1
|
Huang S, Garshick E, Weschler LB, Hong C, Li J, Li L, Qu F, Gao D, Zhou Y, Sundell J, Zhang Y, Koutrakis P. Home environmental and lifestyle factors associated with asthma, rhinitis and wheeze in children in Beijing, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 256:113426. [PMID: 31672368 PMCID: PMC7050389 DOI: 10.1016/j.envpol.2019.113426] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 05/04/2023]
Abstract
BACKGROUND The prevalence of asthma and allergic diseases has increased rapidly in urban China since 2000. There has been limited study of associations between home environmental and lifestyle factors with asthma and symptoms of allergic disease in China. METHODS In a cross-sectional analysis of 2214 children in Beijing, we applied a two-step hybrid Least Absolute Shrinkage and Selection Operator (LASSO) algorithm to identify environmental and lifestyle-related factors associated with asthma, rhinitis and wheeze from a wide range of candidates. We used group LASSO to select variables, using cross-validation as the criterion. Effect estimates were then calculated using adaptive LASSO. Model performance was assessed using Area Under the Curve (AUC) values. RESULTS We found a number of environmental and lifestyle-related factors significantly associated with asthma, rhinitis or wheeze, which changed the probability of asthma, rhinitis or wheeze from -5.76% (95%CI: -7.74%, -3.79%) to 27.4% (95%CI: 16.6%, 38.3%). The three factors associated with the largest change in probability of asthma were short birth length, carpeted floor and paternal allergy; for rhinitis they were maternal smoking during pregnancy, paternal allergy and living close to industrial area; and for wheeze they were carpeted floor, short birth length and maternal allergy. Other home environmental risk factors identified were living close to a highway, industrial area or river, sharing bedroom, cooking with gas, furry pets, cockroaches, incense, printer/photocopier, TV, damp, and window condensation in winter. Lifestyle-related risk factors were child caretakers other than parents, and age<3 for the day-care. Other risk factors included use of antibiotics, and mother's occupation. Major protective factors for wheeze were living in a rural/suburban region, air conditioner use, and mother's occupation in healthcare. CONCLUSIONS Our findings suggest that changes in lifestyle and indoor environments associated with the urbanization and industrialization of China are associated with asthma, rhinitis, and wheeze in children.
Collapse
Affiliation(s)
- Shaodan Huang
- Department of Building Science, Tsitnghua University, Beijing, 100084, China; Beijing Key Lab of Indoor Air Quality Evaluation and Control, Beijing, 100084, China; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, USA
| | - Eric Garshick
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, MA, 02132, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Louise B Weschler
- Department of Building Science, Tsitnghua University, Beijing, 100084, China; 161 Richdale Road, Colts Neck, NJ, 07722, USA
| | - Chuan Hong
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, 02115, USA
| | - Jing Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, USA.
| | - Linyan Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, USA
| | - Fang Qu
- Department of Building Science, Tsitnghua University, Beijing, 100084, China; China Meteorological Administration Training Centre, China Meteorological Administration, Beijing, 100081, China
| | - Dewen Gao
- Beijing Key Lab of Indoor Air Quality Evaluation and Control, Beijing, 100084, China
| | - Yanmin Zhou
- School of Architecture, Tsinghua University, Beijing, 100084, China; Beijing Key Lab of Indoor Air Quality Evaluation and Control, Beijing, 100084, China
| | - Jan Sundell
- School of Environmental Science and Engineering, Tianjin University, Tianjing, 300072, China
| | - Yinping Zhang
- Department of Building Science, Tsitnghua University, Beijing, 100084, China; Beijing Key Lab of Indoor Air Quality Evaluation and Control, Beijing, 100084, China.
