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Biomedical subjects

C Peiffer

Publications and source records attributed to C Peiffer.

10 recordsLinked to original sources
PubMed2001

Effect of cetirizine on bronchial hyperresponsiveness in patients with seasonal allergic rhinitis and asthma.

Although H1 antihistamine compounds (H1) are highly effective in the treatment of allergic rhinitis (AR), their role in the treatment of asthma is still controversial. Because a strong association between AR and bronchial hyperresponsiveness (BHR) has been reported, this study was designed to assess the effect of a new H1 anti histamine, cetirizine (C), on nonspecific BHR in patients with AR. Twelve patients were included in a double-blind, crossover, placebo-controlled trial. All patients had positive skin tests for common allergens and showed BHR to inhaled methacholine after specific nasal allergenic challenge. After a washout period of 1 week to ensure the stability of the BHR, the patients received, by crossover randomization, C 10 mg daily or placebo (P) for 2 weeks. After each treatment period, BHR and nasal blocking index (NBI) were measured 1 and 6 h after nasal challenge. Bronchial responsiveness was expressed as methacholine PD20, the provocation dose of methacholine causing a 20% decrease in FEV1. Measurements were then performed after 2 weeks of C and after 2 weeks of P. Baseline values of PD20 (median) measured before challenge showed no difference after cetirizine or after placebo (1.36 mg). Results 1 h after allergen did not show significant differences between C (methacholine PD20=0.522 mg) and placebo (methacholine PD20=0.455 mg). By contrast, 6 h after challenge, methacholine PD20 was 0.918 mg for C and 0.483 mg for P (P=0.042). Similarly, NBI showed no change between C and P 1 h after challenge, whereas the difference was significant 6 h after challenge (P=0.011 ). These data demonstrate a protective nasal effect of C against BHR measured 6 h after nasal allergen challenge in patients with AR. They suggest that C may be useful in patients with asthma associated with AR.

Adult↗
PubMed2001

Neural substrates for the perception of acutely induced dyspnea.

Little is currently known about the brain regions involved in central processing of dyspnea. We performed a functional imaging study with positron emission tomography (PET) to assess brain activation associated with an important component of dyspnea, respiratory discomfort during loaded breathing. We induced respiratory discomfort in eight healthy volunteers by adding external resistive loads during inspiration and expiration. Brain activation was characterized by a significant increase in regional cerebral blood flow (rCBF) (Z score of peak activation > 3.09). As compared with the unloaded control condition, high loaded breathing was associated with neural activation in three distinct brain regions, the right anterior insula, the cerebellar vermis, and the medial pons (respective Z scores = 4.75, 4.44, 4.41). For these brain regions, we further identified a positive correlation between rCBF and the perceived intensity of respiratory discomfort (respective Z scores = 4.45, 4.75, 4.74) as well as between rCBF and the mean amplitude of mouth pressure swings (DeltaPm), the index of the main generating mechanism of the sensation (respective Z scores = 4.67, 4.36, 4.31), suggesting a common activation by these two parameters. Furthermore, we identified an area in the right posterior cingulate cortex where neural activation was specifically associated with perceived intensity of respiratory discomfort that is not related to DeltaPm (Z score = 4.25). Our results suggest that respiratory discomfort related to loaded breathing may be subserved by two distinct neural networks, the first being involved in the concomitant processing of the genesis and perception of respiratory discomfort and the second in the modulation of perceived intensity of the sensation by various factors other than its main generating mechanism, which may include emotional processing.

Acute Disease↗
PubMed1996

Respiratory sensation related to resistive loads in lung transplant recipients.

In order to assess the contribution of pulmonary afferent nerves to the processing of respiratory sensation, we compared sensation related to inspiratory resistive loaded breathing in 14 lung transplant recipients with normal lung function with that in 14 matched healthy control subjects. Respiratory sensation was characterized for each subject by the correlation coefficient and slope of the linear relationship between the intensity of sensation (expressed as Borg scores [BSc]) and peak inspiratory mouth pressure (peak Pm), which was considered the main physical stimulus of the sensation. Individual correlation coefficients were very high and did not differ between lung transplant recipients and controls. In contrast, individual slopes of BSc as a function of peak Pm (BSc/peak Pm slopes) were significantly lower in lung transplant recipients than in controls (0.63 versus 1.26; p < 0.01). Furthermore, ventilatory responses to external loads differed significantly between lung transplant recipients and controls in terms of higher values and ranges of generated peak Pm and peak inspiratory flow in lung transplant recipients than in controls (all p < 0.05). These results suggest that pulmonary afferent nerves may contribute to ventilatory and sensory responses to external loads. However, as suggested by the inverse relation between BSc/peak Pm slopes and peak Pm ranges, higher stimulus ranges in lung transplant recipients may also have contributed to intergroup differences in respiratory sensation related to loaded breathing.

Adult↗
PubMed1995

Perception of bronchial obstruction in asthmatic patients. Relationship with bronchial eosinophilic inflammation and epithelial damage and effect of corticosteroid treatment.

We studied the perception of bronchoconstriction in asthmatic subjects who were randomly treated with inhaled beta 2 agonist given either alone (n = 9) or associated with inhaled corticosteroids (n = 9). Methacholine and bradykinin challenges, bronchoalveolar lavage, and bronchial biopsies were performed in all subjects. After each dose of agonist, breathlessness was assessed using a visual analog scale (VAS) and the forced expiratory volume in 1 s (FEV1) was measured. The relationship between VAS scores and FEV1 and the slope of the regression line of VAS scores on the corresponding FEV1 (VAS/FEV1 slope) were analyzed for each agonist. Subjects without corticosteroids had good perception of methacholine but poor perception of bradykinin-induced bronchoconstriction. In subjects with corticosteroids, bronchoconstriction was well perceived whatever the agonist. VAS/FEV1 slopes for bradykinin but not for methacholine correlated negatively with the magnitude of eosinophilic inflammation in airway mucosa. VAS/FEV1 slopes for each agonist correlated positively with the percentage of basement membrane covered by airway epithelium. We conclude that in asthmatic patients perception of bronchoconstriction is related to eosinophilic inflammation and to epithelial damage in airways and that corticosteroid treatment is associated with improved perception of bronchoconstriction induced by bradykinin, a mediator endogenously produced in asthma.

