Appraising the small airways in asthma

Jill R. Johnson, Qutayba Hamid*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Purpose of Review: The small airways play an important yet poorly targeted role in asthma pathophysiology, leading to increased morbidity in asthma patients. Assessing inflammation and remodeling in these airways, determining the contribution of small airways to lung dysfunction and enhancing drug delivery to the distal regions of the lung remain challenging. The purpose of this review is to highlight recent advances in our understanding of small airways involvement in asthma. Recent Findings: Inflammation in the small airways can be evaluated through exhaled gas measurements, most often nitric oxide. However, additional exhaled biomarkers have recently been described. Considerable infiltration of mast cells in the distal lung and extensive structural changes to the small airways have also been demonstrated. Advances have been made in the functional assessment of small airways, particularly in the measurement of small airway compliance and ventilation defects and in studies investigating the impact of small particle inhaled corticosteroid treatment on lung function. Summary: Experimental assessments of small airways inflammation, remodeling and function have provided novel insights into the importance of the distal regions of the lung in asthma pathology. Further advances in drug delivery to the small airways have the potential to improve asthma control.

Original languageEnglish
Pages (from-to)23-28
Number of pages6
JournalCurrent Opinion in Pulmonary Medicine
Issue number1
Publication statusPublished - Jan 2012


  • asthma
  • inflammation
  • pharmacotherapy
  • physiology
  • small airways


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