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Upper and Lower Airway Dysanapsis and Airflow Obstruction Among Older Adults

Benjamin Smith, JAMA 2020. Jun 9;323(22):2268-2280. Figure 1. These CT scans of airways (red) and lungs (dark grey) show the spectrum of dysanapsis, with smaller airways in proportion to lung size (left) compared with normal size airways (middle), and larger than normal airways (right).

Dysanapsis refers to a mismatch between airways and lung size. It was previously shown that dysanapsis of the lower airway exists in the general population and is associated with risk of developing COPD. In this study, the upper airway dysanapsis was found to be unrelated to lower airway dysanapsis or airflow obstruction. This suggests that dysanapsis arises from pathways specific to the lower airways. Much is not known about the developmental origins of dysanapsis.

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Upper and Lower Airway Dysanapsis and Airflow Obstruction Among Older Adults. Smith BM, Wiemken A, Hoffman EA, Keenan BT, Allen NB, Bertoni AG, Jacobs DR Jr, Michos ED, Watson KE, Redline S, Schwab RJ, Barr RG, Heckbert SR. Am J Respir Crit Care Med. 2022 Jun 9. doi: 10.1164/rccm.202202-0353LE. Online ahead of print.