Markers of vascular perturbation correlate with airway structural change in asthma

Mats W. Johansson, Stanley J. Kruger, Mark L. Schiebler, Michael D. Evans, Ronald L. Sorkness, Loren C. Denlinger, William W. Busse, Nizar N. Jarjour, Robert R. Montgomery, Deane F. Mosher, Sean B. Fain

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Rationale: Air trapping and ventilation defects on imaging are characteristics of asthma. Airway wall thickening occurs in asthma and is associated with increased bronchial vascularity and vascular permeability. Vascular endothelial cell products have not been explored as a surrogate to mark structural airway changes in asthma. Objectives: Determine whether reporters of vascular endothelial cell perturbation correlate with airway imaging metrics in patients with asthma of varying severity. Methods: Plasma from Severe Asthma Research Program subjects was analyzed by ELISAs for soluble von Willebrand factor mature protein (VWF:Ag) and propeptide (VWFpp), P-selectin, and platelet factor 4. Additional subjects were analyzed over 48 hours after whole-lung antigen challenge. We calculated ventilation defect volume by hyperpolarized helium-3 magnetic resonance imaging and areas of low signal density by multidetector computed tomography (less than2856 Hounsfield units [HU] at functional residual capacity and 2950 HU at total lung capacity [TLC]). Measurements and Main Results: VWFpp and VWFpp/Ag ratio correlated with and predicted greater percentage defect volume on hyperpolarized helium-3 magnetic resonance imaging. P-selectin correlated with and predicted greater area of low density on chest multidetector computed tomography less than 2950 HU at TLC. Platelet factor 4 did not correlate. Following whole-lung antigen challenge, variation in VWFpp, VWFpp/Ag, and P-selectin among time-points was less than that among subjects, indicating stability and repeatability of the measurements. Conclusions: PlasmaVWFppand P-selectinmay beuseful as surrogates of functional and structural defects that are evident on imaging. The results raise important questions aboutwhyVWFpp and P-selectin are associated specifically with different imaging abnormalities.

Original languageEnglish (US)
Pages (from-to)167-178
Number of pages12
JournalAmerican journal of respiratory and critical care medicine
Volume188
Issue number2
DOIs
StatePublished - Jul 15 2013

Keywords

  • Asthma
  • Computed tomography
  • Magnetic resonance imaging
  • P-selectin
  • Von Willebrand factor

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