DETERMINANTS OF RESPONSE TO INHALED IRRITANT IN ASTHMA

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。大约有1000万美国人患有哮喘，其中三分之二是18岁以下的儿童。尽管在确定加重环境因素和开发更有效的治疗方法方面取得了重大进展，但哮喘的患病率和发病率仍在增加。哮喘的特点是支气管对非特异性吸入物（如烟雾、粉尘、烟雾和药物如组胺和甲胆碱）的高反应性。在哮喘中，安慰剂反应率很高；虽然这些反应中的一些反映了对先前高度敏感个体的平均水平的回归，但很可能存在高度的“真实”安慰剂反应。本研究的总体假设是：吸入安慰剂将对吸入甲胆碱后支气管痉挛的发展提供一些个体保护。其他具体假设包括：a)安慰剂反应的存在和强度与心理因素相关，包括人格特征；B)安慰剂反应的存在和程度将受到研究人员（卫生保健提供者）和研究受试者之间感知到的相互作用/干预的影响；换句话说，通过安慰剂或吸入β受体激动剂沙美特罗，提高患者的期望将增加对甲基苯丙胺引起的支气管痉挛的保护。到目前为止，还没有研究检查患者期望对哮喘结果的影响。此外，没有研究评估哮喘患者的干预是否会提高患者的预期结果，并可能导致肺功能的改善。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Asthma affects approximately 10 million Americans, two-thirds of them children under the age of 18. Although important strides have been made in identifying aggravating environmental factors and developing more effective treatments, the prevalence and morbidity of asthma are increasing. Asthma is characterized by bronchial hyperresponsiveness to nonspecific inhaled agents, such as smoke, dusts, fumes and pharmacologics such as histamine and methacholine. In asthma, a high placebo-response rate is seen; while some of these responses represent regression to the mean of a previously highly sensitive individual, it is likely that a high degree of "true" placebo response exists. The overall hypothesis of this study is: inhalation of a placebo will offer some individuals protection against the development of bronchospasm following inhalation of methacholine. Additional specific hypotheses include: a) the presence and magnitude of a placebo response will correlate with psychological factors including personality characteristics; b) the presence and magnitude of a placebo response will be influenced by the perceived interactions/interventions between study personnel (health care providers) and research subjects; in other words, enhanced patient expectations will increase the protection against the development of methacholine-induced bronchospasm offered by placebo or by an inhaled beta agonist, salmeterol. To date, there have been no studies examining the influence of patient expectations on asthma outcomes. Additionally, there are no studies that evaluate an intervention in asthmatic patients that will enhance patient outcome expectations and presumably lead to improved lung function.