Methacholine challenge test: Diagnostic characteristics in asthmatic patients receiving controller medications

Sumino, Kaharu; Sugar, Elizabeth A.; Irvin, Charles G.; Kaminsky, David A.; Shade, Dave; Wei, Christine; Holbrook, Janet T.; Wise, Robert A.; Castro, Mario

doi:10.1016/j.jaci.2012.02.025

Cited by 71 publications

(58 citation statements)

References 35 publications

(38 reference statements)

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“…Allergic asthma is characterized by an increase in airway hyperresponsiveness (AHR) to nonspecific bronchoconstrictors like methacholine (40). The ability of PLGA particle vaccines to suppress the induction of AHR was evaluated 24 h after ten daily intranasal exposures of Der p2 to vaccinated mice.…”

Section: Presence Of Cpg In Vaccine Diminishes Airway Hyperresponsivementioning

confidence: 99%

Development of a Poly (lactic-co-glycolic acid) Particle Vaccine to Protect Against House Dust Mite Induced Allergy

Joshi

Adamcakova‐Dodd

Jing

et al. 2014

AAPS J

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Abstract. Poly(lactic-co-glycolic acid) (PLGA) particles carrying antigen and adjuvant is a promising vaccine system which has been shown to stimulate systemic antigen-specific immune responses. In this study, we investigated the relationship of (i) the sizes of PLGA particle and (ii) the presence of cytosinephosphate-guanine motifs (CpG), with the extent and type of immune response stimulated against Dermatophagoides pteronyssinus-2 (Der p2) antigen. Different sizes of PLGA particles encapsulating CpG were prepared using a double emulsion solvent evaporation method. Mice were vaccinated with Der p2 and different sizes of empty or CpG-loaded PLGA particles. Vaccinated mice were exposed to daily intranasal instillation of Der p2 for 10 days followed by euthanization to estimate leukocyte accumulation in bronchoalveolar lavage (BAL) fluids, antibody profiles, and airway hyperresponsiveness. PLGA particles showed a size-dependent decrease in the proportion of eosinophils found in BAL fluids. Mice vaccinated with the Der p2 coated on 9-μm-sized empty PLGA particles showed increased levels of IgE and IgG1 antibodies as well as increased airway hyperresponsiveness. All sizes of PLGA particles encapsulating CpG prevented airway hyperresponsiveness after Der p2 exposures. Inflammatory responses to Der p2 exposure were significantly reduced when smaller PLGA particles were used for vaccination. In addition, encapsulating CpG in PLGA particles increased IgG2a secretion. This study shows that the size of PLGA particles used for vaccination plays a major role in the prevention of house dust mite-induced allergy and that incorporation of CpG into the PLGA particles preferentially develops a Th1-type immune response.

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Section: Presence Of Cpg In Vaccine Diminishes Airway Hyperresponsivementioning

confidence: 99%

Development of a Poly (lactic-co-glycolic acid) Particle Vaccine to Protect Against House Dust Mite Induced Allergy

Joshi

Adamcakova‐Dodd

Jing

et al. 2014

AAPS J

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“…African Americans with the Arg16Arg genotype who were female or who were smokers had the lowest log PC 20 . Previous studies have found that post-pubertal female children with asthma have greater airway hyperresponsiveness compared to males [38,39] though no differences between sexes were found in a recent study in mostly adults [17]. Cigarette smoke exposure can also increase airway hyperresponsiveness in patients with asthma but there is large heterogeneity in effect [40,41].…”

Section: Discussionmentioning

confidence: 87%

“…Although, sensitivity measured by the challenge may be affected by procedure methodology; for instance, deep inspiration or choice of agent may influence response [10][11][12]. Few studies have included an analysis of differences in airway hyperreactivity (assessed by methacholine bronchial challenge) between African Americans and whites with asthma [13][14][15][16][17]. In several studies, no difference in methacholine sensitivity was noted between African American and whites [13][14][15] though in two studies African Americans had greater sensitivity to methacholine compared to whites [16,17].…”

