{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:07:32Z","timestamp":1790053652671,"version":"4.0.1"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"am","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>COPD with chronic bronchitis is characterized by productive cough with sputum and mucociliary dysfunction, contributing to morbidity and impaired quality of life. The RejuvenAir\u00ae System, a cryosurgical device delivering metered doses of medical-grade liquid nitrogen (i.e., Metered Cryospray [MCS]) to bronchial airways, may stimulate healthy epithelial cell regeneration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the safety and effectiveness of MCS treatment in patients with COPD and CB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eligible patients were randomized 2:1 to receive two bronchoscopies with therapeutic mucus clearance, with or without MCS treatment (i.e., MCS or control group, respectively), 30\u201360 days apart. Safety and clinical effectiveness outcomes were assessed 12 months post-MCS treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Overall, 203 patients (MCS: N\u2009=\u2009136; sham: N\u2009=\u200967) were evaluated. MCS-treated patients had significantly greater improvement in Total St. George\u2019s Respiratory Questionnaire (SGRQ) scores versus controls (treatment difference [95% confidence interval; CI]: \u20135.9 [\u201311.6, \u20130.2]; p\u2009=\u20090.0422), and Total COPD Assessment Test (CAT) scores (treatment difference [95% CI]: \u20133.4 [\u20135.8, \u20131.0]; p\u2009=\u20090.005). Acute exacerbation of COPD (AECOPD; all severities) rates were 70.6% (MCS group) versus 67.2% (control group). Severe AECOPD rates were 21.3% (MCS group) versus 26.9% (control group). Periprocedural pneumothoraces rate per number of MCS treatments delivered was 3.6% (n\/N=10\/276). Eight deaths, 6 (4.3%; MCS) and 2 (2.9%; control), occurred during the study, none were device- or procedure-related. No unanticipated adverse device effects occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MCS treatment demonstrated significant improvement in Total SGRQ and CAT scores, greater reductions in severe AECOPD rates compared to sham, and an acceptable risk-benefit safety profile in patients with COPD and CB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajrccm\/aamag502","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:24:11Z","timestamp":1789755851000},"source":"Crossref","is-referenced-by-count":0,"title":["Metered-Dose Liquid Nitrogen Cryospray for Chronic Bronchitis: Results From the Prospective, Sham-Controlled Trial (SPRAY-CB)"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1267-3483","authenticated-orcid":false,"given":"Gerard J","family":"Criner","sequence":"first","affiliation":[{"name":"Lewis Katz School of Medicine at Temple University Department of Thoracic Medicine and Surgery, , Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8796-6710","authenticated-orcid":false,"suffix":"Jr","given":"Robert F","family":"Browning","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center Department of Medicine, , Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4335-2439","authenticated-orcid":false,"given":"Muhanned","family":"Abu-Hijleh","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center Department of Internal Medicine, Pulmonary Critical Care Medicine\/Interventional Pulmonary, , Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9550-445X","authenticated-orcid":false,"given":"Ken Y","family":"Yoneda","sequence":"additional","affiliation":[{"name":"University of California Pulmonary, Critical Care and Sleep Medicine, , Davis, Sacramento, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8109-8067","authenticated-orcid":false,"given":"Charlie","family":"Strange","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina , Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7942-1435","authenticated-orcid":false,"given":"Momen M","family":"Wahidi","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care , Northwestern Feinberg School of Medicine, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph C","family":"Seaman","sequence":"additional","affiliation":[{"name":"Sarasota Memorial Health Care System , Sarasota, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesh","family":"Krishna","sequence":"additional","affiliation":[{"name":"El Camino Hospital, University of California Interventional Pulmonology, Palo Alto Medical Foundation, , San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9541-5425","authenticated-orcid":false,"given":"Gustavo","family":"Cumbo-Nacheli","sequence":"additional","affiliation":[{"name":"Corewell Health , Grand Rapids, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6491-8740","authenticated-orcid":false,"given":"Ashutosh","family":"Sachdeva","sequence":"additional","affiliation":[{"name":"University of Maryland , Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Sue","sequence":"additional","affiliation":[{"name":"Honor Health Medical Center , Phoenix, AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Bansal","sequence":"additional","affiliation":[{"name":"Penn Highlands Healthcare The Lung Center, , DuBois, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9511-2790","authenticated-orcid":false,"given":"Thomas R","family":"Gildea","sequence":"additional","affiliation":[{"name":"The Cleveland Clinic, Cleveland Clinic Foundation, Respiratory Institute Cleveland , Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8085-2382","authenticated-orcid":false,"given":"Christian","family":"Ghattas","sequence":"additional","affiliation":[{"name":"The Ohio State University , Wexner Medical Center, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J Scott","family":"Ferguson","sequence":"additional","affiliation":[{"name":"University of Wisconsin School of Medicine and Public Health Division of Pulmonary and Critical Care, , Madison, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9008-3617","authenticated-orcid":false,"given":"David","family":"Feller-Kopman","sequence":"additional","affiliation":[{"name":"Dartmouth-Hitchcock Medical Center Section of Pulmonary and Critical Care Medicine, Department of Medicine, , Lebanon; NH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8018-496X","authenticated-orcid":false,"given":"Jonathan S","family":"Kurman","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin Division of Pulmonary & Critical Care, , Milwaukee, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9052-4638","authenticated-orcid":false,"given":"Pallav L","family":"Shah","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London ,","place":["UK"]},{"name":"Chelsea and Westminster NHS Foundation Trust Department of Respiratory Medicine, , London,","place":["UK"]},{"name":"Royal Brompton and Harefield Hospital Department of Respiratory Medicine, , London,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,21]]},"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/advance-article-pdf\/doi\/10.1093\/ajrccm\/aamag502\/71299017\/aamag502.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/advance-article-pdf\/doi\/10.1093\/ajrccm\/aamag502\/71299017\/aamag502.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:28:20Z","timestamp":1790051300000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/advance-article\/doi\/10.1093\/ajrccm\/aamag502\/8826336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/ajrccm\/aamag502","relation":{},"ISSN":["1535-4970"],"issn-type":[{"value":"1535-4970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"article-number":"aamag502"}}