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Updated: Aug 19, 2025
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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
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Small airways dysfunction in patients with systemic sclerosis and interstitial lung disease
Panagiotis K Panagopoulos1, Andreas V Goules1,2, Vasiliki E Georgakopoulou3
1Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Frontiers in Medicine
|December 1, 2022
Summary
Systemic sclerosis (SSc) patients with interstitial lung disease (ILD) show small airways dysfunction, detectable by specific pulmonary function tests (PFTs). Treatment may partially improve this dysfunction, even before structural lung damage is evident.
Area of Science:
- Pulmonary Medicine
- Rheumatology
- Diagnostic Imaging
Background:
- Small airways involvement is reported in systemic sclerosis (SSc).
- Small airways dysfunction is recognized in interstitial lung disease (ILD) of autoimmune origin.
- Evaluating small airways function in SSc patients with ILD is crucial.
Purpose of the Study:
- To assess small airways function in SSc patients with and without ILD.
- To explore the impact of treatment on small airways function in SSc-ILD patients.
- To utilize conventional and contemporary pulmonary function tests (PFTs) for evaluation.
Main Methods:
- Prospective observational study of 35 SSc patients.
- High-resolution computed tomography (HRCT) for ILD and small airways disease (SAD) assessment.
- Pulmonary function tests including spirometry, diffusing capacity, body plethysmography, single breath nitrogen washout (N2SBW), and impulse oscillometry (IOS).
Main Results:
- Phase III slopeN2SBW and R5-R20 demonstrated high diagnostic performance for small airways dysfunction in SSc.
- SSc-ILD patients showed significantly impaired small airways function compared to non-ILD patients (p<0.05).
- Treatment in a subset of SSc-ILD patients led to improvements in phase III slopeN2SBW, R5-R20, and airway resistance (Raw) after 12 months.
Conclusions:
- Phase III slopeN2SBW and R5-R20 can detect small airways dysfunction in SSc-ILD, potentially before structural damage.
- Treatment for ILD may offer partial improvement in small airways function in SSc patients.
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