Severe pediatric asthma with a poor response to omalizumab: a report of three cases and three-dimensional bronchial wall analysis

Mitsuru Tsuge, Masanori Ikeda, Yoichi Kondo, Hirokazu Tsukahara

Research output: Contribution to journalArticlepeer-review

Abstract

Omalizumab is used for the treatment of persistent severe allergic asthma in adults and children. However, some patients remain symptomatic even after omalizumab treatment. In bronchial asthma, chronic inflammation of the bronchial wall causes thickening of the airway wall, resulting from irreversible airway remodeling. Progression of airway remodeling causes airflow obstruction, leading to treatment resistance. We report three Japanese children with severe asthma who had a poor response to omalizumab treatment. They had a long period of inadequate management of asthma before initiating omalizumab. Even after omalizumab treatment, their symptoms persisted, and the parameters of spirometry tests did not improve. We hypothesized that omalizumab was less effective in these patients because airway wall remodeling had already progressed. We retrospectively evaluated the bronchial wall thickness using a three-dimensional bronchial wall analysis with chest computed tomography. The bronchial wall thickness was increased in these cases compared with six responders. Progressed airway wall thickness caused by airway remodeling may be associated with a poor response to omalizumab in children with severe asthma.

Original languageEnglish
JournalJournal of International Medical Research
Volume50
Issue number1
DOIs
Publication statusPublished - Jan 2022

Keywords

  • airway
  • Bronchial asthma
  • bronchial wall thickness
  • child
  • computed tomography
  • omalizumab

ASJC Scopus subject areas

  • Biochemistry
  • Biochemistry, medical
  • Cell Biology

Fingerprint

Dive into the research topics of 'Severe pediatric asthma with a poor response to omalizumab: a report of three cases and three-dimensional bronchial wall analysis'. Together they form a unique fingerprint.

Cite this