Chinese medical journal pulmonary and critical care medicine最新文献

{"title":"Nanovaccines for lung cancer: Platforms, mechanistic insights, and translational challenges","authors":"Hamed Hosseinalizadeh ,&nbsp;Fujing Ge ,&nbsp;Mohsen Davari ,&nbsp;Xiaohong Liu ,&nbsp;Lei Tian ,&nbsp;Jianhua Yu","doi":"10.1016/j.pccm.2026.02.001","DOIUrl":"10.1016/j.pccm.2026.02.001","url":null,"abstract":"<div><div>Lung cancer remains a global health challenge, with high mortality rates and frequent resistance to conventional therapies. In recent years, nanovaccines-based immunotherapy has emerged as a promising frontier, harnessing advances in nanotechnology to enable precise delivery of tumor-associated antigens, potentiate immune activation, and overcome barriers imposed by the tumor microenvironment. This review synthesizes current knowledge and recent progress in the field, highlighting several nanovaccine platforms from mRNA and protein constructs to biomimetic designs, which have demonstrated preclinical efficacy against both primary and metastatic lung cancer. We illustrate how innovations can elicit robust polyclonal T cell responses and remodel the immune landscape within tumors, including co-delivery of antigens and adjuvants, use of patient-derived materials, and integration of multi-omics. Furthermore, the combination of nanovaccines with current therapies, including immune checkpoint inhibitors, cell-based therapies, and gene-modulating strategies, offers new avenues for enhancing therapeutic outcomes. Despite these advances, several challenges remain, including barriers of large-scale manufacturing, safety assessment, regulatory approval, and the need for personalized optimization. Ongoing research and clinical studies will be essential to translate these experimental successes into personalized treatments for patients with lung cancer. Nanovaccine immunotherapy stands poised to become a transformative component in the evolving landscape of lung cancer management.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"4 1","pages":"Pages 1-18"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147556973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy for patients with EGFR-TKI-resistant non-small-cell lung cancer: Potential mechanisms, efficacy predictors, and therapeutic integration","authors":"Xinwei Wu ,&nbsp;Yangbin Shi ,&nbsp;Danni Wang ,&nbsp;Beibei Liu ,&nbsp;Yanwei Zhang ,&nbsp;Lele Zhang ,&nbsp;Fangfei Qian ,&nbsp;Wei Zhang","doi":"10.1016/j.pccm.2026.02.005","DOIUrl":"10.1016/j.pccm.2026.02.005","url":null,"abstract":"<div><div>Immunotherapy has revolutionized the treatment landscape of advanced non-small-cell lung cancer (NSCLC). However, its efficacy in patients with epidermal growth factor receptor (<em>EGFR</em>)-mutant NSCLC, particularly after failure of EGFR-tyrosine kinase inhibitors (TKIs), remains unclear and highly heterogeneous across individuals. This difference in treatment response is closely associated with the dynamic remodeling of the tumor microenvironment (TME) driven by the selective pressure of EGFR-TKIs. This review outlines the evolution of the TME during EGFR-TKI treatment and after the development of TKI resistance. Additionally, it summarizes current clinical evidence regarding immunotherapy after EGFR-TKI resistance, and discusses predictive biomarkers and novel therapeutic approaches. By integrating mechanistic insights with clinical translation, this review provides a comprehensive perspective on the immunotherapy landscape after TKI failure, aiming to identify patient subgroups most likely to benefit from immunotherapy and optimize treatment strategies for <em>EGFR</em>-mutant NSCLC.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"4 1","pages":"Pages 61-71"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147556968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asthma endotypes and theratypes","authors":"Ioana Agache ,&nbsp;Shengjie Li ,&nbsp;Yang Zheng ,&nbsp;Yadong Gao","doi":"10.1016/j.pccm.2026.02.006","DOIUrl":"10.1016/j.pccm.2026.02.006","url":null,"abstract":"<div><div>The model of asthma as a single entity has now been replaced by a much more complex biological network of distinct and interrelating inflammatory and tissue driven pathways. Individual disease manifestations (phenotypes), pathogenetic pathways (endotypes) and response to therapy (theratypes) are discussed here in the context of current stratified management of asthma in the clinic based on biomarkers measured at the point-of-care. As the current classification criteria result in significant overlaps among phenotypes, endotypes and theratypes, this paper further describes the advantage of combining precision immunology, imaging and the digital biomarkers in an unbiased approach offered by machine learning. The new European Academy of Allergy and Clinical Immunology (EAACI) nomenclature for hypersensitivity reaction is detailed as a basis for the stratified asthma management with a special focus on tissue-driven mechanisms (type V asthma), metabolic/microbiome/epigenetic/neurogenic mechanisms (type VI asthma) and direct cellular activation (type VII asthma).