{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:10:22Z","timestamp":1790143822970,"version":"4.0.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary vascular involvement is an important dimension of chronic obstructive pulmonary disease (COPD) heterogeneity, but its biological features may not be fully represented by airflow limitation, gas-transfer impairment, or resting hypoxemia. eosinophil-derived neurotoxin (EDN) is a circulating eosinophil-derived protein whose relationship with pulmonary vascular involvement in stable COPD is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single-center observational cohort study included 53 clinically stable participants with COPD and 10 healthy controls. COPD participants were classified by echocardiographic pulmonary vascular involvement (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910) or its absence (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200943). Right-heart catheterization was not used for group assignment. EDN was measured in EDTA plasma by enzyme-linked immunosorbent assay. The primary analysis estimated the adjusted EDN difference between COPD groups using ordinary least-squares regression with HC3 robust standard errors. Covariates were age, sex, forced expiratory volume in 1 s, diffusing capacity for carbon monoxide, and room-air arterial oxygen tension. Secondary models examined adjusted associations with tricuspid regurgitation (TR) pressure gradient and echocardiographic pulmonary artery-to-aorta ratio (PA\/Ao).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median plasma EDN was 181.58\u2005ng\/mL (interquartile range [IQR], 164.98\u2013202.53) in participants with echocardiographic pulmonary vascular involvement and 125.66\u2005ng\/mL (IQR, 113.14\u2013140.54) in those without such involvement. The adjusted group difference was 48.93\u2005ng\/mL (95% CI, 30.04\u201367.81;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Secondary slopes were positive for TR pressure gradient (0.86\u2005ng\/mL per mmHg; 95% CI, 0.07\u20131.65; nominal\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.033) and PA\/Ao (93.40\u2005ng\/mL per unit; 95% CI, 9.71\u2013177.09; nominal\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.030); Holm-adjusted\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.059 for both. Leave-one-case-out estimates ranged from 44.59 to 53.37\u2005ng\/mL, with every lower 95% confidence bound above zero.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After adjustment for measured respiratory variables, plasma EDN was higher in stable COPD with echocardiographic pulmonary vascular involvement. The corresponding patterns observed for TR pressure gradient and PA\/Ao provide additional rationale for evaluating EDN in external cohorts with standardized echocardiography, paired eosinophil measurements, and invasive hemodynamic assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1966419","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:49:04Z","timestamp":1790142544000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Elevated plasma eosinophil-derived neurotoxin is associated with echocardiographic pulmonary vascular involvement in stable COPD"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaochen","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Qunli Branch, The First Affiliated Hospital of Harbin Medical University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fushi","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Qunli Branch, The First Affiliated Hospital of Harbin Medical University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Qunli Branch, The First Affiliated Hospital of Harbin Medical University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Qunli Branch, The First Affiliated Hospital of Harbin Medical University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shihuan","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Qunli Branch, The First Affiliated Hospital of Harbin Medical University","place":["Harbin, Heilongjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2300239","DOI":"10.1183\/13993003.00239-2023","article-title":"Global initiative for chronic obstructive lung disease 2023 report: gOLD executive summary","volume":"61","author":"Agust\u00ed","year":"2023","journal-title":"Eur Respir J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1164\/rccm.201801-0095PP","article-title":"Pulmonary vascular involvement in chronic obstructive pulmonary disease. 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