Markers of small airway involvement and asthma control in patients with moderate-to-severe asthma

Malagrinò, Laura; Catapano, Giosué; Novelli, Federica; Bacci, Elena; Costa, Francesco; Dente, Federico L.; Franco, Antonella Di; Latorre, Manuela; Vagaggini, Barbara; Celi, Alessandro; Paggiaro, Pierluigi

doi:10.1016/j.anai.2014.03.009

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…Two decades ago, Wagner et al (4) demonstrated a more than sevenfold increase in small airway resistance in asymptomatic asthma with normal spirometry (FEV 1 and forced vital capacity (FVC)). The contribution of the small airways to the development of the clinical features and functional impairment in asthma is incompletely understood (5). Study suggested that asthmatics with AHR have more severe small airways obstruction, but little is known about the role of the small airways in asymptomatic subjects with AHR.…”

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Airway hyper-responsiveness and small airway function in children with well-controlled asthma

Huang

Zhang

et al. 2015

Pediatr Res

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Background: Airway hyper-responsiveness (AHR) and small airway function are critical to children with asthma. Little is known about the role of the small airway in well-controlled subjects with AHR. We aimed to evaluate AHR and small airway function in children with well-controlled asthma, and to investigate the association between them. Methods: We studied 116 cases of children with well-controlled asthma (group A), 46 cases healthy children as controls (group C). Spirometry, impulse oscillometry (IOS), and methacholine challenge test (MCT) were conducted on all the children. results: (i) Group A and group C had no differences in forced expiratory volume in 1 s (FEV 1 ) and FEV 1 /forced vital capacity (FVC) ratio (P > 0.05). Forced expiratory flow between 25 and 75% of vital capacity ) and reactance at 5 Hz (X5) in group A were significantly lower than those in group C. (ii) One hundred and five cases (90.5%) of group A proved positive to MCT. (iii) FEF in group A proved positive to MCT but were lower than those proved negative (P < 0.05). conclusion: AHR persisted in majority of children with well-controlled asthma. Among children with well-controlled asthma, small airway function was lower in those with AHR than those without AHR. a sthma is the most common chronic lower respiratory disease in childhood throughout the world. The newest Global Initiative for Asthma guidelines, as well as international consensus on pediatric asthma suggested that, after initial severity assessment, ongoing care should include continual assessment of the patient's asthma control in terms of real-life activities (1,2). This approach uses a cycle of detailed assessment and intervention to achieve and maintain asthma control. The level of control is defined by frequency of asthma symptoms, and the degree of lung function (forced expiratory volume in 1 s (FEV 1 ), peak expiratory flow). But in some cases called "well controlled asthma" with no disease activity and normal lung function, how can we evaluate and manage them? Airway hyper-responsiveness (AHR) is a clinical feature of asthma and is often in proportion to the underlying severity of the disease. AHR of children with well-controlled asthma can display condition of the disease. But, the evaluation of AHR is not popular in pediatric clinic. In areas without this means, how can we do next?Asthma is an inflammatory airway disorder that involves also the small airways (defined as the peripheral membranous bronchioles <2 mm in diameter) (3). Two decades ago, Wagner et al. (4) demonstrated a more than sevenfold increase in small airway resistance in asymptomatic asthma with normal spirometry (FEV 1 and forced vital capacity (FVC)). The contribution of the small airways to the development of the clinical features and functional impairment in asthma is incompletely understood (5). Study suggested that asthmatics with AHR have more severe small airways obstruction, but little is known about the role of the small airways in asymptomatic subjects with AHR. Therefore, the aim of our...

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confidence: 99%