Allergology international : official journal of the Japanese Society of Allergology
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Growing interest had been focused on the involvement of the small airways in asthma, and impulse oscillometry (IOS) has been utilized as pulmonary functions for detecting large and small airways diseases separately. IOS can measure respiratory resistance and reactance at multiple frequencies, not available by spirometry or body plethysmography, is non-invasive techniques and convenient for elderly patients with a low dependency on cooperation during tidal breathing. ⋯ IOS may have a complementary role of spirometry in detecting subtle airways changes in general practice. However, systemic studies are required to investigate the clinical implication of each IOS index.
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The clinical syndrome of aspirin-intolerant asthma (AIA) is characterized by aspirin/nonsteroidal anti-inflammatory drug intolerance, bronchial asthma, and chronic rhinosinusitis with nasal polyposis. AIA reactions are evidently triggered by pharmacological effect of cyclooxygenase-1 inhibitors. Urine sampling is a non-invasive research tool for time-course measurements in clinical investigations. ⋯ It is considered that mast cell activation probably is a pathophysiologic hallmark of AIA. However, despite the fact that cyclooxygenease-1 is the dominant in vivo PGD(2) biosynthetic pathway, the precise mechanism underlying the PGD(2) overproduction resulting from the pharmacological effect of cyclooxygenease-1 inhibitors in AIA remains unknown. A comprehensive analysis of the urinary concentration of inflammatory mediators may afford a new research target in elucidating the pathophysiology of AIA.
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Most infants and preschool children are not able to voluntarily perform the physiological maneuvers required to complete the pulmonary function tests that are used in adults and older children. Recently, commercial devices using forced oscillation technique (FOT) suitable for young children have become available. In devices with FOT, an oscillation pressure wave is generated by a loud speaker, is applied to the respiratory system, usually at the mouth, and the resulting pressure-flow relationship is analyzed in terms of impedance (Zrs). ⋯ The use of FOT should be considered in patients in whom spirometry or other pulmonary function tests cannot be performed or in cases where the results of other tests appear to be unreliable. In addition, this approach is effective in assessing bronchial hyperresponsiveness. Considering these qualities, FOT is a useful method to study pulmonary function in preschool children with asthma.