The role of small airways in obstructive airway diseases

Abstract BackgroundImpulse oscillometry (IOS) can be used to evaluateairway impedance in patients with obstructive airway diseases. Previous studies have demonstrated that IOS parameters differ betweenbronchiectasis patients and healthy controls. This study aims to explore the usefulness of IOS in assessing disease severity and airway reversibility in bronchiectasis.MethodSeventy-four patients with non-cystic fibrosis bronchiectasis who visited our Respiratory Medicine outpatient clinic were consecutively recruited. Spirometry, plethysmography and IOS tests were performed. Patients were stratified into mild, moderate and severe disease according to Reiff, Bhalla, BSI, FACED, and BRICS scores. Airway reversibility was measured by bronchodilation test (BDT) and the result was classified as positive or negative.. ROC curves of IOS parameters was used to assess the usefulness of IOS parameters in predicting airway reversibility. Correlations between the IOS, spirometric lung function and bronchiectasis severity parameters were analysed.ResultsMany IOS parameters, such as airway resistance at 5Hz (R5), small airways resistance (R5–R20), total airway reactance (X5), resonance frequency (Fres), total airway impedance at 5Hz (Z5), and peripheral resistance (Rp) increased with increased bronchiectasis severity according to the FACED, BSI and Reiff scores. Large airway resistance (R20) and central resistance (Rc) were not significantly different among groups with differentbronchiectasis severity. The difference between R5 and R20 (R5-R20) showed 81.0% sensitivity, and 69.8%specificity in predicting the airway reversibility in bronchiectasis with AUC of 0.794 (95%CI, 0.672-0.915).ConclusionIOS measurements are useful indicators of bronchiectasis severity and may be useful for predicting the airway reversibility.

Download Full-text

Oxidative stress and macrophages: driving forces behind exacerbations of asthma and chronic obstructive pulmonary disease?

AJP Lung Cellular and Molecular Physiology ◽

10.1152/ajplung.00456.2018 ◽

2019 ◽

Vol 316 (2) ◽

pp. L369-L384 ◽

Cited By ~ 10

Author(s):

Linsey E. S. de Groot ◽

T. Anienke van der Veen ◽

Fernando O. Martinez ◽

Jörg Hamann ◽

René Lutter ◽

...

Keyword(s):

Oxidative Stress ◽

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Driving Forces ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Current State ◽

Airway Diseases ◽

Obstructive Airway Diseases

Oxidative stress is a common feature of obstructive airway diseases like asthma and chronic obstructive pulmonary disease (COPD). Lung macrophages are key innate immune cells that can generate oxidants and are known to display aberrant polarization patterns and defective phagocytic responses in these diseases. Whether these characteristics are linked in one way or another and whether they contribute to the onset and severity of exacerbations in asthma and COPD remain poorly understood. Insight into oxidative stress, macrophages, and their interactions may be important in fully understanding acute worsening of lung disease. This review therefore highlights the current state of the art regarding the role of oxidative stress and macrophages in exacerbations of asthma and COPD. It shows that oxidative stress can attenuate macrophage function, which may result in impaired responses toward exacerbating triggers and may contribute to exaggerated inflammation in the airways.

Download Full-text

Small airways: an important but neglected target in the treatment of obstructive airway diseases

Trends in Pharmacological Sciences ◽

10.1016/j.tips.2008.04.003 ◽

2008 ◽

Vol 29 (7) ◽

pp. 340-345 ◽

Cited By ~ 46

Author(s):

Graham Sturton ◽

Carl Persson ◽

Peter J. Barnes

Keyword(s):

Small Airways ◽

Airway Diseases ◽

Obstructive Airway Diseases

Download Full-text

Lung Computational Models and the Role of the Small Airways in Asthma

PEDIATRICS ◽

10.1542/peds.2020-023861kkk ◽

2020 ◽

Vol 146 (Supplement 4) ◽

pp. S359.2-S360

Author(s):

Jennilee Eppley ◽

Todd Mahr

Keyword(s):

Computational Models ◽

Small Airways

Download Full-text

Multimorbidity clusters in patients with chronic obstructive airway diseases in the EpiChron Cohort

Scientific Reports ◽

10.1038/s41598-021-83964-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jonás Carmona-Pírez ◽

Beatriz Poblador-Plou ◽

Ignatios Ioakeim-Skoufa ◽

Francisca González-Rubio ◽

Luis Andrés Gimeno-Feliú ◽

...

Keyword(s):

Substance Use ◽

Chronic Conditions ◽

Large Scale ◽

Mental Health Problems ◽

Epidemiological Studies ◽

Chronic Obstructive ◽

High Morbidity ◽

Airway Diseases ◽

Obstructive Sleep ◽

Obstructive Airway Diseases

AbstractChronic obstructive airway diseases such as chronic obstructive pulmonary disease (COPD), asthma, rhinitis, and obstructive sleep apnea (OSA) are amongst the most common treatable and preventable chronic conditions with high morbidity burden and mortality risk. We aimed to explore the existence of multimorbidity clusters in patients with such diseases and to estimate their prevalence and impact on mortality. We conducted an observational retrospective study in the EpiChron Cohort (Aragon, Spain), selecting all patients with a diagnosis of allergic rhinitis, asthma, COPD, and/or OSA. The study population was stratified by age (i.e., 15–44, 45–64, and ≥ 65 years) and gender. We performed cluster analysis, including all chronic conditions recorded in primary care electronic health records and hospital discharge reports. More than 75% of the patients had multimorbidity (co-existence of two or more chronic conditions). We identified associations of dermatologic diseases with musculoskeletal disorders and anxiety, cardiometabolic diseases with mental health problems, and substance use disorders with neurologic diseases and neoplasms, amongst others. The number and complexity of the multimorbidity clusters increased with age in both genders. The cluster with the highest likelihood of mortality was identified in men aged 45 to 64 years and included associations between substance use disorder, neurologic conditions, and cancer. Large-scale epidemiological studies like ours could be useful when planning healthcare interventions targeting patients with chronic obstructive airway diseases and multimorbidity.

Download Full-text