scholarly journals Does small airway predict bronchial hyperresponsiveness? An observational retrospective study to evaluate small airways dysfunction

2019 ◽  
Vol 143 (2) ◽  
pp. AB13
Author(s):  
Diana Betancor ◽  
Blanca Barroso Garcia ◽  
Victoria Villalobos Violan ◽  
Rosialzira Natasha Vera ◽  
Mar Del Mar Fernandez-Nieto
Keyword(s):  
Retrospective Study ◽  
Bronchial Hyperresponsiveness ◽  
Small Airway ◽  
Small Airways

scholarly journals Small airway dysfunction in patients with cough variant asthma: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jie Gao ◽  
Haigui Wu ◽  
Feng Wu
Keyword(s):  
Retrospective Cohort ◽  
Bronchial Hyperresponsiveness ◽  
Diagnostic Value ◽  
Small Airway ◽  
Small Airways ◽  
Cough Variant Asthma ◽  
Asthmatic Patients ◽  
Cell Test ◽  
Sputum Eosinophils ◽  
The Relationship

Abstract Background Cough variant asthma (CVA) is one of the special populations of asthma. The aim of the study was to compare small airways, the degree of bronchial hyperresponsiveness (BHR) and airway inflammatory subtypes between CVA and classic asthma (CA), and investigate the relationship between these markers to determine the accuracy as indicators of CVA. Methods A total of 825 asthmatic patients participated in the study and 614 were included. 614 patients underwent spirometry and a bronchial challenge with methacholine and 459 patients performed induction sputum cell test. Results The number of CVA patients showed less small airway dysfunction than those of CA patients (p < 0.005). The degree of small airways dysfunction was higher in the CA group compared with the CVA group (p < 0.001). Small airways dysfunction was severer in the eosinophilic airway inflammatory subtype compared with other subtypes (p < 0.05).The area under curve of MMEF, FEF50 and FEF75 (% predicted) was 0.615, 0.621, 0.606, respectively. 0.17mcg of PD20 and 4.7% of sputum eosinophils was the best diagnostic value for CVA with an AUC of 0.582 and 0.575 (p = 0.001 and p = 0.005, respectively). Conclusions The eosinophilic airway inflammatory subtype may be increased small airway dysfunction. The value of small airways, BHR and induction sputum cells in CVA prediction, which reflected significant, but not enough to be clinically useful.

Small Airway Dysfunction Predicts Asthma Control and Exacerbations : Longitudinal Data from the Assessment of Small Airways Involvement in Asthma (ATLANTIS) Study

2021 ◽  
Author(s):  
Monica Kraft ◽  
Richardson Matthew ◽  
Brian Hallmark ◽  
Dean Billheimer ◽  
Maarten van den Berge ◽  
...  
Keyword(s):  
Longitudinal Data ◽  
Asthma Control ◽  
Small Airway ◽  
Small Airways

scholarly journals The Expression of NOX4 in Smooth Muscles of Small Airway Correlates with the Disease Severity of COPD

2016 ◽  
Vol 2016 ◽  
pp. 1-17 ◽  
Author(s):  
Xianyan Liu ◽  
Binwei Hao ◽  
Ailing Ma ◽  
Jinxi He ◽  
Xiaoming Liu ◽  
...  
Keyword(s):  
Disease Severity ◽  
Transforming Growth Factor ◽  
Smooth Muscles ◽  
Nicotinamide Adenine Dinucleotide Phosphate ◽  
Small Airway ◽  
Chronic Obstructive ◽  
Small Airways ◽  
Obstructive Pulmonary Disease ◽  
Pulmonary Functions ◽  
Copd Patients

Airway smooth muscle (ASM) remodeling is a hallmark in chronic obstructive pulmonary disease (COPD), and nicotinamide-adenine dinucleotide phosphate (NADPH) oxidases (NOXs) produced reactive oxygen species (ROS) play a crucial role in COPD pathogenesis. In the present study, the expression of NOX4 and its correlation with the ASM hypertrophy/hyperplasia, clinical pulmonary functions, and the expression of transforming growth factorβ(TGF-β) in the ASM of COPD small airways were investigated by semiquantitative morphological and/or immunohistochemistry staining methods. The results showed that an elevated expression of NOX4 and TGF-β, along with an increased volume of ASM mass, was found in the ASM of small airways in COPD patients. The abundance of NOX4 protein in the ASM was increased with disease severity and inversely correlated with the pulmonary functions in COPD patients. In addition, the expression of NOX4 and ASM markerα-SMA was colocalized, and the increased NOX4 expression was found to accompany an upregulated expression of TGF-βin the ASM of small airways of COPD lung. These results indicate that NOX4 may be a key regulator in ASM remodeling of small airway, in part through a mechanism interacting with TGF-βsignaling in the pathogenesis of COPD, which warrants further investigation.

scholarly journals Increased myofibroblasts in the small airways and relation to remodelling and functional changes in smokers and COPD patients: potential role of epithelial-mesenchymal transition (EMT)

