Airway Tree Caliber and Susceptibility to Pollution-associated Emphysema: MESA Air and Lung Studies

Coralynn Sack; Meng Wang; Victoria Knutson; Amanda Gassett; Eric A Hoffman; Lianne Sheppard; R Graham Barr; Joel D Kaufman; Benjamin Smith

doi:10.1164/rccm.202307-1248OC

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Airway Tree Caliber and Susceptibility to Pollution-associated Emphysema: MESA Air and Lung Studies

Journal article

Peer reviewed

Airway Tree Caliber and Susceptibility to Pollution-associated Emphysema: MESA Air and Lung Studies

Coralynn Sack, Meng Wang, Victoria Knutson, Amanda Gassett, Eric A Hoffman, Lianne Sheppard, R Graham Barr, Joel D Kaufman and Benjamin Smith

American journal of respiratory and critical care medicine, Vol.209(11), pp.1351-1359

01/16/2024

DOI: 10.1164/rccm.202307-1248OC

PMCID: PMC11146562

PMID: 38226871

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https://pmc.ncbi.nlm.nih.gov/articles/PMC11146562/pdf/rccm.202307-1248OC.pdfView

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Abstract

Airway tree morphology varies in the general population and may modify the distribution and uptake of inhaled pollutants. We hypothesized that smaller airway caliber would be associated with emphysema progression and would increase susceptibility to air pollutant-associated emphysema progression. The Multi-Ethnic Study of Atherosclerosis (MESA) is a general population cohort of adults 45-84 years old from six U.S. communities. Airway tree caliber was quantified as the mean of airway lumen diameters measured from baseline cardiac computed tomography (CT) (2000-02). Percent emphysema, defined as percentage of lung pixels below -950 Hounsfield units, was assessed up to 5 times per participant via cardiac CT scan (2000-07) and equivalent regions on lung CT scan (2010-18). Long-term outdoor air pollutant concentrations (PM2.5, NOx, O3) were estimated at residential address with validated spatio-temporal models. Linear mixed models estimated the association between airway tree caliber and emphysema progression; modification of pollutant-associated emphysema progression was assessed using multiplicative interaction terms. Among 6,793 participants (mean±SD age: 62±10 years), baseline airway tree caliber was 3.95±1.1 mm and median (interquartile range) of percent emphysema was 2.88 (1.21-5.68). In adjusted analyses, 10-year emphysema progression rate was 0.75 percentage points (95%CI 0.54-0.96%) higher in the smallest compared to largest airway tree caliber quartile. Airway tree caliber also modified air pollutant-associated emphysema progression. Smaller airway tree caliber was associated with accelerated emphysema progression and modified air pollutant-associated emphysema progression. A better understanding of mechanisms of airway-alveolar homeostasis and air pollutant deposition are needed.

Air Pollution

airway morphology

dysanapsis

emphysema

Details

Title: Subtitle: Airway Tree Caliber and Susceptibility to Pollution-associated Emphysema: MESA Air and Lung Studies
Creators: Coralynn Sack - University of Washington Medical Center
Meng Wang - University at Buffalo, State University of New York
Victoria Knutson - University of Washington
Amanda Gassett - University of Washington
Eric A Hoffman - University of Iowa
Lianne Sheppard - University of Washington
R Graham Barr - Columbia University
Joel D Kaufman - University of Washington
Benjamin Smith - Columbia University
Resource Type: Journal article
Publication Details: American journal of respiratory and critical care medicine, Vol.209(11), pp.1351-1359
DOI: 10.1164/rccm.202307-1248OC
PMID: 38226871
PMCID: PMC11146562
NLM abbreviation: Am J Respir Crit Care Med
ISSN: 1073-449X
eISSN: 1535-4970
Publisher: American Thoracic Society
Language: English
Electronic publication date: 01/16/2024
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
Record Identifier: 9984548410902771

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