Is it really time to look at distal airways to improve asthma phenotyping and treatment?

I n 2011, severe asthma and/or insufficient control of disease remain major challenges for the pulmonologist [1]. Small airway involvement has been demonstrated by a number of studies, particularly in fatal, severe or poorly controlled asthma, and may be a potential target to improve treatment and asthma outcomes [2–5]. Although inhaled corticosteroids (ICSs) remain the cornerstone of asthma treatment, there is a continuing debate on the potential benefit of small-particle formulations. In this context, the recent study by COHEN et al. [6] clearly adds new data to this controversial topic.