2021 ◽  
pp. 00876-2020
Author(s):  
Mathew Suji Eapen ◽  
Wenying Lu ◽  
Tillie L. Hackett ◽  
Gurpreet Kaur Singhera ◽  
Malik Q. Mahmood ◽  
...  
Keyword(s):  
Lung Function ◽  
Epithelial Mesenchymal Transition ◽  
Small Airway ◽  
Normal Lung ◽  
Small Airways ◽  
Mesenchymal Transition ◽  
Functional Changes ◽  
Highly Active ◽  
Copd Patients ◽  
Normal Lung Function

IntroductionPrevious reports showed epithelial mesenchymal transition (EMT) as an active process that contributes to small airway (SA) fibrotic pathology. Myofibroblasts are highly active pro-fibrotic cells that secrete excessive and altered extracellular matrix (ECM). Here we relate SA myofibroblast presence with airway remodelling, physiology and EMT activity in smokers and COPD patients.MethodsLung resections from non-smoker controls (NC), normal lung function smokers (NLFS), COPD current (CS) and ex-smokers (ES) were stained with anti-human αSMA, collagen 1, and fibronectin. αSMA+ive cells were computed in reticular basement membrane (Rbm), lamina propria (LP), and adventitia and presented per mm of Rbm and mm2 of LP. Collagen-1 and fibronectin are presented as a percentage change from normal. All analysis including airway thickness were measured using Image-pro-plus 7.0.ResultsWe found an increase in sub-epithelial LP (especially) and adventitia thickness in all pathological groups compared to NC. Increases in αSMA+ive myofibroblasts were observed in sub-epithelial Rbm, LP, and adventitia in both the smoker and COPD groups compared to NCs. Further, the increase in the myofibroblast population in the LP was strongly associated with decrease in lung function, LP thickening, increase in ECM protein deposition, and finally EMT activity in epithelial cells.ConclusionsThis is the first systematic characterisation of small airway myofibroblasts in COPD based on their localisation, with statistically significant correlations between them and other pan-airway structural, lung function, and ECM protein changes. Finally, we suggest that EMT may be involved in such changes.

scholarly journals Negative Ion Purifier Effects on Indoor Particulate Dosage to Small Airways

2021 ◽  
Vol 19 (1) ◽  
pp. 264
Author(s):  
Mengjie Duan ◽  
Lijuan Wang ◽  
Xingyan Meng ◽  
Linzhi Fu ◽  
Yi Wang ◽  
...  
Keyword(s):  
Indoor Air ◽  
Indoor Air Pollution ◽  
Disease Risk ◽  
Negative Ions ◽  
Underlying Mechanism ◽  
Small Airway ◽  
Ion Concentration ◽  
Negative Ion ◽  
Small Airways

Indoor air quality is an important health factor as we spend more than 80% of our time indoors. The primary type of indoor pollutant is particulate matter, high levels of which increase respiratory disease risk. Therefore, air purifiers are a common choice for addressing indoor air pollution. Compared with traditional filtration purifiers, negative ion air purifiers (NIAPs) have gained popularity due to their energy efficiency and lack of noise. Although some studies have shown that negative ions may offset the cardiorespiratory benefits of air purifiers, the underlying mechanism is still unclear. In this study, we conducted a full-scale experiment using an in vitro airway model connected to a breathing simulator to mimic inhalation. The model was constructed using computed tomography scans of human airways and 3D-printing technology. We then quantified the effects of NIAPs on the administered dose of 0.5–2.5 μm particles in the small airway. Compared with the filtration purifier, the NIAP had a better dilution effect after a 1-h exposure and the cumulative administered dose to the small airway was reduced by 20%. In addition, increasing the negative ion concentration helped reduce the small airway exposure risk. NIAPs were found to be an energy-efficient air purification intervention that can effectively reduce the small airway particle exposure when a sufficient negative ion concentration is maintained.

scholarly journals Bronchodilator Response Predicts Longitudinal Improvement in Small Airway Function in World Trade Center Dust Exposed Community Members

2019 ◽  
Vol 16 (8) ◽  
pp. 1421 ◽  
Author(s):  
Deepak Pradhan ◽  
Ning Xu ◽  
Joan Reibman ◽  
Roberta M. Goldring ◽  
Yongzhao Shao ◽  
...  
Keyword(s):  
World Trade ◽  
World Trade Center ◽  
Small Airway ◽  
Forced Oscillation Technique ◽  
Small Airways ◽  
Bronchodilator Response ◽  
Airway Injury ◽  
Airway Function ◽  
Trade Center ◽  
Over Time

