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Дописи каналу
[Correspondence] Precision-guided immunomodulatory therapy in sepsis
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00153-0/fulltext?rss=yes
Erik H A Michels and colleagues developed a parsimonious three-biomarker framework (procalcitonin, soluble TREM-1, and IL-6) that quantifies the Dysregulated Immune Profile (DIP) as a continuous score (cDIP) beyond organ-failure-based clinical surrogates and identifies patients with differential responses to hydrocortisone.1
| 2 | [Correspondence] Precision-guided immunomodulatory therapy in sepsis – Authors’ reply
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00155-4/fulltext?rss=yes
We agree with Yingying Yang and colleagues that similar continuous Dysregulated Immune Profile (cDIP) values could arise from different host–pathogen configurations. Robustly decomposing immune dysregulation into discrete pathogen-driven versus host-driven components is challenging, as these processes are intrinsically coupled. Pathogen burden, identity, and infection source undoubtedly shape the host response, yet substantial heterogeneity in immune dysregulation persists within each of these factors (see appendix 2 p 39 of the original Article1). | 57 |
| 3 | [Correspondence] Precision-guided immunomodulatory therapy in sepsis
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00154-2/fulltext?rss=yes
We commend Erik H A Michels and colleagues1 for quantifying immune dysregulation in pneumonia and sepsis. Through dimensionality reduction and clustering with 35 biomarkers, they defined three Dysregulated Immune Profiles (DIPs) and a corresponding continuous score (cDIP). By training parsimonious models with three biomarkers, they facilitated the application of these clusters and score to datasets without extensive data, such as a subset (n=425) of the CAPE-COD trial2 (hydrocortisone vs placebo in community-acquired-pneumonia). | 45 |
| 4 | [Editorial] Dying with Dignity—time to cut the red tape
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00198-0/fulltext?rss=yes
While death is a certainty for us all, how and when we die is not. For people with a terminal illness, the reality of death must be confronted alongside common fears of prolonged pain and suffering as well as a loss of autonomy. Although good end-of-life care can manage most symptoms, there are some circumstances that cannot be palliated and a person might feel their quality of life is so poor they would prefer to die. The practice of medical aid in dying (MAiD; also called physician assisted death) allows someone with a terminal diagnosis to obtain medication from a physician to end their life. | 49 |
| 5 | [News] 2026 GINA report for asthma
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00188-8/fulltext?rss=yes
On May 5, 2025, the Global Initiative For Asthma (GINA) published the 2026 update to their Global Strategy for Asthma Management and Prevention. On the same date, an online discussion hosted by GINA panel members and the European Respiratory Society gave an overview of the major changes. | 53 |
| 6 | [Comment] Heterogeneity of severe asthma in Europe: a SHARP-er view
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00165-7/fulltext?rss=yes
Disease-modifying anti-asthmatic drugs, especially biologics, have fundamentally changed the therapeutic landscape of severe asthma, making asthma remission a realistic treatment goal in many patients.1 Although asthma remission concepts continue to evolve, definitions include minimal asthma symptoms, no exacerbations, no use of systemic corticosteroids, and stable or normal lung function, for at least 12 months.2 It has become evident that several challenges reduce remission rates in patients with severe asthma. | 303 |
| 7 | [Articles] Prevalence and disease trajectories of pulmonary fibrosis of childhood interstitial lung disease: a register-based, multicentre observational study
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00052-4/fulltext?rss=yes
The application of standardised criteria for diagnosing pulmonary fibrosis enables identification of affected children among patients with chILD. These children have lower pulmonary function, an increased risk of death, and could benefit from antifibrotic therapies. | 280 |
| 8 | [Articles] Severe asthma and remission prospects in Europe (SHARP): insights from a multicentre observational study based on the European Severe Asthma Registry
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00141-4/fulltext?rss=yes
This pan-European analysis of severe asthma revealed significant clinical heterogeneity and a substantial disease burden despite advanced therapies, highlighting the enduring nature of type 2 inflammation, the potential inadequacy of current remission strategies with available therapeutic approaches, and the necessity for early identification of high-risk patients. | 246 |
| 9 | [Comment] Pulmonary fibrosis in chILD: bridging the gap
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00117-7/fulltext?rss=yes
Childhood interstitial lung disease (chILD) encompasses a group of rare, heterogeneous respiratory conditions associated with substantial morbidity and mortality ranging from 1% to 30% during childhood.1,2 The exact causes of death can differ for each one of the diverse entities.1 In adult ILD, fibrosis is the major component defining progression and carries a dismal prognosis.3 It is a tissue repair response to injury that becomes maladaptive or manifests as a failure of tissue regenerative capacity and has, so far, no effective treatment. | 226 |
| 10 | Evidence. Education. Better Care.
