Small airway disease in asthma: Pathophysiological and diagnostic considerations

Marco Contoli, Pierachille Santus, Alberto Papi

Research output: Contribution to journalArticlepeer-review


Purpose of review The aim of the current review is to summarize the evidence of small airway abnormalities in asthma, the proposed diagnostic tools for small airway abnormalities and the clinical implications of small airway abnormalities in asthma.

Recent findings Pathological abnormalities in the peripheral membranous bronchioles less than 2mm in diameter (i.e. small airways) can be very frequently detected in asthma patients across severity: from mild to the more severe clinical manifestations of the disease. Interestingly, not only are small airway abnormalities present in asthma, but there is evidence that the magnitude of small airway abnormalities correlates with the severity of the disease. So far no unanimously accepted method and/or algorithm is available for small airway abnormality detection; however, some functional techniques and inflammatory markers have been used as surrogates of small airway dysfunction.

Summary Clinicians, and not only researchers, must consider small airways when approaching asthma patients, particularly when dealing with patients with a 'difficult-to-treat phenotype'. The identification of subgroups of asthma patients with prominent small airway disease is not merely speculative, and carries pathophysiological and therapeutic implications.

Original languageEnglish
Pages (from-to)68-73
Number of pages6
JournalCurrent Opinion in Pulmonary Medicine
Issue number1
Publication statusPublished - Jan 11 2015


  • Asthma
  • Diagnosis
  • Inflammation
  • Small airways

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Medicine(all)


Dive into the research topics of 'Small airway disease in asthma: Pathophysiological and diagnostic considerations'. Together they form a unique fingerprint.

Cite this