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Parenchymal destruction in asthma : Fixed airflow obstruction and lung function trajectory

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/88231

Title: Parenchymal destruction in asthma : Fixed airflow obstruction and lung function trajectory
Authors: Shimizu, Kaoruko Browse this author →KAKEN DB
Tanabe, Naoya Browse this author
Oguma, Akira Browse this author
Kimura, Hirokazu Browse this author →KAKEN DB
Suzuki, Masaru Browse this author →KAKEN DB
Yokota, Isao Browse this author →KAKEN DB
Makita, Hironi Browse this author
Sato, Susumu Browse this author
Hirai, Toyohiro Browse this author
Nishimura, Masaharu Browse this author →KAKEN DB
Konno, Satoshi Browse this author →KAKEN DB
Keywords: Asthma
computed tomography
fractal
low-attenuation area
nonsmokers
parenchyma
Issue Date: Mar-2022
Publisher: Elsevier
Journal Title: Journal of allergy and clinical immunology
Volume: 149
Issue: 3
Start Page: 934
End Page: 942 e8
Publisher DOI: 10.1016/j.jaci.2021.07.042
Abstract: Background: Fixed airflow obstruction (FAO) in asthma, particularly in nonsmokers, is generally believed to be caused by airway remodeling. However, parenchymal destruction may also contribute to FAO and longitudinal decline in forced expiratory volume in 1 second (FEV1). Objectives: To evaluate parenchymal destruction, we used emphysema indices, exponent D, and low-attenuation area percentage (LAA%) on computed tomography (CT), and test whether the parenchymal destruction and airway disease are independently associated with FAO and FEV1 decline in both smoking and nonsmoking asthma. Methods: Exponent D, LAA%, wall area percentage at segmental airways, and airway fractal dimension (AFD) in those with asthma were measured on inspiratory CT and compared to those in patients with chronic obstructive pulmonary disease (COPD). Results: Exponent D was lower and LAA% was higher in COPD (n = 42) and asthma with FAO (n = 101) than in asthma without FAO (n = 88). The decreased exponent D and increased LAA% were associated with FAO regardless of smoking status or asthma severity. In multivariable analysis, decreased exponent D and increased LAA% were associated with an increased odds ratio of FAO and decreased FEV1, irrespective of wall area percentage and airway fractal dimension. Moreover, decreased exponent D affected the longitudinal decline in FEV1 in those with severe asthma, independent of smoking status. Conclusions: Patients with asthma with FAO showed parenchymal destruction regardless of smoking status and asthma severity. Parenchymal destruction was associated with an accelerated FEV1 decline, suggesting the involvements of both airway and parenchyma in the pathophysiology of a subgroup of asthma.
Rights: © 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
http://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article (author version)
URI: http://hdl.handle.net/2115/88231
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 清水 薫子

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