This inquiry was designed to determine if there is residual airflow obstruction and/or airway hyperresponsiveness in adults with symptomatic asthma remission.

This inquiry was designed to determine if there is residual airflow obstruction and/or airway hyperresponsiveness in adults with symptomatic asthma remission, and if age at remission or its duration influence these parameters. We studied 30 subdues (20 men, 10 women, 28 atopics, aged 18 to 61 years; mean, 32 years) with a history of asthma (mean duration, 2 to 33 years) still who reported no symptoms or medication requirement for [greater than or equal to] 2 years. They were individually matched for age, sex and atopy, to a check group of 30 subjects without history of asthma. Each make submissive had a respiratory questionnaire and measurements of expiratory liquefys lung volumes, and bronchodilator replication Morning/evening peak expiratory run rates (PEFRs) were recorded for a 2-week period and pair methacholine inhalation tests were obtained forward separate days. Initial [FEV.sub.1] and FVC for ex-asthmatics (controls) were, respectively, 910 [+ or -] 25 percent and 978 [+ or -] 23 percent (1041 [+ or -] 19 and 1040 [+ or -] 18 percent) of predicted values. Twenty nine ex-asthmatics (15 controls) had occasional respiratory symptoms, not attributed to asthma. principally subjects with asthma remission had evidences of mild airflow obstruction, associated to a methacholine answer either increased in 11 ([PCsub20] methacholine, 018 to 56 mg/ml) or "borderline" in 10 others ([PCsub20] between 8 and 20 mg/ml) Airway responsiveness was normal ([PCsub20] [greater than] 20 mg/ml) in 8 ex-asthmatics and in 21 sways ([PC.sub.20] was under 8 mg/ml and between 10 and 20 mg/ml in, respectively, 5 and 4 controls) Mean reversibility of [FEVsub1] after 200 [mu]g of albuterol was 57 (range, -11 to 141 percent) compared with 25 (-44 to 105) in sways Mean and maximal diurnal variation of PEFR were, respectively, 46 [+ or -] 04 percent and 123 [+ or -] 13 percent (control 29 [+ or -] 03 and 70 [+ or -] 08 percent) There was a significant correlation between [PCsub20] and age at the diagnosis of asthma or at the charge of remission. Airway responsiveness was significantly les when asthma or remission of asthma occurr at a younger age, although there was no difference for baseline [FEVsub1] and no significant correlation between [PCsub20] and duration of asthma or of remission. Perception of bronchoconstriction was similar in the pair controls and ex-asthmatics. In conclusion, most numerous ex-asthmatics who considered to be in asthma remission showed a persistent increase in airway responsiveness with or without mild airflow obstruction, suggesting that symptom report may be insufficient to determine that asthma is in pure remission.

Bronchial asthma is characterized by the agency of variable airflow obstruction and airway hyperresponsiveness.[1] Its underlying mechanism is considered to be an airway inflammatory proces with bronchial epithelial damage and mucus secretion, and in which eosinophils and lymphocyte look to play a key role[2] There is still no help for asthma.[3] We may, however, notice remissions, either spontaneously, after withdrawal of exposing to a sensitizing agent, or following bronchial anti-inflammatory therapy. Remissions are for the most part observed in children, being quite rare in adults.[4] Relapses of asthma after remission, however, are common in children. Blair[5] reported a 20 percent the having recourse of wheezing after a period of 3 years without symptoms in asthmatic children. Ryssing[6] reported that in 36 percent of asthmatics who remitted from their asthma, wheezing resum after a 13-year follow-up In another consideration 31 percent of young adults delivered of wheezing at 21 years of long date had recurrent wheezing at 28 years.[7]

Brewster et al[8] has described deposition of collagen, in relation to the neighborhood of myofibroblasts beneath the basement membrane, suggesting a repair proces in asthma, which may lead to chronic morphologic changes. Other observations give an inkling of that subjects with a history of asthma with no or minimal respiratory symptoms frequently show marked inflammatory changes forward bronchial biopsy specimens as shown by way of activated inflammatory cells in the bronchial mucosa.[9,10] This remind ofs that the underlying asthmatic inflammation or hyperresponsiveness may persist for put offed periods of time, even when symptoms have disappeared.

The at hand study was designed to determine if controls who consider themselves to be in remission of their asthma, with neither asthma symptom nor any asthma medication use in the last 2 years, point out to persistence of airflow obstruction and hyperresponsiveness, and if these abnormalities are in relation with the age at the charge of asthma or remission or with their duration.

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METHODS

Subjects

Sixty-five make subordinates took part in this thought (Table 1). Of these, 30 ex-asthmatics were recruited from advertisements in different media.

Inclusion Criteria and Definition of Asthma Remission

We included in the research men or women [greater than or equal to]18 years not new atopic or not, with a proven history of asthma responding to the American Thoracic Society criteria, who were considered to be in asthma remission for at least 2 years.[11] "Remission" of asthma was defined according to the definitions of Bronnimann and Burrows:[4] "asthma was considered to be inactive (ex-asthma) if the make liable denied medications, asthmatic attacks, and 'frequent' (more than two) attacks of shortness of breath with wheezing during the preceding year." We, however, continueed the minimum period of symptom remission to 2 years, to be included in the study

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