Randomized trial evaluates mucus plugs in severe asthma sputum phenotypes, suggesting implications for treatment strategies.
Key Points
This research aims to analyze the impact of inflammation on mucus plugging in severe asthma cases by examining CT-evaluated sputum phenotypes.
Sixty biologic-naïve patients with moderate-to-severe asthma underwent full-inspiration chest CT and sputum induction.
Patients were categorized as sputum producers or non-producers, and sputum phenotypes were analyzed by differential cell count.
Mucus scores, total plug volume, and median plug volume were quantified from CT scans using VIDA|vision software.
Eighty-seven percent of mixed-granulocytic patients had CT mucus scores ≥4, significantly higher than other groups (p < 0.05).
Mucus score and total plug volume were significantly higher in eosinophilic and mixed-granulocytic groups compared to paucigranulocytic group (all p < 0.05).
Patients with many free-eosinophil-granules had significantly higher mucus scores compared to those without (p = 0.003).