Measures of ventilation heterogeneity mapped with hyperpolarized helium-3 MRI demonstrate a T2-high phenotype in asthma.
helium-3 lung MRI
hyperpolarized lung MRI
maldistribution of ventilation
severe asthma
ventilation heterogeneity
Journal
Pediatric pulmonology
ISSN: 1099-0496
Titre abrégé: Pediatr Pulmonol
Pays: United States
ID NLM: 8510590
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
02
12
2020
received:
22
08
2020
accepted:
07
01
2021
pubmed:
24
2
2021
medline:
25
11
2021
entrez:
23
2
2021
Statut:
ppublish
Résumé
Hyperpolarized gas with helium (HHe-3) MR (magnetic resonance) is a noninvasive imaging method which maps and quantifies regions of ventilation heterogeneity (VH) in the lung. VH is an important feature of asthma, but little is known as to how VH informs patient phenotypes. To determine if VH indicators quantified by HHe-3 MR imaging (MRI) predict phenotypic characteristics and map to regions of inflammation in children with problematic wheeze or asthma. Sixty children with poorly-controlled wheeze or asthma underwent HHe-3 MRI, including 22 with bronchoalveolar lavage (BAL). The HHe-3 signal intensity defined four ventilation compartments. The non-ventilated and hypoventilated compartments divided by the total lung volume defined a VH index (VHI %). Children with VHI % in the upper quartile had significantly greater airflow limitation, bronchodilator responsiveness, blood eosinophils, expired nitric oxide (FeNO), and BAL eosinophilic or neutrophilic granulocyte patterns compared to children with VHI % in the lower quartile. Lavage return from hypoventilated bronchial segments had greater eosinophil % than from ventilated segments. In children with asthma, greater VHI % as measured by HHe-3 MRI identifies a severe phenotype with higher type 2 inflammatory markers, and maps to regions of lung eosinophilia. Listed on ClinicalTrials. gov (NCT02577497).
Sections du résumé
BACKGROUND
Hyperpolarized gas with helium (HHe-3) MR (magnetic resonance) is a noninvasive imaging method which maps and quantifies regions of ventilation heterogeneity (VH) in the lung. VH is an important feature of asthma, but little is known as to how VH informs patient phenotypes.
PURPOSE
To determine if VH indicators quantified by HHe-3 MR imaging (MRI) predict phenotypic characteristics and map to regions of inflammation in children with problematic wheeze or asthma.
METHODS
Sixty children with poorly-controlled wheeze or asthma underwent HHe-3 MRI, including 22 with bronchoalveolar lavage (BAL). The HHe-3 signal intensity defined four ventilation compartments. The non-ventilated and hypoventilated compartments divided by the total lung volume defined a VH index (VHI %).
RESULTS
Children with VHI % in the upper quartile had significantly greater airflow limitation, bronchodilator responsiveness, blood eosinophils, expired nitric oxide (FeNO), and BAL eosinophilic or neutrophilic granulocyte patterns compared to children with VHI % in the lower quartile. Lavage return from hypoventilated bronchial segments had greater eosinophil % than from ventilated segments.
CONCLUSION
In children with asthma, greater VHI % as measured by HHe-3 MRI identifies a severe phenotype with higher type 2 inflammatory markers, and maps to regions of lung eosinophilia. Listed on ClinicalTrials. gov (NCT02577497).
Identifiants
pubmed: 33621442
doi: 10.1002/ppul.25303
pmc: PMC8137549
mid: NIHMS1673635
doi:
Substances chimiques
Isotopes
0
Helium
206GF3GB41
Helium-3
I83W8ELB18
Banques de données
ClinicalTrials.gov
['NCT02577497']
Types de publication
Clinical Trial
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1440-1448Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL132177
Pays : United States
Organisme : NIAID NIH HHS
ID : R21 AI151496
Pays : United States
Organisme : NHLBI NIH HHS
ID : U10 HL109250
Pays : United States
Organisme : NIBIB NIH HHS
ID : R21 EB022309
Pays : United States
Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
Eur Respir J. 2015 Jan;45(1):87-97
pubmed: 25359343
Chest. 2006 Oct;130(4):1055-62
pubmed: 17035438
J Allergy Clin Immunol. 2018 Jun;141(6):2048-2060.e13
pubmed: 28939412
Chest. 2019 Jun;155(6):1178-1189
pubmed: 30910637
Eur Respir J. 2000 Jan;15(1):217-31
pubmed: 10678650
Acad Radiol. 2008 Jun;15(6):753-62
pubmed: 18486011
J Clin Invest. 2018 Mar 1;128(3):997-1009
pubmed: 29400693
J Magn Reson Imaging. 2011 Oct;34(4):831-41
pubmed: 21837781
Eur Respir J. 2014 Feb;43(2):343-73
pubmed: 24337046
Respirology. 2012 Nov;17(8):1237-46
pubmed: 22889229
J Allergy Clin Immunol. 2018 Mar;141(3):1140-1141.e4
pubmed: 29129582
Am J Respir Crit Care Med. 2018 Apr 1;197(7):876-884
pubmed: 29313707
Radiology. 1999 Mar;210(3):851-7
pubmed: 10207491
J Magn Reson Imaging. 1997 May-Jun;7(3):538-43
pubmed: 9170039
J Allergy Clin Immunol Pract. 2019 Jul - Aug;7(6):1803-1812.e10
pubmed: 30654199
J Allergy Clin Immunol. 2003 Jun;111(6):1205-11
pubmed: 12789218
J Magn Reson Imaging. 2014 May;39(5):1230-7
pubmed: 24006239
Thorax. 2014 Jan;69(1):63-71
pubmed: 23956019
Radiology. 2015 Jan;274(1):250-9
pubmed: 25144646
J Allergy Clin Immunol. 2016 Mar;137(3):789-96.e7
pubmed: 26521043
Radiology. 2009 Feb;250(2):567-75
pubmed: 19188325
J Allergy Clin Immunol. 2007 May;119(5):1072-8
pubmed: 17353032
Am J Respir Crit Care Med. 1999 Jan;159(1):179-87
pubmed: 9872837
J Allergy Clin Immunol Pract. 2018 Mar - Apr;6(2):545-554.e4
pubmed: 28866107