Abnormal Small Airways Function in Children With Mild Asthma

Singer, Florian; Abbas, Chiara; Yammine, Sophie; Casaulta, Carmen; Frey, Urs; Latzin, Philipp

doi:10.1378/chest.13-0784

Cited by 36 publications

(52 citation statements)

References 46 publications

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“…Studies using these techniques could reveal pathologic measurements in the small airways of children with uncontrolled asthma, but even patients with mild to moderate asthma exhibit abnormal acinar ventilation heterogeneity, suggesting the presence of small airway disease. 25,26 With this in mind, it is even more important that in our cohort patients with asthma without pathologic z scores for FEV 1 and FEF still have increased LTB 4 values in the small airway or alveolar fraction compared with controls. This finding suggests that small airway or alveolar LTB 4 is a sensitive, noninvasive marker of small airways disease for children with asthma, even without lung function impairment.…”

Section: Discussionmentioning

confidence: 86%

Elevated exhaled leukotriene B4 in the small airway compartment in children with asthma

Trischler¹,

MüLLER²,

Könitzer³

et al. 2015

Annals of Allergy, Asthma & Immunology

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Section: Discussionmentioning

confidence: 86%

Elevated exhaled leukotriene B4 in the small airway compartment in children with asthma

Trischler¹,

MüLLER²,

Könitzer³

et al. 2015

Annals of Allergy, Asthma & Immunology

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“…FEF 25-75% has been found to correlate with functional imaging assessment of small airway function [35] as well as indices of ventilation heterogeneity, which are markers of peripheral airway function, obtained with multiple nitrogen washout in normal subjects [36] and with double-tracer gas single-breath washout in mild asthmatics [37]. FEF 25-75% percent of predicted has been demonstrated to correlate better with air trapping in asthmatic subjects than do FEV 1 percent of predicted and FEV 1 /FVC percent of predicted [6].…”

Section: Discussionmentioning

confidence: 99%

Association of FEF25-75% Impairment with Bronchial Hyperresponsiveness and Airway Inflammation in Subjects with Asthma-Like Symptoms

et al. 2016

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Background: Forced expiratory flow at 25 and 75% of the pulmonary volume (FEF_25-75%) might be considered as a marker of early airway obstruction. FEF_25-75% impairment might suggest earlier asthma recognition in symptomatic subjects even in the absence of other abnormal spirometry values. Objectives: The study was designed in order to verify whether FEF_25-75% impairment in a cohort of subjects with asthma-like symptoms could be associated with the risk of bronchial hyperresponsiveness (BHR) and with airway inflammation expressed as fractional exhaled nitric oxide (FeNO) and eosinophil counts in induced sputum. Methods: Four hundred adults with a history of asthma-like symptoms (10.5% allergic) underwent spirometry, determination of BHR to methacholine (PD₂₀FEV₁), FeNO analysis and sputum induction. FEF_25-75% <65% of predicted or <-1.64 z-score was considered abnormal. Results: All subjects had normal FVC, FEV₁ and FEV₁/FVC, while FEF_25-75% was abnormal in 27.5% of them. FEF_25-75% (z-score) was associated with PD₂₀FEV₁ (p < 0.001), FeNO (p < 0.001) and sputum eosinophils (p < 0.001). Patients with abnormal FEF_25-75% showed higher levels of FeNO and eosinophils in induced sputum than did patients with normal FEF_25-75% (p < 0.01 and p < 0.01, respectively). Subjects with abnormal FEF_25-75% had an increased probability of being BHR positive (OR = 13.38; 95% CI: 6.7-26.7; p < 0.001). Conclusions: Our data show that abnormal FEF_25-75% might be considered an early marker of airflow limitation associated with eosinophilic inflammation and BHR in subjects with asthma-like symptoms, indicating a role for FEF_25-75% as a predictive marker of newly diagnosed asthma.

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“…A single-breath washout test has now been proposed which involves an inhalation of 5% SF 6 , 26.3% He, 21% O 2 and the balance as N 2 in order to obtain a so-called dual gas tracer (DTG) phase III slope [3]. After having been introduced as a practical and promising lung function tool [3] and as an early detection tool in cystic fibrosis lung disease [4], the DTG phase III slope is now advocated as a specific index of acinar function abnormality in children with mild asthma [5]. An editorial in the European Respiratory Journal [6], reflecting upon a DTG reproducibility study in normal subjects and chronic obstructive pulmonary disease (COPD) patients [7], rightly pointed out that the clinical utility of DTG indices will depend on their actual physiological meaning.…”

Section: Dual Gas Techniques For Peripheral Airway Function: Diffusinmentioning

confidence: 99%

Dual gas techniques for peripheral airway function: diffusing the issues

Verbanck¹,

Paiva

2015

Eur Respir J

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Abnormal Small Airways Function in Children With Mild Asthma

Cited by 36 publications

References 46 publications

Elevated exhaled leukotriene B4 in the small airway compartment in children with asthma

Elevated exhaled leukotriene B4 in the small airway compartment in children with asthma

Association of FEF25-75% Impairment with Bronchial Hyperresponsiveness and Airway Inflammation in Subjects with Asthma-Like Symptoms

Dual gas techniques for peripheral airway function: diffusing the issues

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