Deep breath reversal and exponential return of methacholine-induced obstruction in asthmatic and nonasthmatic subjects.

Abstract

A deep breath (DB) during induced obstruction results in a transient reversal with a return to pre-DB levels in both asthmatic and nonasthmatic subjects. The time course of this transient recovery has been reported to be exponential by one group but linear by another group. In the present study, we estimated airway resistance (Raw) from measurements of respiratory system transfer impedance before and after a DB. Nine healthy subjects and nine asthmatic subjects were studied at their maximum response during a methacholine challenge. In all subjects, the DB resulted in a rapid decrease in Raw, which then returned to pre-DB levels. This recovery was well fit with a monoexponential function in both groups, and the time constant was significantly smaller in the asthmatic than the nonasthmatic subjects (11.6 +/- 5.0 and 35.1 +/- 15.9 s, respectively). Obstruction was completely reversed in the nonasthmatic subjects (pre- and postchallenge mean Raw immediately after the DB were 2.03 +/- 0.66 and 2.06 +/- 0.68 cmH2O.l-1.s, respectively), whereas in the asthmatic subjects complete reversal did not occur (2.29 +/- 0.78 and 4.84 +/- 2.64 cmH2O.l-1.s, respectively). Raw after the DB returned to postchallenge, pre-DB values in the nonasthmatic subjects (3.78 +/- 1.56 and 3.97 +/- 1.63 cmH2O.l-1.s, respectively), whereas in the asthmatic subjects it was higher but not significantly so (9.19 +/- 4.95 and 7.14 +/- 3.56 cmH2O.l-1.s, respectively). The monoexponential recovery suggests a first-order process such as airway wall-parenchymal tissue interdependence or renewed constriction of airway smooth muscle.