scholarly journals Relationship between CT air trapping criteria and lung function in small airway impairment quantification

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Sébastien Bommart ◽  
Grégory Marin ◽  
Arnaud Bourdin ◽  
Nicolas Molinari ◽  
François Klein ◽  
...  
Keyword(s):  
Lung Function ◽  
Small Airway ◽  
Air Trapping

scholarly journals Air Trapping Is Associated with Heterozygosity for Alpha-1 Antitrypsin Mutations in Patients with Asthma

Respiration ◽  
2021 ◽  
pp. 1-10
Author(s):  
Marina Aiello ◽  
Marianna Ghirardini ◽  
Laura Marchi ◽  
Annalisa Frizzelli ◽  
Roberta Pisi ◽  
...  
Keyword(s):  
Lung Function ◽  
Serum Concentration ◽  
Forced Expiratory Volume ◽  
Small Airway ◽  
University Hospital ◽  
Air Trapping ◽  
Asthmatic Patients ◽  
Alpha 1 Antitrypsin Deficiency ◽  
Alpha 1 Antitrypsin ◽  
Few Data

<b><i>Background:</i></b> Alpha-1 antitrypsin deficiency (AATD) is a hereditary disorder involving lungs, characterized by low serum concentration of the protein alpha-1 antitrypsin (AAT) also called proteinase inhibitor (PI). Asthma is common in AATD patients, but there are only few data on respiratory function in asthmatic patients with AATD. <b><i>Objectives:</i></b> The aim of the study was to evaluate lung function in asthmatic outpatients with mutation in the <i>SERPINA1</i> gene coding for AAT versus asthmatic subjects without mutation. <b><i>Methods:</i></b> We performed the quantitative analysis of the serum concentration of AAT in 600 outpatients affected by mild to moderate asthma from the University Hospital of Parma, Italy. Fifty-seven of them underwent the genetic analysis subsequently; they were subdivided into mutated and non-mutated subjects. All the mutated patients had a heterozygous genotype, except 1 (PI*SS). We assessed the lung function through a flow-sensing spirometer and the small airway parameters through an impulse oscillometry system. <b><i>Results:</i></b> The values of forced vital capacity (% predicted) and those of the residual volume to total lung capacity ratio (%) were, respectively, lower and higher in patients mutated versus patients without mutation, showing a significantly greater air trapping (<i>p =</i> 0.014 and <i>p =</i> 0.017, respectively). Moreover, patients with mutation in comparison to patients without mutation showed lower forced expiratory volume in 3 s (% predicted) and forced expiratory volume in 6 s (L) spirometric values, reflecting a smaller airways contribution. <b><i>Conclusions:</i></b> In asthmatic patients, heterozygosity for AAT with PI*MZ and PI*MS genotypes was associated with small airway dysfunction and with lung air trapping.

Possibilities of pulse oscillometry in the diagnosis of small airway dysfunction in patients with bronchial asthma

MedAlliance ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 72-78
Keyword(s):  
Vital Capacity ◽  
Cross Sectional Study ◽  
Functional Method ◽  
Small Airway ◽  
Entire Group ◽  
Body Plethysmography ◽  
Air Trapping ◽  
Cross Sectional ◽  
Group 2 ◽  
Group 1

Small airway dysfunction (SAD) is associated with poorly controlled asthma and frequent exacerbations. Objective: To assess the prevalence of SAD in asthmatics using spirometry, body plethysmography, and impulse oscillometry (IOS). Materials and methods: The observational cross-sectional study of 61 patients with asthma was performed. Conclusion available SAD was made on the basis of identifying one of the criteria or their combination: 1) slow vital capacity (SVC) - forced vital capacity (FVC) >10% according spirometry; 2) "air trapping" according body plethysmography; 3) presence of pathological frequency dependence of the resistance (R) at 5 and 20 Hz (R5-R20 > 0,07 kPa•sec/l) according IOS. Results: The analysis was performed for the entire group as well as for patients with FEV1 > 80 %pred. and FEV1/SVC < 0,7 (group 1) and patients with FEV1 > 80 %pred. and normal FEV1/SVC (group 2). SAD was most often diagnosed using IOS and the selected criterion R5-R20>0,07 kPa •sec/l since 75% of patients had this deviation in the entire group, 65% of patients in group 1 and 55% of patients in group 2 whereas only in 48% and 24% of cases in the entire group according body plethysmography and spirometry, respectively. Conclusion: SAD is definitely observed in patients with asthma. IOS is a more effective method of diagnosing SAD compared to spirometry and body plethysmography and can serve as a supplement functional method, especially in cases of normal parameters of spirometry and body plethysmography in asthmatics.

scholarly journals Relationship between Exhaled Nitric Oxide and Small Airway Lung Function in Normal and Asthmatic Children

