Skip to main content
PMC home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1984 Jul 21;289(6438):149–151. doi: 10.1136/bmj.289.6438.149

Diminished bronchial reactivity to cold air in diabetic patients with autonomic neuropathy.

R W Heaton, R J Guy, B J Gray, P J Watkins, J F Costello
PMCID: PMC1442010  PMID: 6430388

Abstract

To investigate the role of neural pathways in the nonasthmatic response to eucapnic hyperventilation with below freezing air five diabetic patients with severe symptomatic autonomic neuropathy were studied. Their responses were compared with those shown by five diabetic patients without autonomic neuropathy and five non-diabetic controls. After bronchial provocation testing with cold air the diabetic patients with autonomic neuropathy did not show a significant fall in specific airways conductance (mean (SE) maximum percentage fall 2.0 (3)%), whereas conductance fell in the diabetic patients without neuropathy by 30.8 (2.0)% (p less than 0.001) and in the non-diabetic controls by 22.7 (4.6)% (p less than 0.02). In subjects who do not have asthma the bronchial response to cold air is mediated largely via neural mechanisms.

Full text

PDF
149

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Benson M. K. Bronchial hyperreactivity. Br J Dis Chest. 1975 Oct;69(0):227–239. doi: 10.1016/0007-0971(75)90090-x. [DOI] [PubMed] [Google Scholar]
  2. Douglas N. J., Campbell I. W., Ewing D. J., Clarke B. F., Flenley D. C. Reduced airway vagal tone in diabetic patients with autonomic neuropathy. Clin Sci (Lond) 1981 Nov;61(5):581–584. doi: 10.1042/cs0610581. [DOI] [PubMed] [Google Scholar]
  3. Ewing D. J., Campbell I. W., Clarke B. F. The natural history of diabetic autonomic neuropathy. Q J Med. 1980 Winter;49(193):95–108. [PubMed] [Google Scholar]
  4. Griffin M. P., Fung K. F., Ingram R. H., Jr, McFadden E. R., Jr Dose-response effects of atropine on thermal stimulus-response relationships in asthma. J Appl Physiol Respir Environ Exerc Physiol. 1982 Dec;53(6):1576–1582. doi: 10.1152/jappl.1982.53.6.1576. [DOI] [PubMed] [Google Scholar]
  5. Hargreave F. E., Ryan G., Thomson N. C., O'Byrne P. M., Latimer K., Juniper E. F., Dolovich J. Bronchial responsiveness to histamine or methacholine in asthma: measurement and clinical significance. J Allergy Clin Immunol. 1981 Nov;68(5):347–355. doi: 10.1016/0091-6749(81)90132-9. [DOI] [PubMed] [Google Scholar]
  6. Heaton R. W., Henderson A. F., Gray B. J., Costello J. F. The bronchial response to cold air challenge: evidence for different mechanisms in normal and asthmatic subjects. Thorax. 1983 Jul;38(7):506–511. doi: 10.1136/thx.38.7.506. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Henderson A. F., Heaton R. W., Costello J. F. Effect of nifedipine on bronchoconstriction induced by inhalation of cold air. Thorax. 1983 Jul;38(7):512–515. doi: 10.1136/thx.38.7.512. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Jammes Y., Barthelemy P., Delpierre S. Respiratory effects of cold air breathing in anesthetized cats. Respir Physiol. 1983 Oct;54(1):41–54. doi: 10.1016/0034-5687(83)90112-3. [DOI] [PubMed] [Google Scholar]
  9. Levin A. B. A simple test of cardiac function based upon the heart rate changes induced by the Valsalva maneuver. Am J Cardiol. 1966 Jul;18(1):90–99. doi: 10.1016/0002-9149(66)90200-1. [DOI] [PubMed] [Google Scholar]
  10. O'Byrne P. M., Ryan G., Morris M., McCormack D., Jones N. L., Morse J. L., Hargreave F. E. Asthma induced by cold air and its relation to nonspecific bronchial responsiveness to methacholine. Am Rev Respir Dis. 1982 Mar;125(3):281–285. doi: 10.1164/arrd.1982.125.3.281. [DOI] [PubMed] [Google Scholar]
  11. O'Byrne P. M., Thomson N. C., Morris M., Roberts R. S., Daniel E. E., Hargreave F. E. The protective effect of inhaled chlorpheniramine and atropine on bronchoconstriction stimulated by airway cooling. Am Rev Respir Dis. 1983 Oct;128(4):611–617. doi: 10.1164/arrd.1983.128.4.611. [DOI] [PubMed] [Google Scholar]
  12. Sheppard D., Epstein J., Holtzman M. J., Nadel J. A., Boushey H. A. Dose-dependent inhibition of cold air-induced bronchoconstriction by atropine. J Appl Physiol Respir Environ Exerc Physiol. 1982 Jul;53(1):169–174. doi: 10.1152/jappl.1982.53.1.169. [DOI] [PubMed] [Google Scholar]
  13. Wieling W., van Brederode J. F., de Rijk L. G., Borst C., Dunning A. J. Reflex control of heart rate in normal subjects in relation to age: a data base for cardiac vagal neuropathy. Diabetologia. 1982 Mar;22(3):163–166. doi: 10.1007/BF00283745. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES