Allergy Asthma Immunol Res.  2014 Sep;6(5):376-388. 10.4168/aair.2014.6.5.376.

Small Airways Dysfunction in Asthma: Evaluation and Management to Improve Asthma Control

• Usmani OS

• KMID: 2181073
• DOI: http://doi.org/10.4168/aair.2014.6.5.376

Abstract

The small airways have been neglected for many years, but interest in the topic has been rekindled with recent advances in measurement techniques to assess this region and also the ability to deliver therapeutics to the distal airways. Current levels of disease control in asthmatic patients remain poor and there are several contributory factors including; poor treatment compliance, heterogeneity of asthma phenotypes and associated comorbidities. However, the proposition that we may not be targeting all the inflammation that is present throughout the whole respiratory tree may also be an important factor. Indeed decades ago, pathologists and physiologists clearly identified the importance of small airways dysfunction in asthmatic patients. With improved inhaler technology to deliver drug to target the whole respiratory tree and more sensitive measures to assess the distal airways, we should certainly give greater consideration to treating the small airway region when seeing our asthmatic patients in clinic. The aim of this review is to address the relevance of small airways dysfunction in the daily clinical management of patients with asthma. In particular the role of small particle aerosols in the management of patients with asthma will be explored.

Keyword

Small airways; asthma; physiology; pharmacology; inhalation; aerosols; corticosteroids; long-acting beta agonists

MeSH Terms

Adrenal Cortex Hormones
Aerosols
Asthma*
Comorbidity
Compliance
Humans
Inflammation
Inhalation
Nebulizers and Vaporizers
Pharmacology
Phenotype
Physiology
Population Characteristics
Adrenal Cortex Hormones
Aerosols

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