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, 02115, USA
| |
Collapse
|
2
|
Bonadonna P, Senna G, Zanon P, Cocco G, Dorizzi R, Gani F, Landi M, Restuccia M, Feliciello A, Passalacqua G. Cold-Induced Rhinitis in Skiers—Clinical Aspects and Treatment with Ipratropium Bromide Nasal Spray: A Randomized Controlled Trial. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/194589240101500502] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cold-induced rhinitis (CIR) is common among skiers and is perceived as a troublesome disease. We studied the clinical characteristics of CIR in a population of skiers and we evaluated the effectiveness of ipratropium bromide nasal spray (IBNS) in relieving symptoms in a double-blind placebo-controlled fashion. By means of specific questionnaires, we evaluated 144 subjects (69% men; mean age, 42.2 years). The prevalence of CIR was 48.6% and the distinctive symptom was rhinorrhea (96%), often severe. The prevalence of atopy was higher in the CIR patients (χ2; p = 0.004). Twenty-eight CIR subjects participated in a double-blind placebo-controlled cross-over trial for evaluating the effectiveness of IBNS (80 μg twice per day [b.i.d.]). The severity of symptoms was assessed by a visual analog scale, and the number of cleaning tissues used also was evaluated. The actively treated group showed a significant improvement of rhinorrhea (p = 0.0007) and a reduction in the number of cleaning tissues used (p = 0.0023). Only four mild local side effects were reported. We conclude that IBNS could be regarded as an optimal therapeutic option for treating CIR symptoms in skiers.
Collapse
Affiliation(s)
| | | | - Piero Zanon
- Divisione di Pneumologia, Ospedale Busto Arsizio, Varese, Italy
| | - Giulio Cocco
- Divisione di Pneumologia, Ospedale Cardarelli, Napoli, Italy
| | - Romolo Dorizzi
- Allergy Unit Laboratorio Analisi Chimico Cliniche, Verona General Hospital, Verona, Italy
| | - Federica Gani
- Divisione di Pneumologia, Ospedale S. Luigi, Orbassano, Torino, Italy
| | - Massimo Landi
- Servizio di Allergologia, Ospedale Kolliker, Torino, Italy
| | | | | | | |
Collapse
|
3
|
Liu SC, Lu HH, Fan HC, Wang HW, Chen HK, Lee FP, Yu CJ, Chu YH. The identification of the TRPM8 channel on primary culture of human nasal epithelial cells and its response to cooling. Medicine (Baltimore) 2017; 96:e7640. [PMID: 28767579 PMCID: PMC5626133 DOI: 10.1097/md.0000000000007640] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND It has been proposed that the transient receptor potential (TRP) channel Melastatin 8 (TRPM8) is a cold-sensing TRP channel. However, its presence and its role in the nasal cavity have not yet been fully studied. METHODS Immunohistology was used to study TRPM8 receptors in both the nasal mucosa tissue and the primary cultures of human nasal cells. Cells from primary cultures were immunostained with antibodies to TRPM8, mucin, cytokeratin (CK)-14, CK-18, and vimentin. Western blotting and real-time polymerase chain reaction (PCR) were used to determine the physiological role of TRPM8 in mucus production in the nasal cavity, with and without its agonist and antagonist. RESULTS The TRPM8 is clearly present in the epithelium, mucous glands, and vessels. No obvious TRPM8-immunoreactive cells were detected in the connective tissue. Immunostaining of cytospin preparations showed that epithelial cells test positive for CK-14, CK-18, TRPM8, and mucin 5AC (MUC5AC). Fibroblastic cells are stained negative for TRPM8. Secreted mucins in the cultured supernatant are detected after exposure to menthol and moderate cooling to 24°C. Both induce a statistically significant increase in the level of MUC5AC mRNA and mucin production. BCTC, a TRPM8 antagonist, has a statistically significant inhibitory effect on MUC5AC mRNA expression and MUC5AC protein production that is induced by menthol and moderate cooling to 24°C. CONCLUSIONS The study demonstrates that TRPM8 is present in the nasal epithelium. When it is activated by moderate cooling to 24°C or menthol, TRPM8 induces the secretion of mucin. This study shows that TRPM8 channels are important regulators of mucin production. Therefore, TRPM8 antagonists could be used to treat refractory rhinitis.
