David Aronsson

Allergic rhinitis with or without concomitant asthma : difference in perception of dyspnoea and levels of fractional exhaled nitric oxide

Background/aim Allergic rhinitis (AR) is a risk factor for developing clinical asthma. Moreover, AR is often associated with bronchial hyper‐responsiveness (BHR). The aim of the present study was to investigate whether patients with AR and asthma differed from AR with or without BHR in degree of perception of dyspnoea and airway inflammation, measured as fractionated exhaled nitric oxide (NO).

Comparison of central and peripheral airway involvement before and during methacholine, mannitol and eucapnic hyperventilation challenges in mild asthmatics.

Introduction:  Testing for airway hyperresponsiveness with indirect stimuli as exercise or mannitol has been proposed to better reflect underlying airway inflammation, as compared with methacholine (MCh), believed to act directly on airway smooth muscle cells.

Allergic rhinitis with hyper-responsiveness differ from asthma in degree of peripheral obstruction during metacholine challenge test.

Allergic rhinitis (AR) is a risk factor for developing clinical asthma. Moreover, AR is often associated with bronchial hyper‐responsiveness (BHR). The aim of this study was to compare the degree of involvement of the peripheral airways during metacholine (MCh) challenge test in asthmatics and patients with AR with or without BHR by using the impulse oscillometry (IOS) technique. Fifty‐three patients with seasonal AR were investigated with MCh challenge test and IOS. Thirteen healthy non‐reactive subjects served as controls. MCh challenge test was performed, cut‐off value FEV1PD20 2000 μg. Linear regression analysis was used to calculate a MCh/FEV1 slope (Slope‐FEV1MCh), which was used as an index of BHR. IOS was performed, measuring respiratory resistance and reactance during the MCh challenge test. Twenty‐six subjects had both AR and asthma symptoms, 27 patients reported AR only, without asthma symptoms, 17 (63%) manifested BHR by spirometric criteria. Patients with AR and symptoms of asthma manifested greater peripheral airway obstruction compared to those with AR only with BHR. Increased peripheral obstruction in the asthmatic group compared to patients with AR and BHR may explain previous findings that asthmatics perceive greater airway obstruction during MCh challenge tests.

Cysteinyl‐leukotriene levels in sputum differentiate asthma from rhinitis patients with or without bronchial hyperresponsiveness

Background We have previously reported that asthma differs from rhinitis with or without bronchial hyperresponsiveness in the perception and degree of lower airway inflammation.

Alveolar mast cells shift to an FcεRI-expressing phenotype in mild atopic asthma: a novel feature in allergic asthma pathology.

To cite this article: Andersson CK, Tufvesson E, Aronsson D, Bergqvist A, Mori M, Bjermer L, Erjefält JS. Alveolar mast cells shift to an FcεRI‐expressing phenotype in mild atopic asthma: a novel feature in allergic asthma pathology. Allergy 2011; 66: 1590–1597.

Airway resistance and reactance are affected in systemic sclerosis

Background Interstitial lung disease often occurs as an early complication of systemic sclerosis (SSc). The aim was to investigate whether impulse oscillometry (IOS) could be used to evaluate lung impairment in SSc. Methods Seventy-eight SSc patients, of which 65 had limited cutaneous SSc (lcSSc) and 13 had diffuse cutaneous SSc (dcSSc), were subjected to high-resolution computed tomography (HRCT) and pulmonary function tests (spirometry, IOS, and single breath CO diffusion capacity test). Twenty-six healthy individuals served as controls. Results Patients with lcSSc had higher levels of peripheral airway resistance, that is, R5–R20 (difference between resistance at 5 Hz and resistance at 20 Hz) showed a median (and interquartile range) of 0.05 (0.02–0.09) in lcSSc, 0.01 (0.00–0.04) in dcSSc and 0.04 (0.01–0.06) in healthy controls. They also had higher levels of reactance: reactance area was 0.26 (0.15–0.56) in lcSSc, 0.20 (0.11–0.29) in dcSSc and 0.18 (0.08–0.30) in healthy controls, and resonant frequency was 10.9 (8.8–14.8) in lcSSc, 9.0 (8.3–11.6) in dcSSc and 9.1 (8.0–13.1) in healthy controls. Airway reactance correlated to fibrotic findings on HRCT, such as ground glass opacities and reticulations. Discussion This implies that IOS parameters to some extent are related to fibrosis in patients with SSc.