Pub Date : 2025-12-01DOI: 10.1016/j.pccm.2025.11.003
Bo Wang, Yuan Wang, Kang Ning
{"title":"Unveiling the role of the respiratory microbiome in long COVID pathogenesis and therapeutics","authors":"Bo Wang, Yuan Wang, 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}
Pub Date : 2025-12-01DOI: 10.1016/j.pccm.2025.11.005
Yanan Zhou , Gaoying Chen , Xiang Li , Xiaohe Li , Zeqiang Lin , Li Liu , Dan Pu , Jiyuan Chen , Yuqin Chen , Ziying Lin , Zili Zhang , Lingling Zhu , Wenju Lu , Wen Ning , Jian Wang , Songmin Ying , Jing Zhang , Qinghua Zhou , Yuanlin Song
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.
{"title":"Aging and lung diseases: Unraveling mechanisms and therapeutic targets","authors":"Yanan Zhou , Gaoying Chen , Xiang Li , Xiaohe Li , Zeqiang Lin , Li Liu , Dan Pu , Jiyuan Chen , Yuqin Chen , Ziying Lin , Zili Zhang , Lingling Zhu , Wenju Lu , Wen Ning , Jian Wang , Songmin Ying , Jing Zhang , Qinghua Zhou , 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}
Pub Date : 2025-12-01DOI: 10.1016/j.pccm.2025.11.004
Yan Chen , Ting Yang , Jing Zhang , Xiangqi Chen , Xin Chen , Zhe Cheng , Yaqing Li , Xiaoyun Fan , Wei Han , Zhiyi He , Dedong Ma , Ying Meng , Junxia Yan , Yan Yin , Huihui Zeng , Qiong Zhou , Xiaoming Zhou , Hui Cai , Yanan Cui , Yiming Ma , Rongchang Chen
Background
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.
Methods
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.
Results
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.
Conclusions
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.
{"title":"Type 2 inflammation in chronic obstructive pulmonary disease: A promising treatable trait and practice recommendations","authors":"Yan Chen , Ting Yang , Jing Zhang , Xiangqi Chen , Xin Chen , Zhe Cheng , Yaqing Li , Xiaoyun Fan , Wei Han , Zhiyi He , Dedong Ma , Ying Meng , Junxia Yan , Yan Yin , Huihui Zeng , Qiong Zhou , Xiaoming Zhou , Hui Cai , Yanan Cui , Yiming Ma , 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}
Pub Date : 2025-12-01DOI: 10.1016/j.pccm.2025.11.001
Hui Han , Yongxian Hu
Chimeric antigen receptor (CAR) T cell (CAR-T) therapy is a form of adoptive immunotherapy based on the genetic engineering of T lymphocytes. The expression of CARs on T cells facilitates precise, efficient immune responses by enabling direct binding to target cell-specific surface antigens, circumventing the need for major histocompatibility complex-restricted antigen presentation. Having achieved clinical success in treating refractory hematologic malignancies, research efforts have been increasingly directed toward expanding the application of CAR-T therapy, as there is growing interest in investigating its therapeutic potential for a range of respiratory diseases. This review systematically explores the expanding utilization of CAR-T therapy in treating respiratory diseases such as respiratory malignancies, severe asthma, infectious diseases, idiopathic pulmonary fibrosis, and autoimmune disorders with significant pulmonary involvement, providing a comprehensive summary of the current preclinical and clinical advancements. Despite encouraging outcomes, the clinical translation of CAR-T therapy for respiratory diseases is impeded by several persistent challenges, including the limited availability of tumor-specific antigens because of heterogeneous expression of target antigens, the impairment of CAR-T functionality by the immunosuppressive microenvironment of solid tumors, and considerable manufacturing and logistical hurdles. To address these obstacles, this review highlights emerging combinatorial strategies aimed at enhancing therapeutic efficacy and safety. With ongoing advancements, CAR-T therapy holds promise as a versatile and effective treatment, potentially achieving durable remissions and establishing a novel therapeutic paradigm for patients with otherwise refractory respiratory diseases.
