title: Long-term changes in airway-wall thickness on computed tomography in asthmatic patients.
abstract: BACKGROUND
  Effects of long-term treatment with inhaled corticosteroids (ICSs) on airway-wall thickness in patients with asthma remain unknown.
  
  
  OBJECTIVE
  To determine whether airway-wall thickness consistently decreases after long-term ICS treatment, and to analyze factors contributing to long-term airway-wall changes in asthmatics.
  
  
  METHODS
  A retrospective analysis of long-term changes in airway-wall thickness using computed tomography was performed in 14 patients with asthma. Wall area corrected by body surface area (WA/BSA) was examined at baseline, 12 weeks after the commencement of ICSs (second measurement), and at least 2 years (mean +/- SEM. 4.2 +/- 0.5) after the second measurement (third measurement). Mean +/- SEM changes in WA/BSA from the second to the third measurements were analyzed.
  
  
  RESULTS
  The mean change in WA/BSA was not significant between the second and the third measurements (-0.27 +/- 0.59 mm2/m2/y). Overall, the changes were significantly associated with disease duration but not with other clinical indices. When the 14 patients were divided into 2 groups using a cutoff value of 0.32 mm2/m2/y for the mean change in WA/BSA, for the 5 patients whose WA/BSA exceeded this cutoff, daily ICS doses were not reduced and both forced expiratory volume in the first second (FEV1) and forced vital capacity decreased significantly. For the remaining 9 patients, daily ICS doses were reduced and long-term FEV1 values did not change.
  
  
  CONCLUSIONS
  Despite long-term treatment with ICSs, airway-wall thickness did not consistently decrease. One possible mechanism underlying poor response to long-term treatment may be long-standing asthma.
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. hmatsumo@kuhp.kyoto-u.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Matsumoto
authors.forename: A
authors.initials: A
authors.lastname: Niimi
authors.forename: M
authors.initials: M
authors.lastname: Takemura
authors.forename: T
authors.initials: T
authors.lastname: Ueda
authors.forename: M
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: H
authors.initials: H
authors.lastname: Matsuoka
authors.forename: M
authors.initials: M
authors.lastname: Jinnai
authors.forename: T
authors.initials: T
authors.lastname: Takeda
authors.forename: K
authors.initials: K
authors.lastname: Otsuka
authors.forename: T
authors.initials: T
authors.lastname: Oguma
authors.forename: T
authors.initials: T
authors.lastname: Handa
authors.forename: T
authors.initials: T
authors.lastname: Hirai
authors.forename: K
authors.initials: K
authors.lastname: Chin
authors.forename: M
authors.initials: M
authors.lastname: Mishima
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001249:Asthma / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D012137:Respiratory System / Q000187:drug effects / Q000473:pathology*; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones