In the thesis of Annelies Zwitserloot, they explored ways to detect small airway disease earlier. We examined specialised lung function tests, such as multiple breath washout (MBW) and particles in exhaled air (PExA), as well as scoring methods for CT scans of the lungs.
In children with asthma, we found that, although small airway abnormalities were present, the MBW test provided little additional information compared to the widely used spirometry test. This suggests that MBW test is not useful in the daily care of children with asthma.
In children with cystic fibrosis (CF), however, MBW proved much more valuable. It could clearly distinguish between healthy children and those with CF, even when spirometry results were normal. PExA, on the other hand, was unable to do this.
We also studied the effects of the so-called CFTR modulator, lumacaftor/ivacaftor (Orkambi®), a new drug to treat CF. In children treated with this drug, we observed improvements in MBW and CT-scans, even when spirometry results remained unchanged.
In summary, our studies demonstrate the importance of examining the small airways for the earlier detection of lung disease in children. MBW and CT-scans can contribute to earlier diagnosis and better treatment, especially in CF.
