Small airways response to naturalistic cat allergen exposure in subjects with asthma
It is currently unclear whether the small airways (diameter <2 μm) contribute significantly to late asthmatic reactions to inhaled allergen. We sought to determine whether naturalistic exposure to cat allergen induced late responses in the small airways as measured by pulmonary function testing a...
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| Published in: | Journal of allergy and clinical immunology Vol. 118; no. 5; pp. 1075 - 1081 |
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| Main Authors: | , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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Mosby, Inc
01.11.2006
Elsevier Elsevier Limited |
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| ISSN: | 0091-6749, 1097-6825 |
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| Abstract | It is currently unclear whether the small airways (diameter <2 μm) contribute significantly to late asthmatic reactions to inhaled allergen.
We sought to determine whether naturalistic exposure to cat allergen induced late responses in the small airways as measured by pulmonary function testing and high-resolution computed tomography (HRCT) of the chest performed at end-expiration.
In a group of 10 subjects with cat-induced asthma, physiologic studies (spirometry and lung volumes, including closing volume) and HRCT were performed before and 6 and 23 hours after a cat room challenge that caused a 20% or greater acute fall in FEV
1.
There was no significant decline in FEV
1 at 6 or 23 hours after cat exposure. Forced expiratory flow at 25% to 75% of forced vital capacity was significantly decreased at 6 hours after the challenge and returned to normal by 23 hours. HRCT image analysis as well as closing volume demonstrated increased air trapping from baseline at both 6 and 23 hours after the challenge. In addition, image analysis demonstrated a significant increase in small airways hyperresponsiveness to methacholine at 23 hours after the challenge. No significant mean changes were noted in lung volumes at either 6 or 23 hours or in PC
20 FEV
1 at 23 hours postchallenge.
These findings demonstrate that naturalistic exposure to cat allergen results in significant small airways obstruction and hyperresponsiveness persisting for at least 23 hours, at which time these changes cannot be detected by conventional physiologic measures.
Physiologically silent distal lung inflammation persists after an antigenic challenge. |
|---|---|
| AbstractList | It is currently unclear whether the small airways (diameter <2 μm) contribute significantly to late asthmatic reactions to inhaled allergen.
We sought to determine whether naturalistic exposure to cat allergen induced late responses in the small airways as measured by pulmonary function testing and high-resolution computed tomography (HRCT) of the chest performed at end-expiration.
In a group of 10 subjects with cat-induced asthma, physiologic studies (spirometry and lung volumes, including closing volume) and HRCT were performed before and 6 and 23 hours after a cat room challenge that caused a 20% or greater acute fall in FEV
1.
There was no significant decline in FEV
1 at 6 or 23 hours after cat exposure. Forced expiratory flow at 25% to 75% of forced vital capacity was significantly decreased at 6 hours after the challenge and returned to normal by 23 hours. HRCT image analysis as well as closing volume demonstrated increased air trapping from baseline at both 6 and 23 hours after the challenge. In addition, image analysis demonstrated a significant increase in small airways hyperresponsiveness to methacholine at 23 hours after the challenge. No significant mean changes were noted in lung volumes at either 6 or 23 hours or in PC
20 FEV
1 at 23 hours postchallenge.
These findings demonstrate that naturalistic exposure to cat allergen results in significant small airways obstruction and hyperresponsiveness persisting for at least 23 hours, at which time these changes cannot be detected by conventional physiologic measures.
