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Peripheral airways involvement in children with asthma exacerbation

Maria Wawszczak1, Marek Kulus1, Joanna Peradzyńska2

  • 1Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Warsaw, Poland.

The Clinical Respiratory Journal
|October 22, 2021
PubMed

Insights

Peripheral airways play a key role in pediatric asthma, especially during exacerbations. These findings highlight the lung periphery as a crucial target for asthma therapy in children.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Asthma Pathophysiology

Background:

  • Peripheral airways are implicated in asthma pathogenesis.
  • Their specific contribution to pediatric asthma control and activity remains unclear.
  • Acinar zone involvement in pediatric asthma requires further investigation.

Purpose of the Study:

  • To assess peripheral airway involvement in children with asthma exacerbation and stable asthma.
  • To utilize various pulmonary function tests for comprehensive evaluation.
  • To clarify the role of the lung periphery in pediatric asthma.

Main Methods:

  • Spirometry, body plethysmography, exhaled nitric oxide, impulse oscillometry (IOS), and multiple-breath washout (MBW) were performed.
  • Study included children with asthma exacerbation (n=20) and stable asthma (n=22).
  • Comparative analysis of pulmonary function tests between groups.

Main Results:

  • Peripheral airway function indexes were elevated in children with asthma, particularly during exacerbation.
  • Higher prevalence of abnormal results, including conductive and acinar ventilation inhomogeneity, was noted in asthma exacerbation.
  • Air trapping was observed in 36% of children with acute asthma.

Conclusions:

  • Peripheral airways are significantly involved in pediatric asthma, especially during exacerbations.
  • The lung periphery emerges as a critical therapeutic target in pediatric asthma.
  • Findings offer new insights into the pathophysiology of childhood asthma.
Abstract

Keywords:
acute asthmaimpulse oscillometryinert gas washoutsmall airways disease

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