Computed tomography-based measurements associated with rapid lung function decline in severe asthma

DaWoon Sim et al. conducted a study to examine the association between CT-based airway metrics and lung function decline (LFD) in severe asthma, using data from 102 patients in the Korean Severe Asthma Registry. CT metrics such as wall thickness (WT) and hydraulic diameter (Dh) were derived using AVIEW, alongside functional small airway disease (fSAD) and emphysema percentages. The study revealed significantly lower WT and Dh in patients with severe LFD, emphasizing their role as potential markers. Elevated fractional exhaled nitric oxide (FeNO) and a higher matrix metalloproteinase-9/TIMP1 ratio correlated with more pronounced LFD, linking inflammation to rapid decline. However, fSAD and emphysema percentages were not associated with LFD. This study underscores the importance of CT imaging for identifying at-risk patients and suggests integrating WT and FeNO measurements into asthma management plans for tailored interventions. Further prospective studies are needed to validate these findings.