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Gobbi A, Antonelli A, Dellaca R, Pellegrino GM, Pellegrino R, Fredberg JJ, Solway J, Brusasco V. Effects of increasing tidal volume and end-expiratory lung volume on induced bronchoconstriction in healthy humans. Respir Res 2024; 25:298. [PMID: 39113017 PMCID: PMC11304934 DOI: 10.1186/s12931-024-02909-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/07/2024] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND Increasing functional residual capacity (FRC) or tidal volume (VT) reduces airway resistance and attenuates the response to bronchoconstrictor stimuli in animals and humans. What is unknown is which one of the above mechanisms is more effective in modulating airway caliber and whether their combination yields additive or synergistic effects. To address this question, we investigated the effects of increased FRC and increased VT in attenuating the bronchoconstriction induced by inhaled methacholine (MCh) in healthy humans. METHODS Nineteen healthy volunteers were challenged with a single-dose of MCh and forced oscillation was used to measure inspiratory resistance at 5 and 19 Hz (R5 and R19), their difference (R5-19), and reactance at 5 Hz (X5) during spontaneous breathing and during imposed breathing patterns with increased FRC, or VT, or both. Importantly, in our experimental design we held the product of VT and breathing frequency (BF), i.e, minute ventilation (VE) fixed so as to better isolate the effects of changes in VT alone. RESULTS Tripling VT from baseline FRC significantly attenuated the effects of MCh on R5, R19, R5-19 and X5. Doubling VT while halving BF had insignificant effects. Increasing FRC by either one or two VT significantly attenuated the effects of MCh on R5, R19, R5-19 and X5. Increasing both VT and FRC had additive effects on R5, R19, R5-19 and X5, but the effect of increasing FRC was more consistent than increasing VT thus suggesting larger bronchodilation. When compared at iso-volume, there were no differences among breathing patterns with the exception of when VT was three times larger than during spontaneous breathing. CONCLUSIONS These data show that increasing FRC and VT can attenuate induced bronchoconstriction in healthy humans by additive effects that are mainly related to an increase of mean operational lung volume. We suggest that static stretching as with increasing FRC is more effective than tidal stretching at constant VE, possibly through a combination of effects on airway geometry and airway smooth muscle dynamics.
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Affiliation(s)
- Alessandro Gobbi
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, 20133, Italy
- Restech Srl, Milano, 20124, Italy
| | - Andrea Antonelli
- Allergologia e Fisiopatologia Respiratoria, ASO S. Croce e Carle, 12100, Cuneo, Italy
| | - Raffaele Dellaca
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, 20133, Italy.
| | - Giulia M Pellegrino
- Casa di Cura del Policlinico, Dipartimento di Scienze Neuroriabilitative, Milano, Italy
| | | | - Jeffrey J Fredberg
- Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
| | - Julian Solway
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Vito Brusasco
- Dipartimento di Medicina Sperimentale, Università di Genova, 16132, Genova, Italy
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2
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Wang L, Chitano P, Seow CY. Mechanopharmacology of Rho-kinase antagonism in airway smooth muscle and potential new therapy for asthma. Pharmacol Res 2020; 159:104995. [PMID: 32534100 DOI: 10.1016/j.phrs.2020.104995] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/20/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Abstract
The principle of mechanopharmacology of airway smooth muscle (ASM) is based on the premise that physical agitation, such as pressure oscillation applied to an airway, is able to induce bronchodilation by reducing contractility and softening the cytoskeleton of ASM. Although the underlying mechanism is not entirely clear, there is evidence to suggest that large-amplitude stretches are able to disrupt the actomyosin interaction in the crossbridge cycle and weaken the cytoskeleton in ASM cells. Rho-kinase is known to enhance force generation and strengthen structural integrity of the cytoskeleton during smooth muscle activation and plays a key role in the maintenance of force during prolonged muscle contractions. Synergy in relaxation has been observed when the muscle is subject to oscillatory length change while Rho-kinase is pharmacologically inhibited. In this review, inhibition of Rho-kinase coupled to therapeutic pressure oscillation applied to the airways is explored as a combination treatment for asthma.
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Affiliation(s)
- Lu Wang
- The Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Canada.