Collapse
Affiliation(s)
- Shao-Cheng Liu
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University
| | - Hsuan-Hsuan Lu
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University
- Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Hueng-Chuen Fan
- Department of Pediatrics, Tungs’ Taichung Metro Harbor Hospital
| | - Hsing-Won Wang
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University
- Department of Otolaryngology-Head and Neck Surgery, Shuang Ho Hospital, Taipei, Taiwan, Republic of China
| | - Hang-Kang Chen
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center
| | - Fei-Peng Lee
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University
| | - Chong-Jen Yu
- Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Yueng-Hsiang Chu
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center
| |
Collapse
|
4
|
|
5
|
Abstract
The otolaryngic allergist must be able to distinguish between common nonallergic diagnoses that present very similarly to allergic conditions. This article describes a few of the vast myriad of conditions that must be ruled out before a diagnosis of allergy may be made. After reading this article clinicians will be able to identify various conditions, which will enhance their ability to appropriately make correct decisions for prompt and efficient management of their patients with allergic or nonallergic diseases of the head and neck.
Collapse
Affiliation(s)
- Robert J Stachler
- Department of Otolaryngology Head and Neck Surgery, Henry Ford Health Systems, Detroit, MI, USA.
| | | |
Collapse
|
6
|
Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, van Weel C, Agache I, Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet LP, Bousquet PJ, Camargos P, Carlsen KH, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, van Wijk RG, Kalayci O, Kaliner MA, Kim YY, Kowalski ML, Kuna P, Le LTT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FER, Toskala E, Valovirta E, van Cauwenberge P, Wang DY, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Ben Kheder A, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek JM, Larenas-Linnemann D, Lipworth B, Malo JL, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy 2008; 63 Suppl 86:8-160. [PMID: 18331513 DOI: 10.1111/j.1398-9995.2007.01620.x] [Citation(s) in RCA: 3008] [Impact Index Per Article: 188.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
MESH Headings
- Adolescent
- Asthma/epidemiology
- Asthma/etiology
- Asthma/therapy
- Child
- Global Health
- Humans
- Prevalence
- Rhinitis, Allergic, Perennial/complications
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/epidemiology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/complications
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/epidemiology
- Rhinitis, Allergic, Seasonal/therapy
- Risk Factors
- World Health Organization
Collapse
Affiliation(s)
- J Bousquet
- University Hospital and INSERM, Hôpital Arnaud de Villeneuve, Montpellier, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Hall RL. Energetics of nose and mouth breathing, body size, body composition, and nose volume in young adult males and females. Am J Hum Biol 2005; 17:321-30. [PMID: 15849711 DOI: 10.1002/ajhb.20122] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This research tests the relative ability of body size factors and sex to explain variation in nose volume and to explain metabolic measures during rest and moderate exercise in 50 young adults. It uses standard anthropometric measures plus two new measures of nose morphology (nose/face angle and nose volume) and evaluates body composition with a device for air displacement plethysmography. Standard physiological measures were obtained in nose-only and mouth-only breathing conditions with subjects at rest and using moderate exercise. A factor representing linear and bulk measures of body size and a factor representing lean body mass explain subjects' variation in nose volume, resting volume of oxygen consumed (VO2), and resting ventilation volume (VV) better than subject's sex does. By contrast, during exercise, sex explains VO2 and VV better than do body size factors, probably because hormone-mediated muscularity in males produced greater work output. Nose breathing was found to be more energetically efficient in most but not all subjects, but additional research is needed to explore this finding further. Qualitative comparisons between modes of breathing and the application of this research protocol to studies of climate-related patterns of nasal variation are discussed.
Collapse
Affiliation(s)
- Roberta L Hall
- Department of Anthropology, Oregon State University, Corvallis, Oregon 97331, USA.
