Skip to main content
SpringerLink
Log in

Comparison of refractoriness after exercise-and hyperventilation-induced asthma

  • Published:
Lung Aims and scope Submit manuscript

Abstract

To study the relationship of bronchoconstriction and refractoriness we performed pairs of exercise and hyperventilation tests in 15 patients (mean [SEM] age 28.5 [2.8] years) with a history of exercise-induced asthma. Mean (SEM) maximum specific airway resistance (SRaw) increased during the first exercise test to 33.9 (4.5) and during the second exercise test to 29.8 (5.2) cmH2O×s (n.s.). Mean (SEM) maximum specific airway resistance (SRaw) increased during the first hyperventilation test to 44.0 (5.9) and during the second hyperventilation test to 27.4 (3.3) cmH2O×s (p<0.01). Mean maximum bronchoconstriction after corresponding exercise and hyperventilation tests did not differ statistically. There was a significantly larger interindividual variability in the airway response to hyperventilation (p<0.001). From these data we suggest that similar refractoriness can be observed after both exercise and hyperventilation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Anderson SD (1985) Issues in exercise-induced asthma. J Allergy Clin Immunol 76:763–772

    Article  PubMed  CAS  Google Scholar 

  2. Assoufi A, Dally MB, Newman-Taylor AJ, Denison DM (1986) Cold air test: a simplified standard method for airway reactivity. Bull Eur Physiopathol Respir 22:349–357

    PubMed  CAS  Google Scholar 

  3. Barnes P, Brown M, Silverman M, Dollery C (1981) Circulating catecholamines in exercise- and hyperventilation-induced asthma. Thorax 36:435–440

    PubMed  CAS  Google Scholar 

  4. Barnes P, Brown MJ (1981) Venous histamine in exercise- and hyperventilation-induced asthma in man. Clin Sci 61:159–162

    PubMed  CAS  Google Scholar 

  5. Bar-Or O, Neumann I, Dotan R (1977) Effects of dry and humid climates on exercise-induced asthma in children and preadolescents. J Allergy Clin Immunol 60:163–168

    Article  PubMed  CAS  Google Scholar 

  6. Bar-Yishay E, Ben-Dov I, Godfrey S (1983) Refractory period after hyperventilation-induced asthma. Am Rev Respir Dis 127:572–574

    PubMed  CAS  Google Scholar 

  7. Bascom R, Bleecker ER (1986) Bronchoconstriction induced by distilled water. Sensitivity in asthmatics and relationship to exercise-induced bronchospasm. Am Rev Respir Dis 134:248–253

    PubMed  CAS  Google Scholar 

  8. Belcher NG, Rees PJ, Clark TJH, Lee T (1987) A comparison of the refractory periods induced by hypertonic airway challenge and exercise in bronchial asthma. Am Rev Respir Dis 135:822–825

    PubMed  CAS  Google Scholar 

  9. Belcher NG, Lee TH, Rees PJ (1989) Airway responses to hypertonic saline, exercise and histamine challenges in bronchial asthma. Eur Respir J 2:44–48

    PubMed  CAS  Google Scholar 

  10. Ben-Dov I, Bar-Yishay E, Godfrey S (1982) Refractory period after exercise-induced asthma unexplained by respiratory heat loss. Am Rev Respir Dis 125:530–534

    PubMed  CAS  Google Scholar 

  11. Ben-Dov I, Gur I, Bar-Yishay E, Godfrey S (1983) Refractory period following induced asthma: contributions of exercise and isocapnic hyperventilation. Thorax 38:849–853

    PubMed  CAS  Google Scholar 

  12. Bonnet R, Jörres R, Heitmann U, Magnussen H (1990) Relationship between circadian variations of airway tone and airway responsiveness in bronchial asthma. Am Rev Respir Dis 141:A358

    Google Scholar 

  13. Deal EC Jr, McFadden ER Jr, Ingram RH Jr, Strauss RH, Jaeger JJ (1979) Role of respiratory heat exchange in production of exercise-induced asthma. J Appl Physiol 46:467–475

