Evidence map›Paper›PMID 42025308›Full record

Observational studyThe European respiratory journal2026

Pleural fluid neutrophil extracellular traps are associated with disease severity and risk of 1-year mortality in pleural infection: an observational, international, multicohort study (TORPIDS-3).

Julia Y Chu, Samuel Hollins, Alguili Elsheikh, Stephen Gerry, Nikita Manoharan, Tryfon Zarganes-Tzitzikas, Yinzhou Feng, Elie Antoun, Eihab O Bedawi, John P Corcoran and 17 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The European respiratory journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors.

Julia Y ChuCAMS Oxford Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, University of Oxford, Oxford, UK.
Samuel HollinsCAMS Oxford Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, University of Oxford, Oxford, UK.
Alguili ElsheikhOxford Centre for Respiratory Medicine, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Stephen GerryCentre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Nikita ManoharanCAMS Oxford Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, University of Oxford, Oxford, UK.
Tryfon Zarganes-TzitzikasCentre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Yinzhou FengCAMS Oxford Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, University of Oxford, Oxford, UK.
Elie AntounCAMS Oxford Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, University of Oxford, Oxford, UK.
Eihab O BedawiOxford Centre for Respiratory Medicine, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.ORCID https://orcid.org/0000-0001-9196-3934
John P CorcoranOxford Centre for Respiratory Medicine, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.ORCID https://orcid.org/0000-0002-0480-7819
Amy GilmourDivision of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
Federico MeiRespiratory Disease Unit, Department of Internal Medicine, University Hospital, Ancona, Italy.
Federica MonacoOccupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy.
Marco TomasettiOccupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy.
Argyrios TzouvelekisRespiratory Department, Patras University Hospital, University of Patras, Patras, Greece.
Electra KoulousousaRespiratory Department, Patras University Hospital, University of Patras, Patras, Greece.
Fotios SampsonasRespiratory Department, Patras University Hospital, University of Patras, Patras, Greece.
Malvika BhatnagarOxford Centre for Respiratory Medicine, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Ellice Z ChenCAMS Oxford Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, University of Oxford, Oxford, UK.
Paul E BrennanCentre for Medicines Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Tao DongCAMS Oxford Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, University of Oxford, Oxford, UK.
Ian D PavordRespiratory Medicine Unit, Oxford NIHR Biomedical Research Centre, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Yuanlin SongShanghai Key Laboratory of Lung Inflammation and Injury, Shanghai Respiratory Research Institute, Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
James D ChalmersRadcliffe Department of Medicine, University of Oxford, Oxford, UK.
Julian C KnightCAMS Oxford Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, University of Oxford, Oxford, UK.
Najib M RahmanCAMS Oxford Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, University of Oxford, Oxford, UK.
Nikolaos I KanellakisCAMS Oxford Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, University of Oxford, Oxford, UK nikolaos.kanellakis@ndm.ox.ac.uk.ORCID https://orcid.org/0000-0002-0065-2282

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInflux of large numbers of neutrophils is characteristic of pleural infection; however, neutrophil behaviour is understudied. We designed an observational, multicohort study with the aims to discover and validate the association between neutrophil extracellular traps (NETs), disease severity, 1-year survival and the extent of sonographic septations.

methodsWe analysed five independent datasets across three countries. The PILOT cohort (UK, n=215) was used as a discovery cohort for the association of NETs with disease severity, with validation in four independent cohorts across three countries (UK, Greece and Italy, n=100). The PILOT cohort was further analysed to assess the association of NETs with 1-year survival and the development and extent of sonographic septations. A separate cohort (Oxford-Osler, UK, n=30) was used to assess the relationship between NETs and the need for intrapleural enzyme therapy as rescue treatment.

resultsA 10-unit increase in NETs was associated with 13% higher odds of being in a higher RAPID score group (OR 1.13, 95% CI 1.02-1.27; p=0.02), and this association remained robust in the independent validation cohort (OR 1.29, 95% CI 1.11-1.40; p=0.0005). A 10-unit increase in NETs was also associated with a 15% higher risk of 1-year mortality (HR 1.15, 95% CI 1.01-1.32; p=0.04) independent of the RAPID score, and a 17% higher likelihood of sonographic septations (OR 1.17, 95% CI 1.01-1.37; p=0.04). Citrullinated fibrin was associated with septation severity (OR 1.10, 95% CI 1.04-1.16; p=0.00005).

conclusionsPleural fluid NETs are a biomarker of disease severity and 1-year mortality, in pleural infection. Future studies are required to assess the combination of NET-targeting strategies in combination with existing treatments.

Indexed as

Extracellular TrapsPleural DiseasesAgedCohort StudiesFemaleGreeceHumansItalyMaleMiddle AgedNeutrophilsPilot ProjectsSeverity of Illness IndexUltrasonographyUnited Kingdom

Identifiers

PMID42025308
PMCPMC13519835

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.