Me. Bates et al., RELATIONSHIP OF PLASMA EPINEPHRINE AND CIRCULATING EOSINOPHILS TO NOCTURNAL ASTHMA, American journal of respiratory and critical care medicine, 149(3), 1994, pp. 667-672
Citations number
25
Categorie Soggetti
Emergency Medicine & Critical Care","Respiratory System
The mechanisms of nighttime airway obstruction are not fully establish
ed, but include circadian fluctuations in epinephrine and cortisol. To
evaluate the relationship of circadian patterns in epinephrine and co
rtisol to nighttime airflow obstruction, 10 young adult asthma patient
s (ages 19 to 25 yr) were admitted to a hospital clinical research uni
t for a 3-day study during which plasma concentrations of epinephrine,
cortisol, and histamine were determined along with white blood cell a
nd eosinophil counts every 6 h (1600, 2200, 0400, and 1000 h). Six of
the 10 patients experienced at least one episode of nocturnal asthma (
defined by more than a 15% decrease in antemeridian (A.M.) to postmeri
dian (P.M.) FEV(1) values). Plasma epinephrine levels (pg/ml) showed a
circadian pattern, and the concentration at 2200 h was significantly
(p = 0.039) different for the nocturnal and non-nocturnal asthma group
s. Circulating eosinophil numbers were greater in subjects who had mor
e frequent episodes of nocturnal asthma, and correlated with the frequ
ency of nocturnal asthma (r = 0.732, p = 0.02, Spearman rank correlati
on) and average percent decrease in FEV(1) (r = 0.667, p = 0.035). Pla
sma cortisol concentrations also showed circadian patterns, but no dir
ect association with nocturnal asthma; plasma histamine concentrations
showed no circadian patterns and no association with nocturnal asthma
. Our findings indicate that changes in plasma epinephrine precede the
development of nocturnal airway obstruction and contribute to the lik
elihood of nighttime airflow obstruction.