Pub Date : 2025-09-01DOI: 10.1016/j.pccm.2025.08.005
Qi Zhou , Fengfei Sun , Xinhui Wang
{"title":"Chimeric antigen receptor-T cell therapy for lung cancer: The tumor microenvironment bottleneck and remedies to circumvent it","authors":"Qi Zhou , Fengfei Sun , Xinhui Wang","doi":"10.1016/j.pccm.2025.08.005","DOIUrl":"10.1016/j.pccm.2025.08.005","url":null,"abstract":"","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 3","pages":"Pages 145-148"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183928","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.2025.08.001
Cynthia Hsin-Ya Chao, Yuanpu Peter Di
Lung cancer is the leading cause of cancer-related deaths, with the highest mortality among all cancers. Despite the significant advances in cancer treatments in recent years, especially with the development of checkpoint inhibitor immunotherapy, a definitive treatment has yet to be discovered to cure lung cancer. Lung tumorigenesis involves genetic alterations in a multi-step process with heterogeneity and diversity, such that even though cigarette smoke has been widely acknowledged as a major associated risk factor, many non-smokers still develop lung cancer. Among lung cancers, 85 % are non-small cell lung carcinoma (NSCLC), with adenocarcinoma as the most prevalent NSCLC subtype, making up around 40 % of all lung cancers. The major genetic mutation drivers include the epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), and Kirsten rat sarcoma viral oncogene homolog (KRAS). While the advancement of newer-generation anti-cancer drugs has successfully treated EGFR- and ALK-associated lung cancers, KRAS mutation-associated lung cancer remains extremely challenging and has limited therapeutic options. This review outlines the etiology, epidemiology, and categorization of lung cancer, describing the current therapeutic options and limitations, with a focus on the most challenging-to-treat KRAS-mutated lung cancer. Furthermore, this paper highlights the current state and development of KRAS-mutated cancer treatment by describing the mechanisms and utilities of various KRAS-targeted therapies entering clinical trials, and it underlines the most promising treatment options.
{"title":"Mechanisms and current advances in treating KRAS-mutated lung cancer","authors":"Cynthia Hsin-Ya Chao, Yuanpu Peter Di","doi":"10.1016/j.pccm.2025.08.001","DOIUrl":"10.1016/j.pccm.2025.08.001","url":null,"abstract":"<div><div>Lung cancer is the leading cause of cancer-related deaths, with the highest mortality among all cancers. Despite the significant advances in cancer treatments in recent years, especially with the development of checkpoint inhibitor immunotherapy, a definitive treatment has yet to be discovered to cure lung cancer. Lung tumorigenesis involves genetic alterations in a multi-step process with heterogeneity and diversity, such that even though cigarette smoke has been widely acknowledged as a major associated risk factor, many non-smokers still develop lung cancer. Among lung cancers, 85 % are non-small cell lung carcinoma (NSCLC), with adenocarcinoma as the most prevalent NSCLC subtype, making up around 40 % of all lung cancers. The major genetic mutation drivers include the epidermal growth factor receptor (<em>EGFR</em>), anaplastic lymphoma kinase (<em>ALK</em>), and Kirsten rat sarcoma viral oncogene homolog (<em>KRAS</em>). While the advancement of newer-generation anti-cancer drugs has successfully treated <em>EGFR</em>- and <em>ALK</em>-associated lung cancers, <em>KRAS</em> mutation-associated lung cancer remains extremely challenging and has limited therapeutic options. This review outlines the etiology, epidemiology, and categorization of lung cancer, describing the current therapeutic options and limitations, with a focus on the most challenging-to-treat <em>KRAS</em>-mutated lung cancer. Furthermore, this paper highlights the current state and development of <em>KRAS</em>-mutated cancer treatment by describing the mechanisms and utilities of various <em>KRAS</em>-targeted therapies entering clinical trials, and it underlines the most promising treatment options.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 3","pages":"Pages 149-163"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183929","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.2025.08.002
Wenwen Wu , Vanessa M. McDonald , Gang Wang , Peter Gerard Gibson
Asthma is a heterogeneous condition characterized by diverse clinical phenotypes and variable treatment responses, underscoring the limitations of the traditional “one-size-fits-all” stepwise management paradigm. The treatable traits (TTs) approach, a precision medicine framework, targets individualized, clinically relevant characteristics spanning pulmonary, extrapulmonary, and behavioral domains. This review synthesizes current evidence on the prevalence and impact of TTs across the spectrum of asthma severity—mild, moderate, and severe. Although severe asthma is associated with a greater overall burden of TTs, patients with mild-to-moderate disease frequently present with substantial trait-related challenges, including persistent symptoms and exacerbations. Key traits, such as eosinophilic inflammation, fixed airflow limitation, obesity, gastroesophageal reflux disease, and psychological comorbidities, vary in prevalence yet exert influence across all severity strata. Super-traits, including T2 inflammation and suboptimal inhaler adherence, warrant prioritization owing to their broad therapeutic implications. Optimal implementation requires tailored strategies in both primary and tertiary care, supported by multidisciplinary collaboration, patient engagement, and resource-efficient diagnostic tools. While barriers include limited clinician awareness and integration into existing workflows, enablers such as decision aids and structured education can facilitate adoption. The TTs model represents a promising pathway toward personalized asthma care, with the potential to improve outcomes across all severities.
