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Department of Internal Medicine, University of Iowa College of Medicine, Iowa City, Iowa 52242
Bronchial hyperreactivity
(BHR) is associated with the presence of airway inflammation in asthma
and is seen in individuals occupationally exposed to grain dust. To
better understand the relationship between BHR and pulmonary
inflammation after grain dust exposure, we carried out an inhalation
challenge to corn dust extract (CDE) on seven subjects with BHR [a
20% or greater decrease in forced expiratory volume in 1 s
(FEV1) compared with diluent FEV1 with a
cumulative dose of histamine
47.3 breath units] and compared their
physiological and inflammatory responses with those of seven matched
control subjects. BHR subjects were exposed to nebulized CDE
(target dose of 0.16 µg/kg endotoxin) as tolerated; matched controls
received equal amounts of CDE. Subjects with BHR complained of
chest tightness and dyspnea within the 2 h after inhalation of CDE
significantly more frequently than controls. Similarly, subjects with
BHR developed significantly greater percent declines in
FEV1 at time points up to 4 h after exposure to CDE.
Significant increases in total cells, neutrophils, tumor necrosis
factor-
, interleukin-6, and interleukin-8 were detected in
bronchoalveolar lavage fluid 4 h after inhalation of CDE in all
subjects, but no differences were detected between the control and BHR
groups. These results suggest that, although subjects with BHR develop
a more precipitous decline in FEV1 after exposure to CDE,
the inflammatory response to CDE is similar in subjects with and
without BHR.
inhalation exposure; airway inflammation; endotoxin; lipopolysaccharide
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