Latest medical research, guideline updates, and news—all in one place.
https://whatsapp.com/channel/0029VagObEL3rZZbSTrZSU03 | 259 |
| 11 | [Corrections] Correction to Lancet Respir Med 2026; published online May 28. https://doi.org/10.1016/S2213-2600(26)00160-8
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00199-2/fulltext?rss=yes
Moitra S, Annesi-Maesano I, Alghamdi MS, et al. Toxic skies of war. Lancet Respir Med 2026; published online May 28. https://doi.org/10.1016/S2213-2600(26)00160-8—In the Declaration of interests section of this Correspondence, the statements for Sara De Matteis and Ane Johannessen have been corrected. These corrections have been made to the online version as of June 22, 2026, and will be made to the printed version. | 282 |
| 12 | [News] Trump Administration sparks furore and resignations over fruit-flavoured vape authorisations
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00190-6/fulltext?rss=yes
On May 5, the White House overruled objections from US Food and Drug Administration (FDA) commissioner Marty Makary and ordered the agency to authorise sales of two fruit-flavoured e-cigarette products. | 345 |
| 13 | [Correspondence] Precision-guided immunomodulatory therapy in sepsis
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00153-0/fulltext?rss=yes
Erik H A Michels and colleagues developed a parsimonious three-biomarker framework (procalcitonin, soluble TREM-1, and IL-6) that quantifies the Dysregulated Immune Profile (DIP) as a continuous score (cDIP) beyond organ-failure-based clinical surrogates and identifies patients with differential responses to hydrocortisone.1 | 320 |
| 14 | [Correspondence] Precision-guided immunomodulatory therapy in sepsis
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00154-2/fulltext?rss=yes
We commend Erik H A Michels and colleagues1 for quantifying immune dysregulation in pneumonia and sepsis. Through dimensionality reduction and clustering with 35 biomarkers, they defined three Dysregulated Immune Profiles (DIPs) and a corresponding continuous score (cDIP). By training parsimonious models with three biomarkers, they facilitated the application of these clusters and score to datasets without extensive data, such as a subset (n=425) of the CAPE-COD trial2 (hydrocortisone vs placebo in community-acquired-pneumonia). | 306 |
| 15 | [Correspondence] Precision-guided immunomodulatory therapy in sepsis – Authors’ reply
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00155-4/fulltext?rss=yes
We agree with Yingying Yang and colleagues that similar continuous Dysregulated Immune Profile (cDIP) values could arise from different host–pathogen configurations. Robustly decomposing immune dysregulation into discrete pathogen-driven versus host-driven components is challenging, as these processes are intrinsically coupled. Pathogen burden, identity, and infection source undoubtedly shape the host response, yet substantial heterogeneity in immune dysregulation persists within each of these factors (see appendix 2 p 39 of the original Article1). | 266 |
| 16 | [Editorial] Dying with Dignity—time to cut the red tape
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00198-0/fulltext?rss=yes
While death is a certainty for us all, how and when we die is not. For people with a terminal illness, the reality of death must be confronted alongside common fears of prolonged pain and suffering as well as a loss of autonomy. Although good end-of-life care can manage most symptoms, there are some circumstances that cannot be palliated and a person might feel their quality of life is so poor they would prefer to die. The practice of medical aid in dying (MAiD; also called physician assisted death) allows someone with a terminal diagnosis to obtain medication from a physician to end their life. | 302 |
| 17 | Correlates of 5-year decline in 6-min walk distance in the COPDGene cohort
http://thorax.bmj.com/cgi/content/short/81/7/664?rss=1
Background
Change in 6-min walk distance (6MWD) over time serves as a measure of change in functional exercise performance. We analysed a large cohort of current or former tobacco smokers over a 5-year period to identify correlates of 6MWD decline.
Methods
A total of 4734 participants with normal spirometry or spirometric evidence of chronic obstructive pulmonary disease (COPD) who completed a 5-year follow-up in the COPDGene study were included. Baseline and 5-year assessments included 6MWD, spirometry, St. George’s Respiratory Questionnaire (SGRQ), gender, race and CT measures of emphysema, gas trapping and airway wall thickness. 6MWD decline correlates relative to baseline and 5-year changes were examined using univariate and multivariate linear regression.
Results
At baseline, 2573 had normal spirometry; 487 were classified as GOLD1, 1044 as GOLD2, 514 as GOLD3 and 116 as GOLD4. Average 5-year decline in 6MWD was 35.6±101.7 (SD) metres (p2=12.1% and 9.1%, respectively). 5 year change in variables assessed (including FEV1 and SGRQ) explained only small fractions of 6MWD decline variance (each R2≤5%).
