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Biomedical subjects

C Villette

Publications and source records attributed to C Villette.

6 recordsLinked to original sources

Rye flour induces a stronger early bronchial response than wheat flour in occupational asthma.

BACKGROUND: Our aims were to compare the doses of wheat and rye flour that induce early bronchial responses in occupationally exposed asthmatic subjects and to assess the effects of the dose of inhaled flour, the duration of exposure and the dose rate. METHODS: Ten patients underwent tests with lactose, wheat flour and rye flour. We compared the decrease in forced expiratory volume in 1 s (FEV(1)) observed during the challenge with flour and with lactose. We also calculated the amount of flour that was instantaneously active. RESULTS: Seven subjects had significantly decreased FEV(1) values following exposure to wheat and rye flour and two subjects only did so for rye flour. The provocative dose (PD, dose required to reduce FEV(1) by 15%) of rye was lower than that of wheat flour (geometric mean; PD(15) rye: 95 microg; wheat: 368 microg). The calculated doses of rye and wheat flour were better correlated with the change in FEV(1) than were the cumulative doses. CONCLUSION: The bronchial response was greater with rye than with wheat flour. The response was related to the dose of allergen inhaled and to the dose rate.

Asthma↗

Bronchial challenge with flour: early response is dependent on the dose of activated allergen inhaled.

Specific bronchial challenges provide information about the relationship between inhaled dose of allergen and change in lung function, but the intermediate pathways remain largely obscure. The aim of this study was to investigate the relationships between the early asthmatic response and 1) the inhaled dose of wheat flour, 2) the concentration of wheat flour, 3) the duration of the exposure, and 4) the deactivation of inhaled allergens and mediators. Thirty-one patients with occupational asthma to wheat flour were studied. Particle aerosols were generated by a computer-controlled aerosoliser and the results were expressed as the provocative dose causing a 20% fall in forced expiratory volume in one second (FEVi) (PD20). The cumulative dose (from the beginning of the challenge), the last inhaled dose, and an estimated dose (taking into account exponential deactivation), were calculated. Twenty patients had high reactivity to flour (reaching a PD20 value). Eleven patients had intermediate reactivity (no measurable PD20 but significantly greater fall in FEV1 compared with lactose challenge). A better correlation between change in FEV1 and dose was obtained for the estimated dose than for the cumulative or last inhaled dose. The bronchial response to wheat flour can be measured by the individual specific hyperreactivity and is expressed by provocative dose of flour. However, deactivation of the allergen and mediators has to be taken into account. This problem can be addressed by using a mathematical model.

Administration, Inhalation↗

[Specific bronchial provocation test with solid aerosols. Quantification of results].

OBJECTIVES: To determine 1) the level of specific bronchial reactivity by challenge with flour and 2) the criteria of positivity using a new method for the expression of the results. METHOD: Thirty-eight asthmatic subjects, occupationally exposed to wheat flour, performed a challenge with lactose then with flour. The instantaneous measurement of the concentration and of the inspiratory airflow were used to calculate the inhaled dose and to establish the dose-response relationships. The results were given 1) by the dose of flour provoking a 20% fall in FEV1 (PDf20), 2) by the comparison of the variation of the FEV1 during the challenge with flour to the distribution of the values observed during the challenge with lactose (inferior limit of the confidence interval at 99.7%). RESULTS: The variations of the FEV1 were not significantly related to the inhaled dose of lactose. The specific bronchial reactivity to flour was a continuous data and three groups were distinguished: 1) subjects (n = 15) with high bronchial reactivity had a fall of FEV1 of more than 20% 2) subjects (n = 13) without significant variation of the FEV1 for doses higher than 1,400 micrograms by comparison to the distribution of the values of the lactose test 3) subjects (n = 10) with a significant fall of FEV1 by comparison to the distribution of the values of the lactose test but lower than 20%. For this group with moderate reactivity, the flow of the inhaled dose may be determinant for the bronchial response. CONCLUSIONS: PDf 20 measures the specific bronchial reactivity. However, if the fall in FEV1 is lower than 20%, the specific challenge with flour may be compared to the challenge with lactose to detect the subjects with moderate reactivity. Our results confirmed the role of the inhaled dose and suggested the role of the dose rate in the outset of bronchial obstruction among asthmatic subjects.

