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  • 1
    Electronic Resource
    Electronic Resource
    Cough variant asthma is associated with a higher wheezing threshold than classic asthma (1993)
    Oxford, UK : Blackwell Publishing Ltd
    Clinical & experimental allergy 23 (1993), S. 0 
    Details
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Cough variant asthma is an occult form of asthma in which the only sign or symptom is chronic cough. It is a common problem amongst all ages that frequently goes unrecognized, leading to under diagnosis and under treatment. To characterize the pathophysiological abnormalities in these patients, we performed bronchial provocation tests with methacholine using the stepwise doubling concentration technique, and measured the concentration of methacholine and the severity of airway obstruction when wheezing was first detected. Airway hyper responsiveness, defined as PC20 in the cough variant asthma group was not significantly different from that of classic asthma. There was a good correlation between the PCW (the concentration of methacholine causing wheezing) and the PC20 with the PCW values higher than PC20 values in both groups. However, in the cough variant asthma group, the PCW: PC20 ratio was greater than that of the classic asthma group. Furthermore, the mean % fall in FEV1 at which wheezing was first detected in the former group was significantly larger than that of the latter group. The results indicated that the mechanism for the manifestation of cough without wheeze in the cough variant asthma may be a higher wheezing threshold, i.e. wheezing becomes audible at the greater degree of airway obstruction than classic asthma. They suggested that patients with cough variant asthma may represent a subset of asthmatic subjects whose airways are less able to produce a wheeze.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2222.1993.tb01796.x
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  • 2
    Electronic Resource
    Electronic Resource
    Linkage between bronchial responsiveness to methacholine and gene markers of IL-4 cytokine gene cluster and T-cell receptor α/δ gene complex in Korean nuclear families (2001)
    Oxford, UK : Blackwell Science, Ltd
    Clinical & experimental allergy 31 (2001), S. 0 
    Details
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Several candidate genes have been reported to be linked to intermediate phenotypes of asthma in Caucasian populations.To evaluate linkage between phenotypes of asthma and gene markers of high affinity IgE receptor-β gene (D11S97), IL-4 cytokine gene cluster (IL-4R1), and T-cell receptor α/δ gene complex (D14S50) in Korean nuclear families.Nuclear families (127 probands and their 130 siblings) for the linkage analysis were ascertained through asthmatic children. Linkages between total serum IgE response, skin responses to common aeroallergens, and bronchial responsiveness to methacholine were performed using a sib-pair approach.The square difference of the slope of the dose–response curve (DRS) between sib-pairs with two IL-4R1 identical alleles was smaller than with one or with neither IL-4R1 identical allele (P = 0.004). As for D14S50, the differences of DRS between sib-pairs with two identical alleles and with one identical allele were smaller than with neither identical alleles (P = 0.01). As for D11S97, no significant differences were observed among the groups with identical alleles of two, one or zero. With regard to total serum IgE levels, no significant linkage was found between this phenotype and the above three gene markers. As for skin responses to common aeroallergens, significant evidence was obtained to establish a linkage between this phenotype and the marker IL-4R1 (P = 0.01). However, no significant linkage was found between this phenotype and the markers D11S97 and D14S50.The expression of bronchial responsiveness to methacholine may be influenced by genetic factors in the IL-4 cytokine gene cluster and/or T-cell receptor α/δ gene complex, but the genetic influence of the FcεRI-β gene may be minimal in the expression of bronchial responsiveness in Korean nuclear families.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2222.2001.00952.x
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  • 3
    Electronic Resource
    Electronic Resource
    Coding single nucleotide polymorphism in the high-affinity immunoglobulin E receptor b chain (Fc"RI-b) gene is associated with immunoglobulin E receptor-mediated histamine release from basophils (2002)
    Oxford, UK : Blackwell Science Ltd
    Clinical & experimental allergy 32 (2002), S. 0 
    Details
