{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:18:14Z","timestamp":1787804294458,"version":"build-2784847793"},"reference-count":4,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Pre\u2010chronic obstructive pulmonary disease (pre\u2010COPD) is an early disease state characterised by respiratory symptoms and\/or structural abnormalities without established airflow limitation. We report a woman in her 40s with cough, exertional dyspnoea, preserved spirometry, mild emphysematous change and severe obstructive sleep apnea (apnea\u2010hypopnea index, 88.1\u2009events\/h). Integrated management with inhaled fluticasone furoate\/umeclidinium\/vilanterol and continuous positive airway pressure was initiated. After 12\u2009weeks, FEV\n                    <jats:sub>1<\/jats:sub>\n                    increased from 2.27 to 2.73\u2009L and FEV\n                    <jats:sub>1<\/jats:sub>\n                    \/FVC from 82.5% to 86.9%, while the COPD Assessment Test score decreased from 12 to 3. The patient continued smoking and body weight remained essentially stable. Systemic inflammatory markers showed no clear overall improvement. Eosinophilic asthma was considered less likely because bronchodilator responsiveness was negative, blood eosinophils and total IgE were low, sputum eosinophils were negative, and sputum cytology showed neutrophilic inflammation. This case is hypothesis\u2010generating and suggests that selected pre\u2010COPD patients may benefit from multifactorial trait\u2010oriented management.\n                  <\/jats:p>","DOI":"10.1002\/rcr2.70710","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T04:02:19Z","timestamp":1786161739000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatable Traits\u2010Oriented Management in Pre\u2010\n                    <scp>COPD<\/scp>\n                    With Severe Obstructive Sleep Apnea: A Case Report of Symptomatic and Spirometric Improvement After Integrated Therapy"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4625-1051","authenticated-orcid":false,"given":"Norifumi","family":"Kudeken","sequence":"first","affiliation":[{"name":"Kubagawa Medical Clinic  Naha Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(25)00236-X"},{"key":"e_1_2_9_3_1","volume-title":"Global Strategy for the Diagnosis, Management, and Prevention of COPD: 2025 Report","author":"Global Initiative for Chronic Obstructive Lung Disease (GOLD)","year":"2025"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204752"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09464-3"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70710","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/rcr2.70710","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70710","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:23:26Z","timestamp":1787801006000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.70710"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":4,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/rcr2.70710"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.70710","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"value":"2051-3380","type":"print"},{"value":"2051-3380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-01-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70710"}}