RT Journal Article
SR Electronic
T1 Bronchial hyperresponsiveness: the need for a distinction between hypersensitivity and excessive airway narrowing
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 267
OP 274
DO 10.1183/09031936.93.02030267
VO 2
IS 3
A1 PJ Sterk
A1 EH Bel
YR 1989
UL http://erj.ersjournals.com/content/2/3/267.abstract
AB Bronchial hyperresponsiveness is currently defined as an increase in sensitivity to a wide variety of airway narrowing stimuli. Most patients with asthma and chronic obstructive pulmonary disease (COPD) exhibit such an enhanced sensitivity. In asthma, in particular, this hypersensitivity is accompanied by excessive degrees of airway narrowing. This raises the question as to whether measures of sensitivity, e.g. the provocative concentration or dose producing 20% fall in FEV1 (PC20 or PD20), comprise all the relevant information in bronchial hyperresponsiveness. In adjunct to model studies, there is experimental evidence in man that the potential mechanisms of bronchial hyperresponsiveness can be divided into those causing hypersensitivity and those responsible for the increase in the maximal attainable degree of airway narrowing. The recognition and distinction of these components of hyperresponsiveness have clinical implications in the diagnosis and therapy of asthma and COPD. Bronchial hyperresponsiveness is a composite functional disorder, which requires treatment of each of its components.