Airway Responsiveness to Inhaled Aspirin is Influenced by Airway Hyperresponsiveness in Asthmatic Patients.
10.3904/kjim.2010.25.3.309
- Author:
Sungsoo KIM
1
;
Inseon S CHOI
;
Yeon Joo KIM
;
Chang Seong KIM
;
Eui Ryoung HAN
;
Dong Jin PARK
;
Dae Eun KIM
Author Information
1. Department of Allergy, Chonnam National University Medical School and Research Institute of Medical Sciences, Gwangju, Korea. ischoi@chonnam.ac.kr
- Publication Type:Original Article
- Keywords:
Asthma, aspirin-induced;
Methacholine;
Bronchial reactivity
- MeSH:
Administration, Inhalation;
Adolescent;
Adult;
Aspirin/*administration & dosage/*adverse effects;
Asthma/*physiopathology;
Asthma, Aspirin-Induced/etiology/physiopathology;
Bronchial Hyperreactivity/physiopathology;
Bronchial Provocation Tests;
Drug Hypersensitivity/etiology/physiopathology;
Female;
Humans;
Male;
Methacholine Chloride/*administration & dosage;
Retrospective Studies;
Young Adult
- From:The Korean Journal of Internal Medicine
2010;25(3):309-316
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Many patients with aspirin-induced asthma have severe methacholine airway hyperresponsiveness (AHR), suggesting a relationship between aspirin and methacholine in airway response. This study was performed to determine whether methacholine AHR affects the response of asthmatics to inhaled aspirin. METHODS: The clinical records of 207 asthmatic patients who underwent inhalation challenges with both aspirin and methacholine were reviewed retrospectively. An oral aspirin challenge was performed in patients with a negative inhalation response. The bronchial reactivity index (BRindex) was calculated from the percent decrease in lung function divided by the last dose of the stimulus. RESULTS: Forty-one (20.9%) and 14 (7.1%) patients showed a positive response to aspirin following an inhalation and oral challenge, respectively. Only 24.3 and 14.3% of the responders had a history of aspirin intolerance, respectively. The methacholine BRindex was significantly higher in the inhalation responders (1.46 +/- 0.02) than in the oral responders (1.36 +/- 0.03, p < 0.01) and in non-responders (n = 141, 1.37 +/- 0.01, p < 0.001). The aspirin BRindex was significantly correlated with the methacholine BRindex (r = 0.270, p < 0.001). Three of four patients who received the oral challenge, despite a positive inhalation test, showed negative responses to the oral challenge. Two of these patients had severe AHR. CONCLUSIONS: A considerable number of asthmatic patients with no history of aspirin intolerance responded to the inhalation aspirin challenge. The airway response to aspirin was significantly correlated with methacholine-AHR, and a false-positive response to aspirin inhalation test seemed to occur primarily in patients with severe AHR.