Section: Introductionmentioning

confidence: 99%

Methacholine PC20 In African Americans And Whites With Asthma With Homozygous Genotypes At ADRB2 Codon 16

Blake¹,

Hossain

Lima

2012

C22. Asthma Therapy

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BACKGROUND-African Americans have worse asthma outcomes compared to whites. Adrenoceptor beta 2, surface gene (ADRB2) Gly16Arg genotypes have been associated with β 2 -© 2013 Elsevier Ltd. All rights reserved.Corresponding Author: Kathryn Blake, PharmD., Nemours Children's Clinic, 807 Children's Way, Jacksonville, FL 32207 USA, Telephone: (904) 697-3806, Fax: (904) 697-3799, kblake@nemours.org. All work was performed in the Center for Pharmacogenomics and Translational Research, Nemours Children's Clinic, Jacksonville, FL, USA.Financial Disclosures and Conflicts of Interest: Kathryn Blake, PharmD has no conflicts of interest to report. J Davis Cury, MD has no conflicts of interest to report. Jobayer Hossain, PhD has no conflicts of interest to report. Kelan Tantisira, MD has no conflicts of interest to report. Jianwei Wang, MD has no conflicts of interest to report. Ed Mougey, PhD has no conflicts of interest to report. John Lima, PharmD has no conflicts of interest to report.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. homozygous at codon16 (Arg16Arg or Gly16Gly). NIH Public Access METHODS-AfricanAmericans and whites whose parents and grandparents were of the same race, aged ≥ 10 years, with baseline FEV 1 of ≥60% predicted, and no upper or lower respiratory tract infection within the previous 2 weeks meeting genotype criteria were enrolled. PC 20 was measured after withholding short-acting and long-acting β 2 -agonists for 8 and 12 hours respectively, montelukast for 24 hours, ipratropium bromide and inhaled corticosteroids for 12 hours, and antihistamines for 72 hours.RESULTS-423 participants were screened and 88 had a positive challenge. Participants were 32yrs ± 19yrs (mean ± SD), 70% female, 51% White (vs. African American), 6% Hispanic. Similar numbers of participants were using inhaled corticosteroids by race and genotype. There were significant differences in log PC 20 between race/genotype groups (p=0.012). African American Arg16Arg participants had a lower log PC 20 than White Gly16Gly (p=0.009) and African American Gly16Gly (p=0.041) participants. Both race and genotype contributed significantly to the model (p=0.037 and p=0.014, respectively) but there was no interaction between race and genotype on log PC 20 .CONCLUSIONS AND CLINICAL RELEVANCE-Airway hyperresponsiveness is influenced by race and the ADRB2 codon 16 polymorphism. African Americans with the Arg16Arg genotype have increased airway reactivity and may be at risk for worse asthma outcomes. Inclusion of genetic information as an additional clinical tool may aid in the personalization of a...

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“…Direct bronchoprovocation challenges such as the methacholine and histamine inhalation challenge are the most commonly performed diagnostic tests for AHR [49,54]. Whilst methacholine and histamine induce bronchoconstriction at almost equivalent concentrations [55,56], methacholine is more commonly employed due to a number of systemic side effects associated with histamine including headaches and flushing [47].…”

Section: Methacholine Vs Histamine Inhalation Challengementioning

confidence: 99%

Advances in the diagnosis of exercise-induced bronchoconstriction

Price

Hull

Ansley

2014

Expert Review of Respiratory Medicine

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Methacholine challenge test: Diagnostic characteristics in asthmatic patients receiving controller medications

Cited by 71 publications

References 35 publications

Development of a Poly (lactic-co-glycolic acid) Particle Vaccine to Protect Against House Dust Mite Induced Allergy

Development of a Poly (lactic-co-glycolic acid) Particle Vaccine to Protect Against House Dust Mite Induced Allergy

Methacholine PC20 In African Americans And Whites With Asthma With Homozygous Genotypes At ADRB2 Codon 16

Advances in the diagnosis of exercise-induced bronchoconstriction

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