| |
Collapse
|
8
|
Hall R, Roy D, Boling D. Pleistocene migration routes into the Americas: Human biological adaptations and environmental constraints. Evol Anthropol 2004. [DOI: 10.1002/evan.20013] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
9
|
Kotaru C, Hejal RB, Finigan JH, Coreno AJ, Skowronski ME, Brianas L, McFadden ER. Desiccation and hypertonicity of the airway surface fluid and thermally induced asthma. J Appl Physiol (1985) 2003; 94:227-33. [PMID: 12391050 DOI: 10.1152/japplphysiol.00551.2002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To determine whether drying and hypertonicity of the airway surface fluid (ASF) are involved in thermally induced asthma, nine subjects performed isocapnic hyperventilation (HV) (minute ventilation 62.2 +/- 8.3 l/min) of frigid air (-8.9 +/- 3.3 degrees C) while periciliary fluid was collected endoscopically from the trachea. Osmolality was measured by freezing-point depression. The baseline 1-s forced expiratory volume was 73 +/- 4% of predicted and fell 26.4% 10 min postchallenge (P > 0.0001). The volume of ASF collected was 11.0 +/- 2.2 microl at rest and remained constant during and after HV as the airways narrowed (HV 10.6 +/- 1.9, recovery 6.5 +/- 1.7 microl; P = 0.18). The osmolality also remained stable throughout (rest 336 +/- 16, HV 339 +/- 16, and recovery 352 +/- 19 mosmol/kgH(2)O, P = 0.76). These data demonstrate that airway desiccation and hypertonicity of the ASF do not develop during hyperpnea in asthma; therefore, other mechanisms must cause exercise- and hyperventilation-induced airflow limitation.
Collapse
Affiliation(s)
- Chakradhar Kotaru
- General Clinical Research Center of Case Western Reserve University School of Medicine and Division of Pulmonary and Critical Care Medicine and Department of Medicine of University Hospitals of Cleveland, OH 44106, USA
| | | | | | | | | | | | | |
Collapse
|
10
|
Graudenz GS, Kalil J, Saldiva PH, Gambale W, Latorre MDRDO, Morato-Castro FF. Upper respiratory symptoms associated with aging of the ventilation system in artificially ventilated offices in São Paulo, Brazil. Chest 2002; 122:729-35. [PMID: 12171858 DOI: 10.1378/chest.122.2.729] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The increase of work-related respiratory complaints in artificially ventilated buildings has multiple causes, and the role of allergen exposure and symptoms is still controversial. STUDY OBJECTIVES To analyze the risk factors and the association of work-related symptoms with allergen exposure and different conditions of the same air conditioning system in São Paulo, Brazil. DESIGN Workers were classified according to characteristics of the air conditioning system: the first group (group 1) with ventilation machinery and ducts with > 20 years of use, the second group (group 2) with ventilation machinery with > 20 years of use and ventilation ducts with < 2 years of use, and the third group (group 3) with ventilation machinery and ducts with < 2 years of use. Logistic regression was performed to check the associations between air conditioning groups, allergen exposure (fungi, mites, animal dander, and cockroach), and symptoms. RESULTS There was a higher prevalence of building-related worsening of respiratory symptoms (p = 0.004; odds ratio [OR], 8.53) and symptoms of rhinoconjunctivitis (p = 0.01; OR, 8.49) in group 1. There was a lower relative humidity (p = 0.05) and nonsignificant lower temperature in group 1, when compared to the other groups. The viable mold spores totals were higher outdoors than in the indoor samples (n = 45, p = 0.017). There were higher levels of Der p 1 in group 2 (p = 0.032). All allergen levels were considered low. CONCLUSION There was a strong association of building-related upper-airway symptoms with places having ventilation systems with > 20 years of use.
Collapse
Affiliation(s)
- Gustavo S Graudenz
- Division of Allergy and Clinical Immunology, Internal Medicine Department, School of Medicine, University of São Paulo, Brazil.
| | | | | | | | | | | |
Collapse
|
11
|
Kotaru C, Hejal RB, Finigan JH, Coreno AJ, Skowronski ME, Brianas LJ, McFadden ER. Influence of hyperpnea on airway surface fluid volume and osmolarity in normal humans. J Appl Physiol (1985) 2002; 93:154-60. [PMID: 12070199 DOI: 10.1152/japplphysiol.00830.2001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To determine the effect of hyperpnea on the characteristics of periciliary liquid, we collected airway surface fluid (ASF) and measured its osmolarity in 11 normal people while they breathed dry, frigid air (-17 +/- 1.2 degrees C) at minute ventilations (VE) of 10, 40, and 80 l/min through a heat exchanger. The ASF was collected at the fifth tracheal ring by absorption onto filter paper pledgets inserted via fiber-optic bronchoscopy. Hyperpnea had no influence on the amount of ASF recovered (ASF volume at a VE of 10 l/min = 12.0 +/- 2.0 microl; at 80 l/min = 8.8 +/- 1.5 microl; P = 0.28) or its osmolarity (at a VE of 10, 40, and 80 l/min = 326 +/- 15, 323 +/- 11, and 337 +/- 12 mosM, respectively; P = 0.65). These findings demonstrate that the tracheal mucosa of normal subjects does not dessicate during hyperpnea and that hypertonicity of the periciliary fluid does not develop even at high levels of ventilation.
