Small airway dysfunction by impulse oscillometry in asthmatic patients with normal forced expiratory volume in the 1st second values

Pisi, Roberta; Tzani, Panagiota; Aiello, Marina; Martinelli, Enrico; Marangio, Emilio; Nicolini, Gabriele; Olivieri, Dario; Chetta, Alfredo

doi:10.2500/aap.2013.34.3641

Cited by 68 publications

(47 citation statements)

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“…An advantage of IOS may be the detection of subtle changes in a patient’s airway function earlier than with conventional spirometry [35, 43] and some data suggest that IOS can be used to assess abnormal distal airway function, even in the setting of normal spirometry [35, 44]. Especially, airway reactance was also correlated with ground-glass opacity [45].…”

Section: Discussionmentioning

confidence: 99%

Effects of a mixture of chloromethylisothiazolinone and methylisothiazolinone on peripheral airway dysfunction in children

et al. 2017

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BackgroundChildren who were only exposed to a mixture of chloromethylisothiazolinone (CMIT) and methylisothiazolinone (MIT) as humidifier disinfectant (HD) components were evaluated for humidifier disinfectant-associated lung injury (HDLI) from 2012. This study was to evaluate the pulmonary function using, impulse oscillometry (IOS) for children exposed to a mixture of CMIT/MIT from HD.MethodsTwenty-four children who were only exposed to a mixture of CMIT/MIT, with no previous underlying disease, were assessed by IOS. Diagnostic criteria for HDLI were categorized as definite, probable, possible, or unlikely. Home visits and administration of a standardized questionnaire were arranged to assess exposure characteristics.ResultsDefinite and probable cases showed higher airborne disinfectant exposure intensity during sleep (32.4 ± 8.7 μg/m3) and younger age at initial exposure (3.5 ± 3.3 months) compared with unlikely cases (17.3 ± 11.0 μg/m3, p = 0.026; 22.5 ± 26.2 months, p = 0.039, respectively). Reactance at 5 Hz was significantly more negative in those with high-density exposure during sleep (mean, -0.463 kPa/L/s vs. low density, -0.296, p = 0.001). The reactance area was also higher with high-density exposure during sleep (mean, 3.240 kPa/L vs. low density, 1.922, p = 0.039). The mean bronchodilator response with high-density exposure was within the normal range for reactance.ConclusionsSignificant peripheral airway dysfunction were found in children with high levels of inhalation exposure to a mixture of CMIT/MIT during sleep. Strict regulation of a mixture of CMIT/MIT exposure were associated with positive effects on lung function of children.

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Section: Discussionmentioning

confidence: 99%

Effects of a mixture of chloromethylisothiazolinone and methylisothiazolinone on peripheral airway dysfunction in children

et al. 2017

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“…Thus, on the basis of all this evidence, we may speculate that in the present study, abnormal FEF 25-75% in symptomatic subjects with normal FEV 1 can be considered a marker of early airway obstruction without involvement of the proximal/central airways. Pisi et al [41] suggested investigating small airway dysfunction in asthmatic patients with normal FEV 1 values by using an impulse oscillometry system as an alternative to spirometry.…”

Section: Discussionmentioning

confidence: 99%

Association of FEF25-75% Impairment with Bronchial Hyperresponsiveness and Airway Inflammation in Subjects with Asthma-Like Symptoms

et al. 2016

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Background: Forced expiratory flow at 25 and 75% of the pulmonary volume (FEF_25-75%) might be considered as a marker of early airway obstruction. FEF_25-75% impairment might suggest earlier asthma recognition in symptomatic subjects even in the absence of other abnormal spirometry values. Objectives: The study was designed in order to verify whether FEF_25-75% impairment in a cohort of subjects with asthma-like symptoms could be associated with the risk of bronchial hyperresponsiveness (BHR) and with airway inflammation expressed as fractional exhaled nitric oxide (FeNO) and eosinophil counts in induced sputum. Methods: Four hundred adults with a history of asthma-like symptoms (10.5% allergic) underwent spirometry, determination of BHR to methacholine (PD₂₀FEV₁), FeNO analysis and sputum induction. FEF_25-75% <65% of predicted or <-1.64 z-score was considered abnormal. Results: All subjects had normal FVC, FEV₁ and FEV₁/FVC, while FEF_25-75% was abnormal in 27.5% of them. FEF_25-75% (z-score) was associated with PD₂₀FEV₁ (p < 0.001), FeNO (p < 0.001) and sputum eosinophils (p < 0.001). Patients with abnormal FEF_25-75% showed higher levels of FeNO and eosinophils in induced sputum than did patients with normal FEF_25-75% (p < 0.01 and p < 0.01, respectively). Subjects with abnormal FEF_25-75% had an increased probability of being BHR positive (OR = 13.38; 95% CI: 6.7-26.7; p < 0.001). Conclusions: Our data show that abnormal FEF_25-75% might be considered an early marker of airflow limitation associated with eosinophilic inflammation and BHR in subjects with asthma-like symptoms, indicating a role for FEF_25-75% as a predictive marker of newly diagnosed asthma.

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“…Small airway function as evaluated by peripheral airway IOS indices, correlated better with clinical symptoms and asthma control than spirometry; furthermore, greater small-airways reactance was associated with loss of asthma control. Pisi et al investigated the presence of SAD based on increased peripheral airway IOS indices in 33 adult asthmatic patients with normal FEV1 values [56]. Small airway dysfunction, as assessed by IOS and spirometry, was associated with poor disease control, assessed by the Asthma Control Test.…”

Section: Introductionmentioning

confidence: 99%

Small airway dysfunction and bronchial asthma control : the state of the art

Cottini¹,

Lombardi

Micheletto³

2015

asthma res and pract

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According to national and international guidelines, achieving and maintaining asthma control is a major goal of disease management. In closely controlled clinical trials, good asthma control can be achieved , with the medical treatments currently available, in the majority of patients , but large population-based studies suggest that a significant proportion of patients in real-life setting experience suboptimal levels of asthma control and report lifestyle limitations with a considerable burden on quality of life. Poor treatment adherence and persistence, failure to use inhalers correctly, heterogeneity of asthma phenotypes and associated co-morbidities are the main contributing factors to poor disease control. Now, it is widely accepted that peripheral airway dysfunction , already present in patients with mild asthma, is a key contributor of worse control. The aim of this paper is to investigate the association between small-airways dysfunction and asthma symptoms/control. We therefore performed a PubMed search using keywords : small airways; asthma (limits applied: Humans, English language) and selected papers with a study population of asthmatic patients, reporting measurement of small-airways parameters and clinical symptoms/control.

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Small airway dysfunction by impulse oscillometry in asthmatic patients with normal forced expiratory volume in the 1st second values

Cited by 68 publications

References 0 publications

Effects of a mixture of chloromethylisothiazolinone and methylisothiazolinone on peripheral airway dysfunction in children

Effects of a mixture of chloromethylisothiazolinone and methylisothiazolinone on peripheral airway dysfunction in children

Association of FEF25-75% Impairment with Bronchial Hyperresponsiveness and Airway Inflammation in Subjects with Asthma-Like Symptoms

Small airway dysfunction and bronchial asthma control : the state of the art

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