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A Reversible, Non-invasive Method for Airway Resistance Measurements and Bronchoalveolar Lavage Fluid Sampling in Mice
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Airway Reactance Predicts Static Lung Hyperinflation in Severe Asthma.

Y J Li1, H K Ko2,3, S W Pan2,4

  • 1Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

Journal of Investigational Allergology & Clinical Immunology
|January 16, 2023
PubMed
Summary

Static lung hyperinflation (SLH) in severe asthma correlates with small airway dysfunction (SAD). Airway reactance at 5 Hz (X5) effectively identifies SLH, showing improvement with biologic treatments.

Keywords:
Body plethysmographyImpulse oscillometrySevere asthmaStatic lung hyperinflation

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Area of Science:

  • Pulmonary Medicine
  • Respiratory Physiology
  • Asthma Research

Background:

  • Static lung hyperinflation (SLH), measured by body plethysmography, is linked to poor outcomes in asthma patients.
  • The severity of SLH may correlate with small airway dysfunction (SAD), assessable via impulse oscillometry (IOS).

Purpose of the Study:

  • To investigate the correlation between SLH and SAD in severe asthma patients.
  • To evaluate the impact of treatment on SLH and SAD.
  • To identify potential new markers for SLH assessment.

Main Methods:

  • Analysis of data from the prospective observational Taiwan Severe Asthma Registry.
  • Regular performance of body plethysmography and impulse oscillometry (IOS).
  • Determination of relationships between spirometry and IOS parameters, and analysis of clinical outcome changes with treatment.

Main Results:

  • 83% of 107 severe asthma patients exhibited SLH (elevated RV/TLC ratio).
  • Small airway dysfunction (SAD) significantly correlated with SLH; airway reactance at 5 Hz (X5) demonstrated high accuracy in detecting SLH (AUC=0.84).
  • Twelve-month biologic treatment led to reduced exacerbations, fractional exhaled nitric oxide, blood eosinophils, and improved FEV1 and X5, with a trend toward reduced RV/TLC.

Conclusions:

  • Airway reactance at 5 Hz (X5) is a potential novel parameter for assessing static lung hyperinflation in severe asthma.
  • Treatment with biologics can improve lung function parameters related to SLH and SAD.