Small Airways Response to Bronchodilators in Adults with Asthma or COPD: A Systematic Review

Mohammed A Almeshari,1,2 Nowaf Y Alobaidi,1,3 Elizabeth Sapey,1,4 Omar Usmani,5 Robert A Stockley,6 James A Stockley7 1Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, B15 2TT, UK; 2Rehabilitation Health Sciences Department, College of...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Almeshari MA, Alobaidi NY, Sapey E, Usmani O, Stockley RA, Stockley JA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	asthma copd bronchodilator reversibility small airways function. Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/41bead2fa12a43d1ae52137fed319fdc
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:41bead2fa12a43d1ae52137fed319fdc
record_format	dspace
spelling	oai:doaj.org-article:41bead2fa12a43d1ae52137fed319fdc2021-11-11T18:22:26ZSmall Airways Response to Bronchodilators in Adults with Asthma or COPD: A Systematic Review1178-2005https://doaj.org/article/41bead2fa12a43d1ae52137fed319fdc2021-11-01T00:00:00Zhttps://www.dovepress.com/small-airways-response-to-bronchodilators-in-adults-with-asthma-or-cop-peer-reviewed-fulltext-article-COPDhttps://doaj.org/toc/1178-2005Mohammed A Almeshari,1,2 Nowaf Y Alobaidi,1,3 Elizabeth Sapey,1,4 Omar Usmani,5 Robert A Stockley,6 James A Stockley7 1Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, B15 2TT, UK; 2Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 3Respiratory Therapy Department, King Saud Bin Abdulaziz University for Health Sciences, Alahsa, Saudi Arabia; 4Acute Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2GW, UK; 5Imperial College of London, London, UK; 6Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 7Lung Function & Sleep Department, Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UKCorrespondence: Mohammed A AlmeshariRehabilitation Health Science Department, College of Applied Medical Sciences, King Saud University, P. Box 145111,, Riyadh, ZIP 4545, Saudi ArabiaTel +966 50 8033 880Email malmeshari@ksu.edu.saBackground: Bronchodilator responsiveness (BDR) is commonly used in the diagnosis of lung disease. Although small airways dysfunction is a feature of asthma and COPD, physiological tests of small airways are not included in guidelines for BDR testing. This systematic review assessed the current evidence of BDR using small airways function in asthma and COPD.Methods: The systematic review used standard methodology with the protocol prospectively registered on PROSPERO (CRD42020164140). Electronic medical databases (EMBASE and Medline) were searched using related keywords. Abstracts and full texts were screened independently by two reviewers. Studies that reported the change of physiological small airways function and FEV1 were included in the review. The revised Cochrane risk of bias tool for RCT and NIH quality assessment tool for cohort and cross-sectional studies were used to evaluate the studies.Results: A total of 934 articles were identified, with 12 meeting the inclusion criteria. Ten studies included asthma patients, 1 study included COPD patients and 1 study included both asthma and COPD. A total of 1104 participants were included, of whom 941 were asthmatic, 64 had COPD and 109 were healthy controls. Studies were heterogeneous in design including the device, dose and time intervals for BDR assessment. A small airway BDR was seen for most tests in asthma and COPD, including oscillometry (R5-20, reactance (X5), area of reactance (AX) and resonant frequency (Fres)) and Maximal Mid Expiratory Flow.Conclusion: There is a measurable BDR in the small airways. However, with no consensus on how to assess BDR, studies were heterogeneous. Further research is needed to inform how BDR should be assessed, its clinical impact and place in routine clinical practice.Keywords: asthma, COPD, bronchodilator, reversibility, small airways functionAlmeshari MAAlobaidi NYSapey EUsmani OStockley RAStockley JADove Medical Pressarticleasthmacopdbronchodilatorreversibilitysmall airways function.Diseases of the respiratory systemRC705-779ENInternational Journal of COPD, Vol Volume 16, Pp 3065-3082 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	asthma copd bronchodilator reversibility small airways function. Diseases of the respiratory system RC705-779
spellingShingle	asthma copd bronchodilator reversibility small airways function. Diseases of the respiratory system RC705-779 Almeshari MA Alobaidi NY Sapey E Usmani O Stockley RA Stockley JA Small Airways Response to Bronchodilators in Adults with Asthma or COPD: A Systematic Review
