Thorax最新文献

{"title":"Corticosteroids in COPD carry the danger of fatal aspergillosis.","authors":"David W Denning","doi":"10.1136/thorax-2026-225545","DOIUrl":"https://doi.org/10.1136/thorax-2026-225545","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary pulmonary alveolar proteinosis mimicking ILD progression in anti-MDA5 dermatomyositis.","authors":"Hirotoshi Yasui, Ko Ohara, Kaito Sano, Yasutaka Mori, Yasushi Makino","doi":"10.1136/thorax-2026-225260","DOIUrl":"https://doi.org/10.1136/thorax-2026-225260","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial associations of lung function between parents, offspring and siblings: a two-generation study of the ECRHS and RHINESSA cohorts.","authors":"Lucia Cestelli, Simone Accordini, Andrei Malinovschi, Bryndis Benediktsdóttir, Randi Jacobsen Bertelsen, Francisco Javier Callejas-González, Thórarinn Gíslason, Francisco Gómez Real, John W Holloway, Mathias Holm, Christer Janson, Nils Oskar Jõgi, Rain Jõgi, Ane Johannessen, Caroline Lodge, Anna Oudin, Vivi Schlünssen, Shyamali Dharmage, Cecilie Svanes","doi":"10.1136/thorax-2026-225219","DOIUrl":"https://doi.org/10.1136/thorax-2026-225219","url":null,"abstract":"<p><strong>Background: </strong>The familial aggregation of lung function is incompletely understood, as well as potential sex-specific patterns of associations within families. We aimed to investigate the associations of spirometry measures between parents and offspring and between siblings in two multicentre cohorts.</p><p><strong>Methods: </strong>We studied n=1203 parent-offspring pairs and n=254 sibling pairs from the European Community Respiratory Health Survey (parents, mean age 35 years) and Respiratory Health in Northern Europe, Spain and Australia (offspring, mean age 31 years) cohorts. We used multilevel mixed-effect regression models to assess parent-offspring and between-siblings associations of forced expiratory volume in the first second (FEV₁) and forced vital capacity (FVC) (litres), adjusted for sex, age, height, smoking and body mass index, accounting for clustering within centres and families.</p><p><strong>Results: </strong>FEV₁ and FVC were positively associated between parents and offspring (ß coef. (95% CI): FEV₁ 0.19 (0.14 to 0.25), FVC 0.19 (0.14 to 0.25)) and between first and second sibling (ß coef. (95% CI): FEV₁ 0.30 (0.17 to 0.43), FVC 0.20 (0.08 to 0.32)). The associations of FEV₁ and FVC between mothers and sons were significantly higher (p<0.05) than the other sex combinations. Between siblings, FEV₁ had greater concordance than FVC without evident sex-specific patterns. Results were consistent after exclusion of asthmatic participants. The proportion of variance explained within-family was 76% (95% CI 66% to 87%) for FEV₁ and 80% (95% CI 69% to 91%) for FVC, after adjustment for anthropometric factors. The between-family variance was 23% (95% CI 12% to 34%) for FEV₁ and 19% (95% CI 8% to 30%) for FVC.</p><p><strong>Conclusions: </strong>This study supports phenotypic concordance of lung function within families, with the strongest positive association observed between mothers and sons. Approximately 75-80% of the variance of FEV₁ and FVC was explained within-family.</p>","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of maintenance macrolide de-escalation during the Australian summer on exacerbations of obstructive airway diseases: a randomised, double-blind, placebo-controlled trial.","authors":"Dennis Thomas, Vanessa McDonald, Peter Ab Wark, Shyamala Pradeepan, Scott Twaddell, Andrew Gillman, Mark Hew, Eve Denton, Joy Lee, Jimmy Chien, Madeleine Hinwood, Erin S Harvey, Gijo Thomas, Amber Smith, David Arnold, Peter G Gibson","doi":"10.1136/thorax-2025-224164","DOIUrl":"https://doi.org/10.1136/thorax-2025-224164","url":null,"abstract":"<p><strong>Background: </strong>The optimal duration of maintenance macrolide antibiotic therapy in obstructive airway disease (OAD) remains unclear. This study evaluated the impact of de-escalating maintenance macrolide therapy during the Australian summer on OAD exacerbations.</p><p><strong>Methods: </strong>This double-blind, placebo-controlled, non-inferiority trial recruited 82 participants (mean age: 67.33±13.13; 55% female) undergoing maintenance macrolide therapy for the management of asthma, chronic obstructive pulmonary disease or bronchiectasis. They were randomised to continue (continuation arm) or de-escalate macrolide therapy (de-escalation arm) at the start of the summer (December-February). Follow-up interviews were conducted at 3, 6 and 9 months. The primary outcome was acute exacerbations during the summer. Secondary outcomes included symptom control scores and time to first exacerbation. The non-inferiority margin was 20%.