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Central airway and peripheral lung structures in airway disease-dominant COPD
The concept that the small airway is a primary pathological site for all COPD phenotypes has been challenged by recent findings that the disease starts from the central airways in COPD subgroups and that a smaller central airway tree increases COPD risk. This study aimed to examine whether the compu...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983277/ https://www.ncbi.nlm.nih.gov/pubmed/33778061 http://dx.doi.org/10.1183/23120541.00672-2020 |
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author | Tanabe, Naoya Shimizu, Kaoruko Terada, Kunihiko Sato, Susumu Suzuki, Masaru Shima, Hiroshi Oguma, Akira Oguma, Tsuyoshi Konno, Satoshi Nishimura, Masaharu Hirai, Toyohiro |
author_facet | Tanabe, Naoya Shimizu, Kaoruko Terada, Kunihiko Sato, Susumu Suzuki, Masaru Shima, Hiroshi Oguma, Akira Oguma, Tsuyoshi Konno, Satoshi Nishimura, Masaharu Hirai, Toyohiro |
author_sort | Tanabe, Naoya |
collection | PubMed |
description | The concept that the small airway is a primary pathological site for all COPD phenotypes has been challenged by recent findings that the disease starts from the central airways in COPD subgroups and that a smaller central airway tree increases COPD risk. This study aimed to examine whether the computed tomography (CT)-based airway disease-dominant (AD) subtype, defined using the central airway dimension, was less associated with small airway dysfunction (SAD) on CT, compared to the emphysema-dominant (ED) subtype. COPD patients were categorised into mild, AD, ED and mixed groups based on wall area per cent (WA%) of the segmental airways and low attenuation volume per cent in the Kyoto–Himeji (n=189) and Hokkaido COPD cohorts (n=93). The volume per cent of SAD regions (SAD%) was obtained by nonrigidly registering inspiratory and expiratory CT. The AD group had a lower SAD% than the ED group and similar SAD% to the mild group. The AD group had a smaller lumen size of airways proximal to the segmental airways and more frequent asthma history before age 40 years than the ED group. In multivariable analyses, while the AD and ED groups were similarly associated with greater airflow limitation, the ED, but not the AD, group was associated with greater SAD%, whereas the AD, but not the ED, group was associated with a smaller central airway size. The CT-based AD COPD subtype might be associated with a smaller central airway tree and asthma history, but not with peripheral lung pathologies including small airway disease, unlike the ED subtype. |
format | Online Article Text |
id | pubmed-7983277 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-79832772021-03-26 Central airway and peripheral lung structures in airway disease-dominant COPD Tanabe, Naoya Shimizu, Kaoruko Terada, Kunihiko Sato, Susumu Suzuki, Masaru Shima, Hiroshi Oguma, Akira Oguma, Tsuyoshi Konno, Satoshi Nishimura, Masaharu Hirai, Toyohiro ERJ Open Res Original Articles The concept that the small airway is a primary pathological site for all COPD phenotypes has been challenged by recent findings that the disease starts from the central airways in COPD subgroups and that a smaller central airway tree increases COPD risk. This study aimed to examine whether the computed tomography (CT)-based airway disease-dominant (AD) subtype, defined using the central airway dimension, was less associated with small airway dysfunction (SAD) on CT, compared to the emphysema-dominant (ED) subtype. COPD patients were categorised into mild, AD, ED and mixed groups based on wall area per cent (WA%) of the segmental airways and low attenuation volume per cent in the Kyoto–Himeji (n=189) and Hokkaido COPD cohorts (n=93). The volume per cent of SAD regions (SAD%) was obtained by nonrigidly registering inspiratory and expiratory CT. The AD group had a lower SAD% than the ED group and similar SAD% to the mild group. The AD group had a smaller lumen size of airways proximal to the segmental airways and more frequent asthma history before age 40 years than the ED group. In multivariable analyses, while the AD and ED groups were similarly associated with greater airflow limitation, the ED, but not the AD, group was associated with greater SAD%, whereas the AD, but not the ED, group was associated with a smaller central airway size. The CT-based AD COPD subtype might be associated with a smaller central airway tree and asthma history, but not with peripheral lung pathologies including small airway disease, unlike the ED subtype. European Respiratory Society 2021-03-22 /pmc/articles/PMC7983277/ /pubmed/33778061 http://dx.doi.org/10.1183/23120541.00672-2020 Text en Copyright ©The authors 2021 http://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org) |
spellingShingle | Original Articles Tanabe, Naoya Shimizu, Kaoruko Terada, Kunihiko Sato, Susumu Suzuki, Masaru Shima, Hiroshi Oguma, Akira Oguma, Tsuyoshi Konno, Satoshi Nishimura, Masaharu Hirai, Toyohiro Central airway and peripheral lung structures in airway disease-dominant COPD |
title | Central airway and peripheral lung structures in airway disease-dominant COPD |
title_full | Central airway and peripheral lung structures in airway disease-dominant COPD |
title_fullStr | Central airway and peripheral lung structures in airway disease-dominant COPD |
title_full_unstemmed | Central airway and peripheral lung structures in airway disease-dominant COPD |
title_short | Central airway and peripheral lung structures in airway disease-dominant COPD |
title_sort | central airway and peripheral lung structures in airway disease-dominant copd |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983277/ https://www.ncbi.nlm.nih.gov/pubmed/33778061 http://dx.doi.org/10.1183/23120541.00672-2020 |
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