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While conventional pulmonary function testing remains the cornerstone of diagnosing airflow limitation, its sensitivity for early detection of SAD is insufficient ( Physiological characteristics of the small airway Small airways are defined as those with a diameter of less than 2 mm and are considered part of the distal airway system, comprising membranous bronchioles, respiratory bronchioles, and alveolar ducts ( Initiation phase Epithelial damageEMT (epithelial-mesenchymal transition)impaired barrier functionmucus obstruction The small airway epithelium is the main defense barrier of the respiratory tract against inhaled harmful particles and pathogens