Ventilation Heterogeneity Is a Treatable Trait in Severe Asthma

被引:5
作者
Gibson, Peter G. [1 ,2 ,8 ]
Guerrero, Paola D. Urroz [1 ,3 ]
Poon, Christine [4 ]
Rutherford, Natalie [5 ]
Brooker, Bree [5 ]
Smith, Amber [1 ,3 ]
Grainge, Christopher [2 ]
Wark, Peter A. B. [6 ,7 ]
McDonald, Vanessa M. [1 ,2 ,3 ]
机构
[1] Univ Newcastle, Coll Hlth Med & Well Being, Ctr Excellence Treatable Traits, New Lambton Hts, NSW, Australia
[2] John Hunter Hosp, Dept Resp & Sleep Med, New Lambton Hts, NSW, Australia
[3] Univ Newcastle, Sch Nursing & Midwifery, Callaghan, NSW, Australia
[4] Cyclomed Australia Pty Ltd, Kingsgrove, NSW, Australia
[5] John Hunter Hosp, Dept Nucl Med, New Lambton Hts, NSW, Australia
[6] Monash Univ, Fac Med Nursing & Hlth Sci, Dept Med, Melbourne, Vic, Australia
[7] Dept Resp Med, Alfred Hlth, Melbourne, Vic, Australia
[8] Hunter Med Res Inst, Level 2,Lot 1, New Lambton Hts, NSW 2305, Australia
关键词
Asthma; Eosinophil; Small airway disease; V/P SPECT; Ventilation heterogeneity; Treatable traits; Technegas; QUALITY-OF-LIFE; HYPERPOLARIZED HE-3 MRI; LUNG VENTILATION; PERFUSION; ADULTS; COPD;
D O I
10.1016/j.jaip.2023.12.030
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
BACKGROUND: Ventilation heterogeneity (VH) is a feature of asthma and indicates small airway disease. Nuclear imaging methods assess VH, which can facilitate clinical diagnosis and further our understanding of disease aetiology. OBJECTIVE: We sought to assess VH in severe eosinophilic asthma (SEA) using ventilation/perfusion single-photon emission computed tomography (V/P SPECT), and to assess its use as an objective test of the effect of biologic treatment for ventilation defects in SEA. METHODS: Adults ( double dagger 18 y) with severe asthma were recruited to participate in a cross-sectional observational study. Participants underwent a clinical assessment and V/P SPECT CT using Technegas as the ventilation agent. Measures were repeated for a nested before-after treatment study in people with SEA commencing biologics. RESULTS: A total of 62 participants with severe asthma were recruited. From this, 38 participants with SEA were included in the before-after study. The VH was associated with clinical variables such as lung function impairment and signi fi cantly improved after monoclonal antibody treatment in the severe asthma group. The changes in VH correlated with change in post bronchodilator forced expiratory volume in 1 second (FEV 1 ) %predicted (r = - 0.503; P = .001) and post bronchodilator FEV 1 /FVC (forced vital capacity) (r = - 0.415; P = .01). CONCLUSIONS: The VH is clinically signi fi cant, measurable, and treatable, which establishes VH as a treatable trait in severe asthma. (c) 2024 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). (J Allergy Clin Immunol Pract 2024;12:929-35)
引用
收藏
页码:929 / 935.e4
页数:11
相关论文
共 50 条
[41]   Pressure-support ventilation in children with severe asthma [J].
Wetzel, RC .
CRITICAL CARE MEDICINE, 1996, 24 (09) :1603-1605
[42]   Halothane treatment of severe asthma to avoid mechanical ventilation [J].
Padkin, AJ ;
Baigel, G ;
Morgan, GA .
ANAESTHESIA, 1997, 52 (10) :994-997
[43]   Prediction of the need for mechanical ventilation in acute severe asthma [J].
deDiego, A ;
Perpina, M ;
Leon, M ;
Compte, L ;
Ferrandis, S ;
Cebrian, J .
RESPIRATION, 1996, 63 (02) :73-77
[44]   Ketamine to avoid mechanical ventilation in severe pediatric asthma [J].
Denmark, TK ;
Crane, HA ;
Brown, L .
JOURNAL OF EMERGENCY MEDICINE, 2006, 30 (02) :163-166
[45]   Aspergillus sensitization as a treatable trait in COPD [J].
Tiew, P. Y. ;
Narayana, J. K. ;
Quek, M. S. L. ;
Ang, Y. Y. ;
Ko, F. W. S. ;
Poh, M. E. ;
Jaggi, T. K. ;
Xu, H. ;
Thng, K. X. ;
Koh, M. S. ;
Tee, A. ;
Abisheganaden, J. A. ;
Tsaneva-Atanasova, K. ;
Chew, F. T. ;
Chotirmall, S. H. .
EUROPEAN RESPIRATORY JOURNAL, 2022, 60
[46]   Clinical Benefits of Targeting Treatable Traits in Asthma and Chronic Obstructive Pulmonary Disease [J].
Morishima, Yuko ;
Hizawa, Nobuyuki .
INTERNAL MEDICINE, 2025, 64 (01) :17-23
[47]   Identifying Treatable Trait of Dynamic Hyperinflation in Adults Living With Asthma Using the Glittre-ADL Test [J].
Leandro da Silva Pinto, Paulo Victor ;
Pereira Pinto Fonseca, Iasmin Maria ;
Venancio Lourenco da Silva, Marcela Pinto ;
da Silva, Matheus Mello ;
Rodrigues, Thais Souza ;
Bartholo, Thiago Prudente ;
Lopes, Agnaldo Jose .
PHYSIOTHERAPY RESEARCH INTERNATIONAL, 2025, 30 (04)
[48]   Genomics of Treatable Traits in Asthma [J].
Espuela-Ortiz, Antonio ;
Martin-Gonzalez, Elena ;
Poza-Guedes, Paloma ;
Gonzalez-Perez, Ruperto ;
Herrera-Luis, Esther .
GENES, 2023, 14 (09)
[49]   Heterogeneity of phenotypes in severe asthmatics. The Belgian Severe Asthma Registry (BSAR) [J].
Schleich, F. ;
Brusselle, G. ;
Louis, R. ;
Vandenplas, O. ;
Michils, A. ;
Pilette, C. ;
Peche, R. ;
Manise, M. ;
Joos, G. .
RESPIRATORY MEDICINE, 2014, 108 (12) :1723-1732
[50]   Treatable traits in asthma: moving beyond diagnostic labels [J].
McDonald, Vanessa M. ;
Gibson, Peter G. .
MEDICAL JOURNAL OF AUSTRALIA, 2022, 216 (07) :331-333