{"title":"CAR-T therapy: Advances in respiratory diseases","authors":"Hui Han , Yongxian Hu","doi":"10.1016/j.pccm.2025.11.001","DOIUrl":"10.1016/j.pccm.2025.11.001","url":null,"abstract":"<div><div>Chimeric antigen receptor (CAR) T cell (CAR-T) therapy is a form of adoptive immunotherapy based on the genetic engineering of T lymphocytes. The expression of CARs on T cells facilitates precise, efficient immune responses by enabling direct binding to target cell-specific surface antigens, circumventing the need for major histocompatibility complex-restricted antigen presentation. Having achieved clinical success in treating refractory hematologic malignancies, research efforts have been increasingly directed toward expanding the application of CAR-T therapy, as there is growing interest in investigating its therapeutic potential for a range of respiratory diseases. This review systematically explores the expanding utilization of CAR-T therapy in treating respiratory diseases such as respiratory malignancies, severe asthma, infectious diseases, idiopathic pulmonary fibrosis, and autoimmune disorders with significant pulmonary involvement, providing a comprehensive summary of the current preclinical and clinical advancements. Despite encouraging outcomes, the clinical translation of CAR-T therapy for respiratory diseases is impeded by several persistent challenges, including the limited availability of tumor-specific antigens because of heterogeneous expression of target antigens, the impairment of CAR-T functionality by the immunosuppressive microenvironment of solid tumors, and considerable manufacturing and logistical hurdles. To address these obstacles, this review highlights emerging combinatorial strategies aimed at enhancing therapeutic efficacy and safety. With ongoing advancements, CAR-T therapy holds promise as a versatile and effective treatment, potentially achieving durable remissions and establishing a novel therapeutic paradigm for patients with otherwise refractory respiratory diseases.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 4","pages":"Pages 289-299"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845707","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}
Pub Date : 2025-12-01DOI: 10.1016/j.pccm.2025.11.006
Chun Wang , Kang Chang , Mengyin Chen , Xiaohui Zou , Yawen Ni , Qing Zhang , Li Zhao , Bin Xing , Lijuan Guo , Wenhui Chen , Bin Cao
Background
Alterations in the respiratory microbiome are common following lung transplantation; however, the complex relationship between microbial composition and posttransplant clinical outcomes remains insufficiently characterized. This study aimed to delineate microbial signatures within the lower respiratory tract and to elucidate their associations with posttransplant outcomes in lung transplant recipients (LTRs).
Methods
Metagenomic sequencing was performed on 138 bronchoalveolar lavage fluid (BALF) samples collected in 2023 from patients who had undergone lung transplantation between 2017 and 2023 at the China–Japan Friendship Hospital. Lung function indices, hematologic parameters, and serum cytokine levels were assessed, and patients were prospectively followed to record adverse clinical events.
Results
The lung microbiome of stable LTRs formed four distinct clusters, exhibiting marked heterogeneity in both α- and β-diversity. The most prevalent cluster, enriched with oral-origin commensals, such as Neisseria subflava (N. subflava), Prevotella melaninogenica, and Streptococcus mitis (S. mitis), demonstrated the highest microbial diversity, and was associated with the lowest C-reactive protein levels, fewest adverse events, and the longest complication-free postoperative duration. In contrast, a virus-enriched cluster characterized by reduced diversity and high abundance of Torque teno virus and Cytomegalovirus human betaherpesvirus 5 was associated with poorer outcomes. BALF samples from infected LTRs exhibited more severe dysbiosis than those from immunocompetent individuals, with reduced diversity and pathogen dominance. Concurrent infections aggravated antibody-mediated rejection-related lung function decline, indicating complex microbiome–immune interactions. Integrative modeling of microbiome, hematologic, and pulmonary function data yielded superior diagnostic performance for infection detection (area under the receiver operating characteristic curve = 0.93).
Conclusion
The composition of the lung microbiome may serve as a prognostic biomarker for clinical outcomes after lung transplantation. The presence of diverse, commensal-dominated communities was associated with improved outcomes, whereas viral enrichment correlated with adverse events. These findings underscore the clinical importance of microbiome monitoring in posttransplant management and suggest that targeted modulation of microbial communities could improve long-term graft stability and patient prognosis.
