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General Clinical Research Center of Case Western Reserve University School of Medicine and Division of Pulmonary and Critical Care Medicine and Department of Medicine of University Hospitals of Cleveland, Cleveland 44106; and MetroHealth Medical Center, Cleveland, Ohio 44109-1998
To determine whether drying and
hypertonicity of the airway surface fluid (ASF) are involved in
thermally induced asthma, nine subjects performed isocapnic
hyperventilation (HV) (minute ventilation 62.2 ± 8.3 l/min) of
frigid air (
8.9 ± 3.3°C) while periciliary fluid was
collected endoscopically from the trachea. Osmolality was measured by
freezing-point depression. The baseline 1-s forced expiratory volume
was 73 ± 4% of predicted and fell 26.4% 10 min postchallenge
(P > 0.0001). The volume of ASF collected was
11.0 ± 2.2 µl at rest and remained constant during and after HV
as the airways narrowed (HV 10.6 ± 1.9, recovery 6.5 ± 1.7 µl; P = 0.18). The osmolality also remained stable
throughout (rest 336 ± 16, HV 339 ± 16, and recovery
352 ± 19 mosmol/kgH2O, P = 0.76).
These data demonstrate that airway desiccation and hypertonicity of the
ASF do not develop during hyperpnea in asthma; therefore, other
mechanisms must cause exercise- and hyperventilation-induced airflow limitation.
airway drying; hyperpnea; bronchoconstriction
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