Arvind Manoharan

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The murine asthma model shows that switching off airway β2 receptors with an inverse agonist may confer anti-inflammatory effects as well as corticosteroid-sparing activity. We have assessed for any corticosteroid-sparing effects of propranolol, an inverse agonist, added to low-dose inhaled corticosteroid (ICS) compared with higher dose ICS. A randomized(More)
The clinical relevance of the small airways in persistent asthma has been gaining greater recognition in recent years [1]. Studies have shown that a significant proportion of asthmatics on standard treatment fail to achieve satisfactory asthma control. For example, in one study of 3421 asthmatic subjects who underwent guideline-driven dose titration with(More)
The small airways in the distal lung have been called the quiet zone because they are difficult to assess and treat in patients with asthma who have disproportionate impairment of small airway function. Evidence is accumulating to support a distinct clinical phenotype for patients with asthma who have impaired small airway function. The small airway asthma(More)
BACKGROUND We previously reported that the β(2)-adrenergic receptor (ADRB2) polymorphism had no effect on bronchial hyperresponsiveness (BHR) to methacholine in asthmatic patients. We have now replicated this analysis in a different and larger cohort of patients. OBJECTIVE To assess the effect of the ADRB2 polymorphism in methacholine-responsive patients(More)
Background Beta-blockers remain underused in patients with chronic obstructive pulmonary disease (COPD) and cardiovascular disease. Aim We compared how different inhaled therapies affect tolerability of bisoprolol and carvedilol in moderate to severe COPD. Design A randomized, open label, cross-over study. Methods We compared the cardiopulmonary(More)
BACKGROUND Impulse oscillometry (IOS) is a novel method of assessing airway resistance. IOS is rarely used in assessing airway resistance after bronchoprovocation in adult asthma. OBJECTIVE To ascertain the degree of change in IOS measurements seen in patients with asthma undergoing bronchial challenge testing. METHODS Patients 18 to 65 years old with(More)
Guidelines advocate the use of spirometry to assess pulmonary function in asthmatic patients. Commonly used measures include forced expiratory volume in 1 s (FEV1), forced expiratory ratio (FEV1/FVC), and forced mid-expiratory flow between 25 and 75 % of forced vital capacity (FEF25–75). Impulse oscillometry (IOS) is an effort-independent test performed(More)