Quantification of Pulmonary Inflammation after Segmental Allergen Challenge Using Turbo-Inversion Recovery-Magnitude Magnetic Resonance Imaging

Vogel‐Claussen, Jens; Renne, Julius; Hinrichs, Jan B.; Schönfeld, Christian; Gutberlet, Marcel; Schaumann, Frank; Winkler, Carla; Faulenbach, Cornelia; Krug, Norbert; Wacker, Frank; Hohlfeld, Jens M.

doi:10.1164/rccm.201310-1825oc

Cited by 32 publications

(17 citation statements)

References 30 publications

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“…Clinically, MRI has mainly been used for the evaluation of the para-nasal sinuses and may replace CT for the evaluation of pathological mucosal abnormalities [22,23]. A recent report describes the use of MRI to evaluate the inflammation produced by segmental bronchial allergen challenge [24]. Nasal allergen challenge produced a highly significant change in all the measured variables including all MRI endpoints.…”

Section: Discussionmentioning

confidence: 99%

Using magnetic resonance imaging to quantify the inflammatory response following allergen challenge in allergic rhinitis

Leaker

Scadding

Jones

et al. 2015

Immunity Inflam & Disease

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Current rhinometric and flow assessments measure nasal patency and are often poorly correlated with rhinitis symptoms. To evaluate magnetic resonance imaging (MRI) as a new method to measure inflammatory changes in nasal and sinus mucosa following nasal allergen challenge. A pilot study (n = 6) determined the optimal technical settings for MRI to measure inflammatory change which were then adopted for the main study. This study was a single blind, placebo‐controlled, three‐way crossover trial in 14 subjects with seasonal allergic rhinitis. Effects of cetirizine, cetirizine and pseudoephedrine (Cet+PE), or placebo on total nasal symptom scores (TNSS), peak nasal inspiratory flow (PNIF), nasal nitric oxide (nNO), acoustic rhinometry, and MRI end points following nasal intranasal allergen challenge were measured. There were significant changes in all parameters after allergen challenge (P < 0.01), except for nNO. MRI end points were less variable and more consistent than PNIF and acoustic rhinometry in detecting changes after allergen challenge. Total nasal airspace volume was the most sensitive and reproducible MRI measurement, with a mean reduction from −5.37 cm3 (95%CI −7.35, −3.38; P < 0.001), which was maximal 60 min after allergen challenge. A change of one in TNSS corresponded to a change in MRI volume of −0.57 cm3. There was an improvement in all parameters (except nNO) in subjects taking Cet+PE compared with placebo, however this did not achieve significance probably because of the small study size (overall analysis P > 0.07; comparison of active versus placebo P > 0.09). MRI provides novel insights into the anatomical inflammatory changes post allergen challenge and provides a new method for assessment of nasal patency and objective measurement of inflammatory responses.

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Section: Discussionmentioning

confidence: 99%

Using magnetic resonance imaging to quantify the inflammatory response following allergen challenge in allergic rhinitis

Leaker

Scadding

Jones

et al. 2015

Immunity Inflam & Disease

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“…Beyond COPD, lung MRI has also been used to evaluate the response to therapy in asthmatic patients using a turbo-inversion recovery-magnitude sequence. This sequence shows the extent of the segmental lung edema that corresponds to the severity of the regional allergic reaction, representing a promising biomarker for the non-invasive detection of the inflammatory response in asthmatic patients [58]. …”

Section: New Horizons: Analysis Of Exhaled Gases Post-processing Imamentioning

confidence: 99%

Aging Airways: between Normal and Disease. A Multidimensional Diagnostic Approach by Combining Clinical, Functional, and Imaging Data

Occhipinti¹,

Larici²,

Bonomo³

et al. 2017

Aging and disease

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The lack of data on lung function decline in the aging process as well as the lack of gold standards to define obstructive and restrictive respiratory disease in older people point out the need for a multidimensional assessment and interpretation of the aging airways. By integrating clinical data together with morphologic and morphometric findings clinicians can assess the airways with a more comprehensive perspective, helpful in the interpretation of the “grey zone” between normal aging and disease. This review focuses on the value of a multidimensional approach in the study of the aging airways, including clinical findings, respiratory function tests, and imaging as parts of a whole. Nowadays this multidimensional diagnostic approach can be used in daily clinical practice. In next future, it can be implemented by the analysis of exhaled gases, post-processing imaging techniques, and genetic analysis, that will hopefully reduce the gaps in knowledge of normal aging and airway disease in older people.

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“…Although hampered by low signal intensity, pulmonary 1 H MRI can be performed on conventional scanners without a great deal of physics support. For example, methods have been devised that combine relaxation signals and intravenous contrast to differentiate inflammation, smooth muscle remodelling, oedema and mucus deposition . Conventional 1 H MRI allows for the visualization and quantification of emphysema, the differentiation of oedema from mucous deposition and the differentiation of emphysema from mucous plugs; these findings point to the potential of 1 H MRI to help unmask the many faces of COPD.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

This is what COPD looks like

2015

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Despite decades of research, and the growing healthcare and societal burden of chronic obstructive pulmonary disease (COPD), therapeutic COPD breakthroughs have not occurred. Sub-optimal COPD patient phenotyping, an incomplete understanding of COPD pathogenesis and a scarcity of sensitive tools that provide patient-relevant intermediate endpoints likely all play a role in the lack of new, efficacious COPD interventions. In other words, COPD patients are still diagnosed based on the presence of persistent airflow limitation measured using spirometry. Spirometry measurements reflect the global sum of all the different possible COPD pathologies and perhaps because of this, we lose sight of the different contributions of airway and parenchymal abnormalities. With recent advances in thoracic X-ray computed tomography (CT) and magnetic resonance imaging (MRI), lung structure and function abnormalities may be regionally identified and measured.These imaging endpoints may serve as biomarkers of COPD that can be used to better phenotype patients. Therefore, here we review novel CT and MRI measurements that help reveal COPD phenotypes and what COPD really 'looks' like, beyond spirometric indices. We discuss MR and CT imaging approaches for generating reproducible and sensitive measurements of COPD phenotypes related to pulmonary ventilation and perfusion as well as airway and parenchyma anatomical and morphological features. These measurements may provide a way to advance the development and testing of new COPD interventions and therapies.

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Quantification of Pulmonary Inflammation after Segmental Allergen Challenge Using Turbo-Inversion Recovery-Magnitude Magnetic Resonance Imaging

Abstract: The MRI-based noninvasive TIRM score is a promising biomarker for the noninvasive detection of the inflammatory response after segmental allergen challenge in patients with asthma and may serve to monitor the therapeutic effectiveness of novel antiinflammatory drugs in future human trials.

Cited by 32 publications

References 30 publications

Using magnetic resonance imaging to quantify the inflammatory response following allergen challenge in allergic rhinitis

Using magnetic resonance imaging to quantify the inflammatory response following allergen challenge in allergic rhinitis

Aging Airways: between Normal and Disease. A Multidimensional Diagnostic Approach by Combining Clinical, Functional, and Imaging Data

This is what COPD looks like

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