University of Twente Student Theses


Exploring type 2 asthma phenotypes and taking steps towards measurements of respiratory mechanics during exercise

Tolboom, L.C. (2022) Exploring type 2 asthma phenotypes and taking steps towards measurements of respiratory mechanics during exercise.

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Abstract:PART 1: Asthma is a common heterogeneous disease characterised by bronchial hyperresponsive-ness, airway inflammation and reversible airflow obstruction. Approximately 50 to 70 percent of the general asthma population has type 2 asthma. The present study aims to disentangle type 2 asthma by defining phenotypes which might result in further optimizing patient tailored treatment and thus improving quality of life. Asthma patients treated in secondary care having at least one type 2 inflammation characteristic were included in this study. Cluster analysis in 43 type 2 asthma patients identified three distinct phenotypes. The first phenotype mainly consisted of patients with an early onset asthma, atopy, high inflammatory parameters and disturbed both small and large airway lung function. The second phenotype was characterised by patients having late onset asthma, no atopy, high inflammatory parameters and varying large and small airway lung function. The third was predominantly defined by patients with a moderate early onset, atopy, no type 2 inflammation characteristics and preserved both large and small airway function. Concluding, k-means unsupervised machine learning provides for distinction of patients having type 2 asthma characteristics based on clinical, biological and functional parameters. PART 2: Forced oscillation technique (FOT) is a non-invasive measurement for analysing respiratory mechanics by means of small-amplitude pressure oscillations superimposed on the normal breathing. FOT can be used to diagnose and follow-up treatment of respiratory diseases. Currently FOT can only be applied during quiet breathing. However, patients often do not experience symptoms during normal respiration, while exercise does trigger them. Being able to measure respiratory mechanics during exercise, improves diagnosis and thus possible treatment options. Multiple options were compared to fulfil the signal generation, amplification and conversion to pressure functions. In vitro measurements with the set up showed that the current method is still limited in measurements while heavily breathing was simulated due to either an insufficient test set up or due to the large effect of the breathing signal on the pressure oscillation generating. Despite having no clear results during fast breathing, still many steps have been set towards FOT measurements during exercise and a strong pressure wave was generated when no interference was present.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:33 physics, 44 medicine, 50 technical science in general, 54 computer science
Programme:Technical Medicine MSc (60033)
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