TY - JOUR
T1 - Assessing and accessing the small airways; implications for asthma management
AU - Scichilone, Nicola
AU - Contoli, Marco
AU - Paleari, Davide
AU - Pirina, Pietro
AU - Rossi, Andrea
AU - Sanguinetti, Claudio Maria
AU - Santus, Pierachille
AU - Sofia, Matteo
AU - Sverzellati, Nicola
N1 - Funding Information:
NS has received financial support for research and for congress attendance from Boehringer Ingelheim, Novartis and Chiesi Farmaceutici.
Funding Information:
PP has received financial support for research and for congress attendance from Novartis, Glaxo Smith Kline, Chiesi Farmaceutici, Menarini, and Pfizer.
PY - 2013/4
Y1 - 2013/4
N2 - 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.
AB - 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.
KW - Asthma
KW - Extrafine
KW - Imaging
KW - Inflammation
KW - Peripheral airways
KW - Small airways
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U2 - 10.1016/j.pupt.2012.10.001
DO - 10.1016/j.pupt.2012.10.001
M3 - Article
C2 - 23073337
AN - SCOPUS:84874569220
SN - 1094-5539
VL - 26
SP - 172
EP - 179
JO - Pulmonary Pharmacology and Therapeutics
JF - Pulmonary Pharmacology and Therapeutics
IS - 2
ER -