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01.09.2014 | original article | Ausgabe 17-18/2014

Wiener klinische Wochenschrift 17-18/2014

Irreversible airway obstruction assessed by high-resolution computed tomography (HRCT), exhaled nitric oxide (FENO), and biological markers in induced sputum in patients with asthma

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 17-18/2014
Autoren:
Lanlan Zhang, PhD Jin Gang, Cao Zhigang, Cui Yali, PhD Shen Baozhong, Zhang Fangbiao, Chuntao Liu
Wichtige Hinweise
Shen Baozhong and Liu Chuntao contributed equally to this article.

Summary

Objective

The objective of this study was to explore the significance of assessing irreversible airway obstruction (IAO) in asthma patients by high-resolution computed tomography (HRCT), biological markers in induced sputum, and exhaled nitric oxide (FENO).

Methods

The study was conducted in 34 patients with IAO, 46 patients with reversible airway obstruction (RAO), 40 patients who did not have airway obstruction (NAO), and 40 healthy subjects serving as controls. These patients received a step therapy for at least 3 months based on the guidelines for the prevention and treatment of asthma. After achieving complete or partial control of asthma, HRCT, lung function, FENO, and chemokine levels in induced sputum were measured.

Results

The airway wall area (WA; %) correlated with forced expiratory volume-1 (FEV-1(L); r = −0.67, p < 0.0001), and significant differences in bronchial wall thickening (BWT) of the LEVEL E generation airways were observed between the asthma and control groups (p < 0.01). FENO levels correlated with FEV-1 (%) in the IAO group (r = 0.49, p = 0.01). The levels of matrix metalloproteases-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in asthma patients with IAO, RAO, and NAO were significantly higher than those in the controls (p < 0.05). The level of neutrophilia in the sputum from the IAO group was higher than that from the RAO, NAO and control groups.

Conclusion

Asthma patients with IAO have an increased BWT. Airway measurements with HRCT scans appear to be valuable in the evaluation of airway remodeling in asthma patients with IAO.

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