{"title":"Enrichment of the commensal microbiome in the lower respiratory tract is associated with improved outcomes following lung transplantation","authors":"Chun Wang , Kang Chang , Mengyin Chen , Xiaohui Zou , Yawen Ni , Qing Zhang , Li Zhao , Bin Xing , Lijuan Guo , Wenhui Chen , Bin Cao","doi":"10.1016/j.pccm.2025.11.006","DOIUrl":"10.1016/j.pccm.2025.11.006","url":null,"abstract":"<div><h3>Background</h3><div>Alterations in the respiratory microbiome are common following lung transplantation; however, the complex relationship between microbial composition and posttransplant clinical outcomes remains insufficiently characterized. This study aimed to delineate microbial signatures within the lower respiratory tract and to elucidate their associations with posttransplant outcomes in lung transplant recipients (LTRs).</div></div><div><h3>Methods</h3><div>Metagenomic sequencing was performed on 138 bronchoalveolar lavage fluid (BALF) samples collected in 2023 from patients who had undergone lung transplantation between 2017 and 2023 at the China–Japan Friendship Hospital. Lung function indices, hematologic parameters, and serum cytokine levels were assessed, and patients were prospectively followed to record adverse clinical events.</div></div><div><h3>Results</h3><div>The lung microbiome of stable LTRs formed four distinct clusters, exhibiting marked heterogeneity in both α- and β-diversity. The most prevalent cluster, enriched with oral-origin commensals, such as <em>Neisseria subflava</em> (<em>N. subflava</em>), <em>Prevotella melaninogenica</em>, and <em>Streptococcus mitis</em> (<em>S. mitis</em>), demonstrated the highest microbial diversity, and was associated with the lowest C-reactive protein levels, fewest adverse events, and the longest complication-free postoperative duration. In contrast, a virus-enriched cluster characterized by reduced diversity and high abundance of <em>Torque teno virus</em> and <em>Cytomegalovirus human betaherpesvirus 5</em> was associated with poorer outcomes. BALF samples from infected LTRs exhibited more severe dysbiosis than those from immunocompetent individuals, with reduced diversity and pathogen dominance. Concurrent infections aggravated antibody-mediated rejection-related lung function decline, indicating complex microbiome–immune interactions. Integrative modeling of microbiome, hematologic, and pulmonary function data yielded superior diagnostic performance for infection detection (area under the receiver operating characteristic curve = 0.93).</div></div><div><h3>Conclusion</h3><div>The composition of the lung microbiome may serve as a prognostic biomarker for clinical outcomes after lung transplantation. The presence of diverse, commensal-dominated communities was associated with improved outcomes, whereas viral enrichment correlated with adverse events. These findings underscore the clinical importance of microbiome monitoring in posttransplant management and suggest that targeted modulation of microbial communities could improve long-term graft stability and patient prognosis.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 4","pages":"Pages 308-318"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845655","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}
Pub Date : 2025-12-01DOI: 10.1016/j.pccm.2025.11.007
Yang Jin , Qidan Hu , Jingya Li , Dong Liu , Xiaoying Gu , Jiuyang Xu , Lian Liu , Honglin Hu , Wei Wang , Yeming Wang , Bin Cao
{"title":"Risk factors for severe and prolonged cough in influenza and COVID-19: A post hoc analysis of three randomized controlled trials","authors":"Yang Jin , Qidan Hu , Jingya Li , Dong Liu , Xiaoying Gu , Jiuyang Xu , Lian Liu , Honglin Hu , Wei Wang , Yeming Wang , Bin Cao","doi":"10.1016/j.pccm.2025.11.007","DOIUrl":"10.1016/j.pccm.2025.11.007","url":null,"abstract":"","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 4","pages":"Pages 319-322"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845656","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}
Pub Date : 2025-12-01DOI: 10.1016/j.pccm.2025.11.002
Ming Zhu, Xu Liu, Qianyue Jing, Lei Yao, Xin Yao
The atopic march (AM) describes the sequential progression beginning with atopic dermatitis (AD), followed by the subsequent development of food allergy (FA), allergic asthma (AA), and allergic rhinitis (AR). The chronological characterization of AM is now widely recognized. However, the precise mechanisms leading to these atopic comorbidities after AD onset are not fully understood. Existing evidence suggests that skin barrier dysfunction constitutes a key initiating factor, promoting allergen sensitization and activation of immune responses. Recent studies have revealed that AM exhibits a trans-organ cascade effect, in which AD acts as an early event significantly increasing the risk of asthma development. This implicates a potential systemic link between the skin and lungs, termed the skin–lung axis. We propose the skin–lung axis as a pathway whereby cutaneous inflammation triggers pulmonary immune disorder. However, there remains a lack of a systematic overview regarding the mechanisms underlying this axis. Integrating multidimensional evidence encompassing genetic and epigenetic regulation, immune-inflammatory propagation, microbial-metabolic disturbance, and neuroimmune dysregulation, this review systematically explores the mechanistic role of the skin–lung axis in the AM. With the aim to elucidate how allergic inflammation originating in the skin remotely modulates the pulmonary microenvironment via multiple pathways, thereby facilitating asthma development, this review also discusses therapeutic strategies for preventing and intervening in AM progression.
