Contemporary Concise Review 2019: Asthma.

Keywords: asthma; bronchial thermoplasty; obesity; precision medicine; treatable traits EN asthma bronchial thermoplasty obesity precision medicine treatable traits 651 656 6 05/28/20 20200601 NES 200601 Abbreviations BT bronchial thermoplasty COAT COugh Assessment Test COPD chronic obstructive pulmonary disease CT computed tomography DPI dry powder inhaler FEV 1 forced expiratory volume in 1 s FRC functional residual capacity FVC forced vital capacity GWAS genome-wide association study ICS inhaled corticosteroid IL interleukin ILO inducible laryngeal obstruction IST incremental shuttle walk test LABA long-acting beta-agonist LCQ Leicester Cough Questionnaire MDT multidisciplinary team OCT optical coherence tomography OSA obstructive sleep apnoea pMDI pressurized metered-dose inhaler ROS reactive oxygen species SNP single nucleotide polymorphism TRPA1 transient receptor potential A1 VCD vocal cord dysfunction Summary Treatable traits and a multidisciplinary assessment identify the heterogeneous problems associated with asthma, especially in those with severe disease. The application of bronchial thermoplasty in severe asthma improves clinical symptoms with the treatment acting primarily on second- to seventh-generation airways, reducing gas trapping and dynamic hyperinflation that can be associated with severe asthma; predicting responders remains to be defined. This suggests, in a cohort of adults with asthma and in whom over 70% had a BMI in excess of 25, that some nocturnal symptoms thought to be asthma may be due to undiagnosed sleep apnoea.[23] Endobronchial optical coherence tomography (OCT) is a technique that allows visualization of airway microstructures, internally examined during bronchoscopy, and allows the study of dynamic airway changes. [Extracted from the article]