The effect of omalizumab on ventilation and perfusion in adults with allergic asthma The effect of omalizumab on ventilation and perfusion in adults with allergic asthma

Daniel A. Kelmenson; Vanessa J. Kelly; Tilo Winkler; Mamary T. Kone; Guido Musch; Marcos F. Vidal Melo; Jose G. Venegas; R. Scott Harris

The effect of omalizumab on ventilation and perfusion in adults with allergic asthma The effect of omalizumab on ventilation and perfusion in adults with allergic asthma

Journal article

Open access

The effect of omalizumab on ventilation and perfusion in adults with allergic asthma The effect of omalizumab on ventilation and perfusion in adults with allergic asthma

Daniel A. Kelmenson, Vanessa J. Kelly, Tilo Winkler, Mamary T. Kone, Guido Musch, Marcos F. Vidal Melo, Jose G. Venegas and R. Scott Harris

American journal of nuclear medicine and molecular imaging, Vol.3(4), pp.350-360

01/01/2013

PMCID: PMC3715779

PMID: 23901360

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Abstract

Omalizumab promotes clinical improvement in patients with allergic asthma, but its effect on pulmonary function is unclear. One possibility is that omalizumab improves asthma symptoms through effects on the regional distributions of ventilation, perfusion, and ventilation/perfusion matching, metrics which can be assessed with Nitrogen-13-saline Position Emission Tomography (PET). Four adults with moderate to severe uncontrolled allergic asthma underwent symptom assessment, spirometry and functional pulmonary imaging with Nitrogen-13-saline PET before and after 4-5 months of treatment with omalizumab. PET imaging was used to determine ventilation/perfusion ratios, the heterogeneity (coefficient of variation, COV) of ventilation and perfusion, and lung regions with ventilation defects. There were no significant changes in spirometry values after omalizumab treatment, but there was a trend towards an improvement in symptom scores. There was little change in the matching of ventilation and perfusion. The COV of perfusion was similar before and after omalizumab treatment. The COV of ventilation was also similar before (0.57 (0.28)) and after (0.66 (0.13)) treatment, and it was similar to previously published values for healthy subjects. There was a non-significant trend towards an increase in the extent of ventilation defects after omalizumab treatment, from 5 (15)% to 12.8 (14.7)%. Treatment of moderate to severe uncontrolled allergic asthma with omalizumab did not result in a significant improvement in ventilation and perfusion metrics assessed with functional PET imaging. The normal COV of ventilation which was unaffected by treatment supports the hypothesis that omalizumab exerts its clinical effect on lung function during allergen exposure rather than in between exacerbations.

Life Sciences & Biomedicine

Radiology, Nuclear Medicine & Medical Imaging

Science & Technology

Details

Title: Subtitle: The effect of omalizumab on ventilation and perfusion in adults with allergic asthma The effect of omalizumab on ventilation and perfusion in adults with allergic asthma
Creators: Daniel A. Kelmenson - Harvard Med Sch, Boston, MA USA
Vanessa J. Kelly - Harvard Med Sch, Boston, MA USA
Tilo Winkler - Harvard Med Sch, Boston, MA USA
Mamary T. Kone - Harvard Med Sch, Boston, MA USA
Guido Musch - Harvard Med Sch, Boston, MA USA
Marcos F. Vidal Melo - Harvard Med Sch, Boston, MA USA
Jose G. Venegas - Harvard Med Sch, Boston, MA USA
R. Scott Harris - Harvard Med Sch, Boston, MA USA
Resource Type: Journal article
Publication Details: American journal of nuclear medicine and molecular imaging, Vol.3(4), pp.350-360
PMID: 23901360
PMCID: PMC3715779
NLM abbreviation: Am J Nucl Med Mol Imaging
ISSN: 2160-8407
eISSN: 2160-8407
Publisher: E-Century Publishing Corp
Number of pages: 11
Grant note: CIGE025AUS27 / Novartis
Language: English
Date published: 01/01/2013
Academic Unit: Anesthesia
Record Identifier: 9985142947102771

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