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Small airway disease as a key factor in COPD: new perspectives and insights
Front Med (Lausanne). 2025 Sep 26;12:1648612. doi: 10.3389/fmed.2025.1648612. eCollection 2025.
ABSTRACT
Small airways-defined as bronchioles <2 mm in internal diameter that lack cartilaginous support-are frequently involved in the earliest stages of chronic obstructive pulmonary disease (COPD). While COPD is defined per GOLD by persistent post-bronchodilator airflow limitation, small-airway dysfunction can precede spirometric abnormality, motivating earlier, imaging- and physiology-based detection (Agustí et al., 2023). Pathological progression typically begins with loss and stenosis of terminal bronchioles, followed by mucus retention/plugging, fibrotic remodeling, chronic inflammation, microvascular abnormalities, and cellular senescence, ultimately resulting in irreversible impairment of gas exchange. Early diagnosis remains difficult, but a suite of advanced non-invasive modalities-including impulse oscillometry system/forced oscillation techniques (IOS/FOT), single- and multiple-breath washout tests, high-resolution CT with parametric response mapping (PRM), nuclear medicine approaches (e.g., SPECT), dynamic measurements of lung compliance, and Fluorine-19 (19F) MRI-combined with artificial intelligence markedly improve the sensitivity and specificity for detecting small-airway disease. Therapeutic strategies that target cellular senescence and fibrotic pathways-such as senolytics and antifibrotic interventions-are showing promise, particularly approaches that clear senescent cells or block pro-fibrotic signaling. The integration of single-cell omics, high-resolution microvascular imaging, and molecularly targeted therapies is expected to accelerate precision diagnostics and enable personalized early interventions. This review summarizes recent insights into small-airway physiology, key pathophysiological and molecular mechanisms, and current pharmacological strategies, and emphasizes the clinical principle of "early detection, early diagnosis, early intervention" for managing COPD-related small-airway disease.
PMID:41080967 | PMC:PMC12510933 | DOI:10.3389/fmed.2025.1648612
Programmable promoter editing for precise control of transgene expression
Nature Biotechnology, Published online: 13 October 2025; doi:10.1038/s41587-025-02854-y
DIAL designs synthetic promoters for generation of heritable setpoints of gene expression across a range of cell types.Prevalence of Dropout and Influencing Factors in Digital Psychosocial Intervention Trials for Adult Illicit Substance Users: Systematic Review and Meta-Analysis
Combined Immersive and Nonimmersive Virtual Reality With Mirror Therapy for Patients With Stroke: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Mentalizing Without a Mind: Psychotherapeutic Potential of Generative AI
STAT+: Sarepta to seek approval for gene therapy in rare form of muscular dystrophy
An experimental gene therapy from Sarepta Therapeutics increased levels of the gene missing in an ultra-rare form of muscular dystrophy, according to data the company presented Friday.
The company has said it plans to file for approval in the disease, known as limb-girdle muscular dystrophy (LGMD) 2E. That would make it the first approved treatment in LGMD, a broad collection of highly rare diseases that can deprive patients of the ability to walk and in some cases shorten life. But it is likely to face a significant uphill battle.
The LGMD 2E therapy relies on the same gene-ferrying virus that Sarepta uses in its other treatments, including its approved gene therapy for Duchenne muscular dystrophy, Elevidys, and experimental gene therapies for several other LGMD subtypes.
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Automated AI based identification of autism spectrum disorder from home videos
npj Digital Medicine, Published online: 10 October 2025; doi:10.1038/s41746-025-01993-5
Automated AI based identification of autism spectrum disorder from home videosDNA methylation and machine learning: challenges and perspective toward enhanced clinical diagnostics
This list of non-negotiables helped me to defeat PhD-student guilt
Nature, Published online: 09 October 2025; doi:10.1038/d41586-025-02681-w
By refusing to bend the rules I set for myself, I created structure and a better environment for my mental health.A human pan-disease blood atlas of the circulating proteome
STAT+: Digital health M&A picks up, driven by AI and private equity
Earlier this year, Tom Stanis was puzzling through what was next for his startup Story Health, which helps providers care for people with heart failure. The company had some big-name customers and plans to expand, but it last raised money in 2022. Stanis saw two options: shake more cash out of a stingy venture capital market, or sell.
Armed with $275 million in fresh funding and a built-in customer base, artificial intelligence company Innovaccer made the answer easy. It gobbled up Story Health for an undisclosed mix of equity and cash in September.
Story Health is the fourth Innovaccer acquisition in about a year as it aims to become the default AI platform for health systems. CEO Abhinav Shashank plans to rapidly expand and to “accelerate that development through M&A,” he told STAT.
Innovaccer’s shopping spree is just one example of a trend playing out in digital health: big, well-funded companies with momentum are snapping up smaller players.
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Systematic review: digital biomarkers of fatigue in chronic diseases
npj Digital Medicine, Published online: 08 October 2025; doi:10.1038/s41746-025-01939-x
Systematic review: digital biomarkers of fatigue in chronic diseasesDigital twin models for predicting venetoclax and azacitidine-induced neutropenia in patients with acute myeloid leukemia
npj Digital Medicine, Published online: 06 October 2025; doi:10.1038/s41746-025-01978-4
Digital twin models for predicting venetoclax and azacitidine-induced neutropenia in patients with acute myeloid leukemiaEfficient and accurate search in petabase-scale sequence repositories
Nature, Published online: 08 October 2025; doi:10.1038/s41586-025-09603-w
MetaGraph enables scalable indexing of large sets of DNA, RNA or protein sequences using annotated de Bruijn graphs.AI models that lie, cheat and plot murder: how dangerous are LLMs really?
Nature, Published online: 08 October 2025; doi:10.1038/d41586-025-03222-1
Tests of large language models reveal that they can behave in deceptive and potentially harmful ways. What does this mean for the future?Chemistry Nobel for scientists who developed massively porous ‘super sponge’ materials
Nature, Published online: 08 October 2025; doi:10.1038/d41586-025-03195-1
Susumu Kitagawa, Richard Robson and Omar Yaghi pioneered the creation of metal–organic frameworks, which can capture and store molecules such as carbon dioxide.These immune cells won Nobel fame — can they solve autoimmune disease?
Nature, Published online: 07 October 2025; doi:10.1038/d41586-025-03287-y
Regulatory T cells, which help to dampen inflammation, are being used in clinical trials against ailments such as rheumatoid arthritis.Stop treating code like an afterthought: record, share and value it
Nature, Published online: 07 October 2025; doi:10.1038/d41586-025-03196-0
Scientists, research institutions, funders, libraries and publishers must all improve software practices.Daily briefing: Nobel Prize for discovery of ‘brake’ on immune system
Nature, Published online: 06 October 2025; doi:10.1038/d41586-025-03286-z
Meet the winners of this year’s Nobel Prize in Physiology or Medicine. Plus, creative hobbies could slow brain ageing at the molecular level and a visit to a sewage-filtering wetland.