Linking mucus plugs and chronic bronchitis to bronchodilator responsiveness in young adult smokers: BEACON cohort

<bold>BACKGROUND:</bold> In COPD and asthma, mucus plugging is common but poorly corresponds to symptoms. To investigate if plugging and chronic bronchitis reflect different mucus dysfunction phenotypes, we assessed how their presence/absence related to airway hyper-responsiveness in young adult smokers. <bold>METHODS:</bold> The British Early COPD Network (BEACON) enrolled 30–45-year-old smokers with ≥10 pack year smoking history and FEV1%predicted≥80% without diagnosed/treated asthma. We compared FEV1 bronchodilator reversibility and blood eosinophil count according to the presence/absence of both chronic bronchitis (clinical, CAT, MRC and SGRQ definitions) and mucus plugs (full inspiratory CT thorax scan). <bold>RESULTS:</bold> Among 404 BEACON subjects (60% male; 82% Caucasian; median age 39 (IQR:35-42) years; median pack years 16 (IQR:12-21); FEV1% 100% (IQR:93-109)), 192(48%) reported chronic bronchitis (any definition), 38(9%) had mucus plugs. Those with plugs had greater FEV1 reversibility: 185(IQR:85-253) vs 130(IQR:50-220)mL(P=0.04) and more frequently had bronchodilator responsiveness than those without (P=0.03). We found no difference by chronic bronchitis presence and no differences in eosinophil counts (Fig.1). <bold>CONCLUSION:</bold> FEV1 reversibility was over-represented among those with mucus plugs, but not among those with chronic bronchitis, potentially indicating different pathological processes present among young adult smokers. <fig><object-id>erj;66/suppl_69/OA6435/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>

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Published
2025-09-27
DOI
https://doi.org/10.1183/13993003.congress-2025.oa6435
Primary Topic
Chronic Obstructive Pulmonary Disease (COPD) Research
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article
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article

Linking mucus plugs and chronic bronchitis to bronchodilator responsiveness in young adult smokers: BEACON cohort

Paul Jones, Peter M.A. Calverley, Robert Andrew Stockley, Mirco Govoni et al.
Chronic Obstructive Pulmonary Disease (COPD) Research
article

Linking mucus plugs and chronic bronchitis to bronchodilator responsiveness in young adult smokers: BEACON cohort

Paul Jones, Peter M.A. Calverley, Robert Andrew Stockley, Mirco Govoni, Eric A. Hoffman, Kristoffer Ostridge, Luana Alves-Moreira, Hana Müllerová, Lorcan McGarvey, Julie Yates, Elizabeth Sapey, Andrew I. Ritchie, D.G. Downey, Augusta S. Beech, Sam Bartlett‐Pestell, James P. Allinson, Charlotte E. Bolton, Tom Wilkinson, Lydia Finney, Apolline Marion, Federico Baraldi, Jørgen Vestbo, Gourab Choudhury, Aaron Braddy-Green, Mairi Macleod, Chris Compton, Dave Singh, Jadwiga A. Wedzicha, Jordina Mah
article en

Abstract

<bold>BACKGROUND:</bold> In COPD and asthma, mucus plugging is common but poorly corresponds to symptoms. To investigate if plugging and chronic bronchitis reflect different mucus dysfunction phenotypes, we assessed how their presence/absence related to airway hyper-responsiveness in young adult smokers. <bold>METHODS:</bold> The British Early COPD Network (BEACON) enrolled 30–45-year-old smokers with ≥10 pack year smoking history and FEV1%predicted≥80% without diagnosed/treated asthma. We compared FEV1 bronchodilator reversibility and blood eosinophil count according to the presence/absence of both chronic bronchitis (clinical, CAT, MRC and SGRQ definitions) and mucus plugs (full inspiratory CT thorax scan). <bold>RESULTS:</bold> Among 404 BEACON subjects (60% male; 82% Caucasian; median age 39 (IQR:35-42) years; median pack years 16 (IQR:12-21); FEV1% 100% (IQR:93-109)), 192(48%) reported chronic bronchitis (any definition), 38(9%) had mucus plugs. Those with plugs had greater FEV1 reversibility: 185(IQR:85-253) vs 130(IQR:50-220)mL(P=0.04) and more frequently had bronchodilator responsiveness than those without (P=0.03). We found no difference by chronic bronchitis presence and no differences in eosinophil counts (Fig.1). <bold>CONCLUSION:</bold> FEV1 reversibility was over-represented among those with mucus plugs, but not among those with chronic bronchitis, potentially indicating different pathological processes present among young adult smokers. <fig><object-id>erj;66/suppl_69/OA6435/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>

AstraZeneca (United Kingdom) (GB), Queen's University Belfast (GB), University of Iowa (US), University of Liverpool (GB), University of Ferrara (IT), Manchester Academic Health Science Centre (GB), University College Birmingham (GB), Brentwood Hospital (US), Lung Institute (US), Chiesi Foundation (IT), Nottingham Biomedical Research Centre (GB), Centre for Inflammation Research (GB), The Queen's Medical Research Institute (GB), University of Southampton (GB), University of Birmingham (GB)
Openalex Percentile: Top 48%
Chronic Obstructive Pulmonary Disease (COPD) Research
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