Relation of perceived nasal and bronchial hyperresponsiveness to FEVY , basophil counts , and methacholine response

Perceived nasal and bronchial hyperresponsiveness to tobacco smoke and cold air were assessed in 912 working men in the Paris area. Baseline lung function measurements and peripheral leucocyte counts with standard differential counts were performed. At least one perceived nasal or bronchial hyperresponsiveness symptom was reported by 15-7%. Current smoking was significantly less frequent among those with cough induced by tobacco smoke. Rhinitis induced by cold air was associated with lower FEV, (p < 0 01) and the association remained after adjustment for smoking, asthma, and wheezing (p = 006). Symptoms induced by cold air were related to circulating basophils. Neither perceived nasal nor perceived bronchial hyperresponsiveness was significantly related to the airway response to methacholine in a sample ofthe group (n = 324) surveyed again five years later. The results suggest that the symptom of rhinitis provoked by cold air is a possible "new" risk factor or marker for chronic airflow limitation. In the 1960s allergy and bronchial hyperresponsiveness were considered in the Netherlands as major host risk factors for chronic airflow limitation.' There is now a renewed interest in the "Dutch hypothesis." Several studies have reported an association between bronchial hyperresponsiveness and decline in FEV,.5 6 An association between lung function and serum IgE7 concentrations and eosinophilia"9 have also been reported. Furthermore, mediators of the late nasal response to cold air have been shown to be produced by basophils.'0 Thus immunological mechanisms related to IgE, eosinophils, and basophils might have a key role in the development of chronic airflow limitation. Perceived hyperresponsiveness to stimuli, although used in clinical practice, has rarely been considered in epidemiological studies" 12 and, in the absence of provocation tests, might provide information additional to that derived from the standard questions on asthma and wheezing. We here describe the relationships of bronchial and nasal symptoms provoked by two non-specific stimuli, tobacco smoke and cold air, to FEV, and eosinophil Address for reprint requests: Dr F Kauffmann, INSERM U169, 16 av PV Couturier, F-94807 VillejuifCGdex, France. Accepted 17 March 1988 and basophil counts, using data collected in 1980-1 in a cross sectional survey of a working population. The associations between perceived hyperresponsiveness symptoms and the airway response to inhaled methacholine response obtained five years later in a sample of the men are also reported.