Chest
Original ResearchAsthmaThe Use of Endobronchial Ultrasonography in Assessment of Bronchial Wall Remodeling in Patients With Asthma
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Patients
Thirty-five patients with bronchial asthma and 23 control subjects with clinical indications for bronchoscopy were enrolled in the study. The diagnosis of asthma was established according to Global Initiative for Asthma guidelines. Sixteen patients had mild asthma, 9 patients had moderate asthma, and the remaining 10 patients had severe asthma. In the control group, bronchofiberoscopy was performed to diagnosis hemoptysis and persistent cough or to exclude malignancy. The characteristics of the
Results
Bronchoscopy with EBUS was performed in 62 patients. In 4 patients, we did not obtain an ultrasonographic image that allowed assessment of the bronchial wall, so 58 patients were included in the final analysis. No complications were observed.
EBUS enabled us to measure the total bronchial wall thickness, its particular layers, and WA. The analysis of repeatability of the measurements performed by the two independent radiologists did not show significant discrepancies (L1, p = 0.6928; L2, p =
Discussion
Since EBUS was introduced in the 1990s, it has been continuously investigated for new clinical applications. Yamasaki et al4 have used EBUS to show the diminishing of subepithelial edema in patients with asthma after montelukast therapy. Miyazu et al5 applied this technique to the diagnosis of relapsing polychondritis with tracheobronchial malacia. Irani et al6 used the relative area of the layer measured with EBUS to detect lung transplant rejection or infection, and Murgu et al7 applied this
Conclusions
Besides the methods used to date, including HRCT scans and bronchial biopsies, EBUS may become a new technique for assessing asthma remodeling. In this preliminary study, EBUS was used in asthma research for the first time. Our results show greater thickness of the whole bronchial wall and its particular layers, which correlates positively with RBM and negatively with FEV1, and indicates the relationship between these parameters and asthma severity. Thus, our findings suggest the possibility of
Acknowledgments
Author contributions: Drs. Soja, Grzanka, Sładek, Niżankowska-Mogilnicka, and Szczeklik were responsible for conception and design of the study. Drs. Soja, Grzanka, Sładek, Okoń, Ćmiel, Mikoś, Mikrut, Pulka, Gross-Sondej, Niżankowska-Mogilnicka, and Szczeklik were responsible for analysis and interpretation of the data, manuscript preparation, and final approval of the article.
Financial/nonfinancial disclosures: The authors have reported to the American College of Chest Physicians that no
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Funding/Support: The study was funded by the Polish Scientific Research Committee (grant KBN 3 PO5B022 25).
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