Pattern of Response to Bronchial Challenge with Histamine in Patients with Non-Atopic Cough-Variant and Classic Asthma
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Group
- Age greater than 18 years
- Established diagnosis of CA or CVA in the previous 12 months
- Diagnosis of CA was made according to Global Initiative for Asthma (GINA) criteria [12]
- Diagnosis of CVA was based on: positive challenge testing, clinical improvement while on inhaled corticosteroid (ICS) treatment, and exclusion of other causes of chronic cough. All three criteria were fulfilled in patients with CVA.
- Stable diseases, without exacerbation in the 3 months prior to screening. GINA criteria for CA exacerbation were followed, while for CVA, exacerbation was defined by a board certified senior physician.
- Non-smoker or ex-smokers with smoking history of less than 10 pack/years
- Well-controlled chronicvasomotoric rhinitis
- Non-atopy, defined as negative prick skin testing in previous 6 months, normal values of serum immunoglobulin E (IgE), and normal blood eosinophils count.
- Exacerbation of CA or CVA in the 3 months prior to screening
- Exacerbation of CA or CVA between screening and testing
- Exacerbation of chronic rhinitis before screening or between two visits
- Documented positive skin prick testing and/or eosinophylls (Eo) peripheral blood count greater than 150 cells/mm3, and or sIgE levels greater than 300 I/U
- Verified allergic rhinitis, seasonal or perennial
- Active smokers or ex-smokers with history of more than 10 pack/years
- Unwillingness to further participate in the study
- D1—second to last dose of histamine before fall of FEV1 > 10%
- D2—last dose of histamine after which fall of FEV1 > 10% was recorded
- R1—Percentage of FEV1 fall after D1
- R2—Percentage of FEV1 fall after D2
- D1—second to last dose of histamine before fall of FEV1 > 20%
- D2—last dose of histamine after which fall of FEV1 > 20% was recorded
- R1—Percentage of FEV1 fall after D1
- R2—Percentage of FEV1 fall after D2
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Parameter | Cough-Variant Asthma (n = 49) | “Classic” Asthma (n = 108) | p |
---|---|---|---|
Age (years, MV ± SD) | 40.84 ± 11.39 | 37.52 ± 11.24 | >0.05 a |
Age of asthma diagnosis (years, MV ± SD) | 30.53 ± 10.34 | 28.17 ± 9.51 | >0.05 a |
Males (n, percent) | 11, 22.4% | 37, 34.3% | <0.01 b |
Females (n, percent) | 38, 77.6% | 71, 65.7% | <0.01 b |
Family history of asthma (n, percent) | 10, 20.4% | 29, 26.9% | <0.01 b |
Chronic vasomotoric rhinitis (n, percent) | 18, 36.7% | 61, 56.5% | <0.01 b |
Eo (cells/mm3, MV ± SD) | 116.69 ± 27.25 | 103.10 ± 27.68 | <0.05 a |
sIgE (IU, MV ± SD) | 112.18 ± 35.43 | 111.99 ± 36.15 | >0.05 a |
BMI (kg/m2, MV ± SD) | 26.11 ± 4.69 | 24.73 ± 4.09 | >0.05 a |
Daily ICS dose (mcg budesonide equivalent, MV ± SD) | 289.79 ± 100.5 | 283.33 ± 99.06 | >0.05 a |
FVC (% of predicted, MV ± SD) | 101.04 ± 6.33 | 102.04 ± 6.34 | >0.05 a |
FEV1 (% o fpredicted, MV ± SD) | 94.57 ± 5.81 | 95.97 ± 5.93 | >0.05 a |
Parameter | Cough-Variant Asthma (N = 49) | “Classic” Asthma (N = 108) | p |
---|---|---|---|
Positive challenge (n, percent) | 22, 44.9% | 69, 63.9% | <0.05 a |
PD10 (mcg, MV ± SD) | 207.06 ± 207.72 | 88.48 ± 129.39 | <0.05 b |
PD20 (mcg, MV ± SD) | 489.54 ± 495.99 | 442.88 ± 604.56 | >0.05 b |
FEV1 fall (percent, MV ± SD) | 40.48 ± 46.98 | 33.80 ± 14.75 | >0.05 b |
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Zugic, V.; Mujovic, N.; Hromis, S.; Jankovic, J.; Drvenica, M.; Perovic, A.; Kopitovic, I.; Ilic, A.; Nikolic, D. Pattern of Response to Bronchial Challenge with Histamine in Patients with Non-Atopic Cough-Variant and Classic Asthma. J. Clin. Med. 2018, 7, 174. https://doi.org/10.3390/jcm7070174
Zugic V, Mujovic N, Hromis S, Jankovic J, Drvenica M, Perovic A, Kopitovic I, Ilic A, Nikolic D. Pattern of Response to Bronchial Challenge with Histamine in Patients with Non-Atopic Cough-Variant and Classic Asthma. Journal of Clinical Medicine. 2018; 7(7):174. https://doi.org/10.3390/jcm7070174
Chicago/Turabian StyleZugic, Vladimir, Natasa Mujovic, Sanja Hromis, Jelena Jankovic, Mirjana Drvenica, Aleksandra Perovic, Ivan Kopitovic, Aleksandra Ilic, and Dejan Nikolic. 2018. "Pattern of Response to Bronchial Challenge with Histamine in Patients with Non-Atopic Cough-Variant and Classic Asthma" Journal of Clinical Medicine 7, no. 7: 174. https://doi.org/10.3390/jcm7070174