{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T14:01:54Z","timestamp":1791813714989,"version":"4.3.4"},"reference-count":11,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>Asthma is usually diagnosed by history and presence of airway obstruction with a significant bronchodilator response on spirometry. However, airway obstruction may not always be present, or a bronchodilator response may not be significant. Contrary to wide perception, airway obstruction is not the defining functional feature of asthma. Definitions of asthma have never included the term \u2018airways obstruction\u2019. According to the Global Initiative for Asthma, the diagnosis of asthma requires a history of typical variable symptoms and confirmation by variable expiratory airflow. It has emphasized that variable expiratory airflow is the key physiological feature of asthma. Airway obstruction is a manifestation of this variability and represents one end of the spectrum of this variation. When airways obstruction is observed, a positive bronchodilator response is the most convenient method to confirm the diagnosis. However, when airway obstruction or bronchodilator responsiveness is not demonstrable, there are other options to demonstrate variability in not demonstrable, there are other options to demonstrate variability of expiratory airflows and confirm the diagnosis.<\/jats:p>","DOI":"10.4081\/monaldi.2026.3788","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:30:57Z","timestamp":1791811857000},"source":"Crossref","is-referenced-by-count":0,"title":["Variable expiratory airflow, and not airway obstruction, is the defining physiological feature of asthma"],"prefix":"10.4081","author":[{"given":"Sunil K.","family":"Chhabra","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine, Primus Superspeciality Hospital, New Delhi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"88600","doi-asserted-by":"crossref","unstructured":"Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J 2005;26:948-68.","DOI":"10.1183\/09031936.05.00035205"},{"key":"88601","doi-asserted-by":"crossref","unstructured":"Quanjer PH, Tammeling GJ, Cotes JE, et al. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official statement of the European Respiratory Society. Eur Respir J Suppl 1993;16:5-40.","DOI":"10.1183\/09041950.005s1693"},{"key":"88602","doi-asserted-by":"crossref","unstructured":"Stanojevic S, Kaminsky DA, Miller MR, et al. ERS\/ATS technical standard on interpretive strategies for routine lung function tests. Eur Respir J 2022;60:2101499.","DOI":"10.1183\/13993003.01499-2021"},{"key":"88603","unstructured":"Global Initiative for Asthma. Global strategies for asthma management and prevention. 2026 Update. Available from: https:\/\/ginasthma.org\/2026-gina-strategy-report."},{"key":"88604","doi-asserted-by":"crossref","unstructured":"Pascual RM, Peters SP. The irreversible component of persistent asthma. J Allergy Clin Immunol 2009;124:883-90.","DOI":"10.1016\/j.jaci.2009.09.047"},{"key":"88605","unstructured":"Chhabra SK, Bhatnagar S. Comparison of bronchodilator responsiveness in asthma and chronic obstructive pulmonary disease. Indian J Chest Dis Allied Sci 2002;44:91-7."},{"key":"88606","doi-asserted-by":"crossref","unstructured":"Walker PP, Calverley PM. The volumetric response to bronchodilators in stable chronic obstructive pulmonary disease. COPD 2008;5:147-52.","DOI":"10.1080\/15412550802092928"},{"key":"88607","doi-asserted-by":"crossref","unstructured":"Aaron SD, Vandemheen KL, FitzGerald JM, et al. Canadian respiratory research network. Reevaluation of diagnosis in adults with physician diagnosed asthma. JAMA 2017;317:269-79.","DOI":"10.1001\/jama.2016.19627"},{"key":"88608","doi-asserted-by":"crossref","unstructured":"Bertels X, Edris A, Garcia-Aymerich J, et al. Phenotyping asthma with airflow obstruction in middle-aged and older adults: a CADSET clinical research collaboration. BMJ Open Respir Res 2023;10:e001760.","DOI":"10.1136\/bmjresp-2023-001760"},{"key":"88609","unstructured":"Scadding JG. Definition and clinical categories of asthma. In: Clark TJH, Godfrey S, eds. Asthma 2nd ed. London, UK: Chapman and Hall; 1983."},{"key":"88610","unstructured":"Chhabra SK, Kumar R, Gupta U, et al. Prediction equations for spirometry in adults from northern India. Indian J Chest Dis Allied Sci 2014;56:221-5. Erratum in: Indian J Chest Dis Allied Sci 2015;57:204."}],"container-title":["Monaldi Archives for Chest Disease"],"original-title":[],"link":[{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/3788\/2293","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/download\/3788\/2293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:31:01Z","timestamp":1791811861000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.monaldi-archives.org\/macd\/article\/view\/3788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":11,"URL":"https:\/\/doi.org\/10.4081\/monaldi.2026.3788","relation":{},"ISSN":["2532-5264","1122-0643"],"issn-type":[{"value":"2532-5264","type":"electronic"},{"value":"1122-0643","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,12]]}}}