Airway response to emotional stimuli in asthma: the role of the cholinergic pathway

作者：Ritz Thomas^*; Kullowatz Antje; Goldman Michael D; Smith Hans Juergen; Kanniess Frank; Dahme Bernhard; Magnussen Helgo

来源：Journal of Applied Physiology, 2010, 108(6): 1542-1549.

DOI：10.1152/japplphysiol.00818.2009

• respiratory resistance
• emotion
• airway hyperreactivity

Ritz T, Kullowatz A, Goldman MD, Smith H, Kanniess F, Dahme B, Magnussen H. Airway response to emotional stimuli in asthma: the role of the cholinergic pathway. J Appl Physiol 108: 1542-1549, 2010. First published April 1, 2010; doi:10.1152/japplphysiol.00818.2009.-In asthma, airways constrict in response to emotion and stress, but underlying mechanisms, potential extrathoracic contributions, and associations with airway pathophysiology have not been elucidated. We therefore investigated the role of the cholinergic pathway in emotion-induced airway responses in patients with asthma and the association of these responses with airway pathophysiology. Patients with asthma (n = 54) and healthy participants (n = 25) received either 40 mu g ipratropium bromide or a placebo in a double-blind double-dummy cross-over design in two laboratory sessions with experimental emotion induction. Stimuli were preevaluated films and pictures of pleasant, unpleasant, and neutral quality. Respiratory resistance and reactance at 5 and 20 Hz were measured continuously before and during presentations, together with respiration by impedance plethysmography and end-tidal PCO(2) by capnometry. In addition, measures of airway inflammation (fraction of exhaled nitric oxide), airway hyperreactivity (methacholine challenge), and reversibility of obstruction were obtained. Respiratory resistance at 5 and 20 Hz increased during unpleasant stimuli in asthma patients. This response was blocked by ipratropium bromide and was not substantially associated with asthma severity, airway inflammation, hyperreactivity and reversibility, or pattern of ventilation and PCO(2). Under the placebo condition, changes in resistance during unpleasant films were positively correlated with patients' reports of psychological asthma triggers. In conclusion, airway constriction to unpleasant stimuli in asthma depends on an intact cholinergic pathway, is largely due to the central airways, and is not substantially associated with other indicators of airway pathology. Its link to the perceived psychological triggers in patients' daily lives suggests a physiological basis for emotion-induced asthma.

• 出版日期2010-6