Conclusion
6MWD declined significantly, but with high variability; spirometry, CT, health status, demographic and anthropometric measures accounted for only small portions of this variance. Our findings suggest that a meaningful decline in 6MWD observed over 5 years in COPD patients is in large part related to factors other than decline in pulmonary structure or function. | 317 |
| 18 | Has the time come for workplace screening for obstructive sleep apnoea (OSA)?
http://thorax.bmj.com/cgi/content/short/81/7/638?rss=1
Introduction Obstructive sleep apnoea (OSA) is a common condition whose prevalence is related to the prevalence of obesity. Although efficacious therapy in the form of continuous positive airway pressure (CPAP) exists, the traditional process of OSA diagnosis and subsequent delivery of CPAP is labour intensive and thus far no generalised workplace screening programme exists. However, four developments have prompted us to ask whether this should now change. These are, first, screening algorithms to identify high risk occupations and industries; second, the use of low-cost screening technologies (which have recently been reviewed by the National Institute for Health and Care Excellence, NICE);1 third, understanding of the science of CPAP adherence and, finally, increasing alternative options for those who do not tolerate CPAP, which both offer the prospect of more successful therapy than ever before. Therefore, we evaluated the case for workplace screening against the UK National Screening... | 232 |
| 19 | Multimodality curative-intent treatment in NSCLC: an unprecedented era of change 2017-2025
http://thorax.bmj.com/cgi/content/short/81/7/707?rss=1
Curative-intent multimodality treatment—combining local treatments such as surgery or radiotherapy with systemic therapy—is the cornerstone of care in stage II–III non-small cell lung cancer (NSCLC). Since 2017, the systemic therapy backbones with multimodality treatment have undergone a dramatic transformation, driven by a series of pivotal, practice-changing clinical trials. Immunotherapy and targeted therapies, previously confined to the advanced/metastatic setting, are now firmly embedded in curative-intent regimens. Maintenance immunotherapy following chemoradiation in unresectable stage III disease, adjuvant tyrosine kinase inhibitors in resected epidermal growth factor receptor/anaplastic lymphoma kinase-positive tumours, neoadjuvant and perioperative chemoimmunotherapy in resectable stage II/III NSCLC and adjuvant chemoimmunotherapy following resection have all become new standards of care.
This state-of-the-art review synthesises the key evidence underpinning these developments, highlights their clinical implications and identifies challenges to implementation—particularly the need for redefined clinical pathways, accurate pretreatment staging, timely biomarker testing and coordinated multidisciplinary decision-making. A novel treatment algorithm is proposed to support clinicians in navigating these complex treatment choices.
We conclude that immunotherapy and targeted agents have irrevocably altered curative-intent NSCLC care, establishing multiple new standards that sometimes overlap and compete. In the surgical multimodality treatment pathway, neoadjuvant and perioperative chemoimmunotherapy offers the opportunity to increase the uptake of systemic therapy in comparison to adjuvant therapy and is considered by these authors to represent the optimal treatment path for most patients.
In this unprecedented era of therapeutic expansion, the greatest challenge is no longer the absence of effective treatments, but the complexity of selecting, sequencing and delivering them, as well as patient optimisation. Lung cancer services must evolve through proactive pathway redesign, integrated diagnostics and new models of multidisciplinary care. High-quality, biomarker-driven and patient-centred care is now achievable for many patients with stage II–III NSCLC—but it will require system-level adaptation to deliver it. | 192 |
| 20 | Towards a better understanding of residual sleep apnoea: the role of quantitatively assessed ventilatory control instability
http://thorax.bmj.com/cgi/content/short/81/7/633?rss=1
Untreated obstructive sleep apnoea (OSA) is associated with a wide range of adverse health outcomes, including but not limited to cardiocerebrovascular disease, hypertension and cognitive impairment.1 Positive airway pressure (PAP) therapy remains the first-line treatment for moderate to severe OSA.1 2 However, approximately 10–25% of patients continue to exhibit residual sleep apnoea despite PAP therapy.3 Although several factors contribute to residual sleep apnoea, such as male sex, OSA severity, older age with more comorbidities and central apnoeas,3 4 the physiological mechanisms underlying residual sleep apnoea and the ability to predict it reliably prior to treatment initiation are not well established. Eschbach and colleagues leveraged data from two large randomised controlled trials, the Apnea Positive Pressure Long-term Efficacy Study5 and the Randomized Intervention with Continuous Positive Airway Pressure in Coronary Artery Disease and OSA cohorts, | 166 |
