Dynamic property of central airway walls assessed by computed tomography: correlation with asthma pathophysiology.

IF 1.3 4区 医学 Q3 ALLERGY
Journal of Asthma Pub Date : 2025-07-01 Epub Date: 2025-03-03 DOI:10.1080/02770903.2025.2469312
Masafumi Yamaguchi, Akio Niimi, Hisako Matsumoto, Tetsuya Ueda, Masaya Takemura, Makiko Jinnai, Tsuyoshi Oguma, Yasutaka Nakano, Michiaki Mishima
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Abstract

Objective: A subset of asthmatics suffers from frequent exacerbations. Various features of airway remodeling and the resultant elastic property of airway walls may play pathophysiological roles in these exacerbations. The aim of the study was to examine the collapsibility of airways and sputum biomarkers associated with airway remodeling with different frequencies of exacerbations.

Methods: We studied 29 moderate-to-severe asthmatics classified by the number of exacerbations in the previous year as, ≤1: stable, n = 18; ≥2: difficult, n = 11, and 11 healthy controls (HC). The absolute wall area (Awa) and luminal area (Ai) of a segmental bronchus were measured by computed tomography at full inspiration (FI) and full expiration (FE). We examined the %change of Ai (a measure of airway collapsibility) and Awa (a possible measure of vascular/water contents in the airway wall) from FI to FE. Sputum biomarkers associated with fibrosis [TGF-β1 and matrix metalloproteinase (MMP)-9/tissue inhibitors of metalloproteinase (TIMP)-1 molar ratio] and those associated with angiogenesis/edema [vascular endothelial growth factor (VEGF) and vascular permeability index (sputum/serum ratio of albumin levels)] were examined.

Results: Airway collapsibility was greater in difficult asthmatics than in stable asthmatics and HC. Sputum TGF-β1 levels were higher and MMP-9/TIMP-1 molar ratios were lower in stable asthmatics than in HC. Sputum VEGF levels and vascular permeability index were higher in difficult asthmatics than in HC.

Conclusions: Collapsibility of thickened airway walls may determine their susceptibility to exacerbations. This may depend on the balance between fibrosis and angiogenesis/edema in the airways.

计算机断层扫描评估中央气道壁的动态特性:与哮喘病理生理学的相关性。
目的:哮喘患者的一个子集遭受频繁的恶化。气道重塑的各种特征和由此产生的气道壁弹性可能在这些加重中发挥病理生理作用。该研究的目的是检查气道的可折叠性和痰液生物标志物与不同频率的气道重构相关。方法:选取29例中重度哮喘患者,按前一年发作次数分为≤1例:病情稳定,n = 18例;≥2:困难,n = 11,健康对照(HC) 11。在全吸气(FI)和全呼气(FE)时,采用计算机断层扫描测量支气管绝对壁面积(Awa)和管腔面积(Ai)。我们检测了Ai(气道湿陷性的测量)和Awa(气道壁血管/水含量的可能测量)从FI到FE的百分比变化。检测与纤维化相关的痰生物标志物[TGF-β1和基质金属蛋白酶(MMP)-9 /金属蛋白酶组织抑制剂(TIMP)-1摩尔比]和与血管生成/水肿相关的痰生物标志物[血管内皮生长因子(VEGF)和血管通透性指数(痰/血清白蛋白水平比值)]。结果:哮喘难治性患者气道湿陷性高于稳定型哮喘患者和HC患者。稳定型哮喘患者痰中TGF-β1水平高于HC组,MMP-9/TIMP-1摩尔比低于HC组。哮喘患者痰中VEGF水平和血管通透性指数高于HC患者。结论:增厚气道壁的可折叠性可能决定其对急性加重的易感性。这可能取决于气道中纤维化和血管生成/水肿之间的平衡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Asthma
Journal of Asthma 医学-过敏
CiteScore
4.00
自引率
5.30%
发文量
158
审稿时长
3-8 weeks
期刊介绍: Providing an authoritative open forum on asthma and related conditions, Journal of Asthma publishes clinical research around such topics as asthma management, critical and long-term care, preventative measures, environmental counselling, and patient education.
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