Exercise-induced bronchoconstriction and non-specific airway hyperreactivity in patients suffering from bronchial asthma

Dobrivoje Novković; Vesna Škuletić; Aleksandra Vulin; Gordana Cvetković

doi:10.2298/2003

Dobrivoje Novković Department of Pulmonary Diseases, Military Medical Academy, Belgrade, Serbia
Vesna Škuletić Institute of Pathology, Military Medical Academy, Belgrade, Serbia
Aleksandra Vulin Institute of Cardiovascular Diseases, University Clinic of Cardiology, Sremska Kamenica, Serbia
Gordana Cvetković Department of Pulmonary Diseases, Military Medical Academy, Belgrade, Serbia

DOI: https://doi.org/10.2298/2003

Keywords: asthma, histamine, diagnosis, exercise test, respiratory function tests,

Abstract

Background/Aim. Physical activity is a common stimulus of asthmatic symptoms manifestation. Airway hyperreactivity is a predisposing cause of exercise induced bronchial obstruction, diagnosed by histamine inhalation. The aim of this study was to determine the relation between the amounts of histamine needed to induce non-specific airway hyperreactivity and exercise-induced bronchial obstruction. Methods. This randomized cross-over study included 160 male patients (age 19–27 years) suffering from bronchial asthma who showed positive results as the reaction after the histamine bronchial provocation test. Histamine concentrations were in a range of 0.03 to 4 mg/mL. Each patient participated in the exercise stress test conducted on a conveyor belt. The results of the exercise stress test were considered positive if the FEV1 level dropped by at least 15% from its initial value, 5–10 minutes after the test. Results. All the patients showed positive results as the reaction after the histamine bronchial provocation test, while 50 of them showed positive results after the exercise-induced stress test. There was a statistically highly significant difference in administrated histamine concentrations between the group of patients that had positive results on exercise stress test and those who did not (1mg/mL vs 0.5mg/mL; U = 1678; p < 0.01). Also, there was a statistically significant difference concerning the frequency of the positive results regarding histamine concentration after induced stress test (χ2 = 10.885; p = 0.001). Among the patients with positive results, there was a statistically highly significant number of patients with bronchial obstruction induced by less than 2 mg/mL of histamine (p < 0.01). A statisticlly significant relation between the amount of histamine needed to induce bronchial obstruction and the results of the exercise stress test (p < 0.01) was also observed after the testing. Conclusion. In the group of patients with positive results after the exercise-induced stress test, there were significantly more patients with positive results to non-specific bronchial provocation test with lower histamine concentrations. Histamine concentrations needed to induce non-specific hyperreactivity of asthmatic airway were shown to be related to the reactivity to physical effort.

Author Biographies

Dobrivoje Novković, Department of Pulmonary Diseases, Military Medical Academy, Belgrade, Serbia

Clinic for lugn disease

Vesna Škuletić, Institute of Pathology, Military Medical Academy, Belgrade, Serbia

Institut for pathology

Aleksandra Vulin, Institute of Cardiovascular Diseases, University Clinic of Cardiology, Sremska Kamenica, Serbia

Clinik for cardiology

Gordana Cvetković, Department of Pulmonary Diseases, Military Medical Academy, Belgrade, Serbia

Clinic for lung disease

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