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Detection of excessive bronchoconstriction in asthma

W J Gibbons1, A Sharma, D Lougheed

  • 1Montreal Chest Hospital Centre, McGill University, Quebec, Canada.

American Journal of Respiratory and Critical Care Medicine
|February 1, 1996
PubMed
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Measuring the percent fall in vital capacity (delta FVC%) offers a novel way to assess excessive bronchoconstriction in asthma, distinct from standard PC20 methods. This approach may help identify asthma patients at risk for severe disease.

Area of Science:

  • Pulmonary Medicine
  • Respiratory Physiology
  • Clinical Diagnostics

Background:

  • Airway hyperresponsiveness is typically measured by PC20 or PD20, which indicate the dose of an agonist causing a defined response.
  • These standard measures do not quantify excessive bronchoconstriction, a key aspect of asthma severity.
  • A novel approach is needed to better characterize the spectrum of asthmatic responses.

Purpose of the Study:

  • To evaluate the utility of measuring the percent fall in vital capacity (delta FVC%) as a dependent variable in bronchial dose-response curves.
  • To determine if delta FVC% can detect excessive bronchoconstriction, unlike traditional PC20 measurements.
  • To assess the reproducibility and clinical correlation of delta FVC% in asthma patients.

Main Methods:

Related Experiment Videos

  • Analysis of bronchial dose-response curves using delta FVC% at the PC20 concentration of histamine as the dependent variable.
  • Histamine challenge tests were performed on patients with mild asthma and healthy subjects.
  • Reproducibility of delta FVC% was compared to PC20, and correlations with beta 2-agonist and oral prednisone prescriptions were examined in a larger cohort.

    • Main Results:

    • In mild asthma patients, delta FVC% at PC20 demonstrated comparable reproducibility to PC20.
    • Healthy subjects showed minimal FVC changes, while mild asthmatics exhibited a normally distributed delta FVC% (13.2 ± 5.5 SD%).
    • Delta FVC% correlated with oral prednisone prescriptions (r = 0.55, p < 0.02) but not with beta 2-agonist use or PC20.

    Conclusions:

    • Percent fall in vital capacity (delta FVC%) at a 20% fall in FEV1 is a safe and reproducible method for detecting excessive bronchoconstriction.
    • This measurement reveals distinct individual responses to agonists in asthmatics, potentially identifying those at risk for severe disease.
    • Delta FVC% offers a complementary diagnostic tool to PC20, providing deeper insights into asthma pathophysiology.