Bronchial reactivity to inhaled histamine: a method and clinical survey

Cockcroft, D. W.; Killian, D. N.; Mellon, J. J. A.; Hargreave, Frederick E.

doi:10.1111/j.1365-2222.1977.tb01448.x

Cited by 1,720 publications

(736 citation statements)

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“…Atopy was defined as at least one positive SPT with a wheal size of Z3 mm among five inhalant allergens (cat, dog, house dust mite, grass and alternaria) referenced to negative control and IgE status defined as above or below 120 IU/ml. BHR was assessed by methacholine challenge 27 only omitting this test in subjects with a baseline FEV1 below 70% predicted. Predicted FEV1 values for adults Z18 years were from Crapo et al 1981 28 and for children o18 yrs from Wang et al 1993.…”

Section: Subjectsmentioning

confidence: 99%

Preferential transmission and association of the −403 G → A promoter RANTES polymorphism with atopic asthma

et al. 2004

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Asthma is a complex inherited disease. The study was undertaken to identify the association of RANTES promoter polymorphisms with atopy and asthma using family-based association tests (FBATs) and generation-specific case-control analyses. We identified 154 nuclear families (453 individuals) in whom we established RANTES promoter status using the RFLP-PCR method. Of the two known promoter polymorphisms À403G/A and À28C/G, only the former appeared with a clinically relevant frequency. A total of 61 families were eligible for assessment of transmission of the allele with asthma and atopy by the pedigree disequilibrium test (PDT). Overall, allele frequency for À403A was 38.3% and 84 of 89 (94.3%) alleles were transmitted with physician diagnosed asthma (PDA) (P ¼ 0.001). All 89 children with atopy received the mutant allele, which was more than expected following Mendelian Laws of transmission (P ¼ 0.0001). In 303 unrelated parents, significant associations of the mutant allele were for atopy with or without asthma (P ¼ 0.001). In 150 unrelated children, significant associations were for atopy alone (P ¼ 0.001) and asthma (P ¼ 0.001). No associations were found for bronchial hyperresponsiveness (BHR). The À403 G-A is transmitted with atopy and atopic asthma, although its contribution appears to relate more to atopy than asthma and BHR.

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Section: Subjectsmentioning

confidence: 99%

Preferential transmission and association of the −403 G → A promoter RANTES polymorphism with atopic asthma

et al. 2004

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“…5 This test uses bronchoconstriction stimuli, such as methacholine, and it is considered to be the best choice for diagnosing asthma in patients with normal spirometry tests. 5,6 Bronchial challenge corroborates the diagnosis of asthma through confirming the presence of bronchial hyperresponsiveness. More importantly, it may rule out this diagnosis when bronchial hyperresponsiveness is not detected, because its negative predictive value is high.…”

Section: Introductionmentioning

confidence: 87%

Accuracy of spirometry for detection of asthma: a cross-sectional study

Meneghini

Paulino

Pereira³

et al. 2017

Sao Paulo Med. J.

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BACKGROUND: Asthma is a chronic inflammatory disease with airway hyperresponsiveness. Spirometry is the most commonly used test among asthmatic patients. Another functional test used for diagnosing asthma is the bronchial challenge test. The aim of this study was to analyze the accuracy of spirometry for detecting asthma in the general population. DESIGN AND SETTING: Cross-sectional study with data analysis to evaluate the accuracy of spirometry through calculating sensitivity, specificity and predictive values and through the kappa agreement test. METHODS: Subjects who constituted a birth cohort were enrolled at the age of 23 to 25 years. Spirometric abnormality was defined as reduced forced expiratory volume in one second, i.e. lower than 80% of the predicted value. Measurement of bronchial responsiveness was performed by means of the bronchial challenge test with methacholine. The gold-standard diagnosis of asthma was defined as the presence of bronchial hyperresponsiveness in association with respiratory symptoms. RESULTS: Asthma was detected in 200 subjects (10.4%) out of the sample of 1922 individuals. Spirometric abnormality was detected in 208 subjects (10.9%) of the sample. The specificity of spirometric abnormality for detecting asthma was 90%, sensitivity was 23%, positive predictive value was 22%, and negative predictive value was 91%. The kappa test revealed weak agreement of 0.13 (95% confidence interval, CI: 0.07-0.19) between spirometry and the diagnosis of asthma. CONCLUSION: Spirometry, as a single test, has limitations for detecting asthma in the general population.