</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"4 1","pages":"Pages 19-38"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147556969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression of interstitial lung abnormalities and its impact on mortality in patients with lung cancer resection","authors":"Ruolin Mao ,&nbsp;Haoyun Zhang ,&nbsp;Qing Chang ,&nbsp;Yilong Teng ,&nbsp;Yanfen Ni ,&nbsp;Jiani Chen ,&nbsp;Mengnan Li ,&nbsp;Ning Xu ,&nbsp;Hai Zhang ,&nbsp;Yuqing Chen ,&nbsp;Jianqi Sun ,&nbsp;Kian Fan Chung ,&nbsp;Elisabetta A. Renzoni ,&nbsp;Yi Lu ,&nbsp;Huaping Dai ,&nbsp;Feng Li","doi":"10.1016/j.pccm.2026.02.004","DOIUrl":"10.1016/j.pccm.2026.02.004","url":null,"abstract":"<div><h3>Background</h3><div>Interstitial lung abnormalities (ILAs) are incidental abnormal lung findings on computed tomography that can co-exist with lung cancer, but risk factors for their progression and impact on survival after lung cancer resection remain unclear. This study aimed to identify risk factors for ILA progression, develop a radiomics-based model to predict it, and evaluate the association between ILA progression and mortality.</div></div><div><h3>Methods</h3><div>Patients with ILAs who underwent lung cancer resection in Shanghai Chest Hospital between January 2016 and May 2019 were retrospectively selected and divided into three subcategories at baseline: non-subpleural ILAs, subpleural non-fibrotic ILAs, and subpleural fibrotic ILAs; and three subcategories during follow-up: improved ILAs, unchanged ILAs, and progressive ILAs. Multivariate logistic regression was used to identify clinical and laboratory risk factors associated with ILA progression, and radiomics-based machine learning models were independently constructed to predict ILA progression using baseline CT imaging features. Survival data were analyzed using Kaplan–Meier curves and Cox proportional hazards regression.</div></div><div><h3>Results</h3><div>There were 1363 ILA cases among 10,295 patients who underwent primary lung cancer resection, with a proportion of 13.24%. After 2- and 4-year follow-up, the progression rates of ILAs were 9.86% (65/659) and 10.19% (43/422), respectively. Subpleural fibrotic ILAs (2-year follow-up: OR = 6.078, 95% confidence interval [CI]: 2.633–14.028, <em>P</em> &lt; 0.001; 4-year follow-up: OR = 3.339, 95% CI: 1.085–10.272, <em>P</em> = 0.035), and radiotherapy (OR = 13.595, 95% CI: 4.540–40.710, <em>P</em> &lt; 0.001; OR = 11.496, 95% CI: 2.864–46.141, <em>P</em> = 0.001) were risk factors for ILA progression. Using radiomics features extracted from baseline CT, the AutoGluon machine learning model demonstrated high performance in predicting ILA progression among patients with confirmed ILAs (for all ILAs, mean area under curve value: 0.790, accuracy: 0.801 ± 0.049). The all-cause mortality rates at 2- and 4-year follow-up were 2.11% (27/1281) and 4.26% (53/1245), respectively. Both subpleural fibrotic (log-rank <em>χ</em>² = 23.910, <em>P</em> &lt; 0.001) and progressive ILA groups (log-rank <em>χ</em>² = 26.098, <em>P</em> &lt; 0.001) had higher mortality rates compared with non-subpleural, subpleural non-fibrotic ILA group and improved, unchanged ILA group; and progressive ILAs were a risk factor for death (HR = 2.824, 95% CI: 1.065–7.483, <em>P</em> = 0.037).</div></div><div><h3>Conclusions</h3><div>ILA progression occurs in about 10% of patients after lung cancer resection and is associated with higher mortality. Subpleural fibrotic ILAs and radiotherapy are key risk factors for progression. Radiomics features effectively predict ILA progression, enabling early identification of high-risk patients.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"4 1","pages":"Pages 81-91"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147556971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of acute exacerbation and its related factors among chronic obstructive pulmonary disease patients aged 40 years and older in China","authors":"Qi Luo,&nbsp;Shu Cong,&nbsp;Shige Qi,&nbsp;Jing Fan,&nbsp;Wenjing Wang,&nbsp;Xueting Wang,&nbsp;Liwen Fang","doi":"10.1016/j.pccm.2026.02.002","DOIUrl":"10.1016/j.pccm.2026.02.