{"title":"The value of treatable traits across the spectrum of adult asthma severity","authors":"Wenwen Wu , Vanessa M. McDonald , Gang Wang , Peter Gerard Gibson","doi":"10.1016/j.pccm.2025.08.002","DOIUrl":"10.1016/j.pccm.2025.08.002","url":null,"abstract":"<div><div>Asthma is a heterogeneous condition characterized by diverse clinical phenotypes and variable treatment responses, underscoring the limitations of the traditional “one-size-fits-all” stepwise management paradigm. The treatable traits (TTs) approach, a precision medicine framework, targets individualized, clinically relevant characteristics spanning pulmonary, extrapulmonary, and behavioral domains. This review synthesizes current evidence on the prevalence and impact of TTs across the spectrum of asthma severity—mild, moderate, and severe. Although severe asthma is associated with a greater overall burden of TTs, patients with mild-to-moderate disease frequently present with substantial trait-related challenges, including persistent symptoms and exacerbations. Key traits, such as eosinophilic inflammation, fixed airflow limitation, obesity, gastroesophageal reflux disease, and psychological comorbidities, vary in prevalence yet exert influence across all severity strata. Super-traits, including T2 inflammation and suboptimal inhaler adherence, warrant prioritization owing to their broad therapeutic implications. Optimal implementation requires tailored strategies in both primary and tertiary care, supported by multidisciplinary collaboration, patient engagement, and resource-efficient diagnostic tools. While barriers include limited clinician awareness and integration into existing workflows, enablers such as decision aids and structured education can facilitate adoption. The TTs model represents a promising pathway toward personalized asthma care, with the potential to improve outcomes across all severities.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 3","pages":"Pages 182-192"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183895","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.2025.08.006
Xueyan Zheng , Yongcheng Li , Dongxue Ruan , Lifeng Lin , Ruilin Meng , Dejian Zhao , Jiayin Yu , Xinyi Li , Hongjun Huang , Maigeng Zhou
Background
Non-COVID-19 lower respiratory infections (LRIs) represent a persistent public health concern in China and globally. However, comprehensive assessments of their long-term spatiotemporal trends remain limited. This study aimed to quantify the burden of LRIs by age, sex, and geographic region across China and globally from 1990 to 2021.
Methods
Using standardized methodologies from the Global Burden of Disease Study 2021, we estimated LRI incidence and mortality globally and across 33 provincial-level units in China by sex, age, and year. Attributable incidence and mortality were further analyzed by underlying etiologies and risk factors, with corresponding 95 % uncertainty intervals.
Results
In 2021, LRI accounted for 343.6 (95% UI: 325.2–363.5) million episodes and 2.2 (95% UI: 2.0–2.4) million deaths worldwide, corresponding to age-standardized incidence and mortality rates of 4283.6 (95% UI: 4057.0–4524.9) episodes per 100,000 population and 28.7 (95% UI: 25.9–31.1) per 100,000 population, respectively. This reflected a decline of 32.8 % and 53.6 % since 1990. China contributed 44.7 (95% UI: 41.8–47.8) million episodes and 206,930.2 (95% UI: 171,260.9–251,990.5) deaths in 2021, with respective age-standardized rates of 2853.8 (95% UI: 2664.0–3067.6) episodes per 100,000 population and 14.0 (95% UI: 11.7–17.0) per 100,000 population. Between 1990 and 2021, the age-standardized incidence and mortality rates in China declined by 47.9 % and 76.9 % which were higher than the global average. This progress was primarily driven by reductions in children under 5 years. Older individuals ≥70 years exhibited the highest burden. In 2021, Guangdong reported the highest age-standardized incidence, while Guizhou had the highest mortality. Streptococcus pneumoniae was the leading cause of LRI-related deaths. Ambient particulate matter pollution, smoking, and low temperature were the primary risk factors, with notable sex-specific differences.
