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Distal Airway Inflammation Is Linked to Small Airway Dysfunction in Asthma
Hà Pham-Ngoc1, Thông Hua-Huy1, Nhât-Nam Lê-Dông2
1Department of Respiratory and Sleep Medicine, INSERM UMR1343, Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Université Paris Cité, 75006 Paris, France.
Medical Sciences (Basel, Switzerland)
|June 25, 2026
Summary
Blood eosinophils correlate with airway inflammation markers like exhaled nitric oxide (NO) and small airway dysfunction (SAD) in asthma patients. Distal airway inflammation, measured by alveolar NO concentration (CANO), is linked to SAD.
Area of Science:
- Pulmonology
- Immunology
- Biomarkers
Background:
- Airway inflammation and small airway dysfunction (SAD) are central to asthma pathophysiology.
- Blood eosinophils (Eos) and exhaled nitric oxide (NO) parameters (FeNO, J'awNO, CANO) are key inflammation markers.
- CANO specifically reflects distal airway inflammation.
Purpose of the Study:
- To investigate the association between blood eosinophils (Eos) and exhaled NO parameters in asthma.
- To determine the relationship between exhaled NO parameters and small airway dysfunction (SAD) using spirometry and plethysmography.
Main Methods:
- Observational study of 121 asthma outpatients.
- Measurements included spirometry, plethysmography, exhaled NO (FeNO, J'awNO, CANO), and blood eosinophil counts (Eos).
- Multivariable regression models analyzed associations, adjusting for covariates.
Main Results:
- Blood eosinophils (log[Eos]) showed significant associations with FeNO, J'awNO, and CANO.
- log[Eos] correlated positively with RV and RV/TLC, and negatively with FEF25-75, FEF75, and FEV1.
- Alveolar NO concentration (CANO) was positively associated with RV/TLC and negatively with FEF25-75 and FEF75, indicating a link to SAD.
Conclusions:
- Blood eosinophils are independently associated with all measured exhaled NO parameters in asthma.
- The association between CANO and small airway ventilatory function indices supports a link between distal airway inflammation and SAD.
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