Airway responsiveness to adenosine after a single dose of fluticasone propionate discriminates asthma from COPD

Spicuzza, Lucia; Scuderi, Vincenza; Morjaria, Jaymin B.; Prosperini, G; Arcidiacono, G; Caruso, Massimo; Folisi, Caterina; Maria, Giuseppe U. Di; Polosa, Riccardo

doi:10.1016/j.pupt.2013.05.002

Cited by 3 publications

(3 citation statements)

References 37 publications

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“…with the bronchodilator response [176]. Like other indirect challenge tests, the adenosine challenge test may be particularly useful to ascertain the effects of anti-inflammatory therapies such as inhaled steroids in asthma [177][178][179][180][181].…”

Section: Adenosine Challenge Testingmentioning

confidence: 99%

ERS technical standard on bronchial challenge testing: pathophysiology and methodology of indirect airway challenge testing

et al. 2018

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Recently, this international task force reported the general considerations for bronchial challenge testing and the performance of the methacholine challenge test, a “direct” airway challenge test. Here, the task force provides an updated description of the pathophysiology and the methods to conduct indirect challenge tests. Because indirect challenge tests trigger airway narrowing through the activation of endogenous pathways that are involved in asthma, indirect challenge tests tend to be specific for asthma and reveal much about the biology of asthma, but may be less sensitive than direct tests for the detection of airway hyperresponsiveness. We provide recommendations for the conduct and interpretation of hyperpnoea challenge tests such as dry air exercise challenge and eucapnic voluntary hyperpnoea that provide a single strong stimulus for airway narrowing. This technical standard expands the recommendations to additional indirect tests such as hypertonic saline, mannitol and adenosine challenge that are incremental tests, but still retain characteristics of other indirect challenges. Assessment of airway hyperresponsiveness, with direct and indirect tests, are valuable tools to understand and to monitor airway function and to characterise the underlying asthma phenotype to guide therapy. The tests should be interpreted within the context of the clinical features of asthma.

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Section: Adenosine Challenge Testingmentioning

confidence: 99%

ERS technical standard on bronchial challenge testing: pathophysiology and methodology of indirect airway challenge testing

et al. 2018

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“…On this basis, it has been argued persuasively that adenosine bronchial challenge testing is a better non-invasive tool for monitoring disease activity and an improved method for assessing the response to anti-inflammatory treatments [7]. Moreover, recent findings suggest that bronchial challenging with adenosine may improve diagnostic discrimination between asthma and COPD [8]. …”

Section: Introductionmentioning

confidence: 99%

“…However, nebulisation of AMP has a number of drawbacks. First, the maximum aerosol droplet AMP concentration (300–400 mg/mL; restricted by the nebuliser solution’s viscosity) does not result in AHR in all patients [8, 9]. Furthermore, nebuliser solution AMP concentrations > 20 mg/mL have been shown to greatly affect aerosol formation, which may have implications for the test outcome, such as a shift in deposition site or disproportional dose increase [10].…”

Section: Introductionmentioning

confidence: 99%

A novel method for studying airway hyperresponsiveness in allergic guinea pigs in vivo using the PreciseInhale system for delivery of dry powder aerosols

Lexmond

Keir

Terakosolphan

et al. 2018

Drug Deliv. and Transl. Res.

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Inhaled adenosine receptor agonists induce bronchoconstriction and inflammation in asthma and are used as bronchial challenge agents for the diagnosis of asthma and in respiratory drug development. Recently developed dry powder aerosols of adenosine have several advantages over nebulised adenosine 5′-monophosphate (AMP) as bronchial challenge agents. However, reverse translation of this bronchial challenge technique to pre-clinical drug development is limited by the difficulty of administering powder aerosols to animals. The aim of the current study was to develop methods for delivering powder aerosols of adenosine receptor agonists to sensitised guinea pigs (as a model of allergic asthma) and evaluate their effect as challenge agents for the measurement of airway responsiveness. The PreciseInhale system delivered micronised AMP and adenosine powders, with mass median aerodynamic diameters of 1.81 and 3.21 μm and deposition fractions of 31 and 48% in the lungs, respectively. Bronchoconstrictor responses in passively sensitised, anaesthetised, spontaneously breathing guinea pigs were compared to responses to nebulised and intravenously administered AMP and adenosine. AMP- and adenosine-induced bronchoconstriction following all routes of administration with the magnitude of response ranking intravenous > dry powder > nebulisation, probably reflecting differences in exposure to the adenosine agonists delivered by the different routes. In conclusion, the PreciseInhale system delivered AMP and adenosine dry powder aerosols accurately into the lungs, suggesting this method can be used to investigate drug effects on airway responsiveness.

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Bronchial challenge tests with direct and indirect stimuli – Which are more useful?

Świebocka

Klukowski

Siergiejko

2015

Alergologia Polska - Polish Journal of Allergology

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Airway responsiveness to adenosine after a single dose of fluticasone propionate discriminates asthma from COPD

Cited by 3 publications

References 37 publications

ERS technical standard on bronchial challenge testing: pathophysiology and methodology of indirect airway challenge testing

ERS technical standard on bronchial challenge testing: pathophysiology and methodology of indirect airway challenge testing

A novel method for studying airway hyperresponsiveness in allergic guinea pigs in vivo using the PreciseInhale system for delivery of dry powder aerosols

Bronchial challenge tests with direct and indirect stimuli – Which are more useful?

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