[Bronchial hyper-reactivity and chronic obstructive pulmonary disease]

Bronchial hyper-reactivity (BHR) is a highly sensitive indicator of bronchial asthma, a main predictor of obligatory property of this disease. Modern studies show that BHR occurs in 55-87% of the patients with chronic obstructive pulmonary disease (COPD). Recent epidemiological studies demonstrated that BHR is an independent predictor of COPD risk and the second most important risk factor of COPD after smoking. BHR is believed to modify effects of BHR on the clinical course of COPD and thereby accelerate conversion of obstructive lesions into high mortality rate. Literature data give reason to regard BHR not only as a marker of unfavourable prognosis and severe COPD but also as a pathogenetic and phenotypic characteristic of the disease responsible for variability of its symptoms and therapeutic reaction.