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Protective effect of bronchial challenge with hypertonic saline on nocturnal asthma.
Borges, M C; Ferraz, E; Terra-Filho, J; Vianna, E O.
Afiliação
  • Borges MC; Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Braz J Med Biol Res ; 41(3): 209-14, 2008 Mar.
Article em En | MEDLINE | ID: mdl-18575710
Inhalation of hypertonic saline (HS) causes bronchoconstriction in asthmatic subjects. Repeated inhalation of HS leads to substantially reduced bronchoconstriction, known as the refractory period. Refractoriness due to different stimuli has also been described (cross-refractoriness). Nocturnal asthma is defined as an increase in symptoms, need for medication, airway responsiveness, and/or worsening of lung function that usually occurs from 4 to 6 am. Our objective was to determine the effect of refractoriness on nocturnal asthma. The challenge test consisted of inhalations of 4.5% saline with increasing durations until a reduction of 20% in forced expiratory volume in 1 s (FEV1) (PD20HS) or total time of 15.5 min. Twelve subjects with nocturnal asthma were challenged with HS at 16:00 and 18:00 h and FEV1 was measured at 4:00 h. One to 2 weeks later, FEV1 was determined at 16:00 and 4:00 h. LogPD20HS at 18:00 h was significantly greater than logPD20HS at 16:00 h, 0.51 +/- 0.50 and 0.69 +/- 0.60 mg, respectively (P = 0.0033). When subjects underwent two HS challenges in the afternoon, mean (+/- SD) FEV1 reduction was 206 +/- 414 mL or 9.81 +/- 17.42%. On the control day (without challenge in the afternoon) FEV1 reduction was 523 +/- 308 mL or 22.75 +/- 15.40% (P = 0.021). Baseline FEV1 values did not differ significantly between the control and study days, 2.48 +/- 0.62 and 2.36 +/- 0.46 L, respectively. The refractory period following HS challenges reduces the nocturnal worsening of asthma. This new concept may provide beneficial applications to asthmatic patients.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Asma / Solução Salina Hipertônica / Testes de Provocação Brônquica Limite: Adult / Female / Humans / Male Idioma: En Revista: Braz J Med Biol Res Ano de publicação: 2008 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Asma / Solução Salina Hipertônica / Testes de Provocação Brônquica Limite: Adult / Female / Humans / Male Idioma: En Revista: Braz J Med Biol Res Ano de publicação: 2008 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil