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The following is a summary of “Ventilation Heterogeneity Is a Treatable Trait in Severe Asthma,” published in the April 2024 issue of Allergy & Immunology by Gibson, et al.
Ventilation heterogeneity (VH) is a characteristic of asthma, indicating small airway disease. Nuclear imaging methods, such as ventilation/perfusion single-photon emission computed tomography (V/P SPECT), can assess VH, aiding clinical diagnosis and enhancing our understanding of disease pathogenesis. For a study, researchers sought to evaluate VH in severe eosinophilic asthma (SEA) using V/P SPECT and assess its utility as an objective measure of biological treatment’s impact on SEA ventilation defects.
Adults (≥18 years) with severe asthma participated in a cross-sectional observational study. Participants underwent clinical assessment and V/P SPECT CT using Technegas as the ventilation agent. Measures were repeated in a nested before-after treatment study involving individuals with SEA initiating biologic therapy.
Sixty-two participants with severe asthma were enrolled, with 38 SEA participants included in the before-after treatment analysis. VH was associated with clinical variables such as lung function impairment and significantly improved following monoclonal antibody treatment in the severe asthma cohort. Changes in VH correlated with changes in post-bronchodilator forced expiratory volume in 1 second (FEV1) % predicted (r = -0.503; P = .001) and post-bronchodilator FEV1/forced vital capacity (FVC) ratio (r = -0.415; P = .01).
VH is clinically relevant, quantifiable, and responsive to treatment, establishing it as a treatable trait in severe asthma.
Reference: jaci-inpractice.org/article/S2213-2198(23)01393-4/fulltext
