Document Detail


Airway reactivity is a determinant of bronchodilator responsiveness after methacholine-induced bronchoconstriction.
MedLine Citation:
PMID:  15584317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Airway hyperresponsiveness (AHR) is one of the characteristics of asthma and a risk factor for persistent airflow limitation. Poor response to bronchodilator may be a cause of persistent airflow limitation. Multiple factors may determine bronchodilator responsiveness, including airway reactivity to nonspecific bronchoconstrictive agents. If patients with AHR have poor bronchodilator responsiveness, then it could be a potential mechanism for asthma and persistent airflow limitation in these patients. The objective of this study is to assess the relationship between airway reactivity to methacholine and responsiveness to beta-agonist and beta-agonist/anticholinergic combination in a large subject population. A retrospective data analysis was undertaken of 764 consecutive subjects with > or = 20% reduction in forced expiratory volume during the first second of exhalation from total lung capacity (FEV1) after < or = 189 cumulative units of methacholine. The first 382 subjects received 3 inhalations of metaproterenol and the second 382 subjects received 3 inhalations of albuterol and ipratropium combination after > or = 20% reduction in FEV1. Bronchodilator responsiveness was measured as the percent increase in FEV1 after the treatment. Airway reactivity was assessed as the log10 of methacholine dose response slope. In a simple linear regression model, airway reactivity was significantly related to bronchodilator responsiveness. The coefficient of determination (r2) was 0.15 for the whole groups; 0.14 for metaproterenol group and 0.18 for albuterol/ipratropium combination group (all p<0.0001). The regression coefficient (beta) was 14.0 for the whole group; 14.8 and 13.2, respectively, for the two bronchodilator groups. Airway reactivity to methacholine is a determinant of airway responsiveness to both beta-agonist and beta-agonist/anticholinergic combination. Subjects with higher airway reactivity have higher bronchodilator responsiveness.
Authors:
Annie Lin Parker
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of asthma : official journal of the Association for the Care of Asthma     Volume:  41     ISSN:  0277-0903     ISO Abbreviation:  J Asthma     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-12-08     Completed Date:  2005-01-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8106454     Medline TA:  J Asthma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  671-7     Citation Subset:  IM    
Affiliation:
Department of Pulmonary and Critical Care Medicine, Memorial Hospital of Rhode Island, Pawtucket, Rhode Island 02860, USA. Annie_Parker@brown.edu
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Adolescent
Adult
Albuterol / administration & dosage
Asthma / diagnosis,  drug therapy*,  physiopathology*
Bronchial Hyperreactivity / diagnosis*,  drug therapy*
Bronchial Provocation Tests / methods
Bronchodilator Agents / therapeutic use*
Cohort Studies
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Ipratropium / administration & dosage
Linear Models
Male
Methacholine Chloride / diagnostic use
Middle Aged
Orciprenaline / administration & dosage
Probability
Respiratory Function Tests
Retrospective Studies
Sensitivity and Specificity
Severity of Illness Index
Treatment Outcome
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 18559-94-9/Albuterol; 586-06-1/Orciprenaline; 60205-81-4/Ipratropium; 62-51-1/Methacholine Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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