A novel CT scan-based approach has revealed significant changes in a parameter indicating lung destruction in some asthmatics. This finding could lead to more personalized treatments for asthma accompanied by persistent airflow limitation.
Clinicians have long thought that some people with asthma experience declines in their lung function, called fixed airflow obstruction (FAO), due to changes to their airways. Now, scientists at Hokkaido University and colleagues have found that the issue in these people could extend to the surrounding lung tissue. They published their findings in The Journal of Allergy and Clinical Immunology.
“Bronchial asthma is considered to be mainly due to inflammation and remodeling of the larger respiratory airways,” explains respirologist Kaoruko Shimizu of Hokkaido University. “But not all asthmatics improve with the typical treatments prescribed to alleviate this condition. We wanted to know if changes to the surrounding lung tissue induced a decline in pulmonary function over time in this subgroup of patients,” she explains.
Shimizu and her colleagues applied a novel computer tomography (CT)-based approach to detect changes in lung tissue. In this approach, the scientists examined CT scans employing an index called “exponent D” for areas of reduced lung density with increasing coalescence of neighboring airspaces, which indicates emphysema, or the destruction of air sacs. The team also measured airway obstruction by testing the ability of people with asthma to forcefully exhale air in one second. This ability is reduced when the airways are narrower.
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Journal of Allergy and Clinical Immunology. Research Paper (PDF file):