Evaluation of Airway Wall Thickness Via High-Resolution Computed Tomography in Mild Intermittent Asthma

Aşker, Selvi; Aşker, Müntecep; Özbay, Bülent

doi:10.4187/respcare.02780

Cited by 11 publications

(11 citation statements)

References 30 publications

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“… 34 It was proposed that leptin which is one of the best-known systemically secreted adipokines would affect proliferation and survival of eosinophils and promote airway inflammation in several reports. 35 36 37 Considering that there were reports describing airway inflammation in asthma could be demonstrated as bronchial wall thickening on CT, 38 39 the positive association of SFA with WA or TA shown in this study might suggest that subcutaneous fat tissue may influence the airway inflammation through systemically secreted adipokines. These results were unexpected because visceral fat was better known to be more related to systemic inflammation than subcutaneous fat in other diseases.…”

Section: Discussionmentioning

confidence: 66%

Association Between Airway Parameters and Abdominal Fat Measured via Computed Tomography in Asthmatic Patients

Yang

Choi

et al. 2018

Allergy Asthma Immunol Res

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PurposeWe aimed to investigate whether airway parameters, assessed via computed tomography (CT), are associated with abdominal fat areas and to compare the clinical characteristics of asthmatic patients with and without elevated visceral to subcutaneous fat area ratio (EV).MethodsAsthmatic patients (aged ≥40 years) were prospectively recruited. Chest (airway) and fat areas were assessed via CT. Airway parameters, including bronchial wall thickness (WT), lumen diameter (LD), lumen area (LA), wall area (WA), total area (TA), as well as WA/TA percentage (wall area %) were measured at the apical segmental bronchus in the right upper lobe. Visceral (VFA), subcutaneous (SFA) and total (TFA) fat areas (cm2) were also measured. The correlations between abdominal fat areas and airway parameters were assessed. EV was defined as VFA/SFA ≥ 0.4.ResultsFifty asthmatic patients were included (mean age 62.9 years; 52% female); 38% had severe asthma. Significant correlations were found between VFA and both LD and LA (r = −0.35, P = 0.01; r = −0.34, P = 0.02, respectively), and SFA and both WA and TA (r = 0.38, P = 0.007; r = 0.34, P = 0.02, respectively). Exacerbations, requiring corticosteroid therapy or ER visitation, were significantly more frequent in subjects without EV (83% vs. 34%, P = 0.05).ConclusionsAbdominal fat is associated with asthma, according to the location of fat accumulation. In asthmatic subjects, visceral fat seems to be attributable to the bronchial luminal narrowing, while subcutaneous fat may be related to thickening of bronchial wall.

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Section: Discussionmentioning

confidence: 66%

Association Between Airway Parameters and Abdominal Fat Measured via Computed Tomography in Asthmatic Patients

Yang

Choi

et al. 2018

Allergy Asthma Immunol Res

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“…Air trapping was seen in all cases. Interestingly, bronchial wall thickening, a finding commonly associated with the diagnosis of asthma (13), was seen in all patients of the SA and SA-AID groups, in 7 out of 9 of patients with SA-AG, but only in 3 out of 6 of the SA-AG-AID patients. No bronchiectasis was seen in the SA-AG-AID group.…”

Section: Resultsmentioning

confidence: 92%

Histologic Findings of Severe/Therapy-Resistant Asthma From Video-assisted Thoracoscopic Surgery Biopsies

Bittar¹,

Doberer

Mehrad³

et al. 2017

American Journal of Surgical Pathology

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The histologic changes occurring in severe/therapy-resistant asthma (SA) as defined by the European Respiratory Society (ERS)/American Thoracic Society (ATS) guidelines, particularly at the level of the distal airways are unknown. This study describes the clinical, radiologic and histologic characteristics of twenty-nine SA patients who underwent video-assisted thoracoscopic surgery (VATS) lung biopsy. Pathological observations were correlated with clinical features, especially the presence of autoimmune disease (AID) (15/29, 51.7%). Ten biopsies (10/29, 34.5%) showed only small airway manifestations of asthma, while in 19 (65.5%) asthmatic granulomatosis (AG), manifested by asthmatic bronchiolitis supplemented by an alveolar septal mononuclear infiltrates with non-necrotizing granulomas, was present. SA patients without AG showed more striking small airway injury, subbasement membrane thickening and neutrophilic infiltrates. Cases with concurrent AID had a tendency to more parenchymal eosinophilic inflammation, more bronchiolocentric granulomas and a suggestion of increased responsivity to nonsteroidal immunosuppressive therapy. Histologic examination of VATS lung biopsies in SA demonstrates diverse pathologies including cases associated with granulomatous inflammation in addition to eosinophilic infiltrates. This spectrum of histologies may link to a high incidence of autoimmune disease.

