title: Effects of sex hormones on bronchial reactivity during the menstrual cycle.
abstract: BACKGROUND
  Many asthmatic women complain of symptom exacerbations in particular periods, i.e. during pregnancy and menstrual cycles (perimenstrual asthma: PMA)". The goal of this study was to study the effect of the luteal and follicular phases of the menstrual cycle on bronchial reactivity (BR) in a group of asthmatic women.
  
  
  METHODS
  For this purpose, 36 pre-menopausal women were enrolled and underwent testing for resting pulmonary function, measurement of the diffusing capacity of the lung for carbon monoxide (DLCO), and airway responsiveness to methacholine in the follicular and luteal phases of their menstrual cycles. We also measured plasma hormone levels and levels of cyclic adenosine monophosphate (cAMP; a mediator of bronchial smooth muscle contraction) and testosterone in induced sputum samples.
  
  
  RESULTS
  Our study showed that about 30% of the asthmatic women had decreased PC20FEV1.0 in the follicular phase of menstrual cycle with a significant correlation between PC20FEV1.0 and serum testosterone levels. Moreover, marked increases in sputum testosterone levels (mean=2.6-fold increase) together with significant increases in sputum cAMP concentrations (mean=3.6-fold increases) were observed during the luteal phase of asthmatic patients, suggesting that testosterone contributes to the pathophysiology of PMA. We excluded the possibility that testosterone directly inhibits phosphodiesterase (PDE) activity as incubating PDE with testosterone in vitro did not reduce PDE catalytic activity.
  
  
  CONCLUSIONS
  In conclusion, our data show that PC20FEV1.0 was decreased in the follicular phase of the menstrual cycle in about 30% of women and was associated with lower cAMP levels in sputum samples, which may contribute to bronchoconstriction. Our results also suggest a link between PMA and testosterone levels. However, whether these findings are of clinical significance in terms of the management of asthma or asthma worsening during the menstrual cycle needs further investigation.
authors.forename: Maria
authors.initials: M
authors.lastname: Matteis
authors.forename: Francesca
authors.initials: F
authors.lastname: Polverino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Spaziano
authors.forename: Fiorentina
authors.initials: F
authors.lastname: Roviezzo
authors.forename: Carlo
authors.initials: C
authors.lastname: Santoriello
authors.forename: Nikol
authors.initials: N
authors.lastname: Sullo
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Bucci
authors.forename: Francesco
authors.initials: F
authors.lastname: Rossi
authors.forename: Mario
authors.initials: M
authors.lastname: Polverino
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Owen
authors.affiliation: Department of Experimental Medicine-Section of Pharmacology, 2nd University of Naples, 80136 Naples, Italy. bruno.dagostino@unina2.it.
authors.forename: Bruno
authors.initials: B
authors.lastname: D'Agostino
mesh_terms: D000328:Adult; D001249:Asthma / Q000378:metabolism / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D002248:Carbon Monoxide; D000242:Cyclic AMP / Q000378:metabolism*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005498:Follicular Phase / Q000378:metabolism / Q000502:physiology*; D005541:Forced Expiratory Volume; D006801:Humans; D008183:Luteal Phase / Q000378:metabolism / Q000502:physiology*; D007986:Luteinizing Hormone / Q000097:blood; D016210:Methacholine Chloride; D010727:Phosphoric Diester Hydrolases / Q000378:metabolism; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D011653:Pulmonary Diffusing Capacity; D013183:Sputum / Q000378:metabolism; D013739:Testosterone / Q000378:metabolism*; D055815:Young Adult
chemical_list: D016210:Methacholine Chloride; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D002248:Carbon Monoxide; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D000242:Cyclic AMP; D010727:Phosphoric Diester Hydrolases