An estimated 300 million people suffer from asthma worldwide. Asthma inflammation affects the entire bronchial tree. The small airways, i.e. less than 2 mm diameter, can be affected by inflammation and remodelling. However, their contribution to asthma control and exacerbations has been minimally investigated. Small airways function can be assessed with invasive and non-invasive techniques, including physiological and radiographic testing, in addition to direct and indirect assessments of inflammation. These tests are usually only available in specialised chest clinics. Unfortunately, there is no gold standard tool, or an easy-to-apply measure, available in which to assess small airways dysfunction (SAD). Thus, there is an unmet need to identify SAD easily and correctly across all severities of asthma, and to assess its role in the control of the disease.
The ATLANTIS study ((AssessmenT of smalL Airways involvemeNT In aSthma) aims to:
1) Determine the role of small airways abnormalities in the clinical manifestations of asthma.
2) Evaluate which (combination of) clinical methods best assesses the abnormalities of small airways and large airways dysfunction in asthma and best relates to asthma severity, control and future risk of exacerbations, both cross-sectional and longitudinal.
3) Further develop and validate the small airways dysfunction tool (SADT).
The ATLANTIS study started in 2014 and the first results are expected in 2016. The data gathered could improve our understanding of small airways pathobiology in asthma and provide a database and sample repository to answer future questions.
References: Unmet needs for the assessment of small airways dysfunction in asthma: introduction to the ATLANTIS study. Postma DS et al. Eur Respir J. 2015 Jun;45(6):1534-8. doi: 10.1183/09031936.00214314.
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