Chronic obstructive pulmonary disease (COPD) is marked by persistent airflow limitation. Blood eosinophilia has emerged as a potential biomarker for predicting the risk of exacerbations as well as response to inhaled corticosteroids (ICS). However, its impact on lung function in stable COPD remains uncertain. This study aimed to assess the prevalence of blood eosinophilia in stable COPD patients and explore its relationship with lung function, exercise capacity and exacerbation history. A total of 60 stable COPD patients were included in this cross-sectional study, selected according to specific inclusion and exclusion criteria. Blood eosinophil counts were measured, with eosinophilia defined as ≥2%. Lung function was evaluated through spirometry, while exercise capacity was assessed using the 6-minute walk test (6MWT). Statistical tests were applied to compare data between the eosinophilic and non-eosinophilic groups. Eosinophilia was present in 21.67% of patients. Eosinophilic patients had a higher rate of exacerbations (53.85%) and a lower FEV1 (mean 39.46% predicted) as compared to non-eosinophilic patients (17.02% and 50.79%, respectively). The 6MWT distance was shorter in eosinophilic patients (249.38 meters) as compared to non-eosinophilic patients (274.17 meters). Eosinophilic inflammation in COPD significantly impacts exacerbation risk, lung function and exercise capacity . Eosinophil counts may prove to be a useful biomarker for identifying COPD patients who are more likely to benefit from targeted treatments, such as inhaled corticosteroids (ICS).

Malnutrition in childhood interstitial lung diseases is associated with reduced lung function and greater disease severity: insights from the chILD-EU registry.

This study was undertaken to build upon the work of J. Gordon Zink, DO, FAAO, by developing a novel screening examination (Expanded Zink screen) that can correlate with proper identification of somatic dysfunction, the area of greatest restriction (AGR), and effective treatment in soccer players, which would elevate the osteopathic profession and advance the field of medicine. The objectives of this study are to determine whether the Expanded Zink screen can accurately correlate with the somatic dysfunctions found in soccer players, with what ended up being treated, and with effectiveness of treatment as measured by spirometry. We performed a correlational study that involves female collegiate soccer players during the season who signed up to receive osteopathic manipulative treatment (OMT) after providing written informed consent. We screened 8 University of Pikeville (UPIKE) women's soccer players; exclusion criteria included any pre-existing health problems, such as bleeding disorders, congenital malformations, and spinal cord injuries. Each soccer player underwent pre-OMT spirometry measurements. Next, each soccer player received a screening examination ("Traditional Zink" screen or "Expanded Zink screen") from Operator 1. The soccer player then received the same screening examination from Operator 2. Operator 2 then found somatic dysfunctions and performed OMT. Finally, Operator 1 completed a re-screen of the soccer player utilizing the initial screen and noted any changes in findings. The soccer player then completed post-OMT spirometry measurements. We find that all players in both groups after receiving OMT have a normal lung function pattern or one that improved from an obstructive pattern to a normal pattern as measured by spirometry. All eight soccer players had lumbar somatic dysfunction, innominate somatic dysfunction, and lower extremity somatic dysfunction. All players had all four junctions equalized post-OMT. Seven out of the eight players had cranial somatic dysfunction, and five of them had their cranial somatic dysfunction treated first, including Player 5, who showed clinically significant improvement in lung function post-OMT. Player 5's ribs were treated second in the treatment sequence. A novel Expanded Zink screen accurately correlated OMT of exhaled ribs to lateral asymmetry in rotation at the cervicothoracic junction in Player 5. Spirometry measurement post-OMT in Player 5 revealed clinically significant improvement in lung function showing 32 % change from obstruction to a normal pattern, which we attribute to correction of restrictive ribcage motion/dysfunction utilizing OMT. Both cranium and rib treatments accurately correlate with Expanded Zink screen findings of cranial and rib somatic dysfunctions in Player 5. The Expanded Zink screen can be utilized as a screening model for the hypothesized correlating body regions to identify significant somatic dysfunction and to augment the physician's ability to detect key body regions that need OMT. Through the use of the Expanded Zink screen, we discovered an out-of-pattern rib somatic dysfunction, which may have led to what we call a "restrictive ribcage motion/dysfunction." This type of rib motion may have been the cause of the obstructive pattern on pre-OMT spirometry seen in Player 5. Once the rib was treated, the restrictive ribcage motion resolved, which allowed lung function to be restored to normal.