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Our previous work on linkage analysis showed that histamine release from basophils to anti-IgE stimuli was linked to the gene marker of chromosome 11q13, where the β chain of the high-affinity receptor for IgE (FcεRI-β) is located.Objective  To evaluate the association between FcεRI-mediated histamine release from basophils and four bi-allelic single nucleotide polymorphisms of the FcεRI-β gene.Methods  Phenotypes of asthma, such as maximal histamine release from basophils and atopy, were measured from 80 randomly recruited asthmatic children. Polymorphisms of the FcεRI-β gene were determined by PCR-based methods.Results  The polymorphism in exon 7, resulting in Glu to Gly substitution, was significantly associated with histamine release from basophils to anti-IgE stimuli, but not with total IgE levels and skin test responses to aeroallergens.Conclusion This study supports a role for the FcεRI-β gene in the expression of high affinity IgE receptor-mediated histamine release from basophils.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2222.2002.01295.x
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  • 4
    Electronic Resource
    Electronic Resource
    A comparison of serum haptoglobin levels between acute exacerbation and clinical remission in asthma (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Clinical & experimental allergy 26 (1996), S. 0 
    Details
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Bronchial asthma is characterized by airway inflammation, which underlies the phenomenon of bronchial hyperresponsiveness. The concentration of serum haploglobin (Hp), one of the acute phase reactant proteins, has been reported to correlate with bronchial hyperresponsiveness. The extent to which bronchoconstriction or airway inflammation contributes to airflow obstruction of exacerbation is presumed to determine the responsiveness to the initial bronchodilator therapy.Objective To see whether the Hp levels vary with the disease status of asthma, and also to test whether the Hp level at an acute exacerbation(AE) is correlated with the degree of response to initial bronchodilator therapy.Methods We measured serum Hp levels in 50 children with asthma at the times of an AE and a clinical remission(CR), and analysed the data according to the response to the initial bronchodilator therapy at AE.Results The serum concentration of Hp at AE (228.5 ± 80.8mg/dl, mean ± SD) was significantly (P 〈 0.01) higher than that at CR (152.3 ± 49.8mg/dl) in the total study population. The difference of Hp levels between AE and CR was more marked (101.7 ± 82.2 mg/dl) in the subjects (n= 19) who responded poorly (post-bronchodi-lator FEV1 〈 75% predicted) to the initial bronehodilator therapy at AE than that (61.0 ± 56.5mg/dl) of those (n= 31) who responded well (post-bronchodilator FEV1± 75% predicted). The Hp level at AE eorrelated with the degree of response to initial bronchodilator therapy (r=−0.36, P 〈 0.05), whereas it had no relationship with the severity of exacerbation (r= 0.04. P= 0.79).Conclusion Our results showed that Hp levels may be increased al ihe time of exacerbation in a given asthma patient. The finding that the elevation of Hp level at AE is more marked in the cases with poor response to initial bronchodilaior therapy at AE suggests that the increased Hp level at AE in asthma might relied the degree of airway inflammation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2222.1996.tb00509.x
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  • 5
    Electronic Resource
    Electronic Resource
    Airways of allergic rhinitics are ‘primed’ to repeated allergen inhalation challenge (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Clinical & experimental allergy 24 (1994), S. 0 
    Details
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The hypothesis that repeated exposure to a specific allergen will further increase bronchial responsiveness to that allergen is supported by indirect evidence. However, it has not been tested as intensely in the laboratory setting, and in some cases, conflicting results are presented. In order to test the hypothesis in the atopic subjects, allergen inhalation challenge tests were performed in 29 house dust mite (Dermatophagoides pternyssinus) sensitive subjects with allergic rhinitis. Nine subjects displayed early asthmatic responses (EARs) to the first challenge (Group 1). Twenty subjects with no significant airway response were submitted to the second challenge 24 h later. Thirteen subjects showed EARs (Group FI) and two of these showed late asthmatic responses (LARs)aswell. In Group II, there were significant changes between the first and second challenge in post-allergen early phase FEV1, (88.1 ± 4.2 vs 71.7 ± 4.2%, baseline, P 〈 0.05) and in post-allergen late phase FEV1, (93.1 ± 3.4 vs 86.6 ± 7.8. P 〈 0.05). After the second challenge. PD20 (provocative dose of methacholine required to produce a 20% fall in FEV1) decreased significantly from the baseline values. When challenged separately with twofold dose of allergen, only three and one of the Group II showed EAR and LAR respectively. PD20 did not change significantly after this challenge. These results indicated that two repeated exposure to allergen dose, which is not enough to cause significant airway responses at a time, may provoke asthmatic airway responses in the subjects with allergic rhinitis and that this effect of priming is not attributed to the cumulative dose but to the consequent effect of repeated allergen exposure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2222.1994.tb00244.x
