[Asthma--a small airway disease: concepts and evidence].

Inflammatoric processes in the large airways have traditionally been considered to be very important. But as new studies show inflammation and structural alteration also take place in the peripheral airways. Meanwhile it is highly evident that asthma is related to all areas of the lung--to the large and even the small airways. But the inflammation of the small airways is not sufficiently diagnostically detected. FEV(1) and PEF reflect the participation of the small airways only partially. New findings about inflammation and remodelling in the small airways underline the need of therapies reaching all parts of the lung. A combined therapy with ICS and LABA seem to have the capability to improve efficacy and safety, especially when very fine formulations are chosen. Georg Thieme Verlag KG Stuttgart.New York.