| | - Pasquale Chitano
- The Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Canada
| | - Chun Y Seow
- The Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Canada
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3
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Gazzola M, Khadangi F, Clisson M, Beaudoin J, Clavel MA, Bossé Y. Airway smooth muscle adapting in dynamic conditions is refractory to the bronchodilator effect of a deep inspiration. Am J Physiol Lung Cell Mol Physiol 2020; 318:L452-L458. [PMID: 31913645 DOI: 10.1152/ajplung.00270.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Airway smooth muscle (ASM) is continuously strained during breathing at tidal volume. Whether this tidal strain influences the magnitude of the bronchodilator response to a deep inspiration (DI) is not clearly defined. The present in vitro study examines the effect of tidal strain on the bronchodilator effect of DIs. ASM strips from sheep tracheas were mounted in organ baths and then subjected to stretches (30% strain), simulating DIs at varying time intervals. In between simulated DIs, the strips were either held at a fixed length (isometric) or oscillated continuously by 6% (length oscillations) to simulate tidal strain. The contractile state of the strips was also controlled by adding either methacholine or isoproterenol to activate or relax ASM, respectively. Although the time-dependent gain in force caused by methacholine was attenuated by length oscillations, part of the acquired force in the oscillating condition was preserved postsimulated DIs, which was not the case in the isometric condition. Consequently, the bronchodilator effect of simulated DIs (i.e., the decline in force postsimulated versus presimulated DIs) was attenuated in oscillating versus isometric conditions. These findings suggest that an ASM operating in a dynamic environment acquired adaptations that make it refractory to the decline in contractility inflicted by a larger strain simulating a DI.
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Affiliation(s)
- Morgan Gazzola
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Quebec, Canada
| | - Fatemeh Khadangi
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Quebec, Canada
| | - Marine Clisson
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Quebec, Canada
| | - Jonathan Beaudoin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Quebec, Canada
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Quebec, Canada
| | - Ynuk Bossé
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Quebec, Canada
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4
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Gazzola M, Khadangi F, Clisson M, Beaudoin J, Clavel MA, Bossé Y. Shortening of airway smooth muscle is modulated by prolonging the time without simulated deep inspirations in ovine tracheal strips. J Appl Physiol (1985) 2019; 127:1528-1538. [PMID: 31545157 DOI: 10.1152/japplphysiol.00423.2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The shortening of airway smooth muscle (ASM) is greatly affected by time. This is because stimuli affecting ASM shortening, such as bronchoactive molecules or the strain inflicted by breathing maneuvers, not only alter quick biochemical processes regulating contraction but also slower processes that allow ASM to adapt to an ever-changing length. Little attention has been given to the effect of time on ASM shortening. The present study investigates the effect of changing the time interval between simulated deep inspirations (DIs) on ASM shortening and its responsiveness to simulated DIs. Excised tracheal strips from sheep were mounted in organ baths and either activated with methacholine or relaxed with isoproterenol. They were then subjected to simulated DIs by imposing swings in distending stress, emulating a transmural pressure from 5 to 30 cmH2O. The simulated DIs were intercalated by 2, 5, 10, or 30 min. In between simulated DIs, the distending stress was either fixed or oscillating to simulate tidal breathing. The results show that although shortening was increased by prolonging the interval between simulated DIs, the bronchodilator effect of simulated DIs (i.e., the elongation of the strip post- vs. pre-DI) was not affected, and the rate of re-shortening post-simulated DIs was decreased. As the frequency with which DIs are taken increases upon bronchoconstriction, our results may be relevant to typical alterations observed in asthma, such as an increased rate of re-narrowing post-DI.NEW & NOTEWORTHY The frequency with which patients with asthma take deep inspirations (DIs) increases during bronchoconstriction. This in vitro study investigated the effect of changing the time interval between simulated DIs on airway smooth muscle shortening. The results demonstrated that decreasing the interval between simulated DIs not only decreases shortening, which may be protective against excessive airway narrowing, but also increases the rate of re-shortening post-simulated DIs, which may contribute to the increased rate of re-narrowing post-DI observed in asthma.
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5
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Wang L, Chitano P, Paré PD, Seow CY. Mechanopharmacology and Synergistic Relaxation of Airway Smooth Muscle. ACTA ACUST UNITED AC 2019; 2:0110041-110047. [PMID: 32328573 PMCID: PMC7164492 DOI: 10.1115/1.4042477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 12/20/2018] [Indexed: 12/02/2022]
Abstract
Asthmatic airways are stiffer than normal. We have shown that the cytoskeletal passive stiffness of airway smooth muscle (ASM) can be regulated by intracellular signaling pathways, especially those associated with Rho kinase (ROCK). We have also shown that an oscillatory strain reduces the passive stiffness of ASM and its ability to generate force. Here, we investigated the combined effect of inhibiting the ASM contraction with β2 agonist and decreasing the ASM cytoskeletal stiffness with ROCK inhibitor and/or force oscillation (FO) on the relaxation of contracted ASM. We hypothesize that the ASM relaxation can be synergistically enhanced by the combination of these interventions, because drug-induced softening of the cytoskeleton enhances the FO-induced relaxation and vice versa. Sheep tracheal strips were isotonically contracted to acetylcholine (3 × 10−5 M). At the plateau of shortening, β2 agonist salbutamol (10−7 M), ROCK inhibitor H1152 (10−7 M), and FO (square wave, 1 Hz, amplitude 6% maximal active force) were applied either alone or in combination. After adjusting for nonspecific time-dependent variation, relengthening by individual interventions with low-dose salbutamol or H1152, or small amplitude FO was not significantly different from zero. However, significant relengthening was observed in all combination treatments. The relengthening was greater than the mathematical sum of relengthening caused by individual treatments thereby demonstrating synergistic relaxation. The ASM stiffness did not change with salbutamol or H1152 treatments, but was lower with FO in combination with H1152. The results suggest that the mechanopharmacological treatment can be an effective therapy for asthma.