Conclusions
Despite marked improvements, LRIs remain a major contributor to morbidity and mortality in China, particularly among children and older adults. Addressing the residual burden will require targeted strategies, including enhanced diagnostics, expanded vaccination, air quality control, and strengthened healthcare in high-burden provinces.
{"title":"Burden of non-COVID-19 lower respiratory infections and etiologies in China and globally: An analysis for the global burden of disease study 2021","authors":"Xueyan Zheng , Yongcheng Li , Dongxue Ruan , Lifeng Lin , Ruilin Meng , Dejian Zhao , Jiayin Yu , Xinyi Li , Hongjun Huang , Maigeng Zhou","doi":"10.1016/j.pccm.2025.08.006","DOIUrl":"10.1016/j.pccm.2025.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Non-COVID-19 lower respiratory infections (LRIs) represent a persistent public health concern in China and globally. However, comprehensive assessments of their long-term spatiotemporal trends remain limited. This study aimed to quantify the burden of LRIs by age, sex, and geographic region across China and globally from 1990 to 2021.</div></div><div><h3>Methods</h3><div>Using standardized methodologies from the Global Burden of Disease Study 2021, we estimated LRI incidence and mortality globally and across 33 provincial-level units in China by sex, age, and year. Attributable incidence and mortality were further analyzed by underlying etiologies and risk factors, with corresponding 95 % uncertainty intervals.</div></div><div><h3>Results</h3><div>In 2021, LRI accounted for 343.6 (95% UI: 325.2–363.5) million episodes and 2.2 (95% UI: 2.0–2.4) million deaths worldwide, corresponding to age-standardized incidence and mortality rates of 4283.6 (95% UI: 4057.0–4524.9) episodes per 100,000 population and 28.7 (95% UI: 25.9–31.1) per 100,000 population, respectively. This reflected a decline of 32.8 % and 53.6 % since 1990. China contributed 44.7 (95% UI: 41.8–47.8) million episodes and 206,930.2 (95% UI: 171,260.9–251,990.5) deaths in 2021, with respective age-standardized rates of 2853.8 (95% UI: 2664.0–3067.6) episodes per 100,000 population and 14.0 (95% UI: 11.7–17.0) per 100,000 population. Between 1990 and 2021, the age-standardized incidence and mortality rates in China declined by 47.9 % and 76.9 % which were higher than the global average. This progress was primarily driven by reductions in children under 5 years. Older individuals ≥70 years exhibited the highest burden. In 2021, Guangdong reported the highest age-standardized incidence, while Guizhou had the highest mortality. <em>Streptococcus pneumoniae</em> was the leading cause of LRI-related deaths. Ambient particulate matter pollution, smoking, and low temperature were the primary risk factors, with notable sex-specific differences.</div></div><div><h3>Conclusions</h3><div>Despite marked improvements, LRIs remain a major contributor to morbidity and mortality in China, particularly among children and older adults. Addressing the residual burden will require targeted strategies, including enhanced diagnostics, expanded vaccination, air quality control, and strengthened healthcare in high-burden provinces.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 3","pages":"Pages 193-208"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183896","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.2025.08.003
Xizi Du , Ming Yang
Viral infections account for 60–80 % of asthma exacerbations (AE), representing a major burden in both pediatric and adult populations. The pathogenesis of virus-induced asthma exacerbation (VAE) is mechanistically complex, involving disruption of epithelial integrity, defective interferon responses, and abnormal activation of immune cells such as macrophages and innate lymphoid cells. In addition, the interplay between type 2 (T2) and non-T2 inflammation is dynamically regulated during viral infections, further amplifying airway dysfunction and remodeling. Although inhaled corticosteroids and biologics targeting T2 pathways are widely used, their efficacy in VAE is limited, especially in patients with neutrophilic or steroid-insensitive phenotypes, and virus-specific antiviral therapies for asthma are lacking. Recent advances have highlighted novel approaches targeting host immunity and epithelial-immune interactions, but most of these strategies remain in preclinical or early clinical phases, with few personalized treatment approaches available. This review summarizes insights into VAE pathogenesis and therapeutic advances, and discusses challenges and future directions in the development of targeted therapeutic strategies.
