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The relationship between airway hyper‐responsiveness, markers of inflammation and lung function depends on the duration of the asthmatic disease
Author(s) -
Grönke L.,
Kanniess F.,
Holz O.,
Jörres R. A.,
Magnussen H.
Publication year - 2002
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1046/j.0022-0477.2001.01297.x
Subject(s) - medicine , asthma , exhaled nitric oxide , methacholine , bronchial hyperresponsiveness , pulmonary function testing , sputum , respiratory disease , airway , inflammation , immunology , lung , gastroenterology , spirometry , pathology , anesthesia , tuberculosis
Background The combination of airway hyper‐responsiveness, eosinophilic airway inflammation, and lung function impairment is considered as a hallmark of bronchial asthma. Since airway function might change with time in chronic asthma, the association between parameters which are characteristic of asthma could be different in subjects with different durations of the disease. Objective We assessed whether in patients with asthma the relationship between airway hyper‐responsiveness, non‐invasive markers of airway inflammation, and baseline lung function depended on the duration of the disease. Methods Sixty‐six non‐smoking patients with mild to moderate allergic asthma without corticosteroids were assigned to two groups, according to a duration of the disease (time interval since doctor's diagnosis) of either ≤ 16 years (median 8 years; mean FEV 1 , 92.6% pred.; n = 34) or > 16 year (median 25 years; mean FEV 1 , 87.9% pred.; n = 32). Results Groups did not differ statistically in PC 20 FEV 1 of methacholine, sputum composition, levels of exhaled nitric oxide (NO), lung function parameters, or history of treatment. There were significant correlations between PC 20 FEV 1 , eosinophils and NO in patients with a duration of the disease ≤ 16 year, but no relation to lung function. In contrast, patients with a duration > 16 year showed a correlation between PC 20 FEV 1 of methacholine and lung function but not eosinophils or NO. In both groups, eosinophils and NO were associated with each other. These results were corroborated by the statistical procedure of factor analysis that revealed ‘inflammation’ and ‘lung function’ as major entities and found ‘responsiveness’ to be associated with only one of them in each group. Conclusion Our data demonstrate that with a shorter duration of the asthmatic disease airway hyper‐responsiveness is associated with airway inflammation, whereas with a longer duration it is associated with impaired lung function, suggesting that in chronic asthma ongoing alterations become the primary determinant of functional characteristics.