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Published on: August 7, 2017
Airway Mucus Plugs in Community-Living Adults: A Study Protocol
Maya Abdalla1, Rim Elalami1, Michael H Cho1,2,3
1Division of Pulmonary and Critical Care, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
Introduction:
Mucus pathology plays a critical role in airway diseases like chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD). Up to 32% of community-living persons report clinical manifestations of mucus pathology (e.g., cough and sputum production). However, airway mucus pathology has not been systematically studied in community-living individuals. In this study, we will use an objective, reproducible assessment of mucus pathology on chest computed tomography (CT) scans from community-living individuals participating in the Coronary Artery Risk Development in Young Adults (CARDIA) and Framingham Heart Study (FHS) cohorts.
Methods And Analysis:
We will determine the clinical relevance of CT-based mucus plugs and modifiable and genetic risk and protective factors associated with this process. We will evaluate the associations of mucus plugs with lung function, respiratory symptoms, and chronic bronchitis and examine whether 5-yr. persistent CT-based mucus plugs are associated with the decline in FEV1 and future COPD. Also, we will assess whether modifiable factors, including air pollution and marijuana smoking are associated with increased odds of CT-based mucus plugs and whether cardiorespiratory fitness is related in an opposing manner. Finally, we will determine genetic resilience/susceptibility to mucus pathology. We will use CT data from the FHS and CARDIA cohorts and genome-wide sequencing data from the TOPMed initiative to identify common and rare variants associated with CT-based mucus plugging.
Ethics And Dissemination:
The Mass General Brigham Institutional Review Board approved the study. Findings will be disseminated through peer-reviewed journals and at professional conferences.
Insights
Airway mucus plugs, common in chronic bronchitis and COPD, are now objectively assessed using CT scans in large community studies. This research explores their links to lung function, symptoms, and genetic factors.
Area of Science:
- Pulmonary Medicine
- Radiology
- Genetics
Background:
- Mucus pathology significantly impacts airway diseases such as chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD), affecting up to 32% of community-living individuals.
- Systematic study of airway mucus pathology in community settings is lacking.
- Chest computed tomography (CT) offers an objective method to assess mucus pathology.
Approach:
- Utilize CT scans from the Coronary Artery Risk Development in Young Adults (CARDIA) and Framingham Heart Study (FHS) cohorts for objective mucus plug assessment.
- Analyze associations between CT-identified mucus plugs, lung function, respiratory symptoms, and chronic bronchitis.
- Investigate modifiable risk factors (air pollution, marijuana smoking), cardiorespiratory fitness, and genetic factors (using TOPMed data) related to mucus pathology.
Key Points:
- Determine the clinical relevance of CT-based mucus plugs.
- Evaluate the association of persistent mucus plugs with FEV1 decline and future COPD risk.
- Identify modifiable and genetic factors influencing mucus plug development and resilience.
Conclusions:
- This study will provide objective insights into airway mucus pathology in the general population.
- Findings will elucidate the role of mucus plugs in disease progression and identify potential targets for intervention.
- The research aims to bridge the gap between imaging findings and clinical outcomes in airway diseases.