{"title":"Unraveling the mechanisms of virus-induced asthma exacerbation: epithelial injury, immune dysregulation, and novel interventions","authors":"Xizi Du , Ming Yang","doi":"10.1016/j.pccm.2025.08.003","DOIUrl":"10.1016/j.pccm.2025.08.003","url":null,"abstract":"<div><div>Viral infections account for 60–80 % of asthma exacerbations (AE), representing a major burden in both pediatric and adult populations. The pathogenesis of virus-induced asthma exacerbation (VAE) is mechanistically complex, involving disruption of epithelial integrity, defective interferon responses, and abnormal activation of immune cells such as macrophages and innate lymphoid cells. In addition, the interplay between type 2 (T2) and non-T2 inflammation is dynamically regulated during viral infections, further amplifying airway dysfunction and remodeling. Although inhaled corticosteroids and biologics targeting T2 pathways are widely used, their efficacy in VAE is limited, especially in patients with neutrophilic or steroid-insensitive phenotypes, and virus-specific antiviral therapies for asthma are lacking. Recent advances have highlighted novel approaches targeting host immunity and epithelial-immune interactions, but most of these strategies remain in preclinical or early clinical phases, with few personalized treatment approaches available. This review summarizes insights into VAE pathogenesis and therapeutic advances, and discusses challenges and future directions in the development of targeted therapeutic strategies.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 3","pages":"Pages 164-181"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183930","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 : 2025-06-01DOI: 10.1016/j.pccm.2025.02.007
Lijuan Luo , Lijun Liu , Yiming Ma , Herui Li , Zihang Zeng , Yan Chen
Background
Fungal infections in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients are poorly understood and often result in a poor prognosis. This study aimed to investigate the distribution of common fungi and the clinical features of AECOPD patients positive for fungal pathogens.
Methods
Data were collected from inpatients with AECOPD at the Second Xiangya Hospital of Central South University from January 2016 to December 2019. The enrolled patients were divided into an infection group and a colonization group, and clinical data were compared between the two groups. A 1:1 propensity score matching (PSM) process was employed to ensure balanced samples to analyze the impact of positive fungal pathogens on the clinical features of AECOPD patients. The incidence of acute exacerbations one year after discharge was determined via telephone follow-up.
Results
The most frequently isolated fungal pathogen was Candida albicans (164/395, 41.5 %), followed by Aspergillus (93/395, 23.5 %). After propensity score matching, 68 patients were equally divided into the infection and colonization groups. There was no significant difference in clinical manifestations between the infection and colonization groups (P > 0.05). Patients in the infection group had significantly higher procalcitonin (PCT) values (0.2 [0.1, 0.7] ng/ml vs. 0.1 [0, 0.1] ng/ml; P = 0.003) and lower albumin/globulin ratios (1.1 [0.6, 1.3] vs. 1.1 [1.0, 1.3], P = 0.047) than those in the colonization group. The antibiotic treatment (12.5 [11.0, 19.0] days vs. 10.0 [8.0, 14.0] days; P = 0.002) and hospitalisation duration (18.0 [14.7, 22.5] days vs. 11.0 [8.0, 16.0] days; P < 0.001) in the infection group was significantly longer than that in the colonization group. In addition, more patients in the colonization group received non-invasive mechanical ventilation (76.5 % [26/34] vs. 47.1 % [16/34]; P = 0.013). Compared with the colonization group, more patients in the infection group underwent bronchoscopy (29.4 % [10/34] vs. 2.9 % [1/34]; P = 0.003). Using multivariable analysis, we found that bronchoscopy (OR: 1.350, 95 % CI: 1.020–1.771, P = 0.034) and duration of antibiotics used (OR: 1.318, 95 % CI: 1.090–1.560, P = 0.004) were risk factors for pulmonary fungal infection in AECOPD patients.
