Observational studyJCI insight2024
Persistent mucus plugs in proximal airways are consequential for airflow limitation in asthma.
Observational study in JCI insight, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 8 registered trials, which are not on this map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Severe Asthma Research Program
Severe Asthma Research Program (SARP)-Washington University
Clinical and Molecular Phenotypes of Severe Asthma
The Severe Asthma Research Program at Wake Forest University - Longitudinal Phenomics and Genetics of Severe Asthma.
Severe Asthma Research Program (SARP) - University of Wisconsin
ALXR/FPR Mediated Signaling in Severe Asthma (AMSA)-The Severe Asthma Research Program (SARP) III
Airway Dysfunction, Occlusions and RemodEling: COPD Patients and Mepolizumab (ADORE)
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Effectiveness of biologics for reducing occlusive mucus plugs in patients with severe asthma: a systematic review.Respiratory research · 2026Pooled it
- Effectiveness of mepolizumab on mucus plugs and clinical outcomes in severe eosinophilic asthma with and without coexisting bronchiectasis: a prospective pilot study.ERJ open research · 2026Article
- Protracted bacterial bronchitis in adults and comparison to bronchiectasis.ERJ open research · 2026Article
- Airway mucus plugs in asthma and chronic obstructive pulmonary disease: pathobiology, imaging, and implications for clinical trials.American journal of respiratory and critical care medicine · 2026Review
- TSLP impairs mucociliary transport by inhibiting JAK signaling in both central and peripheral airways.Pflugers Archiv : European journal of physiology · 2026Article
- Airway secretory cells contain both a perinuclear Golgi ribbon and dispersed Golgi satellites.American journal of respiratory cell and molecular biology · 2026Article
- 3D CT-Based quantification of airway structural changes during asthma exacerbations: a retrospective observational study.BMC pulmonary medicine · 2026Observational
- Severe Hypoxia Reduces Adenylyl Cyclase 6 Expression and Function in Bronchial Epithelial Cells.FASEB bioAdvances · 2026Article
- Mucus Plugs and Eosinophilic Inflammation: Expanding the Paradigm to COPD.The journal of allergy and clinical immunology. In practice · 2026Review
- Functional respiratory imaging reveals early structural and functional airway responses to benralizumab in severe eosinophilic asthma.BMJ open respiratory research · 2026Article
- Mucus plugs in chronic obstructive pulmonary disease are heterogeneous in size and shape and occur in relatively large airways.American journal of respiratory and critical care medicine · 2026Article
- Progress in treating mucus plugs in asthma.American journal of respiratory and critical care medicine · 2026Article
- Simulation-Driven Annotation-Free Deep Learning for Automated Detection and Segmentation of Airway Mucus Plugs on Non-Contrast CT Images.Bioengineering (Basel, Switzerland) · 2026Article
- Reply to Jie et al.: mucus plugs on chest CT as COPD risk factor: gaps in the evidence.American journal of respiratory and critical care medicine · 2026Article
- Lower lobe mucus plug distribution and future respiratory exacerbations in tobacco-exposed individuals with and without COPD.The European respiratory journal · 2026Article
- Clinical and pathophysiological roles of lower lobe-dominant mucus plugs on computed tomography in patients with asthma with and without bronchiectasis.The journal of allergy and clinical immunology. Global · 2025Article
- Pulmonary Biomechanics in COPD: Imaging Techniques and Clinical Applications.Journal of biomechanical engineering · 2025Review
- Respiratory and nonrespiratory symptoms before age 1 year predict school-age asthma.The Journal of allergy and clinical immunology · 2025Article
- Cellular and molecular features of asthma mucus plugs provide clues about their formation and persistence.The Journal of clinical investigation · 2025Article
- Innate Immunity and Asthma Exacerbations: Insights From Human Models.Immunological reviews · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
25 authors at 11 institutions in 2 countries.
Funding
Abstract
BACKGROUNDInformation about the size, airway location, and longitudinal behavior of mucus plugs in asthma is needed to understand their role in mechanisms of airflow obstruction and to rationally design muco-active treatments.METHODSCT lung scans from 57 patients with asthma were analyzed to quantify mucus plug size and airway location, and paired CT scans obtained 3 years apart were analyzed to determine plug behavior over time. Radiologist annotations of mucus plugs were incorporated in an image-processing pipeline to generate size and location information that was related to measures of airflow.RESULTSThe length distribution of 778 annotated mucus plugs was multimodal, and a 12 mm length defined short ("stubby", ≤12 mm) and long ("stringy", >12 mm) plug phenotypes. High mucus plug burden was disproportionately attributable to stringy mucus plugs. Mucus plugs localized predominantly to airway generations 6-9, and 47% of plugs in baseline scans persisted in the same airway for 3 years and fluctuated in length and volume. Mucus plugs in larger proximal generations had greater effects on spirometry measures than plugs in smaller distal generations, and a model of airflow that estimates the increased airway resistance attributable to plugs predicted a greater effect for proximal generations and more numerous mucus plugs.CONCLUSIONPersistent mucus plugs in proximal airway generations occur in asthma and demonstrate a stochastic process of formation and resolution over time. Proximal airway mucus plugs are consequential for airflow and are in locations amenable to treatment by inhaled muco-active drugs or bronchoscopy.TRIAL REGISTRATIONClinicaltrials.gov; NCT01718197, NCT01606826, NCT01750411, NCT01761058, NCT01761630, NCT01716494, and NCT01760915.FUNDINGAstraZeneca, Boehringer-Ingelheim, Genentech, GlaxoSmithKline, Sanofi-Genzyme-Regeneron, and TEVA provided financial support for study activities at the Coordinating and Clinical Centers beyond the third year of patient follow-up. These companies had no role in study design or data analysis, and the only restriction on the funds was that they be used to support the SARP initiative.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.