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. 1994 Jun;49(6):540–544. doi: 10.1136/thx.49.6.540

Bronchial responsiveness and acute bronchodilator response in chronic obstructive pulmonary disease and diffuse panbronchiolitis.

H Koyama 1, K Nishimura 1, T Mio 1, A Ikeda 1, N Sugiura 1, T Izumi 1
PMCID: PMC474939  PMID: 8016789

Abstract

BACKGROUND--Diffuse panbronchiolitis (DPB) is characterised clinically by chronic airflow limitation and respiratory tract infection, and pathologically by chronic bronchiolar inflammation. To elucidate the functional differences between chronic obstructive pulmonary disease (COPD) and DPB the bronchial responsiveness to methacholine was compared in 64 patients with COPD and 32 patients with DPB, and the bronchodilator response was compared in 72 patients with COPD and 49 with DPB. METHODS--Bronchial responsiveness to methacholine was determined by the dosimeter method and expressed as PD20FEV1, and bronchodilator response was measured as the change in percentage predicted response with 5 mg nebulised salbutamol. RESULTS--Baseline FEV1 was similar in the two groups of patients. Patients with COPD were more responsive to methacholine than were those with DPB (geometric mean PD20FEV1 8.87 v 48.0 cumulative units). Reversibility of air flow obstruction, expressed as the difference between the percentage predicted postbronchodilator FEV1 and prebronchodilator FEV1, was significantly larger in patients with COPD than in those with DPB (7.87 (6.52)% v 4.16 (4.43)%). CONCLUSIONS--The observation that patients with DPB differ substantially in bronchial responsiveness from those with COPD is thought to reflect the difference in the mechanisms of these two diseases--that is, airway disease in DPB and more parenchymal disease in the group of patients with COPD. The nature of bronchiolar inflammation in COPD and DPB is also different, possibly explaining the difference in bronchial responsiveness. More fixed airflow limitation as a result of structural bronchiolar lesions in DPB will explain the smaller reversibility of airflow obstruction.

