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. 2024 Dec 15;210(12):1432-1440.
doi: 10.1164/rccm.202310-1825OC.

Association of Ground-Glass Opacities with Systemic Inflammation and Progression of Emphysema

Spyridon Fortis  1   2 , Junfeng Guo  3   4 , Prashant Nagpal  5 , Muhammad F A Chaudhary  3 , John D Newell Jr  3   4 , Sarah E Gerard  3 , MeiLan K Han  6 , Ella A Kazerooni  6 , Fernando J Martinez  7   8 , Igor Z Barjaktarevic  9 , R Graham Barr  10 , Sandeep Bodduluri  11 , Robert Paine 3rd  12 , Hira A Awan  3 , Joyce D Schroeder  13 , Lisa D Gravens-Mueller  14 , Victor E Ortega  15 , Wayne H Anderson  16 , Christopher B Cooper  9 , David Couper  17 , Prescott G Woodruff  18 , Russell P Bowler  19 , Surya P Bhatt  11   20 , Eric A Hoffman  2   3   4 , Joseph M Reinhardt  3   4 , Alejandro P Comellas  2
Affiliations

Association of Ground-Glass Opacities with Systemic Inflammation and Progression of Emphysema

Spyridon Fortis et al. Am J Respir Crit Care Med. .

Abstract

Rationale: Ground-glass opacities (GGOs) in the absence of interstitial lung disease are understudied. Objectives: To assess the association of GGOs with white blood cells (WBCs) and progression of quantified chest computed tomography emphysema. Methods: We analyzed data of participants in the SPIROMICS study (Subpopulations and Intermediate Outcome Measures in COPD Study). Chest radiologists and pulmonologists labeled regions of the lung as GGOs, and the adaptive multiple feature method (AMFM) trained the computer to assign those labels to image voxels and quantify the volume of the lung with GGOs (%GGOAMFM). We used multivariable linear regression, zero-inflated negative binomial, and proportional hazards regression models to assess the association of %GGOAMFM with WBCs, changes in percentage emphysema, and clinical outcomes. Measurements and Main Results: Among 2,714 participants, 1,680 had chronic obstructive pulmonary disease (COPD) and 1,034 had normal spirometry. Among participants with COPD, on the basis of multivariable analysis, current smoking and chronic productive cough were associated with higher %GGOAMFM. Higher %GGOAMFM was cross-sectionally associated with higher WBC and neutrophil concentrations. Higher %GGOAMFM per interquartile range at visit 1 (baseline) was associated with an increase in emphysema at 1-year follow-up visit by 11.7% (relative increase; 95% confidence interval, 7.5-16.1%; P < 0.001). We found no association between %GGOAMFM and 1-year FEV1 decline, but %GGOAMFM was associated with exacerbations and all-cause mortality during a median follow-up of 1,544 days (interquartile interval, 1,118-2,059). Among normal spirometry participants, we found similar results, except that %GGOAMFM was associated with progression to COPD at 1-year follow-up. Conclusions: Our findings suggest that GGOAMFM is associated with increased systemic inflammation and emphysema progression.

Keywords: chronic obstructive pulmonary disease; emphysema; ground-glass opacity; inflammation.

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References

    1. Hata A, Schiebler ML, Lynch DA, Hatabu H. Interstitial lung abnormalities: state of the art. Radiology . 2021;301:19–34. - PMC - PubMed
    1. Putman RK, Hatabu H, Araki T, Gudmundsson G, Gao W, Nishino M, et al. Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) Investigators; COPDGene Investigators Association between interstitial lung abnormalities and all-cause mortality. JAMA . 2016;315:672–681. - PMC - PubMed
    1. Lee TS, Jin KN, Lee HW, Yoon SY, Park TY, Heo EY, et al. Interstitial lung abnormalities and the clinical course in patients with COPD. Chest . 2021;159:128–137. - PubMed
    1. Ash SY, Harmouche R, Ross JC, Diaz AA, Rahaghi FN, Vegas Sanchez-Ferrero G, et al. COPDGene Investigators Interstitial features at chest CT enhance the deleterious effects of emphysema in the COPDGene cohort. Radiology . 2018;288:600–609. - PMC - PubMed
    1. Washko GR, Hunninghake GM, Fernandez IE, Nishino M, Okajima Y, Yamashiro T, et al. COPDGene Investigators Lung volumes and emphysema in smokers with interstitial lung abnormalities. N Engl J Med . 2011;364:897–906. - PMC - PubMed