Cottini Marcello, Lombardi Carlo, Comberiati Pasquale, Berti Alvise, Menzella Francesco, Dandurand Ronald J, Diamant Zuzana, Chan Rory
Allergy and Pneumology Outpatient Clinic, Bergamo, Italy.
Departmental Unit of Allergology, Immunology and Pulmonary Diseases, Fondazione Poliambulanza, Brescia, Italy.
Ann Allergy Asthma Immunol. 2025 Feb;134(2):151-158. doi: 10.1016/j.anai.2024.11.006. Epub 2024 Nov 15.
The small airways, also referred to as the lung's silent zone, are closely associated with poor symptom control and more frequent asthma exacerbations. The oscillometry technique superimposes sound or airwaves onto normal tidal breathing and provides information on resistance and reactance, that is, obstacles to airflow occurring inside and outside of the bronchi. More recently, a management paradigm based on so-called "treatable traits" has been proposed to personalize and improve asthma care for individuals by proactively identifying and targeting modifiable pulmonary, extrapulmonary, and behavioral traits affecting asthma control. In this review article, we evaluate the literature on small airways dysfunction as a potential treatable trait in persistent asthma. In particular, we discuss whole- and intrabreath oscillometry and the impact of extrafine inhaled corticosteroids and systemic biologics on the peripheral airways.
小气道，也被称为肺部的“沉默区”，与症状控制不佳和哮喘更频繁发作密切相关。振荡法技术将声音或气波叠加在正常潮气呼吸上，并提供有关阻力和电抗的信息，即支气管内外气流所遇到的阻碍。最近，有人提出了一种基于所谓“可治疗特征”的管理模式，通过主动识别和针对影响哮喘控制的可改变的肺部、肺外和行为特征，来实现哮喘治疗的个性化并改善个体的哮喘护理。在这篇综述文章中，我们评估了关于小气道功能障碍作为持续性哮喘潜在可治疗特征的文献。特别是，我们讨论了全呼吸和呼吸内振荡法，以及超细吸入性糖皮质激素和全身性生物制剂对外周气道的影响。
