Asthmatic risk factors and bronchial reactivity in non-diagnosed asthmatic adults. 1995

M D Lebowitz, and S Bronnimann, and A E Camilli
Respiratory Sciences Center, University of Arizona College of Medicine, Tucson, USA.

Specific respiratory signs and symptoms are thought to occur prior to diagnoses of asthma as part of the natural history. These signs and symptoms include: high IgE, a history of wheezing symptoms, and/or excessive declines in lung function. The first two are thought to distinguish asthma from other airway obstructive diseases (AOD). To predict subsequent AOD, twelve years of follow-up (1972-84) data from the Tucson longitudinal epidemiological study of AOD in a community population were evaluated on 687 subjects aged 19-70 years on entry. To determine the likelihood that non-asthmatics that have these specific risk factors would have marked or intermediate bronchial reactivity to methacholine, an experimental study was performed. This was done in 1984-85 in a robust, efficient post-hoc stratified sample of male subjects ages 30-55 from the population followed from 1972. They were subsequently followed through 1991. Persistent symptoms best predicted final pulmonary function and new diagnosed AOD in subjects in the population. Previously diagnosed AOD also predicted lower pulmonary function. The experimental results indicate that predisposition to reactivity appears likely without the presence of diagnosed asthma. Further, the experimental subjects with high risk had increased symptomatology and decreased lung function when tested at follow-up; not all of the reactivity was explained by these factors. An attempt to predict reactivity by physician evaluation and special questionnaire was not fruitful. In addition, wheeze per se often disappeared without later evidence of asthma (or AOD) diagnosis, questioning some international tendencies to label all wheeze as asthma. Thus, high IgE significantly predicted bronchial responsiveness, but high IgE and symptoms are neither necessary nor sufficient. Also, both preclinical and clinical asthma predict eventual low lung function.

UI MeSH Term Description Entries
D007073 Immunoglobulin E An immunoglobulin associated with MAST CELLS. Overexpression has been associated with allergic hypersensitivity (HYPERSENSITIVITY, IMMEDIATE). IgE
D008137 Longitudinal Studies Studies in which variables relating to an individual or group of individuals are assessed over a period of time. Bogalusa Heart Study,California Teachers Study,Framingham Heart Study,Jackson Heart Study,Longitudinal Survey,Tuskegee Syphilis Study,Bogalusa Heart Studies,California Teachers Studies,Framingham Heart Studies,Heart Studies, Bogalusa,Heart Studies, Framingham,Heart Studies, Jackson,Heart Study, Bogalusa,Heart Study, Framingham,Heart Study, Jackson,Jackson Heart Studies,Longitudinal Study,Longitudinal Surveys,Studies, Bogalusa Heart,Studies, California Teachers,Studies, Jackson Heart,Studies, Longitudinal,Study, Bogalusa Heart,Study, California Teachers,Study, Longitudinal,Survey, Longitudinal,Surveys, Longitudinal,Syphilis Studies, Tuskegee,Syphilis Study, Tuskegee,Teachers Studies, California,Teachers Study, California,Tuskegee Syphilis Studies
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D008173 Lung Diseases, Obstructive Any disorder marked by obstruction of conducting airways of the lung. AIRWAY OBSTRUCTION may be acute, chronic, intermittent, or persistent. Obstructive Lung Diseases,Obstructive Pulmonary Diseases,Lung Disease, Obstructive,Obstructive Lung Disease,Obstructive Pulmonary Disease,Pulmonary Disease, Obstructive,Pulmonary Diseases, Obstructive
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012135 Respiratory Sounds Noises, normal and abnormal, heard on auscultation over any part of the RESPIRATORY TRACT. Breathing Sounds,Crackles,Lung Sounds,Pleural Rub,Rales,Rhonchi,Stridor,Wheezing,Breathing Sound,Crackle,Lung Sound,Pleural Rubs,Rale,Respiratory Sound,Rhonchus,Rub, Pleural,Sound, Breathing,Sound, Lung,Sound, Respiratory,Sounds, Breathing,Sounds, Lung,Stridors,Wheezings
D001985 Bronchial Provocation Tests Tests involving inhalation of allergens (nebulized or in dust form), nebulized pharmacologically active solutions (e.g., histamine, methacholine), or control solutions, followed by assessment of respiratory function. These tests are used in the diagnosis of asthma. Allergen Bronchial Provocation Tests,Allergen Challenge, Endobronchial,Antigen Bronchial Provocation Tests,Bronchial Allergen Challenge,Bronchial Challenge Tests,Inhalation Provocation Tests,Provocation Tests, Bronchial,Endobronchial Challenge Tests,Allergen Challenge, Bronchial,Allergen Challenges, Bronchial,Allergen Challenges, Endobronchial,Bronchial Allergen Challenges,Bronchial Challenge Test,Bronchial Provocation Test,Challenge Test, Bronchial,Challenge Test, Endobronchial,Challenge Tests, Bronchial,Challenge Tests, Endobronchial,Challenge, Bronchial Allergen,Challenge, Endobronchial Allergen,Challenges, Bronchial Allergen,Challenges, Endobronchial Allergen,Endobronchial Allergen Challenge,Endobronchial Allergen Challenges,Endobronchial Challenge Test,Inhalation Provocation Test,Provocation Test, Bronchial,Provocation Test, Inhalation,Provocation Tests, Inhalation,Test, Bronchial Challenge,Test, Bronchial Provocation,Test, Endobronchial Challenge,Test, Inhalation Provocation,Tests, Bronchial Challenge,Tests, Bronchial Provocation,Tests, Endobronchial Challenge,Tests, Inhalation Provocation
D004198 Disease Susceptibility A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the individual more than usually susceptible to certain diseases. Diathesis,Susceptibility, Disease,Diatheses,Disease Susceptibilities,Susceptibilities, Disease
D005260 Female Females

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