Lancet Respiratory Medicine最新文献

{"title":"Adjunct corticosteroids for non-HIV infected patients with severe Pneumocystis jirovecii pneumonia","authors":"Leland Shapiro, Andrés F Henao-Martínez","doi":"10.1016/s2213-2600(25)00197-3","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00197-3","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"22 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603803","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":"Predatory publishers appear in PubMed (and your inbox)","authors":"Owen W Tomlinson","doi":"10.1016/s2213-2600(25)00193-6","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00193-6","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"12 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603804","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":"Type 2 inflammation biomarkers and their association with response to dupilumab in COPD (BOREAS): an analysis of a randomised, placebo-controlled, phase 3 trial","authors":"Stephanie A Christenson, Nicola A Hanania, Surya P Bhatt, Mona Bafadhel, Klaus F Rabe, Claus F Vogelmeier, Alberto Papi, Dave Singh, Elizabeth Laws, Paula Dakin, Ashish Bansal, Xin Lu, Deborah Bauer, Jennifer Maloney, Lacey B Robinson, Raolat M Abdulai","doi":"10.1016/s2213-2600(25)00044-x","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00044-x","url":null,"abstract":"<h3>Background</h3>A raised blood eosinophil count (≥300 cells per μL), a marker of type 2 inflammation, can identify patients with chronic obstructive pulmonary disease (COPD) with higher exacerbation risk. Dupilumab reduced exacerbations in patients with COPD and type 2 inflammation in the BOREAS trial. In this post-hoc analysis, we evaluated the predictive value and longitudinal changes in type 2 inflammatory biomarkers in patients with COPD and type 2 inflammation from the BOREAS trial who received dupilumab treatment.<h3>Methods</h3>BOREAS, a phase 3, multicentre, double-blind, randomised trial was conducted at 275 sites in 24 countries and included patients with COPD and type 2 inflammation (screening blood eosinophils ≥300 cells per μL). Patients were randomly assigned (1:1) to receive 300 mg of dupilumab every 2 weeks for 52 weeks or matching placebo. Randomisation was stratified by country and inhaled corticosteroid dose at baseline. This post-hoc analysis assessed blood eosinophil counts, fractional exhaled nitric oxide (FeNO), serum eotaxin-3, total plasma immunoglobulin E (IgE), and serum pulmonary and activation-regulated chemokine (PARC) concentrations in the safety population. The study was registered at <span><span>ClinicalTrials.gov</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>, <span><span>NCT03930732</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span> and is complete.<h3>Findings</h3>BOREAS was conducted between April 15, 2019, and May 2, 2023, and included 939 patients with COPD and type 2 inflammation. 468 patients were randomly assigned to receive 300 mg of dupilumab every 2 weeks for 52 weeks and 471 were randomly assigned to receive matching placebo. 319 (34%) participants were female and 620 (66%) were male. 657 (70%) were former smokers and 282 (30%) were current smokers. At week 52, greater median percentage reductions were observed in dupilumab versus placebo for most biomarkers (total IgE: −22·5% [IQR −30·4 to −16·5] <em>vs</em> −0·9% [−6·5 to 4·8]; FeNO: −28·6% [−57·1 to 0] <em>vs</em> −6·9% [−35·7 to 25·0]; eotaxin-3: −8·8% [−15·6 to −2·9] <em>vs</em> −0·4% [−5·6 to 5·0]; and PARC: −14·4% [−29·2 to 2·1] <em>vs</em> −0·8% [−13·9 to 17·2]). Reductions were similar across treatment groups by blood eosinophil counts. Exacerbation risk overall was reduced, with a greater magnitude of reduction in those with higher baseline blood eosinophil count (p=0·0056) and baseline FeNO (p=0·043).