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Affiliation(s)
- Lu Wang
- Respiratory Division, Department of Medicine; Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada e-mail:
| | - Pasquale Chitano
- Department of Pathology and Laboratory Medicine, Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada
| | - Peter D Paré
- Respiratory Division, Department of Medicine; Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada
| | - Chun Y Seow
- Department of Pathology and Laboratory Medicine, Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 1Y6, Canada
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Bossé Y. The Strain on Airway Smooth Muscle During a Deep Inspiration to Total Lung Capacity. JOURNAL OF ENGINEERING AND SCIENCE IN MEDICAL DIAGNOSTICS AND THERAPY 2019; 2:0108021-1080221. [PMID: 32328568 PMCID: PMC7164505 DOI: 10.1115/1.4042309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/06/2018] [Indexed: 02/05/2023]
Abstract
The deep inspiration (DI) maneuver entices a great deal of interest because of its ability to temporarily ease the flow of air into the lungs. This salutary effect of a DI is proposed to be mediated, at least partially, by momentarily increasing the operating length of airway smooth muscle (ASM). Concerningly, this premise is largely derived from a growing body of in vitro studies investigating the effect of stretching ASM by different magnitudes on its contractility. The relevance of these in vitro findings remains uncertain, as the real range of strains ASM undergoes in vivo during a DI is somewhat elusive. In order to understand the regulation of ASM contractility by a DI and to infer on its putative contribution to the bronchodilator effect of a DI, it is imperative that in vitro studies incorporate levels of strains that are physiologically relevant. This review summarizes the methods that may be used in vivo in humans to estimate the strain experienced by ASM during a DI from functional residual capacity (FRC) to total lung capacity (TLC). The strengths and limitations of each method, as well as the potential confounders, are also discussed. A rough estimated range of ASM strains is provided for the purpose of guiding future in vitro studies that aim at quantifying the regulatory effect of DI on ASM contractility. However, it is emphasized that, owing to the many limitations and confounders, more studies will be needed to reach conclusive statements.
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Affiliation(s)
- Ynuk Bossé
- Université Laval, Faculty of Medicine, Department of Medicine, IUCPQ, M2694, Pavillon Mallet, Chemin Sainte-Foy, Québec, QC G1V 4G5, Canada e-mail:
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7
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O'Sullivan MJ, Lan B. The Aftermath of Bronchoconstriction. ACTA ACUST UNITED AC 2019; 2:0108031-108036. [PMID: 32328569 DOI: 10.1115/1.4042318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 10/30/2018] [Indexed: 11/08/2022]
Abstract
Asthma is characterized by chronic airway inflammation, airway remodeling, and excessive constriction of the airway. Detailed investigation exploring inflammation and the role of immune cells has revealed a variety of possible mechanisms by which chronic inflammation drives asthma development. However, the underlying mechanisms of asthma pathogenesis still remain poorly understood. New evidence now suggests that mechanical stimuli that arise during bronchoconstriction may play a critical role in asthma development. In this article, we review the mechanical effect of bronchoconstriction and how these mechanical stresses contribute to airway remodeling independent of inflammation.
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Affiliation(s)
- Michael J O'Sullivan
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, 1-G07, Boston, MA 02115
| | - Bo Lan
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, 1-G07, Boston, MA 02115 e-mail:
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8
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Mailhot-Larouche S, Bossé Y. Interval between simulated deep inspirations on the dynamics of airway smooth muscle contraction in guinea pig bronchi. Respir Physiol Neurobiol 2018; 259:136-142. [PMID: 30217723 DOI: 10.1016/j.resp.2018.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/06/2018] [Accepted: 09/10/2018] [Indexed: 11/26/2022]
Abstract
A certain amount of time is required to achieve a maximal contraction from airway smooth muscle (ASM) and stretches of substantial magnitude, such as the ones imparted by deep inspirations (DIs), interfere with contraction. The duration of ASM contraction without interference may thus affect its shortening, its mechanical response to DIs and the overall toll it exerts on the respiratory system. In this study, the effect of changing the interval between DIs on the dynamics of ASM was examined in vitro. Isolated bronchi derived from guinea pigs were held isotonically and stimulated to both contract and relax, in a randomized order, in response to 10-5 M of methacholine and 10-6 M of isoproterenol, respectively. Interference to ASM was inflicted after 2, 5, 10 and 30 min in a randomized order, by imposing a stretch that simulated a DI. The shortening before the stretch, the stiffness before and during the stretch, the post-stretch elongation of ASM and the ensuing re-shortening were measured. These experiments were also performed in the presence of simulated tidal breathing achieved through force fluctuations. The results demonstrate that, with or without force fluctuations, increasing the interval between simulated DIs increased shortening and post-stretch elongation, but not stiffness and re-shortening. These time-dependent effects were not observed when ASM was held in the relaxed state. These findings may help understand to which extent ASM shortening and the regulatory effect of DI are affected by changing the interval between DIs. The potential consequences of these findings on airway narrowing are also discussed.
