Abstract
Background: Efforts have been made to combine radiographical biomarkers such as bronchiectasis or bronchial wall thickness (BWT) to identify asthma sub-phenotypes and their clinical implications.
Objective: To assess whether a composite triple radiological phenotype measured by high resolution computed tomography comprising BWT, mucus plug score (MPS) and mediastinal lymph node (MLN) size might provide a better insight into sub-phenotypes in persistent asthma.
Methods: One hundred and twelve patients with moderate-to-severe asthma were included in this retrospective observational study. A binary method was used to classify patients according to median values for: pooled MLN≥3.6mm; BWT as pooled wall area ≥50% of the total airway area; and MPS≥1 where a mucus plug was considered positive if complete bronchial obstruction was imaged more than 2 cm from a pleural surface.
Results: Patients with the triple imaging phenotype exhibited significantly worse asthma control questionnaire scores exceeding minimal clinical important difference, a higher prevalence of concomitant chronic rhinosinusitis with nasal polyposis and a greater total IgE level.
Conclusion: We have demonstrated an association between poorer symptom control and the triple radiological asthma phenotype.
Objective: To assess whether a composite triple radiological phenotype measured by high resolution computed tomography comprising BWT, mucus plug score (MPS) and mediastinal lymph node (MLN) size might provide a better insight into sub-phenotypes in persistent asthma.
Methods: One hundred and twelve patients with moderate-to-severe asthma were included in this retrospective observational study. A binary method was used to classify patients according to median values for: pooled MLN≥3.6mm; BWT as pooled wall area ≥50% of the total airway area; and MPS≥1 where a mucus plug was considered positive if complete bronchial obstruction was imaged more than 2 cm from a pleural surface.
Results: Patients with the triple imaging phenotype exhibited significantly worse asthma control questionnaire scores exceeding minimal clinical important difference, a higher prevalence of concomitant chronic rhinosinusitis with nasal polyposis and a greater total IgE level.
Conclusion: We have demonstrated an association between poorer symptom control and the triple radiological asthma phenotype.
| Original language | English |
|---|---|
| Article number | 100341 |
| Journal | Journal of Allergy and Clinical Immunology: Global |
| Early online date | 11 Sept 2024 |
| DOIs | |
| Publication status | E-pub ahead of print - 11 Sept 2024 |
Keywords
- asthma
- symptom control
- imaging
- computed tomography
- bronchial wall thickness
- mucus plug
- mediastinal lymph node