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The diagnosis of asthma. Can physiological tests of small airways function help?

Asthma is a common, chronic, and heterogeneous disease with a global impact and substantial economic costs. It is also associated with significant mortality and morbidity and the burden of undiagnosed asthma is significant. Asthma can be difficult to diagnose as there is no gold standard test and, w...

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Autores principales: Almeshari, Mohammed A, Stockley, James, Sapey, Elizabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8543738/
https://www.ncbi.nlm.nih.gov/pubmed/34693751
http://dx.doi.org/10.1177/14799731211053332
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author Almeshari, Mohammed A
Stockley, James
Sapey, Elizabeth
author_facet Almeshari, Mohammed A
Stockley, James
Sapey, Elizabeth
author_sort Almeshari, Mohammed A
collection PubMed
description Asthma is a common, chronic, and heterogeneous disease with a global impact and substantial economic costs. It is also associated with significant mortality and morbidity and the burden of undiagnosed asthma is significant. Asthma can be difficult to diagnose as there is no gold standard test and, while spirometry is central in diagnosing asthma, it may not be sufficient to confirm or exclude the diagnosis. The most commonly reported spirometric measures (forced expiratory volume in one second (FEV(1)) and forced vital capacity assess function in the larger airways. However, small airway dysfunction is highly prevalent in asthma and some studies suggest small airway involvement is one of the earliest disease manifestations. Moreover, there are new inhaled therapies with ultrafine particles that are specifically designed to target the small airways. Potentially, tests of small airways may more accurately diagnose early or mild asthma and assess the response to treatment than spirometry. Furthermore, some assessment techniques do not rely on forced ventilatory manoeuvres and may, therefore, be easier for certain groups to perform. This review discusses the current evidence of small airways tests in asthma and future research that may be needed to further assess their utility.
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spelling pubmed-85437382021-10-26 The diagnosis of asthma. Can physiological tests of small airways function help? Almeshari, Mohammed A Stockley, James Sapey, Elizabeth Chron Respir Dis Review Article Asthma is a common, chronic, and heterogeneous disease with a global impact and substantial economic costs. It is also associated with significant mortality and morbidity and the burden of undiagnosed asthma is significant. Asthma can be difficult to diagnose as there is no gold standard test and, while spirometry is central in diagnosing asthma, it may not be sufficient to confirm or exclude the diagnosis. The most commonly reported spirometric measures (forced expiratory volume in one second (FEV(1)) and forced vital capacity assess function in the larger airways. However, small airway dysfunction is highly prevalent in asthma and some studies suggest small airway involvement is one of the earliest disease manifestations. Moreover, there are new inhaled therapies with ultrafine particles that are specifically designed to target the small airways. Potentially, tests of small airways may more accurately diagnose early or mild asthma and assess the response to treatment than spirometry. Furthermore, some assessment techniques do not rely on forced ventilatory manoeuvres and may, therefore, be easier for certain groups to perform. This review discusses the current evidence of small airways tests in asthma and future research that may be needed to further assess their utility. SAGE Publications 2021-10-23 /pmc/articles/PMC8543738/ /pubmed/34693751 http://dx.doi.org/10.1177/14799731211053332 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Article
Almeshari, Mohammed A
Stockley, James
Sapey, Elizabeth
The diagnosis of asthma. Can physiological tests of small airways function help?
title The diagnosis of asthma. Can physiological tests of small airways function help?
title_full The diagnosis of asthma. Can physiological tests of small airways function help?
title_fullStr The diagnosis of asthma. Can physiological tests of small airways function help?
title_full_unstemmed The diagnosis of asthma. Can physiological tests of small airways function help?
title_short The diagnosis of asthma. Can physiological tests of small airways function help?
title_sort diagnosis of asthma. can physiological tests of small airways function help?
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8543738/
https://www.ncbi.nlm.nih.gov/pubmed/34693751
http://dx.doi.org/10.1177/14799731211053332
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