Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2014, vol. 23, nr 4, July-August, p. 665–668

Publication type: review article

Language: English

Perimenstrual Asthma as a Gynecological and Pulmonological Clinical Problem

Szymon Skoczyński1,A,B,C,D, Aleksandra Semik-Orzech1,A,B,C,D, Wojciech Szanecki2,B,D, Michał Majewski3,B,D, Krzysztof Kołodziejczyk4,A,E, Ewa Sozańska1,B,D, Andrzej Witek2,E,F, Władysław Pierzchała1,E,F

1 Department of Pulmonology in Katowice, Medical University of Silesia in Katowice, Poland

2 Department of Gynecology and Obstetrics, Medical University of Silesia in Katowice, Poland

3 Students’ Scientific Society, Department of Pulmonology in Katowice, Medical University of Silesia in Katowice, Poland

4 Specialist Medical Practice, Katowice, Poland

Abstract

Asthma is one of the most common chronic diseases of the respiratory system. It is estimated that up to 40% of asthmatic women of childbearing age may experience a cyclical exacerbation of asthmatic symptoms during the perimenstrual period, which is called perimenstrual asthma (PMA). The precise prevalence of this particular phenotype of asthma is difficult to determine due to a lack of explicit diagnostic criteria and appropriate epidemiological surveys. According to one of the best documented hypotheses regarding perimenstrual exacerbations of asthma, the impact of female steroid sex hormones on the function of the respiratory system and inflammations in the bronchi may play a central role in this phenomenon. Although the basic medical approach to PMA is similar to that used in other asthma phenotypes, unconventional methods of “experimental” treatment have also been tried. Unfortunately, current knowledge about the pathogenic mechanisms of this phenotype of asthma is incomplete and inconsistent, which justifies the need for further interdisciplinary studies with the participation of specialists in both gynecology and lung diseases. The knowledge thus acquired will help to individualize and focus future therapy on specific cellular and/or hormonal mechanisms to optimize asthma control in patients with PMA.

Key words

perimenstrual asthma, gonadal steroid hormones, inflammation, peak expiratory flow rate.

References (35)

