Chest
Original ResearchAsthmaAirway Remodeling Measured by Multidetector CT Is Increased in Severe Asthma and Correlates With Pathology
Section snippets
Study Design
As part of the Severe Asthma Research Program (SARP) at the National Institutes of Health, a prospective cohort of subjects, following informed consent, underwent detailed testing and MDCT scanning using a standardized protocol that was developed by the SARP.17 MDCT scan data were analyzed and compared in a total of 123 subjects, as follows: patients with severe asthma, n = 63; patients with mild-to-moderate asthma, n = 35; healthy subjects, n = 25. In a subset of patients who underwent airway
Demographics
The characteristics of the subjects in our study (Table 1) demonstrated that those with severe persistent asthma, on average, were older, reported more frequent symptoms of allergies, and had elevated levels of IgE, increased airway hyperresponsiveness, and decreased baseline FEV1 percent predicted compared to patients with mild-to-moderate asthma and healthy subjects. Subjects in the biopsy subset were representative of the overall cohort (Table 1) with the exception that patients with
Discussion
Airway remodeling describes structural changes that in the asthmatic airway collectively result in thickening of the airway wall.2, 3, 8, 9 CT imaging of the airways is being developed as a technique to study airway remodeling in vivo. Multiple studies5, 6, 7, 8, 13, 14, 15 have documented increased airway WT in asthma using CT. Most of these studies5, 13, 14, 15 employed manual tracing methods, using either manual or digital measurement of airway dimensions. These previous studies using manual
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This research was supported by National Institutes of Health grants HL69149, HL64368, HL69349, HL69170, HL-69155, HL69174, HL69130, HL69167, HL69116, and HL69174–05.
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