Current Needs Assessment for Using Lung Clearance Index for Asthma in Clinical Practice

Area of Science:

• Pulmonary Medicine
• Respiratory Physiology

Background:

• Asthma pathophysiology involves airway remodeling, predominantly affecting small airways.
• Conventional spirometry, like FEV1, is insensitive to distal airway changes.
• There's a need for sensitive tests to evaluate small airway disease in asthma.

Purpose of the Study:

• To review evidence for Lung Clearance Index (LCI) as a clinical tool for small airway disease in asthma.
• To assess LCI's utility in monitoring treatment response in severe therapy-resistant asthma (STRA).

Main Methods:

• Review of current evidence on LCI and multiple-breath washout (MBW) in asthma.
• Comparison of LCI sensitivity with conventional lung function tests.

Main Results:

• LCI may be more sensitive than spirometry for detecting small airway obstruction.
• LCI abnormalities might indicate persistent small airway disease and severe asthma endotypes.
• MBW measuring LCI is feasible in children and a sensitive predictor of early airway disease.

Conclusions:

• LCI shows potential as a valuable clinical tool for assessing small airway disease in asthma.
• Further investigation is needed to establish LCI's role in treatment response monitoring for STRA.