| Autor: |
Fleming JS; Southampton NIHR Respiratory and Critical Care Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.; Department of Medical Physics, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom., Conway J; Southampton NIHR Respiratory and Critical Care Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.; Centre for Health and Life Sciences, Brunel University, London, United Kingdom., Bennett MJ; Southampton NIHR Respiratory and Critical Care Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.; Faculty of Medicine, University of Southampton, Southampton, United Kingdom., Tossici-Bolt L; Department of Medical Physics, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom., Guy M; Department of Medical Physics, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom., Blé FX; Translational Science and Experimental Medicine, Research and Early Development, Respiratory, Inflammation and Autoimmune (RIA), R&D BioPharmaceuticals, AstraZeneca R&D, Gothenburg, Sweden., McCrae C; Translational Science and Experimental Medicine, Research and Early Development, Respiratory, Inflammation and Autoimmune (RIA), R&D BioPharmaceuticals, AstraZeneca R&D, Gothenburg, Sweden., Carlsson M; Patient Safety, Chief Medical Office, R&D, AstraZeneca, Gothenburg, Sweden., Bondesson E; Active Biotech, Lund, Sweden. |
| Abstrakt: |
Background: Mucociliary clearance (MCC) rate from the lung has been shown to be reduced in chronic obstructive pulmonary disease (COPD). This study investigates the value of regional clearance measurements in assessing MCC in mild-to-moderate disease. Methods: Measurement of lung MCC using planar gamma camera imaging was performed in three groups: (i) healthy nonsmoking controls (NSCs) ( n = 9), (ii) smoking controls (SCs) who were current smokers with normal lung function ( n = 10), and (iii) current smokers with mild-to-moderate COPD and bronchitis ( n = 15). The mean (±standard deviation) forced expiratory volumes at 1 second (FEV1) for the three groups were 109 (± 18), 94 (± 5), and 78 (± 12), respectively. After inhalation of a technetium-99m labeled aerosol, planar imaging was performed over 4 hours and then at 24 hours. Both lung clearance and tracheobronchial clearance (TBC) (normalized to 24 hours clearance) were calculated for inner and outer lung zones. Inner zone clearance was corrected for input from the outer zone. A novel parameter, the bronchial airways clearance index (BACI), which combined clearance data from both zones, was also evaluated. Regional results were compared with whole lung clearance in the same subjects. Results: Corrected inner zone clearance at 3 hours was not reduced compared with NSC in either SCs or COPD. Outer zone clearance was higher in COPD than in the other groups. Corrected inner zone TBC showed significant reductions in SC and COPD compared with NSC. BACI was significantly reduced in COPD compared with NSC and also correlated with FEV1. The mean BACI for SC was also reduced compared with NSC, but the distribution of results was bimodal, with a significant proportion of subjects having values in the NSC range. Conclusions: Regional MCC demonstrated differences between NSCs, SCs, and subjects with mild-to-moderate COPD, which were not apparent with whole lung measurements. |
