曾患哮喘的吸烟者和非吸烟者呼出的一氧化氮分数与超高分辨率计算机断层扫描显示的气道尺寸和粘液栓的关系。

IF 6.2 2区 医学 Q1 ALLERGY Allergology International Pub Date : 2024-02-24 DOI:10.1016/j.alit.2024.01.013
Yusuke Hayashi , Naoya Tanabe , Hisako Matsumoto , Kaoruko Shimizu , Ryo Sakamoto , Tsuyoshi Oguma , Hironobu Sunadome , Atsuyasu Sato , Susumu Sato , Toyohiro Hirai
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Ultra-high-resolution computed tomography (U-HRCT), which allows accurate structural quantification of airways &gt;1 mm in diameter, was used in this study to examine whether higher FeNO was associated with thicker walls of the 3rd to 6th generation airways and mucus plugging in patients with asthma.</p></div><div><h3>Methods</h3><p>The retrospective analyses included consecutive former smokers and nonsmokers with asthma who underwent U-HRCT in a hospital. The ratio of wall area to summed lumen and wall area was calculated as the wall area percent (WA%). Mucus plugging was visually scored.</p></div><div><h3>Results</h3><p>Ninety-seven patients with asthma (including 59 former smokers) were classified into low (&lt;20 ppb), middle (20–35 ppb), and high (&gt;35 ppb) FeNO groups (n = 24, 26, and 47). 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引用次数: 0

摘要

背景:在吸烟者和非吸烟者哮喘患者中,部分呼出一氧化氮(FeNO)与气道壁重塑和粘液栓的关系仍有待探索。超高分辨率计算机断层扫描(U-HRCT)可对直径大于 1 毫米的气道进行精确的结构量化,本研究采用该技术来检测一氧化氮的升高是否与哮喘患者第三代至第六代气道壁变厚和粘液栓塞有关:回顾性分析包括在一家医院接受 U-HRCT 检查的连续前吸烟者和非吸烟者哮喘患者。管壁面积与管腔和管壁面积总和的比率被计算为管壁面积百分比(WA%)。对粘液堵塞情况进行目测评分:结果:97 名哮喘患者(包括 59 名曾经吸烟者)被分为低(35 ppb)FeNO 组(n = 24、26 和 47)。在包括所有患者的分析和包括非吸烟者或曾经吸烟者的子分析中,高 FeNO 组第六代气道的 WA% 始终高于低 FeNO 组,而第三代至第五代气道的 WA% 却不高。在多变量模型中,在调整年龄、性别、体重指数、吸烟状况、肺活量和过敏性鼻炎存在情况后,高 FeNO 组的第 6 代气道 WA% 和粘液堵塞率均高于低 FeNO 组:结论:较高的 FeNO 可能反映了哮喘患者相对外周气道的炎症和重塑,无论是曾经吸烟者还是非吸烟者。
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Associations of fractional exhaled nitric oxide with airway dimension and mucus plugs on ultra-high-resolution computed tomography in former smokers and nonsmokers with asthma

Background

Associations of fractional exhaled nitric oxide (FeNO) with airway wall remodeling and mucus plugs remain to be explored in smokers and nonsmokers with asthma. Ultra-high-resolution computed tomography (U-HRCT), which allows accurate structural quantification of airways >1 mm in diameter, was used in this study to examine whether higher FeNO was associated with thicker walls of the 3rd to 6th generation airways and mucus plugging in patients with asthma.

Methods

The retrospective analyses included consecutive former smokers and nonsmokers with asthma who underwent U-HRCT in a hospital. The ratio of wall area to summed lumen and wall area was calculated as the wall area percent (WA%). Mucus plugging was visually scored.

Results

Ninety-seven patients with asthma (including 59 former smokers) were classified into low (<20 ppb), middle (20–35 ppb), and high (>35 ppb) FeNO groups (n = 24, 26, and 47). In analysis including all patients and subanalysis including nonsmokers or former smokers, WA% in the 6th generation airways was consistently higher in the high FeNO group than in the low FeNO group, whereas WA% in the 3rd to 5th generation airways was not. In multivariable models, WA% in the 6th generation airways and the rate of mucus plugging were higher in the high FeNO group than in the low FeNO group after adjusting for age, sex, body mass index, smoking status, lung volume, and allergic rhinitis presence.

Conclusions

Higher FeNO may reflect the inflammation and remodeling of relatively peripheral airways in asthma in both former smokers and nonsmokers.

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来源期刊
Allergology International
Allergology International ALLERGY-IMMUNOLOGY
CiteScore
12.60
自引率
5.90%
发文量
96
审稿时长
29 weeks
期刊介绍: Allergology International is the official journal of the Japanese Society of Allergology and publishes original papers dealing with the etiology, diagnosis and treatment of allergic and related diseases. Papers may include the study of methods of controlling allergic reactions, human and animal models of hypersensitivity and other aspects of basic and applied clinical allergy in its broadest sense. The Journal aims to encourage the international exchange of results and encourages authors from all countries to submit papers in the following three categories: Original Articles, Review Articles, and Letters to the Editor.
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