Quantitative assessment of airway remodelling and response to allergen in asthma
Quantitative assessment of airway remodelling and response to allergen in asthma
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DOI：
10.1111/resp.13521
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发表时间：
2019-11-01
期刊：
影响因子：
6.9
通讯作者：
Suter, Melissa J.
中科院分区：
文献类型：
--
作者：
Adams, David C.;Miller, Alyssa J.;Suter, Melissa J.
背景和目的在体内评估哮喘和非哮喘气道的微观结构差异及其功能后果与理解和治疗哮喘有关。在这项研究中，我们使用支气管内光学相干断层扫描来研究过敏性哮喘气道与过敏性非哮喘气道在基线微观结构和对过敏原挑战的反应方面的差异。方法共45例受试者完成研究，其中过敏性、轻度哮喘患者20例，非哮喘性过敏对照组22例，健康对照组3例。在右中叶段性过敏原攻击前和24小时后，对每个受试者右中叶和右上叶的3cm气道段进行成像。研究了光学气道测量（上皮和粘膜厚度、粘膜屈曲和粘液）与气道阻塞(FEV1/FVC（1秒内用力呼气量/用力肺活量）和FEV1% （FEV1占预测值的百分比）之间的关系。结果与非哮喘气道相比，哮喘气道的所有四项影像学指标在基线和对过敏原的反应中均显着增加。哮喘组上皮厚度和粘膜屈曲与FEV1/FVC有显著关系。结论气道微观结构、屈曲和黏液的同时评估显示轻度哮喘组与对照组在结构和功能上存在差异，气道屈曲似乎是最相关的因素。这项研究的结果表明，一个全面的，微观结构的方法来评估气道可能是重要的，在未来的哮喘研究以及哮喘的监测和治疗。
Background and objective In vivo evaluation of the microstructural differences between asthmatic and non-asthmatic airways and their functional consequences is relevant to understanding and, potentially, treating asthma. In this study, we use endobronchial optical coherence tomography to investigate how allergic airways with asthma differ from allergic non-asthmatic airways in baseline microstructure and in response to allergen challenge. Methods A total of 45 subjects completed the study, including 20 allergic, mildly asthmatic individuals, 22 non-asthmatic allergic controls and 3 healthy controls. A 3-cm airway segment in the right middle and right upper lobe were imaged in each subject immediately before and 24 h following segmental allergen challenge to the right middle lobe. Relationships between optical airway measurements (epithelial and mucosal thicknesses, mucosal buckling and mucus) and airway obstruction (FEV1/FVC (forced expiratory volume in 1 s/forced vital capacity) and FEV1% (FEV1 as a percentage of predictive value)) were investigated. Results Significant increases at baseline and in response to allergen were observed for all four of our imaging metrics in the asthmatic airways compared to the non-asthmatic airways. Epithelial thickness and mucosal buckling exhibited a significant relationship to FEV1/FVC in the asthmatic group. Conclusion Simultaneous assessments of airway microstructure, buckling and mucus revealed both structural and functional differences between the mildly asthmatic and control groups, with airway buckling seeming to be the most relevant factor. The results of this study demonstrate that a comprehensive, microstructural approach to assessing the airways may be important in future asthma studies as well as in the monitoring and treatment of asthma.