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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Elsevier
2024-11-01
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| 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. |
| format | Article |
| id | doaj-art-590fec7f2bc042cebcb7f43e0f87ea67 |
| institution | OA Journals |
| issn | 2772-8293 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Allergy and Clinical Immunology: Global |
| 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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