Alpha-1 antitrypsin deficiency (AATD) is a rare genetic disorder that can lead to progressive, early-onset emphysema, with no current therapies able to reverse established lung damage. In this interview, Dr Karina A. Serban and Dr Maria Magallon Serrano discuss the unmet needs in AATD-related emphysema, the rationale for investigating lithium as a potential treatment, key findings from their preclinical study presented at ATS 2026, and the implications for future clinical trial development.

The phase 2b ALIENTO and phase 3 ARNASA studies investigated the efficacy and safety of astegolimab, an IL-33 inhibitor, for patients with COPD. While the primary endpoints showed mixed results, further analysis of patient-reported outcomes has shown promising results. In this Q&A, Dr Frank Sciurba outlines the objectives and findings of the health-related quality of life analysis he presented at ATS 2026, and what the results could mean for the clinical development of astegolimab.

Chronic cough remains a complex and often refractory clinical entity, with heterogeneous underlying mechanisms and significant impact on patient quality of life. The British Thoracic Society clinical statement on chronic cough in adults provides an updated, structured framework for assessment and management, with an emphasis on treatable traits and the recognition of cough hypersensitivity as a central pathophysiological mechanism. In this Q&A, Dr Paul Marsden (Wythenshawe Hospital, Manchester) outlines practical approaches to implementing the latest BTS recommendations in routine care, including diagnostic assessment, use of a treatable traits framework, indications for referral, and strategies for managing refractory chronic cough.

Respirology Reflections is our new, expert-led, practice pearls series delivering concise, actionable insights from leading experts in respiratory and pulmonary medicine. Designed to help healthcare professionals stay current, it highlights real-world challenges, emerging evidence, and actionable strategies to enhance clinical practice, strengthen decision-making, and build confidence in an increasingly complex and fast-evolving field.

The World Bronchiectasis Conference (WBC) is a leading international meeting dedicated to advancing research, clinical care and collaboration in bronchiectasis, bringing together a global community of clinicians, researchers, healthcare professionals, industry partners and patients. This year’s meeting marks 10 years of rapid progress and sets the stage for the next era of innovation. In this Q&A, Organising Committee Co-Chair Prof. Felix C. Ringshausen (Hannover Medical School, Hannover, Germany) reflects on the evolution of the field, the role of EMBARC in driving progress, this year's theme “Paving the Way for the Next Generation,” and the key scientific and clinical advances shaping this year’s World Bronchiectasis Conference.

In the US, 26.8 million people have asthma, including 4.5 million children. Asthma accounts for millions of emergency department visits, tens of billions in healthcare costs and thousands of missed school days each year. The American Lung Association’s Promoting Asthma-Friendly Environments through Partnerships and Collaborations brings together a network of programs to help children better manage their asthma.

Effective asthma management requires more than medication alone. Education, self-management support, and early intervention are essential to helping patients achieve better symptom control and improved quality of life. To address these needs, the American Lung Association has developed a range of evidence-based asthma programs for both adults and children, designed to build practical skills, improve adherence, and support long-term disease management across home, school, and community settings.

Asthma and COPD are common airway diseases with distinct underlying mechanisms, yet in everyday practice many patients present with features of both. Differentiating between asthma-predominant and COPD-predominant disease is an important clinical challenge, with significant implications for diagnosis, treatment selection, and long-term outcomes. In this Q&A, Prof. Felix Herth discusses how clinicians can approach patients with overlapping features of asthma and COPD, including the role of clinical history, lung function testing, biomarkers, imaging, treatment selection, and the importance of reassessing response to therapy over time.

Interstitial lung disease (ILD) encompasses a heterogeneous group of disorders that pose significant challenges for clinical trial design, from patient selection to endpoint definition and global implementation. Despite advances in therapeutic development, translating trial findings into real-world benefit remains difficult, particularly when study populations and protocols do not fully reflect the complexity of routine clinical practice. As part of our Respirology Reflections series, Dr Tejaswini Kulkarni discusses practical strategies for designing more inclusive and pragmatic ILD trials, including patient selection, recruitment, endpoint choice, and aligning study protocols with real-world care.