Potent bronchoprotective effect of deep inspiration and its absence in asthma

被引:175
作者
Kapsali, T
Permutt, S
Laube, B
Scichilone, N
Togias, A
机构
[1] Johns Hopkins Univ, Dept Med, Div Clin Immunol, Baltimore, MD 21224 USA
[2] Johns Hopkins Univ, Dept Med, Div Resp & Crit Care Med, Baltimore, MD 21224 USA
[3] Johns Hopkins Univ, Dept Pediat, Div Pediat Pulm, Baltimore, MD 21224 USA
关键词
hyperresponsiveness; airway dysfunction; lung inflation; bronchoprovocation;
D O I
10.1152/jappl.2000.89.2.711
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
In the absence of deep inspirations, healthy individuals develop bronchoconstriction with methacholine inhalation. One hypothesis is that deep inspiration results in bronchodilation. In this study, we tested an alternative hypothesis, that deep inspiration acts as a bronchoprotector. Single-dose methacholine bronchoprovocations were performed after 20 min of deep breath inhibition, in nine healthy subjects and in eight asthmatics, to establish the dose that reduces forced expiratory volume in 1 s by >15%. The provocation was repeated with two and five deep inspirations preceding methacholine. Additional studies were carried out to assess optimization and reproducibility of the protocol and to rule out the possibility that bronchoprotection may result from changes in airway geometry or from differential spasmogen deposition. In healthy subjects, five deep inspirations conferred 85% bronchoprotection. The bronchoprotective effect was reproducible and was not attributable to increased airway caliber or to differential deposition of methacholine. Deep inspirations did not protect the bronchi of asthmatics. We demonstrated that bronchoprotection is a potent physiologic function of lung inflation and established its absence, even in mild asthma. This observation deepens our understanding of airway dysfunction in asthma.
引用
收藏
页码:711 / 720
页数:10
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