Luminal mucus plugs are spatially associated with airway wall thickening in severe COPD and asthma: A single-centered, retrospective, observational study

Tran, C.; Singh, Gaurav Veer; Haider, Ehsan; Boylan, Colm; Venegas, Carmen; Riaz, Shaista; Duwaiki, Suad Al; Yehya, Moustafa; Ho, Terence; Nair, Parameswaran; Svenningsen, Sarah; Kirby, Miranda

doi:10.1016/j.rmed.2022.106982

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…Beyond bronchial inflammation, Tran et al have found that the airway wall thickness was increased in segments with distal mucus plugs [ 3 ]. With a similar methodology, after adjusting for height, sex, and age, asthmatics with a high mucus score had reduced main bronchial and lobar bronchial calibers.…”

Section: Discussionmentioning

confidence: 99%

“…Asthma is a frequent and heterogeneous pathology comprising different clinical presentations, inflammatory pathways and endotypes [ 1 ]. Recently, the presence of mucus plugs in the airways has been proposed as a phenotypic marker of chronic inflammatory airway diseases such as COPD [ 2 , 3 ] and asthma [ 4 – 6 ]. The presence of chronic mucus plugs in asthmatics airways, quantified by visual scoring of CT scan images, has been associated with increased airway obstruction, higher type 2 (T2) inflammation, and more exacerbations [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Whether mucus plugs are common in these asthmatics is less well studied. Beyond T2 inflammation, the presence of mucus plugs in the airways of asthmatics and COPD subjects has been associated with local thickening of the walls of the obstructed bronchi [ 3 ]. Interestingly, in COPD, the presence of mucus plugs was correlated with the percentage of neutrophils in sputum and not with the eosinophils, suggesting the possibility of non-T2 factors associated with airway mucus plugging [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Mucus plugs in the airways of asthmatic subjects and smoking status

Audousset,

Swaleh,

Olivenstein

et al. 2024

Respir Res

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Background Mucus plugs have been described in the airways of asthmatic subjects, particularly those with associated with type 2 inflammation and sputum eosinophilia. In the current study we addressed the question of whether smoking, neutrophilic inflammation and airway dimensions affected the prevalence of mucus plugs. Methods In a cohort of moderate to severe asthmatics (n = 50), including a group of ex-smokers and current smokers, the prevalence of mucus plugs was quantified using a semi-quantitative score based on thoracic computerized tomography. The relationships between mucus score, sputum inflammatory profile and airway architecture were tested according to patient’s smoking status. Results Among the asthmatics (37% former or active smokers), 74% had at least one mucus plug. The median score was 3 and was unrelated to smoking status. A significant but weak correlation was found between mucus score, FEV1 and FEV1/FVC. Mucus score was significantly correlated with sputum eosinophils. Among former and active smokers, mucus score was correlated with sputum neutrophils. Mucus score was positively associated with FeNO in non-smoking subjects. The lumen dimensions of the main and lobar bronchi were significantly inversely correlated with mucus score. Conclusion Airway mucus plugs could define an asthma phenotype with altered airway architecture and can occur in asthmatic subjects with either neutrophilic or eosinophilic sputum according to their smoking status.

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Section: Discussionmentioning

confidence: 99%