Utility of MostGraph in asthma management: Comparative study with cough-variant asthma

Area of Science:

• Pulmonary Medicine
• Respiratory Physiology
• Diagnostic Imaging

Background:

• Non-invasive methods for detailed airway pathology assessment in asthma are limited.
• Accurate evaluation of structural airway abnormalities, particularly in the peripheral airways, remains challenging.
• The MostGraph, utilizing impulse oscillation system (IOS), offers non-invasive measurement of airway resistance and reactance.

Purpose of the Study:

• To evaluate the utility of the MostGraph in distinguishing airway pathology between bronchial asthma (BA) and cough variant asthma (CVA).
• To focus on assessing peripheral airway involvement in different asthma phenotypes.
• To explore the correlation of MostGraph indices with spirometry and fractional exhaled nitric oxide (FeNO).

Main Methods:

• A cross-sectional study enrolled 383 patients with stable respiratory symptoms (203 BA, 180 CVA).
• All participants underwent spirometry, IOS assessment using the MostGraph, blood tests, and FeNO measurement.
• Data analysis focused on comparing airway obstruction and peripheral impairment indices between BA and CVA groups.

Main Results:

• Bronchial asthma (BA) patients exhibited significantly greater airway obstruction (%FEV1/predicted FEV1) and peripheral impairment (V50/V25, MMF) compared to cough variant asthma (CVA).
• Higher R5-R20 values (indicating peripheral airway resistance) were observed in BA both before and after bronchodilator use.
• MostGraph indices, particularly R5-R20 and Fres, showed significant correlations with spirometry in BA, suggesting peripheral airway involvement and potential remodeling.

Conclusions:

• MostGraph indices, when combined with spirometry, provide a valuable non-invasive tool for characterizing peripheral airway abnormalities in asthma.
• These findings may reflect remodeling-related changes in BA and support enhanced airway monitoring in asthma management.
• The study highlights the potential of IOS-based measurements for differentiating asthma phenotypes and assessing disease severity.