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Peripheral Airway Obstruction in Association with Symptoms and Quality of Life in Asthma

Papapostolou, Georgia LU orcid ; Nasr, Abir LU ; Jarenbäck, Linnea LU ; Ankerst, Jaro LU orcid ; Bjermer, Leif LU ; Tufvesson, Ellen LU ; Romberg, Kerstin LU and Tunsäter, Alf LU (2025) In Journal of Asthma and Allergy 18. p.491-505
Abstract

Introduction: Forced Oscillation Technique (FOT) is increasingly used to measure obstruction in the airways; however, the association between airway obstruction and the actual symptom burden in asthma is not known. Therefore, we aimed to investigate central and peripheral airway obstruction, measured by FOT, in association to symptoms and quality of life in asthma. Methods: 319 asthma patients were recruited and answered questionnaires focusing on symptoms (ACT, ACQ, Nijmegen, HADS and SNOT-22) and quality of life (MiniAQLQ and MiniRQLQ) and performed FOT measurements estimating airway resistance (R5: total resistance, R19: central resistance, R5-R19: peripheral resistance) and reactance (X5) during inspiration and expiration. Results:... (More)

Introduction: Forced Oscillation Technique (FOT) is increasingly used to measure obstruction in the airways; however, the association between airway obstruction and the actual symptom burden in asthma is not known. Therefore, we aimed to investigate central and peripheral airway obstruction, measured by FOT, in association to symptoms and quality of life in asthma. Methods: 319 asthma patients were recruited and answered questionnaires focusing on symptoms (ACT, ACQ, Nijmegen, HADS and SNOT-22) and quality of life (MiniAQLQ and MiniRQLQ) and performed FOT measurements estimating airway resistance (R5: total resistance, R19: central resistance, R5-R19: peripheral resistance) and reactance (X5) during inspiration and expiration. Results: Asthma groups classified based on ACT score cut-off points at 16, 20, and 25 showed higher R5, R5-R19, and lower X5 with increasing symptoms, which was not evident when applying a cut-off of only 20. ACQ-5 cut-offs at 0.75 and 1.5 captured differences in R5 and X5, whereas a Nijmegen cut-off of 23 showed differences in R5 and R19. The total scores from most questionnaires (except for the HADS and SNOT-22) correlated with many of the FOT results, but there were different patterns of correlation between airway obstruction and symptoms in uncontrolled and controlled asthma. Additionally, specific questions were associated with airway obstruction. Conclusion: The increasing symptoms in patients with asthma assessed using questionnaires correlated well with predominantly increasing peripheral airway obstruction. A correlation also exists with the Nijmegen score, which is not specific to asthma. The cut-off points used to define asthma control may capture peripheral airway dysfunction.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
airway obstruction, asthma, quality of life, symptom
in
Journal of Asthma and Allergy
volume
18
pages
15 pages
publisher
Dove Medical Press Ltd.
external identifiers
  • pmid:40206516
  • scopus:105003023156
ISSN
1178-6965
DOI
10.2147/JAA.S497218
language
English
LU publication?
yes
id
a30bb6e1-9dee-4820-9d67-1c63a089edfc
date added to LUP
2025-08-28 11:26:58
date last changed
2025-08-29 03:08:32
@article{a30bb6e1-9dee-4820-9d67-1c63a089edfc,
  abstract     = {{<p>Introduction: Forced Oscillation Technique (FOT) is increasingly used to measure obstruction in the airways; however, the association between airway obstruction and the actual symptom burden in asthma is not known. Therefore, we aimed to investigate central and peripheral airway obstruction, measured by FOT, in association to symptoms and quality of life in asthma. Methods: 319 asthma patients were recruited and answered questionnaires focusing on symptoms (ACT, ACQ, Nijmegen, HADS and SNOT-22) and quality of life (MiniAQLQ and MiniRQLQ) and performed FOT measurements estimating airway resistance (R5: total resistance, R19: central resistance, R5-R19: peripheral resistance) and reactance (X5) during inspiration and expiration. Results: Asthma groups classified based on ACT score cut-off points at 16, 20, and 25 showed higher R5, R5-R19, and lower X5 with increasing symptoms, which was not evident when applying a cut-off of only 20. ACQ-5 cut-offs at 0.75 and 1.5 captured differences in R5 and X5, whereas a Nijmegen cut-off of 23 showed differences in R5 and R19. The total scores from most questionnaires (except for the HADS and SNOT-22) correlated with many of the FOT results, but there were different patterns of correlation between airway obstruction and symptoms in uncontrolled and controlled asthma. Additionally, specific questions were associated with airway obstruction. Conclusion: The increasing symptoms in patients with asthma assessed using questionnaires correlated well with predominantly increasing peripheral airway obstruction. A correlation also exists with the Nijmegen score, which is not specific to asthma. The cut-off points used to define asthma control may capture peripheral airway dysfunction.</p>}},
  author       = {{Papapostolou, Georgia and Nasr, Abir and Jarenbäck, Linnea and Ankerst, Jaro and Bjermer, Leif and Tufvesson, Ellen and Romberg, Kerstin and Tunsäter, Alf}},
  issn         = {{1178-6965}},
  keywords     = {{airway obstruction; asthma; quality of life; symptom}},
  language     = {{eng}},
  pages        = {{491--505}},
  publisher    = {{Dove Medical Press Ltd.}},
  series       = {{Journal of Asthma and Allergy}},
  title        = {{Peripheral Airway Obstruction in Association with Symptoms and Quality of Life in Asthma}},
  url          = {{http://dx.doi.org/10.2147/JAA.S497218}},
  doi          = {{10.2147/JAA.S497218}},
  volume       = {{18}},
  year         = {{2025}},
}