Chest
Is the Short-term Response to Inhaled β-Adrenergic Agonist Sensitive or Specific for Distinguishing Between Asthma and COPD?
Section snippets
Clinical Data
Pulmonary function laboratory technicians at the Toronto Hospital were asked to select pulmonary function studies with an obstructive pattern on spirometry from outpatients referred to the laboratory and followed up by the five staff respirologists. The most recent study showing an obstructive pattern was chosen from patients with more than one study. The technicians had no prior knowledge of the purpose of the study.
A total of 450 pulmonary function tests were selected by two technicians. The
RESULTS
There were 287 cases diagnosed as asthma and 108 cases diagnosed as COPD. The mean age of the patients with asthma was less than the group with COPD (48.8 ± 0.99 vs 65.6 ± 0.87 years, p<0.05). Values for the mean FEV1, FVC, and FEV1/FVC ratio were significantly higher in the patients with asthma both in absolute numbers and percent predicted (Table 1). The acute bronchodilator response of FEV1 was greater in the asthmatic subject group (16.4 ± 0.85 vs 10.6 ± 0.82 L, p<0.05) but showed no
DISCUSSION
We became interested in evaluating acute changes in FEV1 following bronchodilator administration through our participation in pharmaceutically sponsored research protocols. An increase in FEV1 of 15 percent at the time of the initial or second visit of a protocol is generally an absolute requirement for entry into studies examining the effects of medications over time in patients with asthma.1, 2, 3 The implications to be drawn from these guidelines is that the absence of such a change excludes
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Chronic obstructive pulmonary disease subpopulations and phenotyping
2018, Journal of Allergy and Clinical ImmunologyCitation Excerpt :However, although these 2 phenotypes seem quite distinct, there is increasing awareness of the involvement of the small airways and non-TH2 type of inflammation in asthma, as well as involvement of the large airways and eosinophils in patients with COPD. In asthmatic patients irreversible airway obstruction with airway remodeling occurs as disease progresses, whereas in patients with COPD, bronchodilator response to β2-agonist occurs in approximately 45% of patients with COPD117 and might be less common with an emphysema-dominant phenotype.118 Genetic variation of the β2-adrenergic receptor might explain why some patients with COPD have better response to this type of drug.119
Standardized pulmonary function testing
2018, Lung Function Testing in the 21st Century: Methodologies and Tools Bridging Engineering to Clinical PracticeAsthma diagnosis and airway bronchodilator response in HIV-infected patients
2012, Journal of Allergy and Clinical Immunology
Manuscript received December 28, 1992; revision accepted August 5.