scholarly journals Specific bronchial hyperreactivity and hypersensitivity in patients with allergic asthma

2017 ◽  
Vol 74 (11) ◽  
pp. 1043-1047 ◽  
Author(s):  
Slobodan Acimovic ◽  
Olivera Loncarevic ◽  
Jelena Vukovic ◽  
Marko Stojsavljevic ◽  
Nemanja Rancic
Keyword(s):  
Provocation Test ◽  
Forced Expiratory Volume ◽  
Bronchial Hyperreactivity ◽  
Provocation Tests ◽  
Group I ◽  
Bronchial Provocation Test ◽  
Bronchial Provocation Tests ◽  
Group Ii ◽  
Inhalant Allergens ◽  
Bronchial Provocation

Background/Aim. Bronchial asthma is a disease that is characterized by the variability of the clinical picture, physical and functional status and the existence of bronchial hypersensitivity and hyperreactivity with varying degrees. Bronchial responsiveness and sensitivity are tested in patients with clinically suspected existence of asthma and normal spirometry test. The aim of the study was to analyze the patients with atopic asthma and study test results of skin sensitization to inhaled allergens, nonspecific bronchial hyperreactivity and specific hyperreactivity estimated by bronchial provocation tests with inhalant allergens. Methods. The prospective study at the Pulmonology Clinic of the Military Medical Academy in Belgrade Serbia, during 2014, included 70 male subjects aged 18?30 years, who had perennial asthma symptoms. All subjects were nonsmokers, with normal spirometry findings, with normal radiological chest findings and with no symptoms of respiratory infection over the past two months. All respondents were tested with skin prick tests with inhalant allergens and nonspecific bronchial provocation test with histamine. On the basis of histamine test, subjects were divided into two groups: the group I, in which there was a slight degree of hypersensitivity [provocation concentration of histamine causing a 20% fall in forced expiratory volume ? PC20 = 6.09 ? 1.1 mg/mL], and the group II with negative histamine test (PC20 = 14.58 ? 6.34 mg/mL). Specific bronchial provocation test was performed in all patients, and the selection of the allergens was carried out based on the results of testing of skin hypersensitivity. Results. Results of skin sensitization show the highest incidence of mites Dermatophagoides pterronissinus (83.3% group I and 85.0% group II) followed by grass pollen (53.3% group I and 52.0% group II), and house dust (33.3% group I and 50.0% group II). There were no statistically significant differences in allergens between groups (p > 0.05). In both groups, spirometry findings were within normal values [forced vital capacity ? FVC and forced expiratory volume 1 ? FEV1 > 80% predictive value], but statistically significant difference was found in FEV1 between groups (p < 0.05). Specific bronchial provocation tests with solutions of inhaled allergens in both groups caused a significant decline in FEV1 (? 20%) in all patients individually. No statistically significant differences were found neither between groups, nor between individual allergens (average decline in FEV1: Group I 32.9 ? 2.4% and group II 31.5 ? 2.2%). Conclusion. There is no relationship between the degree of specific and non-specific bronchial hyperreactivity in patients with allergic asthma.

The Effects of Long-Term Treatment by Immunotherapy and Fluticazone on Broncial Hyperreactivity

2003 ◽  
Vol 1 (1) ◽  
pp. 13-16
Author(s):  
G. Ilonidis ◽  
G. Anogianakis ◽  
Chr. Trakatelli ◽  
A. Anogeianaki ◽  
J. Giavazis ◽  
...  
Keyword(s):  
Provocation Test ◽  
Term Treatment ◽  
Provocation Tests ◽  
Group I ◽  
Long Term Treatment ◽  
Group Ii ◽  
Male Subjects

