Mechanisms of asthma and allergic inflammationAirway immunopathology of asthma with exercise-induced bronchoconstriction
Section snippets
Subjects
The University of Washington Institutional Review Board approved the study protocol, and written informed consent was obtained from all participants. Subjects 18 to 59 years of age were recruited who had a physician's diagnosis of asthma for 1 year or longer and used only an inhaled β2-agonist for asthma treatment. In accordance with a priori definitions, asthmatic subjects with EIB (EIB+ group) were identified with a 30% or greater decrease in FEV1 after exercise challenge, and asthmatic
Subject characteristics
The characteristics of each of the groups are listed in Table I. The diagnosis of asthma was confirmed in the EIB− group by a 12% or greater bronchodilator response in 4 participants and by a methacholine PC20 of 8 mg/mL or less (mean, 2.8 mg/mL; range, 0.25-8 mg/mL) in 6 participants. There were no differences in baseline lung function or response to the administration of a bronchodilator between the 2 groups. None of the patients in either group reported an asthma-related emergency department
Discussion
Asthma is a phenotypically diverse syndrome that is defined in part by the presence of increased BHR.1 The degree and type of BHR is variable among patients with asthma. The severity of direct BHR is related to baseline lung function,24 possibly indicating structural remodeling of the lung. In contrast, indirect BHR is measured by the response to stimuli, such as exercise, hypertonic aerosols, and AMP, and is thought to act indirectly through the release of inflammatory mediators into the
Acknowledgments
We greatly appreciate the technical assistance of Linda Deller, Patricia McDowell, Peter Meyer, John Smith, and Jon Rudzinski. We thank Dr Lianne Sheppard for her guidance on the biostatistics.
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Supported by a National Institutes of Health grant HL04231 (TSH) and an American Lung Association Clinical Research Grant (TSH).
Disclosure of potential conflict of interest: Dr Hallstrand has given lectures (2001-2004) in sessions at regional and national meetings, which were funded in part by Merck & Co, Inc, and received research support from a Merck & Co Medical School grant awarded to the University of Washington in 2000. Mr Moody does not have a financial relationship with a commercial entity that has an interest in the subject of this article. Dr Aitken does not have a financial relationship with a commercial entity that has an interesting the subject of this article. Dr Henderson has given lectures (2001-2004) in sessions at regional, national, and international meetings, which were funded in part by Merck & Co, Inc, and received research support from a Merck & Co Medical School grant awarded to the University of Washington in 2002.