Evidence map›Paper›PMID 41738094›Full record

ArticleAmerican journal of respiratory and critical care medicine2026

Mucus plugs in chronic obstructive pulmonary disease are heterogeneous in size and shape and occur in relatively large airways.

Omar N Farooqui, Brett M Elicker, Travis S Henry, Lewis D Hahn, Kimberly G Kallianos, Meilan K Han, R Graham Barr, Benjamin M Smith, Alejandro P Comellas, Jessica Bon and 8 more

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In one paragraph

Article in American journal of respiratory and critical care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Omar N FarooquiDivision of Pulmonary and Critical Care Medicine, Department of Medicine and Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, United States.
Brett M ElickerDivision of Cardiac and Pulmonary Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.
Travis S HenryDivision of Cardiothoracic Imaging, Duke Radiology, Duke University, Durham, NC, United States.
Lewis D HahnDepartment of Radiology, Mayo Clinic, Rochester, MN, United States.
Kimberly G KallianosDivision of Cardiac and Pulmonary Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.
Meilan K HanDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, United States.
R Graham BarrDepartment of Medicine, Columbia University Medical Center, New York, NY, United States.
Benjamin M SmithDepartment of Medicine, Columbia University Medical Center, New York, NY, United States.
Alejandro P ComellasDivision of Pulmonary, Critical Care, and Occupational Medicine, Department of Internal Medicine, University of Iowa, Iowa City, IA, United States.
Jessica BonSection of Pulmonary, Critical Care, Allergy, and Immunologic Diseases, Department of Internal Medicine, Wake Forest University, Winston-Salem, NC, United States.
Nadia HanselDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States.
J Michael WellsDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States.
Robert PaineDivision of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Medicine, University Utah School of Medicine, Salt Lake City, UT, United States.
Igor BarjaktarevicDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
Joyce D SchroederDepartment of Radiology, Mayo Clinic, Rochester, MN, United States.
Prescott G WoodruffDivision of Pulmonary and Critical Care Medicine, Department of Medicine and Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, United States.
Brendan K HuangDivision of Pulmonary and Critical Care Medicine, Department of Medicine and Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, United States.
John V FahyDivision of Pulmonary and Critical Care Medicine, Department of Medicine and Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, United States.

Funding

NHLBI TRANS-OMICS FOR PRECISION MEDICINE (TOPMED) FOR THE CENTRALIZED OMICS RESOURCE (CORE) - TASK AREAS 2, 3, AND 4 - 2024 TASK ORDER75N92023D00012 · NHLBI · BAYLOR COLLEGE OF MEDICINE · PI OSBORNE, C KENT · 2023 to 2025
$27.9M
SPIROMICS II: Biological underpinnings of COPD heterogeneity and progressionU01HL137880 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI WOODRUFF, PRESCOTT G · 2017 to 2021
$27.9M
Pulmonary Vascular Changes in Early Chronic Obstructive Pulmonary Disease (COPD)R01HL093081 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI R Graham BARR · 2008 to 2026
$17.2M
Understanding the Origins of Early COPDR01HL144718 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI CURTIS, JEFFREY LOUIS, HAN, MEILAN K · 2020 to 2024
$11.3M
FRAMINGHAM HEART STUDY (FHS), TASK AREA B - PROTOCOL DEVELOPMENT AND BASIC EXAMINATION75N92025D00012 · NHLBI · BOSTON UNIVERSITY (CHARLES RIVER CAMPUS) · PI LLOYD-JONES, DONALD · 2025 to 2025
$8.9M
SPIROMICS GIC SupportU24HL141762 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI COUPER, DAVID J, O'NEAL, WANDA K · 2018 to 2022
$7.2M
SUBPOPULATIONS AND INTERMEDIATE OUTCOMES IN COPD (SPIROMICS) III - TASK AREA B75N92024D00012 · NHLBI · PI ANDERSON, ERICA · 2024 to 2024
$6.9M
PROCESS DEVELOPMENT OF TELACEBEC FOR TUBERCULOSIS75N95024D00012 · NIDA · MIDWEST RESEARCH INSTITUTE · PI SLADE, DESMOND · 2024 to 2025
$742k
AmgenAstraZenecaBoehringer-Ingelheim PharmaceuticalsCOPD FoundationForest Research InstituteNHLBI NIH HHS 75N92024D00012NHLBI NIH HHS 75N92025D00012NHLBI NIH HHS HHSN268200900013CNHLBI NIH HHS HHSN268200900014CNHLBI NIH HHS HHSN268200900015CNHLBI NIH HHS HHSN268200900016CNHLBI NIH HHS HHSN268200900017CNHLBI NIH HHS HHSN268200900018CNHLBI NIH HHS HHSN268200900019CNHLBI NIH HHS HHSN268200900020CNHLBI NIH HHS R01 HL093081NHLBI NIH HHS R01 HL144718NHLBI NIH HHS U01 HL137880NHLBI NIH HHS U24 HL141762NIHNIH HHS 75N90024D00012NIH HHS 75N92023D00012NIH HHS 75N95024D00012NIH HHS 75N98024D00012NIH HHS R01HL093081NIH HHS R01HL144718NIH HHS R01HL182622NIH HHS U01HL137880NIH HHS U24HL141762
6 · The paper itself

Abstract

rationaleMucus plugs occur in chronic obstructive pulmonary disease (COPD), but little is known about their size and airway location or whether these mucus plug features change as emphysema worsens.

methodsComputed tomographic lung scans from 31 participants with COPD from the SubPopulations and InteRmediate Outcomes In COPD Study (SPIROMICS) cohort were analyzed to quantify mucus plug size and airway location and extent of emphysema. Radiologist annotations of mucus plugs were incorporated in an image processing pipeline to generate size and location information. Emphysema was quantified as the percentage of voxels less than -950 Hounsfield units. MEASUREMENTS AND MAIN

resultsThe length distribution of 563 annotated mucus plugs varied from 2 to 50 mm. The distribution was multimodal, and an 11-mm length defined short ("stubby," ≤11 mm) and long ("stringy," >11 mm) plug phenotypes, with stubby plugs being most common (64%). Mucus plugs localized predominantly to airway generations 6 to 9, and their prevalence was highest in lower lobes. On a lobar basis, the mucus plug number decreased as emphysema percentage increased, whereas average mucus plug volume tended to increase.

conclusionCOPD is characterized by mucus plugs of varying size and shape, and emphysematous lung regions may be differentially susceptible to formation of these plugs. The location of mucus plugs in segmental and subsegmental airways in COPD makes them amenable to treatment with inhaled medications or bronchoscopy.

Indexed as

LungMucusPulmonary Disease, Chronic ObstructivePulmonary EmphysemaAgedFemaleHumansMaleMiddle AgedTomography, X-Ray ComputedCOPDemphysemamucus plugs

Identifiers

PMID41738094
PMCPMC13051690

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Registered trials

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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.