Administration, Inhalation↗

Computerized equipment for the delivery of inhaled doses of solid particles in specific bronchial challenge.

An apparatus to generate solid particles was tested for use in diagnosing occupational asthma. This equipment measures the inhaled dose of dry particles during specific inhalation challenge. It includes an aerosol generator, a cyclone type particle size selector, and an inhalation chamber to which a patient breathing at tidal volume can be connected for the test. It is fully controlled by a standard personal computer in automatic mode, acting on the flow rate and the aerosol generator to maintain the concentration at a fixed value, usually 3 mg/m3. The dose of aerosol delivered to the patient was calculated from the aerosol concentration, and the inhaled volume was calculated by integration of the corresponding signals. The coefficient of variation for this measurement was estimated to be 12%. The mass median aerodynamic diameter (MMAD) of aerosol inside the inhalation chamber was measured for three substances: lactose, wheat flour, and buckwheat flour. The MMAD of the aerosol inside the chamber was also estimated from the particle size distribution of the raw powder. The relative difference between the measured MMAD and the calculated value was less than 15%. The corresponding relative difference between the measured geometrical SD and the calculated value was found to be less than 26%.

Administration, Inhalation↗

Quantification of the dose of inhaled flour: relation with nonspecific bronchial and immunological reactivities.

The aim of this study was to investigate the relationship between specific bronchial reactivity and respective nonspecific bronchial and immunological reactivities. Twenty-one patients underwent bronchial challenges with lactose and flour. The aerosol of particles was generated by a computer-controlled aerosolizer. Specific bronchial challenge results were expressed as the provocative dose of flour (PDf) that caused a 20% or 15% decrease in the forced expiratory volume in one second (FEV1). For each subject, the decrease in FEV1 observed during the challenge with flour was compared with the calculated lower limit of the 99.7% confidence interval for the lactose challenge. The subjects also underwent a nonspecific challenge with methacholine and a measurement of the specific immunoglobulin E against wheat. The inhalation of lactose did not significantly affect FEV1. Nine subjects had high reactivity to wheat flour with a PDf20 <400 microg. Five subjects had intermediate reactivity: FEV1 fell by <20% but by significantly more than that in the test with lactose. For 7 subjects, there was no significant change in FEVI for inhaled doses of flour over 1390 microg. The results for specific bronchial challenge were significantly correlated with those for the methacholine test (p<0.02). Positive skin tests and specific immunoglobulin E against wheat were observed more frequently in the high reactivity group. Specific bronchial challenge can be performed safely to establish precise dose-response curves. The provocative dose of flour causing a 20% decrease in forced expiratory volume in one second is useful for evaluating the degree of specific reactivity but is not suitable in cases of intermediate reactivity in which comparison with the lactose test is necessary. Specific reactivity is probably a function of immunological and nonspecific bronchial reactivities.

Adult↗

[Occupational asthma caused by buckwheat flour].

Buckwheat flour, mainly used for pancakes, may induce asthma following inhalation and anaphylactic reactions following ingestion. These allergic reactions are mediated by specific IgE and may be confirmed by skin test and radio-allergo-sorbent test. The occupational asthma of a patient working in pancake restaurant was confirmed by specific challenge test with a computerised device to generate particles. A very small amount of buckwheat flour (10 micrograms) induced an immediate fall of the FEV1 to 56% of the initial value. No bronchial reaction was observed with lactose nor with wheat flour. Specific bronchial challenge identifies the allergen responsible for asthma, measures the level of sensitization and thus can prevent the occupational exposure.

Adult↗