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Hyperventilation-induced asthma: evidence for two mechanisms.

N M Wilson, P J Barnes, H Vickers

    Thorax
    |September 1, 1982
    PubMed
    Summary
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    Airway cooling triggers asthma attacks through two distinct mechanisms. Some patients develop a refractory period, suggesting mediator release, while others show a vagal reflex response.

    Area of Science:

    • Respiratory Medicine
    • Pulmonology
    • Clinical Immunology

    Background:

    • Airway cooling is a known trigger for asthma exacerbations.
    • The precise mechanisms underlying cooling-induced bronchoconstriction in asthma remain unclear.
    • Understanding these mechanisms is crucial for developing targeted therapies.

    Purpose of the Study:

    • To investigate the mechanisms of airway cooling-induced airflow obstruction in asthmatic subjects.
    • To determine if a refractory period exists following hyperventilation challenges.
    • To explore the role of cholinergic pathways in this response.

    Main Methods:

    • 19 asthmatic patients (aged 9-18 years) underwent two isocapnic hyperventilation challenges.
    • Subjects were categorized into 'refractory' and 'non-refractory' groups based on response to the second challenge.

    Related Experiment Videos

  • Cholinergic blockade with inhaled ipratropium bromide was administered to assess vagal reflex involvement.

    • Main Results:

    • Two distinct groups emerged: 'non-refractory' (less than 25% response reduction) and 'refractory' (at least 35% response reduction).
    • Subjects without refractoriness showed significant protection after cholinergic blockade, indicating a vagal reflex.
    • Subjects with a refractory period did not show significant protection, suggesting an alternative mechanism like mediator release.

    Conclusions:

    • Hyperventilation-induced asthma involves at least two distinct mechanisms.
    • One mechanism appears to be a vagal reflex, particularly in non-refractory subjects.
    • Mediator release is a likely mechanism in refractory asthmatic subjects.