Relationship of small airway function with airway sensitivity and reactivity_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 CHEN Yahong , LIANG Yanjing , LIU Xiaofang , YAO Wanzhen

Department of Respiratory Medicine，The Third Hospital，Peking University.Beijing，100083，China Corresponding author：CHEN Ya-hong，E-mail：chenyahong@vip.sina.com;

Corresponding author：

CHEN Yahong, Email: chenyahong@vip.sina.com

Keywords：

Bronchial hyperresponsiveness; Small airway; Airway sensitivity

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Objective To investigate the relationship of small airway function with airway sensitivity and reactivity and assess the factors influencingairway hyperresponsiveness (AHR).Methods Data of consecutive subjects with suspected asthma who had a≥20% reduction in FEV1 after ≤12.8 mmol/L cumulative doses of methacholine were analyzed from January 2005 to April 2006.Airway sensitivity was assessed by the cumulative dose of methacholine required to cause 20% reduction in FEV1 (PD20).Airway reactivity was analyzed using the slope of the dose-response curve (DRS).The DRS was defined as the reduction in FEV1 from baseline after the final dose of methacholine inhaled divided by the cumulative dose inhaled.Because of their highly skewed distribution，DRS was logarithmically transformed (log10) for all analysis.Results A total of 184 consecutive subjects aged 16 to 80 years was enrolled.There were 70 male (38.0%) and 114 female (62.0%) subjects.Subjects with higher airway sensitivity，indicated by lower PD20，also had a lower Vmax50% and Vmax25%，and vise versa.PD20 was negatively correlated wit log10DRS (r=-0.874，P lt;0.01).In a simple linear regression model，log10DNS was significantly correlated with FEV1%，Vmax50% or Vmax25% respectively (the determinant r2 were 0.062，0.097 and 0.085，respectively，all P lt;0.01).In a multiple linear regression model that included age，height，and percentage of predicted FEV1，Vmax50% and Vmax25% accounted for 3.9% and 2.6%，respectively，of variability in airway reactivity.The association between Vmax50% and log10DNS was significant in both male and female subjects.The r2 was higher in male subjects.The subjects were divided into three age groups and the association between Vmax50% or Vmax25% and log10DNS was higher in female than in male for age≤25 years，higher in male than in female for 25 -45 years.No association was found for age gt;45 years in both males and females.Conclusions Impaired small airway function is associated with higher airway sensitivity and reactivity to methacholine in subjects with suspected asthma.

Citation： CHEN Yahong,LIANG Yanjing,LIU Xiaofang,YAO Wanzhen. Relationship of small airway function with airway sensitivity and reactivity. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(3): 177-181. doi: Copy

1.	Britton J，Pavord I，Richards K，et al.Factors influencing the occurrence of airway hyperreactivity in the general population：the importance of atopy and airway caliber.Eur Respir J，1994，7：881-887.
2.	Currie GP，Jackson CM，Lee DK，et al.Determinants of airway hyperresponsiveness in mild asthma.Ann Allergy Asthma Immunol，2003，90：560-563.
3.	陈亚红，姚婉贞，柳晓芳，梁岩静.轻度哮喘患者在支气管激发试验前后小气道功能及弥散功能的改变.中国呼吸与危重监护杂志，2007，6：3-7.
4.	中华医学会呼吸病学会哮喘学组.支气管哮喘防治指南（支气管哮喘的定义、诊断、治疗及教育和管理方案）.中华内科杂志，2003；42：817~822.
5.	Parker AL，Abu-Hijleh M，McCool FD.Ratio between forced expiratory flow between 25% and 75% of vital capacity and FVC is a determinant of airway reactivity and sensitivity to methacholine.Chest，2003，124：63-69.
6.	Kanner RE，Connett JE，Altose MD，et al.Gender difference in airway hyperresponsiveness in smokers with mild COPD.Am J Respir Crit Care Med，1994，150：956-961.
7.	Shaw RJ，Djukanovic R，Tashkin DP，et al.The role of small airways in lung disease.Respir Med，2002，96：67-80.
8.	De Marco R，Locatelli F，Sunyer J，et al.Differences in incidence of reported asthma related to age in men and women.The European Community Respiratory Health Survey Study Group.Am J Respir Crit Care Med，2000，162：68-74.
9.	姚婉贞，赵鸣武，韩荣藓.以肺功能实测值作为支气管激发试验的判定指标比较分析.中华结核和呼吸杂志，1994，17：220-222.

1. Britton J，Pavord I，Richards K，et al.Factors influencing the occurrence of airway hyperreactivity in the general population：the importance of atopy and airway caliber.Eur Respir J，1994，7：881-887.
2. Currie GP，Jackson CM，Lee DK，et al.Determinants of airway hyperresponsiveness in mild asthma.Ann Allergy Asthma Immunol，2003，90：560-563.
3. 陈亚红，姚婉贞，柳晓芳，梁岩静.轻度哮喘患者在支气管激发试验前后小气道功能及弥散功能的改变.中国呼吸与危重监护杂志，2007，6：3-7.
4. 中华医学会呼吸病学会哮喘学组.支气管哮喘防治指南（支气管哮喘的定义、诊断、治疗及教育和管理方案）.中华内科杂志，2003；42：817~822.
5. Parker AL，Abu-Hijleh M，McCool FD.Ratio between forced expiratory flow between 25% and 75% of vital capacity and FVC is a determinant of airway reactivity and sensitivity to methacholine.Chest，2003，124：63-69.
6. Kanner RE，Connett JE，Altose MD，et al.Gender difference in airway hyperresponsiveness in smokers with mild COPD.Am J Respir Crit Care Med，1994，150：956-961.
7. Shaw RJ，Djukanovic R，Tashkin DP，et al.The role of small airways in lung disease.Respir Med，2002，96：67-80.
8. De Marco R，Locatelli F，Sunyer J，et al.Differences in incidence of reported asthma related to age in men and women.The European Community Respiratory Health Survey Study Group.Am J Respir Crit Care Med，2000，162：68-74.
9. 姚婉贞，赵鸣武，韩荣藓.以肺功能实测值作为支气管激发试验的判定指标比较分析.中华结核和呼吸杂志，1994，17：220-222.

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