Association of Ground Glass Opacities with Systemic Inflammation and Progression of Emphysema.

Fortis S, Guo J, Nagpal P, Chaudhary MFA, Newell JD, Gerard SE, Han MK, Kazerooni EA, Martinez FJ, Barjaktarevic IZ, Barr RG, Bodduluri S, Paine Iii R, Awan HA, Schroeder JD, Gravens-Mueller LD, Ortega VE, Anderson WH, Cooper CB, Couper D, Woodruff PG, Bowler RP, Bhatt SP, Hoffman EA, Reinhardt JM, Comellas AP. Association of Ground Glass Opacities with Systemic Inflammation and Progression of Emphysema. American journal of respiratory and critical care medicine. 2024 Jun 6.

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Abstract:

RATIONAL: Ground glass opacities (GGO) in the absence of interstitial lung disease are understudied. OBJECTIVE: To assess the association of GGO with white blood cells (WBCs) and progression of quantified chest CT emphysema. METHODS: We analyzed data of participants in the Subpopulations and Intermediate Outcome Measures In COPD Study (SPIROMICS). Chest radiologists and pulmonologists labeled regions of the lung as GGO and adaptive multiple feature method (AMFM) trained the computer to assign those labels to image voxels and quantify the volume of the lung with GGO (%GGO). We used multivariable linear regression, zero-inflated negative binomial, and proportional hazards regression models to assess the association of %GGO with WBC, changes in %emphysema, and clinical outcomes. MEASUREMENTS AND MAIN RESULTS: Among 2,714 participants, 1,680 had COPD and 1,034 had normal spirometry. Among COPD participants, based on the multivariable analysis, current smoking and chronic productive cough was associated with higher %GGO. Higher %GGO was cross-sectionally associated with higher WBCs and neutrophils levels. Higher %GGO per interquartile range at visit 1 (baseline) was associated with an increase in emphysema at one-year follow visit by 11.7% (Relative increase; 95%CI 7.5-16.1%;P < 0.001). We found no association between %GGO and one-year FEV decline but %GGO was associated with exacerbations and all-cause mortality during a median follow-up time of 1,544 days (Interquartile Interval = 1,118-2,059). Among normal spirometry participants, we found similar results except that %GGO was associated with progression to COPD at one-year follow-up. CONCLUSIONS: Our findings suggest that GGO is associated with increased systemic inflammation and emphysema progression.