ASSOCIATION OF MUCUS PLUGS WITH AIRFLOW OBSTRUCTION AND AIRWAY INFLAMMATION IN MODERATE TO SEVERE ASTHMA

Abstract

SESSION TITLE: Allergy and Airway Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Mucus plugs develop in patients with severe asthma. This retrospective study assessed the link between mucus plugs and airflow obstruction and airway inflammation in patients with moderate to severe asthma. METHODS: Sixty-one adult asthma patients who underwent high resolution CT (HRCT) between August 2018 and August 2019 were enrolled in this study. Airways within the 2 cm peripheral zone on HRCT were excluded from assessment. Mucus plugs were defined as complete occlusion of an airway. The segments of each lobe were examined systematically in HRCT scans and the patients were divided into two groups based on the presence or absence of mucus plugs. Clinical and laboratory parameters, including blood and sputum eosinophil count, serum IgE levels, fractional exhaled nitric oxide (FeNO), oscillometry, and spirometry were compared between the two groups. RESULTS: Mucus plugs were detected in 38 patients (62%). Patients with mucus plugs had significantly higher total serum IgE (390 vs. 69 IU/ml) and FeNO (43 vs. 21 ppb) than those without mucus plugs on HRCT. Patients with mucus plugs also exhibited a lower %FEV1 than those without mucus plugs (69.4% vs. 84.6%, respectively). Respiratory reactance parameters, including measurements of reactance at 5 Hz (X5), resonant frequency (Fres), and low-frequency reactance area (ALX), were all significantly greater in patients with mucus plugs than in those without mucus plugs. However, there was no difference in respiratory resistance between the two groups. CONCLUSIONS: Airway mucus plugs detected on HRCT were associated with airflow obstruction and airway inflammation in moderate to severe asthma. CLINICAL IMPLICATIONS: HRCT should be performed in moderate to severe asthma patients to detect mucus plugs. DISCLOSURES: No relevant relationships by Taisuke Akamatsu, source=Web Response No relevant relationships by Kazuhiro Asada, source=Web Response No relevant relationships by Satoshi Kato, source=Web Response No relevant relationships by YUTARO KISHIMOTO, source=Web Response No relevant relationships by Toshihiro Masuda, source=Web Response No relevant relationships by Hiromasa Nakayasu, source=Web Response No relevant relationships by Kyohei Oishi, source=Web Response No relevant relationships by Mika Saigusa, source=Web Response No relevant relationships by Toshihiro Shirai, source=Web Response No relevant relationships by Shingo Takahashi, source=Web Response No relevant relationships by KANAMI TAMURA, source=Web Response No relevant relationships by Akito Yamamoto, source=Web Response