Meakins-Christie Laboratories, Research Institute of the McGill University Health Centre, Department of Medicine, McGill University, Montréal, QC, Canada.
Department of Physics, Toronto Metropolitan University, Toronto, Canada.
Respir Res. 2024 Jan 23;25(1):52. doi: 10.1186/s12931-024-02665-w.
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 and FEV/FVC. Mucus score was significantly correlated with sputum eosinophils. Among former and active smokers, mucus score was correlated with sputum neutrophils. Mucus score was positively associated with FeNO in non-smoking subjects. The lumen dimensions of the main and lobar bronchi were significantly inversely correlated with mucus score.
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.
在哮喘患者的气道中已经描述了粘液栓，特别是那些与 2 型炎症和痰嗜酸性粒细胞增多相关的粘液栓。在目前的研究中，我们解决了吸烟、中性粒细胞炎症和气道尺寸是否影响粘液栓的流行率的问题。
在一组中重度哮喘患者（n=50）中，包括一组前吸烟者和现吸烟者，使用基于胸部计算机断层扫描的半定量评分来量化粘液栓的流行率。根据患者的吸烟状况测试了粘液评分、痰炎症特征和气道结构之间的关系。
在哮喘患者中（37%为前或现吸烟者），74%至少有一个粘液栓。中位数评分为 3，与吸烟状况无关。粘液评分与 FEV 和 FEV/FVC 之间存在显著但较弱的相关性。粘液评分与痰嗜酸性粒细胞显著相关。在前吸烟者和现吸烟者中，粘液评分与痰中性粒细胞相关。在非吸烟者中，粘液评分与 FeNO 呈正相关。主支气管和肺叶支气管的管腔尺寸与粘液评分呈显著负相关。
气道粘液栓可以定义一种具有改变的气道结构的哮喘表型，并且可以根据其吸烟状况出现在具有中性粒细胞或嗜酸性粒细胞痰的哮喘患者中。