The evolution of lung function, including assessment of small airways, was assessed in individuals enrolled in the World Trade Center Environmental Health Center (WTC-EHC). We hypothesized that a bronchodilator response at initial evaluation shown by spirometry or in small airways, as measured by forced oscillation technique (FOT), would be associated with improvement in large and small airway function over time. Standardized longitudinal assessment included pre and post bronchodilator (BD) spirometry (forced vital capacity, FVC; forced expiratory volume in 1 second, FEV1) and FOT (resistance at 5 Hz, R5; resistance at 5 minus 20 Hz, R5–20). Longitudinal changes were assessed using linear mixed-effects modelling with adjustment for potential confounders (median follow-up 2.86 years; 95% measurements within 4.9 years). Data demonstrated: (1) parallel improvement in airflow and volume measured by spirometry and small airway function (R5 and R5–20) measured by FOT; (2) the magnitude of longitudinal improvement was tightly linked to the initial BD response; and (3) longitudinal values for small airway function on FOT were similar to residual abnormality observed post BD at initial visit. These findings suggest presence of reversible and irreversible components of small airway injury that are identifiable at initial presentation. These results have implications for treatment of isolated small airway abnormalities that can be identified by non-invasive effort independent FOT particularly in symptomatic individuals with normal spirometry indices. This study underscores the need to study small airway function to understand physiologic changes over time following environmental and occupational lung injury.

scholarly journals Lung clearance index: assessment and utility in children with asthma

2019 ◽  
Vol 28 (154) ◽  
pp. 190046 ◽  
Author(s):  
Amy G. L. Nuttall ◽  
Werner Velásquez ◽  
Caroline S. Beardsmore ◽  
Erol A. Gaillard
Keyword(s):  
Early Stage ◽  
Airway Disease ◽  
Small Airway ◽  
Small Airways ◽  
Lung Clearance ◽  
Additional Information ◽  
Small Airway Disease ◽  
Lung Clearance Index ◽  
Children With Asthma ◽  
Ventilation Heterogeneity

There is increasing evidence that ventilation heterogeneity and small airway disease are significant factors in asthma, with evidence suggesting that the small airways are involved from an early stage in childhood asthma. Spirometry is commonly used to monitor lung function in asthmatics; however, it is not sensitive to small airway disease. There has been renewed interest in multibreath washout (MBW) tests, with recognition of the lung clearance index (LCI) as a global index of abnormality in gas mixing of the lungs that therefore also reflects small airway disease. This review summarises the technical and practical aspects of the MBW/LCI in children, and the differences between commercially available equipment. Children with severe asthma are more likely to have an abnormal LCI, whereas most children with mild-to-moderate asthma have an LCI within the normal range, but slightly higher than age-matched healthy controls. Monitoring children with asthma with MBW alongside standard spirometry may provide useful additional information.

scholarly journals Small Airway Impairment and Bronchial Hyperresponsiveness in Asthma Onset

2014 ◽  
Vol 6 (3) ◽  
pp. 242 ◽  
Author(s):  
Bruno Sposato ◽  
Marco Scalese ◽  
Maria Giovanna Migliorini ◽  
Maurizio Di Tomassi ◽  
Raffaele Scala
Keyword(s):  
Bronchial Hyperresponsiveness ◽  
Small Airway

scholarly journals Role of IL-17A in murine models of COPD airway disease

2017 ◽  
Vol 312 (1) ◽  
pp. L122-L130 ◽  
Author(s):  
Haruhiko Yanagisawa ◽  
Mitsuo Hashimoto ◽  
Shunsuke Minagawa ◽  
Naoki Takasaka ◽  
Royce Ma ◽  
...  
Keyword(s):  
T Cells ◽  
Airway Inflammation ◽  
Γδ T Cells ◽  
Small Airway ◽  
Lymphoid Cells ◽  
Chronic Obstructive ◽  
Polymorphonuclear Cells ◽  
Small Airways ◽  
Pathological Feature ◽  
Airway Fibrosis

Small airway fibrosis is a major pathological feature of chronic obstructive pulmonary disease (COPD) and is refractory to current treatments. Chronic inflammatory cells accumulate around small airways in COPD and are thought to play a major role in small airway fibrosis. Mice deficient in α/β T cells have recently been shown to be protected from both experimental airway inflammation and fibrosis. In these models, CD4+Th17 cells and secretion of IL-17A are increased. However, a pathogenic role for IL-17 in specifically mediating fibrosis around airways has not been demonstrated. Here a role for IL-17A in airway fibrosis was demonstrated using mice deficient in the IL-17 receptor A ( il17ra). Il17ra-deficient mice were protected from both airway inflammation and fibrosis in two different models of airway fibrosis that employ COPD-relevant stimuli. In these models, CD4+ Th17 are a major source of IL-17A with other expressing cell types including γδ T cells, type 3 innate lymphoid cells, polymorphonuclear cells, and CD8+ T cells. Antibody neutralization of IL-17RA or IL-17A confirmed that IL-17A was the relevant pathogenic IL-17 isoform and IL-17RA was the relevant receptor in airway inflammation and fibrosis. These results demonstrate that the IL-17A/IL-17 RA axis is crucial to murine airway fibrosis. These findings suggest that IL-17 might be targeted to prevent the progression of airway fibrosis in COPD.

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