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“…[2][3][4][5][6][7][8][9] Further research indicates that airway remodeling is related to the severity of the disease and may result in relatively irreversible narrowing of the airways. 10,11 Many studies have assessed the structural changes that occur in asthma by using high-resolution computed tomography (CT), [12][13][14][15][16][17] in which airway-dimension indices, such as the luminal area, wall area, and wall area percentage, of a selected segmental bronchus are measured by using manual or automated techniques. Some of these studies demonstrated that the airway walls of subjects with asthma are thicker than those of healthy subjects and that airway wall thickening is related to air-flow obstruction and disease severity.…”

Section: Introductionmentioning

confidence: 99%

“…Some of these studies demonstrated that the airway walls of subjects with asthma are thicker than those of healthy subjects and that airway wall thickening is related to air-flow obstruction and disease severity. [12][13][14][15][16][17] However, in previous studies, [12][13][14][15][16][17] one measurement point that was selected in a bronchus for analysis does not reflect the range and the variation trends of structural changes in airways of patients with asthma.…”

Section: Introductionmentioning

confidence: 99%

Airway Remodeling in Asthma: Evaluation in 5 Consecutive Bronchial Generations by Using High-Resolution Computed Tomography

Jiang

Wang

et al. 2018

Respir Care

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BACKGROUND: Airway remodeling is a characteristic structural change that occurs extensively in the airways of patients with asthma. The change can be evaluated by measuring airway dimensions by using high-resolution computed tomography. This study aimed to explore the variation trends of airway dimensions from the second-to sixth-generation bronchi in subjects with asthma. METHODS: Sixty subjects with asthma and 40 healthy controls underwent high-resolution computed tomography. The right upper lobe apical segmental bronchus, right lower lobe posterior basal segmental bronchus, left upper lobe apicoposterior segmental bronchus, and the left lower lobe posterior basal segmental bronchus were identified on computed tomography images. The luminal area, wall area, and wall area percentage of each bronchus were measured from the second (lobar) to the sixth generation. The variation trends of these indices (luminal area, wall area, and wall area percentage) were then compared between the subjects with asthma and the healthy controls. RESULTS: From the proximal to the distal airway, the luminal area and wall area decreased gradually, whereas the wall area percentage increased gradually in all the participants; the difference between the participants with asthma and the healthy controls in the luminal area, wall area, and wall area percentage increased gradually from the second (lobar) to the sixth generation; there was a significant difference between the participants with asthma and the healthy controls in the right lower lobe posterior basal segmental bronchus, left upper lobe apicoposterior segmental bronchus, and left lower lobe posterior basal segmental bronchus wall area percentage (P ‫؍‬ .001, .01 and .001, respectively) but not in the right upper lobe apical segmental bronchus wall area percentage (P ‫؍‬ .050). CONCLUSIONS: Airway remodeling in asthma was more prominent in distal airways and at lower lobe bronchi.

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Evaluation of Airway Wall Thickness Via High-Resolution Computed Tomography in Mild Intermittent Asthma

Cited by 11 publications

References 30 publications

Association Between Airway Parameters and Abdominal Fat Measured via Computed Tomography in Asthmatic Patients

Association Between Airway Parameters and Abdominal Fat Measured via Computed Tomography in Asthmatic Patients

Histologic Findings of Severe/Therapy-Resistant Asthma From Video-assisted Thoracoscopic Surgery Biopsies

Airway Remodeling in Asthma: Evaluation in 5 Consecutive Bronchial Generations by Using High-Resolution Computed Tomography

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