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

Shimizu, Kaoruko; Tanabe, Naoya; Oguma, Akira; Kimura, Hirokazu; Suzuki, Masaru; Yokota, Isao; Makita, Hironi; Sato, Susumu; Hirai, Toyohiro; Nishimura, Masaharu; Konno, Satoshi

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

Shimizu, Kaoruko; Tanabe, Naoya; Oguma, Akira et al.

Journal of allergy and clinical immunology, 2022, 149(3), 934-942 e8

Permalink : https://hdl.handle.net/2115/88231

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アクセス権	open access
URI	https://hdl.handle.net/2115/88231
タイトル	Parenchymal destruction in asthma : Fixed airflow obstruction and lung function trajectory
著者	Shimizu, Kaoruko ; Tanabe, Naoya ; Oguma, Akira ; Kimura, Hirokazu ; Suzuki, Masaru ; Yokota, Isao ; Makita, Hironi ; Sato, Susumu ; Hirai, Toyohiro ; Nishimura, Masaharu ; Konno, Satoshi
e-Rad_Researcher 40399853 著者名 Shimizu, Kaoruko
著者名 Tanabe, Naoya
著者名 Oguma, Akira
e-Rad_Researcher 90789330 著者名 Kimura, Hirokazu
e-Rad_Researcher 10374290 著者名 Suzuki, Masaru
e-Rad_Researcher 20761414 著者名 Yokota, Isao
著者名 Makita, Hironi
著者名 Sato, Susumu
著者名 Hirai, Toyohiro
e-Rad_Researcher 00208224 著者名 Nishimura, Masaharu
e-Rad_Researcher 20399835 著者名 Konno, Satoshi
言語	英語
キーワード	Asthma
	computed tomography
	fractal
	low-attenuation area
	nonsmokers
	parenchyma
発行日	2022-03
出版者	Elsevier
収録物名	Journal of allergy and clinical immunology
巻(号)	149(3)
ページ	934-942 e8
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
権利情報	© 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/
PISSN	0091-6749
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.jaci.2021.07.042