</p><p><strong>Results: </strong>The acute exacerbation rates were 33.3% (14/42) for the continuation arm and 50% (19/38) for the de-escalation arm during the summer season. The primary analysis did not demonstrate non-inferiority (risk difference 16.2%; 95% CI -4.9% to 37.2%, with the upper bound exceeding the 20% non-inferiority margin). Symptom control was maintained and did not differ between arms. The time to first exacerbation was longer in the continuation arm (median 206 vs 90 days; HR 1.98, 95% CI 1.15 to 3.42; p=0.012).</p><p><strong>Conclusion: </strong>Macrolide de-escalation was not found to be non-inferior to continued treatment in individuals with OAD. While some patients may be able to discontinue long-term macrolide therapy during the summer, there remains a risk of exacerbation recurrence.</p><p><strong>Trial registration number: </strong>ACTRN12620001263987.</p>","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional association between visceral adiposity and obstructive sleep apnoea: longitudinal findings from the Wisconsin Sleep Cohort.","authors":"Dandan Zheng, Jun Wu, Yanyuan Dai, Le Chen, Baixin Chen, Bin Zhou, Nikolaos Athanasiou, Alexandros N Vgontzas, Yun Li","doi":"10.1136/thorax-2025-224400","DOIUrl":"https://doi.org/10.1136/thorax-2025-224400","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnoea (OSA) is a prevalent sleep disorder strongly associated with metabolic syndrome. Visceral adiposity is the principal culprit of the metabolic syndrome leading to the development of OSA. The longitudinal relation between visceral adiposity and OSA remains unknown.</p><p><strong>Methods: </strong>We included 311 subjects without OSA at baseline to examine the association between visceral adiposity and incident OSA and 559 subjects without visceral obesity at baseline to examine the association between OSA and incident visceral obesity in a general population sample. OSA was defined as an Apnoea-Hypopnoea Index (AHI) ≥5 events/hour or having been diagnosed or received treatment for OSA. Visceral obesity was defined as a lipid accumulation product (LAP) level higher than the 75th percentile of the overall sample.</p><p><strong>Results: </strong>After a median follow-up duration of 9 years, higher LAP values at baseline predicted higher AHI at follow-up (<i>β</i>=0.19, p=0.001) and visceral obesity at baseline was associated with higher odds of incident OSA (OR 7.10, 95% CI 3.05 to 16.51) after adjusting for confounders. Furthermore, higher AHI values at baseline predicted higher LAP values at follow-up (<i>β</i>=0.09, p=0.002) and OSA at baseline was associated with incident visceral obesity (OR 2.87, 95% CI 1.28 to 6.43) after adjusting for confounders. This bidirectional association was only observed in adults younger than 55 years.</p><p><strong>Conclusions: </strong>The association between visceral adiposity and OSA is bidirectional and significant in young and middle-aged but not in older adults. Our findings suggest that visceral adiposity might be the target of preventative and therapeutic strategies for OSA.</p>","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Journal club.","authors":"Yen Wen Phong","doi":"10.1136/thorax-2026-225718","DOIUrl":"https://doi.org/10.1136/thorax-2026-225718","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Air pollution and chronic obstructive pulmonary disease: beyond respiratory outcomes.","authors":"Huda Badri, Gordon McFiggans, Aristeidis Voliotis","doi":"10.1136/thorax-2026-224963","DOIUrl":"https://doi.org/10.1136/thorax-2026-224963","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing face of lung monitoring in CF: from tracking decline to maintaining healthy lungs.","authors":"Alex Robert Horsley, Jim M Wild","doi":"10.1136/thorax-2026-225228","DOIUrl":"https://doi.org/10.1136/thorax-2026-225228","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary interstitial emphysema after hyperventilation.","authors":"Ryota Inokuchi, Tomoki Wada, Kent Doi","doi":"10.1136/thorax-2026-225248","DOIUrl":"https://doi.org/10.1136/thorax-2026-225248","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic vertebral osteophytes as a rare cause of focal bronchiectasis.","authors":"Arvindran Alaga, Sharimini Mani","doi":"10.1136/thorax-2026-225495","DOIUrl":"https://doi.org/10.1136/thorax-2026-225495","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}