Conclusion
Candida albicans and Aspergillus are the common fungi isolated from patients with AECOPD. The clinical manifestations of AECOPD patients with fungal infection are nonspecific. AECOPD patients with positive fungal isolation who have undergone bronchoscopy and used antibiotics for a longer duration are more likely to have fungal infection.
{"title":"Clinical characteristics of patients with positive fungal pathogens during acute exacerbation of chronic obstructive pulmonary disease: A retrospective study","authors":"Lijuan Luo , Lijun Liu , Yiming Ma , Herui Li , Zihang Zeng , Yan Chen","doi":"10.1016/j.pccm.2025.02.007","DOIUrl":"10.1016/j.pccm.2025.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Fungal infections in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients are poorly understood and often result in a poor prognosis. This study aimed to investigate the distribution of common fungi and the clinical features of AECOPD patients positive for fungal pathogens.</div></div><div><h3>Methods</h3><div>Data were collected from inpatients with AECOPD at the Second Xiangya Hospital of Central South University from January 2016 to December 2019. The enrolled patients were divided into an infection group and a colonization group, and clinical data were compared between the two groups. A 1:1 propensity score matching (PSM) process was employed to ensure balanced samples to analyze the impact of positive fungal pathogens on the clinical features of AECOPD patients. The incidence of acute exacerbations one year after discharge was determined via telephone follow-up.</div></div><div><h3>Results</h3><div>The most frequently isolated fungal pathogen was <em>Candida albicans</em> (164/395, 41.5 %), followed by <em>Aspergillus</em> (93/395, 23.5 %). After propensity score matching, 68 patients were equally divided into the infection and colonization groups. There was no significant difference in clinical manifestations between the infection and colonization groups (<em>P</em> > 0.05). Patients in the infection group had significantly higher procalcitonin (PCT) values (0.2 [0.1, 0.7] ng/ml <em>vs</em>. 0.1 [0, 0.1] ng/ml; <em>P</em> = 0.003) and lower albumin/globulin ratios (1.1 [0.6, 1.3] <em>vs</em>. 1.1 [1.0, 1.3], <em>P</em> = 0.047) than those in the colonization group. The antibiotic treatment (12.5 [11.0, 19.0] days <em>vs</em>. 10.0 [8.0, 14.0] days; <em>P</em> = 0.002) and hospitalisation duration (18.0 [14.7, 22.5] days <em>vs</em>. 11.0 [8.0, 16.0] days; <em>P</em> < 0.001) in the infection group was significantly longer than that in the colonization group. In addition, more patients in the colonization group received non-invasive mechanical ventilation (76.5 % [26/34] <em>vs</em>. 47.1 % [16/34]; <em>P</em> = 0.013). Compared with the colonization group, more patients in the infection group underwent bronchoscopy (29.4 % [10/34] <em>vs</em>. 2.9 % [1/34]; <em>P</em> = 0.003). Using multivariable analysis, we found that bronchoscopy (OR: 1.350, 95 % CI: 1.020–1.771, <em>P</em> = 0.034) and duration of antibiotics used (OR: 1.318, 95 % CI: 1.090–1.560, <em>P</em> = 0.004) were risk factors for pulmonary fungal infection in AECOPD patients.</div></div><div><h3>Conclusion</h3><div><em>Candida albicans</em> and <em>Aspergillus</em> are the common fungi isolated from patients with AECOPD. The clinical manifestations of AECOPD patients with fungal infection are nonspecific. AECOPD patients with positive fungal isolation who have undergone bronchoscopy and used antibiotics for a longer duration are more likely to have fungal infection.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 2","pages":"Pages 111-119"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490256","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 : 2025-06-01DOI: 10.1016/j.pccm.2025.05.003
Han Zhang , Gang Liu , Xiaojun Liu , Yang Yan , Xiaozu Liao , Junmeng Zheng , Songqiao Liu , Zhen Guo , Jian Rong , Fangqiang Song , Chunyao Wang , Zan Chen , Chengbin Zhou , Man Huang , Bingyang Ji
{"title":"Crescent jugular dual-lumen catheter for adult veno-venous extracorporeal membrane oxygenation in China: Multicenter initial experience","authors":"Han Zhang , Gang Liu , Xiaojun Liu , Yang Yan , Xiaozu Liao , Junmeng Zheng , Songqiao Liu , Zhen Guo , Jian Rong , Fangqiang Song , Chunyao Wang , Zan Chen , Chengbin Zhou , Man Huang , Bingyang Ji","doi":"10.1016/j.pccm.2025.05.003","DOIUrl":"10.1016/j.pccm.2025.05.003","url":null,"abstract":"","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 2","pages":"Pages 141-143"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490286","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}