2011 ◽  
Vol 60 (1) ◽  
pp. 53-59 ◽  
Author(s):  
Naoki Nakajima ◽  
Hiroyuki Mochizuki ◽  
Reiko Muramatsu ◽  
Satomi Hagiwara ◽  
Takahisa Mizuno ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Lung Function ◽  
Exhaled Nitric Oxide ◽  
Small Airway ◽  
Asthmatic Children

scholarly journals Increased myofibroblasts in the small airways and relation to remodelling and functional changes in smokers and COPD patients: potential role of epithelial-mesenchymal transition (EMT)

2021 ◽  
pp. 00876-2020
Author(s):  
Mathew Suji Eapen ◽  
Wenying Lu ◽  
Tillie L. Hackett ◽  
Gurpreet Kaur Singhera ◽  
Malik Q. Mahmood ◽  
...  
Keyword(s):  
Lung Function ◽  
Epithelial Mesenchymal Transition ◽  
Small Airway ◽  
Normal Lung ◽  
Small Airways ◽  
Mesenchymal Transition ◽  
Functional Changes ◽  
Highly Active ◽  
Copd Patients ◽  
Normal Lung Function

IntroductionPrevious reports showed epithelial mesenchymal transition (EMT) as an active process that contributes to small airway (SA) fibrotic pathology. Myofibroblasts are highly active pro-fibrotic cells that secrete excessive and altered extracellular matrix (ECM). Here we relate SA myofibroblast presence with airway remodelling, physiology and EMT activity in smokers and COPD patients.MethodsLung resections from non-smoker controls (NC), normal lung function smokers (NLFS), COPD current (CS) and ex-smokers (ES) were stained with anti-human αSMA, collagen 1, and fibronectin. αSMA+ive cells were computed in reticular basement membrane (Rbm), lamina propria (LP), and adventitia and presented per mm of Rbm and mm2 of LP. Collagen-1 and fibronectin are presented as a percentage change from normal. All analysis including airway thickness were measured using Image-pro-plus 7.0.ResultsWe found an increase in sub-epithelial LP (especially) and adventitia thickness in all pathological groups compared to NC. Increases in αSMA+ive myofibroblasts were observed in sub-epithelial Rbm, LP, and adventitia in both the smoker and COPD groups compared to NCs. Further, the increase in the myofibroblast population in the LP was strongly associated with decrease in lung function, LP thickening, increase in ECM protein deposition, and finally EMT activity in epithelial cells.ConclusionsThis is the first systematic characterisation of small airway myofibroblasts in COPD based on their localisation, with statistically significant correlations between them and other pan-airway structural, lung function, and ECM protein changes. Finally, we suggest that EMT may be involved in such changes.

scholarly journals P051 The bigger you are the harder you fall? Short term effects of LUM/IVA (Orkambi) on lung function in children with cystic fibrosis

2019 ◽  
Vol 104 (7) ◽  
pp. e2.57-e2
Author(s):  
Emma O’ Grady ◽  
Rebecca Finnegan ◽  
Anna Smyth ◽  
Stephanie Ryan ◽  
Michael Williamson
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Pulmonary Function Tests ◽  
Real Life ◽  
Young Patients ◽  
Forced Expiratory Volume ◽  
List Type ◽  
High Resolution Computed Tomography ◽  
Air Trapping ◽  
Female Ratio

AimCystic Fibrosis conductance Transmembrane Regulator (CFTR) protein modulators represent a major breakthrough in the pharmacological management of Cystic Fibrosis (CF). Previous studies report acute changes in lung function after first administration of lumacaftor/ivacaftor (LUM/IVA) without a clear underlying mechanism.1 2 Our aim was to explore links between changes in percent predicted forced expiratory volume in one second (ppFEV1) and a number of potentially influencing factors.MethodsWe conducted a retrospective review of all children with CF who were started on LUM/IVA treatment between September 2016 and August 2017 in our institution. Data was collected from patient charts, electronic laboratory and radiology records. CT Thorax images were reviewed for evidence of air trapping using the Brody score.3 Descriptive and statistical analyses were performed using SPSS. ResultsData was collected from 15 children with CF who were started on LUM/IVA treatment. The mean (±SD) age of starting treatment was 14 years (±1.7 years), with a mean weight of 47.3 kg (±8.9 kg) and male-to-female ratio of 9:6. Ninety-three percent of patients experienced an acute decline in ppFEV1 post initiation of LUM/IVA, with an absolute mean decline of -10.8% (0–20%). There is a statistically significant inverse relationship between absolute change in ppFEV1 (FEV1) and baseline ppFEV1. There is no correlation between FEV1 and weight, gender or air trapping score.ConclusionOur results suggest that a LUM/IVA related decline in lung function is more significant in CF children with higher baseline ppFEV1. This offers reassurance when initiating LUM/IVA as the patients who experience significant declines have a greater respiratory reserve with which to support this reduction. ReferencesRatjen F, Hug C, Marigowda G, et al. Efficacy and safety of lumacaftor and ivacaftor in patients aged 6–11 years with cystic fibrosis homozygous for F508del-CFTR: a randomised, placebo-controlled phase 3 trial. Lancet Respir Med 2017;5:557–567.Labaste A, Ohlmann C, Mainguy C, et al. Real-life acute lung function changes after lumacaftor/ivacaftor first administration in paediatric patients with cystic fibrosis. J Cyst Fibros 2017;16:709–712.Brody A, Klein J, Molina P, et al. High- resolution computed tomography in young patients with cystic fibrosis: distribution of abnormalities and correlation with pulmonary function tests. Journal of Pediatrics 2004;145:32–38.

