Airway Remodeling Measured by Multidetector CT Is Increased in Severe Asthma and Correlates With Pathology

Aysola, Ravi; Hoffman, Eric A.; Gierada, David S.; Wenzel, Sally E.; Cook-Granroth, Janice; Tarsi, Jaime; Zheng, Jie; Schechtman, Kenneth B.; Ramkumar, Thiruvamoor; Cochran, Rebecca; Xueping, E.; Christie, Chandrika; Newell, John D.; Fain, Sean B.; Altes, Talissa A.; Castro, Mario

doi:10.1378/chest.07-2779

Cited by 272 publications

(293 citation statements)

References 31 publications

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“…High resolution computed tomographic (HRCT) studies of airway structure are providing quantitative morphometry of the airways and distal lung in adults with severe asthma, but less is known in children [115][116][117][118]. In adults, there are relationships to lung function and more severe exacerbation-prone disease.…”

Section: Structural Abnormalitiesmentioning

confidence: 99%

“…These structural changes lead to ventilatory defects that can be visualised by magnetic resonance imaging with hyperpolarised helium [119]. Initial studies suggest that neutrophilic inflammation may be linked to air trapping, while biopsy-measured epithelial thickness predicts airway wall thickness measured from HRCT scans [116,117].…”

Section: Structural Abnormalitiesmentioning

confidence: 99%

“…Finally, severe airway obstruction is a characteristic in some phenotypes of severe asthma, with studies suggesting that eosinophilic and/or neutrophilic inflammation may contribute to greater airflow limitation [116,123,124]. One of the SARP clusters was characterised by severe airway obstruction, with continued b-agonist reversibility, but without reversibility into the normal range, and in association with sputum neutrophilia [15].…”

Section: Physiologymentioning

confidence: 99%

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International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

et al. 2013

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Severe or therapy-resistant asthma is increasingly recognised as a major unmet need. A Task Force, supported by the European Respiratory Society and American Thoracic Society, reviewed the definition and provided recommendations and guidelines on the evaluation and treatment of severe asthma in children and adults.A literature review was performed, followed by discussion by an expert committee according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach for development of specific clinical recommendations.When the diagnosis of asthma is confirmed and comorbidities addressed, severe asthma is defined as asthma that requires treatment with high dose inhaled corticosteroids plus a second controller and/or systemic corticosteroids to prevent it from becoming “uncontrolled” or that remains “uncontrolled” despite this therapy. Severe asthma is a heterogeneous condition consisting of phenotypes such as eosinophilic asthma. Specific recommendations on the use of sputum eosinophil count and exhaled nitric oxide to guide therapy, as well as treatment with anti-IgE antibody, methotrexate, macrolide antibiotics, antifungal agents and bronchial thermoplasty are provided.Coordinated research efforts for improved phenotyping will provide safe and effective biomarker-driven approaches to severe asthma therapy.

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Section: Structural Abnormalitiesmentioning

confidence: 99%

Section: Structural Abnormalitiesmentioning

confidence: 99%

Section: Physiologymentioning

confidence: 99%

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International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

et al. 2013

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“…3 shows snapshots of the procedure. The percentages of LA (LA%) and WA (WA%) were calculated according to the methodology reported in a previous study (6).…”

Section: Case Reportmentioning

confidence: 99%

Changes in CT Scan-estimated Airway Dimensions during an Acute Exacerbation of Asthma

2013

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Asthma is a chronic airway disease characterized by reversible airflow limitation with airway wall thickening. Although some studies have reported changes in airway dimensions estimated on chest CT in patients with chronic asthma, little is known about dynamic changes in airway dimensions between acute exacerbations of asthma and recovery. Our case documents significant changes in the bronchial wall, as estimated on serial chest CT scans, over a short-term interval during an exacerbation of asthma.

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“…El asma severa representa un grupo heterogéneo de fenotipos (eosinofílico, paucinmune, granulocítico, entre otros) 3 , con diferencias fisiopatológicas detrás de cada uno de ellos, variando los elementos estructurales, celulares y moleculares. uno de los mecanismos responsables de la sintomatología de los pacientes asmáticos está en el engrosamiento de la pared de la vía aérea 4 , atribuible a la inflamación de la vía aérea, hipertrofia del músculo liso, hiperplasia de células caliciformes e hipersecreción mucosa. La contracción del músculo liso genera broncoconstricción y obstrucción del flujo aéreo…”

Section: Introductionunclassified

La termoplastía bronquial - una nueva herramienta terapéutica para el asma bronquial severa

2017

Rev. chil. enferm. respir.

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Bronchial thermoplasty is a tool used in the management ACTUALIZACIÓN Introducciónel asma bronquial es una enfermedad pulmonar heterogénea, usualmente caracterizada por una inflamación crónica de la vía aérea. Está definida por la historia de síntomas respiratorios como sibilancias, disnea, sensación de pecho apretado y tos que varía en intensidad y en el tiempo, junto a limitación variable en el flujo de aire espiratorio 1 . el asma bronquial constituye una de las patologías respiratorias más prevalentes en la población 2 . Si bien la mayoría de los pacientes alcanzarán un buen control con corticoides inhalados y broncodilatadores, un pequeño porcentaje se mantendrá sintomático aún con el tratamiento estándar disponible. Se entiende por asma severo a aquel que requiere de tratamiento con dosis altas de corticoides inhalados más broncodilatadores β 2 -adrenérgicos de larga acción (LABA) para lograr su control, o asma que siga sin control a pesar de este tratamiento 1 . El asma severa representa un grupo heterogéneo de fenotipos (eosinofílico, paucinmune, granulocítico, entre otros) 3 , con diferencias fisiopatológicas detrás de cada uno de ellos, variando los elementos estructurales, celulares y moleculares. uno de los mecanismos responsables de la sintomatología de

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Airway Remodeling Measured by Multidetector CT Is Increased in Severe Asthma and Correlates With Pathology

Abstract: Background-To prospectively apply an automated, quantitative 3-D approach to imaging and airway analysis to assess airway remodeling in asthma.

Cited by 272 publications

References 31 publications

International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma

Changes in CT Scan-estimated Airway Dimensions during an Acute Exacerbation of Asthma

La termoplastía bronquial - una nueva herramienta terapéutica para el asma bronquial severa

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