Computed tomography scans in severe asthma

Walker, Carolina; Gupta, Sumit; Hartley, Ruth; Brightling, Christopher E.

doi:10.1097/mcp.0b013e32834db255

Cited by 42 publications

(28 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Varicose and cystic bronchial dilation were rare, and they were observed mainly in the patients with the most severe asthma, while cylindrical bronchiectasis could be found in nearly all asthmatic patients (14,15). Some investigators reported that bronchial dilation was correlated with disease severity in asthma, FEV 1 , and duration of asthma (15,30,44,45), and contributed to disease severity and difficulty of asthma control (42) but other studies haven't found this correlation (14,28,40,41). Bronchial dilation is an irreversible change due to bronchial wall weakening and increased pressure in airways.…”

Section: Discussionmentioning

confidence: 99%

A morphologic study of the airway structure abnormalities in patients with asthma by high-resolution computed tomography

Wang¹,

Luo²,

Du³

et al. 2016

J. Thorac. Dis.

View full text Add to dashboard Cite

Background: Airway structure changes, termed as airway remodeling, are common in asthma patients due to chronic inflammation, which can be assessed by high-resolution computed tomography (HRCT).Considering the controversial conclusions in the correlation of morphologic abnormalities with clinical feature and outcome, we aimed to further specify and evaluate the structural abnormalities of Chinese asthmatics by HRCT.Methods: From August 2012 to February 2015, outpatients with asthma were recruited consecutively in the Asthma Center of West China Hospital, Sichuan University. Standard HRCT and pulmonary function test (PFT) were performed to collect information of bronchial wall thickening, bronchial dilatation, mucus impaction, emphysema, mosaic perfusion, atelectasis, and spirometric parameters. We reported the incidence of each structural abnormality in HRCT and compared it among different asthmatic severities.Results: A total of 123 asthmatics were enrolled, among which 84 (68.3%) were female and 39 (31.7%) were male. At least one structural abnormality was detected by HRCT in 85.4% asthmatics, and the incidence of bronchial wall thickening, bronchial dilatation, mucus impaction, emphysema, mosaic perfusion, and atelectasis was 57.7%, 51.2%, 22%, 24.4%, 5.7% and 1.6%, respectively. The incidences of bronchial wall thickening, bronchial dilation and emphysema were significantly increased by asthma severity (P<0.05), while incidences of mucus impaction (26/27, 96.30%), mosaic perfusion (6/7, 85.71%) and atelectasis (2/2, 100%) were mainly found in severe asthma. We found a longer asthma history (28.13±18.55 years, P<0.001, P=0.035, respectively).Conclusions: The incidences of structural abnormalities detected by HRCT are fairly high in Chinese asthma populations, especially the bronchial wall thickening and bronchial dilation, which are significantly increased in severe asthma, and are potential risk factors of pulmonary function decline in asthmatics.

show abstract

Section: Discussionmentioning

confidence: 99%

A morphologic study of the airway structure abnormalities in patients with asthma by high-resolution computed tomography

Wang¹,

Luo²,

Du³

et al. 2016

J. Thorac. Dis.

View full text Add to dashboard Cite

show abstract

“…Thus, inflammation and remodeling in this compartment can be detrimental to SA patients, as some reports suggest asthma severity increases in proportion to the involvement of the distal lung (191,192). Unfortunately, most data on the distal lung in asthma provide little to no histological information or association with computed tomographic assessments of air trapping and regional ventilation/perfusion (193), exhaled gases (nitric oxide) (194), or physiological measures (195). Alternatively, autopsy distal lung tissue from fatal asthma specimens often has limited associated clinical information (138).…”

Section: Distal Lung Pathology: Small Airways and Alveolimentioning

confidence: 95%

Pathobiology of Severe Asthma

Bittar¹,

Yousem²,

Wenzel

2015

Annu. Rev. Pathol. Mech. Dis.

108

View full text Add to dashboard Cite

Severe asthma (SA) afflicts a heterogeneous group of asthma patients who exhibit poor responses to traditional asthma medications. SA patients likely represent 5-10% of all asthma patients; however, they have a higher economic burden when compared with milder asthmatics. Considerable research has been performed on pathological pathways and structural changes associated with SA. Although limitations of the pathological approaches, ranging from sampling, to quantitative assessments, to heterogeneity of disease, have prevented a more definitive understanding of the underlying pathobiology, studies linking pathology to molecular markers to targeted therapies are beginning to solidify the identification of select molecular phenotypes. This review addresses the pathobiology of SA and discusses the current limitations of studies, the inflammatory cells and pathways linked to emerging phenotypes, and the structural and remodeling changes associated with severe disease. In all cases, an effort is made to link pathological findings to specific clinical/molecular phenotypes.

show abstract

“…These imaging tools enable the visualization of regional functional impairment in asthmatic lungs, and may facilitates the early diagnosis, asthma phenotyping, the monitoring of disease progress, the assessment of treatment effect and the planning of targeted therapies [6][7][8]. Most previous work has focused on a component of lung function, such as ventilation, perfusion, or ventilation-perfusion mismatch.…”

Section: Introductionmentioning

confidence: 99%