Air trapping in mild and moderate asthma: Effect of inhaled corticosteroids

Tunon-de-Lara, José-Manuel; Laurent, François; Giraud, Violaine; Pérez, Thierry; Aguilaniu, B.; Meziane, H.; Basset-Merle, Armelle; Chanez, Pascal

doi:10.1016/j.jaci.2006.11.005

Cited by 84 publications

(55 citation statements)

References 42 publications

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“…TUNON-DE-LARA et al [62] have shown that 3-month treatment with inhaled corticosteroids (ICS) resulted in decreased lung attenuation and air trapping. Reduction in air trapping, but not in lung attenuation, was more pronounced with hydrofluoroalkane (HFA)-beclomethasone dipropionate (BDP) extrafine formulation (which deposited across all sizes of airways, including small airways) than with fluticasone propionate (which mostly deposited in larger airways) [62].…”

Section: Imaging Techniques In the Evaluation Of Small Airways In Obsmentioning

confidence: 99%

The role of small airways in obstructive airway diseases

Burgel¹

2011

European Respiratory Review

193

139

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This review article is a summary of a seminar organised by the European Respiratory Society on ''The role of small airways in obstructive airway diseases'' which was held in October 2010 in Amsterdam, the Netherlands.The aims of the seminar were to identify important questions related to small airways involvement in asthma and chronic obstructive pulmonary disease (COPD), and to discuss future approaches based on current and evolving knowledge. Data obtained by pathological and physiological measurements in small airways and their relevance to clinical manifestations and therapeutics in asthma and COPD were reviewed.It was concluded that our knowledge on the roles of small airways in asthma and COPD is limited. Studies of large numbers of well-characterised subjects using multiple methods (genetic characterisation, cell biology and physiology, imaging) and integration of the data using mathematical models are suggested to be of interest. The availability of these techniques coupled with our ability to better target inhaled molecules to small airways provide a unique opportunity for a reappraisal of the relevance of small airways in chronic airway diseases.

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Section: Imaging Techniques In the Evaluation Of Small Airways In Obsmentioning

confidence: 99%

The role of small airways in obstructive airway diseases

Burgel¹

2011

European Respiratory Review

193

139

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“…This can be achieved by using HRCT with spirometric gating, allowing for measurement of lung attenuation at various lung volumes [121,122], but the technique is not routinely used. Finally, computed tomography scan studies have been performed after methacholine-induced bronchoconstriction [123] and salbutamol-induced bronchodilation [124].…”

Section: Assessment Of Distal Airways In Asthma: Imaging High-resolutmentioning

confidence: 99%

“…Several studies have used variations in lung density as a mean of assessing the efficacy of inhaled [122,130,131] or systemic [132] therapy. A randomised study has evaluated HRCT findings in subjects treated with inhaled steroids, by comparing extra-fine particles of hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) that are deposited across all sizes of airways and conventional beclomethasone dipropionate that are deposited mostly in proximal airways [130].…”

Section: Assessment Of Distal Airways In Asthma: Imaging High-resolutmentioning

confidence: 99%

Update on the roles of distal airways in asthma

Burgel¹,

Blic²,

Chanez³

et al. 2009

European Respiratory Review

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The present review is the summary of an expert workshop that took place in Vence (France) in 2007 on the role of distal airways in asthma. The evidence showing inflammation and remodelling in distal airways, and their possible involvement in asthma control and natural history, was reviewed. The usefulness and limitations of various techniques used for assessing distal airways were also evaluated, including pulmonary function tests and imaging. Finally, the available data studying the benefit of treatment better targeting distal airways in asthma was examined. It was concluded that both proximal and distal airways were involved in asthma and that distal airways were the major determinant of airflow obstruction. Inflammation in distal airways appeared more intense in severe and uncontrolled asthma. Distal airways were poorly attained by conventional aerosol of asthma medications owing to their granulometry, being composed of 3-5 mm particles. Both proximal and distal airways might be targeted either by delivering medications systemically or by aerosol of extra-fine particles. Extra-fine aerosols of long-acting b-agonists, inhaled corticosteroids or inhaled corticosteroid/long-acting b-agonist combinations have been shown in short-term studies to be not inferior to non-extra-fine aerosols of comparators. However, available studies have not yet demonstrated that extra-fine inhaled medications offer increased benefit compared with usual aerosols in asthmatic patients.

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“…This technique was used to compare the relative efficacy of two different inhaled medications on small airway hyper-reactivity; small-size inhaled particles prompted a significant improvement in air trapping compared with traditional-size particles [62,65]. These studies demonstrate the potential use of quantitative imaging in asthmatic patients as a surrogate end point for small airways remodelling in response to therapies.…”

Section: Imaging Assessment Of Peripheral Airwaysmentioning

confidence: 97%

“…Quantification of air trapping in expiratory studies may provide additional information regarding response to therapy targeted for small airways disease that is not readily captured by physiologic measures [62,65]. This technique was used to compare the relative efficacy of two different inhaled medications on small airway hyper-reactivity; small-size inhaled particles prompted a significant improvement in air trapping compared with traditional-size particles [62,65].…”

Section: Imaging Assessment Of Peripheral Airwaysmentioning

confidence: 99%

Assessing and accessing the small airways; implications for asthma management

Scichilone

Contoli

Paleari

et al. 2013

Pulmonary Pharmacology & Therapeutics

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a b s t r a c tDespite the wealth of experience in the management of asthma, the disease remains inadequately controlled in some patients, who face long-term respiratory impairment and disability. The disease has been characterised as an inflammatory condition affecting first the larger airways and eventually the smaller airways, but there is evidence that peripheral airway involvement defines a particular and more severe phenotype of asthma. For this reason, assessing functional and biological parameters reflective of small airways involvement is important prognostically. No assessment method is universally and directly representative of peripheral airway function, but the traditional spirometric tests, including vital capacity, residual volume and forced vital capacity, are somewhat correlated with this function; useful methods for further assessment include the single-breath nitrogen wash-out test, impulse oscillometry, nitrous oxide and exhaled breath concentrate measurements, as well as computed tomography to reflect air trapping and response to treatment. Formulation advancements have made for easier treatment access to the smaller airways, with the new extrafine formulations resulting in better asthma control compared with non-extrafine formulations.

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Air trapping in mild and moderate asthma: Effect of inhaled corticosteroids

Cited by 84 publications

References 42 publications

The role of small airways in obstructive airway diseases

The role of small airways in obstructive airway diseases

Update on the roles of distal airways in asthma

Assessing and accessing the small airways; implications for asthma management

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