Small airway dysfunction mediates the relationship between FeNO and asthma control.

Background: Most of the Fractional exhaled Nitric Oxide (FeNO)'s physiological production occurs in small airways, but the relationship between FeNO and small airway disease (SAD) in asthma is scant.

Objective: To investigate the relationship between asthma control, changes of FeNO in relation to airway bronchodilation (BD), and SAD.

Methods: Baseline conventional spirometry, impulse oscillometry (IOS), and FeNO pre- and post-bronchodilation (salbutamol 400 mcg) were tested on consecutive community-treated adult asthmatic patients.

Biologics and small molecules: the re-evolution in the treatment of atopic dermatitis in children and adolescents. Current state of the art and future perspectives.

Introduction: In recent years, the understanding of atopic dermatitis (AD) pathogenetic mechanisms has expanded and now it is recognized that Th2 immune axis dysregulation is pivotal to AD pathogenesis. The advent of biological drugs and small molecules have marked a revolution in the treatment of AD. Dupilumab, targeting IL-4 and IL-13, has been the first to demonstrate efficacy in treating moderate to severe AD by modulating type-2 inflammation pathways.

Ascertainment of small airway dysfunction using oscillometry to better define asthma control and future risk: are we ready to implement it in clinical practice?

The small airways comprise generations 8 to 23 of the bronchial tree, consist of airways with an internal diameter <2mm, and are classically difficult to assess and treat in persistent asthma. Small airways dysfunction (SAD) is integral to the asthma management paradigm as it is associated with poorer symptom control, greater levels of type 2 inflammation, and has been proposed as a potential treatable asthma trait. Although identification of SAD by oscillometry has been found to be clinically useful in managing asthma, very few physicians, including specialists, use this technique as part of standard or adjunct evaluation of lung function to diagnose asthma, grade severity of airway obstruction, ascertain disease control or the risk for future exacerbations or to make management decisions.