The Role of Lung Volumes in Asthma

肺容量在哮喘中的作用

• 批准号: 7752226
• 负责人: Robert Llewellyn Owens
• 金额: $ 5.72万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-05 至 2011-08-04
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7752226
• 关键词: Affect; Airway Resistance; Allergic; American; Anti-Inflammatory Agents; Anti-inflammatory; Asthma; Body Weight decreased; Chronic; Disease; Esophageal; Health Care Costs; Incidence; Inflammation; Inflammatory; Lead; Link; Lung; Lung diseases; Manometry; Measurement; Measures; Mediating; Monitor; Obesity; Obstruction; Overweight; Pathogenesis; Patients; Pharmaceutical Preparations; Prevalence; Resistance; Role; Series; Severities; Sleep; Stretching; Techniques; Technology; Testing; Tidal Volume; Weight Gain; Work; airway hyperresponsiveness; base; falls; insight; lung volume; pressure; productivity loss; research study; thoracic pressure

DESCRIPTION (provided by applicant): Asthma is a chronic respiratory disease characterized by ainway inflammation and airway hyper- responsiveness, which causes airflow obstruction. It is extremely prevalent, affecting an estimated 7.7% (22 million) of all Americans, and costly with loss of productivity and direct healthcare costs in the billions of dollars. The incidence and prevalence of asthma are increasing, both in the US and around the world. This increase comes despite greater understanding of the inflammatory and allergic basis for asthma, and despite better anti-inflammatory medications. One explanation for the increasing prevalence of asthma is the concomitant increase in obesity, with the majority of Americans now overweight or obese. Numerous studies have linked asthma and obesity, and demonstrated increased obstruction with weight gain and decreased obstruction with weight loss. However, the mechanisms that underlie this linkage are not known. We believe that low lung volumes contribute to the pathogenesis and severity of asthma. Lung volumes are decreased in obesity, and likely fall further during sleep, particularly in overweight and obese patients. Both upper and lower airway resistance increase with decreasing lung volumes, as airways become smaller. However, prior work showed that lower airway resistance increases out of proportion to the decrease in lung volume that occurs during sleep in asthma patients. This difference between controls and patients with asthma has not been further explored, yet may provide insight into asthma pathogenesis and provide potential targets for therapy. Therefore, we purpose a series of experiments to define the impact of lung volumes during sleep on airway resistance. Technology already in use in our lab will be applied to patients with asthma and controls. Nocturnal airway resistance will be measured continuously using the forced oscillation technique (FOT), a non-invasive measurement that is ideal for use during sleep. Lung volumes can be monitored with magnetometers, and esophageal manometry will be used to measure transpulmonary pressures. Furthermore, we will manipulate lung volumes during sleep both tonically (using negative extra-thoracic pressure) and dynamically (using bi-level positive airway pressure). Asthma is an extremely common disorder, which is becoming more prevalent. The purpose of this study is to examine how nocturnal lung volumes contribute to asthma severity, which may explain part of the link between asthma and obesity. Our work may lead to new targets for therapy.

描述（由申请人提供）：哮喘是一种慢性呼吸道疾病，其特征是AINWay炎症和气道超反应性，这会导致气流阻塞。这非常普遍，影响了所有美国人的7.7％（2200万），并且昂贵，生产率损失和直接医疗保健成本的数十亿美元。在美国和世界各地，哮喘的发病率和患病率都在增加。尽管对哮喘的炎症性和过敏性基础有更大的了解，以及尽管抗炎药更好。哮喘患病率增加的一种解释是肥胖的同时增加，大多数美国人现在超重或肥胖。许多研究已将哮喘和肥胖症联系在一起，并证明随着体重增加而增加阻塞，随着体重减轻而减少阻塞。但是，尚不清楚这种联系的基础的机制。我们认为，低肺体积有助于哮喘的发病机理和严重程度。肥胖症的肺量减少，可能在睡眠期间进一步下降，尤其是在超重和肥胖的患者中。随着气道变小，上和下气道阻力随着肺部的减少而增加。然而，先前的工作表明，较低的气道阻力与哮喘患者在睡眠期间发生的肺部体积减少成比例。对照组和哮喘患者之间的这种差异尚未进一步探索，但可以提供对哮喘发病机理的见解，并为治疗提供潜在的靶标。因此，我们目的是一系列实验来定义睡眠期间肺部体积对气道阻力的影响。我们实验室中已经使用的技术将应用于哮喘和对照患者。夜间气道电阻将使用强制振荡技术（FOT）连续测量，这是一种无创测量，非常适合在睡眠期间使用。可以用磁力仪监测肺部体积，并将使用食管测量法来测量肺压力。此外，我们将在睡眠期间操纵肺部体积（使用负面胸腔压力）和动态（使用双层正气道压力）。哮喘是一种极为常见的疾病，它变得越来越普遍。这项研究的目的是检查夜间肺体积如何导致哮喘严重程度，这可能解释了哮喘与肥胖之间的联系的一部分。我们的工作可能会导致治疗的新目标。