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Aerosol deposition in the lung as a biomarker in asthma and chronic obstruction

Öhrneman, Hugo LU ; Malinovschi, Andrei ; Cai, Gui Hong ; Svartengren, Magnus ; Nicklasson, Hanna ; Jakobsson, Jonas LU ; Wollmer, Per LU and Löndahl, Jakob LU orcid (2026) In Respiratory Research 27(1).
Abstract

Background: The objective of this study was to explore the potential of Airspace Dimension Assessment (AiDA) to rapidly determine the type and severity of airway obstruction, detect emphysema in individuals with chronic airflow limitation (CAL), and distinguish it from non-emphysematous obstruction, asthma, and absence of respiratory disease with normal spirometry. Methods: Among the 744 participants measured with AiDA within the Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort, 40 had asthma, and 34 had a CAL (defined by a post-bronchodilator FEV1/FVC < 0.7), whereof 12 had CT-detected emphysema. AiDA measurements were compared across these groups and to 111 healthy controls (never-smokers with normal spirometry and... (More)

Background: The objective of this study was to explore the potential of Airspace Dimension Assessment (AiDA) to rapidly determine the type and severity of airway obstruction, detect emphysema in individuals with chronic airflow limitation (CAL), and distinguish it from non-emphysematous obstruction, asthma, and absence of respiratory disease with normal spirometry. Methods: Among the 744 participants measured with AiDA within the Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort, 40 had asthma, and 34 had a CAL (defined by a post-bronchodilator FEV1/FVC < 0.7), whereof 12 had CT-detected emphysema. AiDA measurements were compared across these groups and to 111 healthy controls (never-smokers with normal spirometry and no history of respiratory disease). Results: Subjects with CAL had significantly larger distal airspaces radii (median rAiDA=298 μm) than controls (rAiDA=278 μm, p < 0.001), but no significant difference was observed in asthmatics (rAiDA=273 μm, p = 0.79). Subjects with CT-detected emphysema in the CAL group displayed further differentiation from the control (rAiDA=349 μm, p < 0.001), while those without emphysema displayed no significant increase. Unlike rAiDA, neither low attenuation volume nor 15th percentile density could clearly distinguish between obstruction and radiologist-assessed emphysema. In addition, the zero-second particle recovery (R0), which is theorized to reflect conducting airway dysfunction, was decreased in both asthmatics (R0 = 0.41, p = 0.011), and in the CAL group (R0 = 0.45, p = 0.020) when compared to controls (R0 = 0.56). Conclusions: These findings display AiDA’s potential in identifying emphysema as well as obstructive airway disease. The absence of an increased distal airspace radius in asthmatics confirm that rAiDA is a measure of the distal airspaces, unaffected by abnormalities in the conducting airways. However, the decreased R0 in both asthma and CAL suggests that R0 does reflect conducting airway abnormality.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Aerosols, Asthma, Chronic airflow limitation, Chronic obstructive airway disease, Emphysema, Lung function
in
Respiratory Research
volume
27
issue
1
article number
224
publisher
BioMed Central (BMC)
external identifiers
  • pmid:42116137
  • scopus:105041186528
ISSN
1465-9921
DOI
10.1186/s12931-026-03706-2
language
English
LU publication?
yes
id
9dbe1814-8c5f-4b20-a77a-7cfe9ae26c60
date added to LUP
2026-07-02 11:54:27
date last changed
2026-07-03 03:04:24
@article{9dbe1814-8c5f-4b20-a77a-7cfe9ae26c60,
  abstract     = {{<p>Background: The objective of this study was to explore the potential of Airspace Dimension Assessment (AiDA) to rapidly determine the type and severity of airway obstruction, detect emphysema in individuals with chronic airflow limitation (CAL), and distinguish it from non-emphysematous obstruction, asthma, and absence of respiratory disease with normal spirometry. Methods: Among the 744 participants measured with AiDA within the Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort, 40 had asthma, and 34 had a CAL (defined by a post-bronchodilator FEV<sub>1</sub>/FVC &lt; 0.7), whereof 12 had CT-detected emphysema. AiDA measurements were compared across these groups and to 111 healthy controls (never-smokers with normal spirometry and no history of respiratory disease). Results: Subjects with CAL had significantly larger distal airspaces radii (median r<sub>AiDA</sub>=298 μm) than controls (r<sub>AiDA</sub>=278 μm, p &lt; 0.001), but no significant difference was observed in asthmatics (r<sub>AiDA</sub>=273 μm, p = 0.79). Subjects with CT-detected emphysema in the CAL group displayed further differentiation from the control (r<sub>AiDA</sub>=349 μm, p &lt; 0.001), while those without emphysema displayed no significant increase. Unlike r<sub>AiDA</sub>, neither low attenuation volume nor 15th percentile density could clearly distinguish between obstruction and radiologist-assessed emphysema. In addition, the zero-second particle recovery (R<sub>0</sub>), which is theorized to reflect conducting airway dysfunction, was decreased in both asthmatics (R<sub>0</sub> = 0.41, p = 0.011), and in the CAL group (R<sub>0</sub> = 0.45, p = 0.020) when compared to controls (R<sub>0</sub> = 0.56). Conclusions: These findings display AiDA’s potential in identifying emphysema as well as obstructive airway disease. The absence of an increased distal airspace radius in asthmatics confirm that r<sub>AiDA</sub> is a measure of the distal airspaces, unaffected by abnormalities in the conducting airways. However, the decreased R<sub>0</sub> in both asthma and CAL suggests that R<sub>0</sub> does reflect conducting airway abnormality.</p>}},
  author       = {{Öhrneman, Hugo and Malinovschi, Andrei and Cai, Gui Hong and Svartengren, Magnus and Nicklasson, Hanna and Jakobsson, Jonas and Wollmer, Per and Löndahl, Jakob}},
  issn         = {{1465-9921}},
  keywords     = {{Aerosols; Asthma; Chronic airflow limitation; Chronic obstructive airway disease; Emphysema; Lung function}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Respiratory Research}},
  title        = {{Aerosol deposition in the lung as a biomarker in asthma and chronic obstruction}},
  url          = {{http://dx.doi.org/10.1186/s12931-026-03706-2}},
  doi          = {{10.1186/s12931-026-03706-2}},
  volume       = {{27}},
  year         = {{2026}},
}