Increased Airway Vascularity in Newly Diagnosed Asthma Using a High-magnification Bronchovideoscope

Tanaka, Hiroshi; Yamada, Gen; Saikai, Toyohiro; Hashimoto, Midori; Tanaka, Shintaro; Suzuki, Kazuhiko; Fujii, Masaru; Takahashi, Hiroki; Abe, Shosaku

doi:10.1164/rccm.200306-727oc

Cited by 109 publications

(81 citation statements)

References 20 publications

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“…31 Other differences, such as muscle layer thickening 32 and increased number of blood vessels in asthmatic airways, were also reported. 33 These findings support the hypothesis that airway remodeling results in more pronounced bronchial wall thickening in asthma than in COPD. However, one has to bear in mind that these studies were performed on samples from lobar and segmental bronchi, which are easily accessible by fiberoptic bronchoscopy.…”

Section: Discussionsupporting

confidence: 79%

Airway Dimensions in Asthma and COPD in High Resolution Computed Tomography: Can We See the Difference?

et al. 2013

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BACKGROUND: Airway remodeling in asthma and COPD results in bronchial wall thickening. The thickness of the bronchial wall can be measured in high-resolution computed tomography. The objectives of the study were to assess the bronchial lumen and wall dimensions in asthma and COPD patients, in relation to disease severity, and to compare the airway dimensions in patients with asthma and COPD. METHODS: Ten asthma subjects and 12 COPD subjects with stable, mild to moderate disease were investigated. All subjects underwent chest high-resolution computed tomography (window level ؊ 450 Hounsfield units, window width 1,500 Hounsfield units). Cross-sections of bronchi (external diameter 1.0 -5.0 mm) were identified on enlarged images. The following variables were measured: external and internal diameter, wall area, lumen area, total airway area, the percentage of airway wall area, wall thickness, and the ratio of wall thickness to external diameter. Separate sub-analyses were performed for airways with external diameter < 2.0 mm and external diameter > 2.0 mm. RESULTS: We measured 261 and 348 cross-sections of small airways in subjects with asthma and COPD, respectively. There was a significant difference in wall thickness and wall area, which were both greater in asthmatics than in COPD patients. In bronchi with external diameter > 2.0 mm, all measured parameters were significantly higher in asthma than COPD. In individual asthmatics the airway wall thickness was similar in all the assessed bronchi, while in COPD it was related to the external airway diameter. CONCLUSIONS: Our results indicate that bronchial walls are thicker in asthmatics than in patients with COPD. It seems that airway wall thickness and the lumen diameter in patients with asthma are related to disease severity. There is no such a relationship in COPD patients. High-resolution computed tomography may be a useful tool in the assessment of airway structure in obstructive lung disease.

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Section: Discussionsupporting

confidence: 79%

Airway Dimensions in Asthma and COPD in High Resolution Computed Tomography: Can We See the Difference?

et al. 2013

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“…This has been demonstrated in bronchial biopsies [1][2][3] and using high-magnification videobronchoscopy [4]. Airway mucosal blood flow, estimated using a soluble gas uptake method, is also reported to be elevated in patients with asthma compared with control subjects [5].…”

mentioning

confidence: 89%

Respiratory heat and moisture loss is associated with eosinophilic inflammation in asthma

Noble¹,

McCafferty²,

Greening³

et al. 2006

Eur Respir J

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Increased mucosal vascularity is a hallmark of airway inflammation in asthma. It was hypothesised that this would lead to a detectable increase in respiratory heat and moisture loss (RHML), which would reflect the degree of airway inflammation present.A total of 23 subjects with asthma and 18 healthy controls had RHML measured in a crosssectional study. The measurements were made using a device that combines temperature and humidity measurement during inspiration and expiration and allows precise control over inspirate conditions and ventilatory pattern. The subjects with asthma underwent parallel measurements of exhaled nitric oxide, sputum eosinophil percentage and exhaled breath condensate pH.Mean¡SD RHML was elevated in patients with asthma ( This novel correlation between thermal and cellular measurements in asthma suggests that both of these noninvasive indices are sensitive to the degree of underlying chronic airway inflammation.

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“…The asthmatic bronchial tree is marked by new blood vessels, increased vessel area and length, and increased vascular permeability, resulting in edema (1,(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). Furthermore, the pulmonary endothelium may be activated in asthma (28,29).…”

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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Increased Airway Vascularity in Newly Diagnosed Asthma Using a High-magnification Bronchovideoscope

Cited by 109 publications

References 20 publications

Airway Dimensions in Asthma and COPD in High Resolution Computed Tomography: Can We See the Difference?

Airway Dimensions in Asthma and COPD in High Resolution Computed Tomography: Can We See the Difference?

Respiratory heat and moisture loss is associated with eosinophilic inflammation in asthma

Markers Of Vascular Perturbation Correlate With Airway Structural Change In Asthma

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