Thank you for tuning in to the Editor’s Highlight Podcast for the September 2026 issue of the journal 糖心原创®. There is a great lineup of diverse content in this month’s issue.
Over the next 15 minutes, I will provide a brief overview of key manuscripts published in each of our content areas.
First is our Asthma section. It is unclear how dupilumab modifies individual CT scan-visible mucus plugs in patients with moderate to severe asthma. In this issue, Sandhu and colleagues evaluate 32 adults with moderate to severe asthma, 22 of whom received dupilumab, to determine if dupilumab use modifies the volume, radiodensity, and temporospatial behavior of individual CT scan-visible mucus plugs. Reductions in mucus score, total mucus plug count, and total plug volume were greater in those who received dupilumab. Reduction was associated with improved FEV1, FEV1/FVC, and 129Xe MRI ventilation defect percent. Of the participants treated with dupilumab, 36% had complete resolution, and 59% had incomplete resolution of mucus plugs. Patients who were treated had more resolved plugs, fewer fixed-location persistent (FLP) plugs, fewer new-onset plugs, and decreased radiodensity of both FLP plugs and new-onset plugs. These findings show that dupilumab reduces mucus burden in asthma by resolving plugs and decreasing the formation of new plugs. Completing this section is an exploratory analysis of eosinophil counts in adults with asthma treated with the anti-IL-4Rα rademikibart in a randomized trial.
Our Chest Infections content area is next. Only small cohort studies and case reports have reported the management of COVID-19-associated pulmonary aspergillosis (CAPA). In this issue, Reizine and colleagues report findings from a multicenter study of 259 consecutive CAPA cases from ICUs of five major European centers, designed to determine if antifungal treatment is associated with lower 60-day mortality in patients with probable or proven CAPA. Of the patients, 237 (91.5%) received antifungals. Age, immunosuppressive treatment, and remdesivir administration were independently associated with increased 60-day mortality. Male sex and antifungal treatment (HR, 0.31) were associated with lower 60-day mortality. These results show that antifungal treatment is associated with lower 60-day mortality in patients with CAPA. Completing this section is a report of phylogenomic and clinical perspectives of an East Asia-specific cluster of Mycobacterium massiliense.
Our COPD section is next. The association of mild exacerbations or one moderate exacerbation in COPD with prognosis is unknown. In this issue, Wu and colleagues report findings from a multicenter, prospective, community-based cohort study of 915 people with COPD, designed to determine if mild exacerbations or one moderate exacerbation are associated with worse respiratory health outcomes over three years of follow-up. Fifty-two people had frequent exacerbations, 45 people had only one moderate exacerbation, and 41 people had only mild exacerbations. Those with only mild exacerbations had severe emphysema, and those with only one moderate exacerbation had more severe air trapping than those without any exacerbations. Those with prior mild exacerbations or only one moderate exacerbation showed a higher incidence of total exacerbations and moderate to severe exacerbations than those without prior exacerbations. There was no difference in the annual rate of lung function decline. These findings show that even low exacerbation burden is associated with more severe CT imaging-defined lung structural abnormalities and a higher incidence of subsequent exacerbations over three years of follow-up. Also in this section is a research letter that evaluates the association of alcohol consumption with small airways obstruction and a Special Feature review of smoking-related comorbidities detected through low-dose CT lung cancer screening.
Next is our Critical Care content area. Large-scale longitudinal analyses of mortality from ARDS in the pre-COVID-19 era are limited. In this issue, Padappayil and colleagues report findings from a retrospective cohort study of 205,393 hospital admissions in people mechanically ventilated for ARDS in the National Inpatient Sample from 2000 to 2019. The study was designed to determine how in-hospital mortality changed over time. They found that mortality declined from 2000 to 2015 (OR, 0.96) and increased from 2015 to 2019 (OR, 1.05). The length of stay and hospitalization charges decreased until 2015 and then stabilized. Those included from 2015 onward had a greater comorbidity burden and were more likely to have a pulmonary etiology for ARDS. These findings show diverging trends in ARDS outcomes that may be influenced by coding eras (ICD-9 to ICD-10) and a more severe case-mix in the latter portion of the included time frame. Completing this section is a research letter on the efficacy and safety of landiolol in patients with cardiogenic shock.
On to our Diffuse Lung Disease section. Since mid-2023, lung transplant candidates with acute kidney injury have been permitted to undergo lung transplant alone with the potential for renal recovery. In this issue, Balasubramanian and colleagues use the United Nations Organ Sharing registry to report findings from 1,941 patients listed for simultaneous lung-kidney transplant (SLKT) or kidney after lung transplant (KALT). Their evaluation was designed to identify changes in kidney and lung transplant practice patterns and outcomes after mid-2023. Those listed for SLKT, early KALT, and late KALT were 15.4%, 7%, and 77.6%, respectively. Since mid-2023, there has been a decrease in SLKT and an increase in early KALT with shorter kidney transplant (KT) waitlist time and decreased odds of being delisted from KT. SLKT had a higher after lung transplant mortality (21.5% vs 12.5% vs 7.6%) and after KT mortality. These results show that since mid-2023, early KALT has increased and has been associated with better short-term outcomes and reduced delisting. Also in this section is a research letter describing diffuse alveolar hemorrhage in lymphangioleiomyomatosis and a How I Do It review of calcium and vitamin D supplement use in people with sarcoidosis.
