Chest
Clinical InvestigationsEsophagusThe Effects of an Inhaled β2-Adrenergic Agonist on Lower Esophageal Function: A Dose-Response Study
Section snippets
Materials and Methods
A prospective, randomized, double-blind, placebo-controlled crossover design was used to evaluate the effects of increasing doses of inhaled albuterol (Glaxo-Wellcome; Research Triangle Park, NC), 2.5 to 10 mg, or placebo on LES tone, the percentage of LES relaxation, and the frequency of transient LES relaxations (TLESRs). The amplitude, duration, and propagation velocity of esophageal contractions at 5 and 10 cm above the LES also were measured. Esophageal manometry was completed in nine
Results
As illustrated in Figure 1, albuterol inhalation produced a dose-dependent reduction in LES basal tone from 17.0 ± 2.6 mm Hg at baseline to 8.9 ± 2.1 mm Hg at the maximum cumulative dose of 10 mg (F[4,32] = 3.91; p = 0.01) compared to placebo. Reductions in LESP were noted beginning at the cumulative dose of 7.5 mg total (p = 0.02) and were maintained through the 10-mg cumulative dose (p = 0.02). The frequency of TLESRs decreased from 2.2 ± 1.1 to 1.6 ± 1.8/h but did not reach statistical
Discussion
Asthma is a common problem in the United States. It affects approximately 4 to 5% of the US population.1 Standard outpatient therapy involves the use of inhaledβ 2-agonists, inhaled steroids, cromolyn sodium, theophylline, and oral steroids. GER is known to play a significant role in the development and persistence of asthma and is a critical factor in patients with difficult-to-control asthma.8
The primary pathophysiologic mechanisms proposed to account for GER are reduced tonic pressures in
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Sorting out the Relationship Between Esophageal and Pulmonary Disease
2021, Gastroenterology Clinics of North AmericaParadoxical bronchospasm in U.S. military veterans with COPD or asthma at a tertiary VA medical center in Chicago, Illinois
2021, Respiratory Medicine and ResearchCitation Excerpt :Whether upper airway muscle dysfunction coupled with intermittent nocturnal hypoxemia observed in OSA play a role in the pathogenesis of post-bronchodilation PB in veterans with COPD or asthma is uncertain [13, 14]. Likewise, the effects of SABA on esophageal function that may predispose veterans with COPD or asthma to GERD remains to be determined [15]. The mechanism(s) underlying SABA-induced PB in veterans with COPD or asthma was not elucidated in this study.
Bidirectional Association Between GERD and Asthma: Two Longitudinal Follow-Up Studies Using a National Sample Cohort
2020, Journal of Allergy and Clinical Immunology: In PracticeBronchodilators in subjects with asthma-related comorbidities
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2018, Pulmonary Pharmacology and TherapeuticsCitation Excerpt :Patients should be carefully followed up in order to recognize timely any relapse of digestive or reflux related respiratory symptoms and, in this event, the deescalating strategy should be rediscussed. LABA might worsen the reflux by decreasing the tone of the lower esophageal sphincter [79]. Sleep troubles are highly prevalent among COPD patients and are mainly related to respiratory symptoms.
A portion of this study was originally presented at the annual American Gastroenterology Association meeting in Orlando, FL, May 1999.