Small airway disease: A new “phenotype” of obstructive airway disease
Small airways are usually defined as noncartilaginous airways with an internal diameter <2 mm. Robust data are available regarding small airway involvement in various obstructive airway diseases such as bronchial asthma and chronic obstructive pulmonary disease (COPD). Small airway disease (SAD)...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Annals of Medical Science and Research |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/amsr.amsr_2_23 |
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| Summary: | Small airways are usually defined as noncartilaginous airways with an internal diameter <2 mm. Robust data are available regarding small airway involvement in various obstructive airway diseases such as bronchial asthma and chronic obstructive pulmonary disease (COPD). Small airway disease (SAD) can present as a starting point of emphysema, and in few cases, SAD can present with emphysema. Thus, SAD in COPD is a different phenotype along with emphysema and chronic bronchitis. Although bronchial asthma is a disease of large and medium size airways, small airway involvement has been documented in asthma in late stage. Involvement of small airways in asthma is a clinical clue toward the role of inhaled antimuscarinic therapy in this phenotype. Spirometry is a simple and cost-effective but less reliable test to diagnose SAD in comparison to impulse oscillometry. Inhalation therapy with small particle size aerosol long-acting beta-agonist plus inhaled corticosteroids is recommended for treatment of SAD. Targeting small airways in asthma and COPD with ultrafine particle-size inhaled medicines with antimuscarinic drugs will have a successful treatment outcome. |
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| ISSN: | 2949-785X 2949-7868 |