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Assessment of small airways dysfunction with impulse oscillometry, multiple flow nitric oxide and spirometry in the Wessex severe asthma cohort study

Assessment of small airways dysfunction with impulse oscillometry, multiple flow nitric oxide and spirometry in the Wessex severe asthma cohort study
Assessment of small airways dysfunction with impulse oscillometry, multiple flow nitric oxide and spirometry in the Wessex severe asthma cohort study
Rationale: Asthma is a disease of the conducting airways. Small airway events are poorly reflected by standard lung function.Methods: IOS, spirometry and FeNO measures were made in healthy controls (HC, n=76), non-steroid treated mild asthmatics (MA, n=30), steroid treated step 2/3 asthmatics (ModA, n=35) and treatment-resistant step4/5 severe asthmatics (SA n=71), to assess disease related small airways dysfunction. Group comparisons and correlations were undertaken using both parametric and non-parametric statistical analyses.Results: Maximum airway nitric oxide flux (JawNO) , reflecting central airways inflammation, was increased in MA (median 2740, p<0.001) compared to both HC (640)and SA (700). By contrast, alveolar nitric oxide (CANO), which reflects peripheral airway inflammation, was significantly increased in all asthma groups compared to HC (p<0.05). Increased peripheral resistance was significantly elevated in asthma (p<0.001), with R5-R20>10% in absolute values being present in 53.3% of MA, 74.3% of ModA and 84.5% of SA.. A significant negative correlation was noted between R5-R20 and MEF25-75(r=-0.537), p<0.001),and both parameters correlated with asthma control ACQ6 (p<0.001) and asthma quality of life (p<0.001).Conclusion: Increased small airways resistance and distal inflammation is a feature of asthma with increasing peripheral resistance with disease severity. In SA this is associated with worse asthma control and greater impairment in quality of life. These findings emphasise the importance of the small airways to disease pathophysiology in asthma.
0903-1936
Gove, Kerry
6493b359-21cd-4068-88f4-a6e684f73316
Brown, Tom
fdd42359-a39d-4f22-b48d-015d9b94ec76
Rupani, Hitasha
cbc7068a-4279-4c8e-b83f-353210711062
Barber, Clair
ff31b460-34c3-466c-90e4-f70b3e954c82
Kurukulaaratchy, Ramesh
9c7b8105-2892-49f2-8775-54d4961e3e74
Chauhan, Anoop
4f606144-8948-4f82-8cb1-e57e7a05a8ed
Howarth, Peter
ff19c8c4-86b0-4a88-8f76-b3d87f142a21
Gove, Kerry
6493b359-21cd-4068-88f4-a6e684f73316
Brown, Tom
fdd42359-a39d-4f22-b48d-015d9b94ec76
Rupani, Hitasha
cbc7068a-4279-4c8e-b83f-353210711062
Barber, Clair
ff31b460-34c3-466c-90e4-f70b3e954c82
Kurukulaaratchy, Ramesh
9c7b8105-2892-49f2-8775-54d4961e3e74
Chauhan, Anoop
4f606144-8948-4f82-8cb1-e57e7a05a8ed
Howarth, Peter
ff19c8c4-86b0-4a88-8f76-b3d87f142a21

Gove, Kerry, Brown, Tom, Rupani, Hitasha, Barber, Clair, Kurukulaaratchy, Ramesh, Chauhan, Anoop and Howarth, Peter (2015) Assessment of small airways dysfunction with impulse oscillometry, multiple flow nitric oxide and spirometry in the Wessex severe asthma cohort study. European Respiratory Journal, 46 (Suppl 59).

Record type: Meeting abstract

Abstract

Rationale: Asthma is a disease of the conducting airways. Small airway events are poorly reflected by standard lung function.Methods: IOS, spirometry and FeNO measures were made in healthy controls (HC, n=76), non-steroid treated mild asthmatics (MA, n=30), steroid treated step 2/3 asthmatics (ModA, n=35) and treatment-resistant step4/5 severe asthmatics (SA n=71), to assess disease related small airways dysfunction. Group comparisons and correlations were undertaken using both parametric and non-parametric statistical analyses.Results: Maximum airway nitric oxide flux (JawNO) , reflecting central airways inflammation, was increased in MA (median 2740, p<0.001) compared to both HC (640)and SA (700). By contrast, alveolar nitric oxide (CANO), which reflects peripheral airway inflammation, was significantly increased in all asthma groups compared to HC (p<0.05). Increased peripheral resistance was significantly elevated in asthma (p<0.001), with R5-R20>10% in absolute values being present in 53.3% of MA, 74.3% of ModA and 84.5% of SA.. A significant negative correlation was noted between R5-R20 and MEF25-75(r=-0.537), p<0.001),and both parameters correlated with asthma control ACQ6 (p<0.001) and asthma quality of life (p<0.001).Conclusion: Increased small airways resistance and distal inflammation is a feature of asthma with increasing peripheral resistance with disease severity. In SA this is associated with worse asthma control and greater impairment in quality of life. These findings emphasise the importance of the small airways to disease pathophysiology in asthma.

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More information

Published date: September 2015
Venue - Dates: European Respiratory Society International Congress, Amsterdam, Netherlands, 2015-11-26 - 2015-11-30

Identifiers

Local EPrints ID: 422522
URI: https://eprints.soton.ac.uk/id/eprint/422522
ISSN: 0903-1936
PURE UUID: be2c61cc-1f8a-4a70-af8d-fccf05e0863c
ORCID for Clair Barber: ORCID iD orcid.org/0000-0001-5335-5129

Catalogue record

Date deposited: 25 Jul 2018 16:30
Last modified: 14 Mar 2019 01:28

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