Introduction: Bronchiectasis is a chronic progressive respiratory disease characterized by permanent dilatation of the bronchi. It is a complex condition with numerous different etiologies, co-morbidities, and a heterogeneous presentation. As we know, there is a lack of studies that describe the differences and compare the characteristics between focal and multifocal bronchiectasis. The aim of this study is to identify differences in clinical characteristics presentation, severity or distribution in focal and multifocal bronchiectasis, and prognostic implications. Methods: 126 patients with computed tomography (CT)-verified bronchiectasis were enrolled. Baseline characteristics that included age, sex, smoking history, and respiratory symptoms were recorded, with special attention paid to hemoptysis appearance, body mass index, and comorbidities. The type of bronchiectasis determined by CT scan and the modified Reiff scores indicating radiological severity were recorded. Patients were divided in two groups (I is focal and II is multifocal). Results: There were no statistically significant differences in age, smoking status, comorbidity, and BMI between the two groups. Multifocality was associated with a significantly higher proportion of females (p = 0.014), the rate of hemoptysis (p = 0.023), and the number of hospitalizations, but not of exacerbations and prevalence of immunodeficiency (p = 0.049). Significantly, a high number of subjects with multifocality had bronchiectasis of moderate severity, and post-infective and asthma-associated phenotypes were the dominant in this group. Unexpectedly, the cystic and varicose radiological phenotype (which need more time to develop) were more dominant in the focal group. The cylindrical phenotype was equally observed in the multifocal and focal groups. Conclusions: Our study suggests that multifocality is not related to age, number of exacerbations, or radiological phenotype, but it seems to be associated with the clinical post-infective phenotype, immunodeficiency, frequent hospitalizations, and severity. Thus, the presence of multifocal bronchiectasis may act as a biomarker of severity and poor outcomes in these patients.

Introduction: Immunotherapy has made a significant improvement in the treatment of patients with non-small cell lung cancer (NSCLC). It has a role in boosting the immune system, so it can fight cancer cells. Sometimes, this mechanism can lead to an overstimulation or misdirection of immune response, so it can act against the body itself. One of the organs most affected by this reaction is the thyroid gland, and there is no definitive explanation of the causes of this adverse event.Material and methods: In this retrospective observational study, we enrolled 103 patients with NSCLC and high PD-L1 expression (>= 50%) who were treated in our Clinic for pulmonology, University Clinical Center of Serbia, using Pembrolizumab as the first-line therapy.Results: Data analysis showed that 41 (39.81%) of 103 patients in our study had an adverse event of immunotherapy, and 21 of them had autoimmune thyroiditis (20.39%). Of all the patients, 19 of them were treated for chronic obstructive pulmonary disease (COPD) before the onset of Pembrolizumab. During treatment, eight of these patients developed thyroid dysfunction. Patients with COPD were at increased risk of developing autoimmune thyroiditis compared to non-COPD patients (OR 3.9 95% CI 1.135–13.260, p = 0.0227).Conclusion: Our study showed that patients dealing with COPD have a 3.9 times greater risk of developing autoimmune thyroiditis as an adverse event during Pembrolizumab treatment compared with patients without COPD.

Introduction/Aim: Bronchiectasis is a chronic respiratory condition characterized by permanent dilatation of the bronchi with chronic respiratory symptoms. Some studies have found association between malnutrition and bronchiectasis. However, research on obesity remains insufficient and further studies are needed. The aim was to evaluate the association between BMI (body mass index) and phenotypes, endotypes, clinico-radiological presentation and severity. Methods: A retrospective study included 120 patients with bronchiectasis. The socio-epidemiological, clinical, radiographic and laboratory characteristics were compared using statistical analyzes, depending on BMI. Results: The mean age was 61.3 ± 7.6 years. Underweight, normal, overweight, and obese accounted for 6.7%, 48.3%, 27.5%, and 17.5% of all patients. There were statistically significant differences in BACI score (p = 0.01), normal sputum finding (p = 0.03), lower hemoglobin level (p = 0.02) in the underweight group and eosinophil endotype in all groups except underweight (p = 0.04). The mean BACI (Bronchiectasis Aetiology and Co-morbidity Index) score had a rising trend from overweight and obese patients to normal weight the followed by the underweight category. Chronical colonization of Haemophilus was dominant in the underweight whereas Pseudomonas predominated in the overweight and obese. Asthma was most common in overweight and obese patients. We did not find differences between the groups in spirometry findings (but, the majority of all study patients with restriction belonged to the underweight group), Reiff score and radiological phenotype. Conclusion: Underweight patients were females and they were younger than overweight patients, they had lower diffusion capacity, systemic inflammation and higher BACI score, post-infective phenotype and predominantly normal sputum bacterial analysis for colonization screening. On the other hand, overweight and obese patients had chronic colonization by P. aeruginosa, asthma comorbidity, and eosinophil endotype. Those differences are very important for future specific treatment.

Malignant pleural effusion (MPE) is a common clinical manifestation of advanced non-small cell lung cancer (NSCLC) and represents a valuable source of tumor-derived components, including extracellular vesicles (EVs). The aim of this study was to compare three different EV enrichment methods with potential applicability in clinical practice: a commercial Norgen kit (NOR), immunoaffinity capture (IA), and ultracentrifugation (UC). Following EV characterization, IA demonstrated the best overall performance in terms of EV yield and purity, NOR showed intermediate efficiency, while UC was the least effective method. The IA method exhibited characteristics suitable for potential clinical implementation, whereas NOR and UC may require combination with additional enrichment approaches. Advancing pleural effusion–based liquid biopsy toward clinical application will depend on the development of robust, scalable, and user-friendly EV enrichment workflows, along with harmonized guidelines for sample collection, preprocessing, and data reporting. Establishing such standards will enhance reproducibility, enable meaningful cross-study comparisons, and accelerate the integration of EV-based biomarkers into precision oncology.

Progressive pulmonary fibrosis (PPF) comprises interstitial lung diseases characterized by progressive fibrosis and lung function decline. Nintedanib slows disease progression by inhibiting FGFR, VEGFR, and PDGFR signaling, but treatment response varies among patients. We investigated whether VEGFR2, PDGFRB, and TGFB1 gene variants are associated with nintedanib treatment outcomes, including changes in pulmonary function, diffusing capacity and adverse effects. This prospective study included 75 patients with PPF diagnosed according to ATS/ERS/JRS/ALAT criteria and treated with nintedanib at the Clinic of Pulmonology, University Clinical Center of Serbia. Spirometry and diffusing capacity were assessed at baseline and after 6 and 12 months. Genotyping of VEGFR2 rs2071559 and rs1870377; PDGFRB rs2302273, rs2229562, and rs246395; and TGFB1 rs1800470 was performed using TaqMan^® assays. Carriers of the PDGFRB rs2302273 A allele more frequently experienced gastrointestinal adverse events (45.2% vs. 20.5%; p = 0.022; OR 3.2, 95% CI 1.156–8.866) and diarrhea (38.7% vs. 15.9%; p = 0.026; OR 3.3, 95% CI 1.129–9.869). Patients with the PDGFRB rs246395 TT genotype more frequently had a ≥15% decline in DLCO after one year (46% vs. 22%; p = 0.038; OR 3.0, 95% CI 1.045–8.394). No significant associations were observed for the analyzed VEGFR2 or TGFB1 variants. These findings suggest that PDGFRB variants may be associated with nintedanib treatment outcomes, although confirmation in larger cohorts is needed.