Am. J. Respir. Crit. Care Med., Volume 158, Number 1, July 1998, 153-156

Airway Mucosal Blood Flow in Bronchial Asthma

SUNIL D. KUMAR, MICHAEL J. EMERY, NEAL D. ATKINS, IGNACIO DANTA, and ADAM WANNER

Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Miami School of Medicine, Miami, Florida

As an inflammatory airway disease, asthma is expected to be associated with an increase in airway blood flow. We therefore compared airway mucosal blood flow ( _aw) among normal subjects (n = 11) and patients with stable asthma receiving (n = 13) or not receiving (n = 10) long-term inhaled glucocorticosteroid (GS) therapy. _aw was calculated from the uptake of dimethyl ether in the anatomic dead space minus the most proximal 50 ml (DS), and expressed as blood flow per ml DS. Mean (± SE) _aw was 38.5 ± 5.3 µl · min¹ · ml¹ in normals, 68.2 ± 7.9 µl · min¹ · ml¹ in GS-naive asthmatics (p < 0.01), and 55.4 ± 5.3 µl · min¹ · ml¹ in GS-treated asthmatics (p < 0.05). Ten minutes after administration of 180 µg albuterol by metered dose inhaler, mean _aw increased by 83 ± 26% in normal subjects (p < 0.01), but did not change significantly in GS-naive (+5 ± 8%) or GS-treated (+32 ± 15%) asthmatics. These results demonstrate that _aw is increased in stable asthmatics and resistant to further increase by a standard inhaled dose of a beta-adrenergic agonist.

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