BibTex format
@article{Lele:2026:10.1016/j.jaip.2026.06.041,
author = {Lele, S and Pillai, A and Quayum, M and Wechsler, ME and Akuthota, P and Dandurand, RJ and Hammond, R and Bhattacharjee, A and Menzella, F and Poto, R and Comberiati, P and Berti, A and Lombardi, C and Galant, SP and Freund, O and Ventura, L and Portacci, A and Carpagnano, GE and Ortolani, V and Lipworth, B and Siddiqui, S and Cottini, M and Chan, R},
doi = {10.1016/j.jaip.2026.06.041},
journal = {J Allergy Clin Immunol Pract},
pages = {2348--2355.e3},
title = {Combined Large and Small Airway Obstruction Is Associated With Increased Exacerbation Frequency and Poorer Symptom Control in Persistent Asthma.},
url = {http://dx.doi.org/10.1016/j.jaip.2026.06.041},
volume = {14},
year = {2026}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - BACKGROUND: Spirometry remains central to the assessment of asthma but may fail to detect small airways dysfunction (SAD), which contributes to considerable symptoms and exacerbation risk. OBJECTIVE: We investigated whether integrating oscillometry with spirometry improves physiological phenotyping and risk stratification in asthma. METHODS: In this retrospective, multicenter study, data from 1497 adults with asthma were analyzed from the Oscillometry Asthma Registry. SAD was defined using the ratio of resistance heterogeneity between 5 and 20 Hz to resistance at 5 Hz ≥19% and airflow obstruction as forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) <70%. Participants were categorized into 4 mutually exclusive groups: (1) group 1-normal oscillometry and normal spirometry, (2) group 2-abnormal oscillometry with normal spirometry, (3) group 3-normal oscillometry with abnormal spirometry, and (4) group 4-abnormal oscillometry and abnormal spirometry. Associations with symptom control, exacerbations, and type 2 inflammatory biomarkers were assessed using multivariable logistic regression. RESULTS: For ≥1 exacerbation, the adjusted odds ratios (aORs) (95% confidence intervals) for group 4 were as follows: versus group 1, 3.19 (2.31, 4.42); versus group 2, 1.99 (1.46, 2.74); and versus group 3, 1.59 (1.07, 2.37). Corresponding aOR values for group 3 were as follows: versus group 2, 1.26 (0.85, 1.86), and versus group 1, 2.01 (1.37, 2.94). The aOR for ≥1 exacerbation for group 2 versus group 1 was 1.60 (1.18, 2.16). Results were similar when using FEV1/FVC <lower limit of normal instead of traditional predicted values. CONCLUSIONS: The combined use of oscillometry and spirometry identifies distinct physiological phenotypes of asthma with clinically meaningful differences in symptom burden and exacerbation risk.
AU - Lele,S
AU - Pillai,A
AU - Quayum,M
AU - Wechsler,ME
AU - Akuthota,P
AU - Dandurand,RJ
AU - Hammond,R
AU - Bhattacharjee,A
AU - Menzella,F
AU - Poto,R
AU - Comberiati,P
AU - Berti,A
AU - Lombardi,C
AU - Galant,SP
AU - Freund,O
AU - Ventura,L
AU - Portacci,A
AU - Carpagnano,GE
AU - Ortolani,V
AU - Lipworth,B
AU - Siddiqui,S
AU - Cottini,M
AU - Chan,R
DO - 10.1016/j.jaip.2026.06.041
EP - 2355
PY - 2026///
SP - 2348
TI - Combined Large and Small Airway Obstruction Is Associated With Increased Exacerbation Frequency and Poorer Symptom Control in Persistent Asthma.
T2 - J Allergy Clin Immunol Pract
UR - http://dx.doi.org/10.1016/j.jaip.2026.06.041
UR - https://www.ncbi.nlm.nih.gov/pubmed/42413614
VL - 14
ER -