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Can HRCT be used as a marker of airway remodelling in children with difficult asthma?
Respir Res. 2006 Mar 27; 7:46.RR

Abstract

BACKGROUND

Whole airway wall thickening on high resolution computed tomography (HRCT) is reported to parallel thickening of the bronchial epithelial reticular basement membrane (RBM) in adult asthmatics. A similar relationship in children with difficult asthma (DA), in whom RBM thickening is a known feature, may allow the use of HRCT as a non-invasive marker of airway remodelling. We evaluated this relationship in children with DA.

METHODS

27 children (median age 10.5 [range 4.1-16.7] years) with DA, underwent endobronchial biopsy from the right lower lobe and HRCT less than 4 months apart. HRCTs were assessed for bronchial wall thickening (BWT) of the right lower lobe using semi-quantitative and quantitative scoring techniques. The semi-quantitative score (grade 0-4) was an overall assessment of BWT of all clearly identifiable airways in HRCT scans. The quantitative score (BWT %; defined as [airway outer diameter - airway lumen diameter]/airway outer diameter x100) was the average score of all airways visible and calculated using electronic endpoint callipers. RBM thickness in endobronchial biopsies was measured using image analysis. 23/27 subjects performed spirometry and the relationships between RBM thickness and BWT with airflow obstruction evaluated.

RESULTS

Median RBM thickness in endobronchial biopsies was 6.7(range 4.6-10.0) microm. Median qualitative score for BWT of the right lower lobe was 1(range 0-1.5) and quantitative score was 54.3 (range 48.2-65.6)%. There was no relationship between RBM thickness and BWT in the right lower lobe using either scoring technique. No relationship was found between FEV1 and BWT or RBM thickness.

CONCLUSION

Although a relationship between RBM thickness and BWT on HRCT has been found in adults with asthma, this relationship does not appear to hold true in children with DA.

Links

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Authors+Show Affiliations

Saglani S
Respiratory Paediatrics, Royal Brompton Hospital, London, UK. s.saglani@rbht.nhs.uk
Papaioannou G
No affiliation info available
Khoo L
No affiliation info available
Ujita M
No affiliation info available
Jeffery PK
No affiliation info available
Owens C
No affiliation info available
Hansell DM
No affiliation info available
Payne DN
No affiliation info available
Bush A
No affiliation info available

MeSH

AdolescentAsthmaBasement MembraneBiopsyBronchiChildChild, PreschoolForced Expiratory VolumeHumansSpirometryTomography, X-Ray Computed

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

16566832

Citation

Saglani, S, et al. "Can HRCT Be Used as a Marker of Airway Remodelling in Children With Difficult Asthma?" Respiratory Research, vol. 7, 2006, p. 46.
Saglani S, Papaioannou G, Khoo L, et al. Can HRCT be used as a marker of airway remodelling in children with difficult asthma? Respir Res. 2006;7:46.
Saglani, S., Papaioannou, G., Khoo, L., Ujita, M., Jeffery, P. K., Owens, C., Hansell, D. M., Payne, D. N., & Bush, A. (2006). Can HRCT be used as a marker of airway remodelling in children with difficult asthma? Respiratory Research, 7, 46.
Saglani S, et al. Can HRCT Be Used as a Marker of Airway Remodelling in Children With Difficult Asthma. Respir Res. 2006 Mar 27;7:46. PubMed PMID: 16566832.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can HRCT be used as a marker of airway remodelling in children with difficult asthma? AU - Saglani,S, AU - Papaioannou,G, AU - Khoo,L, AU - Ujita,M, AU - Jeffery,P K, AU - Owens,C, AU - Hansell,D M, AU - Payne,D N, AU - Bush,A, Y1 - 2006/03/27/ PY - 2005/09/12/received PY - 2006/03/27/accepted PY - 2006/3/29/pubmed PY - 2006/11/15/medline PY - 2006/3/29/entrez SP - 46 EP - 46 JF - Respiratory research JO - Respir Res VL - 7 N2 - BACKGROUND: Whole airway wall thickening on high resolution computed tomography (HRCT) is reported to parallel thickening of the bronchial epithelial reticular basement membrane (RBM) in adult asthmatics. A similar relationship in children with difficult asthma (DA), in whom RBM thickening is a known feature, may allow the use of HRCT as a non-invasive marker of airway remodelling. We evaluated this relationship in children with DA. METHODS: 27 children (median age 10.5 [range 4.1-16.7] years) with DA, underwent endobronchial biopsy from the right lower lobe and HRCT less than 4 months apart. HRCTs were assessed for bronchial wall thickening (BWT) of the right lower lobe using semi-quantitative and quantitative scoring techniques. The semi-quantitative score (grade 0-4) was an overall assessment of BWT of all clearly identifiable airways in HRCT scans. The quantitative score (BWT %; defined as [airway outer diameter - airway lumen diameter]/airway outer diameter x100) was the average score of all airways visible and calculated using electronic endpoint callipers. RBM thickness in endobronchial biopsies was measured using image analysis. 23/27 subjects performed spirometry and the relationships between RBM thickness and BWT with airflow obstruction evaluated. RESULTS: Median RBM thickness in endobronchial biopsies was 6.7(range 4.6-10.0) microm. Median qualitative score for BWT of the right lower lobe was 1(range 0-1.5) and quantitative score was 54.3 (range 48.2-65.6)%. There was no relationship between RBM thickness and BWT in the right lower lobe using either scoring technique. No relationship was found between FEV1 and BWT or RBM thickness. CONCLUSION: Although a relationship between RBM thickness and BWT on HRCT has been found in adults with asthma, this relationship does not appear to hold true in children with DA. SN - 1465-993X UR - https://www.unboundmedicine.com/medline/citation/16566832/Can_HRCT_be_used_as_a_marker_of_airway_remodelling_in_children_with_difficult_asthma DB - PRIME DP - Unbound Medicine ER -