TY - JOUR
T1 - Bronchial inflammation and airway responses to deep inspiration in asthma and chronic obstructive pulmonary disease
AU - Slats, Annelies M.
AU - Janssen, Kirsten
AU - van Schadewijk, Annemarie
AU - van der Plas, Dirk T.
AU - Schot, Robert
AU - van den Aardweg, Loost G.
AU - de Jongste, Johan C.
AU - Hiemstra, Pieter S.
AU - Mauad, Thais
AU - Rabe, Klaus F.
AU - Sterk, Peter J.
PY - 2007
Y1 - 2007
N2 - Rationale: Deep inspirations provide physiologic protection against airway narrowing in healthy subjects, which is impaired in asthma and chronic obstructive pulmonary disease (COPD). Airway inflammation has been suggested to alter airway mechanics during deep inspiration. Objectives: We tested the hypothesis that the number of bronchial inflammatory cells is related to deep inspiration-induced bronchodilation in asthma and COPD. Methods: In a cross-sectional study, three modified methacholine challenges were performed in 13 patients with mild, persistent asthma, 12 patients with mild to moderate COPD, and 12 healthy control subjects. Measurements and Main Results: After a 20-minute period of deep inspiration avoidance, inhalation of methacholine was followed by either one or five deep inspirations, or preceded by five deep inspirations. The response to deep inspiration was measured by forced oscillation technique. Inflammatory cells were counted within the lamina propria and airway smooth muscle area in bronchial biopsies of patients with asthma and COPD. The reduction in expiratory resistance by one and five deep inspirations was significantly less in asthma (mean change +/- SID: -0.5 +/- 0.8 and -0.9 +/- 1.0 cm H2O/ L/s, respectively) and COPD (+0.2 +/- 1.1 and +0.4 1.0 cm H2O/ L/s, respectively) as compared with healthy subjects (-1.5 +/- 1.3 and -2.0 +/- 1.2 cm H2O/L/s, respectively; p = 0.05 and p 0.001, respectively). In asthma, this was related to an increase in mast cell numbers within the airway smooth muscle area (r = 0.73; p = 0.03), and in CD4. lymphocytes in the lamina propria (r = 0.61; p = 0.04). Conclusions: Inflammation in the airway smooth muscle bundles and submucosa of bronchial biopsies is positively associated with impaired airway mechanics during deep inspiration in asthma, but not in COPD. Clinical trial registered with www.clinicaltrials.gov (NCT 00279136)
AB - Rationale: Deep inspirations provide physiologic protection against airway narrowing in healthy subjects, which is impaired in asthma and chronic obstructive pulmonary disease (COPD). Airway inflammation has been suggested to alter airway mechanics during deep inspiration. Objectives: We tested the hypothesis that the number of bronchial inflammatory cells is related to deep inspiration-induced bronchodilation in asthma and COPD. Methods: In a cross-sectional study, three modified methacholine challenges were performed in 13 patients with mild, persistent asthma, 12 patients with mild to moderate COPD, and 12 healthy control subjects. Measurements and Main Results: After a 20-minute period of deep inspiration avoidance, inhalation of methacholine was followed by either one or five deep inspirations, or preceded by five deep inspirations. The response to deep inspiration was measured by forced oscillation technique. Inflammatory cells were counted within the lamina propria and airway smooth muscle area in bronchial biopsies of patients with asthma and COPD. The reduction in expiratory resistance by one and five deep inspirations was significantly less in asthma (mean change +/- SID: -0.5 +/- 0.8 and -0.9 +/- 1.0 cm H2O/ L/s, respectively) and COPD (+0.2 +/- 1.1 and +0.4 1.0 cm H2O/ L/s, respectively) as compared with healthy subjects (-1.5 +/- 1.3 and -2.0 +/- 1.2 cm H2O/L/s, respectively; p = 0.05 and p 0.001, respectively). In asthma, this was related to an increase in mast cell numbers within the airway smooth muscle area (r = 0.73; p = 0.03), and in CD4. lymphocytes in the lamina propria (r = 0.61; p = 0.04). Conclusions: Inflammation in the airway smooth muscle bundles and submucosa of bronchial biopsies is positively associated with impaired airway mechanics during deep inspiration in asthma, but not in COPD. Clinical trial registered with www.clinicaltrials.gov (NCT 00279136)
U2 - https://doi.org/10.1164/rccm.200612-1814OC
DO - https://doi.org/10.1164/rccm.200612-1814OC
M3 - Article
C2 - 17379851
SN - 1073-449X
VL - 176
SP - 121
EP - 128
JO - American journal of respiratory and critical care medicine
JF - American journal of respiratory and critical care medicine
IS - 2
ER -