Document Detail


Modulation of airway reactivity and peak flow variability in asthmatics receiving the oral contraceptive pill.
MedLine Citation:
PMID:  9105066     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Female sex-steroid hormones may play an important influence in asthma. The aim of this study was to compare airway reactivity to adenosine monophosphate (AMP) in female asthmatics with natural menstrual cycles and those taking the oral combined contraceptive pill (OCP). Eighteen asthmatic subjects were evaluated. Nine subjects, mean (SEM) age, 24 (6) years, FEV1 93% (10) predicted, with natural cycles (group 1) were compared with nine subjects, age 24 (6) years, FEV1 93% (9) predicted taking the OCP (group 2). Group 1 subjects were evaluated at the follicular (visit 1) and luteal (visit 2) phases; group 2 subjects were evaluated during the week off OCP (visit 1) and at the end of the OCP cycle (visit 2). At each visit, serum progesterone and estradiol were measured. Airway reactivity to AMP was evaluated and expressed as PC20 (FEV1; mg/ml). Morning and evening peak expiratory flow rates (PEFR) were monitored throughout the study. In group 1, there was a significant increase in serum progesterone (nmol/l) and estradiol (pmol/l). (Visit 1 vs. 2): 2.5 vs. 13.5 (95% CI 2.1 to 19.9; p = 0.02) and 152.3 vs. 358.1 (95% CI 113.0 to 298.5; p < 0.001), respectively. In group 2, however, there was no increase between visit 1 vs. 2 in hormones: 0.9 vs. 1.0 and 75.7 vs. 21.8 for progesterone and estradiol, respectively. There was a significant increase in airway reactivity in group 1 during the luteal phase. Geometric mean PC20 (mg/ml) was 18.8 and 4.7 at visit 1 and 2, respectively: a 4.0-fold difference (95% CI 1.25 to 13.03; p = 0.03) amounting to two doubling doses. In contrast, there was no change in PC20 in group 2. Geometric mean PC20 was 23.5 and 21.4: a 1.06-fold difference (95% CI 0.41 to 2.78; p = 0.83). In group 1, morning and evening PEFR (l/min) were significantly different at both visits: at visit 1 (A.M. PEFR vs. P.M. PEFR) 403 vs. 430 (95% CI 5 to 50; p < 0.001) and visit 2, 415 vs. 439 (95% CI 1 to 46; p < 0.001). In group 2, there was no significant difference in diurnal PEFR variability at both visits; 411 vs. 417 at visit 1 and 413 vs. 427 at visit 2. In conclusion, asthmatic patients receiving the OCP had attenuated cyclical change in airway reactivity as well as reduced diurnal PEFR variability, which was associated with suppression of the normal luteal phase rise in sex-hormones.
Authors:
K S Tan; L C McFarlane; B J Lipworth
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  155     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-05-07     Completed Date:  1997-05-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1273-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Pharmacology, University of Dundee, Ninewells Hospital and Medical School, Scotland, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adenosine Monophosphate / diagnostic use
Adult
Asthma / physiopathology*
Bronchial Hyperreactivity / physiopathology*
Bronchial Provocation Tests
Bronchoconstrictor Agents / diagnostic use
Case-Control Studies
Contraceptives, Oral, Combined / pharmacology*
Estradiol / blood
Estradiol Congeners / pharmacology
Ethinyl Estradiol / pharmacology
Female
Humans
Menstrual Cycle / physiology*
Peak Expiratory Flow Rate / drug effects
Progesterone / blood
Chemical
Reg. No./Substance:
0/Bronchoconstrictor Agents; 0/Contraceptives, Oral, Combined; 0/Estradiol Congeners; 50-28-2/Estradiol; 57-63-6/Ethinyl Estradiol; 57-83-0/Progesterone; 61-19-8/Adenosine Monophosphate

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


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