{"title":"Skin-lung axis in the atopic march: The immune link from skin to lungs","authors":"Ming Zhu, Xu Liu, Qianyue Jing, Lei Yao, Xin Yao","doi":"10.1016/j.pccm.2025.11.002","DOIUrl":"10.1016/j.pccm.2025.11.002","url":null,"abstract":"<div><div>The atopic march (AM) describes the sequential progression beginning with atopic dermatitis (AD), followed by the subsequent development of food allergy (FA), allergic asthma (AA), and allergic rhinitis (AR). The chronological characterization of AM is now widely recognized. However, the precise mechanisms leading to these atopic comorbidities after AD onset are not fully understood. Existing evidence suggests that skin barrier dysfunction constitutes a key initiating factor, promoting allergen sensitization and activation of immune responses. Recent studies have revealed that AM exhibits a trans-organ cascade effect, in which AD acts as an early event significantly increasing the risk of asthma development. This implicates a potential systemic link between the skin and lungs, termed the skin–lung axis. We propose the skin–lung axis as a pathway whereby cutaneous inflammation triggers pulmonary immune disorder. However, there remains a lack of a systematic overview regarding the mechanisms underlying this axis. Integrating multidimensional evidence encompassing genetic and epigenetic regulation, immune-inflammatory propagation, microbial-metabolic disturbance, and neuroimmune dysregulation, this review systematically explores the mechanistic role of the skin–lung axis in the AM. With the aim to elucidate how allergic inflammation originating in the skin remotely modulates the pulmonary microenvironment via multiple pathways, thereby facilitating asthma development, this review also discusses therapeutic strategies for preventing and intervening in AM progression.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 4","pages":"Pages 273-288"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845660","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}
Pub Date : 2025-12-01DOI: 10.1016/j.pccm.2025.11.008
Xiaoqian Ma , Lili Zhu , Huijuan Xiao , Yushan He , Huaping Dai
<div><h3>Background</h3><div>Interstitial lung disease (ILD) and pulmonary sarcoidosis are a group of complex respiratory conditions imposing a significant and growing global health burden. A comprehensive, up-to-date assessment of their epidemiological trends is crucial for informing policy. This study analyzes the global, regional, and national burden of ILD and pulmonary sarcoidosis from 1990 to 2023, with projections to 2050, using data from the Global Burden of Diseases (GBD) 2023 study.</div></div><div><h3>Methods</h3><div>We extracted data on incidence, prevalence, deaths, and disability-adjusted life years (DALYs) across 204 countries and territories from the GBD 2023 database. We analyzed temporal trends using absolute numbers and age-standardized rates, examining the relationship between disease burden and the socio-demographic index (SDI). Future burden to 2050 was also forecast.</div></div><div><h3>Results</h3><div>Globally, the absolute burden of ILD and pulmonary sarcoidosis increased substantially from 1990 to 2023, with incident cases rising to 428.16 (95 % UI: 385.88–484.19) thousand, prevalent cases to 4581.13 (95 % UI: 4092.82–5166.99) thousand, deaths to 112.65 (95 % UI: 90.85–141.59) thousand, and DALYs to 4.46 (95% UI: 3.74–5.65) million in 2023, which were 1.57, 1.22, 1.45, and 2.40 times higher than their respective 1990 levels. From 1990 to 2023, the global age-standardized incidence rate (ASIR, average annual percentage change [AAPC] 0.60%) and age-standardized prevalence rate (ASPR, AAPC 0.32%) of ILD and sarcoidosis increased modestly, whereas age-standardized death rate (ASDR, AAPC 1.97%) and age-standardized DALY rate (AAPC 1.34%) rose more