Tags

Type your tag names separated by a space and hit enter

Relationship between loss in parenchymal elastic recoil pressure and maximal airway narrowing in subjects with alpha1-antitrypsin deficiency.
Am J Respir Crit Care Med. 1997 Jan; 155(1):135-40.AJ

Abstract

Airway hyperresponsiveness is characterized by an increase in sensitivity and excessive airway narrowing to inhaled bronchoconstrictor stimuli. There is experimental evidence that maximal airway narrowing is related to lung elasticity in normal and asthmatic subjects. We hypothesized that reduced lung elasticity by parenchymal destruction increases the level of maximal airway narrowing in subjects with alpha1-antitrypsin deficiency. To that end, we measured complete dose-response curves to methacholine, quasistatic pressure-volume (P-V) curves, diffusion capacity for carbon monoxide per unit lung volume (DLCO/VA), and mean lung density by spirometrically controlled computed tomography (CT) scan in eight non- or ex-smoking subjects with alpha1-antitrypsin deficiency. Methacholine dose-response curves were expressed as the provocative concentration causing 20% fall in FEV1 (PC20). A maximal response plateau was considered if > or = 3 highest doses fell within a 5% response range, the maximal response (MFEV1) being the average value on the plateau. The P-V curves were characterized by an index of compliance (exponent K), and elastic recoil pressures at 90, and 100% of TLC (PL90 and PLmax). In all subjects a complete dose-response curve to methacholine could be recorded. MFEV1 was significantly correlated with logPC20 (r = -0.94, p < 0.001), but not with baseline FEV1 (r = -0.53, p > 0.15). There was a significant relationship between MFEV1 and PL90 (r = -0.79, p < 0.02), PLmax (r = -0.87, p < 0.005), and K (r = 0.79, p < 0.02). Furthermore MFEV1 was significantly correlated with DLCO/VA (r = -0.76, p < 0.03) and with lung density (r = 0.78, p < 0.04). We conclude that in subjects with alpha1-antitrypsin deficiency the level of maximal airway narrowing increases with loss in lung elasticity, with reduction in diffusing capacity, and with lowered mean lung density. This suggests that loss in elastic recoil pressure secondary to parenchymal destruction contributes to excessive airway narrowing in humans in vivo.

Authors+Show Affiliations

Department of Pulmonology, Leiden University Hospital, and Department of Medical Statistics, State University Leiden, the Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9001302

Citation

Cheung, D, et al. "Relationship Between Loss in Parenchymal Elastic Recoil Pressure and Maximal Airway Narrowing in Subjects With Alpha1-antitrypsin Deficiency." American Journal of Respiratory and Critical Care Medicine, vol. 155, no. 1, 1997, pp. 135-40.
Cheung D, Schot R, Zwinderman AH, et al. Relationship between loss in parenchymal elastic recoil pressure and maximal airway narrowing in subjects with alpha1-antitrypsin deficiency. Am J Respir Crit Care Med. 1997;155(1):135-40.
Cheung, D., Schot, R., Zwinderman, A. H., Zagers, H., Dijkman, J. H., & Sterk, P. J. (1997). Relationship between loss in parenchymal elastic recoil pressure and maximal airway narrowing in subjects with alpha1-antitrypsin deficiency. American Journal of Respiratory and Critical Care Medicine, 155(1), 135-40.
Cheung D, et al. Relationship Between Loss in Parenchymal Elastic Recoil Pressure and Maximal Airway Narrowing in Subjects With Alpha1-antitrypsin Deficiency. Am J Respir Crit Care Med. 1997;155(1):135-40. PubMed PMID: 9001302.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between loss in parenchymal elastic recoil pressure and maximal airway narrowing in subjects with alpha1-antitrypsin deficiency. AU - Cheung,D, AU - Schot,R, AU - Zwinderman,A H, AU - Zagers,H, AU - Dijkman,J H, AU - Sterk,P J, PY - 1997/1/1/pubmed PY - 1997/1/1/medline PY - 1997/1/1/entrez SP - 135 EP - 40 JF - American journal of respiratory and critical care medicine JO - Am. J. Respir. Crit. Care Med. VL - 155 IS - 1 N2 - Airway hyperresponsiveness is characterized by an increase in sensitivity and excessive airway narrowing to inhaled bronchoconstrictor stimuli. There is experimental evidence that maximal airway narrowing is related to lung elasticity in normal and asthmatic subjects. We hypothesized that reduced lung elasticity by parenchymal destruction increases the level of maximal airway narrowing in subjects with alpha1-antitrypsin deficiency. To that end, we measured complete dose-response curves to methacholine, quasistatic pressure-volume (P-V) curves, diffusion capacity for carbon monoxide per unit lung volume (DLCO/VA), and mean lung density by spirometrically controlled computed tomography (CT) scan in eight non- or ex-smoking subjects with alpha1-antitrypsin deficiency. Methacholine dose-response curves were expressed as the provocative concentration causing 20% fall in FEV1 (PC20). A maximal response plateau was considered if > or = 3 highest doses fell within a 5% response range, the maximal response (MFEV1) being the average value on the plateau. The P-V curves were characterized by an index of compliance (exponent K), and elastic recoil pressures at 90, and 100% of TLC (PL90 and PLmax). In all subjects a complete dose-response curve to methacholine could be recorded. MFEV1 was significantly correlated with logPC20 (r = -0.94, p < 0.001), but not with baseline FEV1 (r = -0.53, p > 0.15). There was a significant relationship between MFEV1 and PL90 (r = -0.79, p < 0.02), PLmax (r = -0.87, p < 0.005), and K (r = 0.79, p < 0.02). Furthermore MFEV1 was significantly correlated with DLCO/VA (r = -0.76, p < 0.03) and with lung density (r = 0.78, p < 0.04). We conclude that in subjects with alpha1-antitrypsin deficiency the level of maximal airway narrowing increases with loss in lung elasticity, with reduction in diffusing capacity, and with lowered mean lung density. This suggests that loss in elastic recoil pressure secondary to parenchymal destruction contributes to excessive airway narrowing in humans in vivo. SN - 1073-449X UR - https://www.unboundmedicine.com/medline/citation/9001302/Relationship_between_loss_in_parenchymal_elastic_recoil_pressure_and_maximal_airway_narrowing_in_subjects_with_alpha1_antitrypsin_deficiency_ L2 - http://www.atsjournals.org/doi/full/10.1164/ajrccm.155.1.9001302?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -