{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:59:38Z","timestamp":1785394778266,"version":"3.55.0"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Key R & D Program of Hunan Province","award":["No.2022SK2038"],"award-info":[{"award-number":["No.2022SK2038"]}]},{"DOI":"10.13039\/501100004761","name":"the Natural Science Foundation of Hunan Province, China","doi-asserted-by":"crossref","award":["2023JJ41025"],"award-info":[{"award-number":["2023JJ41025"]}],"id":[{"id":"10.13039\/501100004761","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The National Key Clinical Specialist Construction Program of China","award":["z047-02"],"award-info":[{"award-number":["z047-02"]}]},{"name":"The Youth Science Foundation of Xiangya Hospital","award":["2022Q06"],"award-info":[{"award-number":["2022Q06"]}]},{"name":"the Scientific Research Project of Hunan Health Commission","award":["No.D202303029041"],"award-info":[{"award-number":["No.D202303029041"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82300097"],"award-info":[{"award-number":["82300097"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Noncommunicable Chronic Diseases \u2013 National Science and Technology Major Project","award":["2024ZD0522302"],"award-info":[{"award-number":["2024ZD0522302"]}]},{"name":"Project Program of National Clinical Research Center for Geriatric Disorders","award":["No. 2020LNJJ05"],"award-info":[{"award-number":["No. 2020LNJJ05"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Combined pulmonary fibrosis and emphysema (CPFE) is a distinct yet clinically underrecognised syndrome. Interstitial pneumonia is a common pulmonary manifestation of connective tissue diseases (CTDs), and some CTD-interstitial lung disease (CTD-ILD) patients have concurrent emphysema that is frequently overlooked clinically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study explored the clinical characteristics and factors associated with emphysema in CTD-ILD patients to guide clinical management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This single-centre retrospective study included patients with CTD-related lung diseases from the ILD database of Xiangya Hospital. Patients were screened with standardised respiratory disease keywords and verified by chest HRCT. All eligible cases were stratified into CTD-ILD and CTD-CPFE groups based on emphysema presentation on re-assessed HRCT images.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Admission data, including demographics, comorbidities, inflammatory biomarkers, autoimmune antibodies, HRCT findings, pulmonary function test results and in-hospital treatment information, were collected for subsequent grouped analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      445 CTD-ILD patients were included, and 48 (10.8%) were CPFE. Patients with CPFE were predominantly male (68.8%), had a higher prevalence of a smoking history (68.8% vs 31.2%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), a lower body mass index (BMI) (20.4 vs 22.2\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.004), and a higher prevalence of prior tuberculosis (TB) (14.6% vs 4.3%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.009). Multivariable regression analysis showed that sex, BMI, smoking status, and history of TB were independently associated with CPFE. Male sex was associated with a markedly increased likelihood of CPFE (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003). TB was associated with increased likelihood, whereas higher BMI was associated with reduced likelihood (odds ratio: 33 and 0.57, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>CTD-CPFE may represent a distinct subgroup within CPFE, with several characteristic features, including a relatively lower prevalence of smoking history. A low BMI and a history of TB were associated with the presence of CPFE, highlighting the potential importance of nutritional and immune status in patients with CTD-ILD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666261471313","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:11:53Z","timestamp":1785150713000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The prevalence and unique clinical features of CPFE among patients with connective tissue disease\u2013associated interstitial lung disease: a retrospective, real-world study"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9506-6024","authenticated-orcid":false,"given":"Shuwan","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, Hunan, China"},{"name":"Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7437-2419","authenticated-orcid":false,"given":"Aiyuan","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, Hunan, China"},{"name":"Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1025-0591","authenticated-orcid":false,"given":"Wei","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, Hunan, China"},{"name":"Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9403-4896","authenticated-orcid":false,"given":"Qing","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, Hunan, China"},{"name":"Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzhong","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, Hunan, China"},{"name":"Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1172-8163","authenticated-orcid":false,"given":"Yanan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, Hunan, China"},{"name":"Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2810-320X","authenticated-orcid":false,"given":"Haiyuan","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongli","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, Hunan, China"},{"name":"Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9598-218X","authenticated-orcid":false,"given":"Ruoxi","family":"He","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China"},{"name":"Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan China"},{"name":"Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, Hunan, China"},{"name":"Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5883-0531","authenticated-orcid":false,"given":"Pinhua","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China"},{"name":"Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan China"},{"name":"Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, Hunan, China"},{"name":"Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.8492"},{"key":"e_1_3_4_3_2","first-page":"767","article-title":"Combined pulmonary fibrosis and emphysema (CPFE): an entity different from emphysema or pulmonary fibrosis alone","volume":"7","author":"Lin H","year":"2015","unstructured":"Lin H, Jiang S. Combined pulmonary fibrosis and emphysema (CPFE): an entity different from emphysema or pulmonary fibrosis alone. J Thorac Dis 2015; 7: 767\u2013779.","journal-title":"J Thorac Dis"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202206-1041ST"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2018.33.e96"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-2403"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/JCMA.0000000000000201"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.4046\/trd.2014.77.1.18"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejro.2022.100419"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00393-022-01281-7"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1098602"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2018.10.011"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2018.01.038"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12154"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-2572"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-1062"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S286360"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-023-02405-6"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S307192"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00014-2018"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-13-31"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201503-126AW"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI143226"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S116086"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/crj.12621"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.4103\/lungindia.lungindia_522_16"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.858"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12031100"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1080\/02813430802452732"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-019-1209-5"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004225"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-79860-4"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2013.06.015"}],"container-title":["Therapeutic Advances in Respiratory Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17534666261471313","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17534666261471313","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17534666261471313","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:17:37Z","timestamp":1785392257000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17534666261471313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":33,"alternative-id":["10.1177\/17534666261471313"],"URL":"https:\/\/doi.org\/10.1177\/17534666261471313","relation":{},"ISSN":["1753-4666","1753-4666"],"issn-type":[{"value":"1753-4666","type":"print"},{"value":"1753-4666","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"article-number":"17534666261471313"}}