Airway Responsiveness in Asthma: Bronchial Challenge with Histamine and 4.5% Sodium Chloride Before and Afte Budesonide

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Abstract:

Inhalation of histamine is commonly used to assess the severity of and to monitor treatment of asthma. Histamine causes airways to narrow by acting directly on specific receptors. Hyperosmolar saline causes airways of asthmatics to narrow indirectly by endogenously mediated events that are potentially modified by drugs used to treat asthma. We wished to determine if hyperosmolar saline (S) is a useful challenge for assessing the airway responsiveness of asthmatic subjects being treated with steroids and to compare changes in airway responses to those changes observed with histamine (H). The airway responses to S and H were assessed by the dose of aerosol provoking a 20% fall in FEV1 and the percent fall in FEV1 per unit dose of aerosol inhaled-the dose response slope (DRS). We studied asthmatic subjects before and during treatment with budesonide—1000 g per day. There was a significant correlation (Spearman's) between PD20 to H and S and DRS to H and S after budesonide (P < 0.05). After 2 months of treatment; the mean PD20 (95% CI) was increased 4.6 (2.5, 8.6) fold to H, and 9.7 (4.2, 22) fold to S, (P = NS) the DRS reduced 7.0 (4.3, 11.5) fold to H and 16.6 (8.4,33) fold to S (P = NS). Responsiveness to H, measured by PD20 remained throughout the treatment, whereas five subjects did not record a 20% fall after S and the DRS decreased to values close to those we measured in healthy subjects. In conclusion, challenge with 4.5% sodium chloride can be used to assess the early benefits of treatment with aerosol steroids.

Document Type: Research Article

DOI: http://dx.doi.org/10.2500/108854197778612817

Publication date: January 1, 1997

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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