Functional respiratory imaging provides novel insights into the long-term respiratory sequelae of bronchopulmonary dysplasia

2020 ◽  
pp. 2002110
Author(s):  
Kristien Vanhaverbeke ◽  
Monique Slaats ◽  
Mohammed Al-Nejar ◽  
Niek Everaars ◽  
Annemiek Snoeckx ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Lung Function ◽  
Bronchopulmonary Dysplasia ◽  
Functional Assessment ◽  
Airway Resistance ◽  
Ct Images ◽  
Air Trapping ◽  
Distal Airway ◽  
Conventional Ct

RationaleBronchopulmonary dysplasia (BPD) is a common complication of preterm birth. Lung function and imaging are classically used to assess BPD. Functional Respiratory Imaging (FRI) combines a structural and functional assessment of the airways and their vasculature. We aimed to assess BPD with FRI and to correlate these findings with the clinical presentation.MethodsWe included 37 adolescents with a history of preterm birth (22 BPD cases and 15 preterm controls). The study protocol included a detailed history, lung function testing and CT (at TLC and FRC) with FRI. CT images were also assessed using the Aukland scoring system.ResultsBPD patients had lower FEV1/FVC (p=0.02) and impaired diffusion capacity (p=0.02).Aukland CT scores were not different between the two groups. FRI analysis showed higher lobar volumes in BPD patients at FRC (p<0.01) but not at TLC. Airway resistance was significantly higher in the BPD group, especially in the distal airways. Additionally, FRI showed more air trapping in BPD patients, in contrast to findings on conventional CT images.ConclusionThis study is the first to use FRI in research for BPD. FRI analysis showed higher lobar volumes in BPD patients, indicating air trapping and reduced inspiratory capacity. In contrast to Aukland CT scores, FRI showed more air trapping in the BPD group, suggesting that FRI might be a more sensitive detection method. Importantly, we also showed increased distal airway resistance in BPD patients. By combining structural and functional assessment, FRI may help to better understand the long-term sequelae of BPD.

Air trapping is associated with heterozygosity for Alpha-1  Antitrypsin mutations in patients with asthma

2020 ◽  
Author(s):  
Marina Aiello ◽  
Ghirardini Marianna ◽  
Pisi Roberta ◽  
Ferrarotti Ilaria ◽  
Bertorelli Giuseppina ◽  
...  
Keyword(s):  
Lung Function ◽  
Serum Concentration ◽  
Genetic Disorder ◽  
University Hospital ◽  
Small Airways ◽  
Air Trapping ◽  
Asthmatic Patients ◽  
Alpha 1 Antitrypsin Deficiency ◽  
Alpha 1 Antitrypsin ◽  
Few Data

Abstract Background: Alpha-1 Antitrypsin Deficiency (AATD) is a hereditary genetic disorder involving lungs in adults, characterized by low serum concentration of the protein alpha-1 antitrypsin (AAT). Several reports indicate that asthma is common in AATD patients, but there are only few data on respiratory function in asthmatic patients with AATD. The aim of the study is to evaluate lung function in asthmatic outpatients with AATD vs. asthmatic subjects without AATD. Methods: We performed the quantitative analysis of the serum concentration of AAT in 600 outpatients affected by mild to moderate asthma from the University Hospital of Parma, Italy. Fifty-seven of them underwent the genetic analysis subsequently, they were subdivided into AATD and non-AATD subjects. All the AATD patients had a heterozygous genotype, except one (PI*SS). We assessed the lung function through a flow-sensing spirometer and the small airways parameters through an impulse oscillometry system.Results: The values of FVC (% predicted) and of the RV/TLC (%) ratio were respectively lower and higher in patients with AATD vs. patients without AATD, showing a significantly greater air trapping (p = 0.014 and p = 0.017 respectively). Moreover, patients with AATD in comparison to patients without AATD showed lower FEV3 (% predicted) and FEV6 (L) spirometric values, reflecting a smaller airways contribution.Conclusions: AATD in asthmatic heterozygote patients with PI*MZ and PI*MS genotypes was associated with small airways dysfunction and with lung air trapping.

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