    PubMed  Google Scholar 

  14. Deal EC Jr, McFadden ER Jr, Ingram RH Jr, Breslin FJ, Jaeger JJ (1980) Airway responsiveness to cold air and hyperpnea in normal subjects and in those with hay fever and asthma. Am Rev Respir Dis 121:621–628

    PubMed  Google Scholar 

  15. DuBois AB, Botelho WSY, Bedell GN, Marshall R, Comroe JH Jr (1956) A rapid plethysmographic method for measuring thoracic gas volume: a comparison with a nitrogen washout method for measuring functional residual capacity in normal subjects. J Clin Invest 35:322–326

    PubMed  CAS  Google Scholar 

  16. Edmunds A, Tooley M, Godfrey S (1978) The refractory period after exercise-induced asthma: the duration and relation to the severity of exercise. Am Rev Respir Dis 117:247–254

    PubMed  CAS  Google Scholar 

  17. Eschenbacher WL, Sheppard D (1985) Respiratory heat loss is not the sole stimulus for bronchoconstriction induced by isocapnic hyperpnea with cold air. Am Rev Respir Dis 131:894–901

    PubMed  CAS  Google Scholar 

  18. Florentin D, Dessanges JR, Marsac J, Lockhart A (1984) Reappraisal of the refractory period after hyperventilation-induced asthma. Clin Sci 67:59

    Google Scholar 

  19. Gilbert IA, Fouke JM, McFadden ER (1987) Heat and water flux in the intrathoracic airways and exercise-induced asthma. J Appl Physiol 63:1681–1691

    PubMed  CAS  Google Scholar 

  20. Gilbert JA, Fouke JM, McFadden ER Jr (1988) Intra-airway thermodynamics during exercise and hyperventilation in asthmatics. J Appl Physiol 64:2167–2174

    PubMed  CAS  Google Scholar 

  21. Heaton RW, Henderson AF, Gray BJ, Costello JF (1983) The bronchial response to cold air challenge: evidence for different mechanisms in normal and asthmatic subjects. Thorax 38:506–511

    PubMed  CAS  Google Scholar 

  22. Ingram RH Jr, McFadden ER Jr (1983) Are exercise and isocapnic voluntary hyperventilation identical bronchial provocations? Eur J Respir Dis 64 (suppl. 128):242–245

    Google Scholar 

  23. James L, Faciane J, Sly RM (1976) Effect of treadmill exercise on asthmatic children. J Allergy Clin Immunol 57:408–416

    Article  PubMed  CAS  Google Scholar 

  24. Lee T, Nagakura T, Cromwell O, Brown M, Causon R, Kay A (1984) Neutrophil chemotactic activity and histamine in atopic and nonatopic subjects after exercise-induced asthma. Am Rev Respir Dis 129:409–412

    PubMed  CAS  Google Scholar 

  25. Magnussen H, Scheidt-Mackes M, Kesseler KH (1983) Körperliche Belastung und Hyperventilation als auslösende Faktoren der Atemwegsobstruktion beim Asthma bronchiale. Prax Klin Pneumol 37:685–686

    PubMed  Google Scholar 

  26. Magnussen H, Reuss G, Jörres R (1986) Airway response to methacholine during exercise induced refractoriness in asthma. Thorax 41:667–670

    PubMed  CAS  Google Scholar 

  27. Magnussen H, Reuss G, Jörres R (1988) Methylxanthines inhibit exercise-induced bronchoconstriction at low serum theophylline concentration and in a dose-dependent fashion. J Allergy Clin Immunol 81:531–537

    Article  PubMed  CAS  Google Scholar 

  28. Malo J-L, Cartier A, L’Archevéque J, Ghezzo H, Martin RR (1986) Cold air inhalation has a cumulative bronchospastic effect when inhaled in consecutive doses for progressively increasing degrees of ventilation. Am Rev Respir Dis 134:990–993

    PubMed  CAS  Google Scholar 

  29. Margolskee DJ, Bigby BG, Boushey HA (1988) Indomethacin blocks airway tolerance to repetitive exercise but not to eucapnic hyperpnea in asthmatic subjects. Am Rev Respir Dis 137:842–846

