ArticleJournal of asthma and allergy2021
The Relevance of Small Airway Dysfunction in Asthma with Nocturnal Symptoms.
Article in Journal of asthma and allergy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 22 citations in OpenAlex.
- The silent zone of paediatric asthma: integrating small airway dysfunction assessment into clinical practice.EClinicalMedicine · 2026Review
- Clinical Significance of Reduced Forced Expiratory Volume in 3 Seconds to Forced Expiratory Volume in 6 Seconds in Adults.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2026Article
- Beyond symptoms: uncovering type 2 inflammation and small airway dysfunction in Treatment-Naïve asthma.BMC pulmonary medicine · 2026Article
- From FEVJournal of asthma and allergy · 2026Review
- Small airway disease (SAD) in asthma in pregnancy evaluated by impulse oscillometry: A cross-sectional study.Lung India : official organ of Indian Chest Society · 2025Article
- Minimal clinically important difference for impulse oscillometry in adults with asthma.The European respiratory journal · 2023Article
- Who and how, DNA sensors in NETs-driven inflammation.Frontiers in immunology · 2023Review
- Monoclonal antibodies targeting small airways: a new perspective for biological therapies in severe asthma.Asthma research and practice · 2022Review
- Small Airways: The "Silent Zone" of 2021 GINA Report?Frontiers in medicine · 2022Review
- Prognosis of bronchial asthma in children with different pulmonary function phenotypes: A real-world retrospective observational study.Frontiers in pediatrics · 2022Article
- BMAL1/FOXA2-induced rhythmic fluctuations in IL-6 contribute to nocturnal asthma attacks.Frontiers in immunology · 2022Article
- Daytime and Nighttime Visual Analog Scales May Be Useful in Assessing Asthma Control Levels Before and After Treatment.Journal of asthma and allergy · 2022Article
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Authors and funding
13 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleSmall airway dysfunction (SAD) is a frequent feature of asthma that has been linked to disease severity and poor symptom control. However, little is known about the role of SAD in nocturnal asthma.
objectiveTo study the association between the severity of SAD and frequency of nocturnal symptoms compared to conventional lung function testing.
methodsWe assessed the frequency of self-reported nocturnal symptoms through the asthma control test. We studied the impact of nocturnal asthma using the Asthma Quality of Life Questionnaire (AQLQ) and the Multidimensional Fatigue Inventory (MFI-20). We assessed the lung function using spirometry, body plethysmography, impulse oscillometry, single and multiple inert gas washout and measured markers of T2-inflammation (blood and sputum eosinophils; fractional exhaled nitric oxide (FeNo)). We stratified the patients according to the presence and frequency of nocturnal asthma.
resultsA total of 166 asthma patients were enrolled in the analysis. Eighty-seven patients (52%) reported to have nocturnal symptoms at least once in the last four weeks. The odds ratio of nocturnal asthma correlated with the severity of all non-spirometric measures of SAD, yet neither with airflow obstruction (FEV1 and FEV/FVC) nor with large airway resistance (R20). Patients with frequent nocturnal asthma (n = 29) had a numerical increase of T2 markers and more severe SAD, as indicated by all non-spirometric measures of SAD (all p-values < 0.05), worse overall asthma control, increased fatigue and reduced quality of life (all p-values < 0.01) compared to patients with infrequent nocturnal asthma (n = 58) or patients without nocturnal asthma (n = 79). We identified 63 patients without airflow obstruction, nearly 43% of them (n = 27) had nocturnal asthma. In this subgroup, only markers of air trapping and ventilation heterogeneity were significantly elevated and correlated with the frequency of nocturnal symptoms: LCI (Spearman's coefficient = -0.42, p < 0.001), RV% (-0.32, p = 0.02).
conclusionSAD is closely associated to asthma with nocturnal symptoms. Spirometry might underestimate the broad spectrum of distal lung function impairments in this population of patients.
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