{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:37:10Z","timestamp":1787618230688,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,11,15]],"date-time":"2017-11-15T00:00:00Z","timestamp":1510704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"GlaxoSmithKline (GSK)"},{"name":"NH&MRC Practitioner Fellowship"},{"name":"Boehringer Ingelheim"},{"name":"Australian Postgraduate Award"},{"name":"NH&MRC Early Career Fellowship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>Smokers develop respiratory symptoms and peripheral airway dysfunction even when spirometry is preserved. Multiple breath nitrogen washout (MBNW) and impulse oscillometry system (IOS) are potentially useful measures of peripheral airway function but they have not been compared in such subjects. We hypothesized that MBNW and IOS are jointly abnormal in smokers with normal spirometry and that these abnormalities relate to respiratory symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty smokers with normal spirometry completed a symptom questionnaire, had ventilation heterogeneity in diffusion (Sacin) and convection\u2010dependent (Scond) airways and trapped gas volume at functional residual capacity as a percentage of vital capacity (%VtrFRC\/VC) measured by MBNW. Respiratory resistance and reactance at 5 and 20 Hz were measured using IOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Respiratory symptoms were reported in 55 (68%) subjects. Forty (50%) subjects had at least one abnormal MBNW parameter, predominantly in Sacin. Forty\u2010one (51%) subjects had at least one abnormal IOS parameter, predominantly in resistance. Sixty\u2010one (76%) subjects had an abnormality in either MBNW or IOS. Chronic bronchitis symptoms were associated with an increased Scond, while wheeze was associated with lower spirometry and an increased resistance. Abnormalities in MBNW and IOS parameters were unrelated to each other.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Respiratory symptoms and peripheral airway dysfunction are common in smokers with normal spirometry. Symptoms of chronic bronchitis related to conductive airway abnormalities, while wheeze was related to spirometry and IOS. The clinical significance of abnormalities in peripheral airway function in smokers remains undetermined.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.13215","type":"journal-article","created":{"date-parts":[[2017,11,16]],"date-time":"2017-11-16T00:26:39Z","timestamp":1510791999000},"page":"512-518","source":"Crossref","is-referenced-by-count":64,"title":["Peripheral airway dysfunction and relationship with symptoms in smokers with preserved spirometry"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1143-0383","authenticated-orcid":false,"given":"Kanika","family":"Jetmalani","sequence":"first","affiliation":[{"name":"The Woolcock Emphysema Centre Woolcock Institute of Medical Research  Glebe NSW Australia"},{"name":"Sydney Medical School The University of Sydney  Camperdown NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Thamrin","sequence":"additional","affiliation":[{"name":"The Woolcock Emphysema Centre Woolcock Institute of Medical Research  Glebe NSW Australia"},{"name":"Sydney Medical School The University of Sydney  Camperdown NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claude S.","family":"Farah","sequence":"additional","affiliation":[{"name":"The Woolcock Emphysema Centre Woolcock Institute of Medical Research  Glebe NSW Australia"},{"name":"Sydney Medical School The University of Sydney  Camperdown NSW Australia"},{"name":"Department of Respiratory Medicine Concord Hospital  Concord NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Bertolin","sequence":"additional","affiliation":[{"name":"The Woolcock Emphysema Centre Woolcock Institute of Medical Research  Glebe NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Chapman","sequence":"additional","affiliation":[{"name":"The Woolcock Emphysema Centre Woolcock Institute of Medical Research  Glebe NSW Australia"},{"name":"Translational Airways Group, Molecular Biosciences Team University of Technology Sydney  Ultimo NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7609-9794","authenticated-orcid":false,"given":"Norbert","family":"Berend","sequence":"additional","affiliation":[{"name":"The Woolcock Emphysema Centre Woolcock Institute of Medical Research  Glebe NSW Australia"},{"name":"Department of Respiratory Research George Institute of Global Health  Newtown NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl M.","family":"Salome","sequence":"additional","affiliation":[{"name":"The Woolcock Emphysema Centre Woolcock Institute of Medical Research  Glebe NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory G.","family":"King","sequence":"additional","affiliation":[{"name":"The Woolcock Emphysema Centre Woolcock Institute of Medical Research  Glebe NSW Australia"},{"name":"Sydney Medical School The University of Sydney  Camperdown NSW Australia"},{"name":"Department of Respiratory Medicine Royal North Shore Hospital  St Leonards NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1505971"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.112433"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197410102911503"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2012.12.023"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1106955"},{"key":"e_1_2_7_7_1","first-page":"305","article-title":"Relationship between the single\u2010breath n test and age, sex, and smoking habit in three North American cities","volume":"120","author":"Buist AS","year":"1979","journal-title":"Am. 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