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Can HRCT be used as a marker of airway remodelling in children with difficult asthma?

Saglani, S; Papaioannou, G; Khoo, L; Ujita, M; Jeffery, PK; Owens, CM; Hansell, DM; ... Bush, A; + view all (2006) Can HRCT be used as a marker of airway remodelling in children with difficult asthma? Respiratory Research , 7 , Article 46. 0.1186/1465-9921-7-46. Green open access

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Abstract

BACKGROUND: Whole airway wall thickening on high resolution computed tomography (HRCT) is reported to parallel thickening of the bronchial epithelial reticular basement membrane (RBM) in adult asthmatics. A similar relationship in children with difficult asthma (DA), in whom RBM thickening is a known feature, may allow the use of HRCT as a non-invasive marker of airway remodelling. We evaluated this relationship in children with DA. METHODS: 27 children (median age 10.5 [range 4.1-16.7] years) with DA, underwent endobronchial biopsy from the right lower lobe and HRCT less than 4 months apart. HRCTs were assessed for bronchial wall thickening (BWT) of the right lower lobe using semi-quantitative and quantitative scoring techniques. The semi-quantitative score (grade 0-4) was an overall assessment of BWT of all clearly identifiable airways in HRCT scans. The quantitative score (BWT %; defined as [airway outer diameter - airway lumen diameter]/airway outer diameter x100) was the average score of all airways visible and calculated using electronic endpoint callipers. RBM thickness in endobronchial biopsies was measured using image analysis. 23/27 subjects performed spirometry and the relationships between RBM thickness and BWT with airflow obstruction evaluated. RESULTS: Median RBM thickness in endobronchial biopsies was 6.7(range 4.6-10.0) microm. Median qualitative score for BWT of the right lower lobe was 1(range 0-1.5) and quantitative score was 54.3 (range 48.2-65.6)%. There was no relationship between RBM thickness and BWT in the right lower lobe using either scoring technique. No relationship was found between FEV1 and BWT or RBM thickness. CONCLUSION: Although a relationship between RBM thickness and BWT on HRCT has been found in adults with asthma, this relationship does not appear to hold true in children with DA

Type: Article
Title: Can HRCT be used as a marker of airway remodelling in children with difficult asthma?
Open access status: An open access version is available from UCL Discovery
DOI: 0.1186/1465-9921-7-46
Publisher version: http://dx.doi.org/0.1186/1465-9921-7-46
Language: English
Additional information: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Asthma, Children, HRCT, Rads, Adolescent, Adult, Asthma, Basement Membrane, Biopsy, Bronchi, Child, Preschool, Forced Expiratory Volume, Humans, Metabolism, Methods, Pathology, Physiopathology, Spirometry, Tomography, X-ray computed
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science
URI: https://discovery.ucl.ac.uk/id/eprint/41809
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