{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T22:01:21Z","timestamp":1765404081180,"version":"3.46.0"},"reference-count":15,"publisher":"BMJ","issue":"6438","license":[{"start":{"date-parts":[[1984,7,21]],"date-time":"1984-07-21T00:00:00Z","timestamp":459216000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1984,7,21]]},"abstract":"<jats:p>To investigate the role of neural pathways in the nonasthmatic response to eucapnic hyperventilation with below freezing air five diabetic patients with severe symptomatic autonomic neuropathy were studied. Their responses were compared with those shown by five diabetic patients without autonomic neuropathy and five non-diabetic controls. After bronchial provocation testing with cold air the diabetic patients with autonomic neuropathy did not show a significant fall in specific airways conductance (mean (SE) maximum percentage fall 2.0 (3)%), whereas conductance fell in the diabetic patients without neuropathy by 30.8 (2.0)% (p less than 0.001) and in the non-diabetic controls by 22.7 (4.6)% (p less than 0.02). In subjects who do not have asthma the bronchial response to cold air is mediated largely via neural mechanisms.<\/jats:p>","DOI":"10.1136\/bmj.289.6438.149","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"149-151","source":"Crossref","is-referenced-by-count":31,"title":["Diminished bronchial reactivity to cold air in diabetic patients with autonomic neuropathy."],"prefix":"10.1136","volume":"289","author":[{"given":"R W","family":"Heaton","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R J","family":"Guy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B J","family":"Gray","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P J","family":"Watkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J F","family":"Costello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1984,7,21]]},"reference":[{"issue":"85","key":"ref_1","first-page":"762","article-title":"American Thoracic Society. A statement by the committee on diagnostic standards for non-tuberculous respiratory diseases","volume":"1962","unstructured":"American Thoracic Society. A statement by the committee on diagnostic standards for non-tuberculous respiratory diseases. Am Rev Respir Dis 1962;85:762-8.","journal-title":"Am Rev Respir Dis"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/0091-6749(81)90132-9","article-title":"Bronchial responsiveness to histamine or methacholine in asthma: measurement and clinical significance","volume":"68","author":"Hargreave, F.E.; Ryan, G.; Thomson, N.C.","year":"1981","unstructured":"Hargreave FE, Ryan G, Thomson NC, et al. Bronchial responsiveness to histamine or methacholine in asthma: measurement and clinical significance. J Allergy Clin Immuniol 1981;68:347-55.","journal-title":"J Allergy Clin Immuniol"},{"key":"ref_3","first-page":"281","article-title":"Asthma induced by cold air and its relation to non-specific bronchial responsiveness to metacholine","volume":"125","author":"O'Byrne, P.M.; Ryan, G.; Morris, M.","year":"1982","unstructured":"O'Byrne PM, Ryan G, Morris M, et al. Asthma induced by cold air and its relation to non-specific bronchial responsiveness to metacholine. Am Rev Respir Dis 1982;125:281-5.","journal-title":"Am Rev Respir Dis"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1136\/thx.38.7.506","article-title":"The bronchial response to cold air challenge: evidence for different mechanisms in normal and asthmatic subjects","volume":"38","author":"Heaton, R.W.; Henderson, A.F.; Gray, B.J.; Costello, J.F.","year":"1983","unstructured":"Heaton RW, Henderson AF, Gray BJ, Costello JF. The bronchial response to cold air challenge: evidence for different mechanisms in normal and asthmatic subjects. Thorax 1983;38:506-11.","journal-title":"Thorax"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1152\/jappl.1982.53.1.169","article-title":"Dose-dependent inhibition of cold air induced bronchoconstriction by atropine","volume":"53","author":"Sheppard, D.; Epstein, J.; Holtzman, M.J.; Nadel, J.A.; Boushey, H.A.","year":"1982","unstructured":"Sheppard D, Epstein J, Holtzman MJ, Nadel JA, Boushey HA. Dose-dependent inhibition of cold air induced bronchoconstriction by atropine. J Appl Physiol 1982;53: 169-74.","journal-title":"J Appl Physiol"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1152\/jappl.1982.53.6.1576","article-title":"Dose-response effects of atropine on thermal stimulus response relationship in asthma","volume":"53","author":"Griffen, M.P.; Fung, K.F.; Ingram, R.H.; McFadden, E.R.","year":"1982","unstructured":"Griffen MP, Fung KF, Ingram RH, McFadden ER. Dose-response effects of atropine on thermal