Mucus plugs in the airways of asthmatic subjects and smoking status.

Journal

Respiratory research
ISSN: 1465-993X
Titre abrégé: Respir Res
Pays: England
ID NLM: 101090633

Informations de publication

Date de publication:
23 Jan 2024
Historique:
received: 03 09 2023
accepted: 02 01 2024
medline: 24 1 2024
pubmed: 24 1 2024
entrez: 23 1 2024
Statut: epublish

Résumé

Mucus plugs have been described in the airways of asthmatic subjects, particularly those with associated with type 2 inflammation and sputum eosinophilia. In the current study we addressed the question of whether smoking, neutrophilic inflammation and airway dimensions affected the prevalence of mucus plugs. In a cohort of moderate to severe asthmatics (n = 50), including a group of ex-smokers and current smokers, the prevalence of mucus plugs was quantified using a semi-quantitative score based on thoracic computerized tomography. The relationships between mucus score, sputum inflammatory profile and airway architecture were tested according to patient's smoking status. Among the asthmatics (37% former or active smokers), 74% had at least one mucus plug. The median score was 3 and was unrelated to smoking status. A significant but weak correlation was found between mucus score, FEV Airway mucus plugs could define an asthma phenotype with altered airway architecture and can occur in asthmatic subjects with either neutrophilic or eosinophilic sputum according to their smoking status.

Sections du résumé

BACKGROUND BACKGROUND
Mucus plugs have been described in the airways of asthmatic subjects, particularly those with associated with type 2 inflammation and sputum eosinophilia. In the current study we addressed the question of whether smoking, neutrophilic inflammation and airway dimensions affected the prevalence of mucus plugs.
METHODS METHODS
In a cohort of moderate to severe asthmatics (n = 50), including a group of ex-smokers and current smokers, the prevalence of mucus plugs was quantified using a semi-quantitative score based on thoracic computerized tomography. The relationships between mucus score, sputum inflammatory profile and airway architecture were tested according to patient's smoking status.
RESULTS RESULTS
Among the asthmatics (37% former or active smokers), 74% had at least one mucus plug. The median score was 3 and was unrelated to smoking status. A significant but weak correlation was found between mucus score, FEV
CONCLUSION CONCLUSIONS
Airway mucus plugs could define an asthma phenotype with altered airway architecture and can occur in asthmatic subjects with either neutrophilic or eosinophilic sputum according to their smoking status.

Identifiants

DOI: 10.1186/s12931-024-02665-w PMID: 38263221
pubmed: 38263221
doi: 10.1186/s12931-024-02665-w
pii: 10.1186/s12931-024-02665-w
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

52

Informations de copyright

© 2024. The Author(s).

