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논문 기본 정보

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학술저널
저자정보
김주희 (Division of Pulmonary Allergy and Critical Care Medicine Department of Medicine Hallym University Sacred Heart Hospital Hallym University College of Medicine Anyang Korea.) Shin Kyung Eun (Department of Radiology Soonchunhyang University Bucheon Hospital Soonchunhyang University College of Medicine Bucheon Korea.) Chang Hun Soo (Department of Anatomy and BK21 FOUR Project Soonchunhyang University College of Medicine Cheonan Korea.) Lee Jong-Uk (Department of Interdisciplinary Program in Biomedical Science Major Soonchunhyang University Bucheon Hospital Soonchunhyang University College of Medicine Bucheon Korea.) Park Seung-lee (Department of Interdisciplinary Program in Biomedical Science Major Soonchunhyang University Bucheon Hospital Soonchunhyang University College of Medicine Bucheon Korea.) Park Jai Soung (Department of Radiology Soonchunhyang University Bucheon Hospital Soonchunhyang University College of Medicine Bucheon Korea.) Park Jong Sook (Division of Allergy and Respiratory Medicine Department of Internal Medicine Soonchunhyang University Bucheon Hospital Soonchunhyang University College of Medicine Bucheon Korea.) Park Choon-Sik (Division of Allergy and Respiratory Medicine Department of Internal Medicine Soonchunhyang University Bucheon Hospital Soonchunhyang University College of Medicine Bucheon Korea.)
저널정보
대한천식알레르기학회(구 대한알레르기학회) Allergy, Asthma & Immunology Research Allergy, Asthma & Immunology Research Vol.15 No.2
발행연도
2023.3
수록면
174 - 185 (12page)
DOI
10.4168/aair.2023.15.2.174

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Purpose: A subset of asthmatics suffers from persistent airflow limitation, known as remodeled asthma, despite optimal treatment. Typical quantitative scoring methods to evaluate structural changes of airway remodeling on high-resolution computed tomography (HRCT) are time-consuming and laborious. Thus, easier and simpler methods are required in clinical practice. We evaluated the clinical usefulness of a simple, semi-quantitative method based on 8 HRCT parameters by comparing asthmatics with a persistent decline of post-bronchodilator (BD)-FEV1 to those with a BD-FEV1 that normalized over time and evaluated the relationships of the parameters with BD-FEV1. Methods: Asthmatics (n = 59) were grouped into 5 trajectories (Trs) according to the changes of BD-FEV1 over 1 year. After 9–12 months of guideline-based treatment, HRCT parameters including emphysema, bronchiectasis, anthracofibrosis, bronchial wall thickening (BWT), fibrotic bands, mosaic attenuation on inspiration, air-trapping on expiration, and centrilobular nodules were classified as present (1) or absent (0) in 6 zones. Results: The Tr5 group (n = 11) was older and exhibited a persistent decline in BD-FEV1. The Tr5 and Tr4 groups (n = 12), who had a lower baseline BD-FEV1 that normalized over time, had longer durations of asthma, frequent exacerbations, and higher doses of steroid use compared to the Tr1–3 groups (n = 36), who had a normal baseline BD-FEV1. The Tr5 group had higher emphysema and BWT scores than the Tr4 (P = 8.25E-04 and P = 0.044, respectively). Scores for the other 6 parameters were not significantly different among the Tr groups. BD-FEV1 was inversely correlated with the emphysema and BWT scores in multivariate analysis (P = 1.70E-04, P = 0.006, respectively). Conclusions: Emphysema and BWT are associated with airway remodeling in asthmatics. Our simple, semi-quantitative scoring system based on HRCT may be an easy-to-use method for estimating airflow limitation.
#Asthma #airway remodeling #emphysema #forced expiratory volume #computed tomography

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