In those patients with questionable chest tightness, dyspnoea, isolated cough and a normal spirometry, the objective demonstration of increased airway responsiveness can help in making a diagnosis of asthma. Most investigators consider bronchial hyperreactivity as a predominant feature of asthma. However, some authors have shown that the predictive power of bronchial responsiveness in diagnosis of asthma is relatively poor, because of a quite large overlap between symptomatic and asymptomatic subjects. It appears evident that the relationship between bronchial reactivity and asthma is less clear than is generally supposed. Another feature that characterizes patients with asthma is eosinophilia. The eosinophil is the major cell responsible for the inflammation occurring in asthma. There are, in fact, inverse relationships between blood eosinophil count and forced expiratory volume in one second (FEV1), and provocative dose of histamine causing a 20% decrease in FEV1 (PD20FEV1) in patients with asthma. Furthermore, eosinophils from patients with asthma release significantly more eosinophil cationic protein (ECP) and eosinophil protein X (EPX) than cells from control subjects. The use of bronchoalveolar lavage (BAL) as a safe technique in asthmatics has provided a potentially useful tool to correctly diagnose and better define bronchial asthma. However, it is evident that the absolute clinical value of these new parameters needs further studies to be definitively clarified.

Bronchial reactivity, eosinophils and BAL in diagnosis of asthma

Crimi N.;Vancheri C.;
1993-01-01

Abstract

In those patients with questionable chest tightness, dyspnoea, isolated cough and a normal spirometry, the objective demonstration of increased airway responsiveness can help in making a diagnosis of asthma. Most investigators consider bronchial hyperreactivity as a predominant feature of asthma. However, some authors have shown that the predictive power of bronchial responsiveness in diagnosis of asthma is relatively poor, because of a quite large overlap between symptomatic and asymptomatic subjects. It appears evident that the relationship between bronchial reactivity and asthma is less clear than is generally supposed. Another feature that characterizes patients with asthma is eosinophilia. The eosinophil is the major cell responsible for the inflammation occurring in asthma. There are, in fact, inverse relationships between blood eosinophil count and forced expiratory volume in one second (FEV1), and provocative dose of histamine causing a 20% decrease in FEV1 (PD20FEV1) in patients with asthma. Furthermore, eosinophils from patients with asthma release significantly more eosinophil cationic protein (ECP) and eosinophil protein X (EPX) than cells from control subjects. The use of bronchoalveolar lavage (BAL) as a safe technique in asthmatics has provided a potentially useful tool to correctly diagnose and better define bronchial asthma. However, it is evident that the absolute clinical value of these new parameters needs further studies to be definitively clarified.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/615950
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