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Do small airway abnormalities characterize asthma phenotypes? In search of proof
1Research Centre on Asthma and COPD, Department of Clinical and Experimental Medicine, University of Ferrara, Ferrara, Italy. ctm@unife.it
Summary
Small airway abnormalities are crucial in severe asthma, particularly in smokers and the elderly, impacting treatment response. Further research into peripheral airway treatments is warranted for these patient groups.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Asthma Pathogenesis
Background:
- Small airway abnormalities are a long-standing topic in asthma research.
- Their specific role in distinct asthma phenotypes remains largely unclear.
Purpose of the Study:
- To review the role of small airways in severe asthma.
- To focus on asthma phenotypes in smokers and the elderly, known for poor treatment response.
Main Methods:
- Literature review of existing data on small airway involvement.
- Analysis of evidence for distal inflammation and air trapping in severe asthma.
- Examination of data concerning asthma in smokers and the elderly.
Main Results:
- Severe asthma shows evidence of distal inflammation and air trapping, indicating small airway impairment.
- Limited data suggests small airway abnormalities contribute to asthma in smokers and the elderly.
- These phenotypes may serve as models for significant small airway disease.
Conclusions:
- Small airway abnormalities are implicated in severe asthma, especially in smokers and the elderly.
- Assessing small airway impairment in these patients is clinically relevant.
- Investigating targeted peripheral airway therapies may offer benefits beyond current asthma treatments.
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