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  • 6
    Electronic Resource
    Electronic Resource
    The importance of maximal airway response to methacholine in the prediction of asthma development in patients with allergic rhinitis (2002)
    Oxford, UK : Blackwell Science Ltd
    Clinical & experimental allergy 32 (2002), S. 0 
    Details
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Allergic rhinitis is a known predictor and correlate of asthma incidence. However, it is not clear which patients with allergic rhinitis are at greater risk of the development of asthma.Objective The aim of this study was to investigate whether airway hypersensitivity and/or increased maximal response on the dose–response curve to methacholine would predict the development of asthma in subjects with allergic rhinitis.Methods One hundred and forty-one children with allergic rhinitis were prospectively studied for 7 years. At the initiation of the study, bronchial provocation test with methacholine using a stepwise increasing concentration technique was performed to measure PC20 (provocative concentration causing a 20% fall in FEV1) and maximal response. Each subject was evaluated at least every 6 months and details of asthmatic symptoms or signs experienced during the intervening period were taken.Results Twenty of 122 subjects available for the follow-up developed asthma. Nine (19.6%) of 46 hypersensitive (PC20 〈 18 mg/mL) subjects developed asthma, compared with 11 (14.5%) of 76 normosensitive subjects (P = 0.462). Eight (32%) of 25 subjects without maximal response plateau developed asthma, compared with 12 (12.4%) of 97 subjects with maximal response plateau (P = 0.018). Score test for trend revealed a significant association between the level of maximal response (P = 0.007), but not the degree of methacholine PC20 (P = 0.123), and the future development of asthma.Conclusion An increased maximal airway response to methacholine is shown to be a better predictor for the future development of asthma in patients with allergic rhinitis, than airway hypersensitivity to methacholine.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2222.2002.01399.x
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  • 7
    Electronic Resource
    Electronic Resource
    Sputum eosinophilia in cough-variant asthma as a predictor of the subsequent development of classic asthma (2003)
    Oxford, UK : Blackwell Science Ltd
    Clinical & experimental allergy 33 (2003), S. 0 
    Details
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background A significant proportion of patients diagnosed with cough-variant asthma eventually manifest classic asthma signs, such as wheezing and dyspnoea. The aim of this study was to investigate whether the percentage of eosinophils and/or concentration of eosinophilic cationic protein (ECP) in sputum induced from patients with cough-variant asthma can predict the development of classic asthma.Methods Sixty-two children with cough-variant asthma were prospectively studied for 4 years. At the initiation of the study, sputum was induced with hypertonic saline, and the sputum samples were analysed for total and differential cell counts, and for ECP. Each subject was checked clinically at least every 3 months, and details of classic asthma signs experienced during the intervening periods were taken.Results Twenty-four (47.1%) of the 51 subjects available for follow-up developed signs of classic asthma, while 27 did not. The only significant difference in the sputum parameters between these two groups was a higher percentage of sputum eosinophils in subjects who developed classic asthma. A significant association was found between sputum eosinophil percentage and classic asthma development, but not between the concentration of sputum ECP and classic asthma development.Conclusion Sputum eosinophilia in cough-variant asthma may be a correlate of the later development of classic asthma. This suggests that sputum differential cell counts may be useful in the clinical management of patients with cough-variant asthma, as they may enable the prediction of the subsequent classic asthma development.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2222.2003.01788.x
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  • 8
    Electronic Resource
    Electronic Resource
    Sputum eosinophil counts and eosinophil cationic protein levels in cough-variant asthma and in classic asthma, and their relationships to airway hypersensitivity or maximal airway response to methacholine (2004)
    Oxford, UK : Munksgaard International Publishers
