Abstract:

Small airway dysfunction (SAD) widely exists in different stages of childhood asthma, which is based on airway inflammation, airway remodeling and airway hyperresponsiveness. Among them, airway inflammation is the main pathological feature of SAD. It has been recently found that immune cells involved in the progression of the disease, such as type 2 innervate lymphoid cells (ILC2s), macrophages, and granulocyte, played an important role in clinical control and targeted therapy of asthma. At the same time, with continuous improvement of clinical detection technologies such as impulse oscillometry and exhaled nitric oxide detecting, more and more evidence suggests that SAD is associated with the early occurrence and development of pediatric asthma. The development of ultra-fine particle aerosol and monoclonal antibody targeting small airways has provided a new means for the precise control of asthma. Therefore, the function of small airways in chronic respiratory diseases, including asthma, has received extensive attention in recent years. Previous studies have shown that SAD increases the risk of uncontrolled asthma in children, but it is often ignored. This article describes the latest research progress of SAD and childhood asthma from the aspects of pathogenesis, diagnostic evaluation and treatment, so as to provide a new perspective and understanding for long-term asthma management targeting small airways.

Key words: small airway dysfunction (SAD), airway inflammation, airway remodeling, child, asthma, asthma control