What does this research mean for the field?

In COPD patients without comorbid asthma, asthma-like features such as blood eosinophilia are associated with increased mucus plugging on CT imaging but do not affect overall airway morphology. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to explore the relationship between asthma-like features and CT imaging metrics in patients with COPD.

May 20, 2026

C73-17 Asthma Like Features in Mucus Plugs and Airway Morphology on CT Imaging

Key Points

This research aims to explore the relationship between asthma-like features and CT imaging metrics in patients with COPD.
Analyzed data from 91 patients with COPD and assessed asthma-like features and CT scans.
Calculated mucus plug scores, wall area at segmental bronchi, and total airway count using inspiratory CT scans.
Constructed multivariate models, adjusted for age, sex, body mass index, and smoking status, to examine associations.
Blood eosinophil count had a median value of 178.6/μL; correlating positively with mucus plug scores.
Of 91 patients, 45 had asthma-like features; these individuals exhibited increased mucus plug scores compared to those without.
No significant correlation was noted between blood neutrophil count and mucus plugs for patients lacking asthma-like features.

Abstract

Abstract Background Asthma-like-features: blood eosinophilia, atopy, and bronchodilator reversibility (BDR) may be linked to lnt1 ong term disease stability and better prognosis in patients with chronic obstructive pulmonary disease (COPD) under optimal treatment (Suzuki M. et.al. AJRCCM 2016). However, how intrapulmonary morphology affects these clinical features is undetermined. AimWe investigated the associations between the asthma-like-features and computed tomogrphay (CT) findings of airway diseases, including mucus plugs in smokers with COPD who did not past or present comorbid of asthma in the Hokkaido COPD cohort. Methods In 91 patients (Female/Male 7/84) with the assessment of asthma-like-features according to abovementioned study and analyzable CT scans at the entry or year 1, % wall area at the segmental bronchus and total airway count and mucus plug scores using inspiratory scan and small airway disease using a pair of inspiratory and expiratory CT scans were calculated. Multivariate models were constructed to examine the association between asthma-like-features and CT derived metrics, adjusted for age, sex, body mass index, and smoking status. Results Blood eosinophil count varied with median (25% - 75%tile) of 178.6 (90.4, 286.2) /μL, while atopy and BDR were positive in 15 and 20 patients, respectively. Patients with any asthma-like-features (N = 45) showed an increased mucus plug score and no significant differences in any of airway indices, compared with those with none of asthma-like-features (N = 46). Of the three factors, blood eosinophil count was positively correlated with mucus plug score (Estimate(95% confidential interval); -1.41(-2.24, -0.58)). In subgroup analysis based on asthma-like-features, the association was consistent in patients with any of asthma-like-features, but not in those with none of the factors. Moreover, there was no correlation between blood neutrophil count and mucus plug score in patients without the asthma-like-features. Interpretations Asthma-like-features might cause further mucus plugging, but not affect the airway morphology. Mucus plugs may be associated with eosinophilic inflammation in COPD with asthma-like-features. Conclusions The presence of asthma-like features might suggest an increased Mp in eosinophilic COPD. A large-scale study should determine the role of asthma-like-features in the management of patients with eosinophilic COPD. This abstract is funded by: None for this analysis

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