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9
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Mailhot-Larouche S, Lortie K, Marsolais D, Flamand N, Bossé Y. An in vitro study examining the duration between deep inspirations on the rate of renarrowing. Respir Physiol Neurobiol 2017; 243:13-19. [PMID: 28487171 DOI: 10.1016/j.resp.2017.04.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/07/2017] [Accepted: 04/29/2017] [Indexed: 12/12/2022]
Abstract
The factors altering the bronchodilatory response to a deep inspiration (DI) in asthma are important to decipher. In this in vitro study, we investigated the effect of changing the duration between DIs on the rate of force recovery post-DI in guinea pig bronchi. The airway smooth muscle (ASM) within the main bronchi were submitted to length oscillation that simulated tidal breathing in different contractile states during 2, 5, 10 or 30min prior to a larger length excursion that simulated a DI. The contractile states of ASM were determined by adding either methacholine or isoproterenol. Irrespective of the contractile state, the duration between DIs neither affected the measured force during length oscillation nor the bronchodilator effect of DI. Contrastingly, the rate of force recovery post-DI in contracted state increased as the duration between DIs decreased. Similar results were obtained with contracted parenchymal strips. These findings suggest that changing the duration between DIs may alter the rate of ASM force recovery post-DI and thereby affect the rate of renarrowing and the duration of the respiratory relief afforded by DI.
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Affiliation(s)
- Samuel Mailhot-Larouche
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Katherine Lortie
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - David Marsolais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Nicolas Flamand
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Ynuk Bossé
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada.
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10
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Klansky A, Irvin C, Morrison-Taylor A, Ahlstrand S, Labrie D, Haverkamp HC. No effect of elevated operating lung volumes on airway function during variable workrate exercise in asthmatic humans. J Appl Physiol (1985) 2016; 121:89-100. [PMID: 27150833 DOI: 10.1152/japplphysiol.00538.2015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 05/02/2016] [Indexed: 11/22/2022] Open
Abstract
In asthmatic adults, airway caliber fluctuates during variable intensity exercise such that bronchodilation (BD) occurs with increased workrate whereas bronchoconstriction (BC) occurs with decreased workrate. We hypothesized that increased lung mechanical stretch would prevent BC during such variable workrate exercise. Ten asthmatic and ten nonasthmatic subjects completed two exercise trials on a cycle ergometer. Both trials included a 28-min exercise bout consisting of alternating four min periods at workloads equal to 40 % (Low) and 70% (High) peak power output. During one trial, subjects breathed spontaneously throughout exercise (SVT), such that tidal volume (VT) and end-inspiratory lung volume (EILV) were increased by 0.5 and 0.6 liters during the high compared with the low workload in nonasthmatic and asthmatic subjects, respectively. During the second trial (MVT), VT and EILV were maintained constant when transitioning from the high to the low workload. Forced exhalations from total lung capacity were performed during each exercise workload. In asthmatic subjects, forced expiratory volume 1.0 s (FEV1.0) increased and decreased with the increases and decreases in workrate during both SVT (Low, 3.3 ± 0.3 liters; High, 3.6 ± 0.2 liters; P < 0.05) and MVT (Low, 3.3 ± 0.3 liters; High, 3.5 ± 0.2 liters; P < 0.05). Thus increased lung stretch during MVT did not prevent decreases in airway caliber when workload was reduced. We conclude that neural factors controlling airway smooth muscle (ASM) contractile activity during whole body exercise are more robust determinants of airway caliber than the ability of lung stretch to alter ASM actin-myosin binding and contraction.
