Mucus plugs correlate with small airway remodelling in Asthma: A multi-resolution study
Bibliographic record
Abstract
Rationale: The observation of mucus plugs in proximal large airways on high-resolution computed tomography (HRCT) has highlighted the role of persistent mucus plugs in asthma, which correlate with disease severity and airflow obstruction. Due to the resolution of HRCT, it is unknown if mucus plugs within the distal small airways (<2mm in diameter) contribute to airflow obstruction. Objectives: To determine the prevalence of distal mucus plugs and their association with small airway remodelling in asthma. Methods: Lungs from 12 control, 5 non-fatal, and 11 fatal asthma patients underwent systematic uniform random sampling to obtain 239 lung tissue samples. The samples were imaged using micro-CT to assess mucus plugs and airway morphology, while histology and imaging mass spectrometry were used to evaluate airway wall remodelling and mucus composition. Main Results: Within the distal lung, 34% of pre-terminal bronchioles, 32% of terminal bronchioles, and 27% of transitional bronchioles had mucus plugs in fatal and non-fatal asthmatic patients. Mucus plugs comprised of 80% MUC5AC and 20% MUC5B, and 85% were ‘stringy’ in shape, extending over 90% of the bronchiole length. Mucus-plugged airways had thickened airway walls, narrowed airway lumens, and luminal folding compared to unplugged airways from the same patient due to increased epithelial, basement membrane, and smooth muscle thickening. Conclusion: In asthma, over 31% of distal small airways are obstructed by mucus plugs, which are associated with airway wall remodelling and lumen narrowing, making them a critical target for improving lung ventilation and patient outcomes.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".