Bronchial hyperreactivity in perimenstrual asthma is associated with increased Th-2 response in lower airways

Abstract

Background: perimenstrual asthma (PMA) is a commonly observed, usually difficult-to-treat asthma phenotype. The mechanisms underlying this phenomenon remain unexplained. The aim of the study was to assess the degree of airway hyperresponsiveness and its relationship to proinflammatory cytokines concentration in lower airways of PMA compared to non-PMA patients.Methods: Premenopausal women with regular menstrual cycles diagnosed as: PMA (n=12), non-PMA asthmatics (n=9), and healthy controls (n=10) were prospectively followed for 10 weeks over two consecutive menstrual cycles. The bronchial responsiveness (BR) test to methacholine was performed in each subject prior to the study. The serum for total immunoglobulin E (IgE) concentrations was taken and sputum was induced in the 26th day of each of the two cycles. Sputum concentration of eotaxin, IL-4 and IL-10 were measured by ELISA.Results: Levels of BR to metacholine as well, as total blood IgE concentrations in PMA subjects were significantly higher than in non-PMA asthmatics and healthy controls (P=0.001, P=0.022 respectively) and correlated with each other (P=0.030; r =−0.65). Sputum eotaxin and IL-4 concentrations in luteal phase were increased in PMA patients when compared with non-PMA asthmatics (P=0.016; P=0.041, respectively) and healthy subjects (P<0.001 both cytokines). No differences for the sputum levels of IL-10 among studied groups were seen.Conclusions: BR level in perimenstrual asthma is higher than in non-PMA asthmatics and correlates with increased total IgE serum concentration. The increased level of BR in PMA patients is associated with a shift in the type-1/type-2 cytokine balance toward a type-2 response.

Asma E Hormônios Sexuais: Uma Revisão Sobre O Comportamento Da Asma Na Mulher

“…É relatado também, segundo demais estudos, que na fase lútea há maiores concentrações de IgE sérica total e maior grau de hiperresponsividade brônquica em mulheres com o fenótipo PMA (31) (32) , os quais podem ser responsáveis pela maior exacerbação do quadro de asma neste período.…”

The influence of chlorine in indoor swimming pools on the composition of breathing phase of professional swimmers

“…Including males and females was considered at the stage of study protocol preparation, however this study was not addressed to asthma but to airway response of healthy airways. Therefore, taking into account changing airway response and immunity [49] and possible changes in the female airway immunity caused by genetic factors [50] and possible changes in females airway reactivity and immunological response in different menstrual phases we have decided not to include females into study protocol [51]. However, considering obtained strong signal form male subjects we have decided to assess in the future response of female respiratory system to chlorine compounds low level exposition.…”