steeply. Significant regional disparities were observed in 2023, with Andean Latin America and High-income Asia Pacific recording the highest burdens, and Southeast Asia the lowest. Nationally, Peru reported the highest ASIR, ASDR and age-standardized DALY rate, while Mauritius reported the highest ASPR. Burden levels were generally positively correlated with SDI. The age group with the highest global ILD and pulmonary sarcoidosis incident cases in 2023 was observed in individuals aged 70–74 years. For individuals aged 60 and above, males consistently had higher incidence rates than females across all age groups. In 2023, the estimated burden of ILD and pulmonary sarcoidosis in China was substantial, with 45,154.35 incident cases, 627,044.96 prevalent cases, 10,278.66 deaths, and 267,349.11 DALYs. Correspondingly, the age-standardized rates were 2.12 per 100,000 for incidence, 27.98 per 100,000 for prevalence, 0.46 per 100,000 for death, and 12.02 per 100,000 for DALYs. Forecasts indicate that by 2050, the global crude death and DALY rates will increase by approximately 83.53 % and 60.43 %, respectively. This rise is primarily attributable to population growth and aging, particularly in high-income regions.</div></div><div><h3>Conclusions</h3><div>The global burden of ILD and pulm
{"title":"Global, regional, and national burden of interstitial lung disease and pulmonary sarcoidosis from 1990 to 2023, and projections to 2050: A systematic analysis for the Global Burden of Disease Study 2023","authors":"Xiaoqian Ma , Lili Zhu , Huijuan Xiao , Yushan He , Huaping Dai","doi":"10.1016/j.pccm.2025.11.008","DOIUrl":"10.1016/j.pccm.2025.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Interstitial lung disease (ILD) and pulmonary sarcoidosis are a group of complex respiratory conditions imposing a significant and growing global health burden. A comprehensive, up-to-date assessment of their epidemiological trends is crucial for informing policy. This study analyzes the global, regional, and national burden of ILD and pulmonary sarcoidosis from 1990 to 2023, with projections to 2050, using data from the Global Burden of Diseases (GBD) 2023 study.</div></div><div><h3>Methods</h3><div>We extracted data on incidence, prevalence, deaths, and disability-adjusted life years (DALYs) across 204 countries and territories from the GBD 2023 database. We analyzed temporal trends using absolute numbers and age-standardized rates, examining the relationship between disease burden and the socio-demographic index (SDI). Future burden to 2050 was also forecast.</div></div><div><h3>Results</h3><div>Globally, the absolute burden of ILD and pulmonary sarcoidosis increased substantially from 1990 to 2023, with incident cases rising to 428.16 (95 % UI: 385.88–484.19) thousand, prevalent cases to 4581.13 (95 % UI: 4092.82–5166.99) thousand, deaths to 112.65 (95 % UI: 90.85–141.59) thousand, and DALYs to 4.46 (95% UI: 3.74–5.65) million in 2023, which were 1.57, 1.22, 1.45, and 2.40 times higher than their respective 1990 levels. From 1990 to 2023, the global age-standardized incidence rate (ASIR, average annual percentage change [AAPC] 0.60%) and age-standardized prevalence rate (ASPR, AAPC 0.32%) of ILD and sarcoidosis increased modestly, whereas age-standardized death rate (ASDR, AAPC 1.97%) and age-standardized DALY rate (AAPC 1.34%) rose more steeply. Significant regional disparities were observed in 2023, with Andean Latin America and High-income Asia Pacific recording the highest burdens, and Southeast Asia the lowest. Nationally, Peru reported the highest ASIR, ASDR and age-standardized DALY rate, while Mauritius reported the highest ASPR. Burden levels were generally positively correlated with SDI. The age group with the highest global ILD and pulmonary sarcoidosis incident cases in 2023 was observed