Effect of CPAP on airway reactivity and airway inflammation in children with moderate–severe asthma

Eduardo Praca, Hasnaa Jalou, Nadia Krupp, Angela Delecaris, Joseph Hatch, James Slaven, Susan Gunst, Robert Tepper

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background and objective: Asthma is characterized by airway hyperreactivity and airway inflammation. We previously demonstrated that adults with mild well-controlled asthma exhibited a marked decrease in airway reactivity (PC20 increased >2-fold) after using nocturnal continuous positive airway pressure (CPAP) for 1 week. If CPAP produces a similar suppression of airway reactivity in children with moderate–severe asthma, who require chronic use of corticosteroids, then this non-pharmacological therapy might provide a beneficial alternative or supplemental therapy in these subjects. Methods: Children aged 8–17 years with moderate–severe asthma were treated with 4 weeks of nocturnal CPAP (8–10 cm H2O) or sham CPAP (<2 cm H2O). Adherence was monitored with a modem installed in the equipment or by memory cards. Airway reactivity, assessed by methacholine bronchial challenge, was measured prior to and following treatment. Results: The percentage of subjects adherent to treatment was similar in both groups (19/27 CPAP vs 19/28 sham, ~70%). There was a tendency for PC20 to increase with treatment in both groups (3.0–5.3 mg/mL CPAP vs 3.2 to 4.3 mg/mL sham, P = 0.083); however, the change did not differ significantly between groups (P = 0.569). Conclusion: We found that the 4-week treatment with nocturnal CPAP did not produce a twofold suppression of airway reactivity in children with moderate–severe asthma.

Original languageEnglish (US)
JournalRespirology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Continuous Positive Airway Pressure
Asthma
Inflammation
Therapeutics
Modems
Methacholine Chloride
Adrenal Cortex Hormones
Equipment and Supplies

Keywords

  • bronchial challenge
  • chronic mechanical strain
  • induced sputum
  • lung function

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Effect of CPAP on airway reactivity and airway inflammation in children with moderate–severe asthma. / Praca, Eduardo; Jalou, Hasnaa; Krupp, Nadia; Delecaris, Angela; Hatch, Joseph; Slaven, James; Gunst, Susan; Tepper, Robert.

In: Respirology, 01.01.2018.

Research output: Contribution to journalArticle

Praca, Eduardo ; Jalou, Hasnaa ; Krupp, Nadia ; Delecaris, Angela ; Hatch, Joseph ; Slaven, James ; Gunst, Susan ; Tepper, Robert. / Effect of CPAP on airway reactivity and airway inflammation in children with moderate–severe asthma. In: Respirology. 2018.
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abstract = "Background and objective: Asthma is characterized by airway hyperreactivity and airway inflammation. We previously demonstrated that adults with mild well-controlled asthma exhibited a marked decrease in airway reactivity (PC20 increased >2-fold) after using nocturnal continuous positive airway pressure (CPAP) for 1 week. If CPAP produces a similar suppression of airway reactivity in children with moderate–severe asthma, who require chronic use of corticosteroids, then this non-pharmacological therapy might provide a beneficial alternative or supplemental therapy in these subjects. Methods: Children aged 8–17 years with moderate–severe asthma were treated with 4 weeks of nocturnal CPAP (8–10 cm H2O) or sham CPAP (<2 cm H2O). Adherence was monitored with a modem installed in the equipment or by memory cards. Airway reactivity, assessed by methacholine bronchial challenge, was measured prior to and following treatment. Results: The percentage of subjects adherent to treatment was similar in both groups (19/27 CPAP vs 19/28 sham, ~70{\%}). There was a tendency for PC20 to increase with treatment in both groups (3.0–5.3 mg/mL CPAP vs 3.2 to 4.3 mg/mL sham, P = 0.083); however, the change did not differ significantly between groups (P = 0.569). Conclusion: We found that the 4-week treatment with nocturnal CPAP did not produce a twofold suppression of airway reactivity in children with moderate–severe asthma.",
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