description	Mohammed A Almeshari,1,2 Nowaf Y Alobaidi,1,3 Elizabeth Sapey,1,4 Omar Usmani,5 Robert A Stockley,6 James A Stockley7 1Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, B15 2TT, UK; 2Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 3Respiratory Therapy Department, King Saud Bin Abdulaziz University for Health Sciences, Alahsa, Saudi Arabia; 4Acute Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2GW, UK; 5Imperial College of London, London, UK; 6Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 7Lung Function & Sleep Department, Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, UKCorrespondence: Mohammed A AlmeshariRehabilitation Health Science Department, College of Applied Medical Sciences, King Saud University, P. Box 145111,, Riyadh, ZIP 4545, Saudi ArabiaTel +966 50 8033 880Email malmeshari@ksu.edu.saBackground: Bronchodilator responsiveness (BDR) is commonly used in the diagnosis of lung disease. Although small airways dysfunction is a feature of asthma and COPD, physiological tests of small airways are not included in guidelines for BDR testing. This systematic review assessed the current evidence of BDR using small airways function in asthma and COPD.Methods: The systematic review used standard methodology with the protocol prospectively registered on PROSPERO (CRD42020164140). Electronic medical databases (EMBASE and Medline) were searched using related keywords. Abstracts and full texts were screened independently by two reviewers. Studies that reported the change of physiological small airways function and FEV1 were included in the review. The revised Cochrane risk of bias tool for RCT and NIH quality assessment tool for cohort and cross-sectional studies were used to evaluate the studies.Results: A total of 934 articles were identified, with 12 meeting the inclusion criteria. Ten studies included asthma patients, 1 study included COPD patients and 1 study included both asthma and COPD. A total of 1104 participants were included, of whom 941 were asthmatic, 64 had COPD and 109 were healthy controls. Studies were heterogeneous in design including the device, dose and time intervals for BDR assessment. A small airway BDR was seen for most tests in asthma and COPD, including oscillometry (R5-20, reactance (X5), area of reactance (AX) and resonant frequency (Fres)) and Maximal Mid Expiratory Flow.Conclusion: There is a measurable BDR in the small airways. However, with no consensus on how to assess BDR, studies were heterogeneous. Further research is needed to inform how BDR should be assessed, its clinical impact and place in routine clinical practice.Keywords: asthma, COPD, bronchodilator, reversibility, small airways function
format	article
author	Almeshari MA Alobaidi NY Sapey E Usmani O Stockley RA Stockley JA
author_facet	Almeshari MA Alobaidi NY Sapey E Usmani O Stockley RA Stockley JA
author_sort	Almeshari MA
title	Small Airways Response to Bronchodilators in Adults with Asthma or COPD: A Systematic Review
title_short	Small Airways Response to Bronchodilators in Adults with Asthma or COPD: A Systematic Review
title_full	Small Airways Response to Bronchodilators in Adults with Asthma or COPD: A Systematic Review
title_fullStr	Small Airways Response to Bronchodilators in Adults with Asthma or COPD: A Systematic Review
title_full_unstemmed	Small Airways Response to Bronchodilators in Adults with Asthma or COPD: A Systematic Review
title_sort	small airways response to bronchodilators in adults with asthma or copd: a systematic review
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/41bead2fa12a43d1ae52137fed319fdc
work_keys_str_mv	AT almesharima smallairwaysresponsetobronchodilatorsinadultswithasthmaorcopdasystematicreview AT alobaidiny smallairwaysresponsetobronchodilatorsinadultswithasthmaorcopdasystematicreview AT sapeye smallairwaysresponsetobronchodilatorsinadultswithasthmaorcopdasystematicreview AT usmanio smallairwaysresponsetobronchodilatorsinadultswithasthmaorcopdasystematicreview AT stockleyra smallairwaysresponsetobronchodilatorsinadultswithasthmaorcopdasystematicreview AT stockleyja smallairwaysresponsetobronchodilatorsinadultswithasthmaorcopdasystematicreview
_version_	1718431819191287808

Small Airways Response to Bronchodilators in Adults with Asthma or COPD: A Systematic Review

Ejemplares similares