in individuals aged 70–74 years. For individuals aged 60 and above, males consistently had higher incidence rates than females across all age groups. In 2023, the estimated burden of ILD and pulmonary sarcoidosis in China was substantial, with 45,154.35 incident cases, 627,044.96 prevalent cases, 10,278.66 deaths, and 267,349.11 DALYs. Correspondingly, the age-standardized rates were 2.12 per 100,000 for incidence, 27.98 per 100,000 for prevalence, 0.46 per 100,000 for death, and 12.02 per 100,000 for DALYs. Forecasts indicate that by 2050, the global crude death and DALY rates will increase by approximately 83.53 % and 60.43 %, respectively. This rise is primarily attributable to population growth and aging, particularly in high-income regions.</div></div><div><h3>Conclusions</h3><div>The global burden of ILD and pulm","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 4","pages":"Pages 300-307"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845676","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}
Pub Date : 2025-09-01DOI: 10.1016/j.pccm.2025.08.004
Kailun Fei , Wenjing Yang , Jianchun Duan , Jiachen Xu , Jie Zhao , Jie Wang , Zhijie Wang
Background
The disease burden, treatment patterns, and financial costs associated with chemotherapy-induced myelosuppression (CIM) in Chinese patients with extensive-stage small cell lung cancer (ES-SCLC) remain poorly characterized, particularly in terms of real-world evidence derived from large populations. This study aimed to describe the incidence, treatment patterns, costs, and healthcare resource utilization (HCRU) in Chinese patients with ES-SCLC who develop CIM.
Methods
Adults diagnosed with ES-SCLC who started etoposide–platinum (EP) chemotherapy for the first time between January 1, 2018 and December 31, 2022 were retrospectively identified in the Chinese National Cancer Information Database. Baseline demographic and clinical data were collected. Information on CIM-related events, treatment, costs, and HCRU during EP chemotherapy and during follow-up was assessed. Costs and HCRU were compared among patients with grade 3–4 CIM, grade 1–2 CIM, and no CIM using the Kruskal–Wallis test.
Results
In total, 7505 patients with ES-SCLC (mean age 61.2 years; 17.7 % [1332/7505] female; body mass index 23.2±3.3 kg/m2) were enrolled. After initiation of EP-based chemotherapy, 6901 patients (92.0 %) experienced at least one CIM-related event. At least one grade 3–4 CIM event occurred in 1883 patients (25.1 %) and consisted of single-lineage (neutropenia [n=609, 8.1 %], thrombocytopenia [n=85, 1.1 %], anemia [n=797, 10.6 %]), two-lineage (n=318, 4.2 %), and three-lineage (n=74, 1.0 %) events. Patients receiving immune checkpoint inhibitors (ICIs) plus EP (n=1674) had a significantly higher incidence of at least one CIM during the ICI combination therapy (87.8 % [1469/1674] vs. 82.8 % [4827/5831]; χ²=23.43, P<0.0001) and grade 3–4 CIM (25.7 % [430/1674] vs. 20.6 % [1201/5831]; χ²=19.51, P<0.0001) compared to those receiving other EP-based therapies during EP chemotherapy (n=5831). Rates of use of granulocyte colony-stimulating factor, thrombopoietin, interleukin-11, erythropoiesis-stimulating agents, and blood transfusion were 81.1 % (n=6087), 9.2 % (n=691), 12.4 % (n=927), 9.0 % (n=678), and 12.1 % (n=907), respectively. HCRU and total costs per patient were higher for those with grade 3–4 CIM than for those without CIM or grade 1–2 CIM, and significant differences in the total cost were observed across groups (H=195.54, P <0.0001).
Conclusion
Despite the availability of supportive care for CIM in patients with ES-SCLC in China, a considerable clinical and financial burden persists. Strategies that protect bone marrow from progressing to high-grade myelosuppression could reduce the burden on patients and healthcare organizations.
