caa a22 4500 467934657 CHVBK 20180406152953.0 cr unu---uuuuu 170328e20061201xx s 000 0 eng 10.1007/s00408-006-0017-0 doi (NATIONALLICENCE)springer-10.1007/s00408-006-0017-0 Comparison of 4 AM and 4 PM Bronchial Responsiveness to Hypertonic Saline in Asthma [Elektronische Daten] [Erica Ferraz, Marcos Borges, J. Terra-Filho, José Martinez, Elcio Vianna] Bronchial responsiveness to methacholine or histamine increases at night and may contribute to the mechanisms of nocturnal asthma. Hypertonic saline (HS) is a more clinically relevant stimulus for the diagnosis and assessment of the severity of asthma, but the circadian variation in bronchial responsiveness to hypertonic challenges has not been addressed. The aim of this study was to compare the responsiveness to hypertonic saline at 4:00 AM and at 4:00 PM. Eighteen diurnally active patients (11 women) with asthma, 31 ± 9 years of age (mean ± SD) and with a forced expiratory volume in 1 s (FEV1) of 79.11% ± 12.85%, underwent two challenge tests (4:00 AM and 4:00 PM) in random sequence separated by an interval of 7 days. The challenge test consisted of inhalations of 4.5% saline with increasing doses by doubling the duration of nebulization (0.5, 1, 2, 4, and 8 min). The inhalation continued until a drop of 20% in FEV1 was achieved or total time of 15.5 min. The provocative dose that caused the 20% drop in FEV1 (PD20) was calculated. Differences were found between 4:00 PM and 4:00 AM values for inhalation times [3.80 ± 3.57 min and 2.19 ± 2.42 min (p = 0.001), respectively] and for PD20 [4.94 ± 6.77 ml and 2.93 ± 4.74 ml (p = 0.002), respectively]. Eight patients with a home-assessed nocturnal peak expiratory flow (PEF) drop of more than 15% formed the nocturnal asthma group. The behavior of these patients was similar to that of the non-nocturnal asthma group. We conclude that the bronchial responsiveness to HS increases at night. Springer Science+Business Media, Inc., 2006 Bronchial responsiveness nationallicence Circadian rhythm nationallicence Hypertonic saline nationallicence Nocturnal asthma nationallicence Pulmonary function testing nationallicence HS : hypertonic saline nationallicence FEV1 : forced expiratory volume in 1 s nationallicence PD20 : provocative dose causing 20% drop in FEV1 nationallicence PEF : peak expiratory flow nationallicence IQR : interquartile range nationallicence Ferraz Erica Department of Medicine, University of São Paulo Medical School at Ribeirão Preto, Ribeirão Preto, Av. Bandeirantes, 3900, 14048.900, São Paulo, Brazil aut Borges Marcos Department of Medicine, University of São Paulo Medical School at Ribeirão Preto, Ribeirão Preto, Av. Bandeirantes, 3900, 14048.900, São Paulo, Brazil aut Terra-Filho J. Department of Medicine, University of São Paulo Medical School at Ribeirão Preto, Ribeirão Preto, Av. Bandeirantes, 3900, 14048.900, São Paulo, Brazil aut Martinez José Department of Medicine, University of São Paulo Medical School at Ribeirão Preto, Ribeirão Preto, Av. Bandeirantes, 3900, 14048.900, São Paulo, Brazil aut Vianna Elcio Department of Medicine, University of São Paulo Medical School at Ribeirão Preto, Ribeirão Preto, Av. Bandeirantes, 3900, 14048.900, São Paulo, Brazil aut Lung Springer-Verlag; www.springer-ny.com 184/6(2006-12-01), 341-346 0341-2040 184:6<341 2006 184 408 https://doi.org/10.1007/s00408-006-0017-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00408-006-0017-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ferraz Erica Department of Medicine, University of São Paulo Medical School at Ribeirão Preto, Ribeirão Preto, Av. Bandeirantes, 3900, 14048.900, São Paulo, Brazil aut NATIONALLICENCE 700 1- Borges Marcos Department of Medicine, University of São Paulo Medical School at Ribeirão Preto, Ribeirão Preto, Av. Bandeirantes, 3900, 14048.900, São Paulo, Brazil aut NATIONALLICENCE 700 1- Terra-Filho J. Department of Medicine, University of São Paulo Medical School at Ribeirão Preto, Ribeirão Preto, Av. Bandeirantes, 3900, 14048.900, São Paulo, Brazil aut NATIONALLICENCE 700 1- Martinez José Department of Medicine, University of São Paulo Medical School at Ribeirão Preto, Ribeirão Preto, Av. Bandeirantes, 3900, 14048.900, São Paulo, Brazil aut NATIONALLICENCE 700 1- Vianna Elcio Department of Medicine, University of São Paulo Medical School at Ribeirão Preto, Ribeirão Preto, Av. Bandeirantes, 3900, 14048.900, São Paulo, Brazil aut NATIONALLICENCE 773 0- Lung Springer-Verlag; www.springer-ny.com 184/6(2006-12-01), 341-346 0341-2040 184:6<341 2006 184 408 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer