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Nonspecific bronchial reactivity and its relationship to the clinical expression of asthma: a longitudinal study

Nonspecific bronchial reactivity and its relationship to the clinical expression of asthma: a longitudinal study
Nonspecific bronchial reactivity and its relationship to the clinical expression of asthma: a longitudinal study
The contribution of nonspecific bronchial reactivity to the day-to-day clinical expression of asthma is uncertain. We have examined this relationship in a longitudinal study of eight children and 12 adults. Measurements of reactivity to methacholine were made every 2 to 3 wk over a period of 12 to 18 months, deriving the dose that caused a 20% fall in FEV1 (PD20). Throughout the study, all patients kept a daily record of symptoms and treatment and twice daily measurements of peak expiratory flow (PEF). A significant relationship was found between subjects' overall reactivity (median PD20) and both their average day-to-day variation in morning PEF (Spearman's rho = -0.53, p = 0.016) and diurnal variation in PEF (Spearman's rho = -0.60, p = 0.004). However, examining the temporal relationship between reactivity and asthma within subjects, individual PD20 measurements were not consistently related to concurrent asthma severity: in only six subjects did changes in PD20 generally reflect simultaneous trends in symptoms or PEF. In several patients, exacerbations of asthma occurred in the absence of bronchial hyperreactivity (PD20 greater than 12.8 mumol). We conclude that nonspecific bronchial reactivity is only one mechanism underlying airflow obstruction in asthma, and that its relationship to the clinical state of asthma is not sufficiently close to be of practical clinical use.
0003-0805
350-357
Josephs, Lynn K.
865f1878-f0ca-42c3-a030-df6dcbc705b0
Gregg, I.
2976ca7e-54e7-4bb3-b0b2-1e47500a8c50
Mullee, M.A.
fd3f91c3-5e95-4f56-8d73-260824eeb362
Holgate, S.T.
2e7c17a9-6796-436e-8772-1fe6d2ac5edc
Josephs, Lynn K.
865f1878-f0ca-42c3-a030-df6dcbc705b0
Gregg, I.
2976ca7e-54e7-4bb3-b0b2-1e47500a8c50
Mullee, M.A.
fd3f91c3-5e95-4f56-8d73-260824eeb362
Holgate, S.T.
2e7c17a9-6796-436e-8772-1fe6d2ac5edc

(1989) Nonspecific bronchial reactivity and its relationship to the clinical expression of asthma: a longitudinal study. American Review of Respiratory Disease, 140 (2), 350-357. (doi:10.1164/ajrccm/140.2.350). (PMID:2669579)

Record type: Article

Abstract

The contribution of nonspecific bronchial reactivity to the day-to-day clinical expression of asthma is uncertain. We have examined this relationship in a longitudinal study of eight children and 12 adults. Measurements of reactivity to methacholine were made every 2 to 3 wk over a period of 12 to 18 months, deriving the dose that caused a 20% fall in FEV1 (PD20). Throughout the study, all patients kept a daily record of symptoms and treatment and twice daily measurements of peak expiratory flow (PEF). A significant relationship was found between subjects' overall reactivity (median PD20) and both their average day-to-day variation in morning PEF (Spearman's rho = -0.53, p = 0.016) and diurnal variation in PEF (Spearman's rho = -0.60, p = 0.004). However, examining the temporal relationship between reactivity and asthma within subjects, individual PD20 measurements were not consistently related to concurrent asthma severity: in only six subjects did changes in PD20 generally reflect simultaneous trends in symptoms or PEF. In several patients, exacerbations of asthma occurred in the absence of bronchial hyperreactivity (PD20 greater than 12.8 mumol). We conclude that nonspecific bronchial reactivity is only one mechanism underlying airflow obstruction in asthma, and that its relationship to the clinical state of asthma is not sufficiently close to be of practical clinical use.

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Published date: August 1989
Organisations: Primary Care & Population Sciences

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Local EPrints ID: 370367
URI: http://eprints.soton.ac.uk/id/eprint/370367
ISSN: 0003-0805
PURE UUID: 17fd39db-042b-4bc4-aa8a-e4f76e7188d1

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Date deposited: 29 Oct 2014 12:04
Last modified: 17 Jul 2017 21:51

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Contributors

Author: Lynn K. Josephs
Author: I. Gregg
Author: M.A. Mullee
Author: S.T. Holgate

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