Airway remodelling assessed by sputum and high-resolution computed tomography in asthma and COPD

• Published in: The European respiratory journal Vol. 24; no. 6; pp. 910 - 917
• Main Authors: Vignola, A.M, Paganin, F, Capieu, L, Scichilone, N, Bellia, M, Maakel, L, Bellia, V, Godard, P, Bousquet, J, Chanez, P
• Format: Journal Article
• Language: English
• Published: Leeds Eur Respiratory Soc 01-12-2004; Maney
• Subjects: Adult; Aged; Asthma - diagnostic imaging; Asthma - physiopathology; Biological and medical sciences; Chronic obstructive pulmonary disease, asthma; Female; Humans; Male; Matrix Metalloproteinase 9 - metabolism; Medical sciences; Middle Aged; Pancreatic Elastase - metabolism; Pneumology; Pulmonary Disease, Chronic Obstructive - diagnostic imaging; Pulmonary Disease, Chronic Obstructive - physiopathology; Respiratory Function Tests; Sputum - chemistry; Statistics, Nonparametric; Tissue Inhibitor of Metalloproteinase-1 - metabolism; Tomography, X-Ray Computed; Lung disease; Chronic; High resolution; Radiodiagnosis; Respiratory disease; Sputum; Bronchus disease; Medical imagery; Computerized axial tomography; Obstructive pulmonary disease; Airway remodelling asthma chronic obstructive pulmonary disease high-resolution computed tomography sputum; Asthma
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/09031936.04.00032603

It is not known whether sputum elastase, metalloproteinase (MMP)-9 and tissue-inhibitor metalloproteinase (TIMP)-1 are related to structural changes of the airways, as assessed by high-resolution computed tomography (HRCT) scan. The relationships between these markers and the magnitude of structural changes of the airways in asthma and chronic obstructive pulmonary disease (COPD) were assessed. Induced sputum and HRCT scan were performed in 30 asthmatics (14 mild and 16 severe) and in 12 patients with COPD. A greater extent of HRCT scan abnormalities was found in COPD than in severe and mild asthmatics. HRCT scan abnormalities correlated with the degree of airway obstruction in COPD and in severe asthma. HRCT scan abnormalities also correlated with the levels of sputum elastase both in COPD and in severe asthma. HRCT scan abnormalities were associated with sputum MMP-9/TIMP-1 ratio in mild asthma, severe asthma and COPD. In conclusion, this study demonstrates that sputum elastase and the metalloproteinase-9/tissue-inhibitor metalloproteinase-1 ratio are associated with the magnitude of high-resolution computed tomography scan abnormalities of the airways in asthma and chronic obstructive pulmonary disease, and suggests that the levels of these markers reflect the extent of structural changes of the airways.