Methacholine and physostigmine airway reactivity in asthmatic and nonasthmatic subjects

Miller, Michael M.; Fish, James E.; Patterson, Roy

doi:10.1016/0091-6749(77)90036-7

Cited by 23 publications

(4 citation statements)

References 12 publications

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“…The inhalation test method is simple and portable, and is therefore suitable for clinical, epidemi- ological, and research studies. For example, it may be used to diagnose the presence of asthma (Cockcroft et al, 1977a), to examine the effect of medications (Cockcroft et al, 1977c), to help predict long-term medication requirements (Cockcroft et al, 1977a), to provide an index of risk to nonspecific stimuli in the environment , to help predict the dose of allergen that will trigger asthma (Killian et al, 1976;, to determine the specificity of responses to simple chemicals when antibodies cannot be shown (Vallieres et al, 1977), and to explore mechanisms of hyperreactivity (Ouellette and Reed, 1965;Casterline et al, 1976;Empey et al, 1976;Casterline and Evans, 1977;Cockcroft et al, 1977b;Miller et al, 1977, Frith et al, 1978Ruffin et al, 1978). The present study shows a close correlation between bronchial responsiveness to histamine and methacholine.…”

Section: Discussionmentioning

confidence: 99%

Reproducibility and comparison of responses to inhaled histamine and methacholine.

Juniper¹,

Frith²,

Dunnett³

et al. 1978

Thorax

530

218

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. Thorax, 33,. Reproducibility and comparison of responses to inhaled histamine and methacholine. The efficiency of a standardised inhalation test procedure was studied by examining the reproducibility of responses to histamine and methacholine. In addition, the responses to the two agents were compared. Each set of duplicate tests was carried out on a separate day within one week, and all factors known or presumed to influence responses were carefully controlled. The results were expressed as the provocative concentration of the agent causing a 20% fall in forced expired volume in one second (PC20). Responses to histamine and methacholine were highly reproducible (coefficients of determination [r2] = 0 994 and 0 990 respectively).Responsiveness to histamine correlated closely with responsiveness to methacholine (r2 = 0 85).There was a small but significant cumulative dose effect with methacholine (P<0 01) but not with histamine. Side effects of throat irritation, flushing, and headache were more frequent with histamine than methacholine, and were dose-related. The high level of reproducibility indicates the efficiency of the test procedure. The similar severity of effects by agents with different mnechanisms of action suggests that the primary cause of non-specific bronchial hyperreactivity lies at the level of bronchial smooth muscle.Non-specific bronchial reactivity is the term used to indicate the responsiveness of the airways to chemical mediators, such as histamine, acetylcholine, and prostaglandin F2a, or to the synthetic analogues of acetylcholine, such as methacholine and carbachol. Its measurement is becoming increasingly important in clinical practice, epidemiology, and research.Non-specific bronchial reactivity is measured by inhalation tests, usually with histamine or methacholine. In the past different methods have been used, making critical analysis of results difficult. Recently Chai et al (1975) and Orehek and Gayrard (1976) have emphasised the importance of the standardisation of tests. Standardisation requires consideration of the many different factors that will influence the results.In this study we have standardised a simple inhalation test using histamine and methacholine. We have investigated the efficiency of the method by examining the reproducibility of responses over a short period. In addition we have compared the responsiveness to each agent and investigated the possibility of cumulative dose-effects and recorded side effects. Subjects and methods SUBJECTSThe patients were adults with asthma attending the regional chest and allergy unit. All had episodic dyspnoea or wheezing and documented variation in forced expired volume in one second (FEV1) of more than 20%, either spontaneously or after medication. None had features of any other respiratory disorder.Normal adults were volunteers from hospital staff. They had no present or past symptoms of rhinitis, asthma, or other respiratory disorder. They were non-smokers, non-atopic, and had normal spirometry. Non-atopic implied that they...

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Section: Discussionmentioning

confidence: 99%

Reproducibility and comparison of responses to inhaled histamine and methacholine.

Juniper¹,

Frith²,

Dunnett³

et al. 1978

Thorax

530

218

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“…For both types of challenge tests, there are standardized protocols available that allow comparison of BHR with these stimuli over time and between populations [4]. Methacholine and histamine are both pharmacological stimuli that cause bronchoconstriction by directly activating contraction of bronchial smooth muscle cells after binding to cholinergic receptors [8–10], and additionally to histamine receptors in case of histamine inhalation [8, 11–13].…”

Section: Mechanism Of Bronchoconstrictionmentioning

confidence: 99%

Direct or indirect stimuli for bronchial challenge testing: what is the relevance for asthma epidemiology?

Meer¹,

Marks²,

Postma³

2004

Clin Experimental Allergy

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“…Anticholinesterase agents can provoke airway constriction by inhibiting the destruction of endogenous acetylcholine at parasympathetic nerve terminals [88]. This effect 100.0 7 is largely dismissed by most authors as being prevented by concurrent administration of anticholinergic agents, although the use of neostigmine in asthmatics has been cautioned against [71].…”

Section: R Bur~vrll and Jg Jonesmentioning

confidence: 99%

The airways and anaesthesia II

Burwell

Jones²

1996

Anaesthesia

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Methacholine and physostigmine airway reactivity in asthmatic and nonasthmatic subjects

Cited by 23 publications

References 12 publications

Reproducibility and comparison of responses to inhaled histamine and methacholine.

Reproducibility and comparison of responses to inhaled histamine and methacholine.

Direct or indirect stimuli for bronchial challenge testing: what is the relevance for asthma epidemiology?

The airways and anaesthesia II

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