https://doi.org/10.4081/monaldi.2024.3005
Small airway involvement in severe asthma: how common is it and what are its implications?
Submitted: March 27, 2024
Accepted: September 26, 2024
Published: December 4, 2024
Accepted: September 26, 2024
Abstract Views: 98
PDF_EARLY VIEW: 4
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Asthma is a prevalent chronic respiratory disease affecting all age groups globally, causing significant morbidity and mortality. Small airway involvement, often undetected by traditional spirometry, has emerged as a critical aspect of asthma pathophysiology, especially in severe cases. This retrospective observational study aimed to assess small airway dysfunction using impulse oscillometry (IOS) in 94 severe asthma patients. Results indicated that 27.3% of patients had small airway obstruction. While spirometry showed no statistical differences between groups, IOS parameters were significantly different, highlighting its sensitivity in detecting small airway disease. Patients with small airway involvement exhibited poorer asthma control, emphasizing the clinical relevance of identifying and addressing small airway dysfunction. The study underscores the need for comprehensive evaluation tools like IOS alongside spirometry, especially in severe asthma management. Further large-scale studies are warranted to validate IOS's utility in optimizing therapeutic strategies and improving asthma control, particularly in resource-limited settings. Recognizing and addressing small airway involvement could lead to individualized management approaches and better outcomes in severe asthma patients.
Hekking PPW, Wener RR, Amelink M, et al. The prevalence of severe refractory asthma. J Allergy Clin Immunol 2015;135:896-902.
DOI: https://doi.org/10.1016/j.jaci.2014.08.042
Chung KF, Wenzel SE, Brozek JL, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 2014;43:343-73.
DOI: https://doi.org/10.1183/09031936.00202013
van der Wiel E, ten Hacken NHT, Postma DS, van den Berge M. Small-airways dysfunction associates with respiratory symptoms and clinical features of asthma: a systematic review. J Allergy Clin Immunol 2013;131:646-57.
DOI: https://doi.org/10.1016/j.jaci.2012.12.1567
Burgel PR. The role of small airways in obstructive airway diseases. Eur Respir Rev 2011;20:23-33.
DOI: https://doi.org/10.1183/09059180.00010410
Leach CL, Davidson PJ, Hasselquist BE, Boudreau RJ. Lung deposition of hydrofluoroalkane-134a beclomethasone is greater than that of chlorofluorocarbon fluticasone and chlorofluorocarbon beclomethasone: a cross-over study in healthy volunteers. Chest 2002;122:510-6.
DOI: https://doi.org/10.1378/chest.122.2.510
Agrawal A, Desiraju K. Impulse oscillometry: the state-of-art for lung function testing. Lung India 2016;33:410-6.
DOI: https://doi.org/10.4103/0970-2113.184875
Perez T. Is it really time to look at distal airways to improve asthma phenotyping and treatment? Eur Respir J 2011;38:1252-4.
DOI: https://doi.org/10.1183/09031936.00067711
Usmani OS, Singh D, Spinola M, et al. The prevalence of small airways disease in adult asthma: a systematic literature review. Respir Med 2016;116:19-27.
DOI: https://doi.org/10.1016/j.rmed.2016.05.006
Carr TF, Altisheh R, Zitt M. Small airways disease and severe asthma. World Allergy Organ J 2017;10:20.
DOI: https://doi.org/10.1186/s40413-017-0153-4
10. Scichilone N, Battaglia S, Olivieri D, Bellia V. The role of small airways in monitoring the response to asthma treatment: what is beyond FEV1? Allergy 2009;64:1563-9.
DOI: https://doi.org/10.1111/j.1398-9995.2009.02139.x
Nikkhah M, Amra B, Eshaghian A, et al. Comparison of impulse osillometry system and spirometry for diagnosis of obstructive lung disorders. Tanaffos 2011;10:19-25.
Postma DS, Brightling C, Baldi S, et al. Exploring the relevance and extent of small airways dysfunction in asthma (ATLANTIS): baseline data from a prospective cohort study. Lancet Respir Med 2019;7:402-16.
DOI: https://doi.org/10.1016/S2213-2600(19)30049-9
Mousa H, Kamal E. Impulse oscillation system versus spirometry in assessment of obstructive airway diseases. Egypt J Chest Dis Tuberc 2018;67:106-12.
DOI: https://doi.org/10.4103/ejcdt.ejcdt_3_18
Cottini M, Licini A, Lombardi C, et al. Small airway dysfunction and poor asthma control: a dangerous liaison. Clin Mol Allergy 2021;19:7.
DOI: https://doi.org/10.1186/s12948-021-00147-8
Cohen J, Douma WR, ten Hacken NHT, et al. Ciclesonide improves measures of small airway involvement in asthma. Eur Respir J 2008;31:1213-20.
DOI: https://doi.org/10.1183/09031936.00082407
Ethics Approval
Approved by the Ethics and Scientific Committee (Ref. 29/MERB/2019) as per the Declaration of Helsinki.How to Cite
Talwar, Dhruv, Sourabh Pahuja, Deepak Prajapat, Kanishka Kumar, Anupam Prakash, and Deepak Talwar. 2024. “Small Airway Involvement in Severe Asthma: How Common Is It and What Are Its Implications?”. Monaldi Archives for Chest Disease, December. https://doi.org/10.4081/monaldi.2024.3005.
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