Respiratory Research Analysis

In a 48‑week double‑blind phase 3 RCT (n=164), once‑daily inhaled molgramostim (300 μg) significantly improved DLCO at 24 and 48 weeks versus placebo and produced clinically meaningful improvement in SGRQ total score at 24 weeks, with similar adverse event rates between groups.

Impact: Largest rigorous RCT showing a targeted inhaled biologic improves physiology and patient‑reported outcomes in a rare pulmonary disease, closing a key therapeutic gap.

Clinical Implications: Molgramostim may become a disease‑directed therapy for autoimmune PAP, potentially reducing whole‑lung lavage and improving gas exchange and quality of life; guideline and reimbursement updates will be needed.

A pragmatic multicenter RCT (n=2,143 analyzed) randomized sedated adults to lateral versus supine positioning and found lateral positioning significantly reduced incidence and severity of hypoxaemia, decreased need for airway rescue interventions, and did not compromise safety.

Impact: A simple, low‑cost intervention with broad applicability that immediately reduces peri‑procedural hypoxaemia and airway rescues—high potential for rapid practice and guideline change.

Clinical Implications: Adopt lateral positioning during procedural sedation to reduce desaturation events, especially in settings with limited monitoring or rescue resources; apply with attention to patient‑specific contraindications.

The authors developed a low-dose intranasal, tlr4-mutant mouse model sustaining A. baumannii lung infection for ≥3 weeks, revealing a late-stage adhesin (InvL) required for persistence, distinguishing antibiotics that sterilize versus allow persister formation, and demonstrating outcome modulation by coinfecting species.

Impact: Enables mechanistic and therapeutic study of chronic respiratory infection, antibiotic persistence, and polymicrobial interactions—areas poorly captured by acute models.

Clinical Implications: Provides a platform to evaluate regimens targeting persisters and to identify late‑stage virulence targets (e.g., InvL) that could guide novel therapeutics; human‑relevant validation is the next step.

Paired pleural fluid and serum measures (n=76) showed pleural IL‑6 ~5,000‑fold higher than serum, correlating with severity and length of stay; two‑sample Mendelian randomization using IL6R variants (1,601 cases vs 830,709 controls) predicted a large protective effect of IL‑6 pathway inhibition on pleural infection incidence.

Impact: Convergent biomarker evidence and genetic causal inference identify IL‑6 as a tractable therapeutic target in pleural infection, directly informing randomized trials.

Clinical Implications: Supports pleural IL‑6 measurement for risk stratification and prioritizes clinical trials of IL‑6 pathway inhibitors (e.g., tocilizumab) for empyema/pleural infection.

Apnea Interact Xplainer, an interpretable AI, was trained and externally validated on 15,807 polysomnograms across seven multi-ethnic cohorts, achieving 0.738–0.810 accuracy for four-level severity classification, R²=0.92–0.96 for AHI prediction, and 0.970 sensitivity for early detection using oximetry-only inputs.

Impact: Addresses adoption barriers by providing externally validated, interpretable AI that functions with limited-signal inputs, enabling scalable screening and transparent clinician–patient workflows.

Clinical Implications: Supports oximetry-based screening pathways, routine hypoxic burden reporting alongside AHI, and triage strategies for prioritizing full polysomnography or urgent therapy.