As the global population ages, identifying risk factors for age-related diseases, such as COPD, is crucial for public health. Mosaic loss of Y chromosome (mLOY) in blood cells is an age-related somatic mosaicism event, but its relationship with pulmonary health remains undercharacterized. To examine the association between mLOY and pulmonary outcomes in men. Leveraging mLOY assessment (cell fraction ≥ 5%) in over 12000 men, including 5097 from the COPDGene Study and 7235 from six additional cohorts in the Trans-Omics for Precision Medicine program, we investigated mLOY associations with respiratory outcomes and epigenetic aging using multivariable cross-sectional, longitudinal, and prospective models. Primary outcomes included spirometry, CT-based emphysema, and epigenetic pace of aging. The prevalence of mLOY increased with age. Cross-sectionally, mLOY was associated with airflow obstruction, with reduced FEV1/FVC of 0.018 [95% CI, -0.030 to -0.006] in COPDGene and 0.020 [95% CI, -0.027 to -0.013] in TOPMed. mLOY was also associated with greater CT-quantified lung emphysema and faster pace epigenetic aging. Longitudinally, mLOY was associated with faster FEV1 decline (∼55mL/year vs ∼38mL/year). Prospectively, mLOY was associated with higher odds of developing COPD [OR = 1.84, 95% CI, 1.10-3.07] and preserved ratio impaired spirometry (PRISm) [OR = 2.87, 95% CI, 1.09-7.56] among participants with normal lung function at baseline. Associations remained robust after adjusting for clonal hematopoiesis and telomere length. mLOY is associated with lower lung function, accelerated lung function decline, higher emphysema, and faster pace of aging, positioning mLOY as a potential biomarker of respiratory aging in men.

Bronchiectasis is a common but neglected respiratory condition, particularly in resource-poor countries such as Bangladesh. Cystic fibrosis (CF), a recognized cause of bronchiectasis in children, especially among Caucasians, is increasingly reported in adults of Asian descent. However, CF remains under-recognized in Bangladesh, and no prior data exist on its prevalence in adults. This study aimed to determine the prevalence of CF in adult bronchiectasis patients and to assess their lung function characteristics using spirometry in Bangladesh. This cross-sectional study was conducted in the Department of Respiratory Medicine at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from June 2023 to November 2024. A total of 130 adults with bronchiectasis were enrolled in accordance with the inclusion and exclusion criteria. CF diagnosis was established using pilocarpine iontophoresis sweat chloride testing, and lung function severity was assessed by spirometry. Statistical analyses were performed using SPSS version 25. Among 130 participants, 12 were diagnosed with CF, representing 9.2% of patients. Obstructive airway abnormality was the predominant pattern among CF patients (75.0%), with half presenting in the mild category. A moderate negative correlation was observed between forced expiratory volume in 1 s (FEV1 % predicted) and sweat chloride concentration (Cl-) (Spearman's rho = *-0.477, p = 0.117). Approximately one in ten adult bronchiectasis patients in Bangladesh were found to have CF, and most had mild airway obstruction. These findings highlight that CF, traditionally regarded as a childhood disease, should also be considered in adult bronchiectasis, particularly in South Asian populations where it remains underdiagnosed.

Removing race from pulmonary function tests in children with idiopathic scoliosis.