Next is our Education and Clinical Practice content area. It is unclear if menopause modifies lung function in women with HIV (WWH). In this issue, Abelman and colleagues report findings from a cross-sectional study of 1,206 participants in the Women’s Interagency HIV Study, designed to determine if menopause is associated with lung function in WWH and women at risk for HIV. Of the participants, 36% currently smoked, and 31% previously smoked. There was no statistically significant association of HIV with FEV1 or FVC, but there was an association with lower DLCO. Significant differences in lung function were noted by menopausal phase in women 41 to 50 years of age but not 51 to 60 years. Among those 41 to 50 years old, women in late perimenopause had a reduction of 109 mL in FEV1 and 125 mL in FVC, and postmenopausal women had a reduction of 310 mL in FEV1 and 307 mL in FVC. Late perimenopausal women had a -1.40 mL/min/mm Hg lower DLCO. These results show that menopausal phase is associated with lung function in WWH and women without HIV. Other original research articles in this section include a national retrospective cohort study assessing the association of hospital transfer-in rate prevalence with hospital outcomes, an assessment of whether telemonitoring can predict patient-reported leak perception in long-term home noninvasive ventilation for patients with chronic respiratory failure, and a genetic analysis of persistent tachypnea of infancy.
Our Pulmonary Vascular content area is next. The prognostic value of natriuretic peptides in stratifying the risk of patients with chronic thromboembolic pulmonary hypertension (CTEPH) following pulmonary endarterectomy (PEA) has not been assessed. In this issue, Ghio and colleagues report findings from 1,176 consecutive patients with CTEPH who underwent PEA to determine if brain natriuretic peptide (BNP) and high-sensitivity troponin I (hs-TNI) predict long-term prognosis after PEA and add prognostic value beyond persistent pulmonary hypertension (PH) following surgery. Of the patients, 357 had normal BNP, 488 had abnormal BNP, and 22 had abnormal hs-TNI levels at three to six months of follow-up. The proportion of people with World Health Organization functional class III to IV or with compromised exercise capacity increased from those with normal BNP, to those with an abnormal BNP, and additionally in those with an elevated hs-TNI. During a follow-up of 54 months, 45 cardiac deaths occurred. Those with abnormal BNP following surgery had a five-fold increase in mortality after adjustment for the presence of persistent PH. These findings suggest that plasma BNP levels are robust prognostic parameters that provide additional information beyond persistent PH in those with CTEPH who have undergone PEA. Also in this section is an original research article that evaluates the importance of postprocessing methods for assessing right ventricular volumes and function in people with PH, a research letter reporting on treatment of pulmonary arterial hypertension with an initial combination of macitentan with riociguat, a Special Features review on implementation challenges of the current PH guidelines and proceedings in the United States, and a How I Do It review that describes an approach to diagnosis and treatment of right heart thrombus associated with pulmonary embolism.
Next is our Sleep Medicine content area. The association of OSA with atrial fibrillation (AF) varies by population and definitions of OSA and AF. In this issue, Xu and colleagues use data from 1,679 participants in the Multi-Ethnic Study of Atherosclerosis to determine if high-cardiovascular disease (CVD)-risk OSA, defined by elevated hypoxic burden or heart rate response to respiratory events, is associated with incident AF. During a median follow-up of 6.7 years, AF was identified in 14.1% of people with high-CVD-risk OSA, 10.1% of those with low-CVD-risk OSA, and 8.4% of those with non-OSA. The adjusted HR was similar in female and male participants. These findings show that OSA-related hypoxemia or heart rate surge may be useful for predicting which patients with OSA are at increased risk of incident AF. Completing this section is an assessment of the impact of short-term CPAP on abdominal adiposity in OSA using PET/MRI.
Next is our Thoracic Oncology content area. Segmentation-free deep learning (DL) models of chest imaging may improve screening efficiency but require additional validation and improvement. In this issue, Phellan and colleagues report findings from a retrospective cohort study from four different screening programs that included 22,469 participants and 52,482 low-dose CT (LDCT) scan series, designed to determine if the integration of DL based on LDCT scans and clinical data improves lung cancer risk prediction. The area under the receiver operating characteristic curve (AUC) of an established model, called Sybil, was 0.93 in year one and 0.79 in year six in independent cohorts. In the absence of documented nodules and when only small nodules were present, the AUC decreased to 0.64 and 0.61, respectively, in year six. A model that incorporated Sybil and key clinical and epidemiological factors had a higher predictive performance (AUC, 0.83 vs 0.80), which was most notable when nodules were absent (AUC, 0.76 vs. 0.64). These results suggest Sybil performs better for short-term lung cancer risk prediction and may have suboptimal accuracy in the absence of lung nodules, while an integrated model may improve predictive performance. Also in this section is a study that evaluates the association of sleep-related hypoxemia with survival in patients with non-small cell lung cancer and another that evaluates patient perceptions of quality of shared decision-making for lung cancer screening in telehealth vs in-person discussions. Completing this section is a modified Delphi consensus statement on procedural techniques, airway management, and specimen acquisition for peripheral lung transbronchial and endobronchial ultrasound-guided cryobiopsy.
I encourage you to read our Commentary series, where you will find a thoughtful piece on the conceptual rationale and clinical uncertainty in the use of biologics for asthma and COPD exacerbations, as well as another that discusses what we can learn across borders about disposable e-cigarette regulation to safeguard adolescent lung health. In our Humanities series, you will find an Exhalations piece titled, “The Space Between Breaths.” Finally, please review our case series publications for the month, which provide novel and educational cases to help improve your clinical skills.
I hope you enjoy reading all of the high-quality content available in this month’s issue of the journal 糖心原创. As always, I am grateful to the authors of this work, to the reviewers who volunteered their time to improve the quality of these manuscripts, and to our Editorial Board for guiding everything that we do. Until next month, I hope you enjoy the September issue.