Clinical Tests of Respiratory Function

The profile of research activity in respiratory medicine has changed with increasing emphasis on cellular and sub-cellular mechanisms of disease rather than on the integrated function of the lungs. There have also been steady advances in the investigation and understanding of traditional "whole-organ" function. Major expansion has also occurred in the fields of respiratory muscle function, sleep-related breathing disorders and the function of the transplanted lung. Even in the more traditional areas of chronic airway disease and asthma, understanding of the pathophysiology continues to improve and there is greater appreciation of abnormal respiratory function in disorders which primarily affect other bodily systems. Paradoxically, greater emphasis on the "new biology" increases rather than lessens the need for better understanding of whole-organ function. Firstly, for the clinical value of advances at a cellular or molecular level to be exploited, their effects need to be assessed by physiological methods. Thus, the two types of investigation should be seen as complementary and in no way conflicting.