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Selected References

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  1. Anthonisen N. R., Wright E. C. Bronchodilator response in chronic obstructive pulmonary disease. Am Rev Respir Dis. 1986 May;133(5):814–819. [PubMed] [Google Scholar]
  2. BLAKEMORE W. S., FORSTER R. E., MORTON J. W., OGILVIE C. M. A standardized breath holding technique for the clinical measurement of the diffusing capacity of the lung for carbon monoxide. J Clin Invest. 1957 Jan;36(1 Pt 1):1–17. doi: 10.1172/JCI103402. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. 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]
  4. Brand P. L., Quanjer P. H., Postma D. S., Kerstjens H. A., Koëter G. H., Dekhuijzen P. N., Sluiter H. J. Interpretation of bronchodilator response in patients with obstructive airways disease. The Dutch Chronic Non-Specific Lung Disease (CNSLD) Study Group. Thorax. 1992 Jun;47(6):429–436. doi: 10.1136/thx.47.6.429. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Campbell A. H., Barter C. E., O'Connell J. M., Huggins R. Factors affecting the decline of ventilatory function in chronic bronchitis. Thorax. 1985 Oct;40(10):741–748. doi: 10.1136/thx.40.10.741. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Chai H., Farr R. S., Froehlich L. A., Mathison D. A., McLean J. A., Rosenthal R. R., Sheffer A. L., Spector S. L., Townley R. G. Standardization of bronchial inhalation challenge procedures. J Allergy Clin Immunol. 1975 Oct;56(4):323–327. doi: 10.1016/0091-6749(75)90107-4. [DOI] [PubMed] [Google Scholar]
  7. Chung K. F. Role of inflammation in the hyperreactivity of the airways in asthma. Thorax. 1986 Sep;41(9):657–662. doi: 10.1136/thx.41.9.657. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Clément J., Van De Woestijne K. P. Pressure correction in volume and flow-displacement body plethysmography. J Appl Physiol. 1969 Dec;27(6):895–897. doi: 10.1152/jappl.1969.27.6.895. [DOI] [PubMed] [Google Scholar]
  9. Desai S. J., Gephardt G. N., Stoller J. K. Diffuse panbronchiolitis preceding ulcerative colitis. Chest. 1989 Jun;95(6):1342–1344. doi: 10.1378/chest.95.6.1342. [DOI] [PubMed] [Google Scholar]
  10. Dompeling E., van Schayck C. P., Molema J., Akkermans R., Folgering H., van Grunsven P. M., van Weel C. A comparison of six different ways of expressing the bronchodilating response in asthma and COPD; reproducibility and dependence of prebronchodilator FEV1. Eur Respir J. 1992 Sep;5(8):975–981. [PubMed] [Google Scholar]
  11. Dompeling E., van Schayck C. P., Molema J., Folgering H., van Grunsven P. M., van Weel C. Inhaled beclomethasone improves the course of asthma and COPD. Eur Respir J. 1992 Sep;5(8):945–952. [PubMed] [Google Scholar]
  12. Eggleston P. A., Rosenstein B. J., Stackhouse C. M., Alexander M. F. Airway hyperreactivity in cystic fibrosis. Clinical correlates and possible effects on the course of the disease. Chest. 1988 Aug;94(2):360–365. doi: 10.1378/chest.94.2.360. [DOI] [PubMed] [Google Scholar]
  13. Homma H., Yamanaka A., Tanimoto S., Tamura M., Chijimatsu Y., Kira S., Izumi T. Diffuse panbronchiolitis. A disease of the transitional zone of the lung. Chest. 1983 Jan;83(1):63–69. doi: 10.1378/chest.83.1.63. [DOI] [PubMed] [Google Scholar]
  14. Hruban R. H., Meziane M. A., Zerhouni E. A., Khouri N. F., Fishman E. K., Wheeler P. S., Dumler J. S., Hutchins G. M. High resolution computed tomography of inflation-fixed lungs. Pathologic-radiologic correlation of centrilobular emphysema. Am Rev Respir Dis. 1987 Oct;136(4):935–940. doi: 10.1164/ajrccm/136.4.935. [DOI] [PubMed] [Google Scholar]
  15. Ip M., Lam W. K., So S. Y., Liong E., Chan C. Y., Tse K. M. Analysis of factors associated with bronchial hyperreactivity to methacholine in bronchiectasis. Lung. 1991;169(1):43–51. doi: 10.1007/BF02714140. [DOI] [PubMed] [Google Scholar]
  16. Izumi T. Diffuse panbronchiolitis. Chest. 1991 Sep;100(3):596–597. doi: 10.1378/chest.100.3.596. [DOI] [PubMed] [Google Scholar]
  17. Kadota J., Sakito O., Kohno S., Sawa H., Mukae H., Oda H., Kawakami K., Fukushima K., Hiratani K., Hara K. A mechanism of erythromycin treatment in patients with diffuse panbronchiolitis. Am Rev Respir Dis. 1993 Jan;147(1):153–159. doi: 10.1164/ajrccm/147.1.153. [DOI] [PubMed] [Google Scholar]
