Advertisement

Lung

, Volume 168, Issue 1, pp 237–247 | Cite as

Physiological assessment of inflammation in the peripheral lung of asthmatic patients

  • Roland H. Ingram
Review

Abstract

Even the asymptomatic asthmatic person with normal lung function may have peripheral airway obstruction and inflammation along with hyperresponsiveness to nonspecific challenges. The airway caliber change induced immediately following a deep inhalation (DI) appears to relate to the mechanism (inflammation vs. smooth muscle constriction) and site (peripheral vs. more central) of obstruction and the degree of hyperresponsiveness. Data are presented and reviewed that support the notion that relative hysteresis of parenchyma (including peripheral airways and alveolar ducts) and airways (more centrally located, conducting airways) can explain the magnitude and sign of airway caliber change that follow a DI in asthmatic subjects.

Key words

Asthma Airway inflammation Bronchodilation Inspiration, deep 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Beaupré A, Orehek J (1982) Factors influencing the bronchodilator effect of a deep inspiration in asthmatic patients with provoked bronchoconstriction. Thorax 37:124PubMedCrossRefGoogle Scholar
  2. 2.
    Burns CB, Taylor WR, Ingram RH Jr (1985) Effects of deep inhalation in asthma: relative airway and parenchymal hysteresis. J Appl Physiol 59:1590PubMedGoogle Scholar
  3. 3.
    Cosio M, Ghezzo H, Hogg JC, et al (1978) The relations between structural changes in small airways and pulmonary function tests. N Engl J Med 298:1277PubMedGoogle Scholar
  4. 4.
    DeTroyer A, Yernault JC, Rodenstein D (1978) Influence of beta-2 agonist aerosols on pressure-volume characteristics of the lungs. Am Rev Respir Dis 118:987Google Scholar
  5. 5.
    Fairshter RD (1986) Effect of a deep inspiration on expiratory flow in normals and patients with chronic obstructive pulmonary disease. Bull Eur Physiopathol Respir 22:119PubMedGoogle Scholar
  6. 6.
    Fish JE:, Peterman VI, Cugell DW (1977) Effect of deep inspiration on airway conductance in subjects with allergic rhinitis and allergic asthma. J Allergy Clin Immunol 60:41PubMedCrossRefGoogle Scholar
  7. 7.
    Fish JE, Ankin ML, Kelly JF, et al (1980) Regulation of bronchomotor tone by lung inflation in asthmatic and non-asthmatic subjects. J Appl Physiol 50:1079Google Scholar
  8. 8.
    Froeb HF, Mead J (1968) Relative hysteresis of the dead space and lung in vivo. J Appl Physiol 25:244PubMedGoogle Scholar
  9. 9.
    Gayard P, Orehek J, Grimaud C, et al (1975) Bronchoconstrictor effects of a deep inspiration in patients with asthma. Am Rev Respir Dis 111:433Google Scholar
  10. 10.
    Ingram RH Jr (1987) Site and mechanism of obstruction and hyperresponsiveness in asthma. Am Rev Respir Dis 136:(4)2:S62Google Scholar
  11. 11.
    Kariya ST, Thompson LM, Ingenito EP, Ingram RH Jr (1989) Effect of lung volume, volume history and methacholine on tissue viscance in man. J Appl Physiol 66:977PubMedCrossRefGoogle Scholar
  12. 12.
    Lim TK, Pride NB, Ingram RH Jr (1987) Effects of volume history during spontaneous and acutely induced obstruction in asthma. Am Rev Respir Dis 135:591PubMedGoogle Scholar
  13. 13.
    Lim TK, Ang SM, Rossing TH, Ingenito EP, Ingram RH Jr (1989) The effects of deep inhalations on maximal expiratory flows during intensive treatment of spontaneous asthmatic episodes. Am Rev Respir Dis 140:340PubMedGoogle Scholar
  14. 14.
    Orehek J, Chairpin D, Velardocchio JM, et al (1980) Bronchomotor effect of bronchoconstriction-induced deep inspirations in asthmatics. Am Rev Respir Dis 121:297PubMedGoogle Scholar
  15. 15.
    Orehek J, Nicoli S, Delpierre S, et al. (1981) Influence of the previous deep inspiration on the spirometric measurement of provoked bronchoconstriction in asthma. Am Rev Respir Dis 123:269PubMedGoogle Scholar
  16. 16.
    Parham WM, Shepard RH, Norman PS, et al (1983) Analysis of time course and magnitude of lung inflation effects on airway tone: relation to airway reactivity. Am Rev Respir Dis 128:240PubMedGoogle Scholar
  17. 17.
    Pedersen OF, Ingram RH Jr (1987) The use of maximal expiratory flow volume curves on air and He/O2 to assess site of airflow obstruction. Bull Eur Physiopathol Respir 23:649PubMedGoogle Scholar
  18. 18.
    Pichurko BM, Ingram RH, Jr (1987) Effect of airway tone and volume history on maximal expiratory flow in asthma. J Appl Physiol 62:1133PubMedGoogle Scholar
  19. 19.
    Pliss LB, Ingenito EP, Ingram RH Jr (1989) Responsiveness, inflammation and effects of deep breaths on obstruction in mild asthma. J Appl Physiol 66:2298PubMedGoogle Scholar
  20. 20.
    Sestier M, Cartier A, Martin R, Malo J (1984) Bronchial responsiveness to methacholine and effects of respiratory maneuvers. J Appl Physiol 56:122PubMedGoogle Scholar
  21. 21.
    Wang YT, Thompson LM, Ingenito EP, Ingram RH Jr (1990) Effects of increasing doses of beta agonists on airway and parenchymal hysteresis. J Appl Physiol 68:(2)Google Scholar
  22. 22.
    Weiss JW, McFadden ER, Ingram RH Jr (1982) Bronchodilatation, lung recoil, and density dependence of maximal expiratory flow. J Appl Physiol 52:874PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • Roland H. Ingram
    • 1
  1. 1.Department of MedicineHennepin County Medical CenterMinneapolisUSA

Personalised recommendations