Perception of acute airway function changes by patients with mild asthma

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Abstract:

The objective of this study was to compare the perception of dyspnea during acute bronchoconstriction and bronchodilation in patients with mild asthma with normal lung function who never experienced severe asthma exacerbations in the past. We studied 83 mild, stable asthmatic patients aged 18‐58 years. All patients underwent the methacholine challenge followed by the bronchodilation test with salbutamol. The perceptual sensitivity of changes in airway function was analyzed by linear regression coefficients, slope alphaconstr, and slope alphadilat. Additionally, the perception score was determined at a 20% decrease in FEV1 (PS20) during the methacholine challenge. The finding was that perceptual sensitivity for bronchoconstriction and bronchodilation, expressed as slope alphaconstr and slope alphadilat, was similar in the study subjects (mean ± SD, 0.09 ± 0.05 and 0.10 ± 0.05, respectively). The two subgroups under assessment were named poor perceivers when PS20 < 1 (n = 19) and good perceivers when PS20 ≥ 1 (n = 64). While assessing them, the values of slope alphaconstr did not differ from the values of slope alphadilat in either of the subgroups of poor perceivers or good perceivers. However, the poor perceivers sensed changes in airway function significantly less than the good perceivers did, although overlapping values of slope alpha were observed. In conclusion, this study indicates that perceptual sensitivity during acute bronchoconstriction and bronchodilation is comparably the same in mild, stable asthmatic patients. However, some of these asthmatic patients may display a diminished perception of dyspnea, which can lead to the deterioration of their asthma without their noticing the corresponding symptoms. Thus, they may delay treatment for acute asthma.

Keywords: Asthma; bronchoconstriction; bronchodilation; dyspnea; exacerbation; methacholine; perception; salbutamol

Document Type: Research Article

DOI: http://dx.doi.org/10.2500/aap.2009.30.3233

Affiliations: Laboratory of Pulmonology, Institute for Biomedical Research, Kaunas, Lithuania; Department of Pulmonology and Immunology, Kaunas University of Medicine, Kaunas, Lithuania. kestutis.malakauskas@kmu.lt

Publication date: May 1, 2009

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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