Small airway dysfunction and poor asthma control: a dangerous liaison

Clinical and Molecular Allergy

Marcello Cottini¹  Anita Licini¹  Diego Bagnasco²  Carlo Lombardi³  Alvise Berti⁴  Pasquale Comberiati⁵ 

[1] Allergy and Pneumology Outpatient Clinic, Bergamo, Italy;Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genova, Italy;Departmental Unit of Allergology, Immunology and Pulmonary Diseases, Fondazione Poliambulanza, Brescia, Italy;Ospedale Santa Chiara and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy;Thoracic Disease Research Unit, Mayo Clinic, Rochester, MN, USA;Section of Pediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy;

关键词: Asthma;    Small airway diseases;    IOS;    FOT;    Impulse oscillometry;    Asthma control;    Lung function;   

DOI  :  10.1186/s12948-021-00147-8

来源: Springer

【 摘 要 】

Asthma is a common chronic condition, affecting approximately 339 million people worldwide. The main goal of the current asthma treatment guidelines is to achieve clinical control, encompassing both the patient symptoms and limitations and the future risk of adverse asthma outcomes. Despite randomized controlled trials showing that asthma control is an achievable target, a substantial proportion of asthmatics remain poorly controlled in real life. The involvement of peripheral small airways has recently gained greater recognition in asthma, and many studies suggest that the persistent inflammation at these sites leads to small airway dysfunction (SAD), strongly contributing to a worse asthma control. Overall, the impulse oscillometry (IOS), introduced in the recent years, seems to be able to sensitively assess small airways, while conventional spirometry does not. Therefore, IOS may be of great help in characterizing SAD and guiding therapy choice. The aim of this article is to review the literature on SAD and its influence on asthma control, emphasizing the most recent evidence.

【 授权许可】

CC BY