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Translating Basic Research Into Clinical Practice |

Small Airway Disease in Asthma and COPD: Clinical Implications

Maarten van den Berge, MD; Nick H. T. ten Hacken, MD; Judith Cohen, MD; W. Rob Douma, MD; Dirkje S. Postma, MD
Author and Funding Information

From the Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Correspondence to: Dirkje S. Postma, MD, PhD, Department of Pulmonary, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; e-mail: d.s.postma@long.umcg.nl


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;139(2):412-423. doi:10.1378/chest.10-1210
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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.

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