Source: Annual Congress 2002 - Asthma: Inflammation, hyperreactivity, treatment side effects
Disease area: Airway diseases

Abstract

[Background] An important endogenous factor that contributes to the development of frequent exacerbations in asthma is a diminished perception of breathlessness. It is not well known that inhaled corticosteroid improve the perception of bronchoconstriction and hypoxia in asthma. [Methods] We studied 36 patients with mild asthma (17 male and 19 female, mean age 39.2 yr). They were allocated to the use of either a short-acting beta-2 agonist (salbutamol, n=18: beta group) or an inhaled corticosteroid (fluticasone, n=18: ICS group). We examined the methacholine challenge test and hypoxic ventilatory response (HOVR). In HOVR, we recorded minute ventilation (VE) and the mouth occulusion pressure at 100 msec of inspiration (P 0.1). The severity of dyspnea during the methacholine challenge test and during hypoxia was assessed by a Borg score. Borg scores of all subjects were plotted against percentage of fall in FEV1 from baseline and fall in SpO2 from baseline. Individual Borg/FEV1 slopes (Slope-Borg Mch) and Borg/SpO2 slopes (Slope-Borg HOVR), representing an index of dyspnea, were calculated by liner regression analysis for Mch challenges and HOVR. [Results] In the ICS group, P 0.1 showed significantly lower level than beta group (p=0.046), and the slope-Borg Mch showed higher level than beta group (p=0.0019). The Slope-Borg HOVR did not differ significantly between the beta group and the ICS group. [Conclusion] Inhaled corticosteroid may improve the perception of bronchoconstriction, and changed the HOVR.

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S. Shiraishi, K. Hirata, K. Ohtani, K. Asai, J. Yoshikawa (Osaka, Japan). Inhaled corticosteroid improved the perception of dyspnea during methacholine induced bronchoconstriction and changed the hypoxic ventilatory response in patients with asthma. Eur Respir J 2002; 20: Suppl. 38, 422

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