Thirty subjects (20 female and 10 male), all allergic to the mites D. Pteronyssinus and D. Farinae, participated in the present study which covered a period of four years. The subjects were randomly divided in two groups. Group I included 10 female and 5 male subjects, with an average age of 25.8 (+/− 3.5) years who received immunotherapy only. Group II had an average age of 31.5 (+/− 4) years and they received immunotherapy along with fluticazone propionate (1000mcg/day). The protocol for immunotherapy was the same for both groups. The basis FEV1 was determined for each subject of both Groups I and II and afterwards they were subjected to provocation tests of nebulized methacholine solution administered in consecutively larger concentrations until a drop in FEV1 >20 % (PC20), was observed. Three years later, when their therapy was completed, all subjects were subjected to the same provocation test and a significant reduction in bronchial hyperactivity was documented for both groups. In particular, for Group I, the percentage of change in FEV1 values was 27.25 +/- 5.23 % and PC20 5.11 +/− 2.64 mg/ml before immunotherapy, while after immunotherapy the same indicators were 22.22 +/- 7.08 % (P<0.05) and 6.85 +/− 4.03 mg/ml, (P<0.05) respectively. For Group II, the percentage of change in FEV1 values was 26.28 +/− 2.5 % and PC20 5.42 +/− 2.5 mg/ml before immunotherapy, while after immunotherapy the same indicators were 12.27 +/- 2.49 % (P<0.01)and 11.64 +/− 5.14 mg/ml, P<0.01 respectively. It is concluded that although significant reduction in hyperreactivity can be achieved through immunotherapy, the combination of immunotherapy with daily fluticazone propionate administration shows the most promising results.

scholarly journals Hyperreactivity of the bronchi in children, whooping cough convalescents

2020 ◽  
Vol 12 (4) ◽  
pp. 51-57
Author(s):  
Yu. V. Nesterova ◽  
A. V. Orlov ◽  
I. V. Babachenko
Keyword(s):  
Bronchial Asthma ◽  
Whooping Cough ◽  
Nitrogen Monoxide ◽  
Bronchial Hyperreactivity ◽  
Final Conclusion ◽  
Provocation Tests ◽  
Bronchial Provocation Tests ◽  
History Of ◽  
Bronchial Provocation

Objective: to assess the presence and degree of bronchial hyperreactivity in convalescents of whooping cough based on the results of bronchial provocation tests.Materials and methods. Using bronchial provocative samples with a 0,02/0,33% histamine solution and 0,33% methacholine solution on a PROVOTEST-2 apparatus from PARI, bronchial hyperreactivity was studied in 12 pertussis convalescents aged 7 to 17 years. The level of endogenous nitrogen monoxide in exhaled air (FeNO) was measured using a portable NObreath electrochemical analyzer (from Bedfont Scientific Ltd.).The results. According to the results of BPP, 6 of 12 convalescents of whooping cough were found to have bronchial hyperreactivity of varying degrees. When conducting a breath test with a histamine solution, bronchial hyperreactivity was recorded in three children, in a sample with methacholine, in five. In 3 out of 6 children with revealed signs of bronchial hyperreactivity, the history of atopy was not burdened, which suggests a connection between the pertussis and the development of bronchial hyperreactivity. A significant increase in the level of endogenous nitric monoxide (above 16 ppb) was observed in 2 out of 10 patients. Follow-up observation showed that the duration of cough with whooping cough ranged from 3 to 6 months, and in patients with positive results of several tests it was maximum. Two out of three children with bronchial asthma showed elevated levels of FeNO and samples with methacholine. Follow-up observation showed that whooping cough aggravated bronchial asthma and demanded correction therapy.Conclusion. A pilot study on the evaluation of bronchial provocative tests suggests that the formation of bronchial hyperreactivity in convalescents of whooping cough is probable, including without a history of atopy, which increases the risk of developing bronchial asthma, however, additional studies are required for a final conclusion.

scholarly journals The importance of impulse oscillometry in bronchial provocation testing in confirming the diagnosis of asthma in male army recruits

2017 ◽  
Vol 74 (2) ◽  
pp. 127-132
Author(s):  
Dragan Koruga ◽  
Kristina Tot-Veres ◽  
Goran Plavec ◽  
Olivera Loncarevic
Keyword(s):  
Provocation Test ◽  
Forced Expiratory Volume ◽  
Impulse Oscillometry ◽  
Average Increase ◽  
Provocation Tests ◽  
Military Recruits ◽  
One Step ◽  
Provocation Testing ◽  
Bronchial Provocation ◽  
Army Recruits