Physiologically silent distal lung inflammation persists after an antigenic challenge. It is currently unclear whether the small airways (diameter <2 microm) contribute significantly to late asthmatic reactions to inhaled allergen. We sought to determine whether naturalistic exposure to cat allergen induced late responses in the small airways as measured by pulmonary function testing and high-resolution computed tomography (HRCT) of the chest performed at end-expiration. In a group of 10 subjects with cat-induced asthma, physiologic studies (spirometry and lung volumes, including closing volume) and HRCT were performed before and 6 and 23 hours after a cat room challenge that caused a 20% or greater acute fall in FEV(1). There was no significant decline in FEV(1) at 6 or 23 hours after cat exposure. Forced expiratory flow at 25% to 75% of forced vital capacity was significantly decreased at 6 hours after the challenge and returned to normal by 23 hours. HRCT image analysis as well as closing volume demonstrated increased air trapping from baseline at both 6 and 23 hours after the challenge. In addition, image analysis demonstrated a significant increase in small airways hyperresponsiveness to methacholine at 23 hours after the challenge. No significant mean changes were noted in lung volumes at either 6 or 23 hours or in PC(20) FEV(1) at 23 hours postchallenge. These findings demonstrate that naturalistic exposure to cat allergen results in significant small airways obstruction and hyperresponsiveness persisting for at least 23 hours, at which time these changes cannot be detected by conventional physiologic measures. Physiologically silent distal lung inflammation persists after an antigenic challenge. It is currently unclear whether the small airways (diameter <2 microm) contribute significantly to late asthmatic reactions to inhaled allergen.BACKGROUNDIt is currently unclear whether the small airways (diameter <2 microm) contribute significantly to late asthmatic reactions to inhaled allergen.We sought to determine whether naturalistic exposure to cat allergen induced late responses in the small airways as measured by pulmonary function testing and high-resolution computed tomography (HRCT) of the chest performed at end-expiration.OBJECTIVESWe sought to determine whether naturalistic exposure to cat allergen induced late responses in the small airways as measured by pulmonary function testing and high-resolution computed tomography (HRCT) of the chest performed at end-expiration.In a group of 10 subjects with cat-induced asthma, physiologic studies (spirometry and lung volumes, including closing volume) and HRCT were performed before and 6 and 23 hours after a cat room challenge that caused a 20% or greater acute fall in FEV(1).METHODSIn a group of 10 subjects with cat-induced asthma, physiologic studies (spirometry and lung volumes, including closing volume) and HRCT were performed before and 6 and 23 hours after a cat room challenge that caused a 20% or greater acute fall in FEV(1).There was no significant decline in FEV(1) at 6 or 23 hours after cat exposure. Forced expiratory flow at 25% to 75% of forced vital capacity was significantly decreased at 6 hours after the challenge and returned to normal by 23 hours. HRCT image analysis as well as closing volume demonstrated increased air trapping from baseline at both 6 and 23 hours after the challenge. In addition, image analysis demonstrated a significant increase in small airways hyperresponsiveness to methacholine at 23 hours after the challenge. No significant mean changes were noted in lung volumes at either 6 or 23 hours or in PC(20) FEV(1) at 23 hours postchallenge.RESULTSThere was no significant decline in FEV(1) at 6 or 23 hours after cat exposure. Forced expiratory flow at 25% to 75% of forced vital capacity was significantly decreased at 6 hours after the challenge and returned to normal by 23 hours. HRCT image analysis as well as closing volume demonstrated increased air trapping from baseline at both 6 and 23 hours after the challenge. In addition, image analysis demonstrated a significant increase in small airways hyperresponsiveness to methacholine at 23 hours after the challenge. No significant mean changes were noted in lung volumes at either 6 or 23 hours or in PC(20) FEV(1) at 23 hours postchallenge.These findings demonstrate that naturalistic exposure to cat allergen results in significant small airways obstruction and hyperresponsiveness persisting for at least 23 hours, at which time these changes cannot be detected by conventional physiologic measures.CONCLUSIONThese findings demonstrate that naturalistic exposure to cat allergen results in significant small airways obstruction and hyperresponsiveness persisting for at least 23 hours, at which time these changes cannot be detected by conventional physiologic measures.Physiologically silent distal lung inflammation persists after an antigenic challenge.CLINICAL IMPLICATIONSPhysiologically silent distal lung inflammation persists after an antigenic challenge. Background It is currently unclear whether the small airways (diameter <2 μm) contribute significantly to late asthmatic reactions to inhaled allergen. Objectives We sought to determine whether naturalistic exposure to cat allergen induced late responses in the small airways as measured by pulmonary function testing and high-resolution computed tomography (HRCT) of