Few studies have described long-term respiratory sequelae of adolescent (people aged 10-19years) tuberculosis (TB) survivors. We hypothesized that compared with healthy adolescents with no history of TB, survivors of adolescent pulmonary TB have greater respiratory impairment (reduced lung function) and disability (symptoms and activity limitations). In this prospective cohort study in Lima, Peru, we used spirometry, oscillometry, and the St George's Respiratory Questionnaire (SGRQ) to evaluate, on 2 separate occasions, the lung health of adolescents successfully treated for pulmonary TB and matched healthy controls. TB survivors with abnormal lung function underwent chest computed tomography (CT). Using mixed-effects regression with an interaction term for time since treatment completion and random effects for individual and matched pairs, we modeled changes in lung function and disability over 24months from treatment completion, comparing findings between TB survivors and controls. Compared with 101 controls (median age 17years, 56% male), 101 TB survivors (median age 18years, 56% male) had less favorable forced expiratory volume in 1 second, forced vital capacity, total airway resistance (R5), small airway resistance (R5-20), and reactance area (AX). Over the study period, AX, R5, and R5-20 improved for TB survivors but remained worse than controls. TB survivors had persistently greater respiratory disability (measured by SGRQ). Chest CTs of TB survivors demonstrated architectural distortion, reticular patterns, nodules, and bronchiectasis. Adolescent TB survivors experience persistent, symptomatic chronic lung disease despite bacteriological cure. Our findings highlight the need for respiratory assessments beyond treatment completion.

The study evaluates the long-term effect of COVID-19 on lung function in children, considering symptoms, physical examination findings, radiologic and laboratory evaluations during the acute infection period (AIP). This prospective, longitudinal, multicenter study involved 270 patients with confirmed SARS-CoV-2 infection. Patients underwent pulmonary function tests (PFTs) (spirometry, diffusion capacity of the lung for carbon monoxide (DLCO), and plethysmography) at the 3rd and 6th months of follow-up. Clinical characteristics, radiological, and laboratory findings during AIP were analyzed to establish the relationship with PFT parameters on long-term follow-up. The mean age was 12.97 ± 3.43 years (6-18 years), and 141(52.2%) were girls. Most patients had mild disease, while 193 patients were classified as having pneumonia. Overall mean PFT parameters were normal at the 3rd and 6th months, and FEV1%, FVC%, and DLCOadj% showed statistically significant longitudinal changes. Abnormal DLCOadj was observed in patients with COVID-19 pneumonia at the 6th month when compared with the non-pneumonia group (p = 0.046). At the 3rd month follow-up, comorbidities were independently associated with abnormal FEV1 (OR 6.30, 95% CI 2.61-15.17, p < 0.001) and abnormal FVC (OR 3.47, 95% CI 1.72-7.00, p < 0.001). Respiratory system related abnormal physical examination findings were also independently associated with abnormal FEV1 (OR 3.04, 95% CI 1.13-8.21, p = 0.028). Dyspnea showed a borderline association with abnormal FVC (OR 2.11, 95% CI 0.98-4.54, p = 0.057). Pathologic chest radiography, interlobular septal thickening on thorax CT, ground-glass opacity, fever, dyspnea, and respiratory system related abnormal physical examination findings during the AIP were associated with abnormal PFT parameters during follow-up. Disease severity scores did not differ significantly between children with normal and abnormal. Most children had preserved mean pulmonary function during follow-up after SARS-CoV-2 infection. However, children with COVID-19 pneumonia, comorbidities, and respiratory system related abnormal physical examination findings during the AIP may be at increased risk for persistent functional abnormalities. Follow-up assessment in higher-risk children should include spirometry, and DLCO measurement should be considered when feasible.

Initial asthma management often relies on a one-size-fits-all approach; however, the heterogeneity of treatment-naive, uncontrolled asthma remains insufficiently characterized. Specifically, the complex relationships among symptom burden, type 2 (T2) inflammation, and pulmonary function in this population are poorly understood. We sought to identify distinct clinical phenotypes in treatment-naive adults via multidimensional analysis and evaluate the association between symptom scores and T2 inflammation. This single-center, retrospective study analyzed 171 treatment-naive adults with uncontrolled asthma (5-item Asthma Control Questionnaire [ACQ-5] score ≥ 1.5). We performed k-means clustering using 20 variables, including demographics, symptoms, T2 biomarkers (blood eosinophils and fractional exhaled nitric oxide), and lung function (FEV1 and forced expiratory flow at 25% to 75% of forced vital capacity). Logistic regression assessed the ability of ACQ-5 scores to predict T2-high status (blood eosinophils ≥ 300/μL and fractional exhaled nitric oxide > 50 ppb). Cluster analysis identified 3 phenotypes: relative T2-low/preserved function (32.7%); severe T2/obstructive (29.2%); and (3) T2-moderate/small airway dysfunction predominant (38.0%). The prevalence of T2-high status varied significantly (30.4%, 64.0%, and 50.8%, respectively; P = .002). ACQ-5 scores showed limited ability to discriminate T2-high status (area under the curve 0.615). Multivariable modeling provided only modest improvement (area under the curve 0.644). In this study population, treatment-naive uncontrolled asthma comprises 3 clinically distinct phenotypes with divergent inflammatory and functional profiles. Symptom burden alone appeared to be a limited predictor of T2-high inflammation. These exploratory findings suggest that incorporating objective biomarkers and functional assessments into initial care may help tailor therapeutic strategies for patients with small airway dysfunction or discordant symptom-inflammation profiles. Further validation in larger cohorts is required.

