Evidence map›Paper›PMID 42330343›Full record

ReviewAmerican journal of respiratory and critical care medicine2026

Airway mucus plugs in asthma and chronic obstructive pulmonary disease: pathobiology, imaging, and implications for clinical trials.

Christopher B Bosma, Shawn D Aaron, Bartolome R Celli, Grace Parraga, Sally Seymour, George R Washko, James P Allinson, Federico Baraldi, Richard C Boucher, Mario Castro and 20 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review 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

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.

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. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

30 authors.

Christopher B BosmaDivision of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, United States.ORCID 0000-0001-7438-7453
Shawn D AaronDivision of Respirology, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Bartolome R CelliDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Mass General Brigham and Harvard Medical School, Boston, MA, United States.
Grace ParragaRobarts Research Institute, Department of Medicine, Department of Medical Biophysics, and Department of Medical Imaging, Western University, London, ON, Canada.
Sally SeymourSeymour Pharmaceutical Consulting LLC, Washington, DC, United States.
George R WashkoDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.
James P AllinsonNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Federico BaraldiDepartment of Translational Medicine, University of Ferrara, Ferrara, Italy.
Richard C BoucherMarisco Lung Institute/Cystic Fibrosis and Pulmonary Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Mario CastroDivision of Pulmonary, Critical Care, and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS, United States.
Sanjay H ChotirmallLee Kong Chian School of Medicine, Nanyang Technological University, Singapore.ORCID 0000-0003-0417-7607
Alejandro A DiazDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.ORCID 0000-0001-5037-2919
John V FahyDivision of Pulmonary and Critical Care Medicine and the Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, United States.
Jonathan G GoldinDepartment of Radiology, University of California, Los Angeles, Los Angeles, CA, United States.
Andrew J HalaykoDepartment of Internal Medicine, University of Manitoba and Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.ORCID 0000-0002-7865-4552
David M G HalpinFaculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom.
Eric HoffmanDivision of Physiologic Imaging, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
Wassim W LabakiDivision of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, United States.ORCID 0000-0002-3203-5537
Njira LugogoDivision of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, United States.
Ella KazerooniDepartment of Radiology, University of Michigan, Ann Arbor, MI, United States.
Mehmet KesimerMarisco Lung Institute/Cystic Fibrosis and Pulmonary Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Alberto PapiDepartment of Translational Medicine, University of Ferrara, Ferrara, Italy.
Sundaresh RamDepartment of Radiology and Imaging Sciences, Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, United States.
Kathryn A RamseyWal-yan Respiratory Research Centre, The Kids Research Institute Australia, University of Western Australia, Perth, Australia.
Raúl San José EstéparDepartment of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States.ORCID 0000-0002-3677-1996
Naoya TanabeDepartment of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Kyle WhelanDivision of Pulmonary, Allergy, and Critical Care, UMass Memorial Medical Center, Worcester, MA, United States.
Jadwiga A WedzichaNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Fernando J MartinezDivision of Pulmonary, Allergy, and Critical Care, UMass Memorial Medical Center, Worcester, MA, United States.
MeiLan K HanDivision of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, United States.

Funding

COPD FoundationGlobal Initiative for Chronic Obstructive Lung DiseaseNIHUniversity of Iowa
6 · The paper itself

Abstract

Mucus plugs have been previously recognized as an important pathological feature in asthma and chronic obstructive pulmonary disease (COPD), but their clinical role in these diseases has not been explored in depth until recently. Mucus plug formation is driven by mucus hyperconcentration, changes in mucus viscoelastic properties, impaired clearance, and mucociliary collapse. Scoring systems, such as the bronchopulmonary segment mucus plug score, have been used to associate greater mucus plug burden with poor clinical outcomes. Additional scoring methods obtained through quantitative image processing are currently under development. Mucus plug burden has been associated with greater exacerbations and spirometric decline in both asthma and COPD, as well as greater mortality in COPD. Recently, mucus plug burden has been used as an endpoint in clinical trials to evaluate the effectiveness of biologic therapies in asthma; multiple biologic therapies demonstrated decreases in mucus plug burden and associated improvements in spirometry with treatment. Together, these data suggest that mucus plugs may be a treatable trait in asthma and COPD. Mucus plug burden has current clinical, phenotypic, and predictive utility and shows promise as a future biomarker. Increased incorporation into clinical trials, expanded evidence of treatment effect, and standardization of methodology and imaging protocols will be needed. Computed tomographic detection of mucus plug burden is ready for greater incorporation into both research outcomes and clinical care.

Indexed as

AsthmaMucusPulmonary Disease, Chronic ObstructiveClinical Trials as TopicHumansasthmaCOPDmucus plugsmucus plug score

Identifiers

PMID42330343
PMCPMC13519308

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.