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Acute exacerbation of chronic obstructive pulmonary disease (COPD) (AECOPD) represents a pivotal event in the clinical course of COPD and contributes substantially to disease progression and healthcare burden. This study examined the incidence and demographic distribution of AECOPD among Chinese COPD patients aged ≥40 years and evaluated factors associated with its occurrence, providing population-based evidence to inform community prevention, standardized treatment, rehabilitation, and health management strategies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Data were derived from the Chinese Chronic Obstructive Pulmonary Disease Surveillance (2019–2020), a nationwide cross-sectional survey conducted in 125 surveillance counties (districts) across 31 provinces, autonomous regions, and municipalities in China. Using a multistage stratified cluster random sampling design, residents aged ≥40 years were enrolled. Participants completed standardized questionnaires, physical measurements, and pre- and post-bronchodilator spirometry administered by trained investigators. COPD was defined as a post-bronchodilator forced expiratory volume in one second (FEV₁)/forced vital capacity (FVC) &lt;70%. The incidence of AECOPD and corresponding hospitalization rates were estimated and compared across subgroups. Stepwise multivariable logistic regression was used to identify factors associated with AECOPD, with Model I including sociodemographic, behavioral, and environmental factors and Model II additionally incorporating disease-related characteristics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 7455 COPD patients were included in the analysis. The overall incidence of AECOPD was 9.0% (95% confidence interval [CI]: 7.9–10.1%), and the hospitalization rate was 4.3% (95% CI: 3.5–5.0%). Higher incidence and hospitalization rates were observed among patients aged ≥65 years (10.8%, 5.7%) and those residing in southern region (10.3%, 5.0%). Elevated rates were also noted among individuals with body mass index (BMI) &lt;18.5 kg/m² (16.1%, 10.0%), smoking history (9.1%, 4.3%), prior hospital admission for severe pulmonary disease in childhood (21.6%, 9.3%), exposure to biomass (10.8%, 5.3%), occupational exposure to harmful factors (10.5%, 4.9%), and a history of chronic respiratory diseases (28.2%, 14.9%). The highest rates were observed in patients with a modified Medical Research Council (mMRC) score ≥2 (40.7%, 23.0%). Rates were 22.4% and 11.5% among those with a COPD Assessment Test (CAT) score ≥10 and 33.0% and 19.5% among those with ≥3 comorbidities. By Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades, incidence and hospitalization rates were 4.6% and 1.7% (Stage I), 10.7% and 4.6% (Stage II), and 28.7% and 18.9% (Stages III–IV). Multivariable analyses identified residence in southern region, hospital admission for severe pulmonary disease in childhood, mMRC score ≥2, CAT score ≥10, GOLD stage III–IV, and a higher n","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"4 1","pages":"Pages 72-80"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147556972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trained immunity in respiratory diseases: Mechanisms of action and intervention strategies","authors":"Szu-yu Lee ,&nbsp;Jing Li ,&nbsp;Xikun Zhou","doi":"10.1016/j.pccm.2026.02.003","DOIUrl":"10.1016/j.pccm.2026.02.003","url":null,"abstract":"<div><div>Trained immunity refers to a form of nonspecific immunological memory established through epigenetic modifications and metabolic reprogramming in innate immune cells following stimulation. This concept offers a novel framework for understanding and treating respiratory diseases. Chronic inflammation and dysregulated immune memory resulting from respiratory immune imbalance underlie many respiratory conditions, including infectious pneumonia, asthma, and chronic obstructive pulmonary disease (COPD). The core mechanisms of trained immunity involve epigenetic regulation—mediated by histone modifications such as histone H3 lysine 4 trimethylation (H3K4me3)—and metabolic reprogramming, exemplified by glycolysis. Trained immunity exhibits a “double-edged sword” effect in respiratory diseases: appropriate activation enhances pathogen clearance, whereas excessive activation may lead to sustained inflammation and tissue damage. Intervention strategies targeting trained immunity—such as vaccine-induced training, metabolic modulation, and natural product application—have shown clinical promise. However, the field faces challenges, including a lack of specific regulatory approaches and clinically applicable biomarkers. Future efforts should focus on deepening mechanistic insights and facilitating the clinical translation of precise interventions, thereby opening new paradigms for the prevention and treatment of respiratory diseases.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"4 1","pages":"Pages 39-60"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147556974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomic and lipidomic signatures associated with clinical improvement after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension","authors":"Jinglin Tian ,&nbsp;Sugang Gong ,&nbsp;Ping Yuan ,&nbsp;Jingru Huang ,&nbsp;Xincheng Li ,&nbsp;Jun Wang ,&nbsp;Tao Wang ,&nbsp;Zhenchi Li ,&nbsp;Lan Wang ,&nbsp;Deming Gou","doi":"10.1016/j.pccm.2026.02.007","DOIUrl":"10.1016/j.pccm.2026.02.007","url":null,"abstract":"","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"4 1","pages":"Pages 92-94"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147556970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aging and lung diseases: Unraveling mechanisms