  18. Kelly C., Ward C., Stenton C. S., Bird G., Hendrick D. J., Walters E. H. Number and activity of inflammatory cells in bronchoalveolar lavage fluid in asthma and their relation to airway responsiveness. Thorax. 1988 Sep;43(9):684–692. doi: 10.1136/thx.43.9.684. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Mitchell I., Corey M., Woenne R., Krastins I. R., Levison H. Bronchial hyperreactivity in cystic fibrosis and asthma. J Pediatr. 1978 Nov;93(5):744–748. doi: 10.1016/s0022-3476(78)81070-1. [DOI] [PubMed] [Google Scholar]
  20. Mullen J. B., Wiggs B. R., Wright J. L., Hogg J. C., Paré P. D. Nonspecific airway reactivity in cigarette smokers. Relationship to airway pathology and baseline lung function. Am Rev Respir Dis. 1986 Jan;133(1):120–125. doi: 10.1164/arrd.1986.133.1.120. [DOI] [PubMed] [Google Scholar]
  21. Nagai A., West W. W., Thurlbeck W. M. The National Institutes of Health Intermittent Positive-Pressure Breathing trial: pathology studies. II. Correlation between morphologic findings, clinical findings, and evidence of expiratory air-flow obstruction. Am Rev Respir Dis. 1985 Nov;132(5):946–953. doi: 10.1164/arrd.1985.132.5.946. [DOI] [PubMed] [Google Scholar]
  22. Nagai H., Shishido H., Yoneda R., Yamaguchi E., Tamura A., Kurashima A. Long-term low-dose administration of erythromycin to patients with diffuse panbronchiolitis. Respiration. 1991;58(3-4):145–149. doi: 10.1159/000195915. [DOI] [PubMed] [Google Scholar]
  23. Nishimura K., Kitaichi M., Izumi T., Itoh H. Diffuse panbronchiolitis: correlation of high-resolution CT and pathologic findings. Radiology. 1992 Sep;184(3):779–785. doi: 10.1148/radiology.184.3.1509067. [DOI] [PubMed] [Google Scholar]
  24. O'Connor G. T., Sparrow D., Weiss S. T. The role of allergy and nonspecific airway hyperresponsiveness in the pathogenesis of chronic obstructive pulmonary disease. Am Rev Respir Dis. 1989 Jul;140(1):225–252. doi: 10.1164/ajrccm/140.1.225. [DOI] [PubMed] [Google Scholar]
  25. Pang J., Chan H. S., Sung J. Y. Prevalence of asthma, atopy, and bronchial hyperreactivity in bronchiectasis: a controlled study. Thorax. 1989 Nov;44(11):948–951. doi: 10.1136/thx.44.11.948. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Poletti V., Patelli M., Poletti G., Bertanti T., Spiga L. Diffuse panbronchiolitis observed in an Italian. Chest. 1990 Aug;98(2):515–516. doi: 10.1378/chest.98.2.515. [DOI] [PubMed] [Google Scholar]
  27. Postma D. S., de Vries K., Koëter G. H., Sluiter H. J. Independent influence of reversibility of air-flow obstruction and nonspecific hyperreactivity on the long-term course of lung function in chronic air-flow obstruction. Am Rev Respir Dis. 1986 Aug;134(2):276–280. doi: 10.1164/arrd.1986.134.2.276. [DOI] [PubMed] [Google Scholar]
  28. Pride N. B. Bronchial hyperreactivity in smokers. Eur Respir J. 1988 May;1(5):485–487. [PubMed] [Google Scholar]
  29. Randhawa P., Hoagland M. H., Yousem S. A. Diffuse panbronchiolitis in North America. Report of three cases and review of the literature. Am J Surg Pathol. 1991 Jan;15(1):43–47. [PubMed] [Google Scholar]
  30. Ruffin R. E., Dolovich M. B., Wolff R. K., Newhouse M. T. The effects of preferential deposition of histamine in the human airway. Am Rev Respir Dis. 1978 Mar;117(3):485–492. doi: 10.1164/arrd.1978.117.3.485. [DOI] [PubMed] [Google Scholar]
  31. Saetta M., Shiner R. J., Angus G. E., Kim W. D., Wang N. S., King M., Ghezzo H., Cosio M. G. Destructive index: a measurement of lung parenchymal destruction in smokers. Am Rev Respir Dis. 1985 May;131(5):764–769. doi: 10.1164/arrd.1985.131.5.764. [DOI] [PubMed] [Google Scholar]
  32. Snider G. L. Chronic obstructive pulmonary disease: a definition and implications of structural determinants of airflow obstruction for epidemiology. Am Rev Respir Dis. 1989 Sep;140(3 Pt 2):S3–S8. doi: 10.1164/ajrccm/140.3_Pt_2.S3. [DOI] [PubMed] [Google Scholar]
  33. Weir D. C., Sherwood Burge P. Measures of reversibility in response to bronchodilators in chronic airflow obstruction: relation to airway calibre. Thorax. 1991 Jan;46(1):43–45. doi: 10.1136/thx.46.1.43. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Yan K., Salome C. M., Woolcock A. J. Prevalence and nature of bronchial hyperresponsiveness in subjects with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1985 Jul;132(1):25–29. doi: 10.1164/arrd.1985.132.1.25. [DOI] [PubMed] [Google Scholar]

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