Severe asthma affects 5–10 % of asthma patients worldwide, imposing a significant burden due to an increased risk of mortality, impaired quality of life, and substantial economic costs. Recent advancements in biologic therapies have transformed asthma management by targeting specific inflammatory pathways, particularly type 2 inflammation. Biologic treatments such as omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab have demonstrated efficacy in reducing exacerbations, improving lung function, and achieving clinical remission in a subset of patients. This review provides an overview of the mechanisms of action, indications, and treatment efficacy of biologics used in asthma management. We also explore the concept of asthma remission and the potential for achieving it through biologic therapies and complementary strategies, including optimized inhaler use, macrolides, and bronchial thermoplasty. In addition, we discuss how to choose among these treatments wisely and examine the limitations of each biologic therapy. Despite these advancements, clinical remission rates remain modest, underscoring the need for refined patient selection. Emerging tools such as airway biomarkers, proteomics, and advanced imaging techniques offer promising avenues to improve diagnosis and personalize treatment approaches. Future research focused on making advanced biomarkers more accessible and feasible for point-of-care testing will enhance treatment precision. The next step will be integrating a multiomics approach into personalized asthma management for severe disease, further improving asthma control, achieving sustained remission, and ultimately reducing the burden of severe asthma.
{"title":"Achieving remission in severe asthma","authors":"Sarita Thawanaphong , Santi Nolasco , Parameswaran Nair","doi":"10.1016/j.pccm.2025.05.001","DOIUrl":"10.1016/j.pccm.2025.05.001","url":null,"abstract":"<div><div>Severe asthma affects 5–10 % of asthma patients worldwide, imposing a significant burden due to an increased risk of mortality, impaired quality of life, and substantial economic costs. Recent advancements in biologic therapies have transformed asthma management by targeting specific inflammatory pathways, particularly type 2 inflammation. Biologic treatments such as omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab have demonstrated efficacy in reducing exacerbations, improving lung function, and achieving clinical remission in a subset of patients. This review provides an overview of the mechanisms of action, indications, and treatment efficacy of biologics used in asthma management. We also explore the concept of asthma remission and the potential for achieving it through biologic therapies and complementary strategies, including optimized inhaler use, macrolides, and bronchial thermoplasty. In addition, we discuss how to choose among these treatments wisely and examine the limitations of each biologic therapy. Despite these advancements, clinical remission rates remain modest, underscoring the need for refined patient selection. Emerging tools such as airway biomarkers, proteomics, and advanced imaging techniques offer promising avenues to improve diagnosis and personalize treatment approaches. Future research focused on making advanced biomarkers more accessible and feasible for point-of-care testing will enhance treatment precision. The next step will be integrating a multiomics approach into personalized asthma management for severe disease, further improving asthma control, achieving sustained remission, and ultimately reducing the burden of severe asthma.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 2","pages":"Pages 77-87"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490307","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 : 2025-06-01DOI: 10.1016/j.pccm.2025.05.002
Cungui Mao
Lung cancer remains a leading cause of cancer-related mortality worldwide. Sphingolipids, a diverse class of lipids featuring a sphingoid base backbone, play essential roles in cellular processes and membrane structure. Complex sphingolipids such as sphingomyelins and glycosphingolipids maintain membrane integrity, while their metabolites—ceramide, sphingosine, and their phosphorylated forms, ceramide-1-phosphate (C1P) and sphingosine-1-phosphate (S1P)—act as bioactive lipids involved in regulating key cellular functions. Ceramide and sphingosine are generally tumor-suppressive, promoting apoptosis and inhibiting cell proliferation, whereas C1P and S1P support tumor progression through enhanced cell survival, proliferation, angiogenesis, and metastasis. S1P exerts its effects via G protein-coupled S1P receptors (S1PRs) and intracellular pathways, while C1P acts primarily through intracellular signaling. Dysregulation of these metabolites contributes to lung cancer pathogenesis, influencing tumor survival and resistance to therapy. Targeting sphingolipid metabolism—either by enhancing ceramide and sphingosine levels or inhibiting C1P and S1P—has shown promise in preclinical models. Moreover, these sphingolipid metabolites hold potential as biomarkers for diagnosis and prognosis in lung cancer. This review explores the roles of sphingolipids in lung cancer biology, their impact on tumor progression, and their therapeutic potential.
