Clinical correlates of lung ventilation defects in asthmatic children

Altes, Talissa A.; Mugler, John P.; Ruppert, K.; Tustison, Nicholas J.; Gersbach, Joanne; Szentpetery, Sylvia; Meyer, Craig H.; Lange, Eduard E. de; Teague, W. Gerald

doi:10.1016/j.jaci.2015.08.045

Cited by 46 publications

(46 citation statements)

References 31 publications

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“…Data from studies in adults suggest that the size and location of ventilation defects tends to persist over weeks to years34 and are more commonly found in the lung periphery and correspond to areas of air trapping on multidetector CT 35. In the only paediatric study that included preschool children, there was no effect of age on the detection of ventilation defects suggesting that these peripheral defects may be present from an early age 33. Abnormalities are commonly seen in conventional chest X-rays of infants and preschool children with RW, and recent evidence would suggest that radiological abnormalities predict more severe disease 8.…”

Section: Discussionmentioning

confidence: 98%

“…This study showed that LCI is significantly increased in infants with prenatal tobacco smoke exposure and infants who had a lower respiratory tract infection in the first year of life,32 suggesting these changes may correlate with early structural lung impairment; however, no imaging data were available to correlate these functional tests with imaging. Ventilation heterogeneity imaging is limited in RW and asthma, but persistent ventilation defects have been noted in asthmatics children compared with HC 33. Data from studies in adults suggest that the size and location of ventilation defects tends to persist over weeks to years34 and are more commonly found in the lung periphery and correspond to areas of air trapping on multidetector CT 35.…”

Section: Discussionmentioning

confidence: 99%

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Ventilation inhomogeneity in infants with recurrent wheezing

Foong²,

Kowalik

et al. 2018

Thorax

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Ventilation inhomogeneity in infants with recurrent wheezing

Foong²,

Kowalik

et al. 2018

Thorax

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“…The limited number of normal healthy controls in our study might explain this discrepancy. Since height and weight have also been shown to influence the regression equations in many FOT indexes, we generated Asymmetric branching of the bronchial tree may cause discrepancies in the anatomic and acoustic characteristics of the central and peripheral airways, and lung ventilation defects are not uniformly distributed in asthmatic lungs [26]; hence, it has been argued that R5-R20 merely represents the frequency-dependence of resistance or the heterogeneity of airway resistance rather than the true resistance of peripheral airways [27]. Historically, however, it has been presumed that R5, R20, and R5-R20 represent the resistances of the whole, central-large, and peripheral-small airways, respectively.…”

Section: Salivary Sp-d Levels Correlate With R5-r20 In Asthmatic Chilmentioning

confidence: 99%

The Biomarker Salivary SP-D May Indicate Small Airway Inflammation and Asthma Exacerbation

Okazaki¹,

Murai²,

Kidoguchi³

et al. 2017

J Investig Allergol Clin Immunol

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Background: Noninvasive and child-friendly biomarkers are important tools for understanding the various phenotypes of childhood asthma. Objective: The aim of this study was to examine the usefulness of salivary surfactant protein (SP) D in assessing the pathophysiology of childhood asthma. Methods: We measured salivary concentrations of SP-D and forced oscillation technique (FOT) indexes in 19 healthy controls and 21 asthmatic children. Regression equations for the predictive values of FOT indexes were generated from healthy controls. We analyzed the correlations between salivary SP-D concentration and percentages of the predictive values of FOT indexes, as well as the severity of exacerbation. Results: We found that salivary SP-D levels were higher in asthmatic children than in healthy controls. In the asthmatic children, salivary SP-D levels correlated with the percentages of predicted differences in resistance between 5 Hz and 20 Hz (%R5-R20), which represented the resistance of peripheral airways, and with the severity of asthma exacerbation. Conclusion: Salivary SP-D may reflect asthmatic inflammation in peripheral small airways and may be a useful marker for monitoring the degree of exacerbation in childhood asthma.

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“…Recently, lung defect volume percentage was found to correlate with several clinical features of asthma such as severity, symptom score, medication requirement, airway physiology, and atopic markers in children with mild and severe asthma (40). Another recent study (41) using helium-3 MR in a subset of 44 children participating in the Childhood Origins of Asthma (COAST) study (42)found that children with asthma had more and larger ventilation defects and a greater degree of restricted gas diffusion (lower average root-mean-square diffusion length) than non-asthmatic children in this cohort, without correlation between the two measures.…”

Section: Use Of Hp Gas Mri In Childrenmentioning

confidence: 99%

Hyperpolarized Gas Magnetic Resonance Lung Imaging in Children and Young Adults

Flors

Mugler

Lange

et al. 2016

Journal of Thoracic Imaging

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Summary The assessment of early pulmonary disease and its severity can be difficult in children as they often cannot perform procedures such as spirometry. Computed tomography provides detailed structural images of the pulmonary parenchyma but its major drawback is that the patient is exposed to ionizing radiation. In this context, MRI is a promising technique for the evaluation of pediatric lung disease, especially when serial imaging is needed. Traditionally, MRI played a small role in evaluating the pulmonary parenchyma. Because of its low proton density, the lungs display low signal intensity on conventional proton-based MRI. Hyperpolarized (HP) gases are inhaled contrast agents with an excellent safety profile and provide high signal within the lung allowing for high temporal and spatial resolution imaging of the lung airspaces. Besides morphological information, HP MR images also offer valuable information about pulmonary physiology. HP gas MRI has already made new contributions to the understanding of pediatric lung diseases and may become a clinically useful tool. In this article, we discuss the HP gas MRI technique, special considerations that need to be considered when imaging children, and the role of MRI in two of the most common chronic pediatric lung diseases, asthma and cystic fibrosis. We also will discuss how HP gas MRI may be used to evaluate normal lung growth and development, and the alterations occurring in chronic lung disease of prematurity and in patients with a congenital diaphragmatic hernia.

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Clinical correlates of lung ventilation defects in asthmatic children

Abstract: The lung defect volume percentage measured by using (3)He MRI correlates with several clinical features of asthma, including severity, symptom score, medication requirement, airway physiology, and atopic markers.

Cited by 46 publications

References 31 publications

Ventilation inhomogeneity in infants with recurrent wheezing

Ventilation inhomogeneity in infants with recurrent wheezing

The Biomarker Salivary SP-D May Indicate Small Airway Inflammation and Asthma Exacerbation

Hyperpolarized Gas Magnetic Resonance Lung Imaging in Children and Young Adults

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