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“…This includes four normal volunteers who were nonsmokers and had no respiratory conditions, and five nonsmoking subjects referred for the investigation of occupational asthma and in whom a previous or concomitant investigation excluded this diagnosis. Four of these subjects suffered from nonoccupational asthma (baseline forced expiratory volume in one second (FEV1) varying 61±112% pred [4], provocative concentration of methacholine causing a 20% fall in FEV1 (PC20) using a standardized methodology [5] varying 0.1±8 mg . mL -1 ).…”

Section: Methodsmentioning

confidence: 99%

What is the respiratory retention of inhaled hexamethylene di-isocyanate?

et al. 2000

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Isocyanates are a frequent cause of occupational asthma. Specific inhalation challenges are often required to confirm the diagnosis. The inhaled concentration has to be assessed during this procedure. However, the respiratory retention of di-isocyanate has not, to the authors knowledge, been evaluated in humans.The existence of a closed-circuit apparatus, designed to carry out these challenges, makes it possible to assess the dose. The respiratory retention of hexamethylene diisocyanate (HDI) generated in vapour form, in both normal subjects (n=4) and subjects referred for the investigation of occupational asthma due to HDI in whom the diagnosis was excluded (n=5), was assessed. The latter group included four subjects with nonoccupational asthma.The HDI was generated at concentrations varying 5.1±15.2 ppb. The expired concentrations of HDI during such challenges varied 1.4±5.3 ppb. Therefore, the respiratory retention was 61±90%.To conclude, the majority of inhaled hexamethylene di-isocyanate vapour is retained within the airways and/on lung parenchyma. Eur Respir J 2000; 16: 729±730. Isocyanates are a common cause of occupational asthma (OA) [1]. Specific inhalation challenges with the causal agent are used to confirm the diagnosis in specialized centres [2]. For these tests, the inhaled concentration has to remain stable and below the threshold-limit-value (TLV) for a short-term exposure, that is <20 ppb in the case of hexamethylene di-isocyanate (HDI) [3]. However, the key factor that determines an asthmatic reaction is more likely to be the respiratory retention than the concentration. As far as we know, the proportion of inhaled HDI that is retained has not been determined.Therefore, an assessment was carried out of the dose of inhaled HDI using an apparatus that has been described previously [2]. This apparatus allows on-line information to be obtained about the inhaled and exhaled concentrations, thus enabling the respiratory retention to be assessed. Material and methodsThe apparatus used for inhalation challenge procedures with HDI has been described [2]. Briefly, it includes three components: a generator of isocyanates, an exposure chamber and instruments for on-line assessment of concentration. The subject inhales isocyanate vapours at spontaneous tidal volume breathing through a mouthpiece connected to the central part of a plexiglass cylinder covered with Teflon, which is, in effect, the exposure chamber. Isocyanate concentrations were assessed with a GMD instrument (model 720-120; GMD Systems Inc., Pittsburgh, PA, USA) by connecting the port to the inhalation tube. The total length of the 2-cm-diameter tube, connecting the 9 exposure chamber to the mouth, was 26 cm. The inspiratory port was located at a distance of 12 cm from the subject's mouth while the expiratory port was 2 cm away from the mouth. Use of unidirectional valves (n=4) avoided contamination of the inspired and expired air samples. Assessments of concentrations were carried out in three phases: 1) The stability of the inspi...

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Bronchial reactivity to inhaled histamine: a method and clinical survey

Cited by 1,720 publications

References 14 publications

Preferential transmission and association of the −403 G → A promoter RANTES polymorphism with atopic asthma

Preferential transmission and association of the −403 G → A promoter RANTES polymorphism with atopic asthma

Accuracy of spirometry for detection of asthma: a cross-sectional study

What is the respiratory retention of inhaled hexamethylene di-isocyanate?

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