Lack of correlation between bronchoconstrictor response and bronchodilator response in a population-based study

Autor: Scott T. Weiss, W. R. Douma, A. De Gooijer, Gh Koeter, Dirkje S. Postma, Bert Rijcken, Jan P. Schouten
Přispěvatelé: Groningen Research Institute for Asthma and COPD (GRIAC)
Rok vydání: 1998
Předmět:
Male
bronchial hyperresponsiveness
SAMPLE
INHALED HISTAMINE
Provocation test
Pulmonary function testing
RESPONSIVENESS
Cohort Studies
Bronchodilator
Surveys and Questionnaires
Lung volumes
education.field_of_study
respiratory system
Middle Aged
Bronchodilator Agents
Respiratory Function Tests
LUNG-FUNCTION
RESPIRATORY SYMPTOMS
Bronchial hyperresponsiveness
Anesthesia
epidemiology
Female
Bronchial Hyperreactivity
medicine.drug
circulatory and respiratory physiology
SMOKERS
Histamine
Pulmonary and Respiratory Medicine
Adult
Adolescent
medicine.drug_class
Terbutaline
Population
Bronchi
OBSTRUCTIVE PULMONARY-DISEASE
Sensitivity and Specificity
Bronchial Provocation Tests
reversibility
Administration
Inhalation
medicine
Humans
education
Asthma
Chi-Square Distribution
Dose-Response Relationship
Drug
business.industry
medicine.disease
REACTIVITY
respiratory tract diseases
ASTHMA
business
Zdroj: European Respiratory Journal, 10(12), 2772-2777. EUROPEAN RESPIRATORY SOC JOURNALS LTD
ISSN: 0903-1936
Popis: Bronchodilator and bronchoconstrictor responsiveness have been considered physiological opposites in patients with obstructive airways disease, Provocation challenges have been replaced by bronchodilator tests in the assessment of cases of severe airways obstruction, The aim of this study was to examine the relationship between bronchoconstrictor and bronchodilator responsiveness, and their supposed interchangeability, in a general population, From the Vlagtwedde-Vlaardingen follow-up study, 101 adults were recruited (mean (so) age 55 (11) yrs, 67 males and 34 females, and 31 were smokers), All completed a questionnaire on airways symptoms, Bronchoconstrictor and bronchodilator responsiveness were assessed with cumulative dose-response curves, using histamine and terbutaline, respectively. Thus, it was possible to relate histamine sensitivity of the airways (the concentration of histamine, at which forced expiratory volume in one second (FEV1) falls by 10% (PC10)) to the maximal bronchodilator response (Delta FEV1) and the sensitivity to the bronchodilator (cumulative dose of inhaled terbutaline at which FEV1 increases by 10% (RD10)). Subjects with a bronchoconstrictor response (PC10 less than or equal to 16 mg.mL(-1); n=38) had more respiratory symptoms than those without (n=63) (40 versus 21%) and also lower baseline FEV1 values (90 versus 96% predicted), but had comparable bronchodilator responsiveness, Subjects with a bronchodilator response (Delta FEV1 greater than or equal to 9% of the predicted value; n= 13) did not differ from those without (n=88) for all parameters, including symptoms, allergy and pulmonary function, In those with a bronchoconstrictor response, there was a weak but significant correlation between the PC10 and RD10 (rho= -0.32), but not between FC10 and Delta FEV1. This study suggests that bronchoconstrictor and bronchodilator responsiveness are not highly correlated, even in subjects with airways obstruction, Symptoms were associated with the presence of a bronchoconstrictor, but not a bronchodilator, response, We conclude that bronchoconstrictor and bronchodilator responsiveness are two different phenotypic markers that are not interchangeable in epidemiological studies.
Databáze: OpenAIRE
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