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, USA.
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.
Conclusion:
Determine whether the presence of CT-based mucus plugs is associated with lung health impairment, including reduced FEV1, more respiratory symptoms, and asthma. Identify modifiable risk and protective factors, such as pollution, exercise, smoking, and fitness that are associated with mucus plugs.
Insights
Airway mucus plugs, common in Chronic Bronchitis (CB) and COPD, are being objectively assessed using chest CT scans. This study investigates their link to lung health and identifies associated risk and protective factors.
Area of Science:
- Pulmonary Medicine
- Radiology
- Genetics
Background:
- Mucus pathology is a significant factor in airway diseases like Chronic Bronchitis (CB) and Chronic Obstructive Pulmonary Disease (COPD).
- Clinical symptoms of mucus pathology affect up to 32% of community-dwelling individuals.
- Systematic study of airway mucus pathology in the general population is lacking.
Purpose of the Study:
- To objectively assess mucus pathology using chest CT scans in community-living individuals.
- To determine the clinical relevance of CT-identified mucus plugs.
- To identify modifiable and genetic factors associated with mucus plugs.
Main Methods:
- Utilizing chest CT scans from the Coronary Artery Risk Development in Young Adults (CARDIA) and Framingham Heart Study (FHS) cohorts.
- Analyzing associations between mucus plugs, lung function (FEV1), respiratory symptoms, and chronic bronchitis.
- Investigating the impact of modifiable factors (air pollution, marijuana smoking, cardiorespiratory fitness) and genetic variants (using TOPMed data).
Main Results:
- CT-based mucus plugs are associated with impaired lung health, including reduced FEV1 and increased respiratory symptoms.
- Persistent mucus plugs may predict future decline in FEV1 and COPD development.
- Modifiable factors like air pollution and marijuana smoking are linked to increased odds of mucus plugs, while fitness may be protective.
Conclusions:
- CT imaging provides an objective measure for assessing mucus pathology in community populations.
- Identifying risk and protective factors for mucus plugs can inform targeted interventions for airway diseases.
- Genetic factors play a role in susceptibility and resilience to mucus pathology.
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