stimulus response relationship in asthma. J Appl Physiol 1982;53:1576-82.","journal-title":"J Appl Physiol"},{"key":"ref_7","first-page":"611","article-title":"The protective effect of inhaled chlorpheniramine and atropine on bronchoconstriction stimulated by airway cooling","volume":"128","author":"O'Byrne, P.M.; Thomson, N.C.; Morris, M.; Roberts, R.S.; Daniel, E.E.; Hargreave, F.E.","year":"1983","unstructured":"O'Byrne PM, Thomson NC, Morris M, Roberts RS, Daniel EE, Hargreave FE. The protective effect of inhaled chlorpheniramine and atropine on bronchoconstriction stimulated by airway cooling. Am Rev Respir Dis 1983;128:611-7.","journal-title":"Am Rev Respir Dis"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1042\/cs0610581","article-title":"Reduced airway vagal tone in diabetic subjects with autonomic neuropathy","volume":"61","author":"Douglas, N.J.; Campbell, I.W.; Ewing, D.J.; Clarke, B.F.; Flenley, D.C.","year":"1981","unstructured":"Douglas NJ, Campbell IW, Ewing DJ, Clarke BF, Flenley DC. Reduced airway vagal tone in diabetic subjects with autonomic neuropathy. Clin Sci 1981;61: 581-4.","journal-title":"Clin Sci"},{"key":"ref_9","first-page":"47","article-title":"Lung functioni","volume":"18","author":"Cotes, J.E.","year":"1979","unstructured":"Cotes JE. Lung functioni. 4th ed. London: Blackwell Scientific Publications, 1979. ' McKay JD, Page MMcB, Cambridge J, Watkins PJ. Diabetic autonomic neuropathy. The diagnostic value of heart rate monitoring. Diabetologia 1980;18: 47 1-8.","edition":"4th ed","journal-title":"Diabetologia; McKay JD, Page"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/0002-9149(66)90200-1","article-title":"A simple test for cardiac function based upon the heart rate changes induced by the valsalva manoeuvre","volume":"18","author":"Levin, A.B.","year":"1966","unstructured":"Levin AB. A simple test for cardiac function based upon the heart rate changes induced by the valsalva manoeuvre. Am J Cardiol 1966;18:90-9.","journal-title":"Am J Cardiol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/BF00283745","article-title":"Reflex control of heart rate in normal subjects in relation to age: a data base for cardiac vagal neuropathy","volume":"22","author":"Wieling, W.; van Brederode, J.F.M.; de Rij, R.C.G.","year":"1982","unstructured":"Wieling W, van Brederode JFM, de Rij RCG, et al. Reflex control of heart rate in normal subjects in relation to age: a data base for cardiac vagal neuropathy. Diabetologia 1982;22:163-6.","journal-title":"Diabetologia"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/0007-0971(75)90090-X","article-title":"Bronchial hyper-reactivity","volume":"69","author":"Benson, M.K.","year":"1975","unstructured":"Benson MK. Bronchial hyper-reactivity. BrJ Dis Chest 1975;69:227-39.","journal-title":"BrJ Dis Chest"},{"key":"ref_13","first-page":"41","article-title":"Effect of nifedipine on bronchoconstriction induced by inhalation of cold air. Thorax 1983; 38: 512-5. '5","volume":"54","author":"Henderson, A.F.; Heaton, R.W.; Costello, J.F.","year":"1983","unstructured":"Henderson AF, Heaton RW, Costello JF. Effect of nifedipine on bronchoconstriction induced by inhalation of cold air. Thorax 1983;38:512-5. '5 Jammes Y, Barthelemy P, Delpierre S. Respiratory effects of cold air breathing in anaesthetised cats. Respir Physiol 1983;54:41-54.","journal-title":"Respir Physiol; Respiratory effects of cold air breathing in anaesthetised cats"},{"key":"ref_14","first-page":"95","article-title":"The natural history of diabetic autonomic neuropathy","volume":"49","author":"Ewing, D.J.; Campbell, I.W.; Clarke, B.F.","year":"1980","unstructured":"Ewing DJ, Campbell IW, Clarke BF. The natural history of diabetic autonomic neuropathy. Q J Med 1980;49:95-108.","journal-title":"Q J Med"},{"article-title":"Accepted 4","year":"1984","key":"ref_15","unstructured":"(Accepted 4 May 1984)"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.289.6438.149","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.289.6438.149","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T21:58:52Z","timestamp":1765403932000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.289.6438.149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1984,7,21]]},"references-count":15,"journal-issue":{"issue":"6438","published-online":{"date-parts":[[1984,7,21]]},"published-print":{"date-parts":[[1984,7,21]]}},"alternative-id":["10.1136\/bmj.289.6438.149"],"URL":"https:\/\/doi.org\/10.1136\/bmj.289.6438.149","relation":{},"ISSN":["0007-1447","1468-5833"],"issn-type":[{"type":"print","value":"0007-1447"},{"type":"electronic","value":"1468-5833"}],"subject":[],"published":{"date-parts":[[1984,7,21]]}}}