    PubMed  CAS  Google Scholar 

  30. McNeill RS, Nairn JR, Millar JS, Ingram CG (1965) Exercise-induced asthma. Q J Med 35:55–67

    Google Scholar 

  31. Noviski N, Bar-Yishay E, Gur I, Godfrey S (1988) Respiratory heat/water loss alone does not determine the severity of exercise-induced asthma. Eur Respir J 1:253–256

    PubMed  CAS  Google Scholar 

  32. O’Connor GT, Sparrow D, Weiss ST (1989) The role of allergy and nonspecific airway hyper-responsiveness in the pathogenesis of chronic obstructive pulmonary disease. Am Rev Respir Dis 140:225–252

    PubMed  CAS  Google Scholar 

  33. Rakotosihanaka F, Melaman F, d’Athis P, Florentin D, Dessanges JF, Lockhart A (1986) Refractoriness after hyperventilation-induced asthma. Bull Eur Physiopathol Respir 22:581–587

    PubMed  CAS  Google Scholar 

  34. Rosenthal RR, Laube BL, Hood DB, Norman PS (1990) Analysis of refractory period after exercise and eucapnic voluntary hyperventilation challenge. Am Rev Respir Dis 141:368–372

    PubMed  CAS  Google Scholar 

  35. Sachs L (1984) Angewandte Statistik, 6th ed. Berlin, Springer.

    Google Scholar 

  36. Schnall RP, Landau LI (1980) Protective effect of repeated short sprints in exercise-induced asthma. Thorax 35:828–832

    PubMed  CAS  Google Scholar 

  37. Schoeffel RE, Anderson SD, Lindsay DA (1980) Multiple exercise and histamine challenges in asthmatic patients. Thorax 35:164–170

    Article  PubMed  CAS  Google Scholar 

  38. Sheppard D, Eschenbacher WL (1984) Respiratory water loss as a stimulus to exercise-induced bronchoconstriction. J Allergy Clin Immunol 73:640–643

    Article  PubMed  CAS  Google Scholar 

  39. Stearns DR, McFadden ER, Breslin FJ, Ingram RH (1981) Reanalysis of the refractory period in exertional asthma. J Appl Physiol 50:503–508

    PubMed  CAS  Google Scholar 

  40. Strauss RH, McFadden ER, Ingram RH, Deal E, Jaeger J (1978) Influence of heat and humidity on the airway obstruction induced by exercise in asthma. J Clin Invest 61:433–440

    Article  PubMed  CAS  Google Scholar 

  41. Tal A, Pasterkamp H, Serrette C, Leahy F, Chernick V (1984) Response to cold air hyperventilation in normal and in asthmatic children. J Pediatr 104:516–521

    Article  PubMed  CAS  Google Scholar 

  42. Tessier P, Cartier A, L’Archevéque J, Ghezzo H, Martin RR, Malo JL (1986) Within- and between-day reproducibility of isocapnic cold air challenges in subjects with asthma. J Allergy Clin Immunol 78:379–387

    Article  PubMed  CAS  Google Scholar 

  43. van Aalderen WMC, Postma DS, Koeter GH, Knol K (1989) Circadian change in bronchial responsiveness and airflow obstruction in asthmatic children. Thorax 44:803–807

    PubMed  Google Scholar 

  44. Wiebicke W, Poynter A, Montgomery M, Chernick V, Pasterkamp H (1988) Effect of terfenadine on the response to exercise and cold air in asthma. Pediatr Pulmonol 4:225–229

    Article  PubMed  CAS  Google Scholar 

  45. Wilson NM, Barnes PJ, Vickers H, Silverman M (1982) Hyperventilation-induced asthma: evidence for two mechanisms. Thorax 37:657–662

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Krankenhaus Grosshansdorf, Zentrum für Pneumologie und Thoraxchirurgie, LVA Freie und Hansestadt Hamburg, Germany

    D. Nowak, G. Kuziek, R. Jörres & H. Magnussen

Authors
  1. D. Nowak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Kuziek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Jörres
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. Magnussen
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nowak, D., Kuziek, G., Jörres, R. et al. Comparison of refractoriness after exercise-and hyperventilation-induced asthma. Lung 169, 57–67 (1991). https://doi.org/10.1007/BF02714143

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02714143

Key words

Search

Navigation