<h3>Interpretation</h3>Patients with COPD and type 2 inflammation who were given dupilumab showed reduced type 2 inflammatory biomarkers, with elevated blood eosinophil count and FeNO predicting greater treatment response","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"107 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594612","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":"Transforming COPD management: the role of dupilumab","authors":"Yunus Çolak","doi":"10.1016/s2213-2600(25)00082-7","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00082-7","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"11 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594609","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":"Evaluation of the effect of multimorbidity on difficult-to-treat asthma using a novel score (MiDAS): a multinational study of asthma cohorts","authors":"Ramesh J Kurukulaaratchy, Anna Freeman, Aruna T Bansal, Latha Kadalayil, Eve Denton, Vanessa Clark, Peter G Gibson, Judit Varkonyi-Sepp, Ben Ainsworth, J J Hudson-Colby, Adam Lewis, Chellan Eames, Liuyu Wei, Wei Chern Gavin Fong, Ratko Djukanovic, Sanja Hromis, Tunn Ren Tay, Njira Lugogo, Vanessa M McDonald, Mark Hew, Hans Michael Haitchi","doi":"10.1016/s2213-2600(25)00135-3","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00135-3","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Multimorbidity (ie, co-existence of two or more health conditions) is highly prevalent in patients with difficult-to-treat asthma. However, it remains unclear how multimorbidity correlates with disease severity and adverse health outcomes in these patients and which comorbidities are most important. We aimed to address this knowledge gap by developing a patient-centred, clinically descriptive multimorbidity score for difficult-to-treat asthma.&lt;h3&gt;Methods&lt;/h3&gt;We used data from the UK-based Wessex Asthma Cohort of Difficult Asthma (WATCH; n=500, data collected between April 22, 2015, and April 1, 2020) to develop the Multimorbidity in Difficult Asthma Score (MiDAS). Initially, we created a modified Asthma Severity Scoring System (m-ASSESS) in WATCH. We then conducted univariate association analysis to test the association between the 13 commonest comorbidities and m-ASSESS in WATCH and used a branch-and-bound approach to select the most relevant comorbidities for inclusion in MiDAS. We calculated MiDAS values for all patients with complete information in WATCH (n=319) and assessed them for correlation with components of m-ASSESS, proinflammatory biomarkers, and St George's Respiratory Questionnaire (SGRQ) score, a quality-of-life measure. We also assessed the association of MiDAS with multiple clinical outcomes in four international cohorts: two from Australia (n=236, data collected between June 14, 2014, and April 1, 2022; and n=140, Aug 6, 2012, to Oct 18, 2016), one from southeast Asia (n=151, March 21, 2017, to Jan 16, 2024), and one from the USA (n=100, July 9, 2021, to Dec 14, 2023).&lt;h3&gt;Findings&lt;/h3&gt;We selected seven common comorbidities (ie, rhinitis, gastro-oesophageal reflux disease, breathing pattern disorder, obesity, bronchiectasis, non-steroidal anti-inflammatory drug-exacerbated respiratory disease, and obstructive sleep apnoea) for inclusion in MiDAS on the basis of the branch-and-bound analysis and combined them using multivariate linear regression to derive a MiDAS model associated with m-ASSESS in WATCH. The range of MiDAS scores was 9·6–16·2. In WATCH members, mean MiDAS value was 11·97 (SD 1·21) and MiDAS was nominally correlated with m-ASSESS components of poor asthma control (τ=0·31 [95% CI 0·24–0·38]) and exacerbations (τ=0·16 [0·08–0·24]). MiDAS was also correlated with worse total SGRQ score (&lt;em&gt;r&lt;/em&gt;=0·39 [95% 0·28–0·49], p&lt;0·0001) and with the proinflammatory plasma cytokines interleukin (IL)-4 (&lt;em&gt;r&lt;/em&gt;=0·19 [95% CI 0·06–0·31], p=0·0036), IL-5 (&lt;em&gt;r&lt;/em&gt;=0·35 [0·24–0·46], p&lt;0·0001), and leptin (&lt;em&gt;r&lt;/em&gt;=0·29 [0·17–0·40], p&lt;0·0001) in WATCH. MiDAS values across the four international cohorts were similar to those of WATCH (UK cohort), with mean values of 12·33 (SD 1·47) and 12·31 (1·37) in the Australian cohorts, 11·80 (1·20) in the USA cohort, and 11·55 (1·23) in the Singapore cohort. In these cohorts, MiDAS correlated with worse asthma control, worse quality of life, anxiety, depressio","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"21 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586761","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":"Eosinophils in asthma phenotypes: perpetrators or guilty by association?","authors":"Marek Lommatzsch, Roland Buhl, Karl-Christian Bergmann, Guy G Brusselle, G Walter Canonica, David J Jackson, Liam G Heaney, Parameswaran Nair, J Christian Virchow","doi":"10.1016/s2213-2600(25)00174-2","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00174-2","url":null,"abstract":"25 years after publication of a clinical trial in <em>The