Références

Kaur R, Chupp G. Phenotypes and endotypes of adult asthma: moving toward precision medicine. J Allergy Clin Immunol. 2019;144(1):1–12.
doi: 10.1016/j.jaci.2019.05.031 pubmed: 31277742
Dunican EM, Elicker BM, Henry T et al. Mucus plugs and Emphysema in the pathophysiology of airflow obstruction and hypoxemia in smokers. Am J Respir Crit Care Med 2020.
Tran C, Singh GV, Haider E, et al. Luminal mucus plugs are spatially associated with airway wall thickening in severe COPD and asthma: a single-centered, retrospective, observational study. Respir Med. 2022;202:106982.
doi: 10.1016/j.rmed.2022.106982 pubmed: 36116144
Dunican EM, Elicker BM, Gierada DS, et al. Mucus plugs in patients with asthma linked to eosinophilia and airflow obstruction. J Clin Invest. 2018;128(3):997–1009.
doi: 10.1172/JCI95693 pubmed: 29400693 pmcid: 5824874
Tang M, Elicker BM, Henry T, et al. Mucus plugs persist in Asthma, and changes in mucus plugs associate with changes in Airflow over Time. Am J Respir Crit Care Med. 2022;205(9):1036–45.
doi: 10.1164/rccm.202110-2265OC pubmed: 35104436 pmcid: 9851493
Chan R, Duraikannu C, Lipworth B. Clinical associations of mucus plugging in moderate to severe asthma. J Allergy Clin Immunol Pract. 2022;S2213–2198(22):00943–6.
DG, EM, KJ, et al. Mucus plugs in Asthma at CT Associated with Regional Ventilation defects at 3He MRI. Radiology. 2022;303(1):184–90.
Persson EK, Verstraete K, Heyndrickx I et al. Protein crystallization promotes type 2 immunity and is reversible by antibody treatment. Science 2019;364(6442).
Ueki S, Miyabe Y, Yamamoto Y, et al. Charcot-Leyden crystals in eosinophilic inflammation: active cytolysis leads to crystal formation. Curr Allergy Asthma Rep. 2019;19(8):35.
doi: 10.1007/s11882-019-0868-0 pubmed: 31203469 pmcid: 6952074
Schofield JPR, Burg D, Nicholas B, et al. Stratification of asthma phenotypes by airway proteomic signatures. J Allergy Clin Immunol. 2019;144(1):70–82.
doi: 10.1016/j.jaci.2019.03.013 pubmed: 30928653
American Thoracic Society. Proceedings of the ATS workshop on refractory asthma: current understanding, recommendations, and unanswered questions. Am J Respir Crit Care Med. 2000;162(6):2341–51.
doi: 10.1164/ajrccm.162.6.ats9-00
Pepe C, Foley S, Shannon J, et al. Differences in airway remodeling between subjects with severe and moderate asthma. J Allergy Clin Immunol. 2005;116(3):544–9.
doi: 10.1016/j.jaci.2005.06.011 pubmed: 16159622
Kaminska M, Foley S, Maghni K, et al. Airway remodeling in subjects with severe asthma with or without chronic persistent airflow obstruction. J Allergy Clin Immunol. 2009;124(1):45–51e1.
doi: 10.1016/j.jaci.2009.03.049 pubmed: 19481790
Smith BM, Traboulsi H, Austin JHM, et al. Human airway branch variation and chronic obstructive pulmonary disease. PNAS. 2018;115(5):E974–81.
doi: 10.1073/pnas.1715564115 pubmed: 29339516 pmcid: 5798356
Pizzichini E, Leff JA, Reiss TF, et al. Montelukast reduces airway eosinophilic inflammation in asthma: a randomized, controlled trial. Eur Respir J. 1999;14(1):12–8.
doi: 10.1034/j.1399-3003.1999.14a04.x pubmed: 10489822
Dweik RA, Boggs PB, Erzurum SC, et al. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med. 2011;184(5):602–15.
doi: 10.1164/rccm.9120-11ST pubmed: 21885636 pmcid: 4408724
Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319–38.
doi: 10.1183/09031936.05.00034805 pubmed: 16055882
Kubach J, Lutter P, Bopp T, et al. Human CD4 + CD25 + regulatory T cells: proteome analysis identifies galectin-10 as a novel marker essential for their anergy and suppressive function. Blood. 2007;110(5):1550–8.
doi: 10.1182/blood-2007-01-069229 pubmed: 17502455
Noh S, Jin S, Park CO, et al. Elevated Galectin-10 expression of IL-22-Producing T cells in patients with atopic dermatitis. J Invest Dermatol. 2016;136(1):328–31.
doi: 10.1038/JID.2015.369 pubmed: 26763457
Svenningsen S, Haider E, Boylan C, et al. CT and functional MRI to evaluate airway mucus in severe asthma. Chest. 2019;155(6):1178–89.
doi: 10.1016/j.chest.2019.02.403 pubmed: 30910637
Tamura K, Shirai T, Hirai K, et al. Mucus plugs and small Airway Dysfunction in Asthma, COPD, and Asthma-COPD overlap. Allergy Asthma Immunol Res. 2022;14(2):196–209.
doi: 10.4168/aair.2022.14.2.196 pubmed: 35255537 pmcid: 8914605
Okajima Y, Come CE, Nardelli P, et al. Luminal plugging on chest CT scan: Association with lung function, quality of life, and COPD Clinical Phenotypes. Chest; 2020.
Bohadana A, Teculescu D, Martinet Y. Mechanisms of chronic airway obstruction in smokers. Respir Med. 2004;98(2):139–51.
doi: 10.1016/j.rmed.2003.09.005 pubmed: 14971877
Chassagnon G, Burgel P-R. Mucus plugs in medium-sized airways: a novel imaging biomarker for phenotyping chronic obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2021;203(8):932–4.
doi: 10.1164/rccm.202011-4178ED pubmed: 33264069 pmcid: 8048760
Al-Samri MT, Benedetti A, Préfontaine D, et al. Variability of sputum inflammatory cells in asthmatic patients receiving corticosteroid therapy: a prospective study using multiple samples. J Allergy Clin Immunol. 2010;125(5):1161–1163e4.
doi: 10.1016/j.jaci.2010.02.005 pubmed: 20392486
Chua JC, Douglass JA, Gillman A, O’Hehir RE, Meeusen EN. Galectin-10, a potential biomarker of eosinophilic airway inflammation. PLoS ONE. 2012;7(8):e42549.
doi: 10.1371/journal.pone.0042549 pubmed: 22880030 pmcid: 3412795
Nyenhuis SM, Alumkal P, Du J, Maybruck BT, Vinicky M, Ackerman SJ. Charcot-Leyden crystal protein/galectin-10 is a surrogate biomarker of eosinophilic airway inflammation in asthma. Biomark Med. 2019;13(9):715–24.
doi: 10.2217/bmm-2018-0280 pubmed: 31157540 pmcid: 6630493
O’Riordan TG, Zwang J, Smaldone GC. Mucociliary clearance in adult asthma. Am Rev Respir Dis. 1992;146(3):598–603.
doi: 10.1164/ajrccm/146.3.598 pubmed: 1519834
Corcoran TE, Huber AS, Hill SL, et al. Mucociliary Clearance differs in mild asthma by levels of type 2 inflammation. Chest. 2021;160(5):1604–13.
doi: 10.1016/j.chest.2021.05.013 pubmed: 34029561 pmcid: 8628176
Guntur VP, Manka LA, Moore CM, et al. Refractory neutrophilic asthma and ciliary genes. J Allergy Clin Immunol. 2022;149(6):1970–80.
doi: 10.1016/j.jaci.2021.12.761 pubmed: 35034774

Auteurs

Camille Audousset (C)

Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montréal, QC, Canada. Camille.audousset@chu-lille.fr.

Sana Swaleh (S)

Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montréal, QC, Canada.

Ron Olivenstein (R)

Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montréal, QC, Canada.

Motahareh Vameghestahbanati (M)

Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montréal, QC, Canada.

Miranda Kirby (M)

Department of Physics, Toronto Metropolitan University, Toronto, Canada.
Institute for Biomedical Engineering, Science and Technology (iBEST), St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.

Alexandre Semionov (A)

Department of Radiology, McGill University Health Centre, Montréal, Canada.

Benjamin M Smith (BM)

Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montréal, QC, Canada.

James G Martin (JG)

Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montréal, QC, Canada.

Classifications MeSH