{"title":"Sphingolipid metabolism dysregulation: A cause for lung cancer development, progression, and resistance to therapies","authors":"Cungui Mao","doi":"10.1016/j.pccm.2025.05.002","DOIUrl":"10.1016/j.pccm.2025.05.002","url":null,"abstract":"<div><div>Lung cancer remains a leading cause of cancer-related mortality worldwide. Sphingolipids, a diverse class of lipids featuring a sphingoid base backbone, play essential roles in cellular processes and membrane structure. Complex sphingolipids such as sphingomyelins and glycosphingolipids maintain membrane integrity, while their metabolites—ceramide, sphingosine, and their phosphorylated forms, ceramide-1-phosphate (C1P) and sphingosine-1-phosphate (S1P)—act as bioactive lipids involved in regulating key cellular functions. Ceramide and sphingosine are generally tumor-suppressive, promoting apoptosis and inhibiting cell proliferation, whereas C1P and S1P support tumor progression through enhanced cell survival, proliferation, angiogenesis, and metastasis. S1P exerts its effects via G protein-coupled S1P receptors (S1PRs) and intracellular pathways, while C1P acts primarily through intracellular signaling. Dysregulation of these metabolites contributes to lung cancer pathogenesis, influencing tumor survival and resistance to therapy. Targeting sphingolipid metabolism—either by enhancing ceramide and sphingosine levels or inhibiting C1P and S1P—has shown promise in preclinical models. Moreover, these sphingolipid metabolites hold potential as biomarkers for diagnosis and prognosis in lung cancer. This review explores the roles of sphingolipids in lung cancer biology, their impact on tumor progression, and their therapeutic potential.</div></div>","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 2","pages":"Pages 88-96"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490253","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 : 2025-06-01DOI: 10.1016/j.pccm.2025.04.001
Xue Fan, Linxi Yin, Xuenan Hou, Qing Zhou
<div><h3>Background</h3><div>Tracheal, bronchial, and lung (TBL) cancer remains a leading cause of cancer-related deaths globally, with its burden influenced by aging populations, smoking, air pollution, and advances in treatment. China, as one of the most affected countries, faces significant challenges due to rapid industrialization and an aging population. This study aimed to systematically assess the temporal trends and disease burden of tracheal, bronchial, and lung cancer in China from 1990 to 2021, in comparison with global patterns, to provide evidence for targeted prevention and public health policymaking.</div></div><div><h3>Methods</h3><div>Using data from the Global Burden of Disease (GBD) database (1990–2021), this study analyzed trends in the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of TBL cancer in China and globally. Joinpoint regression analysis was applied to identify significant changes in trends over time, and the average annual percentage change (AAPC) was calculated to quantify the overall temporal trends. Statistical significance was evaluated using Permutation tests, with results reported as 95 % confidence intervals (95 % CI).</div></div><div><h3>Results</h3><div>In 2021, China accounted for 41.0 % (934,704 of 2,280,688) of global incident cases, 38.8 % (1,262,275 of 3,253,729) of global prevalent cases, 40.4 % (814,364 of 2,016,547) of global deaths, and 40.7 % (18,920,203 of 46,536,272) of global DALYs. The AAPC for China’s age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) were 0.9 % (95 % CI: 0.8 % to 1.1 %, <em>P</em> <em><</em> 0.05), 1.8 % (95 % CI: 1.6 % to 2.0 %, <em>P</em> <em><</em> 0.05), 0.4 % (95 % CI: 0.2 % to 0.6 %, <em>P</em> <em><</em> 0.05), and 0.1 % (95 % CI: 0.1 % to 2.0 %, <em>P</em> > 0.05), respectively, while the global AAPCs were −0.3 % (95 % CI: −0.4 % to −0.2 %, <em>P</em> <em><</em> 0.05), 0.3 % (95 % CI: 0.2 % to 0.4 %, <em>P</em> <em><</em> 0.05), −0.5 % (95 % CI: −0.7 to −0.4 %, <em>P</em> <em><</em> 0.05) and −0.9 % (95 % CI: −1.0 % to −0.8 %, <em>P</em> <em><</em> 0.05). Notably, over the last two decades, the growth rate of China’s ASIR has slowed, the ASMR and ASDR stopped rising and showed a significant decline compared to previous trends. The burden of TBL cancer varied by age and gender; over the past decade, the ASIR, ASMR, and ASDR for males in China have shown a declining trend, whereas the rates for females have increased. Additionally, the peak age of burden has shifted to older age groups compared to 1990.