Abstract
Anticholinergics, or specific antimuscarinic agents, by inhibition of muscarinic receptors cause bronchodilatation, which might correlate with activation of these receptors by the muscarinic agonist methacholine. The aim of this study was to determine whether a positive bronchodilator response to the anticholinergic ipratropium bromide could predict airway hyperresponsiveness in patients with persistent allergic asthma. The study comprised 40 patients with mild and moderate persistent allergic asthma. Diagnosis was established by clinical and functional follow-up (skin-prick test, spirometry, bronchodilator tests with salbutamol and ipratropium bromide, and methacholine challenge testing). The bronchodilator response was positive to both bronchodilator drugs in all patients. After salbutamol inhalation, forced expiratory volume in 1 second (FEV1) increased by 18.39 ± 6.18%, p < .01, whereas after ipratropium bromide, FEV1 increased by 19.14 ± 6.74%, p < .01. The mean value of FEV1 decreased by 25.75 ± 5.16%, p < .01 after methacholine (PC20 FEV1 [provocative concentration of methacholine that results in a 20% fall in FEV1] from 0.026 to 1.914 mg/mL). Using linear regression, between methacholine challenge testing and bronchodilator response to salbutamol, a positive, weak, and stastistically significant correlation for FEV1 was found (p < .05). Correlations between methacholine challenge testing and the bronchodilator response to ipratropium bromide were positive and weak but not statistically significant. The positive bronchodilator response to ipratropium bromide could not predict airway hyperresponsiveness.
Highlights
Anticholinergics, or specific antimuscarinic agents, by inhibition of muscarinic receptors cause bronchodilatation, which might correlate with activation of these receptors by the muscarinic agonist methacholine
Airway hyperresponsiveness can be quantified by measuring the dose or concentration of inhaled methacholine or histamine that causes a 20% decrease in forced expiratory volume in 1 second (FEV1) (PC20FEV1 [provocative concentration of methacholine that results in a 20% fall in FEV1])
Our results showed a positive bronchodilator response to salbutamol in all patients with persistent allergic asthma
Summary
Anticholinergics, or specific antimuscarinic agents, by inhibition of muscarinic receptors cause bronchodilatation, which might correlate with activation of these receptors by the muscarinic agonist methacholine. The aim of this study was to determine whether a positive bronchodilator response to the anticholinergic ipratropium bromide could predict airway hyperresponsiveness in patients with persistent allergic asthma. Airway hyperresponsiveness in asthma is characterized by an increased sensitivity and an increased maximal response to a variety of bronchoconstrictor agents.[1,2,3,4] It is known that inflammatory processes have been associated with the presence of airway hyperresponsiveness in subjects with asthma.[5,6] Airway hyperresponsiveness can be quantified by measuring the dose or concentration of inhaled methacholine or histamine that causes a 20% decrease in forced expiratory volume in 1 second (FEV1) (PC20FEV1 [provocative concentration of methacholine that results in a 20% fall in FEV1]). Anticholinergics, or muscarinic antagonists, by inhibition of muscarinic receptors cause bronchodilatation, which might correlate with activation of these receptors by the muscarinic agonist methacholine
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