This Article Full Text Full Text (PDF) Online Supplement All Versions of this Article: 200904-0497OCv1 180/4/304    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Farha, S. Articles by Erzurum, S. C. PubMed PubMed Citation Articles by Farha, S. Articles by Erzurum, S. C.

Effects of the Menstrual Cycle on Lung Function Variables in Women with Asthma

¹ Respiratory Institute and ² Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio

Correspondence and requests for reprints should be addressed to Samar Farha, M.D., Cleveland Clinic, 9500 Euclid Avenue, NC22, Cleveland, OH 44195. E-mail: farhas{at}ccf.org

Rationale: Angiogenesis is a defining pathologic feature of airway remodeling and contributes to asthma severity. Women experience changes in asthma control over the menstrual cycle, a time when vessels routinely form and regress under the control of angiogenic factors. One vital function modulated over the menstrual cycle in healthy women is gas transfer, and this has been related to angiogenesis and cyclic expansion of the pulmonary vascular bed.

Objectives: We hypothesized that changes in gas transfer and the pulmonary vascular bed occur in women with asthma over the menstrual cycle and are associated with worsening airflow obstruction.

Methods: Twenty-three women, 13 with asthma and 10 healthy control subjects, were evaluated over the menstrual cycle with weekly measures of spirometry, gas transfer, nitric oxide, hemoglobin, factors affecting hemoglobin binding affinity, and proangiogenic factors.

Measurements and Main Results: Airflow and lung diffusing capacity varied over the menstrual cycle with peak levels during menses that subsequently declined to nadir in early luteal phase. In contrast to healthy women, changes in lung diffusing capacity (DL_CO) were associated with changes in membrane diffusing capacity and DL_CO was not related to proangiogenic factors. DL_CO did not differ between the two groups, although methemoglobin and carboxyhemoglobin were higher in women with asthma than in healthy women.

Conclusions: Women with asthma experience cyclic changes in airflow as well as gas transfer and membrane diffusing capacity supportive of a hormonal effect on lung function.

Key Words: gas transfer • angiogenesis • asthma • menstrual cycle • proangiogenic progenitor cell

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject One of the functions modulated over the menstrual cycle in the healthy woman is gas transfer, and this has been related to angiogenesis and cyclic expansion of the pulmonary vascular bed. However, gas transfer has never been evaluated in women with asthma over the menstrual cycle. What This Study Adds to the Field Airflow and gas transfer vary over the menstrual cycle, but the cyclic respiratory changes occur by different physiologic mechanisms in women with asthma compared with healthy women.