Bronchial hyperresponsiveness (or other combinations with airway or hyperreactivity, BH used as a general abbreviation)[1] is a state characterised by easily triggered bronchospasm (contraction of the bronchioles or small airways).
Bronchial hyperresponsiveness can be assessed with a bronchial challenge test. This most often uses products like methacholine or histamine. These chemicals trigger bronchospasm in normal individuals as well, but people with bronchial hyperresponsiveness have a lower threshold.
Bronchial hyperresponsiveness is a hallmark of asthma but also occurs frequently in people with chronic obstructive pulmonary disease (COPD).[2] In the Lung Health Study, bronchial hyperresponsiveness was present in approximately two-thirds of patients with non-severe COPD, and this predicted lung function decline independently of other factors.[3] In asthma it tends to be reversible with bronchodilator therapy, while this is not the case in COPD.
Bronchial hyperresponsiveness has been associated with gas cooking among subjects with the GSTM1 null genotype.[4]
↑ Postma DS, Kerstjens HA (November 1998). "Characteristics of airway hyperresponsiveness in asthma and chronic obstructive pulmonary disease". Am. J. Respir. Crit. Care Med. 158 (5 Pt 3): S187–92. doi:10.1164/ajrccm.158.supplement_2.13tac170. PMID9817744.
↑ Tashkin DP, Altose MD, Connett JE, Kanner RE, Lee WW, Wise RA (June 1996). "Methacholine reactivity predicts changes in lung function over time in smokers with early chronic obstructive pulmonary disease. The Lung Health Study Research Group". Am. J. Respir. Crit. Care Med. 153 (6 Pt 1): 1802–11. doi:10.1164/ajrccm.153.6.8665038. PMID8665038.
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Bronchospasm or a bronchial spasm is a sudden constriction of the muscles in the walls of the bronchioles. It is caused by the release (degranulation) of substances from mast cells or basophils under the influence of anaphylatoxins. It causes difficulty in breathing which ranges from mild to severe.
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A bronchial challenge test is a medical test used to assist in the diagnosis of asthma. The patient breathes in nebulized methacholine or histamine. Thus the test may also be called a methacholine challenge test or histamine challenge test respectively. Both drugs provoke bronchoconstriction, or narrowing of the airways. Whereas histamine causes nasal and bronchial mucus secretion and bronchoconstriction via the H1 receptor, methacholine utilizes the M3 receptor for bronchoconstriction. The degree of narrowing can then be quantified by spirometry. People with pre-existing airway hyperreactivity, such as asthmatics, will react to lower doses of drug.
Obstructive lung disease is a category of respiratory disease characterized by airway obstruction. Many obstructive diseases of the lung result from narrowing (obstruction) of the smaller bronchi and larger bronchioles, often because of excessive contraction of the smooth muscle itself. It is generally characterized by inflamed and easily collapsible airways, obstruction to airflow, problems exhaling, and frequent medical clinic visits and hospitalizations. Types of obstructive lung disease include asthma, bronchiectasis, bronchitis and chronic obstructive pulmonary disease (COPD). Although COPD shares similar characteristics with all other obstructive lung diseases, such as the signs of coughing and wheezing, they are distinct conditions in terms of disease onset, frequency of symptoms, and reversibility of airway obstruction. Cystic fibrosis is also sometimes included in obstructive pulmonary disease.
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