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Factors in Bronchial Hyperreactivity

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Highlights in Asthmology

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Abstract

In patients with asthma, bronchospasm can be provoked by the inhalation of a wide variety of different agents [11]. These agents, which are sometimes called inciters of bronchospasm [31], include analogues of the parasympathetic neurotransmitter acetylcholine, chemical mediators of inflammation such as histamine, serotonin, prostaglandins, and leukotrienes, and agents that may occur in inhaled air such as fog (distilled water aerosol), sulfur dioxide, and particulate matter. Other agents appear important not so much because they trigger bronchoconstriction, but rather because they act as inducers of increased bronchomotor responsiveness [31]. Some agents appear to act both as inciters and as inducers. Inhalation of specific antigens, for example, may trigger both an immediate and a delayed asthmatic response; the delayed response is associated with an increase in bronchial reactivity that persists long after tests of airway caliber have returned to baseline [15]. It thus appears that the persistent, striking bronchial hyperreactivity of asthma may be the result of a kind of positive feedback loop, with the agents or events responsible for causing acute bronchospasm in reactive individuals also causing a further increase in reactivity. This accounts for the interest in defining the factors underlying both the acute and the delayed responses to inhaled materials, for a better understanding of the mechanisms of bronchial hyperreactivity may lead to the development of means of preventing or reversing asthma itself.

Supported in part by U.S. National Heart, Lung, and Blood Institute Program Project Grant HL-24136.

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    François Bernard Michel M.D. , Jean Bousquet M.D., Ph.D.  & Philippe Godard M.D. ,  & 

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Boushey, H.A. (1987). Factors in Bronchial Hyperreactivity. In: Michel, F.B., Bousquet, J., Godard, P. (eds) Highlights in Asthmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-70316-4_28

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