{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:11:18Z","timestamp":1786986678758,"version":"build-2736575974"},"reference-count":54,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T00:00:00Z","timestamp":1519862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T00:00:00Z","timestamp":1519862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journal.chestnet.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Chest"],"published-print":{"date-parts":[[2018,3]]},"DOI":"10.1016\/j.chest.2017.11.016","type":"journal-article","created":{"date-parts":[[2017,11,29]],"date-time":"2017-11-29T17:49:14Z","timestamp":1511977754000},"page":"618-629","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":35,"title":["Further Studies of Unsuspected Emphysema in Nonsmoking Patients With Asthma With Persistent Expiratory Airflow Obstruction"],"prefix":"10.1016","volume":"153","author":[{"given":"Arthur F.","family":"Gelb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric K.","family":"Verbeken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.","family":"Schein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxanna","family":"Moridzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diem","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Fraser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Barbers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaa","family":"Elatre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael N.","family":"Koss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric F.","family":"Glassy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay A.","family":"Nadel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"4","key":"10.1016\/j.chest.2017.11.016_bib1","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1152\/jappl.1967.23.4.433","article-title":"Elastic recoil of the lungs in chronic asthmatic patients before and after therapy","volume":"23","author":"Gold","year":"1967","journal-title":"J\u00a0Appl Physiol"},{"issue":"5","key":"10.1016\/j.chest.2017.11.016_bib2","first-page":"788","article-title":"The static elastic properties in the lungs in asthma","volume":"98","author":"Woolcock","year":"1968","journal-title":"Am Rev Respir Dis"},{"issue":"4","key":"10.1016\/j.chest.2017.11.016_bib3","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1152\/jappl.1969.27.4.452","article-title":"Serical studies of factors influencing airway dynamics during recovery from acute asthma attacks","volume":"27","author":"McFadden","year":"1969","journal-title":"J\u00a0Appl Physiol"},{"issue":"1","key":"10.1016\/j.chest.2017.11.016_bib4","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1164\/ajrccm\/142.1.79","article-title":"Changes in total lung capacity during spontaneous asthma","volume":"142","author":"Blackie","year":"1990","journal-title":"Am Rev Respir Dis"},{"issue":"2","key":"10.1016\/j.chest.2017.11.016_bib5","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1152\/jappl.1973.34.2.143","article-title":"Pulmonary conductance and elastic recoil relationship in asthma and emphysema","volume":"34","author":"Colebatch","year":"1973","journal-title":"J\u00a0Appl Physiol"},{"issue":"2","key":"10.1016\/j.chest.2017.11.016_bib6","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/0002-9343(76)90165-0","article-title":"The mechanism of increase in total lung capacity during acute asthma","volume":"61","author":"Peress","year":"1976","journal-title":"Am J Med"},{"issue":"6","key":"10.1016\/j.chest.2017.11.016_bib7","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1152\/jappl.1975.38.6.974","article-title":"Changes in lung mechanics during asthma induced by exercise","volume":"38","author":"Freedman","year":"1975","journal-title":"J\u00a0Appl Physiol"},{"issue":"3","key":"10.1016\/j.chest.2017.11.016_bib8","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1152\/jappl.1974.37.3.297","article-title":"Lung mechanics in antigen-induced asthma","volume":"37","author":"Mansell","year":"1974","journal-title":"J\u00a0Appl Physiol"},{"issue":"5","key":"10.1016\/j.chest.2017.11.016_bib9","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1152\/jappl.1980.49.5.869","article-title":"Tonic inspiratory muscle activity as a cause of hyperinflation in histamine-induced asthma","volume":"49","author":"M\u00fcller","year":"1980","journal-title":"J\u00a0Appl Physiol Respir Environ Exrc Physiol"},{"issue":"5","key":"10.1016\/j.chest.2017.11.016_bib10","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1164\/ajrccm.162.5.2001037","article-title":"Unsuspected pseudophysiologic emphysema in chronic persistent asthma","volume":"162","author":"Gelb","year":"2000","journal-title":"Am J Respir Crit Care Med"},{"issue":"3","key":"10.1016\/j.chest.2017.11.016_bib11","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1378\/chest.121.3.715","article-title":"Unsuspected loss of lung elastic recoil in chronic persistent asthma","volume":"121","author":"Gelb","year":"2002","journal-title":"Chest"},{"issue":"4","key":"10.1016\/j.chest.2017.11.016_bib12","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/S0012-3692(15)31289-7","article-title":"Risk factors for near-fatal asthma","volume":"126","author":"Gelb","year":"2004","journal-title":"Chest"},{"key":"10.1016\/j.chest.2017.11.016_bib13","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1136\/thx.35.4.298","article-title":"Lung elastic recoil and reduced airflow in clinically stable asthma","volume":"35","author":"McCarthy","year":"1980","journal-title":"Thorax"},{"issue":"6","key":"10.1016\/j.chest.2017.11.016_bib14","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1378\/chest.130.6.1726","article-title":"Improvements in distal lung function correlate with asthma symptoms after treatment with oral montelukast","volume":"130","author":"Kraft","year":"2006","journal-title":"Chest"},{"issue":"2","key":"10.1016\/j.chest.2017.11.016_bib15","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1378\/chest.109.2.353","article-title":"Contribution of emphysema and small airways in COPD","volume":"109","author":"Gelb","year":"1996","journal-title":"Chest"},{"issue":"5","key":"10.1016\/j.chest.2017.11.016_bib16","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.2214\/ajr.163.5.7976869","article-title":"Emphysema: definition, imaging, and quantification","volume":"163","author":"Thurlbeck","year":"1994","journal-title":"AJR Am J Roentgenol"},{"issue":"1","key":"10.1016\/j.chest.2017.11.016_bib17","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1378\/chest.08-0049","article-title":"A\u00a0multivariate analysis of risk factors for the air-trapping asthmatic phenotype as measured by quantitative CT analysis","volume":"135","author":"Busacker","year":"2009","journal-title":"Chest"},{"issue":"11","key":"10.1016\/j.chest.2017.11.016_bib18","doi-asserted-by":"crossref","first-page":"2455","DOI":"10.1183\/09031936.97.10112455","article-title":"Measurement of CT lung density in patients with chronic asthma","volume":"10","author":"Biernacki","year":"1997","journal-title":"Eur Respir J"},{"issue":"1","key":"10.1016\/j.chest.2017.11.016_bib19","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1148\/radiol.2431060194","article-title":"Pulmonary emphysema: radiation dose and section thickness at multidetector CT quantification: comparison with macroscopic and microscopic morphometry","volume":"243","author":"Madani","year":"2007","journal-title":"Radiology"},{"issue":"4","key":"10.1016\/j.chest.2017.11.016_bib20","first-page":"363","article-title":"Unsuspected mild emphysema in nonsmoking patients with chronic asthma with persistent airway obstruction","volume":"133","author":"Gelb","year":"2014","journal-title":"J\u00a0Allergy Clin Immunol"},{"issue":"2","key":"10.1016\/j.chest.2017.11.016_bib21","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1378\/chest.14-2483","article-title":"Unraveling the pathophysiology of the asthma-COPD overlap syndrome: unsuspected mild centrilobular emphysema is responsible for loss of lung elastic recoil in never smokers with asthma with persistent expiratory airflow limitation","volume":"148","author":"Gelb","year":"2015","journal-title":"Chest"},{"issue":"1","key":"10.1016\/j.chest.2017.11.016_bib22","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1152\/jappl.1967.22.1.95","article-title":"Significance of the relationship between lung recoil and maximum expiratory flow","volume":"22","author":"Mead","year":"1967","journal-title":"J\u00a0Appl Physiol"},{"issue":"4","key":"10.1016\/j.chest.2017.11.016_bib23","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1378\/chest.68.4.538","article-title":"Effect of aging on lung mechanics in healthy nonsmokers","volume":"68","author":"Gelb","year":"1975","journal-title":"Chest"},{"issue":"1","key":"10.1016\/j.chest.2017.11.016_bib24","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.jaci.2003.09.008","article-title":"Development of the asthma control test: a survey for assessing asthma control","volume":"113","author":"Nathan","year":"2004","journal-title":"J\u00a0Allergy Clin Immunol"},{"issue":"6","key":"10.1016\/j.chest.2017.11.016_bib25","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1016\/j.jaci.2012.03.036","article-title":"In moderate-to-severe asthma patients monitoring exhaled nitric oxide during excerbation is not a good predictor of spirometric response to corticosteroid","volume":"129","author":"Gelb","year":"2013","journal-title":"J\u00a0Allergy Clin Immunol"},{"issue":"3","key":"10.1016\/j.chest.2017.11.016_bib26","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1378\/chest.101.3.793","article-title":"The senile lung: comparison with normal and emphysematous lungs. 1. Structural aspects","volume":"101","author":"Verbeken","year":"1992","journal-title":"Chest"},{"issue":"3","key":"10.1016\/j.chest.2017.11.016_bib27","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1378\/chest.101.3.800","article-title":"The senile lung: comparison with normal and emphysematous lungs. 2. Functional aspects","volume":"101","author":"Verbeken","year":"1992","journal-title":"Chest"},{"issue":"2 pt 1","key":"10.1016\/j.chest.2017.11.016_bib28","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1164\/ajrccm.162.2.9907151","article-title":"The effect of age and duration of disease on airway structure in fatal asthma","volume":"162","author":"Bai","year":"2000","journal-title":"Am J Respir Crit Care Med"},{"issue":"8","key":"10.1016\/j.chest.2017.11.016_bib29","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1164\/rccm.200403-305OC","article-title":"Abnormal alveolar attachments with decreased elastic fiber content in distal lung in fatal asthma","volume":"170","author":"Mauad","year":"2004","journal-title":"Am J Respir Crit Care Med"},{"issue":"5","key":"10.1016\/j.chest.2017.11.016_bib30","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1016\/j.jaci.2009.02.032","article-title":"The outer wall of small airways is a major site of remodeling in fatal asthma","volume":"123","author":"Dolhnikoff","year":"2009","journal-title":"J\u00a0Allergy Clin Immunol"},{"issue":"5","key":"10.1016\/j.chest.2017.11.016_bib31","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/j.jaci.2007.06.031","article-title":"Asthma therapy and airway remodeling","volume":"120","author":"Mauad","year":"2007","journal-title":"J\u00a0Allergy Clin Immunol"},{"issue":"10","key":"10.1016\/j.chest.2017.11.016_bib32","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1164\/rccm.201110-1849OC","article-title":"Airway smooth muscle hypertrophy and hyperplasia in asthma","volume":"185","author":"James","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"issue":"3","key":"10.1016\/j.chest.2017.11.016_bib33","doi-asserted-by":"crossref","first-page":"348","DOI":"10.3109\/15412555.2012.752806","article-title":"Airway dimensions in fatal asthma and fatal COPD: overlap in older patients","volume":"10","author":"Senhorini","year":"2013","journal-title":"COPD"},{"issue":"1","key":"10.1016\/j.chest.2017.11.016_bib34","first-page":"50","article-title":"Physiologic diagnosis of subclinical emphysema","volume":"107","author":"Gelb","year":"1973","journal-title":"Am Rev Respir Dis"},{"issue":"3","key":"10.1016\/j.chest.2017.11.016_bib35","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1164\/ajrccm.158.3.9801045","article-title":"Pseudophysiologic emphysema resulting from severe small-airway disease","volume":"158","author":"Gelb","year":"1998","journal-title":"Am J Respir Crit Care Med"},{"issue":"5","key":"10.1016\/j.chest.2017.11.016_bib36","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1111\/j.1365-2222.2005.02235.x","article-title":"Inflammatory cell mapping of the respiratory tract in fatal asthma","volume":"35","author":"de Magalh\u00e3es Sim\u00f5es","year":"2005","journal-title":"Clin Exp Allergy"},{"issue":"11","key":"10.1016\/j.chest.2017.11.016_bib37","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1136\/thx.2010.157719","article-title":"Systemic upregulation of neutrophil \u03b1-defensins and serine proteases in neutrophilic asthma","volume":"66","author":"Baines","year":"2011","journal-title":"Thorax"},{"issue":"4","key":"10.1016\/j.chest.2017.11.016_bib38","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/j.jaci.2011.01.022","article-title":"Mast cell-associated alveolar inflammation in patients with atopic uncontrolled asthma","volume":"127","author":"Andersson","year":"2011","journal-title":"J\u00a0Allergy Clin Immunol"},{"key":"10.1016\/j.chest.2017.11.016_bib39","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1136\/thx.12.3.219","article-title":"The centrilobular form of hypertrophic emphysema and its relation to chronic bronchitis","volume":"12","author":"Leopold","year":"1957","journal-title":"Thorax"},{"issue":"4","key":"10.1016\/j.chest.2017.11.016_bib40","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1183\/09031936.00172007","article-title":"Epidermal growth factor receptor-mediated innate immune responses and their roles in airway diseases","volume":"32","author":"Burgel","year":"2008","journal-title":"Eur Respir J"},{"issue":"6","key":"10.1016\/j.chest.2017.11.016_bib41","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1164\/rccm.201109-1640OC","article-title":"A\u00a0large subgroup of mild-to-moderate asthma is persistently noneosinophilic","volume":"185","author":"McGrath","year":"2012","journal-title":"Am J Respir Crit Care Med"},{"issue":"4","key":"10.1016\/j.chest.2017.11.016_bib42","first-page":"894","article-title":"Loss of alveolar attachments in smokers: a morphometric correlate of lung function impairment","volume":"132","author":"Saetta","year":"1985","journal-title":"Am Rev Respir Dis"},{"issue":"3","key":"10.1016\/j.chest.2017.11.016_bib43","first-page":"162","article-title":"Validation of lung density threshold at CT for the distinction between senile lung and emphysema in elderly subjects","volume":"75","author":"Bellia","year":"2011","journal-title":"Monaldi Arch Chest Dis"},{"key":"10.1016\/j.chest.2017.11.016_bib44","doi-asserted-by":"crossref","first-page":"419328","DOI":"10.1155\/2011\/419328","article-title":"Quantitative CT associations between emphysema, airway wall thickness and body composition in COPD","volume":"2011","author":"Rutten","year":"2011","journal-title":"Pulm Med"},{"issue":"9","key":"10.1016\/j.chest.2017.11.016_bib45","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1136\/thx.2010.136374","article-title":"Quantitative analysis of high-resolution computed tomography scans in severe asthma subphenotypes","volume":"65","author":"Gupta","year":"2010","journal-title":"Thorax"},{"issue":"17","key":"10.1016\/j.chest.2017.11.016_bib46","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1056\/NEJMoa1106955","article-title":"Small-airway obstruction and emphysema in chronic obstructive pulmonary disease","volume":"365","author":"McDonough","year":"2011","journal-title":"N\u00a0Engl J Med"},{"issue":"1","key":"10.1016\/j.chest.2017.11.016_bib47","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1378\/chest.126.1.59","article-title":"Asthma as a risk factor for chronic obstructive pulmonary disease in a longitudinal study","volume":"126","author":"Silva","year":"2004","journal-title":"Chest"},{"issue":"3","key":"10.1016\/j.chest.2017.11.016_bib48","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/j.jaci.2013.01.010","article-title":"Clinical phenotypes of chronic obstructive pulmonary disease and asthma: recent advances","volume":"131","author":"Carolan","year":"2013","journal-title":"J\u00a0Allergy Clin Immunol"},{"issue":"2","key":"10.1016\/j.chest.2017.11.016_bib49","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1586\/17476348.2014.879826","article-title":"The potential to predict the course of childhood asthma","volume":"8","author":"Belsky","year":"2014","journal-title":"Expert Rev Respir Med"},{"issue":"9","key":"10.1016\/j.chest.2017.11.016_bib50","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1136\/thoraxjnl-2013-204815","article-title":"The association between childhood asthma and adult chronic obstructive pulmonary disease","volume":"69","author":"Tai","year":"2014","journal-title":"Thorax"},{"issue":"6","key":"10.1016\/j.chest.2017.11.016_bib51","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1016\/j.jaci.2013.12.1033","article-title":"Outcomes of childhood asthma to the age of 50 years","volume":"133","author":"Tai","year":"2014","journal-title":"J\u00a0Allergy Clin Immunol"},{"issue":"9","key":"10.1016\/j.chest.2017.11.016_bib52","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1136\/thoraxjnl-2014-205401","article-title":"The early origins of COPD in severe asthma: the one thing that leads to another, or the two things that come together?","volume":"69","author":"Mattes","year":"2014","journal-title":"Thorax"},{"key":"10.1016\/j.chest.2017.11.016_bib53","series-title":"Bronchitis","first-page":"43","article-title":"The host factor in bronchitis","author":"Orie","year":"1961"},{"issue":"3","key":"10.1016\/j.chest.2017.11.016_bib54","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.jaci.2015.06.018","article-title":"Revisiting the Dutch hypothesis","volume":"136","author":"Postma","year":"2015","journal-title":"J\u00a0Allergy Clin Immunol"}],"container-title":["Chest"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0012369217331276?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0012369217331276?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T07:59:11Z","timestamp":1757923151000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0012369217331276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3]]},"references-count":54,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["S0012369217331276"],"URL":"https:\/\/doi.org\/10.1016\/j.chest.2017.11.016","relation":{},"ISSN":["0012-3692"],"issn-type":[{"value":"0012-3692","type":"print"}],"subject":[],"published":{"date-parts":[[2018,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Further Studies of Unsuspected Emphysema in Nonsmoking Patients With Asthma With Persistent Expiratory Airflow Obstruction","name":"articletitle","label":"Article Title"},{"value":"Chest","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.chest.2017.11.016","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}