Background/Aim. Impulse oscillometry (IOS) is a technique valid for measuring the lung function in obstructive lung diseases and bronchial provocation tests. However, no consensus exists for its use. The aim of the study was to assess impulse oscillometry sensitivity for detection of early airways changes during bronchial provocation testing and to compare with changes obtained with spirometry and bodyplethysmography in male army recruits. Methods. Male military recruits were submitted to bronchial provocation test with histamine by the aerosol provocation system. Out of 52 male military recruits subjected to attempts to make the diagnosis of asthma the study included 31 subjects with fall of forced expiratory volume in one second (FEV1) above 20%. The changes of impulse oscillometry were measured one step before and after provocation dose (PD) of histamine and compared with the changes of bodyplethysmography and spirometry. Results. The average age of male army recruits was 23.3 year. After bronchoprovocation there was an average increase of the total resistance at 5 Hz (R5) by 66.6%, resonant frequency (Fres) by 102.2%, Goldman index (AX) by 912.1%, the arway resistance (Raw) by 121.5%, and a decrease in reactance at 5 Hz (X5) by 132.1% and FEV1 by 25.6%. One step before the last inhaled of PD20 there was an average increase of 26.7% in R5, 24.1% in Fres, 85.3% in AX, 11.9% in Raw and a decrease in X5 by 26.9% and FEV1 by 4.3%. A correlation between impulse oscillometry and bodyplethysmography parameters was obtained. Conclusion. This paper demonstrates a sufficient sensitivity of impulse oscillometry to detect changes in airways, so it may play a complementary role in the diagnosis of asthma in male military recruits.

scholarly journals Evaluation of frequency of positive exercise-induced bronchospasm between swimmers and sedentary individuals

2017 ◽  
Vol 30 (2) ◽  
pp. 277-285
Author(s):  
Laricy Martins da Mata ◽  
Regiane Coissi Sanches ◽  
Marceli Rocha Leite ◽  
Francis Lopes Pacagnelli ◽  
Luiz Carlos Marques Vanderlei ◽  
...  
Keyword(s):  
Provocation Test ◽  
Forced Expiratory Volume ◽  
Time Interval ◽  
Rr Intervals ◽  
Significance Level ◽  
Bronchial Provocation Test ◽  
Group 2 ◽  
Exercise Induced ◽  
The Relationship ◽  
Bronchial Provocation

Abstract Introduction: Despite the prevalence of prescribed asthma, there is uncertainty about the incidence of exercise-induced bronchospasm (EIB). Objective: Compare the frequency of EIB between swimmers and sedentary individuals, and observe heart rate variability during bronchial activity. Methods: In total, 18 swimmers (group 1) and 18 sedentary individuals (group 2) were included. The participants rested for 30 minutes for evaluation of HRV. Blood pressure (PA), respiratory rate (RR), and pulse oxygen saturation (SpO2) were measured. The volunteers remained seated for the spirometry test (maneuver of forced vital capacity - FVC). This was repeated 5, 10, 15, 20, and 30 minutes after the exercise test. The statistical analysis used the Student t, Mann Whitney, and Shapiro-Wilks tests. The significance level was p <0.05. Results: The spirometry findings showed 3 sedentary individuals and 10 swimmers with obstructive ventilatory disorder (OVD). Only 2 of the sedentary and none of the swimmer group demonstrated positive bronchial provocation. A key criterion for diagnosing OVD, the relationship between forced expiratory volume in one second and FVC (FEV1/FVC), was statistically lower in the swimmer group. The measures of the root mean square of the successive differences between adjacent normal RR intervals, in a time interval (RMSSD), and the standard deviation of all normal RR intervals recorded in a time interval (SDNN) were significantly higher among the athletes. Conclusion: The bronchial provocation test identified a higher prevalence of bronchospasm among sedentary individuals. However, there was a reduction in the FEV1/FVC ratio and higher HRV in the group of swimmers.

