胞膜结合TIM-3上调。实验数据显示,间歇性缺氧驱动这些生物标志物的表达,这些生物标志物与炎症介质呈正相关,与t细胞增殖和浸润呈负相关。这些发现强调了低氧血症和免疫抑制之间的机制联系。结论:半乳糖凝集素-9和sTIM-3是OSA合并黑色素瘤或肺癌患者中长期生存的预后生物标志物。它们的上调强调了通过免疫调节将osa诱导的低氧血症与癌症侵袭性联系起来的潜在病理生理途径。进一步的验证可以为风险分层和个性化治疗策略提供信息。
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Archivos De Bronconeumologia
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