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Affiliation(s)
- Andrew Klansky
- Johnson State College, Department of Environmental and Health Sciences, Johnson, Vermont; and
| | - Charlie Irvin
- University of Vermont, Vermont Lung Center, Burlington, Vermont
| | - Adriane Morrison-Taylor
- Johnson State College, Department of Environmental and Health Sciences, Johnson, Vermont; and
| | - Sarah Ahlstrand
- Johnson State College, Department of Environmental and Health Sciences, Johnson, Vermont; and
| | - Danielle Labrie
- Johnson State College, Department of Environmental and Health Sciences, Johnson, Vermont; and
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11
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Ansell TK, Noble PB, Mitchell HW, McFawn PK. Pharmacological bronchodilation is partially mediated by reduced airway wall stiffness. Br J Pharmacol 2015; 171:4376-84. [PMID: 24846164 DOI: 10.1111/bph.12781] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 03/31/2014] [Accepted: 04/25/2014] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AND PURPOSE In asthmatic patients, airflow limitation is at least partly reversed by administration of pharmacological bronchodilators, typically β2 -adrenoceptor agonists. In addition to receptor-mediated bronchodilation, the dynamic mechanical environment of the lung itself can reverse bronchoconstriction. We have now explored the possibility that bronchodilators exert a synergistic effect with oscillatory loads by virtue of reducing airway wall stiffness, and therefore, enhancing the bronchodilatory response to breathing manoeuvres. EXPERIMENTAL APPROACH Whole porcine bronchial segments in vitro were contracted to carbachol and relaxed to the non-specific β-adrenoceptor agonist, isoprenaline, under static conditions or during simulated breathing manoeuvres. KEY RESULTS The bronchodilatory response to isoprenaline was greater during breathing manoeuvres compared with the response under static conditions. As the bronchodilatory response to breathing manoeuvres is dependent upon airway smooth muscle (ASM) strain, and therefore, airway wall stiffness, our findings are likely to be explained by the effect of isoprenaline on reducing airway wall stiffness, which increased ASM strain, producing greater bronchodilation. CONCLUSIONS AND IMPLICATIONS A contribution of reduced airway stiffness and increased ASM strain to the bronchodilator action of isoprenaline is shown, suggesting that oscillatory loads act synergistically with pharmacologically mediated bronchodilation. The implications for the treatment of asthma are that reducing airway wall stiffness represents a potential target for novel pharmacological agents.
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Affiliation(s)
- T K Ansell
- School of Anatomy, Physiology and Human Biology, University of Western Australia, Crawley, WA, Australia
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12
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Harvey BC, Parameswaran H, Lutchen KR. Can breathing-like pressure oscillations reverse or prevent narrowing of small intact airways? J Appl Physiol (1985) 2015; 119:47-54. [PMID: 25953836 DOI: 10.1152/japplphysiol.01100.2014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 05/01/2015] [Indexed: 01/20/2023] Open
Abstract
Periodic length fluctuations of airway smooth muscle during breathing are thought to modulate airway responsiveness in vivo. Recent animal and human intact airway studies have shown that pressure fluctuations simulating breathing can only marginally reverse airway narrowing and are ineffective at protecting against future narrowing. However, these previous studies were performed on relatively large (>5 mm diameter) airways, which are inherently stiffer than smaller airways for which a preponderance of airway constriction in asthma likely occurs. The goal of this study was to determine the effectiveness of breathing-like transmural pressure oscillations to reverse induced narrowing and/or protect against future narrowing of smaller, more compliant intact airways. We constricted smaller (luminal diameter = 2.92 ± 0.29 mm) intact airway segments twice with ACh (10(-6) M), once while applying tidal-like pressure oscillations (5-15 cmH2O) before, during, and after inducing constriction (Pre + Post) and again while only imposing the tidal-like pressure oscillation after induced constriction (Post Only). Smaller airways were 128% more compliant than previously studied larger airways. This increased compliance translated into 196% more strain and 76% greater recovery (41 vs. 23%) because of tidal-like pressure oscillations. Larger pressure oscillations (5-25 cmH2O) caused more recovery (77.5 ± 16.5%). However, pressure oscillations applied before and during constriction resulted in the same steady-state diameter as when pressure oscillations were only applied after constriction. These data show that reduced straining of the airways before a challenge likely does not contribute to the emergence of airway hyperreactivity observed in asthma but may serve to sustain a given level of constriction.
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Affiliation(s)
- Brian C Harvey
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
| | | | - Kenneth R Lutchen
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts
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13
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Pascoe CD, Donovan GM, Bossé Y, Seow CY, Paré PD. Bronchoprotective effect of simulated deep inspirations in tracheal smooth muscle. J Appl Physiol (1985) 2014; 117:1502-13. [PMID: 25324512 DOI: 10.1152/japplphysiol.00713.2014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Deep inspirations (DIs) taken before an inhaled challenge with a spasmogen limit airway responsiveness in nonasthmatic subjects. This phenomenon is called bronchoprotection and is severely impaired in asthmatic subjects. The ability of DIs to prevent a decrease in forced expiratory volume in 1 s (FEV1) was initially attributed to inhibition of airway narrowing. However, DIs taken before methacholine challenge limit airway responsiveness only when a test of lung function requiring a DI is used (FEV1). Therefore, it has been suggested that prior DIs enhance the compliance of the airways or airway smooth muscle (ASM). This would increase the strain the airway wall undergoes during the subsequent DI, which is part of the FEV1 maneuver. To investigate this phenomenon, we used ovine tracheal smooth muscle strips that were subjected to shortening elicited by acetylcholine with or without prior strain mimicking two DIs. The compliance of the shortened strip was then measured in response to a stress mimicking one DI. Our results show that the presence of "DIs" before acetylcholine-induced shortening resulted in 11% greater relengthening in response to the third DI, compared with the prior DIs. This effect, although small, is shown to be potentially important for the reopening of closed airways. The effect of prior DIs was abolished by the adaptation of ASM to either shorter or longer lengths or to a low baseline tone. These results suggest that DIs confer bronchoprotection because they increase the compliance of ASM, which, consequently, promotes greater strain from subsequent DI and fosters the reopening of closed airways.