and therapeutic targets","authors":"Yanan Zhou ,&nbsp;Gaoying Chen ,&nbsp;Xiang Li ,&nbsp;Xiaohe Li ,&nbsp;Zeqiang Lin ,&nbsp;Li Liu ,&nbsp;Dan Pu ,&nbsp;Jiyuan Chen ,&nbsp;Yuqin Chen ,&nbsp;Ziying Lin ,&nbsp;Zili Zhang ,&nbsp;Lingling Zhu ,&nbsp;Wenju Lu ,&nbsp;Wen Ning ,&nbsp;Jian Wang ,&nbsp;Songmin Ying ,&nbsp;Jing Zhang ,&nbsp;Qinghua Zhou ,&nbsp;Yuanlin Song","doi":"10.1016/j.pccm.2025.11.005","DOIUrl":"10.1016/j.pccm.2025.11.005","url":null,"abstract":"<div><div>As life expectancy increases globally, the prevalence of various age-related diseases among the elderly is rising. Advancing age is associated with both the incidence and mortality of a variety of respiratory diseases; however, the specific correlations and underlying mechanisms remain incompletely understood. This review summarizes changes in lung physiology and structure, as well as the biology of immune system cells, in relation to idiopathic pulmonary fibrosis, acute respiratory distress syndrome, pulmonary hypertension, asthma, chronic obstructive pulmonary disease, and lung cancer. It also offers a comprehensive discussion of the relationships between these lung diseases and aging, along with potential mechanistic insights. Finally, the review underscores that the association between aging and lung disease supports the development of personalized intervention strategies, with particular consideration of disease heterogeneity. Future research should prioritize the identification and validation of robust aging biomarkers and aging-related disease phenotypes.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 4","pages":"Pages 246-272"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the role of the respiratory microbiome in long COVID pathogenesis and therapeutics","authors":"Bo Wang,&nbsp;Yuan Wang,&nbsp;Kang Ning","doi":"10.1016/j.pccm.2025.11.003","DOIUrl":"10.1016/j.pccm.2025.11.003","url":null,"abstract":"","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 4","pages":"Pages 221-224"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 2 inflammation in chronic obstructive pulmonary disease: A promising treatable trait and practice recommendations","authors":"Yan Chen ,&nbsp;Ting Yang ,&nbsp;Jing Zhang ,&nbsp;Xiangqi Chen ,&nbsp;Xin Chen ,&nbsp;Zhe Cheng ,&nbsp;Yaqing Li ,&nbsp;Xiaoyun Fan ,&nbsp;Wei Han ,&nbsp;Zhiyi He ,&nbsp;Dedong Ma ,&nbsp;Ying Meng ,&nbsp;Junxia Yan ,&nbsp;Yan Yin ,&nbsp;Huihui Zeng ,&nbsp;Qiong Zhou ,&nbsp;Xiaoming Zhou ,&nbsp;Hui Cai ,&nbsp;Yanan Cui ,&nbsp;Yiming Ma ,&nbsp;Rongchang Chen","doi":"10.1016/j.pccm.2025.11.004","DOIUrl":"10.1016/j.pccm.2025.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 inflammation is a key inflammatory endotype of chronic obstructive pulmonary disease (COPD). The precise identification and targeted intervention of treatable traits related to type 2 inflammation are crucial directions in the current management of COPD. Recently, a growing body of evidence-based medical data has accumulated regarding the clinical characteristics, biomarkers, therapeutic agents, and efficacy evaluation of type 2 inflammation in COPD, providing strong support for clinical diagnosis and treatment. This clinical practice recommendation systematically reviewed the evidence-based medical literature and integrated clinical experience to present expert opinions, aiming to standardize and improve the management of type 2 inflammation in COPD.</div></div><div><h3>Methods</h3><div>This clinical practice recommendation followed Appraisal of Guidelines for Research and Evaluation II (AGREE II) and the Reporting Items for Practice Guidelines in HealThcare (RIGHT) statement to ensure the thoroughness and transparency. Clinical questions were primarily derived from surveys among experts in the field and thorough discussion at meetings. The evidence grading levels and recommendation grades adopted in the clinical practice recommendation follow the evidence grading levels and recommendation grades established by the Oxford Centre for Evidence-Based Medicine. The expert opinions were formulated through open discussion and expert voting. Expert opinions with an agreement rate of 80 % or higher among the experts are incorporated in the clinical practice recommendation.</div></div><div><h3>Results</h3><div>Eight clinical questions concerning diagnosis and treatment were proposed after expert discussion. In addition, fifteen specific major points of expert opinions about type 2 inflammation in COPD, involving clinical features, biomarkers, correlation with clinical outcomes, inhaled corticosteroid (ICS) treatment, biologic treatment and treatment response, were determined.</div></div><div><h3>Conclusions</h3><div>A set of comprehensive clinical practice recommendations focusing on the treatable trait of type 2 inflammation in COPD was established, which may provide potential guidance for the precision management of COPD.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 4","pages":"Pages 225-245"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}