The occurrence of refractoriness and mast cell mediator release following mannitol-induced bronchoconstriction

2011 ◽  
Vol 110 (4) ◽  
pp. 1029-1035 ◽  
Author(s):  
Johan Larsson ◽  
Clare P. Perry ◽  
Sandra D. Anderson ◽  
John D. Brannan ◽  
Sven-Erik Dahlén ◽  
...  
Keyword(s):  
Mast Cell ◽  
Smooth Muscle ◽  
Urinary Excretion ◽  
Provocation Test ◽  
Forced Expiratory Volume ◽  
Exercise Challenge ◽  
Bronchial Provocation Test ◽  
Exercise Induced ◽  
Bronchial Provocation ◽  
Mast Cell Mediator Release

For several hours after exercise-induced bronchoconstriction, there is diminished responsiveness to repeated challenge. The mechanism causing this refractoriness is unclear. Inhalation of dry powder mannitol is a new bronchial provocation test that has been suggested as a surrogate for an exercise challenge. Refractoriness to repeated mannitol challenge has however not been established. Our objective was to investigate if repeated challenge with mannitol is associated with refractoriness and diminished release of mast cell mediators of bronchoconstriction. Sixteen subjects with asthma underwent repeated inhalation of mannitol 90 min apart. Lung function was assessed by forced expiratory volume in 1 s (FEV1). The urinary excretion (ng/mmol creatinine) of the mediators 9α,11β-prostaglandin (PG) F2 and leukotriene (LT) E4 were measured. The group mean fall in FEV1 after the second challenge was 48.5 ± 5.8% of the first ( P < 0.001). The protection afforded by the initial challenge, however, varied considerably between subjects (range 88–0%). Furthermore, the urinary excretion of the two mediators was increased after both challenges. The average excretion of mediators after the challenges was significantly higher for the six most refractory subjects. This was observed both for LTE4 (95.6 ± 5.2 vs. 58.0 ± 2.4 for the 6 least refractory) ( P < 0.001) and for 9α,11β-PGF2 (137.6 ± 6.7 vs. 50.1 ± 1.1 for the 6 least refractory) ( P = 0.002). As occurs with exercise-induced bronchoconstriction, repeated inhalation of mannitol induced refractoriness. We propose that refractoriness is due to tachyphylaxis at the level of the airway smooth muscle responsiveness to mediators of bronchoconstriction rather than due to fatigue of their release from mast cells.

scholarly journals The Effects of Long-Term Administration of Sodium Nedocromil on Bronchial Hypereactivity

2003 ◽  
Vol 1 (3) ◽  
pp. 119-123 ◽  
Author(s):  
G. Ilonidis ◽  
G. Anogianakis ◽  
CH. Trakatelli ◽  
A. Anogeianaki ◽  
M. Chomatidis ◽  
...  
Keyword(s):  
Allergic Asthma ◽  
Term Treatment ◽  
Bronchial Hyperreactivity ◽  
Methacholine Challenge ◽  
Intrinsic Asthma ◽  
Group I ◽  
Long Term Treatment ◽  
The Mean ◽  
Group Ii

The effect of long-term treatment with sodium nedocromil on airway hypereactivity was investigated in two groups of 20 patients each. Group I patients presented with allergic asthma while Group II patients presented with intrinsic asthma. For each subject of the two groups, the base FEV1 was measured and nebulized methacholine was administrated in consecutively higher concentrations until a decrease in FEV1 of >20 % was observed. Following measurement, all patients included in the study were treated with 12 mg of sodium nedocromil per day for 12 months. At the end of the treatment, bronchial hyperreactivity was evaluated for a second time by administering the same dosage of methacholine that originally produced a decline in FEV1 of >20 %. In Group I patients (allergic asthma) mean FEV1 was 3126 ml, before challenge, while after methacholine challenge FEV1 was 2400ml. Following 1-year of sodium nedocromil administration the FEV1 was 2601ml (P<0.05). Before treatment, the mean fall in FEV1, following methacholine challenge, was 23.67% while following a 1-year-long sodium nedocromil administration this value reduced to 15.70% (P<0.05). Correspondingly, PC20 was 5.59 while after sodium nedocromil administration it increased to 11.66 (P<0.05). In Group II patients (intrinsic asthma) mean FEV1 was 2750 ml, before challenge, while after methacholine challenge FEV1 was 2066ml. Following 1-year of sodium nedocromil administration the FEV1 was 2223ml (P<0.05). Before treatment, the mean fall in FEV1, following methacholine challenge, was 27.65 % while following a 1-year-long sodium nedocromil administration this value reduced to 21.92 % (P<0.05). Correspondingly, PC20 was 5.91 while after sodium nedocromil administration it increased to 6.19 (P<0.05). The results suggest a positive effect of long-term sodium nedocromil administration in bronchial hyperreactivity for both groups of patients.

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