Asthma is a common chronic disease, affecting up to 300 million people worldwide. Approximately 10% of these have severe asthma and they experience recurrent hospitalizations and struggle to maintain a normal lifestyle, despite receiving high doses of anti-asthma medication*.

This pilot project wants to lead the way for the use of 3D X-ray tomographic microscopy (XRTM) in hospital settings, potentially changing the way severe asthma patients are treated. The study will allow easy identification and research of iBALT** in severe asthmatics, clear visualization of airway remodeling without sectioning biopsies, and how biological treatment affects these two things. This will potentially also reduce the number of biopsies taken from patients, which can lead to less invasive procedures.

A clinical feature of many patients with severe asthma is airway autoimmunity, seen by the presence of autoantibodies in their lungs. Some of the manifestations of this autoimmunity are airway remodeling resulting in difficulty breathing, and unnormal immunological responses in the lungs, with them being highly pro-inflammatory producing many disease promoting proteins. A source of the autoantibodies could be the iBALT lymphoid structures, which are difficult to identify using conventional sampling and 2D histological methods. For that reason, they are not well-studied in asthmatics – both their size and function, but also if they can be normalized with medical treatment.

This HALRIC pilot project aims to combine the 3D XRTM approach with conventional cell-specific histology for identification and visualization, and for better research of the effects of airway remodeling and iBALT in autoimmune severe asthma, before and after treatment. This combined imaging approach will allow better understanding of iBALT and airway remodeling, and potentially change the way autoimmune severe asthma patients are treated in the future.

For further information about this HALRIC pilot project, please contact:
lise.lotte.eriksen@regionh.dk

References:

* Reference: J Asthma Allergy 14, 1106–1115 (2021):
Severe Asthma in a General Population Study: Prevalence and Clinical Characteristics

** iBALT = inducible bronchus-associated lymphoid tissue are structures found locally in the lungs, giving the optimal milieu for production and activation of immune cells capable of producing more autoantibodies.