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Deep Inhalation Bronchodilation and Oral Corticosteroids in Asthma

Donald W. Cockcroft, MD
Author and Funding Information

Affiliations: Saskatoon, Canada
 ,  Dr. Cockcroft is Professor and Head of the Division of Respirology, Critical Care and Sleep Medicine, Royal University Hospital.

Correspondence to: Donald W. Cockcroft, MD, FCCP, Division of Respirology, Critical Care and Sleep Medicine, Royal University Hospital, 103 Hospital Dr, Ellis Hall, 5th Floor, Saskatoon, SK S7N 0W8 Canada; e-mail: cockcroft@sask.usask.ca



Chest. 2006;130(1):7-8. doi:10.1378/chest.130.1.7
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Airway smooth-muscle hyperresponsiveness is a characteristic feature of asthma.1 Airway hyperresponsiveness is most commonly identified in the laboratory by the leftward shift of bronchoconstrictor (eg, methacholine) dose-response curves. A reduction in methacholine concentration producing a 20% fall in FEV1 indicates increased ease of development of bronchoconstriction.,12 Subjects with asthma also demonstrate an increased magnitude of bronchoconstriction, with progressive elevation of the level and eventual disappearance of the methacholine dose-response plateau.2 Another feature of the hyperresponsive airway smooth muscle in asthma is the bronchoactive effect of maximal lung inflation. In subjects with asthmatic airflow obstruction in the midst of an exacerbation, maximal inflation has a bronchoconstrictor effect.3 By contrast, in normal nonasthmatic subjects and subjects with mild asthma, maximal lung inflation has a potent bronchodilator effect.4

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