the chest performed at end-expiration. Methods In a group of 10 subjects with cat-induced asthma, physiologic studies (spirometry and lung volumes, including closing volume) and HRCT were performed before and 6 and 23 hours after a cat room challenge that caused a 20% or greater acute fall in FEV1. Results There was no significant decline in FEV1at 6 or 23 hours after cat exposure. Forced expiratory flow at 25% to 75% of forced vital capacity was significantly decreased at 6 hours after the challenge and returned to normal by 23 hours. HRCT image analysis as well as closing volume demonstrated increased air trapping from baseline at both 6 and 23 hours after the challenge. In addition, image analysis demonstrated a significant increase in small airways hyperresponsiveness to methacholine at 23 hours after the challenge. No significant mean changes were noted in lung volumes at either 6 or 23 hours or in PC20FEV1at 23 hours postchallenge. Conclusion These findings demonstrate that naturalistic exposure to cat allergen results in significant small airways obstruction and hyperresponsiveness persisting for at least 23 hours, at which time these changes cannot be detected by conventional physiologic measures. Clinical implications Physiologically silent distal lung inflammation persists after an antigenic challenge. |
| Author | Corren, Jonathan Kleerup, Eric C. Kim, Hyun J. Zeidler, Michelle R. Goldin, Jonathan G. Silverman, Jeffrey M. Gjertson, David W. Kennedy, Nola J. Tashkin, Donald P. Truong, Dao A. Newman, Kenneth B. |
| Author_xml | – sequence: 1 givenname: Michelle R. surname: Zeidler fullname: Zeidler, Michelle R. organization: From the Divisions of Pulmonary, Critical Care Medicine and Hospitalists – sequence: 2 givenname: Jonathan G. surname: Goldin fullname: Goldin, Jonathan G. organization: Thoracic Radiology, David Geffen School of Medicine – sequence: 3 givenname: Eric C. surname: Kleerup fullname: Kleerup, Eric C. organization: From the Divisions of Pulmonary, Critical Care Medicine and Hospitalists – sequence: 4 givenname: Hyun J. surname: Kim fullname: Kim, Hyun J. organization: Thoracic Radiology, David Geffen School of Medicine – sequence: 5 givenname: Dao A. surname: Truong fullname: Truong, Dao A. organization: Thoracic Radiology, David Geffen School of Medicine – sequence: 6 givenname: David W. surname: Gjertson fullname: Gjertson, David W. organization: Thoracic Radiology, David Geffen School of Medicine – sequence: 7 givenname: Nola J. surname: Kennedy fullname: Kennedy, Nola J. organization: School of Public Health, University of California, Los Angeles – sequence: 8 givenname: Kenneth B. surname: Newman fullname: Newman, Kenneth B. organization: Forest Laboratories, New York – sequence: 9 givenname: Donald P. surname: Tashkin fullname: Tashkin, Donald P. organization: From the Divisions of Pulmonary, Critical Care Medicine and Hospitalists – sequence: 10 givenname: Jeffrey M. surname: Silverman fullname: Silverman, Jeffrey M. organization: Keck School of Medicine at the University of Southern California and Landmark Imaging – sequence: 11 givenname: Jonathan surname: Corren fullname: Corren, Jonathan email: jcorren@ucla.edu organization: Division of Clinical Immunology and Allergy, David Geffen School of Medicine and Allergy Research Foundation |
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| Keywords | BDP-CFC RV BDP-HFA TLC image analysis HU Asthma computer-assisted LAC FVC CV CRC tomography FRC Fel d 1 protein x-ray computed HRCT bronchial hyperreactivity CV/VC FEF 25-75 MCT Fel d I protein Allergy Hyperreactivity X ray Respiratory system Respiratory tract Immunology Tomography Bronchus disease Obstructive pulmonary disease Computer aid Human Fissipedia Immunopathology Lung disease Carnivora Radiodiagnosis Respiratory disease Exploration Exposure Radiography Vertebrata Image analysis Mammalia Cat Allergen |
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| Snippet | It is currently unclear whether the small airways (diameter <2 μm) contribute significantly to late asthmatic reactions to inhaled allergen.
We sought to... It is currently unclear whether the small airways (diameter <2 microm) contribute significantly to late asthmatic reactions to inhaled allergen. We sought to... Background It is currently unclear whether the small airways (diameter <2 μm) contribute significantly to late asthmatic reactions to inhaled allergen.... It is currently unclear whether the small airways (diameter <2 microm) contribute significantly to late asthmatic reactions to inhaled allergen.BACKGROUNDIt is... |
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| SubjectTerms | Adult Allergens - administration & dosage Allergens - immunology Animals Asthma Asthma - immunology Asthma - physiopathology Biological and medical sciences bronchial hyperreactivity Bronchial Provocation Tests Bronchoscopy Bronchospirometry Cats computer-assisted Fel d 1 protein Female Fundamental and applied biological sciences. Psychology Fundamental immunology Glycoproteins - administration & dosage Glycoproteins - immunology Humans image analysis Immunopathology Male Medical imaging Medical sciences Plethysmography Studies Tomography Tomography, X-Ray Computed Total Lung Capacity x-ray computed |
| Title | Small airways response to naturalistic cat allergen exposure in subjects with asthma |
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