Assessing small airway impairment in mild-to-moderate smoking asthmatic patients

Contoli, Marco; Bellini, Federico; Morandi, Luca; Forini, Giacomo; Bianchi, Stefano; Gnesini, Giulia; Marku, Brunilda; Rabe, Klaus F.; Papi, Alberto

doi:10.1183/13993003.01708-2015

Cited by 15 publications

(12 citation statements)

References 14 publications

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“…SAD significantly contributes to the pathophysiology of asthma, 6 and it is associated with the development of asthma. 11,12 When SAD in CRSwNP patients develops into asthma, disease se- In this study, we identified a negative correlation between SAD and Lund-Mackay scores in non-asthmatic CRSwNP patients, which verified that the presence and severity of CRSwNPs were related to a decrease in lower airway function. Smoking was identified as a risk factor for impaired lung function in non-asthmatic CRSwNP patients, which is consistent with previous studies.…”

Section: Discussionsupporting

confidence: 64%

“…Therefore, SAD in CRSwNP patients may be an early sign of lower airway disease. SAD significantly contributes to the pathophysiology of asthma, 6 and it is associated with the development of asthma 11,12 . When SAD in CRSwNP patients develops into asthma, disease severity in the upper and lower airways becomes simultaneously enhanced.…”

Section: Discussionmentioning

confidence: 99%

“…Given the "united airways" concept, whether CRSwNP patients exhibit a similar pattern of SAD is not known. SAD is also involved in the pathogenesis of asthma, 6 and it is associated with poor clinical outcomes of asthma 11,12 . Therefore, it is important to investigate whether SAD exists in non‐asthmatic CRSwNP patients to monitor the development of asthma comorbidity.…”

Section: Introductionmentioning

confidence: 99%

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Impaired small airway function in non‐asthmatic chronic rhinosinusitis with nasal polyps

Zheng

Zhao

et al. 2020

Clin Experimental Allergy

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Background: There is clinical evidence for impaired lung function in chronic rhinosinusitis with nasal polyps (CRSwNP) patients, which may be due to a high incidence of asthma comorbidity. The lung function characteristics of non-asthmatic CRSwNP patients are not known. Small airway dysfunction (SAD) is involved in the pathogenesis of asthma. However, whether SAD is detected in non-asthmatic patients with CRSwNPs remains unclear. Objective: This study analysed the lung function of non-asthmatic patients with CRSwNPs and evaluated its clinical relevance in CRSwNPs. Methods: The clinical data for 191 consecutive CRSwNP patients (73 asthmatic and 118 non-asthmatic) and 30 control subjects were prospectively collected. The patients were followed up for at least 3 years (mean [standard deviation], 42.47 ± 8.38 months). Serum and tissue total IgE levels were measured in 95 and 93 patients, respectively. Tissue eosinophil counts were documented in 63 patients. Results: Non-asthmatic CRSwNP patients had decreased forced expiratory flow at 75% of the FVC (FEF 75) and FEF 50 compared to the control subjects, and this difference was related to the severity of CRSwNP. The risk factors for impaired lung function in asthmatic and non-asthmatic patients were duration of asthma and smoking. A multivariate logistic analysis showed that decreased FEF 50 was associated with the recurrence of non-asthmatic CRSwNPs. The lung function of CRSwNP patients negatively correlated with the degree of type-2 inflammation, which was defined by the levels of Eos and IgE in polyp tissues and blood. The SAD of non-asthmatic CRSwNP patients was related to serum IgE levels. Conclusions and clinical relevance: This study provides evidence that non-asthmatic CRSwNP patients may have SAD, which correlated with the severity and recurrence of CRSwNP. The decreased lung function of patients with CRSwNP was related to the degree of type-2 inflammation.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impaired small airway function in non‐asthmatic chronic rhinosinusitis with nasal polyps

Zheng

Zhao

et al. 2020

Clin Experimental Allergy

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“…Our results differ from those of Contoli et al [29] who also investigated the efficacy of extrafine particle treatment in smokers with asthma. In this study, smokers and never-smokers with asthma, initially treated with non-extrafine particle ICS, were switched to an equipotent dose extrafine particle beclomethasone for a period of three months.…”

Section: Discussioncontrasting

confidence: 99%

Extrafine compared to non-extrafine particle inhaled corticosteroids in smokers and ex-smokers with asthma

Cox

Boudewijn

Vroegop

et al. 2017

Respiratory Medicine

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“…The range of frequencies used in modern FOT devices also allows independent assessment of both proximal and peripheral airways, where the lower frequency (5 Hz) penetrates down through the proximal airways to the peripheral airways giving the measure of total airway resistance, whereas higher frequencies (20 Hz) relate to proximal airway resistance. Thus, research has interpreted R5-R20 as a marker of peripheral airway resistance and found to be increased in non-symptomatic smokers compared to non-smokers [38,50,51]. Changes in R5 and R5-20 have also been observed in adolescents exposed to maternal smoking and are therefore projected to be a sensitive marker of airway changes in passive smokers [52].…”

Section: Clinically Relevant Fot Parameters For Detecting Early Changes In Smokersmentioning

confidence: 99%

Clinical Application of Forced Oscillation Technique (FOT) in Early Detection of Airway Changes in Smokers

Bhattarai

Myers

Chia

et al. 2020

JCM

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The forced oscillation technique (FOT) is a non-invasive method to assess airway function by emitting oscillatory signals into the respiratory tract during tidal ventilation. This opinion piece discusses the current use, trialled modification and future directions in utilizing FOT as a novel diagnostic tool for early detection of small airway changes in smokers. The published evidence to date has shown that FOT parameters could be a sensitive diagnostic tool to detect early respiratory changes in smokers. Multiple frequencies and the frequency dependence of resistance and reactance can provide the most valuable and early information regarding smoking induced changes in airways. Considering its non-invasiveness, lower level of discomfort to patients than spirometry, feasibility, and cost effectiveness, it could be the first-choice diagnostic technique for detection of early respiratory changes in smokers. The finding of FOT could further be supported and correlated with inflammatory markers.

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Assessing small airway impairment in mild-to-moderate smoking asthmatic patients

Cited by 15 publications

References 14 publications

Impaired small airway function in non‐asthmatic chronic rhinosinusitis with nasal polyps

Impaired small airway function in non‐asthmatic chronic rhinosinusitis with nasal polyps

Extrafine compared to non-extrafine particle inhaled corticosteroids in smokers and ex-smokers with asthma

Clinical Application of Forced Oscillation Technique (FOT) in Early Detection of Airway Changes in Smokers

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