Topical tacrolimus in atopic dermatitis: Effects of ... - Helda - Helsinki.fi

Respiratory symptoms and findings
To exclude seasonal variation in respiratory symptoms, patients were enrolled from late
October to early January after the pollen season and before the typical respiratory
infection epidemics. Measurements were done once for the study groups in Study III,
and at baseline and after 12 months of treatment in Study V.
Lung function tests
The forced expiratory volume in one second (FEV1) (Quanjer et al. 1993) was recorded
with a flow-volume spirometer (Medikro 905, Medikro Oy, Kuopio, Finland), with
results expressed as percentages of the national predicted values (Viljanen et al. 1982).
Bronchial hyper-responsiveness was evaluated with a dosimetric histamine challenge
test employing increasing inhaled doses of 0.025, 0.1, 0.4, and 1.6 mg buffered
histamine diphosphate (Sovijärvi et al. 1993). Based on the dose-response curve, the
provocative dose of inhaled histamine producing a decrease of 15% in FEV1
(PD15FEV1) was determined. According to PD15FEV1, bronchial hyperreactivity was
graded as mild (0.41-1.60 mg), moderate (0.11-0.40 mg) or severe (1.6 mg were considered to have normal bronchial
responsiveness. Additionally, the result was expressed in terms of the slope of the dose
response curve, as a continuous and log-normally distributed index (O’Connor et al.
1987). At the time of lung function testing, all patients were free from respiratory tract
infections for at least the preceding 2 weeks, and short-acting beta-2-agonists were
withheld for at least the previous 12 hours.
Questionnaire
A previously validated questionnaire was chosen for estimating the prevalence of
physician-diagnosed asthma and allergic rhinitis (Haahtela et al. 1980). The degree of
asthma symptoms (cough, wheezing, dyspnoea) and of nasal symptoms experienced by
the AD patients during the preceding year were estimated on a visual analogue scale
(VAS) from 0 to 10 cm. AD patients with symptoms of at least 1 cm in VAS in Study
III and of at least 2 cm in VAS in Study V were considered to have current asthma or
nasal symptoms. The patients in Study V answered the questionnaire also at 48 months
of treatment. The control subjects in Study III gave qualitative answers as to any
possible asthmatic or nasal symptoms.
Induced sputum
Sputum was induced by inhalation of 5 ml of 3% NaCl solution, with an ultrasonic
nebulizer (Omron U1, Omron, Germany) for 15 minutes (Djukanovic et al. 2002, Metso
et al. 2001). Subjects were pre-treated with 200 �g salbutamol (Buventol Easyhaler 100
microg/dose���Orion Pharma), by inhalation. PEF values were measured before and
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