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Affiliation(s)
- Christopher D Pascoe
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Graham M Donovan
- Department of Mathematics, University of Auckland, Auckland, New Zealand
| | - Ynuk Bossé
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada; and
| | - Chun Y Seow
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Peter D Paré
- Department of Medicine, Respiratory Division, University of British Columbia, Vancouver, British Columbia, Canada; Center for Heart Lung Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
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Chapman DG, Pascoe CD, Lee-Gosselin A, Couture C, Seow CY, Paré PD, Salome CM, King GG, Bossé Y. Smooth Muscle in the Maintenance of Increased Airway Resistance Elicited by Methacholine in Humans. Am J Respir Crit Care Med 2014; 190:879-85. [DOI: 10.1164/rccm.201403-0502oc] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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15
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Abstract
Asthma is a prevalent respiratory disorder triggered by a variety of inhaled environmental factors, such as allergens, viruses, and pollutants. Asthma is characterized by an elevated activation of the smooth muscle surrounding the airways, as well as a propensity of the airways to narrow excessively in response to a spasmogen (i.e. contractile agonist), a feature called airway hyperresponsiveness. The level of airway smooth muscle (ASM) activation is putatively controlled by mediators released in its vicinity. In asthma, many mediators that affect ASM contractility originate from inflammatory cells that are mobilized into the airways, such as eosinophils. However, mounting evidence indicates that mediators released by remote organs can also influence the level of activation of ASM, as well as its level of responsiveness to spasmogens and relaxant agonists. These remote mediators are transported through circulating blood to act either directly on ASM or indirectly via the nervous system by tuning the level of cholinergic activation of ASM. Indeed, mediators generated from diverse organs, including the adrenals, pancreas, adipose tissue, gonads, heart, intestines, and stomach, affect the contractility of ASM. Together, these results suggest that, apart from a paracrine mode of regulation, ASM is subjected to an endocrine mode of regulation. The results also imply that defects in organs other than the lungs can contribute to asthma symptoms and severity. In this review, I suggest that the endocrine mode of regulation of ASM contractility is overlooked.
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Affiliation(s)
- Ynuk Bossé
- Institut Universitaire de Cardiologie et de Pneumologie de QuébecUniversité Laval, Québec, Québec, Canada G1V 4G5
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16
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Noble PB, Pascoe CD, Lan B, Ito S, Kistemaker LEM, Tatler AL, Pera T, Brook BS, Gosens R, West AR. Airway smooth muscle in asthma: linking contraction and mechanotransduction to disease pathogenesis and remodelling. Pulm Pharmacol Ther 2014; 29:96-107. [PMID: 25062835 DOI: 10.1016/j.pupt.2014.07.005] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Revised: 07/12/2014] [Accepted: 07/15/2014] [Indexed: 02/07/2023]
Abstract
Asthma is an obstructive airway disease, with a heterogeneous and multifactorial pathogenesis. Although generally considered to be a disease principally driven by chronic inflammation, it is becoming increasingly recognised that the immune component of the pathology poorly correlates with the clinical symptoms of asthma, thus highlighting a potentially central role for non-immune cells. In this context airway smooth muscle (ASM) may be a key player, as it comprises a significant proportion of the airway wall and is the ultimate effector of acute airway narrowing. Historically, the contribution of ASM to asthma pathogenesis has been contentious, yet emerging evidence suggests that ASM contractile activation imparts chronic effects that extend well beyond the temporary effects of bronchoconstriction. In this review article we describe the effects that ASM contraction, in combination with cellular mechanotransduction and novel contraction-inflammation synergies, contribute to asthma pathogenesis. Specific emphasis will be placed on the effects that ASM contraction exerts on the mechanical properties of the airway wall, as well as novel mechanisms by which ASM contraction may contribute to more established features of asthma such as airway wall remodelling.