Lancet</em> on the anti-IL-5 antibody mepolizumab in individuals with allergic asthma, evidence has accumulated that the pathogenetic role of eosinophils is fundamentally different between asthma phenotypes. In the allergen-driven form of asthma, often starting in childhood or during adolescence (ie, early onset asthma), blood eosinophil counts are variable, mainly dependent on allergen exposure, and play only a minor role (as a so-called sidekick) in allergen-induced asthma symptoms. By contrast, eosinophils are persistently elevated and are crucial drivers of the disease in the intrinsic (eosinophilic) form of asthma, which typically starts in adulthood (ie, adult-onset asthma). These data suggest that eosinophilia should not be considered a treatable trait in people with chronic airway diseases, but only a complement to an accurate clinical diagnosis. This evidence has major implications for the diagnosis of asthma phenotypes and the treatment of asthma (eg, choice of the right biologic).","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"41 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586835","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":"Beyond the airways in difficult-to-treat asthma: multimorbidity as the rule, not the exception","authors":"Hannu Kankaanranta, Bright I Nwaru","doi":"10.1016/s2213-2600(25)00170-5","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00170-5","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"10 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586836","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":"A History of the World in Six Plagues","authors":"Talha Burki","doi":"10.1016/s2213-2600(25)00251-6","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00251-6","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"81 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578256","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":"Evidence required to evaluate the use of bacteriologically confirmed asymptomatic tuberculosis disease as a primary endpoint in prevention of tuberculosis disease vaccine licensure trials","authors":"Richard G White, Gavin J Churchyard, Katherine C Horton, Andrew Fiore-Gartland, Marcel A Behr, Rebecca A Clark, Frank Cobelens, Joel D Ernst, Hanif Esmail, Alberto L Garcia-Basteiro, Sri Rezeki Hadinegoro, Willem A Hanekom, Mark Hatherill, Philip C Hill, Rudzani Muloiwa, Puck T Pelzer, Lele Rangaka, Helen Rees, Lewis Schrager, Margaret Stanley, Rein M G J Houben","doi":"10.1016/s2213-2600(25)00164-x","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00164-x","url":null,"abstract":"Current licensure trials of new vaccines to prevent tuberculosis disease use bacteriologically confirmed symptomatic tuberculosis disease as the primary endpoint. Globally, the incidence of symptomatic tuberculosis disease is low, making licensure trials large, long, and expensive. New data suggest that bacteriologically confirmed asymptomatic tuberculosis disease might occur more frequently than symptomatic tuberculosis disease. Therefore, if vaccines have efficacy against asymptomatic disease, tuberculosis vaccine licensure trials could include it in the primary endpoint, potentially leading to smaller or shorter trials. We describe the potential benefits and risks of this inclusion in the primary endpoint of tuberculosis vaccine licensure trials. We also simulate licensure trial endpoint accrual and summarise feedback from anonymous regulators and policy makers on the knowledge needed to consider this proposal and research studies needed to fill these evidence gaps. If bacteriologically confirmed asymptomatic tuberculosis disease could be included in the primary endpoint of tuberculosis disease licensure trials, it could lead to cheaper and more rapid tuberculosis vaccine development.","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"1 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565769","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":"WHA adopts landmark resolution on lung health","authors":"Esther Nakkazi","doi":"10.1016/s2213-2600(25)00247-4","DOIUrl":"https://doi.org/10.1016/s2213-2600(25)00247-4","url":null,"abstract":"No Abstract","PeriodicalId":51307,"journal":{"name":"Lancet Respiratory Medicine","volume":"273 1","pages":""},"PeriodicalIF":76.2,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547426","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}