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The Prevalence and Predictors of Airway Hyper-Responsiveness in Sarcoidosis.
MedLine Citation:
PMID:  22296033     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
SUMMARY AT A GLANCE: We found a higher prevalence of airway hyper-responsiveness (AHR) in patients with sarcoidosis using direct (histamine) challenge than indirect (hypertonic saline) challenge, and AHR was inversely associated with baseline % predicted FEV(1) . This suggests that AHR in sarcoidosis reflects the consequences of airway remodelling following inflammation. ABSTRACT: Background and objective:  Obstructive airflow limitation is the most common physiological impairment in sarcoidosis. This study determined the prevalence of airway hyper-responsiveness (AHR) in sarcoidosis, the correlation between responses to direct (using histamine) and indirect (using hypertonic saline) bronchial challenge, and the clinical, physiological and radiological predictors of AHR. Methods:  Subjects with sarcoidosis and a baseline forced expiratory volume in one second (FEV(1) ) >35% predicted underwent hypertonic and histamine challenge, lung function testing and HRCT of the chest. AHR was defined as a 15% fall in FEV(1) to hypertonic saline, and a 20% fall in FEV(1) to histamine. Results:  The 52 subjects had well preserved lung function (FEV(1 ) = 2.8L ± 0.7, 87% predicted). AHR was detected in 5/47 (11%) to hypertonic saline and 19/43 (44%) to histamine challenge. On univariate analysis, response to histamine challenge was predicted by conglomerate fibrosis (p = 0.02) and reticular pattern (p = 0.03) on HRCT. The baseline % predicted FEV(1) was significantly inversely associated with AHR on univariate (p = 0.004), and multivariate analysis (p = 0.01) when adjusted by HRCT patterns. Conclusions:  The higher prevalence of AHR using histamine challenge than hypertonic saline challenge, and the association with baseline % predicted FEV(1) , suggests that the AHR in sarcoidosis may reflect the consequences of airway remodelling following inflammation. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.
Authors:
Lisa M Young; Nichola Good; David Milne; Irene Zeng; John Kolbe; Margaret L Wilsher
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-1
Journal Detail:
Title:  Respirology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1843     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616368     Medline TA:  Respirology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.
Affiliation:
Green Lane Respiratory Services and Department of Radiology, Auckland District Health Board, and Department of Medicine, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand.
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