title: Small airway disease in asthma and COPD: clinical implications.
abstract: Asthma and COPD have a high personal, societal, and economic impact. Both diseases are characterized by airway obstruction and an inflammatory process. The inflammatory process affects the whole respiratory tract, from central to peripheral airways that are <2 mm in internal diameter, the so-called small airways. There is an increased interest in small airway disease, and some new insights have been gained about the contribution of these small airways to the clinical expression of asthma and COPD, as reviewed in this article. Newly developed devices enable drugs to target the small airways, and this may have implications for treatment of patients with asthma, particularly those not responding to large-particle inhaled corticosteroids or those with uncontrollable asthma. The first studies in COPD are promising, and results from new studies are eagerly awaited.
authors.affiliation: Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: van den Berge
authors.affiliation: Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Nick H T
authors.initials: NHT
authors.lastname: Ten Hacken
authors.affiliation: Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Judith
authors.initials: J
authors.lastname: Cohen
authors.affiliation: Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: W Rob
authors.initials: WR
authors.lastname: Douma
authors.affiliation: Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: d.s.postma@long.umcg.nl.
authors.forename: Dirkje S
authors.initials: DS
authors.lastname: Postma
mesh_terms: D000336:Aerosols / Q000008:administration & dosage; D000403:Airway Resistance / Q000502:physiology*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D003952:Diagnostic Imaging; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000503:physiopathology; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D012129:Respiratory Function Tests
chemical_list: D000336:Aerosols; D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D005938:Glucocorticoids