Collapse
Affiliation(s)
- C Kotaru
- General Clinical Research Center and Division of Pulmonary and Critical Care Medicine, University Hospitals of Cleveland, Ohio 44106, USA
| | | | | | | | | | | | | |
Collapse
|
12
|
Assanasen P, Baroody FM, Naureckas E, Solway J, Naclerio RM. Supine position decreases the ability of the nose to warm and humidify air. J Appl Physiol (1985) 2001; 91:2459-65. [PMID: 11717205 DOI: 10.1152/jappl.2001.91.6.2459] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We tested the hypothesis that decreasing nasal air volume (i.e., increasing nasal turbinate blood volume) improves nasal air conditioning. We performed a randomized, two-way crossover study on the conditioning capacity of the nose in six healthy subjects in the supine and upright position. Cold, dry air (CDA) was delivered to the nose via a nasal mask, and the temperature and humidity of air were measured before it entered and after it exited the nasal cavity. The total water gradient (TWG) across the nose was calculated and represents the nasal conditioning capacity. Nasal volume decreased significantly from baseline without changing the mucosal temperature when subjects were placed in the supine position (P < 0.01). TWG in supine position was significantly lower than that in upright position (P < 0.001). In the supine position, nasal mucosal temperature after CDA exposure was significantly lower than that in upright position (P < 0.01). Our data show that placing subjects in the supine position decreased the ability of the nose to condition CDA compared with the upright position, in contrast to our hypothesis.
Collapse
Affiliation(s)
- P Assanasen
- Section of Otolaryngology-Head and Neck Surgery, The Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
| | | | | | | | | |
Collapse
|
13
|
McLane ML, Nelson JA, Lenner KA, Hejal R, Kotaru C, Skowronski M, Coreno A, Lane E, McFadden ER. Integrated response of the upper and lower respiratory tract of asthmatic subjects to frigid air. J Appl Physiol (1985) 2000; 88:1043-50. [PMID: 10710402 DOI: 10.1152/jappl.2000.88.3.1043] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To evaluate the influence of cold air hyperpnea on integrated upper and lower airway behavior, 22 asthmatic volunteers hyperventilated through their mouths (OHV) and noses (NHV) while pulmonary and nasal function were determined individually and in combination. In the isolated studies, OHV at a minute ventilation of 65 +/- 3 l/min lowered the 1-s forced expiratory volume (FEV(1)) 24 +/- 2% (P < 0. 001) and NHV (40 l/min) induced a 31 +/- 9% (P < 0.001) increase in nasal resistance (NR). In the combined studies, oral hyperpnea reduced the FEV(1) (DeltaFEV(1) 26 +/- 2%, P < 0.001) and evoked a significant rise in NR (DeltaNR 26 +/- 9%, P = 0.01). In contrast, NHV only affected the upper airway. NR rose 33 +/- 9% (P = 0.01), but airway caliber did not change (DeltaFEV(1) 2%, P = 0.27). The results of this investigation demonstrate that increasing the transfer of heat and water in the lower respiratory tract alters bronchial and nasal function in a linked fashion. Forcing the nose to augment its heat-exchanging activity, however, reduces nasal caliber but has no effect on the intrathoracic airways.
Collapse
Affiliation(s)
- M L McLane
- Division of Pulmonary and Critical Care Medicine, University Hospitals of Cleveland, Cleveland, Ohio 44106, USA
| | | | | | | | | | | | | | | | | |
Collapse
|