Document Detail

The role of small airway disease in asthma.
MedLine Citation:
PMID:  24296687     Owner:  NLM     Status:  In-Data-Review    
PURPOSE OF REVIEW: This review provides an update on the importance of the peripheral 'small' airways in asthma. As the small airways account for less than 10% of total airway resistance, thus having little impact on standard lung function measures such as forced expiratory volume and peak flow, they have been referred to as the 'silent zone'.
RECENT FINDINGS: The study has revealed that small airway involvement is present in all stages of asthmatic disease, being related to important clinical phenotypes such as nocturnal asthma, exercise-induced asthma, and difficult-to-control asthma, including those with the risk of repeated asthma exacerbations. Uncontrolled small airway inflammation is related to airway remodeling and progression of the disease, with a more rapid decline in the lung function. Moreover, studies on both children and adults have shown that the involvement of the small airways represents a crucial step in asthma development. New tools have been developed and old tools have been refined, providing an opportunity to better understand small airway inflammation and dysfunction.
SUMMARY: Small airway inflammation is present in all stages of asthmatic disease and plays an important role in many key clinical conditions/phenotypes. In order to control the disease, we need to target small airway inflammation, which is not only difficult to reach by standard inhaled medications but also to some extent different. A better understanding of the important role small airways are playing in asthma will show that the 'silent zone' is by far not silent at all.
Leif Bjermer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in pulmonary medicine     Volume:  20     ISSN:  1531-6971     ISO Abbreviation:  Curr Opin Pulm Med     Publication Date:  2014 Jan 
Date Detail:
Created Date:  2013-12-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503765     Medline TA:  Curr Opin Pulm Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  23-30     Citation Subset:  IM    
Department of Respiratory Medicine & Allergology, Skane University Hospital, Lund University, Lund, Sweden.
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