open access

Vol 86, No 6 (2018)
ORIGINAL PAPERS
Published online: 2018-12-30
Submitted: 2018-10-17
Accepted: 2018-12-18
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Influence of omalizumab therapy on airway remodeling assessed with high-resolution computed tomography (HRCT) in severe allergic asthma patients

Marek Przybyszowski, Kinga Paciorek, Weronika Zastrzeżyńska, Agnieszka Gawlewicz-Mroczka, Anna Trojan-Królikowska, Anna Orłowska, Jerzy Soja, Wiesław Pawlik, Krzysztof Sładek
DOI: 10.5603/ARM.a2018.0046
·
Pubmed: 30594995
·
Adv Respir Med 2018;86(6):282-290.

open access

Vol 86, No 6 (2018)
ORIGINAL PAPERS
Published online: 2018-12-30
Submitted: 2018-10-17
Accepted: 2018-12-18

Abstract

Introduction: Airway remodeling is an important factor in persistent obstruction in severe asthma. High resolution computed tomography (HRCT) is an effective method of detecting changes in airway structure. Our aim was to use HRCT to assess changes in airway remodeling in patients with severe allergic asthma who are treated with omalizumab.

Material and methods: In 12 patients with severe allergic asthma, HRCT was performed before and after treatment with omalizumab. In selected bronchi airways, parameters were calculated: bronchial wall area (BA), also corrected for body surface area (BSA); percentage of wall area (WA%); and the ratio of luminal area to total bronchial area (Ai/Ao). Clinical response to treatment was assessed using an asthma control questionnaire (ACQ), asthma quality of life questionnaire (AQLQ), and number of exacerbations per year. Assessment included spirometry and blood eosinophilia.

Results: Treatment resulted in significant improvement in ACQ (p = 0.035) and AQLQ (p = 0.001). We observed significant reduction in exacerbations per year (p = 0.002) and reduction of daily systemic steroid dose (p = 0.032). FEV1 and peripheral blood eospinophilia did not change (p = 0.846 and p = 0.221). Airway dimensions (Ai/Ao) of particular bronchi were consistent with the mean of the parameters calculated for all bronchi measured. Although we observed a significant decrease in WA (p = 0.002) and WA/BSA (p = 0.002), WA% and Ai/Ao did not improve (p = 0.39 and p = 0.49). We found no correlations between changes in airways and changes in spirometry or clinical parameters.

Conclusion: Despite clinical effectiveness of omalizumab, its effect on airway remodeling may be limited.

Abstract

Introduction: Airway remodeling is an important factor in persistent obstruction in severe asthma. High resolution computed tomography (HRCT) is an effective method of detecting changes in airway structure. Our aim was to use HRCT to assess changes in airway remodeling in patients with severe allergic asthma who are treated with omalizumab.

Material and methods: In 12 patients with severe allergic asthma, HRCT was performed before and after treatment with omalizumab. In selected bronchi airways, parameters were calculated: bronchial wall area (BA), also corrected for body surface area (BSA); percentage of wall area (WA%); and the ratio of luminal area to total bronchial area (Ai/Ao). Clinical response to treatment was assessed using an asthma control questionnaire (ACQ), asthma quality of life questionnaire (AQLQ), and number of exacerbations per year. Assessment included spirometry and blood eosinophilia.

Results: Treatment resulted in significant improvement in ACQ (p = 0.035) and AQLQ (p = 0.001). We observed significant reduction in exacerbations per year (p = 0.002) and reduction of daily systemic steroid dose (p = 0.032). FEV1 and peripheral blood eospinophilia did not change (p = 0.846 and p = 0.221). Airway dimensions (Ai/Ao) of particular bronchi were consistent with the mean of the parameters calculated for all bronchi measured. Although we observed a significant decrease in WA (p = 0.002) and WA/BSA (p = 0.002), WA% and Ai/Ao did not improve (p = 0.39 and p = 0.49). We found no correlations between changes in airways and changes in spirometry or clinical parameters.

Conclusion: Despite clinical effectiveness of omalizumab, its effect on airway remodeling may be limited.

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Keywords

asthma, airway remodeling, HRCT, omalizumab, biological treatment

About this article
Title

Influence of omalizumab therapy on airway remodeling assessed with high-resolution computed tomography (HRCT) in severe allergic asthma patients

Journal

Advances in Respiratory Medicine

Issue

Vol 86, No 6 (2018)

Pages

282-290

Published online

2018-12-30

DOI

10.5603/ARM.a2018.0046

Pubmed

30594995

Bibliographic record

Adv Respir Med 2018;86(6):282-290.

Keywords

asthma
airway remodeling
HRCT
omalizumab
biological treatment

Authors

Marek Przybyszowski
Kinga Paciorek
Weronika Zastrzeżyńska
Agnieszka Gawlewicz-Mroczka
Anna Trojan-Królikowska
Anna Orłowska
Jerzy Soja
Wiesław Pawlik
Krzysztof Sładek

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