title: Isolated small airway reactivity during bronchoprovocation as a mechanism for respiratory symptoms in WTC dust-exposed community members.
abstract: Small airway dysfunction occurs following WTC dust exposure, but its role in producing symptoms is unclear.
  
  
  
  Methacholine challenge (MCT) was used to assess the relationship between onset of respiratory symptoms and small airway abnormalities in 166 symptomatic WTC dust-exposed patients. Forced oscillation testing (FOT) and respiratory symptoms were assessed during MCT. FOT parameters included resistance at 5 and 20 Hz (R5 and R20 ) and the R5 minus R20 (R5-20 ).
  
  
  
  Baseline spirometry was normal in all (mean FEV1 100 + 13% predicted, mean FEV1 /FVC 80 + 4%). MCT revealed bronchial hyperreactivity by spirometry in 67 patients. An additional 24 patients became symptomatic despite minimal FEV1 change (<5%); symptom onset coincided with increased R5 and R5-20 (P > 0.001 vs. baseline). The dose-response of FOT (reactivity) was greater compared with subjects that remained asymptomatic (P < 0.05).
  
  
  
  FOT during MCT uncovered reactivity in small airways as a mechanism for respiratory symptoms in subjects with inhalational lung injury. Am. J. Ind. Med. 59:767-776, 2016. © 2016 Wiley Periodicals, Inc.
authors: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, NYU School of Medicine, New York, New York.|Andre Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, New York.
authors: Kenneth I
authors: KI
authors: Berger
authors: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, NYU School of Medicine, New York, New York.
authors: Samantha
authors: S
authors: Kalish
authors: Department of Population Health, NYU School of Medicine, New York, New York.
authors: Yongzhao
authors: Y
authors: Shao
authors: Department of Population Health, NYU School of Medicine, New York, New York.
authors: Michael
authors: M
authors: Marmor
authors: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, NYU School of Medicine, New York, New York.
authors: Angeliki
authors: A
authors: Kazeros
authors: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, NYU School of Medicine, New York, New York.|Andre Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, New York.
authors: Beno W
authors: BW
authors: Oppenheimer
authors: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, NYU School of Medicine, New York, New York.|Andre Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, New York.
authors: Yinny
authors: Y
authors: Chan
authors: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, NYU School of Medicine, New York, New York.
authors: Joan
authors: J
authors: Reibman
authors: Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, NYU School of Medicine, New York, New York.|Andre Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, New York.
authors: Roberta M
authors: RM
authors: Goldring
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D016535:Bronchial Hyperreactivity / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D016085:Bronchoconstrictor Agents; D004391:Dust; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D055370:Lung Injury / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D016210:Methacholine Chloride; D008875:Middle Aged; D012189:Retrospective Studies; D047851:September 11 Terrorist Attacks; D013147:Spirometry; D063189:Symptom Assessment; D014797:Vital Capacity
chemical_list: D016085:Bronchoconstrictor Agents; D004391:Dust; D016210:Methacholine Chloride
keywords: airway physiology; bronchial hyper-reactivity; forced oscillation; methacholine challenge test; respiratory function