  1. Gibbs CJ, Coutts II, Lock R, Finnegan OC, White RJ: Premenstrual exacerbation of asthma. Thorax 1984, 39, 833–836.
  2. Frank RT: The hormonal causes of premenstrual tension. Arch Neurol Psychiatr 1931, 26, 1053–1057.
  3. Chandler MH, Schuldheisz S, Phillips BA, Muse KN: Premenstrual asthma: the effect of estrogen on symptoms, pulmonary function and beta 2-receptors. Pharmacotherapy 1997, 17, 222–234.
  4. Rees L: An aethiological study of premenstrual asthma. J Psychosom res 1963, 7, 191–197.
  5. Nakasato H, Ohrui T, Sekizawa K, Matsui T, Yamaya M, Tamura G, Sasaki H: Prevention of severe premenstrual asthma attacks by leukotriene receptor antagonist. J Allergy ClinImmunol 1999, 104, 585–588.
  6. Ensom MH, Chong E, Carter D: Premenstrual symptoms in women with premenstrual asthma. Pharmacotherapy 1999, 19, 374–382.
  7. Eliasson O, Scherzer HH, DeGraff AC Jr: Morbidity in asthma in relation to the menstrual cycle. J Allergy Clin Immunol 1986, 77, 87–94.
  8. Magadle R, Berar-Yanay N, Weiner P: Long acting bronchodilators in premenstrual exacerbation of asthma. respir Med 2001, 95, 740–743.
  9. De Marco R, Locatelli F, Sunyer J, Burney P: Differences in incidence of reported asthma related to age in men and women. A retrospective analysis of the data of the European respiratory Health Survey. Am J respir Crit Care Med 2000,162, 68–74.
  10. Romieu I, Fabre A, Fournier A, Kauffmann F, Varraso R, Mesrine S, Leynaert B, Clavel-Chapelon F: Postmenopausal hormone therapy and asthma onset in the E3N cohort. Thorax 2010, 65, 292–297.
  11. Barr RG, Wentowski CC, Grodstein F, Somers SC, Stampfer MJ, Schwartz J, Speizer FE, Camargo CA Jr: Prospective study of postmenopausal hormone use and newly diagnosed asthma and chronic obstructive pulmonary disease. Arch Intern Med 2004, 164, 379–386.
  12. Troisi RJ, Speizer FE, Willett WC, Trichopoulos D, Rosner B: Menopause, postmenopausal estrogen preparations, and the risk of adult-onset asthma. A prospective cohort study. Am J respir Crit Care Med 1995, 152, 1183–1188.
  13. Gómez Real F, Svanes C, Björnsson EH, Franklin KA, Gislason D, Gislason T, Gulsvik A, Janson C, Jögi R, Kiserud T, Norbäck D, Nyström L, Torén K, Wentzel-Larsen T, Omenaas E: Hormone replacement therapy, body mass index and asthma in perimenopausal women: a cross sectional survey. Thorax 2006, 61, 34–40.
  14. Matsuo N, Shimoda T, Matsuse H, Kohno S: A case of menstruation-associated asthma: treatment with oral contraceptives. Chest 1999, 116, 252–253.
  15. Derimanov GS, Oppenheimer J: Exacerbation of premenstrual asthma caused by an oral contraceptive. Ann Allergy Asthma Immunol 1998, 81, 243–246.
  16. Forbes L, Jarvis D, Burney P: Do hormonal contraceptives influence asthma severity? Eur respir J 1999, 14, 1028–1033.
  17. Mandhane PJ, Hanna SE, Inman MD, Duncan JM, Greene JM, Wang HY, Sears MR: Changes in exhaled nitric oxide related to estrogen and progesterone during the menstrual cycle. Chest 2009, 136, 1301–1307.
  18. Couse JF, Lindzey J, Grandien K, Gustafsson JA, Korach KS: Tissue distribution and quantitative analysis of estrogen receptor-alpha (Eralpha) and estrogen receptor-beta (Erbeta) messenger ribonucleic acid in the wildtype and Eralpha-knockout mouse. Endocrinology 1997, 138, 4613–4621.
  19. Foster PS, Goldie RG, Paterson JW: Effect of steroids on beta-adrenoceptor-mediated relaxation of pig bronchus. Br J Pharmacol 1983, 78, 441–445.
  20. Miyaura H, Iwata M: Direct and indirect inhibition of Th1 development by progesterone and glucocorticoids. J Immunol 2002, 168, 1087–1094.
  21. De Oliveira AP, Peron JP, Damazo AS, Franco AL, Domingos HV, Oliani SM, Oliveira-Filho RM, Vargaftig BB, Tavares-de-Lima W: Female sex hormones mediate the allergic lung reaction by regulating the release of inflammatory mediators and the expression of lung E-selectin in rats. respir res 2010, 11, 115.
  22. Degano B, Prévost MC, Berger P, Molimard M, Pontier S, Rami J, Escamilla R: Estradiol decreases the acetylcholine-elicited airway reactivity in ovariectomized rats through an increase in epithelial acetylcholinesterase activity. Am J respir Crit Care Med 2001, 164, 1849–1854.
  23. Huerta-Yepez S, Baay-Guzman GJ, Garcia-Zepeda R, Hernandez-Pando R, Vega MI, Gonzalez-Bonilla C, Bonavida B: 2-Methoxyestradiol (2-ME) reduces the airway inflammation and remodeling in an experimental mouse model. Clin Immunol 2008, 129, 313–324.
  24. Shah SP, Gohil PV, Shah GB: role of estrogen receptor-α in an experimental model of bronchial asthma. Iran Biomed J 2010, 14, 41–48.
  25. Bradding P: Mast cell regulation of airway smooth muscle function in asthma. Eur respir J 2007, 29, 827–830.
  26. de Oliveira AP, Domingos HV, Cavriani G, Damazo AS, Dos Santos Franco AL, Oliani SM, Oliveira-Filho RM, Vargaftig BB, de Lima WT: Cellular recruitment and cytokine generation in a rat model of allergic lung are differentially modulated by progesterone and estradiol. Am J Physiol Cell Physiol 2007, 293, 1120–1128.
  27. Oguzulgen IK, Turktas H, Erbas D: Airway inflammation in premenstrual asthma. J Asthma 2002, 39, 517–522.
  28. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2011. Available from: http://www.ginasthma.org/.
  29. Barkman RP: Sudden death in asthma. Med J Aust 1981, 1, 316–317.
  30. Lenoir RJ: Severe acute asthma and the menstrual cycle. Anaesthesia 1987, 42, 1287–1290.
  31. Beynon HL, Garbett ND, Barnes PJ: Severe premenstrual exacerbations of asthma: effect of intramuscular progesterone. Lancet 1988, 2, 370–372.
  32. Ensom MH, Chong G, Beaudin B, Bai TR: Estradiol in severe asthma with premenstrual worsening. Ann Pharmacother 2003, 37, 1610–1613.
  33. Ensom MH, Chong G, Zhou D, Beaudin B, Shalansky S, Bai TR: Estradiol in premenstrual asthma: a doubleblind, randomized, placebo-controlled, crossover study. Pharmacotherapy 2003, 23, 561–571.
  34. Murray RD, New JP, Barber PV, Shalet SM: Gonadotrophin-releasing hormone analogues: a novel treatment for premenstrual asthma. Eurrespir J 1999, 14, 966–967.
  35. Pasaoglu G, Mungan D, Abadoglu O, Misirligil Z: Leukotriene receptor antagonists: a good choice in the treatment of premenstrual asthma? J Asthma 2008, 45, 95–99.
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