    Allergy 59 (2004), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  The aims of this study were to compare the degree of airway inflammation in cough-variant asthma (CVA) with that in classic asthma (CA), and to examine the relationship between airway inflammation and airway hypersensitivity or maximal airway response to methacholine in both conditions.Methods:  Sputum was induced in 41 CVA patients, in 41 methacholine PC20-matched CA patients, and in 20 healthy children. The sputum samples were analyzed for total and differential cell counts, and for eosinophilic cationic protein (ECP). A high-dose methacholine challenge test was performed in CVA and CA patients to determine PC20 and maximal airway response.Results:  Sputum eosinophil percentages and ECP levels were significantly elevated in CVA and CA vs the control, but no significant differences were found between the two asthma groups. In the two asthma groups, neither sputum parameters correlated significantly with methacholine PC20. However, the absence of a maximal response plateau or its higher level, when present, was associated with increased eosinophil percentages and ECP levels in the CVA group.Conclusions:  The degree of eosinophilic inflammation may not be causally related to differences in presented asthma manifestations. The identification of a maximal response plateau and the level of this plateau in patients with CVA may provide information pertinent to airway eosinophilic inflammation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1398-9995.2004.00655.x
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  • 9
    Electronic Resource
    Electronic Resource
    Changes in serum haptoglobin level after allergen challenge test in asthmatic children (1998)
    Oxford, UK : Blackwell Publishing Ltd
    Allergy 53 (1998), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Bronchial asthma is characterized by airway inflammation, which underlies the phenomenon of bronchial hyperresponsiveness. Previous studies have shown that this correlates with the serum concentration of haptoglobin. The occurrence of the late asthmatic response (LAR) after an allergen challenge test is associated with airway inflammation. The objectives of this study were to examine serum levels of haptoglobin during the 24 h after allergen challenge and to compare changes between the subjects with and without LAR. We studied two groups of children with perennial asthma who developed the early asthmatic response (EAR) only (group 1: n = 14), and EAR but also LAR (group II: n = 14) after an allergen (Dermatophagoides pteronyssinus) challenge test. Serum concentrations of haptoglobin were measured at baseline, at EAR, and at 2 h (recovery), 8 h (LAR), and 24 h after the challenge. Baseline levels were similar in the two groups (group I: 128±57 mg/dl: group II: 129±50 mg/dl). In group I, there was no significant change in the level at any time point; in contrast, the subjects in group II showed a relative fall (92±40 mg/dl) at 8 h, and an increase (161±79 mg/dl) at 24 h after the challenge. Our results indicate that the serum concentration of haptoglobin decreases at the time of LAR and is subsequently replenished during the ensuing time. Although further studies are needed, we think that haptoglobin may be inflused into the airways during the inflammatory process associated with LAR, and that this may be followed by “overshooting” production.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1398-9995.1998.tb03868.x
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  • 10
    Electronic Resource
    Electronic Resource
    The importance of maximal airway response to methacholine in the prediction of wheezing development in patients with cough-variant asthma (2002)
    Oxford, UK : Munksgaard International Publishers
    Allergy 57 (2002), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: A significant proportion of patients diagnosed with cough-variant asthma eventually manifest classic asthma signs, such as wheezing and dyspnea. The aim of this study was to investigate whether the degree of airway hypersensitivity and/or the level of maximal airway response can predict the development of wheezing in subjects with cough-variant asthma.Methods: At study initiation, a high-dose methacholine inhalation test was performed to measure provocative concentration causing a 20% fall (PC20) in forced expiratory volume in 1 s (FEV1) and maximal airway response. Each person was evaluated regularly every 3 months for 4 years and also on the occasion of wheezing being perceived for the first time.Results: Of the 48 patients available in the follow-up period, 21 (Group 1) developed clinical wheezing, while 27 (Group 2) did not. There was no significant difference in PC20 levels between the two groups. The level of maximal airway response, however, was significantly higher in Group 1 than in Group 2. The score test for trend revealed a significant association between the future development of wheezing and the level of maximal airway response (P = 0.007), but not the level of methacholine PC20 (P = 0.423).Conclusions: The level of maximal airway response, rather than the degree of airway hypersensitivity, may be an important risk factor for the future development of classic asthma in patients with cough-variant asthma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1034/j.1398-9995.2002.23602.x
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