Airway mucus and <sup>129</sup>Xe MRI ventilation after single inhaler triple therapy in asthma
Bibliographic record
Abstract
Background In asthma, fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) was previously demonstrated to improve forced expiratory volume in 1 s (FEV1) and asthma control, but the mechanism by which this occurs, especially at the level of the small airways, is not well-understood. We asked the question, does FF/UMEC/VI influence asthma control by improving airway structure–function and airway occlusions? Hence, our objective was to measure airway structure–function using 129Xe magnetic resonance imaging (MRI) ventilation defect percentage (VDP), computed tomography (CT) and airwave oscillometry after 6-week single-inhaler FF/UMEC/VI and 1 year later. Methods Participants with Global Initiative for Asthma Step 4–5 (GINA4–5) asthma who were poorly controlled on inhaled corticosteroid/long-acting β-2 agonist (ICS/LABA) provided written informed consent to baseline, 6- and 12-week visits as well as an open-extension 1-year visit. All received FF/UMEC/VI (200/62.5/25 µg) at baseline and underwent MRI, spirometry, plethysmography and oscillometry, pre- and post-bronchodilator (BD). The Asthma Control Questionnaire, the Asthma Quality of Life Questionnaire (AQLQ) and St. George's Respiratory Questionnaire (SGRQ) were completed. CT was acquired at baseline and 1 year later. Results Thirty-one participants (24 females, 54±15 yrs) completed the baseline visit, 28 (21 females, 54±15 yrs) completed the 6-week visit and 15 patients attended the 1-year visit. At 6-weeks, there was significantly improved pre-BD VDP (p=0.02), FEV1 (p=0.008), distal airways resistance (R5–19) (p=0.001), AQLQ (p<0.001) and SGRQ-scores (p=0.001), which persisted at 1 year. VDP improved in participants with elevated mucus score and eosinophil count, while R5–19 improvements were independent of type 2 inflammation. Mean airway mucus score, lumen area and total airway count were significantly improved at 1 year. Conclusions In participants with GINA4–5 asthma, who had been poorly controlled on ICS/LABA, single-inhaler FF/UMEC/VI resulted in improved VDP and FEV1 at 6-weeks. These improvements persisted 1-year later when airway markers were also significantly improved, consistent with the reversal of airway remodelling.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".