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...
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doaj-1532173ef30e43489dec59e2899e57922021-04-06T10:24:09ZengEuropean Respiratory SocietyERJ Open Research2312-05412021-03-017110.1183/23120541.00672-202000672-2020Central airway and peripheral lung structures in airway disease-dominant COPDNaoya Tanabe0Kaoruko Shimizu1Kunihiko Terada2Susumu Sato3Masaru Suzuki4Hiroshi Shima5Akira Oguma6Tsuyoshi Oguma7Satoshi Konno8Masaharu Nishimura9Toyohiro Hirai10 Dept of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Dept of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan Terada Clinic, Respiratory Medicine and General Practice, Himeji, Japan Dept of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Dept of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan Dept of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Dept of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan Dept of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Dept of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan Dept of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan Dept of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan 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.http://openres.ersjournals.com/content/7/1/00672-2020.full |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Naoya Tanabe Kaoruko Shimizu Kunihiko Terada Susumu Sato Masaru Suzuki Hiroshi Shima Akira Oguma Tsuyoshi Oguma Satoshi Konno Masaharu Nishimura Toyohiro Hirai |
spellingShingle |
Naoya Tanabe Kaoruko Shimizu Kunihiko Terada Susumu Sato Masaru Suzuki Hiroshi Shima Akira Oguma Tsuyoshi Oguma Satoshi Konno Masaharu Nishimura Toyohiro Hirai Central airway and peripheral lung structures in airway disease-dominant COPD ERJ Open Research |
author_facet |
Naoya Tanabe Kaoruko Shimizu Kunihiko Terada Susumu Sato Masaru Suzuki Hiroshi Shima Akira Oguma Tsuyoshi Oguma Satoshi Konno Masaharu Nishimura Toyohiro Hirai |
author_sort |
Naoya Tanabe |
title |
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_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_sort |
central airway and peripheral lung structures in airway disease-dominant copd |
publisher |
European Respiratory Society |
series |
ERJ Open Research |
issn |
2312-0541 |
publishDate |
2021-03-01 |
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. |
url |
http://openres.ersjournals.com/content/7/1/00672-2020.full |
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