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The role of the small airways in the pathophysiology of asthma and chronic obstructive pulmonary disease

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Title: The role of the small airways in the pathophysiology of asthma and chronic obstructive pulmonary disease
Authors: Bonini, M
Usmani, OS
Item Type: Journal Article
Abstract: Chronic respiratory diseases, such as asthma and chronic obstructive pulmonary disease (COPD), represent a major social and economic burden for worldwide health systems. During recent years, increasing attention has been directed to the role of small airways in respiratory diseases, and their exact contribution to the pathophysiology of asthma and COPD continues to be clarified. Indeed, it has been suggested that small airways play a distinct role in specific disease phenotypes. Besides providing information on small airways structure and diagnostic procedures, this review therefore aims to present updated and evidence-based findings on the role of small airways in the pathophysiology of asthma and COPD. Most of the available information derives from either pathological studies or review articles and there are few data on the natural history of small airways disease in the onset or progression of asthma and COPD. Comparisons between studies on the role of small airways are hard to draw because both asthma and COPD are highly heterogeneous conditions. Most studies have been performed in small population samples, and different techniques to characterize aspects of small airways function have been employed in order to assess inflammation and remodelling. Most methods of assessing small airways dysfunction have been largely confined to research purposes, but some data are encouraging, supporting the utilization of certain techniques into daily clinical practice, particularly for early-stage diseases, when subjects are often asymptomatic and routine pulmonary function tests may be within normal ranges. In this context further clinical trials and real-life feedback on large populations are desirable.
Issue Date: 2-Jun-2015
Date of Acceptance: 2-Jun-2015
URI: http://hdl.handle.net/10044/1/50843
DOI: https://dx.doi.org/10.1177/1753465815588064
ISSN: 1753-4666
Publisher: SAGE Publications
Start Page: 281
End Page: 293
Journal / Book Title: Therapeutic Advances in Respiratory Disease
Volume: 9
Issue: 6
Copyright Statement: © The Author(s), 2015. The final, definitive version of this paper has been published in Therapeutic Advances in Respiratory Disease by Sage Publications Ltd. All rights reserved. It is available at: http://journals.sagepub.com/doi/10.1177/1753465815588064
Sponsor/Funder: National Institute for Health Research
Funder's Grant Number: CDF-2011-04-053
Keywords: Science & Technology
Life Sciences & Biomedicine
Respiratory System
asthma
COPD
pathophysiology
phenotype
small airways
EXHALED NITRIC-OXIDE
LUNG-VOLUME REDUCTION
INDUCED SPUTUM
VENTILATION HETEROGENEITY
COMPUTED-TOMOGRAPHY
NITROGEN WASHOUT
PARTICLE-SIZE
MILD ASTHMA
INFLAMMATION
Animals
Asthma
Biomarkers
Humans
Lung
Phenotype
Prognosis
Pulmonary Disease, Chronic Obstructive
Respiratory Function Tests
Publication Status: Published
Appears in Collections:National Heart and Lung Institute
Airway Disease
Faculty of Medicine



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