Asthma-like peak flow variability in various lung diseases

Abstract

Background and Objectives:Bronchodilator reversibility and diurnal peak flow variability are considered characteristic of asthma patients. Patients with chronic obstructive pulmonary disease (COPD) show poor reversibility. But reversibility and variability in other pulmonary diseases manifesting with airflow obstruction in not known. Therefore, we assessed reversibility and peak flow variability in patients with various lung diseases to recognize the pattern.Materials and Methods:Seventy consecutive patients with a diagnosis of lung diseases manifesting with airflow obstruction were recruited in the study. These included 23 patients with asthma, 11 patients with bronchiectasis, 16 patients with post-tubercular lung disease (PTLD), and 20 patients with COPD. Ten healthy matched control subjects were also selected to pair with asthmatic patients. Bronchodilator reversibility test was done initially and peak expiratory flow rate (PEFR) was measured for a duration of 1 week by patients themselves on a chart that was given to them. The mean amplitude percentage of these records were analyzed.Results:The mean values of peak flow variability were 14.73% ± 6.1% in asthmatic patients, 11.98% ± 7.5% in patients with bronchiectasis, and 10.54% ± 5.3% in PTLD. The difference in the mean values of peak flow variability between asthma and bronchiectasis, that is, 14.73 (6.1) vs 11.98 (7.5) was not statistically significant (P > 0.05). Forced expiratory volume one second (FEV1) reversibility values were 14.77% ± 26.93%, 11.24% ± 20.43%, 10.85% ± 13.02%, 16.83% ± 22.84%, and 5.47% ± 4.99% in asthma, COPD, PTLD, bronchiectasis, and healthy subjects, respectively.Conclusion:Both reversibility and diurnal peak flow variability were higher in patients with various lung diseases compared with normal healthy subjects. Although these are characteristic of asthma, some cases of bronchiectasis and PTLD patients may also manifest asthma-like PEFR variability and reversibility.

A Personalized Alert System for Air-quality Monitoring Based on Lung Functionality: An Observational Pilot Study

“…Given that well-controlled asthma patients generally exhibit low PEF variability, akin to healthy individuals, they will be an appropriate group for further study. Conversely, poorly controlled asthmatics at high risk usually present high PEF variability, which our proposed alert system should more likely detect [14,17,35].…”

“…These personalized strategies have gained increased focus in modern healthcare, taking into consideration the specific asthma phenotype and endotype of each individual [16]. This personalized approach, facilitated by advanced understanding of asthma's pathophysiology, has spurred targeted biologic therapies and precision medicine [17]. Additionally, there is a growing interest in leveraging digital health interventions and smart inhaler technologies for continuous monitoring and provision of personalized feedback to patients [18].…”

“…We propose that this tailored approach will gradually empower individuals to proactively monitor their respiratory health, foresee potential exacerbations, and initiate timely interventions, consequently avoiding asthma attacks and enhancing their overall quality of life. While our current study focuses on healthy individuals, we believe that the concept and scenario are applicable and beneficial for asthmatic patients [17].…”

An Observational Pilot Study of a Tailored Environmental Monitoring and Alert System for Improved Management of Chronic Respiratory Diseases

“… 16 Advanced understanding of asthma’s pathophysiology has led to targeted biologic therapies and precision medicine. 17 The rise of digital health interventions, like smart inhalers, offers continuous monitoring and personalized feedback. 18 While these developments are promising, personalized asthma management remains nascent, requiring further research, especially in real-time monitoring and predictive analytics.…”

“…While our current study focuses on healthy individuals, we believe that the concept and scenario are applicable and beneficial for asthmatic patients. 17 …”