Does the reversal of airway remodeling accompany asthma remission?
Bibliographic record
Abstract
Background: Asthma patients who were treated for 2.5-years with anti-IL5Rα were previously shown to significantly improve 129Xe MRI ventilation defect percent (VDP), airway mucus, total airway count (TAC) and pulmonary vascular blood distribution (McIntosh; Chest 2023). In these participants, we investigated the potential relationship between the reversal of airway and pulmonary vascular remodeling with markers of clinical remission. Methods & results: Participants with eosinophilic asthma (n=31) consented to anti-IL5Rα therapy, spirometry, 129Xe MRI, CT, asthma control questionnaire (ACQ-5) at baseline and post-Rx visits; 12 returned for long-term follow-up at 2.5 years. 129Xe MRI VDP and CT airway wall-thickness-percent (WT%), lumen area (LA), TAC, mucus-score, and small vessel volume (BV5/TBV) were measured. Asthma remission was evaluated (Perez-De Llano; AJRCCM 2024). Imaging/pathologic normalization was defined based on normal values: 2-Domain=VDP≤4%+mucus-score≤1, 3-Domain=2-Domain+WT%≤18.5% or LA≥8.1 or TAC≥205, and 4-Domain=3-Domain+BV5/TBV≥0.56. At 2.5-years, 92/58/83/50% achieved 2, 3 (+control), 3 (+lung function) and 4-domain clinical remission, while 67/50/42% achieved 2, 3 (+WT% or TAC or LA) and 4 (+BV5/TBV) imaging normalization. Five participants achieved both clinical remission and imaging/pathologic normalization. Conclusions: This is the first demonstration of the reversal of airway and lung vascular remodeling to normal values in patients with severe asthma who achieved clinical remission whilst treated with anti-IL5Rα for over 2.5 years. The reversal and normalization of airway and pulmonary vascular remodeling in asthma may constitute a potential treatment target in severe asthma patients.
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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 | 0.000 |
| 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 | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".