Changes in Small Airway Physiology Measured by Impulse Oscillometry in Subjects with Allergic Asthma Following Methacholine and Inhaled Allergen Challenge

被引：0

作者：

Stenberg, Henning ^{[1
,2
]}

Chan, Rory ^{[3
]}

Abd-Elaziz, Khalid ^{[4
]}

Pelgroem, Arjen ^{[5
]}

Lammering, Karin ^{[6
]}

Haan, Gerda Kuijper-De ^{[7
]}

Weersink, Els ^{[5
]}

Lutter, Rene ^{[5
]}

Zwinderman, Aeilko H. ^{[8
]}

de Jongh, Frans ^{[5
]}

Diamant, Zuzana ^{[4
,9
,10
]}

机构：

[1] Lund Univ, Ctr Primary Hlth Care Res, Dept Clin Sci, S-21428 Malmo, Sweden

[2] Univ Clin Primary Care Skane, S-29189 Kristianstad, Region Skane, Sweden

[3] Univ Dundee, Sch Med, Dundee DD1 9SY, Scotland

[4] Univ Med Ctr Groningen, Dept Clin Pharm & Pharmacol, NL-9700 RB Groningen, Netherlands

[5] Amsterdam Univ Med Ctr, Dept Pulm Med, NL-1007 MB Amsterdam, Netherlands

[6] Lung Funct Ctr O2CO2, NL-2582 EZ The Hague, Netherlands

[7] QPS NL, NL-9713 AG Groningen, Netherlands

[8] Amsterdam Univ Med Ctr, Dept Epidemiol & Data Sci, NL-1105 AZ Amsterdam, Netherlands

[9] Katholieke Univ Leuven, Dept Microbiol Immunol & Transplantat, B-3000 Leuven, Belgium

[10] Charles Univ Prague, Thomayer Hosp, Fac Med 1, Dept Resp Med, Prague 12108, Czech Republic

来源：

JOURNAL OF CLINICAL MEDICINE | 2025年 / 14卷 / 03期

关键词：

asthma; small airways; impulse oscillometry; lung function; methacholine challenge; allergen bronchoprovocation test; DOUBLE-BLIND; LUNG-FUNCTION; HYPERRESPONSIVENESS; RESPONSES; DYSFUNCTION; CHILDREN; ADULTS; FEF25-75-PERCENT; STANDARDIZATION; RESPONSIVENESS;

D O I：

10.3390/jcm14030906

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Small airway dysfunction (SAD) is associated with impaired asthma control, but small airway physiology is not routinely assessed in clinical practice. Previously, we demonstrated impulse oscillometry (IOS)-defined small airway dysfunction (SAD) in dual responders (DRs) upon bronchoprovocation with various allergens. Aim: To compare lung physiology using spirometry and IOS following bronchoprovocation with methacholine (M) and inhaled house dust mite (HDM) extract in corticosteroid-na & iuml;ve asthmatic subjects. Methods: Non-smoking, clinically stable HDM-allergic asthmatic subjects (18-55 years, FEV1 > 70% of pred.) underwent an M and inhaled HDM challenge on two separate days. Airway response was measured by IOS and spirometry, until a drop in FEV1 >= 20% (PC20) from post-diluent baseline (M), and up to 8 h post-allergen (HDM). Early (EAR) and late asthmatic response (LAR) to HDM were defined as >= 20% and >= 15% fall in FEV1 from post-diluent baseline during 0-3 h and 3-8 h post-challenge, respectively. IOS parameters (Rrs5, Rrs20, Rrs5-20, Xrs5, AX, Fres) were compared between mono-responders (MRs: EAR only) and dual responders (EAR + LAR). Correlations between maximal % change from baseline after the two airway challenges were calculated for both FEV1 and IOS parameters. Results: A total of 47 subjects were included (11 MRs; 36 DRs). FEV1 % predicted did not differ between MR and DR at baseline, but DR had lower median PC20M (0.84 (range 0.07-7.51) vs. MR (2.15 (0.53-11.29)); p = 0.036). During the LAR, DRs had higher IOS values than MRs. For IOS parameters (but not for FEV1), the maximal % change from baseline following M and HDM challenge were correlated. PC20M was inversely correlated with the % change in FEV1 and the % change in Xrs5 during the LAR (r= -0.443; p = 0.0018 and r= -0.389; p = 0.0075, respectively). Conclusions: During HDM-induced LAR, changes in small airway physiology can be non-invasively detected with IOS and are associated with increased airway hyperresponsiveness and changes in small airway physiology during methacholine challenge. DRs have a small airways phenotype, which reflects a more advanced airway disease.

引用

页数：16

共 66 条

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