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Background: Few studies have compared the associations between long-term exposures to particulate matters (aerodynamic diameter ≤1, ≤2.5 and ≤10 µm: PM 1 , PM 2.5 and PM 10 , respectively) and asthma and asthma-related respiratory symptoms. The objective of the present study was to compare the strength of the aforementioned associations in middle-aged and elderly adults., Methods: We calculated the mean 722-day personal exposure estimates of PM 1 , PM 2.5 and PM 10 at 1 km×1 km spatial resolution between 2013 and 2019 at individual levels from China High Air Pollutants (CHAP) datasets. Using logistic regression models, we presented the associations as odds ratios and 95% confidence intervals, for each interquartile range (IQR) increase in PM 1 /PM 2.5 /PM 10 concentration. Asthma denoted a self-reported history of physician-diagnosed asthma or wheezing in the preceding 12 months., Results: We included 7371 participants in COPD surveillance from Guangdong, China. Each IQR increase in PM 1 , PM 2.5 and PM 10 was associated with a greater odds (OR (95% CI)) of asthma (PM 1 : 1.22 (1.02-1.45); PM 2.5 : 1.24 (1.04-1.48); PM 10 : 1.30 (1.07-1.57)), wheeze (PM 1 : 1.27 (1.11-1.44); PM 2.5 : 1.30 (1.14-1.48); PM 10 : 1.34 (1.17-1.55)), persistent cough (PM 1 : 1.33 (1.06-1.66); PM 2.5 : 1.36 (1.09-1.71); PM 10 : 1.31 (1.02-1.68)) and dyspnoea (PM 1 : 2.10 (1.84-2.41); PM 2.5 : 2.17 (1.90-2.48); PM 10 : 2.29 (1.96-2.66)). Sensitivity analysis results were robust after excluding individuals with a family history of allergy. Associations of PM 1 , PM 2.5 and PM 10 with asthma and asthma-related respiratory symptoms were slightly stronger in males., Conclusion: Long-term exposure to PM is associated with increased risks of asthma and asthma-related respiratory symptoms., Competing Interests: Conflict of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Wei-jie Guan is an Associate Editor of ERJ Open Research., (Copyright ©The authors 2024.)

Chronic Pseudomonas aeruginosa (PA) infection significantly contributes to morbidity and mortality in bronchiectasis patients. Initiating antibiotics early may lead to the eradication of PA. Here we outline the design of a trial (ERASE; NCT06093191) assessing the efficacy and safety of inhaled tobramycin, alone or with oral ciprofloxacin, in bronchiectasis patients with a new isolation of PA. This multicentre, 2×2 factorial randomised, double-blind, placebo-controlled, parallel-group trial includes a 2-week screening period, a 12-week treatment phase (with a combination of ciprofloxacin or a placebo at initial 2 weeks) and a 24-week follow-up. 364 adults with bronchiectasis and a new PA isolation will be randomly assigned to one of four groups: placebo (inhaled saline and ciprofloxacin placebo twice daily), ciprofloxacin alone (750 mg ciprofloxacin and inhaled saline twice daily), inhaled tobramycin alone (inhaled 300 mg tobramycin and ciprofloxacin placebo twice daily) or a combination of both drugs (inhaled 300 mg tobramycin and 750 mg ciprofloxacin twice daily). The primary objective of this study is to assess the proportion of patients successfully eradicating PA in each group by the end of the study. Efficacy will be evaluated based on the eradication rate of PA at other time points (12, 24 and 36 weeks), the occurrence of exacerbations and hospitalisations, time to first pulmonary exacerbations, patient-reported outcomes, symptom measures, pulmonary function tests and the cost of hospitalisations. To date no randomised trial has evaluated the benefit of different PA eradication strategies in bronchiectasis patients. The ERASE trial will therefore generate crucial data to inform future clinical guidelines., Competing Interests: Conflict of interest: W-J. Guan reports consulting fees from Joincare Pharmaceutical Co. Ltd., lecture fees from Joincare Pharmaceutical Co. Ltd., support for travel to attend domestic meetings from Joincare Pharmaceutical Co. Ltd., and is an associate editor of this journal. Conflict of interest: S.H. Chotirmall reports grants paid to his institution from the Singapore Ministry of Education, National Medical Research Council Singapore, consulting fees from CSL Behring, Pneumagen Ltd, Boehringer Ingelheim and Pneumagen Ltd, lecture fees from AstraZeneca and Chiesi, and participation in Data Safety and Monitoring Committees for Inovio Pharmaceuticals and Imam Abdulrahman Bin Faisal University. Conflict of interest: J.D. Chalmers reports grants from GSK, Boehringer Ingelheim, Genentech, Insmed, Grifols, Novartis, Gilead and AstraZeneca, consulting fees from AstraZeneca, Grifols, Genentech, GSK, Chiesi, Zambon, Trudell and Pfizer, and is an associate editor of this journal. Conflict of interest: J.F. Xu reports consulting fees from AstraZeneca and Boehringer Ingelheim. Conflict of interest: The remaining authors have nothing to disclose., (Copyright ©The authors 2024.)

Background: The early radiological signs of progression in bronchiectasis remain unclear. The objective of the present study was to compare endobronchial optical coherence tomography (EB-OCT) and chest computed tomography (CT) for the evaluation of radiological progression of bronchiectasis via stratification of the presence (TW + ) or absence (TW - ) of thickened-walled bronchioles surrounding dilated bronchi in patients with bronchiectasis based on CT, and determine the risk factors., Methods: In this prospective cohort study, we performed both chest CT and EB-OCT at baseline and 5-year follow-up, to compare changes in airway calibre metrics. We evaluated bacterial microbiology, sputum matrix metalloproteinase-9 levels and free neutrophil elastase activity at baseline. We compared clinical characteristics and airway calibre metrics between the TW + and TW - groups. We ascertained radiological progression at 5 years via CT and EB-OCT., Results: We recruited 75 patients between 2014 and 2017. At baseline, EB-OCT metrics (mean luminal diameter (p=0.017), inner airway area (p=0.005) and airway wall area (p=0.009) of seventh- to ninth-generation bronchioles) were significantly greater in the TW + group than in the TW - group. Meanwhile, EB-OCT did not reveal bronchiole dilatation (compared with the same segment of normal bronchioles) surrounding nondilated bronchi on CT in the TW - group. At 5 years, 53.1% of patients in the TW + group progressed to have bronchiectasis measured with EB-OCT, compared with only 3.3% in TW - group (p<0.05). 34 patients in the TW + group demonstrated marked dilatation of medium-sized and small airways. Higher baseline neutrophil elastase activity and TW + bronchioles on CT predicted progression of bronchiectasis., Conclusion: Thickened-walled bronchioles surrounding the dilated bronchi, identified with EB-OCT, indicates progression of bronchiectasis., Competing Interests: Conflict of interest: W-j. Guan is an associate editor of this journal., (Copyright ©The authors 2023.)