Prenatal Vitamin D, childhood wheeze, asthma, and lung function: Results from the Vitamin D Antenatal Asthma Reduction Trial (VDAART).

The Effects of Antiplatelet Administration on Cytokine Production and Lung Function During Ex Vivo Lung Perfusion

When viruses meet cystic fibrosis: Insights into host-pathogen dynamics.

Background: Hajj pilgrims are expected to be able to walk a minimum of 12 kilometers. Therefore, good physical fitness is required. COVID-19 is a disease that can cause deconditioning of heart and lung function. Objective: The purpose of this study was to determine the effect of COVID-19 history on cardiorespiratory fitness of hajj pilgrim candidates. Methods: This cross-sectional study was conducted on prospective hajj pilgrim candidates in Salatiga City aged 50-70 years who fit the inclusion criteria. Subject characteristics such as age, comorbid history, and exercise history were collected from subject interviews. Body Mass Index (BMI) was measured by calculating height and weight. Physical activity history was assessed using Indonesian version of the International Physical Activity Questionnaire (IPAQ). Cardiorespiratory fitness was assessed using the six minutes walking test (6MWT). Data were analyzed using comparative test. Results: A total of 32 subjects with a history of COVID-19 with 31 mild symptoms and 1 moderate symptom, and 101 subjects without a history of COVID-19 were included as research subjects. There was significant difference in age (p=0.006) and education (p=0.003) between subject with COVID-19 history and without COVID-19 history (p=0.006). The VO2max result from 6MWT in subjects with history of COVID-19 were significantly lower than those in subjects without a history of COVID-19 (p=0.007, 14.54±3.54 mL/kg/min vs 16.36±3.19 mL/kg/min). Conclusion: COVID-19 history affects the cardiorespiratory fitness of hajj pilgrim candidates. Endurance training should be recommended for Hajj pilgrim candidates with a history of COVID-19 to improve cardiorespiratory fitness.

Alveolar macrophages (AMs) are pivotal immune sentinels, essential for maintaining tissue homeostasis and mediating immune responses to inhaled particles and pathogens. They demonstrate remarkable plasticity by transitioning from proinflammatory (M1) and anti-inflammatory/reparative (M2) phenotypes in response to local signals. Upon exposure to environmental agents, such as particulate matter, atypical respiratory pathogens, opportunistic Gram-negative bacteria, or respiratory viruses, they undergo dynamic activation that profoundly influences their functional repertoire. Acute or chronic environmental/biological insults disrupt normal AM activities such as phagocytosis, efferocytosis, and cytokine production, inciting oxidative stress, inflammasome activation, and in some cases forms of programmed cell death such as pyroptosis. Although these responses are indispensable for eliminating noxious particles and pathogens, such as Mycoplasma pneumoniae or Klebsiella pneumoniae, influenza A, or SARS-CoV-2, they can also derail the resolution phase by perpetuating inflammation, driving tissue remodeling and fibrosis, and thereby fueling chronic lung disorders such as chronic obstructive pulmonary disease (COPD), pneumoconiosis, and post-COVID interstitial lung disease. Moreover, environmental and microbial exposures modify AMs by altering receptor repertoires, intracellular phenotype by signaling cascades, and cross talk with epithelial and mesenchymal cells that collectively determine the disease trajectory. Elucidating how diverse environmental agents, together with pathogens such as M. pneumoniae, K. pneumoniae, influenza A, and SARS-CoV-2, shape AM biology is therefore pivotal for understanding the pathogenesis of COPD, pneumoconiosis, progressive fibrotic lung disease, and COVID-19-related pulmonary sequelae. This review brings together the current insights into exposure-driven modulation of AM functions, highlighting recent advances and identifying knowledge gaps relevant for therapeutic targeting of exposure-induced and pathogen-mediated lung pathology.

