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Small airway abnormalities in asthmatic patients with persistent airflow limitation.

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Title: Small airway abnormalities in asthmatic patients with persistent airflow limitation.
Authors: Contoli, Marco (AUTHOR), Baraldi, Federico (AUTHOR), Morandi, Luca (AUTHOR), Gnesini, Giulia (AUTHOR), Bigoni, Tommaso (AUTHOR), Papi, Alberto (AUTHOR)
Source: Journal of Asthma. May2026, Vol. 63 Issue 5, p582-589. 8p.
Subjects: Asthma, Respiratory obstructions, Respiratory measurements, Chronic obstructive pulmonary disease, Patient reported outcome measures, Pulmonary function tests, Dyspnea
Abstract: Background: A subset of patients with asthma develops persistent airflow limitation (PAL) despite optimal treatment. The role of small airways dysfunction (SAD) in this phenotype, and its relationship with symptoms, remains incompletely understood. Objectives: To assess small airways function in asthmatic patients with PAL and compare it with patients with fully reversible asthma and with COPD; and to explore correlations between small airway indices and patient-reported outcomes. Methods: We enrolled 60 patients (20 with asthma and PAL, 20 with fully reversible asthma, 20 with COPD) matched for age, sex, and pre-bronchodilator FEV1. Small airways function was evaluated using impulse oscillometry (IOS; R5–R20) and single-breath nitrogen washout test (SBNWT; dN2). Patients completed a daily symptom diary (dyspnea, cough, sputum, and rescue medication use) over four weeks. Results: Compared with fully reversible asthma, asthmatic patients with PAL showed significantly higher dN2 and R5–R20 values, though less pronounced than in COPD. SAD (R5–R20 > 0.07 kPa·L−1·s) was present in all COPD patients, 79% of PAL patients, and 37% of reversible asthma patients (p < 0.001). In PAL, R5–R20 correlated strongly with dyspnea scores (r = 0.64, p < 0.001). In reversible asthma, R5–R20 correlated with cough and rescue medication use, whereas in COPD, symptoms were primarily related to residual volume. Conclusions: Small airways dysfunction is highly prevalent in asthmatic patients with PAL and significantly contributes to daily symptom burden. Its intermediate severity between COPD and reversible asthma suggests that SAD plays a central role in the pathogenesis of fixed obstruction, suggesting a potential role for targeted diagnostic and therapeutic strategies. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Asthma is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Small airway abnormalities in asthmatic patients with persistent airflow limitation.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Contoli%2C+Marco%22&quot;&gt;Contoli, Marco&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Baraldi%2C+Federico%22&quot;&gt;Baraldi, Federico&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Morandi%2C+Luca%22&quot;&gt;Morandi, Luca&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Gnesini%2C+Giulia%22&quot;&gt;Gnesini, Giulia&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bigoni%2C+Tommaso%22&quot;&gt;Bigoni, Tommaso&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Papi%2C+Alberto%22&quot;&gt;Papi, Alberto&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Journal+of+Asthma%22&quot;&gt;Journal of Asthma&lt;/searchLink&gt;. May2026, Vol. 63 Issue 5, p582-589. 8p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Asthma%22&quot;&gt;Asthma&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Respiratory+obstructions%22&quot;&gt;Respiratory obstructions&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Respiratory+measurements%22&quot;&gt;Respiratory measurements&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Chronic+obstructive+pulmonary+disease%22&quot;&gt;Chronic obstructive pulmonary disease&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Patient+reported+outcome+measures%22&quot;&gt;Patient reported outcome measures&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Pulmonary+function+tests%22&quot;&gt;Pulmonary function tests&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Dyspnea%22&quot;&gt;Dyspnea&lt;/searchLink&gt;
– Name: Abstract
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  Group: Ab
  Data: Background: A subset of patients with asthma develops persistent airflow limitation (PAL) despite optimal treatment. The role of small airways dysfunction (SAD) in this phenotype, and its relationship with symptoms, remains incompletely understood. Objectives: To assess small airways function in asthmatic patients with PAL and compare it with patients with fully reversible asthma and with COPD; and to explore correlations between small airway indices and patient-reported outcomes. Methods: We enrolled 60 patients (20 with asthma and PAL, 20 with fully reversible asthma, 20 with COPD) matched for age, sex, and pre-bronchodilator FEV1. Small airways function was evaluated using impulse oscillometry (IOS; R5–R20) and single-breath nitrogen washout test (SBNWT; dN2). Patients completed a daily symptom diary (dyspnea, cough, sputum, and rescue medication use) over four weeks. Results: Compared with fully reversible asthma, asthmatic patients with PAL showed significantly higher dN2 and R5–R20 values, though less pronounced than in COPD. SAD (R5–R20 &gt; 0.07 kPa&#183;L−1&#183;s) was present in all COPD patients, 79% of PAL patients, and 37% of reversible asthma patients (p &lt; 0.001). In PAL, R5–R20 correlated strongly with dyspnea scores (r = 0.64, p &lt; 0.001). In reversible asthma, R5–R20 correlated with cough and rescue medication use, whereas in COPD, symptoms were primarily related to residual volume. Conclusions: Small airways dysfunction is highly prevalent in asthmatic patients with PAL and significantly contributes to daily symptom burden. Its intermediate severity between COPD and reversible asthma suggests that SAD plays a central role in the pathogenesis of fixed obstruction, suggesting a potential role for targeted diagnostic and therapeutic strategies. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of Journal of Asthma is the property of Taylor &amp; Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1080/02770903.2026.2612741
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      – Code: eng
        Text: English
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        PageCount: 8
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    Subjects:
      – SubjectFull: Asthma
        Type: general
      – SubjectFull: Respiratory obstructions
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      – SubjectFull: Respiratory measurements
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      – SubjectFull: Chronic obstructive pulmonary disease
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      – SubjectFull: Dyspnea
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      – TitleFull: Small airway abnormalities in asthmatic patients with persistent airflow limitation.
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              M: 05
              Text: May2026
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              Y: 2026
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