</div></div><div><h3>Conclusion</h3><div>China bears a significant share of the global burden of TBL cancer. Over the last two decades, the growth rate of China’s ASIR has slowed, while its ASMR and ASDR have declined, potentially attributable to advancements in targeted therapies and immunotherapies.</div></d
{"title":"Temporal trends in the burden of tracheal, bronchial, and lung cancer in China and globally: A comprehensive analysis from 1990 to 2021","authors":"Xue Fan, Linxi Yin, Xuenan Hou, Qing Zhou","doi":"10.1016/j.pccm.2025.04.001","DOIUrl":"10.1016/j.pccm.2025.04.001","url":null,"abstract":"<div><h3>Background</h3><div>Tracheal, bronchial, and lung (TBL) cancer remains a leading cause of cancer-related deaths globally, with its burden influenced by aging populations, smoking, air pollution, and advances in treatment. China, as one of the most affected countries, faces significant challenges due to rapid industrialization and an aging population. This study aimed to systematically assess the temporal trends and disease burden of tracheal, bronchial, and lung cancer in China from 1990 to 2021, in comparison with global patterns, to provide evidence for targeted prevention and public health policymaking.</div></div><div><h3>Methods</h3><div>Using data from the Global Burden of Disease (GBD) database (1990–2021), this study analyzed trends in the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of TBL cancer in China and globally. Joinpoint regression analysis was applied to identify significant changes in trends over time, and the average annual percentage change (AAPC) was calculated to quantify the overall temporal trends. Statistical significance was evaluated using Permutation tests, with results reported as 95 % confidence intervals (95 % CI).</div></div><div><h3>Results</h3><div>In 2021, China accounted for 41.0 % (934,704 of 2,280,688) of global incident cases, 38.8 % (1,262,275 of 3,253,729) of global prevalent cases, 40.4 % (814,364 of 2,016,547) of global deaths, and 40.7 % (18,920,203 of 46,536,272) of global DALYs. The AAPC for China’s age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) were 0.9 % (95 % CI: 0.8 % to 1.1 %, <em>P</em> <em><</em> 0.05), 1.8 % (95 % CI: 1.6 % to 2.0 %, <em>P</em> <em><</em> 0.05), 0.4 % (95 % CI: 0.2 % to 0.6 %, <em>P</em> <em><</em> 0.05), and 0.1 % (95 % CI: 0.1 % to 2.0 %, <em>P</em> > 0.05), respectively, while the global AAPCs were −0.3 % (95 % CI: −0.4 % to −0.2 %, <em>P</em> <em><</em> 0.05), 0.3 % (95 % CI: 0.2 % to 0.4 %, <em>P</em> <em><</em> 0.05), −0.5 % (95 % CI: −0.7 to −0.4 %, <em>P</em> <em><</em> 0.05) and −0.9 % (95 % CI: −1.0 % to −0.8 %, <em>P</em> <em><</em> 0.05). Notably, over the last two decades, the growth rate of China’s ASIR has slowed, the ASMR and ASDR stopped rising and showed a significant decline compared to previous trends. The burden of TBL cancer varied by age and gender; over the past decade, the ASIR, ASMR, and ASDR for males in China have shown a declining trend, whereas the rates for females have increased. Additionally, the peak age of burden has shifted to older age groups compared to 1990.</div></div><div><h3>Conclusion</h3><div>China bears a significant share of the global burden of TBL cancer. Over the last two decades, the growth rate of China’s ASIR has slowed, while its ASMR and ASDR have declined, potentially attributable to advancements in targeted therapies and immunotherapies.</div></d","PeriodicalId":72583,"journal":{"name":"Chinese medical journal pulmonary and critical care medicine","volume":"3 2","pages":"Pages 120-131"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490251","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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