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Affiliation(s)
- Peter B Noble
- School of Anatomy, Physiology and Human Biology, University of Western Australia, WA, Australia
| | - Chris D Pascoe
- Center for Heart Lung Innovation, University of British Columbia, BC, Canada
| | - Bo Lan
- Center for Heart Lung Innovation, University of British Columbia, BC, Canada; Bioengineering College, Chongqing University, Chongqing, China
| | - Satoru Ito
- Department of Respiratory Medicine, Nagoya University, Aichi, Japan
| | - Loes E M Kistemaker
- Department of Molecular Pharmacology, University of Groningen, The Netherlands
| | - Amanda L Tatler
- Division of Respiratory Medicine, University of Nottingham, United Kingdom
| | - Tonio Pera
- Center for Translational Medicine, Thomas Jefferson University, Philadelphia, PA, USA
| | - Bindi S Brook
- School of Mathematical Sciences, University of Nottingham, United Kingdom
| | - Reinoud Gosens
- Department of Molecular Pharmacology, University of Groningen, The Netherlands
| | - Adrian R West
- Department of Physiology, University of Manitoba, MB, Canada; Biology of Breathing, Manitoba Institute of Child Health, MB, Canada.
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17
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Hulme KM, Salome CM, Brown NJ, Berend N, Agus HM, Horlyck KR, King GG, Chapman DG. Deep inspiration volume and the impaired reversal of bronchoconstriction in asthma. Respir Physiol Neurobiol 2013; 189:506-12. [PMID: 23994826 DOI: 10.1016/j.resp.2013.08.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 07/26/2013] [Accepted: 08/21/2013] [Indexed: 01/08/2023]
Abstract
It is unclear whether the failure to reverse bronchoconstriction with deep inspiration (DI) in asthma is due to reduced maximal dilatation of the DI. We compared the effect of different DI volumes on maximal dilatation and reversal of bronchoconstriction in nine asthmatics and ten non-asthmatics. During bronchoconstriction, subjects took DI to 40%, 70% and 100% inspiratory capacity, on separate days. Maximal dilatation was measured as respiratory system resistance (Rrs) at end-inspiration and residual dilatation as Rrs at end-expiration, both expressed as percent of Rrs at end-tidal expiration prior to DI. DI volume was positively associated with maximal dilatation in non-asthmatics (ANOVA p=0.055) and asthmatics (p=0.023). DI volume was positively associated with residual dilatation in non-asthmatics (p=0.004) but not in asthmatics (p=0.53). The degree of maximal dilatation independently predicted residual dilatation in non-asthmatics but not asthmatics. These findings suggest that the failure to reverse bronchoconstriction with DI in asthma is not due to reduced maximal dilatation, but rather due to increased airway narrowing during expiration.
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18
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Lee-Gosselin A, Pascoe CD, Couture C, Paré PD, Bossé Y. Does the length dependency of airway smooth muscle force contribute to airway hyperresponsiveness? J Appl Physiol (1985) 2013; 115:1304-15. [PMID: 23970527 DOI: 10.1152/japplphysiol.01480.2012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Airway wall remodeling and lung hyperinflation are two typical features of asthma that may alter the contractility of airway smooth muscle (ASM) by affecting its operating length. The aims of this study were as follows: 1) to describe in detail the "length dependency of ASM force" in response to different spasmogens; and 2) to predict, based on morphological data and a computational model, the consequence of this length dependency of ASM force on airway responsiveness in asthmatic subjects who have both remodeled airway walls and hyperinflated lungs. Ovine tracheal ASM strips and human bronchial rings were isolated and stimulated to contract in response to increasing concentrations of spasmogens at three different lengths. Ovine tracheal strips were more sensitive and generated greater force at longer lengths in response to acetylcholine (ACh) and K(+). Equipotent concentrations of ACh were approximately a log less for ASM stretched by 30% and approximately a log more for ASM shortened by 30%. Similar results were observed in human bronchi in response to methacholine. Morphometric and computational analyses predicted that the ASM of asthmatic subjects may be elongated by 6.6-10.4% (depending on airway generation) due to remodeling and/or hyperinflation, which could increase ACh-induced force by 1.8-117.8% (depending on ASM length and ACh concentration) and enhance the increased resistance to airflow by 0.4-4,432.8%. In conclusion, elongation of ASM imposed by airway wall remodeling and/or hyperinflation may allow ASM to operate at a longer length and to consequently generate more force and respond to lower concentration of spasmogens. This phenomenon could contribute to airway hyperresponsiveness.