{"title":"Burden of chemotherapy-induced myelosuppression (CIM) in Chinese patients with extensive-stage small cell lung cancer (ES-SCLC): A retrospective real-world study","authors":"Kailun Fei , Wenjing Yang , Jianchun Duan , Jiachen Xu , Jie Zhao , Jie Wang , Zhijie Wang","doi":"10.1016/j.pccm.2025.08.004","DOIUrl":"10.1016/j.pccm.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>The disease burden, treatment patterns, and financial costs associated with chemotherapy-induced myelosuppression (CIM) in Chinese patients with extensive-stage small cell lung cancer (ES-SCLC) remain poorly characterized, particularly in terms of real-world evidence derived from large populations. This study aimed to describe the incidence, treatment patterns, costs, and healthcare resource utilization (HCRU) in Chinese patients with ES-SCLC who develop CIM.</div></div><div><h3>Methods</h3><div>Adults diagnosed with ES-SCLC who started etoposide–platinum (EP) chemotherapy for the first time between January 1, 2018 and December 31, 2022 were retrospectively identified in the Chinese National Cancer Information Database. Baseline demographic and clinical data were collected. Information on CIM-related events, treatment, costs, and HCRU during EP chemotherapy and during follow-up was assessed. Costs and HCRU were compared among patients with grade 3–4 CIM, grade 1–2 CIM, and no CIM using the Kruskal–Wallis test.</div></div><div><h3>Results</h3><div>In total, 7505 patients with ES-SCLC (mean age 61.2 years; 17.7 % [1332/7505] female; body mass index 23.2±3.3 kg/m<sup>2</sup>) were enrolled. After initiation of EP-based chemotherapy, 6901 patients (92.0 %) experienced at least one CIM-related event. At least one grade 3–4 CIM event occurred in 1883 patients (25.1 %) and consisted of single-lineage (neutropenia [<em>n</em>=609, 8.1 %], thrombocytopenia [<em>n</em>=85, 1.1 %], anemia [<em>n</em>=797, 10.6 %]), two-lineage (<em>n</em>=318, 4.2 %), and three-lineage (<em>n</em>=74, 1.0 %) events. Patients receiving immune checkpoint inhibitors (ICIs) plus EP (<em>n</em>=1674) had a significantly higher incidence of at least one CIM during the ICI combination therapy (87.8 % [1469/1674] <em>vs.</em> 82.8 % [4827/5831]; <em>χ²</em>=23.43, <em>P</em><0.0001) and grade 3–4 CIM (25.7 % [430/1674] <em>vs.</em> 20.6 % [1201/5831]; <em>χ²</em>=19.51, <em>P</em><0.0001) compared to those receiving other EP-based therapies during EP chemotherapy (<em>n</em>=5831). Rates of use of granulocyte colony-stimulating factor, thrombopoietin, interleukin-11, erythropoiesis-stimulating agents, and blood transfusion were 81.1 % (<em>n</em>=6087), 9.2 % (<em>n</em>=691), 12.4 % (<em>n</em>=927), 9.0 % (<em>n</em>=678), and 12.1 % (<em>n</em>=907), respectively. HCRU and total costs per patient were higher for those with grade 3–4 CIM than for those without CIM or grade 1–2 CIM, and significant differences in the total cost were observed across groups (<em>H</em>=195.54, <em>P</em> <0.0001).</div></div><div><h3>Conclusion</h3><div>Despite the availability of supportive care for CIM in patients with ES-SCLC in China, a considerable clinical and financial burden persists. Strategies that protect bone marrow from progressing to high-grade myelosuppression could reduce the burden on patients and healthcare organizations.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 3","pages":"Pages 209-217"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183897","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}
Pub Date : 2025-09-01DOI: 10.1016/j.pccm.2025.08.007
Shunlian Hu , Jijin Jiang , Jiayi Wang , Qiuhong Li , Wenhui Wu , Jin-Fu Xu
{"title":"Transcriptome analysis identifies upregulation of GBP4 in sarcoidosis and pulmonary hypertension","authors":"Shunlian Hu , Jijin Jiang , Jiayi Wang , Qiuhong Li , Wenhui Wu , Jin-Fu Xu","doi":"10.1016/j.pccm.2025.08.007","DOIUrl":"10.1016/j.pccm.2025.08.007","url":null,"abstract":"","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 3","pages":"Pages 218-220"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183898","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}
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