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Assessing and accessing the small airways; implications for asthma management

Scichilone, Nicola and Contoli, Marco and Paleari, Davide and Pirina, Pietro and Rossi, Andrea and Sanguinetti, Claudio Maria and Santus, Pierachille and Sofia, Matteo and Sverzellati, Nicola (2013) Assessing and accessing the small airways; implications for asthma management. Pulmonary pharmacology & therapeutics, Vol. 26 (2), p. 172-179. eISSN 1522-9629. Article.

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DOI: 10.1016/j.pupt.2012.10.001

Abstract

Despite the wealth of experience in the management of asthma, the disease remains inadequately controlled in some patients, who face long-term respiratory impairment and disability. The disease has been characterised as an inflammatory condition affecting first the larger airways and eventually the smaller airways, but there is evidence that peripheral airway involvement defines a particular and more severe phenotype of asthma. For this reason, assessing functional and biological parameters reflective of small airways involvement is important prognostically. No assessment method is universally and directly representative of peripheral airway function, but the traditional spirometric tests, including vital capacity, residual volume and forced vital capacity, are somewhat correlated with this function; useful methods for further assessment include the single-breath nitrogen wash-out test, impulse oscillometry, nitrous oxide and exhaled breath concentrate measurements, as well as computed tomography to reflect air trapping and response to treatment. Formulation advancements have made for easier treatment access to the smaller airways, with the new extrafine formulations resulting in better asthma control compared with non-extrafine formulations.

Item Type:Article
ID Code:8733
Status:Published
Refereed:Yes
Uncontrolled Keywords:Asthma, peripheral airways, small airways, inflammation, imaging, extrafine
Subjects:Area 06 - Scienze mediche > MED/10 Malattie dell'apparato respiratorio
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Medicina Clinica e Sperimentale
Publisher:Academic Press / Elsevier
eISSN:1522-9629
Copyright Holders:© 2012 Elsevier Ltd.
Deposited On:04 Mar 2013 10:36

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