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Affiliation(s)
- Audrey Lee-Gosselin
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Department of Medicine, Université Laval, Québec City, Québec, Canada
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19
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Gobbi A, Pellegrino R, Gulotta C, Antonelli A, Pompilio P, Crimi C, Torchio R, Dutto L, Parola P, Dellacà RL, Brusasco V. Short-term variability in respiratory impedance and effect of deep breath in asthmatic and healthy subjects with airway smooth muscle activation and unloading. J Appl Physiol (1985) 2013; 115:708-15. [PMID: 23766502 DOI: 10.1152/japplphysiol.00013.2013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Inspiratory resistance (RINSP) and reactance (XINSP) were measured for 7 min at 5 Hz in 10 subjects with mild asymptomatic asthma and 9 healthy subjects to assess the effects of airway smooth muscle (ASM) activation by methacholine (MCh) and unloading by chest wall strapping (CWS) on the variability of lung function and the effects of deep inspiration (DI). Subjects were studied at control conditions, after MCh, with CWS, and after MCh with CWS. In all experimental conditions XINSP was significantly more negative in subjects with asthma than in healthy subjects, suggesting greater inhomogeneity in the former. However, the variability in both RINSP and XINSP was increased by either ASM activation or CWS, without significant difference between groups. DI significantly reversed MCh-induced changes in RINSP both in subjects with asthma and healthy subjects, but XINSP in the former only. This effect was impaired by CWS more in subjects with asthma than in healthy subjects. The velocity of RINSP and XINSP recovery after DI was faster in subjects with asthma than healthy subjects. In conclusion, these results support the opinion that the short-term variability in respiratory impedance is related to ASM tone or operating length, rather than to the disease. Nevertheless, ASM in individuals with asthma differs from that in healthy individuals in an increased velocity of shortening and a reduced sensitivity to mechanical stress when strain is reduced.
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Affiliation(s)
- Alessandro Gobbi
- TBM Lab, Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
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20
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Ansell TK, McFawn PK, Mitchell HW, Noble PB. Bronchodilatory response to deep inspiration in bronchial segments: the effects of stress vs. strain. J Appl Physiol (1985) 2013; 115:505-13. [PMID: 23722712 DOI: 10.1152/japplphysiol.01286.2012] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
During deep inspirations (DI), a distending force is applied to airway smooth muscle (ASM; i.e., stress) and the muscle is lengthened (i.e., strain), which produces a transient reversal of bronchoconstriction (i.e., bronchodilation). The aim of the present study was to determine whether an increase in ASM stress or the accompanying increase in strain mediates the bronchodilatory response to DI. We used whole porcine bronchial segments in vitro and a servo-controlled syringe pump that applied fixed-transmural pressure (Ptm) or fixed-volume oscillations, simulating tidal breathing and DI. The relationship between ASM stress and strain during oscillation was altered by increasing doses of acetylcholine, which stiffened the airway wall, or by changing the rate of inflation during DI, which utilized the viscous properties of the intact airway. Bronchodilation to DI was positively correlated with ASM strain (range of r values from 0.81 to 0.95) and negatively correlated with stress (range of r values from -0.42 to -0.98). Fast fixed-Ptm DI produced greater bronchodilation than slow DI, despite less ASM strain. Fast fixed-volume DI produced greater bronchodilation than slow DI, despite identical ASM strain. We show that ASM strain, rather than stress, is the critical determinant of bronchodilation and, unexpectedly, that the rate of inflation during DI also impacts on bronchodilation, independent of the magnitudes of either stress or strain.
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Affiliation(s)
- Thomas K Ansell
- School of Anatomy, Physiology and Human Biology, University of Western Australia, Crawley, Australia.
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21
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Harvey BC, Parameswaran H, Lutchen KR. Can tidal breathing with deep inspirations of intact airways create sustained bronchoprotection or bronchodilation? J Appl Physiol (1985) 2013; 115:436-45. [PMID: 23722710 DOI: 10.1152/japplphysiol.00009.2013] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Fluctuating forces imposed on the airway smooth muscle due to breathing are believed to regulate hyperresponsiveness in vivo. However, recent animal and human isolated airway studies have shown that typical breathing-sized transmural pressure (Ptm) oscillations around a fixed mean are ineffective at mitigating airway constriction. To help understand this discrepancy, we hypothesized that Ptm oscillations capable of producing the same degree of bronchodilation as observed in airway smooth muscle strip studies requires imposition of strains larger than those expected to occur in vivo. First, we applied increasingly larger amplitude Ptm oscillations to a statically constricted airway from a Ptm simulating normal functional residual capacity of 5 cmH2O. Tidal-like oscillations (5-10 cmH2O) imposed 4.9 ± 2.0% strain and resulted in 11.6 ± 4.8% recovery, while Ptm oscillations simulating a deep inspiration at every breath (5-30 cmH2O) achieved 62.9 ± 12.1% recovery. These same Ptm oscillations were then applied starting from a Ptm = 1 cmH2O, resulting in approximately double the strain for each oscillation amplitude. When extreme strains were imposed, we observed full recovery. On combining the two data sets, we found a linear relationship between strain and resultant recovery. Finally, we compared the impact of Ptm oscillations before and after constriction to Ptm oscillations applied only after constriction and found that both loading conditions had a similar effect on narrowing. We conclude that, while sufficiently large strains applied to the airway wall are capable of producing substantial bronchodilation, the Ptm oscillations necessary to achieve those strains are not expected to occur in vivo.
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Affiliation(s)
- Brian C Harvey
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, USA.
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