Astma je kronična upalna bolest dišnih putova. Upala u astmi nije prisutna samo u velikim, već i u malim dišnim putovima. Opstrukcija i upala malih dišnih putova posebno su važne u noćnoj astmi, astmi izazvanoj naporom te astmi s učestalim egzacerbacijama. U dijagnosticiranju i praćenju bolesnika s astmom moguće je procijeniti stupanj opstrukcije i upale u malim dišnim putovima neinvazivnim metodama: spirometrijom, pletizmografijom, kompjutorskom tomografijom visoke rezolucije te frakcijom izdahnutog NO. Razvoj inhalacijskih kortikosteroida vrlo sitnih čestica omogućio je liječenje upale u malim dišnim putovima te postizanje jednake ili bolje kontrole astme uz značajno niže doze inhalacijskih kortikosteroida.Asthma is a chronic infl ammatory disease of the airways. Inflammation in asthma is not only present in large airways, but also present in small, peripheral airways. Obstruction and infl ammation of small airways is especially associated with nocturnal asthma, exercise-induced asthma, and asthma with frequent exacerbations. In diagnosis and monitoring of asthma patients, it is important to estimate inflammation and degree of obstruction of small airways with non–invasive methods: spirometry, plethysmography, high resolution computed tomography and fractional exhaled NO. Development of ultrafine particles inhaled corticosteroids enabled us to treat inflammation of small airways and achieve a similar or even better asthma control with signifi cantly lower inhaled corticosteroid doses
