Quantitative Chest CT and Multi-Omics to Distinguish Asthma From COPD and Predict Treatment Response

This is a prospective, observational, multi-center cohort study designed to integrate quantitative chest CT imaging with multi-omics data to improve differentiation between asthma and chronic obstructive pulmonary disease (COPD) and to identify biomarkers associated with treatment response.

Eligible participants will include adults diagnosed with asthma or COPD who agree to participate in longitudinal clinical follow-up. At baseline and during follow-up, participants will undergo standard clinical assessments, including symptom questionnaires, pulmonary function testing, blood sampling, and chest CT imaging. Additional biological samples, such as sputum and microbiome specimens, may be collected when clinically feasible.

Quantitative CT metrics (e.g., low attenuation area percentage, parametric response mapping features, airway wall measurements, and mucus plug scores) will be extracted from imaging data. These imaging biomarkers will be integrated with clinical variables, laboratory parameters (including inflammatory markers and immunoglobulin profiles), and microbiome data.

The primary objectives are: (1) to identify imaging and biological signatures that distinguish asthma from COPD, and (2) to determine whether these signatures can predict response to standard clinical treatments. No investigational drugs or medical devices are involved, and all procedures reflect routine clinical care.

Data will be analyzed using advanced statistical and computational methods to explore associations between imaging, biological markers, and clinical outcomes. Results are expected to enhance understanding of disease mechanisms and support the development of personalized treatment strategies for chronic airway diseases.

Inclusion criteria

• Age ≥19 years
• COPD group: post-bronchodilator FEV1/FVC < 0.70
• Asthma group: clinically confirmed diagnosis of asthma by a physician
• Able to provide voluntary written informed consent

Exclusion criteria

• Acute exacerbation or active lower respiratory tract infection (e.g., pneumonia) within the past 4 weeks
• Pregnancy or breastfeeding
• Inability to undergo chest CT (e.g., poor cooperation or severe medical condition)
• Refusal to consent to study procedures