We investigated whether a relationship between small airways dysfunction and bronchial hyperresponsiveness (BHR), expressed both in terms of ease of airway narrowing and of excessive bronchoconstriction, could be demonstrated in asthma. Methods: 63 (36 F; mean age 42 yr ± 14) stable, mild-to-moderate asthmatic patients (FEV1 92% pred ±14; FEV1/FVC 75% ± 8) underwent the methacholine challenge test (MCT). The degree of BHR was expressed as PD20 (in μg) and as ΔFVC%. Peripheral airway resistance was measured pre- and post-MCT by impulse oscillometry system (IOS) and expressed as R5-R20 (in kPa sL−1). Results: All patients showed BHR to methacholine (PD20 < 1600 μg) with a PD20 geometric (95% CI) mean value of 181(132–249) μg and a ΔFVC% mean value of 13.6% ± 5.1, ranging 2.5 to 29.5%. 30 out of 63 patients had R5-R20 > 0.03 kPa sL−1 (>upper normal limit) and showed ΔFVC%, but not PD20 values significantly different from the 33 patients who had R5-R20 ≤ 0.03 kPa sL−1 (15.8% ± 4.6 vs 11.5% ± 4.8, p < 0.01 and 156(96–254) μg vs 207 (134–322) μg, p = 0.382). In addition, ΔFVC% values were significantly related to the corresponding pre- (r = 0.451, p < 0.001) and post-MCT (r = 0.376, p < 0.01) R5-R20 values. Conclusions: Our results show that in asthmatic patients, small airway dysfunction, as assessed by IOS, is strictly associated to BHR, expressed as excessive bronchoconstriction, but not as ease of airway narrowing.

Small airway dysfunction is associated to excessive bronchoconstriction in asthmatic patients / Alfieri, Veronica; Aiello, Marina; Pisi, Roberta; Tzani, Panagiota; Mariani, Elisa; Marangio, Emilio; Olivieri, Dario; Nicolini, G; Chetta, Alfredo Antonio. - In: RESPIRATORY RESEARCH. - ISSN 1465-9921. - 15:(2014), p. 86. [10.1186/s12931-014-0086-1]

Small airway dysfunction is associated to excessive bronchoconstriction in asthmatic patients.

ALFIERI, Veronica;AIELLO, Marina;PISI, Roberta;TZANI, Panagiota;MARIANI, Elisa;MARANGIO, Emilio;OLIVIERI, Dario;CHETTA, Alfredo Antonio
2014-01-01

Abstract

We investigated whether a relationship between small airways dysfunction and bronchial hyperresponsiveness (BHR), expressed both in terms of ease of airway narrowing and of excessive bronchoconstriction, could be demonstrated in asthma. Methods: 63 (36 F; mean age 42 yr ± 14) stable, mild-to-moderate asthmatic patients (FEV1 92% pred ±14; FEV1/FVC 75% ± 8) underwent the methacholine challenge test (MCT). The degree of BHR was expressed as PD20 (in μg) and as ΔFVC%. Peripheral airway resistance was measured pre- and post-MCT by impulse oscillometry system (IOS) and expressed as R5-R20 (in kPa sL−1). Results: All patients showed BHR to methacholine (PD20 < 1600 μg) with a PD20 geometric (95% CI) mean value of 181(132–249) μg and a ΔFVC% mean value of 13.6% ± 5.1, ranging 2.5 to 29.5%. 30 out of 63 patients had R5-R20 > 0.03 kPa sL−1 (>upper normal limit) and showed ΔFVC%, but not PD20 values significantly different from the 33 patients who had R5-R20 ≤ 0.03 kPa sL−1 (15.8% ± 4.6 vs 11.5% ± 4.8, p < 0.01 and 156(96–254) μg vs 207 (134–322) μg, p = 0.382). In addition, ΔFVC% values were significantly related to the corresponding pre- (r = 0.451, p < 0.001) and post-MCT (r = 0.376, p < 0.01) R5-R20 values. Conclusions: Our results show that in asthmatic patients, small airway dysfunction, as assessed by IOS, is strictly associated to BHR, expressed as excessive bronchoconstriction, but not as ease of airway narrowing.
2014
Small airway dysfunction is associated to excessive bronchoconstriction in asthmatic patients / Alfieri, Veronica; Aiello, Marina; Pisi, Roberta; Tzani, Panagiota; Mariani, Elisa; Marangio, Emilio; Olivieri, Dario; Nicolini, G; Chetta, Alfredo Antonio. - In: RESPIRATORY RESEARCH. - ISSN 1465-9921. - 15:(2014), p. 86. [10.1186/s12931-014-0086-1]
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