Thorax最新文献

{"title":"The 2026 Tobacco and Vapes Act: on to the tobacco endgame.","authors":"Parris J Williams, Nicholas S Hopkinson","doi":"10.1136/thorax-2026-225329","DOIUrl":"10.1136/thorax-2026-225329","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":"635-637"},"PeriodicalIF":7.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164183","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":"Lung cancer in idiopathic pulmonary fibrosis: do antifibrotics have a preventive effect?","authors":"Francesca Gonnelli, Martina Bonifazi","doi":"10.1136/thorax-2026-224808","DOIUrl":"10.1136/thorax-2026-224808","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":"623-625"},"PeriodicalIF":7.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933877","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":"Loop gain predicts residual sleep apnoea among people using positive airway pressure.","authors":"Erin Eschbach, Clete Kushida, Yuksel Peker, Jen-Hwa Chu, Zhichao Xu, Hung-Mo Lin, Yunshan Xu, Ali Azarbarzin, Andrew Wellman, H Klar Yaggi, Scott Sands, Andrey Zinchuk","doi":"10.1136/thorax-2025-223878","DOIUrl":"10.1136/thorax-2025-223878","url":null,"abstract":"<p><strong>Rationale: </strong>Residual sleep apnoea-defined by an Apnoea-Hypopnoea Index ≥10 events/hour-affects~20% of obstructive sleep apnoea patients treated with positive airway pressure therapy and poses a major clinical challenge. Ventilatory control instability is a plausible cause of residual sleep apnoea. Elevated loop gain (LG), a measure of ventilatory instability, may be a risk factor, but this has not been rigorously tested.</p><p><strong>Objective: </strong>To assess whether high LG at baseline is associated with residual sleep apnoea on positive airway pressure therapy in two large, randomised control trials: Apnoea Positive Pressure Long-Term Efficacy Study (APPLES) and Randomised Intervention with CPAP in Coronary Artery Disease and OSA (RICCADSA).</p><p><strong>Methods: </strong>LG was estimated from baseline polysomnography using a validated method. Residual sleep apnoea was defined using polysomnography on positive airway pressure at 2 months (APPLES) or device downloads at 3 months (RICCADSA). Logistic regression estimated the odds of residual sleep apnoea with high LG (highest quartile), adjusting for confounders. A sensitivity analysis was performed using linear regression, where both the exposure and outcome were defined continuously.</p><p><strong>Measurements and main results: </strong>In the unadjusted analysis, high LG was associated with threefold odds of residual sleep apnoea in both samples. After adjustment, elevated odds persisted in both APPLES (2.17 (1.24-3.78)) and RICCADSA (3.31 (1.33-8.24)). Associations remained after accounting for measures of central sleep apnoea. Linear regression confirmed the association of LG and residual Apnoea-Hypopnoea Index.</p><p><strong>Conclusions: </strong>High LG is a significant risk factor for residual sleep apnoea on positive airway pressure therapy. Ventilatory control instability identified at baseline may warrant closer monitoring or the initiation of adjunctive therapies aimed at reducing LG and improving the therapeutic response.</p>","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":"694-701"},"PeriodicalIF":9.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional decline in COPD: looking beyond FEV₁.","authors":"Amy Attaway, Jessica Bon","doi":"10.1136/thorax-2026-225166","DOIUrl":"10.1136/thorax-2026-225166","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":"631-632"},"PeriodicalIF":7.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164664","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":"Granules of truth: unpacking the eosinophilic endotype in bronchiectasis.","authors":"Omri A Arbiv, Christina S Thornton","doi":"10.1136/thorax-2025-224609","DOIUrl":"10.1136/thorax-2025-224609","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":"621-622"},"PeriodicalIF":7.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198091","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":"Elastic parametric response mapping: localising reversible small airway disease in COPD.","authors":"Husham Sharifi, Terry Earl Robinson, Rex Moats, H Henry Guo","doi":"10.1136/thorax-2025-224630","DOIUrl":"10.1136/thorax-2025-224630","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":"626-628"},"PeriodicalIF":7.