Adrenal Cortex Hormones↗
PubMed1992

Relationship between spontaneous dyspnoea and lability of airway obstruction in asthma.

1. As marked lability of bronchial obstruction is a risk factor for asthma severity, it may influence dyspnoea, the most common subjective complaint in asthma. We therefore studied the relationship between spontaneous dyspnoea and the degree of bronchial lability, as assessed by the daily variability in peak expiratory flow rate and the bronchial responsiveness to either carbachol or salbutamol, in 33 stable symptomatic asthmatic patients. 2. Three times daily, for 10 consecutive days, the patients rated the intensity of their dyspnoea on a visual analogue scale and immediately afterwards recorded their peak expiratory flow rate. Within the next 5 days, we determined the bronchial response by measuring the forced expiratory volume in 1 s and the specific resistance of airways to either carbachol or salbutamol according to baseline airway obstruction. 3. We characterized dyspnoea for each patient by using two parameters: (1) the relationship with underlying airway obstruction, as assessed by the correlation coefficient r between dyspnoea scores and corresponding values of peak expiratory flow rate (r DSc-PEFR), and (2) the intensity, as assessed by the mean visual analogue scale dyspnoea score adjusted for comparable airway obstruction. Bronchial lability was characterized by (1) variability in mean daily peak expiratory flow rate and (2) bronchial responsiveness to either carbachol (as assessed by the threshold dose and the slope of the dose-response curve) or salbutamol (as assessed by the threshold dose and maximal response). We assessed the relationship between dyspnoea and bronchial lability by correlating each of their respective characteristics. 4. We found large inter-subject differences in both characteristics of dyspnoea.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Chronobiological study of the relationship between dyspnoea and airway obstruction in symptomatic asthmatic subjects.

1. We performed a chronobiological study of the relationship between peak expiratory flow rate (PEFR) and magnitude of dyspnoea in 35 symptomatic asthmatic patients to determine how accurately asthmatic subjects assess spontaneous airway obstruction and whether this accuracy varies throughout the 24 h period and depends on characteristics of the subjects or asthma. 2. At 07.00, 11.00, 15.00, 19.00 and 23.00 hours on 8 consecutive days in their ordinary environment and under their usual drug regimen, the subjects first rated their dyspnoea with a visual analogue scale and immediately after recorded their PEFR. 3. The linear regression coefficients between dyspnoea score and PEFR for the 35 subjects were continuously distributed between -0.93 and +0.21, with most r values ranging from -0.9 to -0.5. The group median r values calculated at each time point showed that strongest correlation between dyspnoea score and PEFR occurred at 7 h. which coincided with the lowest PEFR values. 4. We chose r = -0.7 (r2 = 0.5) as a limit to distinguish good perceivers (-1 less than r less than or equal to -0.7) from bad perceivers of airway obstruction. These two populations differed only by a higher variability of both PEFR and dyspnoea score in good than in bad perceivers, but not for severity, duration or treatment of asthma, absolute value of dyspnoea score, age or sex. 5. Our study quantified an important intra- and between-subject variability in the accuracy of perception of spontaneous airway obstruction in asthmatic subjects which seems to be unrelated to most characteristics of asthma.

Adult↗
PubMed1989

[Sulfidopeptide leukotrienes and asthma].

The role of sulfidopeptide leukotrienes in asthma alone or in association with other mediators is still debated. Sulfidopeptide leukotrienes (s-LT) C4, D4 and E4 are 5-lipoxygenase derivatives of membrane arachidonic acid. All s-LT contract bronchial smooth muscle in vitro and provoke an acute bronchial obstruction in vivo in both healthy and asthmatic subjects. Numerous cells, including mast cells, alveolar macrophages, polynuclear basophils and eosinophils, are capable of secreting s-LT following such diverse stimuli as allergen exposure, platelet activating factor and calcium ionophore A 23187. In addition to constricting bronchial smooth muscle, s-LT promote the occurrence of mucosal oedema increase micro-vascular permeability in the bronchial wall, and cause hypersecretion of mucus by tracheo-bronchial glands. These effects lead to worsening of airways obstruction. s-LT increase non specific bronchial hyper-responsiveness. Clinical trials aiming to test the efficacy of new anti-leukotrienes are currently under way. In general these products have a real antagonistic effect on exogenous s-LT. Their efficacy vis-a-vis other types of stimulus such as allergens, histamine and exercise does not seem to be constant and depends largely on the composition and perhaps the route of administration (inhaled versus oral). The contribution of s-LT as part of the therapeutic arsenal for the long term treatment of asthma remains to be established.

Asthma↗
PubMed1984

[Disorders of glucose tolerance and pathology of the labyrinth].

A prolonged oral glucose tolerance test (OGTT) was performed on 59 patients who presented audio-vestibular disturbances. The group was compared to a control group of 22 patients. 67.7% of the symptomatic group had a pathologic OGTT; of these, 16.9% had a glucose intolerance and 50.8% a reactive hypoglycemia; in the latter case, a statistically significant difference with the control group was found.

Adult↗