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Related Experiment Video

Updated: Jun 14, 2025

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Computed tomography-based measurements associated with rapid lung function decline in severe asthma.

Da Woon Sim1, Sanghun Choi2, Jinyoung Jeong2

  • 1Department of Allergy, Asthma and Clinical Immunology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
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Biomarkers like lower airway wall thickness and higher fractional exhaled nitric oxide (FeNO) can predict accelerated lung function decline in severe asthma. Early management for patients with these indicators may help slow disease progression.

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Area of Science:

  • Pulmonary Medicine
  • Radiology
  • Biomarker Discovery

Background:

  • Severe asthma patients face lung function decline (LFD), but reliable predictive biomarkers are lacking.
  • Understanding predictors of accelerated LFD is crucial for timely intervention.

Purpose of the Study:

  • To identify variables associated with previous LFD in severe asthma.
  • To explore computed tomography (CT) imaging features and biomarkers in relation to LFD groups.

Main Methods:

  • 102 severe asthma patients' CT scans analyzed for airway wall thickness (WT) and hydraulic diameter.
  • Functional small airway disease and emphysema quantified.
  • Annual lung function changes calculated to define LFD groups.
  • Imaging metrics and biomarkers compared across LFD groups.

Main Results:

  • Lower WT and smaller hydraulic diameter correlated with enhanced LFD, independent of smoking status.
  • CT-derived emphysema and functional small airway disease did not significantly differ by LFD.
  • Higher fractional exhaled nitric oxide (FeNO) and MMP-9/TIMP-1 ratio observed in enhanced LFD groups.

Conclusions:

  • Reduced airway wall thickness on CT scans and elevated FeNO indicate increased airway inflammation and predict accelerated LFD in severe asthma.
  • Targeted management for severe asthma patients with low WT and high FeNO may mitigate LFD.