Targeting pulmonary fibrosis through Solanum xanthocarpum phytochemicals: A synergistic network pharmacology and docking investigation.

BLAD at Post-Transplant Peak Lung Function vs. BLAD at 12 Months Confers Increased Risk for Mortality

Fibrotic interstitial lung diseases (ILDs) cause loss of forced vital capacity (FVC) and increased risk of death over time. Most clinical trials aim to slow FVC decline and reduce mortality. However, the association of lower FVC with higher mortality will bias simple estimates of differences in FVC progression between groups. Therefore, both the time-dependent decline in FVC and increase in mortality should be jointly modeled. We developed a Bayesian, joint mixed-effects disease progression model (DPM), using minimally informative prior distributions, for FVC trajectory and the hazard for ILD-related mortality over time. This model minimizes bias due to mortality in estimating differences in the rate of FVC decline and is suitable for use when characterizing populations or in estimating a treatment effect in a clinical trial. The DPM was applied to individual patient data from prospective cohort studies of fibrotic ILD. The DPM yields a higher estimated rate of FVC decline (6.0% vs 4.7%/year) and a more precise fit than a linear mixed model of FVC alone, and replicates the nonlinear pattern in the observed data. By modeling the full FVC trajectory rather than only the change from baseline at a given time point, the DPM increases the information from each patient and reduces both the time to information and the effect of variability in baseline FVC measurements on the estimation of treatment effects. The joint DPM provides an integrated approach to minimizing bias in the estimation of treatment effects in clinical trials in fibrotic ILDs.

Predicting Post-Transplant FEV1 Using Donor Lung Function Measured During EVLP with Machine Learning

This study aimed to examine the association between pulmonary function and serum biomarkers among Egyptian workers occupationally exposed to ultrafine calcium carbonate (CaCO 3 ) particles, which can penetrate biological membranes and accumulate in the lungs. A cross-sectional study was conducted on 80 nonsmoking males: 40 CaCO 3 -exposed workers and 40 matched controls. Participants underwent medical and occupational history taking, clinical examination, spirometry, and serum biomarker measurement (Clara cell protein 16 [CC16], matrix metalloproteinase-9 [MMP-9], and tissue inhibitor of metalloproteinase-1 [TIMP-1]). Exposed workers demonstrated a significantly higher prevalence of respiratory symptoms along with significantly reduced pulmonary function indices. They also showed decreased CC16 and elevated MMP-9 and TIMP-1 levels. Biomarkers correlated with lung function decline and exposure duration. Chronic CaCO 3 exposure was associated with increased respiratory risk, necessitating protective workplace measures.

Primary ciliary dyskinesia (PCD) is a rare genetic disorder that causes chronic lung disease. Patients with PCD often experience pulmonary exacerbations with worsening symptoms and lung function decline. This review provides an overview of the existing knowledge regarding the PEx in PCD and reveals understudied topics that should be addressed in the future. We describe the different PCD-specific PEx definitions that exist in the literature, and provide data on the frequency of PEx. Few studies targeted the pathophysiology of PEx, with a focus on the most common microorganisms in the airways and on inflammatory markers that are increased in the sputum (total cells, neutrophils, neutrophil elastase, interleukin-8). Several risk factors for PEx have been identified, among them female sex, age, and airway infection with Pseudomonas aeruginosa. Lung clearance index appears to be a good prognostic factor for future PEx. Current treatment and prevention strategies are described. Further research is needed to enhance our knowledge on PEx mechanisms, on appropriate treatment therapies, and on the long-term consequences of this condition.