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277171","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":"Childhood haematological and immunoglobulin trajectories and risk of asthma at 18 years.","authors":"Trine Mølbaek-Engbjerg, Mina Ali, David Horner, Nicklas Brustad, Tamo Sultan, Signe Kjeldgaard Jensen, Jonathan Thorsen, Nilo Vahman, Susanne Brix, Ann-Marie Malby Schoos, Jakob Stokholm, Klaus Bønnelykke, Bo L K Chawes","doi":"10.1136/thorax-2026-224832","DOIUrl":"https://doi.org/10.1136/thorax-2026-224832","url":null,"abstract":"<p><strong>Background: </strong>Asthma is an inflammatory airway disease originating in early life, but it is understudied whether childhood trajectories of haematological and immunoglobulin (Ig) measures associate with risk of developing asthma.</p><p><strong>Methods: </strong>We modelled trajectories of blood neutrophils, lymphocytes, eosinophils, platelets and Ig (IgE, IgA, IgM and IgG) measured at ages 4, 5, 6, 7, 12 and 18 years in the Copenhagen Prospective Studies on Asthma in Childhood 2000 birth cohort (n=411) and investigated association with asthma diagnosis, airway obstruction using spirometry (forced expiratory volume in 1 s (FEV₁)) and plethysmography (specific airway resistance (sRaw)), type 2 airway inflammation (fractional exhaled nitric oxide (FeNO)) and airway hyper-responsiveness (AHR) at age 18. We employed linear regression, linear mixed model (LMM) with variable slopes and intercepts and latent class trajectory (LCT) analysis adjusting for relevant confounders.</p><p><strong>Results: </strong>In the LMM analyses, increasing blood neutrophils through childhood (slope, adjusted OR (aOR)=1.30 per 10⁹ cells/L, 95% CI 1.01 to 1.68, p=0.040), higher eosinophils (intercept, aOR=1.51 per 10⁹ cells/L, 95% CI 1.17 to 1.98, p=0.002), higher total IgE and increasing total IgE (intercept, aOR=1.28 per IgE g/L, 95% CI 1.00 to 1.63, p=0.049; slope, aOR=1.37, 95% CI 1.07 to 1.77, p=0.015) were significantly associated with asthma at age 18. Further, higher eosinophils (intercept, beta estimate=3.84 ppb per 10⁹ cells/L, 95% CI 1.53 to 6.15, p=0.001), higher total IgE and increasing total IgE (intercept, beta estimate=3.91 ppb per g/L, 95% CI 1.64 to 6.18, p=0.001; slope, beta estimate=4.84, 95% CI 2.55 to 7.14, p=4.4×10^-⁵) were associated with higher FeNO, whereas higher platelet count (intercept, beta estimate=-0.07 L per 10⁹ cells/L, 95% CI -0.12 to -0.03, p=0.002) was associated with lower FEV₁ at age 18, and increasing total IgE was associated with increased AHR, that is, lower methacholine dose causing a 20% drop in FEV₁ (slope, beta estimate=-0.75 per g/L, 95% CI -1.24 to -0.27, p=0.002). The LCT models confirmed that specific childhood trajectories of eosinophils and total IgE were associated with higher FeNO levels and increased AHR, and that a specific platelet count trajectory was associated with lower FEV₁. There were no consistent associations with trajectories of lymphocytes, IgG, IgA or IgM and no associations with sRaw.</p><p><strong>Conclusion: </strong>Trajectories of haematological and Ig measures throughout childhood, particularly platelet counts, eosinophils and total IgE, were associated with airway inflammation, reduced lung function and increased AHR at age 18.</p>","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228459","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 quality, walking and COPD: preserving the benefits of physical activity in an urban world.","authors":"David C Christiani","doi":"10.1136/thorax-2026-225396","DOIUrl":"https://doi.org/10.1136/thorax-2026-225396","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219865","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":"CTHRC1: a serum biomarker for a pathological fibroblast in IPF.","authors":"Aaditya Khatri, Jamie L Todd","doi":"10.1136/thorax-2026-225250","DOIUrl":"10.1136/thorax-2026-225250","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219875","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":"Preventing severe asthma exacerbations in at-risk patients: time for a rethink.","authors":"Ran Wang, Luke Daines, Stephen J Fowler","doi":"10.1136/thorax-2026-225181","DOIUrl":"https://doi.org/10.1136/thorax-2026-225181","url":null,"abstract":"","PeriodicalId":23284,"journal":{"name":"Thorax","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211059","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}