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Reduced wall thickness (WT) and elevated FeNO are associated with rapid lung function decline in severe asthma, according to findings published in Annals of Allergy, Asthma & Immunology. The researchers aimed to identify CT imaging features and biomarkers associated with lung function decline in patients with severe asthma. They analyzed the CT scans of 102 patients for airway structural parameters (WT and hydraulic diameter [Dh]) and parenchymal variables (functional small airway disease and emphysema). Patients were grouped based on annual changes in lung function. Results showed that patients with accelerated lung function decline had significantly lower WT and smaller Dh, while functional small airway disease and emphysema did not significantly differ. Biomarkers such as FeNO and blood matrix metalloproteinase-9/TIMP metallopeptidase inhibitor 1 ratio were elevated in patients with greater lung function decline. The authors concluded that targeted management plans may help mitigate lung function decline in these patients.