Increased frequency of bronchial hyperresponsiveness in patients with inflammatory bowel disease

Abstract

Abstract:Although bronchopulmonary manifestations are rare in inflammatory bowel diseases (IBD), subclinical abnormalities have been described in up to 50% of cases. The pathophysiology of these abnormalities remains unknown. However, a latent inflammation of the bronchial mucosa secondary to the inflammation of the intestinal mucosa has been suggested. This subclinical inflammation may lead to increased bronchial responsiveness. We studied the bronchial responsiveness in 38 inflammatory bowel disease (IBD) patients, using the methacholine test. Bronchial hyperresponsiveness was defined by a PC 20 M< 16 mg/ml. Twenty-four healthy controls were also studied. There was no significant difference in baseline FEV 1 between IBD patients and controls. However, there was a significantly greater fall in FEV 1 in the IBD patients at the concentrations of methacholine tested. The frequency of bronchial hyperresponsiveness was significantly higher in the IBD population (45%) than in controls (17%; P<0.03). Atopy, defined by skin test, was more common in IBD patients (42%) than in controls (21%). Even when only nonatopic subjects were considered, the frequency of bronchial hyperresponsiveness was significantly higher in IBD patients (41%) than in controls (5%; P<0.02). Thus, subclinical bronchial hyperresponsiveness is common in IBD, and may be considered a further extraintestinal manifestation.

Pulmonary function in patients with ulcerative colitis and its relationship with disease severity

“…This observation indicates that subclinical interstitial lung disease may be present in patients with UC as it is known that a reduction in the diffusing capacity of the lungs is a common and early manifestation of interstitial lung disease 27. The observed reduction in DLCO in our study might well be consistent with the presence of a subclinical alveolitis28 supporting the hypothesis of the migration of an inflammation via the bloodstream, from the intestine into both lung parenchyma and airway mucosa 29…”

Increased frequency of asymptomatic bronchial hyperresponsiveness in nonasthmatic patients with food allergy

“…For example, an increased frequency of asymptomatic bronchial hyperresponsiveness (BHR) was reported in nonasthmatic patients with inflammatory bowel disease. This finding suggests that the inflammatory bowel disease alone favours the development of nonspecific BHR, probably through the activation of the common mucosal immune system [4].…”

Respiratory System Involvement in Inflammatory Bowel Diseases

“…No relationship was found between duration of IBD and pulmonary function test results [26]. Bronchial hyperresponsiveness on methacholine challenge was independent of activity, extent and time of duration of IBD [29][30][31]. Exhaled NO correlated positively with IBD activity [37][38][39], but no relation was found for alveolar epithelial per-meability measured with the use of Tc-99m DTPA aerosol scintigraphy [40,41].…”

“…Abnormalities in PFT could be found even in nonsmoking IBD patients with no history of respiratory tract disorder and with normal chest x-ray [28]. Bronchial hypersensitivity in provocation tests with methacholine was observed in 17-71% of IBD patients, more often than in control groups [29][30][31].…”