Decreased computed tomographic lung density during exacerbation of asthma

Mitsunobu, Fumihiro; Ashida, Kozo; Hosaki, Yasuhiro; Tsugeno, Hirofumi; Okamoto, Makoto; Nishida, Norikazu; Nagata, Takuya; Takata, Shingo; Tanizaki, Yoshiro

doi:10.1183/09031936.03.00081702

Cited by 47 publications

(30 citation statements)

References 31 publications

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“…In another study, the percentage of lung field occupied by low attenuation area at inspiration showed some correlation with FEV1/FVC, suggesting an association between asthma severity and small airways [60]. Furthermore, MITSUNOBU et al [61] reported decreased CT lung density during asthma exacerbations. These findings were at least partially reversible, and changes in mean lung density and the relative lung area with low attenuation were related to the change in FEV1 and RV [61].…”

Section: Imaging Techniques In the Evaluation Of Small Airways In Obsmentioning

confidence: 92%

“…Furthermore, MITSUNOBU et al [61] reported decreased CT lung density during asthma exacerbations. These findings were at least partially reversible, and changes in mean lung density and the relative lung area with low attenuation were related to the change in FEV1 and RV [61]. TUNON-DE-LARA et al [62] have shown that 3-month treatment with inhaled corticosteroids (ICS) resulted in decreased lung attenuation and air trapping.…”

Section: Imaging Techniques In the Evaluation Of Small Airways In Obsmentioning

confidence: 98%

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The role of small airways in obstructive airway diseases: Figure 1.

Burgel¹

2011

Eur Respir Rev

196

139

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This review article is a summary of a seminar organised by the European Respiratory Society on ''The role of small airways in obstructive airway diseases'' which was held in October 2010 in Amsterdam, the Netherlands.The aims of the seminar were to identify important questions related to small airways involvement in asthma and chronic obstructive pulmonary disease (COPD), and to discuss future approaches based on current and evolving knowledge. Data obtained by pathological and physiological measurements in small airways and their relevance to clinical manifestations and therapeutics in asthma and COPD were reviewed.It was concluded that our knowledge on the roles of small airways in asthma and COPD is limited. Studies of large numbers of well-characterised subjects using multiple methods (genetic characterisation, cell biology and physiology, imaging) and integration of the data using mathematical models are suggested to be of interest. The availability of these techniques coupled with our ability to better target inhaled molecules to small airways provide a unique opportunity for a reappraisal of the relevance of small airways in chronic airway diseases.

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Section: Imaging Techniques In the Evaluation Of Small Airways In Obsmentioning

confidence: 92%

Section: Imaging Techniques In the Evaluation Of Small Airways In Obsmentioning

confidence: 98%

The role of small airways in obstructive airway diseases: Figure 1.

Burgel¹

2011

Eur Respir Rev

196

139

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“…airway narrowing in disease causes variation in the regional lung volume at which airways close, and this, in turn, leads to heterogeneity in lung density on scans taken at end expiration [29][30][31][32][33][34]. A limitation of the use of expiratory CT scans is the difficulty in breath-holding at low lung volume.…”

Section: Computed Tomographic Imaging Of the Airways Pa De Jong Et Almentioning

confidence: 99%

“…MITSUNOBU et al [32] showed that mean lung density on inspiratory scans decreased during exacerbations of asthma. GOLDIN et al [75] showed that the distributions of attenuation values are shifted to the left (low density) during airway narrowing in CT scans acquired before and after methacholine challenge.…”

Section: Gas Trappingmentioning

confidence: 99%

Computed tomographic imaging of the airways: relationship to structure and function

Jong

Müller²,

Paré³

et al. 2005

Eur Respir J

157

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Alterations in the structure of the airways, collectively termed airway remodelling, contribute to airflow obstruction in a variety of chronic lung diseases. While histology has provided valuable insights into the structure of airway wall remodelling, this technique is invasive and does not allow the longitudinal analysis of airway wall dimensions. Technical advances in computed tomography allow the assessment of airway wall dimensions, and are ideally suited for the noninvasive investigation of the pathogenesis of airway wall remodelling and the evaluation of new therapeutic interventions. The aim of this article is to review the use of computed tomography in the investigation of airway structure and function in health and disease.

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“…In nonsmokers with severe or unstable asthma, however, low-attenuation areas at TLC have also been observed in a diffuse pattern ( Figure 1C). This pattern has been attributed in various publications to hyperinflation, airflow limitation, and complexity of terminal airspace geometry (6,(12)(13)(14)(15)(16)(17) and remains comparatively understudied in asthma relative to the more common air trapping measure at FRC.…”

mentioning

confidence: 99%

Markers Of Vascular Perturbation Correlate With Airway Structural Change In Asthma

Johansson¹,

Kruger²,

Montgomery³

et al. 2011

C35. Insights Into Lung Disease Using Novel Methods

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Rationale: Air trapping and ventilation defects on imaging are characteristics of asthma. Airway wall thickening occurs in asthma and is associated with increased bronchial vascularity and vascular permeability. Vascular endothelial cell products have not been explored as a surrogate to mark structural airway changes in asthma. Objectives: Determine whether reporters of vascular endothelial cell perturbation correlate with airway imaging metrics in patients with asthma of varying severity. Methods: Plasma from Severe Asthma Research Program subjects was analyzed by ELISAs for soluble von Willebrand factor mature protein (VWF:Ag) and propeptide (VWFpp), P-selectin, and platelet factor 4. Additional subjects were analyzed over 48 hours after whole-lung antigen challenge. We calculated ventilation defect volume by hyperpolarized helium-3 magnetic resonance imaging and areas of low signal density by multidetector computed tomography (less than 2856 Hounsfield units [HU] at functional residual capacity and 2950 HU at total lung capacity [TLC]). Measurements and Main Results: VWFpp and VWFpp/Ag ratio correlated with and predicted greater percentage defect volume on hyperpolarized helium-3 magnetic resonance imaging. P-selectin correlated with and predicted greater area of low density on chest multidetector computed tomography less than 2950 HU at TLC.Platelet factor 4 did not correlate. Following whole-lung antigen challenge, variation in VWFpp, VWFpp/Ag, and P-selectin among time-points was less than that among subjects, indicating stability and repeatability of the measurements. Conclusions: Plasma VWFpp and P-selectin may be useful as surrogates of functional and structural defects that are evident on imaging. The results raise important questions about why VWFpp and P-selectin are associated specifically with different imaging abnormalities.

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Decreased computed tomographic lung density during exacerbation of asthma

Cited by 47 publications

References 31 publications

The role of small airways in obstructive airway diseases: Figure 1.

The role of small airways in obstructive airway diseases: Figure 1.

Computed tomographic imaging of the airways: relationship to structure and function

Markers Of Vascular Perturbation Correlate With Airway Structural Change In Asthma

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