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Airway structural involvement detected by quantitative computed tomography in controlled and uncontrolled asthma
Letícia Pereira Lima1, Izabela Maria Elias Silva1, Lucas Botelho Azevedo1
1Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
BMC Pulmonary Medicine
|July 2, 2026
Summary
Airway remodeling is present in controlled asthma, not just severe cases. Quantitative computed tomography (qCT) reveals these structural changes and their link to lung function in asthma patients.
Area of Science:
- Pulmonary Medicine
- Radiology
- Medical Imaging
Background:
- Airway remodeling is traditionally linked to severe, uncontrolled asthma.
- The extent of airway remodeling in controlled asthma is not well understood.
- Quantitative computed tomography (qCT) offers a method to assess airway morphology.
Purpose of the Study:
- To compare airway morphology in severe uncontrolled asthma (SA), controlled asthma (CA), and non-asthmatic controls (C) using qCT.
- To investigate correlations between qCT metrics and spirometric measurements.
Main Methods:
- A cross-sectional observational study included 76 participants (SA, CA, C).
- Subjects underwent spirometry and high-resolution chest CT.
- Automated software (YACTA v2.7) was used for quantitative CT analysis of airway metrics.
Main Results:
- Both SA and CA groups showed increased airway wall thickness (WT) and relative wall thickness (Wall%) compared to controls.
- Total airway count (TAC) was progressively higher from SA to CA to C.
- Lumen area was smaller in SA compared to CA and C.
- Forced expiratory volume in 1 second (FEV1) correlated positively with TAC and negatively with Wall%.
Conclusions:
- Airway remodeling is evident in controlled asthma, challenging traditional views.
- qCT is valuable for assessing airway structural changes in asthma pathophysiology.
- Further research is needed to understand structural involvement in controlled asthma.
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