Differential effects of methacholine and antigen challenge on gas exchange in allergic subjects.

In order to better characterize the differential effects of nonspecific and specific (antigen) bronchial challenge on gas exchange, seven ragweed-sensitive subjects with a history of asthma underwent progressive inhalation challenge with methacholine and ragweed extract on two different days. For comparable severity of bronchospasm (mean specific airway conductance 0.05 sec-1cm-1H2O for methacholine and 0.06 sec-1cm-1H2O for ragweed), there was a greater decrease in mean arterial oxygen saturation after ragweed (4.7%) than after methacholine challenge (2.7%) (p less than 0.05). While this was not accompanied by differences in static lung volumes, the density-dependent index decreased by 19% after ragweed (p less than 0.001) but remained unchanged after methacholine challenge. These results suggest that a greater involvement of peripheral airways in the bronchospastic response is, at least in part, responsible for the greater decrease in arterial oxygen saturation after ragweed challenge.