Diagnostic properties of the methacholine and mannitol bronchial challenge tests: A comparison study

Kim, Min Hye; Song, Woo Jung; Kim, Tae Wan; Jin, Hyun Jung; Sin, You Seob; Ye, Young-Min; Kim, Sang Heon; Lee, Byung‐Jae; Park, Hae‐Sim; Yoon, Ho Joo; Choi, Dong Il; Min, Kyung Up; Cho, Sang Heon

doi:10.1111/resp.12334

Cited by 18 publications

(14 citation statements)

References 30 publications

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“…For this reason, methacholine may be used as a pharmaceutical in broncho provocation tests for the detection of bronchial reactivity 3,10,15 and also for this reason we used it in this clinical trial, as a drug that provokes bronchoconstriction.…”

Section: Discussionmentioning

confidence: 99%

“…Through this test, the drug causes bronchoconstriction and people with pre-existing airway hyperreactivity, such as asthmatics, will react to lower doses of drug. Methacholine inhalation test also helps in the assesment of disease severity [15][16][17] . With this research we expect to demonstrate that bronchoconstrictor effects of methacholine in patients with asthma are reduced if the patient has previously inhaled benzodiazepine.…”

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confidence: 99%

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Reversion of methacholine induced bronchoconstriction with inhaled diazepam in patients with asthma

et al. 2016

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Reversion of methacholine induced bronchoconstriction with inhaled diazepam in patients with asthma

et al. 2016

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“…Compared to treatment guidelines based upon symptoms and lung function, treatment strategies targeting reductions in AHR to mannitol (STAMINA trial) (28) or methacholine (AMPUL trial) (9) both lead to improvements in the number of mild exacerbations. Mannitol appears more specific in detecting a diagnosis of asthma although it is less sensitive than methacholine (27, 29, 30). Interestingly, the biggest distinction may be in the effect of allergen exposure with increased responsiveness to methacholine but reduced responsiveness to mannitol three hours after allergen challenge (31).…”

Section: Measurement Of Ahr: To What Do We Respond and How Do We Mmentioning

confidence: 99%

Mechanisms of airway hyper‐responsiveness in asthma: the past, present and yet to come

Chapman

Irvin

2015

Clin Experimental Allergy

120

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Airway hyperresponsiveness (AHR) has long been considered a cardinal feature of asthma. The development of the measurement of AHR forty years ago initiated many important contributions to our understanding of asthma and other airway diseases. However, our understanding of AHR in asthma remains complicated by the multitude of potential underlying mechanisms which in reality are likely to have different contributions amongst individual patients. Therefore the present review will discuss the current state of understanding of the major mechanisms proposed to contribute to AHR and highlight the way in which AHR testing is beginning to highlight distinct abnormalities associated with clinically relevant patient populations. In doing so we aim to provide a foundation by which future research can begin to ascribe certain mechanisms to specific patterns of bronchoconstriction and subsequently match phenotypes of bronchoconstriction with clinical phenotypes. We believe that this approach is not only within our grasp but will lead to improved mechanistic understanding of asthma phenotypes and hopefully better inform the development of phenotype-targeted therapy.

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“…It has a high sensitivity but a low specificity for active asthma and a low sensitivity to recognize EIB (29, 50). Mannitol test can reproduce the “osmolar” mechanism of EIA/EIB, through the osmotic action of this agent, demonstrating sensitivity and specificity comparable to the MCH for the diagnosis of EIA/EIB (29, 51, 52). Another effective test, made by ventilating dry air with CO 2 for 6 min through a low-resistance circuit at a rate higher than that usually realized during maximum exercise, is the EVH test (19).…”

Section: Diagnosismentioning

confidence: 93%

Exercise-Induced Bronchospasm and Allergy

et al. 2017

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Sport is an essential part of childhood, with precious and acknowledged positive health effects but the impact of exercise-induced bronchoconstriction (EIB) significantly reduces participation in physical activity. It is important to recognize EIB, differentiating EIB with or without asthma if the transient narrowing of the airways after exercise is associated with asthmatic symptoms or not, in the way to select the most appropriate treatment among the many treatment options available today. Therapy is prescribed based on symptoms severity but diagnosis of EIB is established by changes in lung function provoked by exercise evaluating by direct and indirect tests. Sometimes, in younger children it is difficult to obtain the registration of difference between the preexercise forced expiratory volume in the first second (FEV1) value and the lowest FEV1 value recorded within 30 min after exercise, defined as the gold standard, but interrupter resistance, in association with spirometry, has been showed to be a valid alternative in preschool age. Atopy is the main risk factor, as demonstrated by epidemiologic data showing that among the estimated pediatric population with EIB up to 40% of them have allergic rhinitis and 30% of these patients may develop adult asthma, according with atopic march. Adopting the right treatment and prevention, selecting sports with no marked hyperventilation and excessive cooling of the airways, children with EIB can be able to take part in physical activity like all others.

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Diagnostic properties of the methacholine and mannitol bronchial challenge tests: A comparison study

Abstract: The present study demonstrated overall similar diagnostic properties of two diagnostic tests, but also suggested their intercomplementary roles for asthma. The clinical trial registration number at ClinicalTrial.gov is NCT02104284.

Cited by 18 publications

References 30 publications

Reversion of methacholine induced bronchoconstriction with inhaled diazepam in patients with asthma

Reversion of methacholine induced bronchoconstriction with inhaled diazepam in patients with asthma

Mechanisms of airway hyper‐responsiveness in asthma: the past, present and yet to come

Exercise-Induced Bronchospasm and Allergy

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