The triple radiologic asthma phenotype is associated with worse disease control

Background: Efforts have been made to combine radiographic biomarkers such as bronchiectasis or bronchial wall thickness (BWT) for the purpose of identifying asthma subphenotypes and their clinical implications. Objective: Our aim was to assess whether a composite triple radiologic phenotype measure...

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Main Authors: Rory Chan, MBChB, PhD, Chary Duraikannu, FRCR, Mohamed Jaushal Thouseef, FRCR, Brian Lipworth, MD
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:Journal of Allergy and Clinical Immunology: Global
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772829324001371
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author Rory Chan, MBChB, PhD
Chary Duraikannu, FRCR
Mohamed Jaushal Thouseef, FRCR
Brian Lipworth, MD
author_facet Rory Chan, MBChB, PhD
Chary Duraikannu, FRCR
Mohamed Jaushal Thouseef, FRCR
Brian Lipworth, MD
author_sort Rory Chan, MBChB, PhD
collection DOAJ
description Background: Efforts have been made to combine radiographic biomarkers such as bronchiectasis or bronchial wall thickness (BWT) for the purpose of identifying asthma subphenotypes and their clinical implications. Objective: Our aim was to assess whether a composite triple radiologic 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 subphenotypes in persistent asthma. Methods: A total of 112 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 the following: a pooled mediastinal lymph node size of 3.6 mm or more; a BWT as a pooled wall area of at least 50% of the total airway area; and a mucus plug score of 1 or higher, with a mucus plug 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, with their scores exceeding minimal clinical important difference, a higher prevalence of concomitant chronic rhinosinusitis with nasal polyps, and a greater total IgE level. Conclusion: We have demonstrated an association between poorer symptom control and the triple radiologic asthma phenotype.
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spelling doaj-art-590fec7f2bc042cebcb7f43e0f87ea672025-08-20T02:14:50ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932024-11-013410034110.1016/j.jacig.2024.100341The triple radiologic asthma phenotype is associated with worse disease controlRory Chan, MBChB, PhD0Chary Duraikannu, FRCR1Mohamed Jaushal Thouseef, FRCR2Brian Lipworth, MD3Scottish Centre for Respiratory Research, School of Medicine, University of Dundee, Dundee, United Kingdom; Corresponding author: Rory Chan, MBChB, PhD, Scottish Centre for Respiratory Research, Ninewells Hospital and Medical School, University of Dundee, DD1 9SY, Scotland, UK.Department of Radiology, Ninewells Hospital Dundee, Dundee, United KingdomDepartment of Radiology, Ninewells Hospital Dundee, Dundee, United KingdomScottish Centre for Respiratory Research, School of Medicine, University of Dundee, Dundee, United KingdomBackground: Efforts have been made to combine radiographic biomarkers such as bronchiectasis or bronchial wall thickness (BWT) for the purpose of identifying asthma subphenotypes and their clinical implications. Objective: Our aim was to assess whether a composite triple radiologic 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 subphenotypes in persistent asthma. Methods: A total of 112 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 the following: a pooled mediastinal lymph node size of 3.6 mm or more; a BWT as a pooled wall area of at least 50% of the total airway area; and a mucus plug score of 1 or higher, with a mucus plug 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, with their scores exceeding minimal clinical important difference, a higher prevalence of concomitant chronic rhinosinusitis with nasal polyps, and a greater total IgE level. Conclusion: We have demonstrated an association between poorer symptom control and the triple radiologic asthma phenotype.http://www.sciencedirect.com/science/article/pii/S2772829324001371Asthmasymptom controlimagingcomputed tomographybronchial wall thicknessmucus plug
spellingShingle Rory Chan, MBChB, PhD
Chary Duraikannu, FRCR
Mohamed Jaushal Thouseef, FRCR
Brian Lipworth, MD
The triple radiologic asthma phenotype is associated with worse disease control
Journal of Allergy and Clinical Immunology: Global
Asthma
symptom control
imaging
computed tomography
bronchial wall thickness
mucus plug
title The triple radiologic asthma phenotype is associated with worse disease control
title_full The triple radiologic asthma phenotype is associated with worse disease control
title_fullStr The triple radiologic asthma phenotype is associated with worse disease control
title_full_unstemmed The triple radiologic asthma phenotype is associated with worse disease control
title_short The triple radiologic asthma phenotype is associated with worse disease control
title_sort triple radiologic asthma phenotype is associated with worse disease control
topic Asthma
symptom control
imaging
computed tomography
bronchial wall thickness
mucus plug
url http://www.sciencedirect.com/science/article/pii/S2772829324001371
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