Available techniques for the assessment of bronchial airways by size (small vs. large airways)
Method | Small airway function | Large airway function |
---|---|---|
1. Spirometry | FEF25–75%, FVC, FVC/SVC | FEV1, FEV1/FVC |
2. IOS | R5–R20, X5, AX, Fres Δ X5 in-esp | R20 |
3. Single or multiple breath nitrogen washout (SBNW/MBNW) test | Slope phase III, CV, CC, Sacin, Scond | |
4. Body plethysmography | RV, RV/TLC | |
5. High resolution CT (HRCT) | Air trapping, airway wall thickness | Airway wall thickness |
6. Nuclear medicine (scintigraphy, SPECT, PET) | Regional ventilation defects | |
7. 3He-MRI | Non-ventilated lung volume | |
8. Bronchoscopy | Transbronchial biopsy, BAL | Endobronchial biopsy |
9. Sputum induction | Late phase sputum | Early phase sputum |
10. Exhaled nitric oxide (eNO) | Alveolar eNO | |
11. CT and computational fluid dynamics | Changes in airway volume and resistance |
AX: reactance area; Fres: resonant frequency; FEV1: forced expiratory volume in 1 s; R5: resistance at 5 Hz; Sacin and Scond: acinar and conductive airways ventilation heterogeneity; TLC: total lung capacity; FEF25–75%: forced mid-expiratory flow; SVC: slow vital capacity; X5: reactance at 5 Hz; esp: espiratory; CV: closing capacity; CC: closing volume; SPECT: single-photon emission CT; PET: positron emission tomography; BAL: broncho-alveolar lavage
Note. Adapted from “Small airway dysfunction and poor asthma control: a dangerous liaison,” by Cottini M, Licini A, Lombardi C, Bagnasco D, Comberiati P, Berti A. Clin Mol Allergy. 2021;19:7 (https://clinicalmolecularallergy.biomedcentral.com/articles/10.1186/s12948-021-00147-8). CC-BY.
JP: Conceptualization, Writing—original draft, Writing—review & editing. CL, PC, ML, AB, EH, and GP: Writing—original draft, Writing—review & editing. MC: Conceptualization, Writing—original draft, Writing—review & editing, Supervision.
The authors declare that they have no conflicts of interest.
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© The Author(s) 2023.