Normativa sobre el estudio de la hiperrespuesta bronquial inespecífica en el asma

Tordera, Miguel Perpiñá; Río, Francisco García; Gutiérrez, Francisco Javier Álvarez; Serrano, Carolina Cisneros; Torrero, Luis Compte; Costa, Luis Manuel Entrenas; Moreno, Carlos Melero; Nieto, María Jesús Rodríguez; Fernández, Alfons Torrego

doi:10.1016/j.arbres.2013.05.001

Cited by 17 publications

(21 citation statements)

References 109 publications

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“…This review focuses on the different noninvasive or minimally invasive methods to measure airway inflammation that can help achieve the goal of a better-suited, more personalized and effective treatment for asthma patients. Using a similar approach, several authors have proposed adjusting treatment in accordance with the degree of bronchial hyperresponsiveness and observed improved control [20,21];this point will not be discussed here.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Noninvasive Methods for the Study of Bronchial Inflammation in the Control of Patients with Asthma

Muñoz

Bustamante²,

López-Campos³

et al. 2015

Int Arch Allergy Immunol

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Bronchial asthma is one of the most prevalent respiratory conditions. Although it is defined as an inflammatory disease, the current guidelines for both diagnosis and follow-up of patients are based only on clinical and lung function parameters. Current research is focused on finding markers that can accurately predict future risk, and on assessing the ability of these markers to guide medical treatment and thus improve prognosis. The use of noninvasive methods to study airway inflammation is gaining increasing support. The study of eosinophils in induced sputum has proved useful for the diagnosis of asthma; however, its clinical implementation is complex. Some studies have shown that the measurement of exhaled nitric oxide (FeNO) may also be useful to establish disease phenotypes and improve control. Others have found that the measurement of pH and certain markers of oxidative stress, cytokines and prostanoids in exhaled breath condensate (EBC) may also be useful as well as the measurement of the temperature of exhaled breath and the analysis of volatile organic compounds (VOCs). In conclusion, since asthma is an inflammatory disease, it seems appropriate to try to control it through the study of airway inflammation using noninvasive methods. In this regard, the analysis of induced sputum cells has proved very useful, although the clinical implementation of this technique seems difficult. Other techniques such as temperature measurement, the analysis of FeNO, the analysis of the VOCs in exhaled breath, or the study of certain biomarkers in EBC require further study in order to determine their clinical applicability.

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Section: Introductionmentioning

confidence: 99%

Usefulness of Noninvasive Methods for the Study of Bronchial Inflammation in the Control of Patients with Asthma

Muñoz

Bustamante²,

López-Campos³

et al. 2015

Int Arch Allergy Immunol

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“…In other words, all the situations that may decrease a quality of test or increase risk and discomfort of patients are included; therefore, these points should be identified through interviews or questionnaires before the test. If the contraindication is confirmed, it is necessary to consult with a medical doctor or a laboratory director before conducting the test 2 3 .…”

Section: Methacholine Provocation Testmentioning

confidence: 99%

“…There is controversy about the level of lung function that is contraindications of the methacholine provocation test. Typically, the basal FEV 1 <1.5 L or predicted normal value <60% in adults are used as a relative contraindication, The National Asthma Expert Panel Report 2nd edition has recommended FEV 1 <65% as a relative contraindication 2 3 .…”

Section: Methacholine Provocation Testmentioning

confidence: 99%

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Nonspecific Bronchoprovocation Test

et al. 2017

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Bronchial asthma is a disease characterized by the condition of airway hyper-responsiveness, which serves to produce narrowing of the airway secondary to airway inflammation and/or various spasm-inducing stimulus. Nonspecific bronchoprovocation testing is an important method implemented for the purpose of diagnosing asthma; this test measures the actual degree of airway hyper-responsiveness and utilizes direct and indirect bronchoprovocation testing. Direct bronchoprovocation testing using methacholine or histamine may have superior sensitivity as these substances directly stimulate the airway smooth muscle cells. On the other hand, this method also engenders the specific disadvantage of relatively low specificity. Indirect bronchoprovocation testing using mannitol, exercise, hypertonic saline, adenosine and hyperventilation serves to produce reactions in the airway smooth muscle cells by liberating mediators with stimulation of airway inflammatory cells. Therefore, this method has the advantage of high specificity and also demonstrates relatively low sensitivity. Direct and indirect testing both call for very precise descriptions of very specific measurement conditions. In addition, it has become evident that challenge testing utilizing each of the various bronchoconstrictor stimuli requires distinct and specific protocols. It is therefore important that the clinician understand the mechanism by which the most commonly used bronchoprovocation testing works. It is important that the clinician understand the mechanism of action in the testing, whether direct stimuli (methacholine) or indirect stimuli (mannitol, exercise) is implemented, when the testing is performed and the results interpreted.

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“…[ 76 ] A methacholine challenge test may be helpful in excluding asthma objectively, owing to its high sensitivity even at low doses. [ 122 ] Clinical asthma is unlikely when methacholine challenge at a dose of 16 mg/mL does not produce a 20% fall in FEV 1 . [ 123 124 ] In patients with normal chest radiograph, clinical examination and spirometry, methacholine challenge test had the highest sensitivity to diagnose asthma (85.7%) when compared with PEF variability, blood and sputum eosinophil counts.…”

Section: Diagnosis Of Asthmamentioning

confidence: 99%

Guidelines for diagnosis and management of bronchial asthma: Joint ICS/NCCP (I) recommendations

et al. 2015

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Normativa sobre el estudio de la hiperrespuesta bronquial inespecífica en el asma

Cited by 17 publications

References 109 publications

Usefulness of Noninvasive Methods for the Study of Bronchial Inflammation in the Control of Patients with Asthma

Usefulness of Noninvasive Methods for the Study of Bronchial Inflammation in the Control of Patients with Asthma

Nonspecific Bronchoprovocation Test

Guidelines for diagnosis and management of bronchial asthma: Joint ICS/NCCP (I) recommendations

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